question stringlengths 1 6.54k | choices listlengths 4 4 | answer stringclasses 4
values | rationale stringlengths 0 22.5k ⌀ | split stringclasses 1
value | dataset stringclasses 6
values | subject stringclasses 1
value |
|---|---|---|---|---|---|---|
In fracture of both bone forearm at same level, position of the arm in plaster is? | [
"Full supination",
"10 degree supination",
"Full pronation",
"Mid- prone"
] | D | A twisting force (usually fall on hand) produce spiral fracture of both bones at different level (radius usually at higher level) A direct blow or angulating force causes a transverse fracture of both bones at same level. Rotational deformity in fracture shaft radius (produced by muscle pull) Biceps and supinator muscles, both of which are supinators, are inseed into upper third of the shaft of radius. Pronator teres is inseed into the middle third of bones and pronators quadratus into lower third. Treatment rationale A fracture of radius at the junction of upper and middle thirds proximal to pronators teres is therefore situated between two groups of muscles. The proximal fragment has only supinators inseed into it and the distal fragment has only pronators. Thus causing supination of proximal fragment and pronation of distal fragment. Fracture of upper third of radius are, therefore, should be immobilized with the hand and forearm supinated, so that the distal fragment is rotated into the same axis as the proximal fragment. If the fracture is at, or below, the middle third (distal to pronator teres) of the bone, The proximal fragment has both supinators and pronators muscles attached to it. It therefore takes up the mid position halfway between full supination and full pronation, and this forearm fracture should usually be immobilized with the hand and forearm in the mid position. Ref: Maheshwari 3/e, Page 91, Apley's Ohopedics 8/e, Page 611-13, Campbell's Operative ohopedics 10/e, Page 3042-44, Rockwood & Green's Fractures in Adult 6/e, Page 969-730. | train | med_mcqa | null |
Mean ± 250 in normal distribution | [
"68%",
"95%",
"99%",
"50%"
] | B | In normal distribution :
Mean ± 150 lovers 68% values.
Mean ± 250 lovers 95% values.
Mean ± 350 lovers 99% values. | train | med_mcqa | null |
In a patient of trauma with no head injury, the target blood pressure for resuscitation is | [
"SBP 50-70 mm of Hg",
"SBP 70-90 mm of Hg",
"SBP 90-110 mm of Hg",
"SBP > 110 mm of Hg"
] | B | The initial aim of resuscitation is to maintain the blood supply to the vital organs: the brain, hea and kidneys. For a sho time, this can be achieved with a target systolic blood pressure of 70-90 mmHgThe concept of "permissive hypotension" refers to managing trauma patients by restricting the amount of fluid resuscitation administered while maintaining blood pressure in the lower than normal range if there is still active bleeding during the acute period of injury. Although this treatment approach may avoid the adverse effects of early and high-dose fluid resuscitation, it carries the potential risk of tissue hypoperfusion.Bailey and love 27e 324 | train | med_mcqa | null |
An 8 year old female patient complains of pain and bleeding in upper front teeth region and gives a history of fall while playing 30 minutes ago. Patient found the avulsed tooth on the ground. Intra-oral examination reveals bleeding and avulsion of maxillary right central incisor. Which of the following is not an appropriate option in the management of this patient? | [
"If the tooth is dirty, wash it briefly (10 seconds) under cold running water",
"Find the tooth and pick it up by the root",
"Encourage the patient/parent to replant the tooth",
"If repositioning is not possible, place the tooth in a suitable storage medium"
] | B | If a parent calls to report that a tooth has been avulsed, and it can be determined that the injury is without other oral, neurologic, or higher-priority physical complications, the dentist may instruct the parent to do the following (primary teeth should not be replanted) :
1. Keep the patient calm.
2. Find the tooth and pick it up by the crown (the white part). Avoid touching the root.
3. If the tooth is dirty, wash it briefly (10 seconds) under cold running water and reposition it. Try to encourage the patient/parent to replant the tooth. Bite on a handkerchief to hold the tooth in position.
4. If repositioning is not possible, place the tooth in a suitable storage medium (see below).
5. Seek emergency dental treatment immediately, unless the patient was knocked unconscious. If the child was unconscious for a period of time, first seek emergency medical evaluation for a concussion. | train | med_mcqa | null |
Pyriform sinus is laterally bounded by what? | [
"Interarytenoid aery",
"Thyroid aery",
"Epiglottis",
"Thyrohyoid membrane"
] | D | On either side of the laryngeal orifice in humans is a recess, termed the piriform sinus (also piriformrecess, pyriform sinus, piriform fossa, or smuggler's fossa), which is bounded medially by the aryepiglottic fold, laterally by the thyroid cailage and thyrohyoid membrane. The fossae are involved in speech. | train | med_mcqa | null |
Which of the following is included in the Levenson criteria for congenital cholesteatoma ? | [
"White mass medial to normal tympanic membrane",
"Atticoantral perforation of the tympanic membrane",
"Definite history of otorrhoea",
"History of prior otologic procedures"
] | A | Ans. is 'a' i.e., White mass medial to normal tympanic membrane Levenson criteria for congenital cholesteatoma White mass medial to normal TM. Normal pars flaccida and tensa. No history of otorrhea or perforations. No prior otologic procedures. Prior bouts of otitis media no ground for exclusions. | train | med_mcqa | null |
Which of the following would be the best treatment for a 2 cm thyroid nodule in a 50 year old man with FNAC revealing it to be a papillary carcinoma? | [
"Hemithyroidectomy",
"Total thyroidectomy with left sided modified neck dissection",
"Near total thyroidectomy with radiotherapy",
"Hemithyroidectomy with modified neck dissection"
] | B | Total or Near total thyroidectomy is the procedure of choice in papillary carcinoma of thyroid. Modified neck dissection is done if enlarged lymphnodes are found. Total thyroidectomy is recommended for papillary (> 1.0 cm), follicular, Huhle cell, and medullary carcinomas if the operation can be done without producing permanent hypoparathyroidism or injury to the recurrent laryngeal nerves. | train | med_mcqa | null |
Restless leg syndrome is caused by: | [
"Chronic renal failure",
"Hypercalcemia",
"Hypophosphatemia",
"None of the above"
] | A | Secondary restless leg syndrome can occur due to chronic renal failure, pregnancy, anemia, ferritin deficiency and peripheral neuropathy. It could be due to disordered dopamine function along with abnormality of iron metabolism. Restless leg syndrome is a neurologic disorder characterised by the presence of: An urge to move the legs, usually caused or accompanied by an unpleasant sensation in the legs The symptoms usually begin or worsen with rest The symptoms worsens during the evening or night. There is paial or complete relief by movement Ref: Olanow C.W., Schapira A.H. (2012). Chapter 372. Parkinson's Disease and Other Movement Disorders. 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 |
A young patient presents to the ophthalmology clinic with loss of central vision. There is no obvious family history. ERG and EOG were observed to be normal. Which of the following is the most likely diagnosis? | [
"Stargardt's disease",
"Best's Vitelliform Dystrophy",
"Retinitis Pigmentosa",
"Cone- Rod Dystrophy"
] | A | Loss of central vision with a normal ERG and EOG is consistent with a diagnosis of Stargardt's disease. Stargardt's disease is an autosomal recessive disorder and hence a negative family history is not uncommon. | train | med_mcqa | null |
Down syndrome is due to non-disjunction of - | [
"21",
"18",
"11",
"15"
] | A | Ans. is 'a' i.e., 21 Chromosome In 95% of cases of Down syndrome-trisomy of 21:-o Extra chromosome is of maternal in origin.o 1% have mosaic with some all have 46 chromosome,o 4% have robertsonian translocation,o t (13 : 21)o t (14 : 21)o t (15 : 21)o Very rarely long arm of chromosome 21 is triplicate (Partial trisomy). | train | med_mcqa | null |
Nephrocalcinosis is seen in - | [
"Hypoparathyroidism",
"Medullary sponge kidney",
"DM",
"All"
] | B | Ans. is 'b' i.e., Medullary sponge kidneyo Deposition of calcium stones on renal papillae is called nephrocalcinosis.o Nephrocalcinosis seen in -Renal tubular acidosis type I (A). Bater's syndrome Excess calcium intake Medullary sponge kidney Multiple myeloma Sarcoidosis Severe hypercalciuria Vitamin-D intoxication TB kidney (Love & Bailey) Hyperparathyroidism Metastatic bone disease | train | med_mcqa | null |
Smell of bitter almonds is seen in poisoning with | [
"Phosphorus",
"Hydrocyanic acid",
"Nitric acid",
"Oxalic acid"
] | B | Cyanide can be a colorless gas, such as hydrogen cyanide (HCN) or cyanogen chloride (CNCl), or a crystal form such as sodium cyanide (NaCN) or potassiumcyanide (KCN). Cyanide sometimes is described as having a "bitter almond" smell, but it does not always give off an odor, and not everyone can detect this odor. Ref ganong's review of medical physiology 25e p143 | train | med_mcqa | null |
Which of the following is false regarding microarray technique | [
"Core principle is DNA Hybridization",
"Also known as DNA chip or biochip",
"Can detect deletions and insertions",
"Can detect Robertsonian translocation"
] | D | Microarray assay can't detect certain chromosome rearrangements such as balanced translocations (eg: Robertsonian translocations) and inversions. Although there has been an exchange of DNA, there is no net gain or loss of DNA. Hence microarray can't detect it. | train | med_mcqa | null |
Which of the following is caused by congenital A-17 hydroxylase deficiency: | [
"hypercalemia",
"Hyperkalemia",
"Hermaphroditism",
"Hypeension"
] | D | 17 -hydroxylase (17 -OH) deficiency syndrome is a rare genetic disorder of steroid biosynthesis causing decreased production of glucocoicoids and sex steroids and increased synthesis of mineralocoicoid precursors. Reduced or absent levels of both gonadal and adrenal sex hormones result in sexual infantilism in 46, XX females and ambiguous genitalia in 46, XV males. Excessive mineralocoicoid activity produces varying degrees of hypeension Q and hypokalemia Q. Patients usually are diagnosed with this condition during an evaluation of delayed pubey. absent secondary sexual characteristics or primary amenorrhea. REF : OP-GHAI 9th edition | train | med_mcqa | null |
Defloration means: | [
"Loss of virginity",
"Infeility",
"Rape",
"Virginity"
] | A | Loss of virginity | train | med_mcqa | null |
Basal cell carcinoma commonly spreads by - | [
"Lymphatics",
"Haematogenous",
"Direct spread",
"All the above"
] | C | null | train | med_mcqa | null |
Semicircular canals are stimulated by - | [
"Gravity",
"Linear acceleration",
"Rotation",
"Sound"
] | C | null | train | med_mcqa | null |
Antipseudomonal action is a characteristic of which of the following antimicrobials? | [
"Cefopodoxime",
"Cefoperazone",
"Cefotetan",
"Ceforanide"
] | B | Cefoperazone is 3rd generation cephalosporin, which is active against gram positive as well as gram negative bacterias. It is one of the few antibiotics that have anti-pseudomonal action. It exes its action by inhibiting bacterial cell wall growth. Main adverse effect of this drug is Hypothrombinemia and Disulfiram reaction. Ref: Sherwood L. Gorbach, John G. Balett, Neil R. Blacklo (2004), Chapter 19, "Cephalosporins", In the book, "Infectious Diesases", 3rd Edition, Lippincott Publications, USA, Page 196 | train | med_mcqa | null |
Most common form of Nocardial respiratory tract infection is ? | [
"Laryngitis",
"Pharyngitis",
"Tonsilitis",
"Pneumonia"
] | D | Ans. is 'd' i.e.,Pneumonia Nocardia are 'gram positive' `acid fast' filaments. Nocardia are strict aerobes and paially urease and catalase positive. Since nocardiae are among the few aerobic microorganism that use paraffin as a carbon source, paraffin baiting can be used to isolate the organism from mixed culture. | train | med_mcqa | null |
Low QRS voltage on ECG indicates - | [
"Pulmonary embolism",
"Pericardial effusion",
"Cor pulmonale",
"Infective endocarditis"
] | B | Ans. is 'b' i.e., Pericardial effusion [Ref: ECG Interpretation : From Pathyphysiology to clinical interpretation (Springer)2999- p. 281; 150 Practice ECG interpretation & Review by Tavlor (John Wiley & Sons) 2003-p. 48,491Causes of low voltage QRS complexeso Adrenal insufficiencyo Anasarcao Artifactual or spurious, eg, unrecognized standardization of ECG at one-half the usual gain (i.e., 5 mm/tnv)o Cardiac infiltration or replacement (e.g., amyloidosis, tumor)o Cardiac transplantation, especially with acute or chronic rejectiono Cardiomyopathy, idiopathic or secondary?o Chronic obstructive pulmonary diseaseo Constrictive pericarditiso Hypothyroidism, usually with sinus bradycardiao Left pneumothorax (mid-left chest leads)o Myocardial infarction, extensiveo Myocarditis, acute or chronico Normal variano Obesityo Pericardial effusiono Pericardial tamponade, usually with sinus tachycardiao Pleural effusions | train | med_mcqa | null |
Which of the following is a nonculturalable fungus? | [
"Rhinosporidium",
"Candida",
"Sporothrix",
"Penicillium"
] | A | Ans. is 'a' i.e., Rhinosporidium . Rhinosporidium seeberi has not been cultivated in media. . Blastospores (Blastoconidia) are formed by cladosporum. . Chlamydospores (Chlamydoconidia) are formed by Candida albicans. Phialoconidia are formed by Aspergillus fumigatus | train | med_mcqa | null |
Which of the following is not true regarding the second number of the instrument formula? | [
"Indicates the primary cutting edge angle",
"The angle is expressed as a percent of 360 degrees",
"This number is always 50 or less",
"It can be omitted to give 3 number code"
] | C | The second number of a four-number code indicates the primary cutting edge angle, measured from a line parallel to the long axis of the instrument handle in clockwise centigrades.
The angle is expressed as a percent of 360 degrees (e.g., 85 = 85% x 360 degrees = 306 degrees).
The instrument is positioned, so that this number always exceeds 50.
If the edge is locally perpendicular to the blade, then this number is normally omitted, resulting in a three-number code.
Ref: Sturdevant's art and science of operative dentistry, 4th edition page 311 | train | med_mcqa | null |
A 50-yr-old male presents with erythematous shallow erosions with blisters and yellowish scales over seborrheic areas. Oral mucosa is not involved. Immunopathology demonstrates IgG deposition on keratinocytes and autoantibodies against Dsg-1. The diagnosis is? | [
"Pemphigoid",
"Pemphigus vulgaris",
"Pemphigus foliaceous",
"Dermatitis herpetiformis"
] | C | Pemphigus Foliaceous: Characterized by small flaccid bullae with crusting and scaling. Bullae rupture, resulting in moist erosions and cornflakes like crusts. Nikolsky's sign is positive Oral mucosa involvement is absent. associated with thyroid disease, rheumatoid ahritis and type 1 DM DIF: Perilesional skin biopsy demonstrates IgG on surface keratinocytes. Indirect immunofluorescence: Circulating IgG antibodies against keratinocytes cell surface antigen. Autoantigens: Ab directed against Desmoglein1 Rx: Topical and systemic glucocoicoids are mainstay. | train | med_mcqa | null |
Receptor for diphtheria toxin lies at ? | [
"Cell membrane",
"Mucous membrane",
"Nucleus",
"None"
] | A | Ans. is 'a' i.e., Cell membrane Diphtheria toxin The diphtheria toxin acts by inhibiting protein synthesis. It inhibits polypeptide chain elongation in the presence of nicotinamide adinine dinucleotide (NAD) by inactivating elongation factor, EF - 2. The diphtheria toxin is a protein which consists of two fragments, A and B. Both fragments are necessary for the toxic effect : Fragment A - has enzymatic activity and inhibits protein synthesis by inhibiting the chain elongation by inactivating the elongation factor - 2 (Ef - 2). Fragment B - responsible for binding the toxin to the cells. The toxin binds to specific receptors (HB-EGF receptors) present on susceptible cells and enters by receptor-mediated endocytosis. Toxin has special affinity for ceain tissues such as myocardium, adrenals and nerve endings. | train | med_mcqa | null |
Barbed broach is used for: | [
"Extirpation of pulp",
"Enlargement of canal",
"Obturation of canals",
"All of the above"
] | A | null | train | med_mcqa | null |
Depression occurs as a side effect due to the use of: | [
"Reserpine",
"Propranolol",
"Morphine",
"Amphetamine"
] | A | null | train | med_mcqa | null |
Will's gauge is used to measure | [
"Vertical height",
"Bi-zygomatic width",
"Inter condylar distance",
"Inter papillary width"
] | A | null | train | med_mcqa | null |
Pharmacokinetics is - | [
"Study of drug movement in the body",
"Study of drug effects",
"Study of drug responses, governed by heredity",
"None of the above"
] | A | Ans. is 'a' i.e., Study of drug movement in the body Pharmakokinetics is the quantitative study of drug movement, in through and out of the body. o That means, it is the study of the effect of body on the drug. o So, it is also known as ADME study as it deals with Absorption, Distribution, Metabolism and Excretion of a drug. Remember Pharmacodynamics (D) --> Drug does to body Pharmacokinetics --> Body does to drug. | train | med_mcqa | null |
Transovarian transmission is a feature of? | [
"Scrub fever",
"Epidemic typhus",
"Endemic typhus",
"Trench fever"
] | A | Ans. is 'a' i.e., Scrub typhus o Orientia tsutsugamushi is transmitted trans ovarially in mites. o Transovarian transmission is seen in : o Scrub typhus o Rickettsial pox o Indian tick typhus o Q. fever Rocky mountain spotted fever | train | med_mcqa | null |
A patient with complaints of having a deformed nose. He has visited several plastic surgeons but they have assured that there is nothing wrong with his nose. In spite of these reassurances, he continues to believe that his nose is deformed, He also complains that nobody takes him seriously because of the deformity of his nose, and he is extremely embarrassed because of this. he is most probably sufferingfrom: | [
"Somatization disorder",
"Hypochondrial disorder",
"Delusional disorder",
"OCD"
] | C | Delusional disorderFalse, firm, fixed, unshakable belief that patient holds (nose deformed) irrespective of reassurances, goes towards DELUSION. If the option of body dysmorphic disorder with absent insight, was there , it would have been the best answer. Acc to DSM-5, if a patient has delusional Belief about body appearance, body dysmorphic disorder with absent insight should be preferred over delusional disorder | train | med_mcqa | null |
Treatment of retinoblastoma is by | [
"5FU + Cisplatin + Vinblastine",
"Carboplatin + Etoposide + Vincristine",
"Cyclophosphamide + Etoposide + Vincristine",
"Cyclophosphamide + Doxorubicin + Etoposide"
] | B | Ans. (b) Carboplatin + Etoposide + VincristineRef: Ryan's retina 6/e, p. 2392; Kanski 8/e, p. 502; Parson's 22/e, p. 381Chemotherapy agents commonly used for treatment of retinoblastoma are Age <= 36 monthsAge > 36 monthsVincristine0.05 mg/kg1.5 mg/m2Etoposide5 mg/kg150 mg/ m2Carboplatin18.6 mg/kg560 to 600 mg/m2 | train | med_mcqa | null |
True regarding Delirium are all except: | [
"Acute onset",
"Sleep disturbance",
"Myoclonus",
"Normal consciousness"
] | D | Ref: A Short Textbook of Psychiatry by Niraj Ahuja, 6th editionExplanation:Clouding of consciousness is a characteristic ofDeliriumDELIRIUMMost Common organic disorder seen in clinical practice* Delirium is characterized by the followingAcute onsetClouding of consciousnessDisorientationDecreased attention spanDistractibilityMarked perceptual disturbancesInsomnia at night with daytime drowsinessWorsening of symptoms in evening and night (Sun downing)Impairment of registration and retention of new memoriesPsychomotor disturbances - agitation &. retardationAutonomic dysfunctionSpeech disturbances - slurring of speech, incoherence, dysarthriaFleeting delusionsMotor symptoms - asterixis, mutifocal myoclonus, carphologia, floccillation (Picking movements at coversheets & clothes).Occupational delirium (elaborate panto- mimes as if continuing the usual occupation in a hospital bed ) | train | med_mcqa | null |
who gave the concept of modelling in conversion disorder | [
"freud",
"erikson",
"morel",
"lorenz"
] | A | CONTRIBUTIONS OF FREUD o Father of psychoanalysis He founded a type of psychotherapy called psychoanalysis. It is nothing but analyzing the psych(MIND) o Interpretation of dreams According to Freud dreams are royal road to unconscious In dreams several conflicts that are present in the unconscious comes to the consciousness in the form of dreams Thus by analyzing ones dreams we could understand the unconscious conflicts o Psychosexual stages of life o Freud divided development into 5 stages namely psycho sexual development o It is divivded namely oral , anal , phallic, latent, genital phase. o Conversion disorders conversion disorder is conveing a psychological pain to physical symptoms present physical symptoms which has some connection with unconscious conflict is called SYMBOLIZATION present physical symptoms which has some resemblance with illness in family members, which is called MODELLING patient has illness like neurological deficit but they have apparent in concern towards their own illness which is known as LA BELLE INDIFFERENCE main defense mechanism in conversion disorder is REPRESSION o Repression defence mechanism * REPRESSION is called QUEEN of defense mechanisms o COUCH and FREE ASSOSIATION * He introduced a technique called as a couch technique where he makes the patient lie on the couch, he asks the patient to speak from 'cabbages to kings. This method is called FREE ASSOSIATION. By allowing the patient to speak whatever that comes to their mind randomly so that by analyzing their thoughts we could understand the conflict in the unconscious. o Topographical theory of mind Freud gave topographical theory mind It is divided into pre conscious, unconscious, conscious Later he disregarded topographical theory of mind and gave structural theory of mind o Structural theory of mind It is divided into id, ego, super ego Id= instinctual desires like anger, hunger, sexual instinct Ego= function of mind to work based on ego to avoid guilt from super ego Super ego= based on moral principle, obtained from family members and relatives, teachers Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition pg no. 845 | train | med_mcqa | null |
Anti - mullerian Hormone is | [
"Glycolipid secreted by granulosa cells of secondary follicle.",
"Indirectly reflects primordial follicle pool.",
"Increase progressively across menopausal transition.",
"Secreted by mullerian duct derivatives."
] | B | AMH is a Glycoprotein, declines progressively with menopause. | train | med_mcqa | null |
According to Veau's classification system of clefts, defects involving the soft palate upto the alveolus and usually involving the lip is | [
"Group A",
"Group B",
"Group C",
"Group D"
] | C | null | train | med_mcqa | null |
Aedes agypti can fly - | [
"100 m",
"200 m",
"1000 m",
"3-5 km"
] | A | The flight range of different mosquitoes: Anopheles - 3 to 5 km Culex - 11 km Aedes - 100 m REFERENCE: PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE, 25TH EDITION, PG NO. 831 | train | med_mcqa | null |
Cyclical trend of occurrence of disease is shown by all except | [
"Measles",
"Rubella",
"Influenza",
"Polio"
] | D | Cyclical trend is occurance of disease in cyclical pattern
Eg :
Measles : every 2-3 years.
Rubella : every 6-9 years.
Influenza : every 10-15 years (pandemic).
Polio cases occurance is considered as epidemic / short term fluctuation. | train | med_mcqa | null |
False regarding bacterial plasmids is: | [
"Extrachromosomal",
"Eliminated by treating with radiation",
"Transmission of different species",
"Can cause lysogenic conversion"
] | D | Ans. is 'd' i.e., Can cause lysogenic conversion(Ref: Ananthanarayan, 9th/e, p. 60 and 8th/e, p. 60)* Lysogenic conversion is due to phage (viral) genome, not due to bacterial plasmid.* Plasmid is extrachromosomal DNA and Radiation can damage Plasmid.* Plasmid can be transferred to different species, e.g., multi-drug resistance transfer between shigella and E. coli factor. | train | med_mcqa | null |
A substance is present in concentration of 2mg% in the afferent arteriole and zero mg% in the efferent. True about the substance is | [
"It is freely filtered in glomerulus",
"Secreted in cortical nephron",
"Absorbed in PCT",
"Impermeable in loop of Henle"
] | A | Ans. (a) It is freely filtered in glomerulus(Ref: Ganong, 25th ed/p.673)Concentration of 0 mg% means the substance is freely filtered into the bowman's space | train | med_mcqa | null |
Hyperrenninemia which drug should not be given- | [
"Beta blocker",
"Calcium channel blocker",
"ACE inhibitor",
"None of the above"
] | C | Angiotensin-conveing enzyme (ACE) inhibitors help relax your veins and aeries to lower your blood pressure. ACE inhibitors prevent an enzyme in your body from producing angiotensin II, a substance that narrows your blood vessels. This narrowing can cause high blood pressure and force your hea to work harder. Angiotensin II also releases hormones that raise your blood pressure addition to high blood pressure, ACE inhibitors prevent, treat or improve symptoms in conditions such as: Coronary aery disease Hea failure Diabetes Ceain chronic kidney diseases Hea attacks Scleroderma -- a disease that involves hardening of the skin and connective tissues Migraines Your doctor may prescribe other medications in addition to an ACE inhibitor, such as a diuretic or calcium channel blocker. ACE inhibitors shouldn't be taken with an angiotensin receptor blocker or with a direct renin inhibitor. ACE inhibitors work better for younger people than for older people. They also work better for white people than for black people. Your doctor may recommend a different medication Ref Harrison20th edition pg 287 | train | med_mcqa | null |
Lardaceous spleen is seen in: | [
"Alcoholic hepatitis",
"Chronic active hepatitis",
"Focal amyloidosis",
"Diffuse amyloidosis"
] | D | Amyloidosis of the spleen is seen in two forms :- The sago spleen in which amyloid deposits are limited to the follicles, And the lardaceous spleen in which amyloid is deposited in the walls of the splenic sinusoids and spares the follicles. | train | med_mcqa | null |
Dark radiolucent shadows appearing at the neck of teeth, most obvious on the mesial and distal aspect: | [
"Radiation caries",
"Rampant caries",
"Early childhood caries.",
"None of the above"
] | A | null | train | med_mcqa | null |
Cardioselective beta blockers is contraindicated in | [
"COPD",
"II & III degree heart block",
"Asthma",
"Tachycardia"
] | B | (B) II & III degree heart block# Except for those drugs specifically approved for use in heart failure, beta blockers are contraindicated in heart failure patients> Side effects of beta-blockers are related to their cardiac mechanisms and include bradycardia, reduced exercise capacity, heart failure, hypotension, and atrioventicular (AV) nodal conduction block.> Beta-blockers are therefore contraindicated in patients with sinus bradycardia and partial AV block.> Non-selective beta-blockers are contraindicated in patients with asthma or chronic obstructive pulmonary disease which is not a contraindication for cardioselective beta blockers. | train | med_mcqa | null |
All of the following are true about phrenic nerve, except- | [
"Lies superficial to the prevertebral layer of deep cervical fascia",
"Innervates the central part of the diaphragm",
"It is formed at the lateral border of scalenus anterior",
"Right phrenic nerve passes anteriorly to second part of the subclavian artery"
] | A | Ans- A Ref- The phrenic nerve is a bilateral, mixed nerve that originates in the neck and descends through the thorax to reach the diaphragm. As the only source of motor innervation to the diaphragm, this nerve has an important role in breathing. In this article, we shall look at the anatomy of the phrenic nerve - its anatomical course, motor and sensory functions. Overview Nerve roots: Anterior rami of C3, C4 and C5. Motor functions: Innervates the diaphragm. Sensory functions: Innervates the central part of the diaphragm, the pericardium and the mediastinal part of the parietal pleura. Anatomical Course The phrenic nerve mainly originates from the C4 spinal root, but it also receives contributions from C3 and C5. It also receives some communicating fibres from the cervical plexus. The nerve begins at the lateral border of the anterior scalene muscle. It then continues inferiorly over the anterior surface of anterior scalene, deep to the prevertebral layer of deep cervical fascia. From here, the course of the phrenic nerve differs between the left and right: Right Phrenic Nerve: Passes anteriorly to second part of the subclavian artery, and posteriorly to the subclavian vein. Enters the thorax via the superior thoracic aperture. Descends anteriorly to the right lung root, down the right side of the pericardium. Reaches the diaphragm and pierces the muscle to supply the underlying surface. Left Phrenic Nerve: Passes anteriorly to the first part of the subclavian artery, and posteriorly to the subclavian vein. Enters the thorax via the superior thoracic aperture. Crosses the aortic arch and vagus nerve, and descends anteriorly to the left lung root, down the left side of the pericardium. Reaches the diaphragm and pieces the muscle to supply the underlying surface. By TeachMeSeries Ltd (2018) Fig 1.0 - The origin of the phrenic nerve from the anterior rami of C3,4 and 5. Motor Functions The phrenic nerve provides motor innervation to the diaphragm; the main muscle of respiration. As the phrenic nerve is a bilateral structure, each nerve supplies the ipsilateral side of the diaphragm (i.e. the hemi-diaphragm on the same side as itself). Sensory Functions Sensory fibres from the phrenic nerve supply the central part of the diaphragm, including the surrounding pleura and peritoneum. The nerve also supplies sensation to the mediastinal pleura and the pericardium. By TeachMeSeries Ltd (2018) Fig 1.1 - The phrenic nerve provides sensory innervation to the diaphragm, mediastinal pleura and pericardium. Clinical Relevance: Diaphragmatic Paralysis The phrenic nerve provides motor innervation to the diaphragm. If the nerve becomes damaged, paralysis of the diaphragm will result. Causes of phrenic nerve palsy include: Mechanical trauma - ligation or damage to the nerve during surgery. Compression - due to a tumour within the chest cavity. Neuropathies - such diabetic neuropathy. Paralysis of the diaphragm produces a paradoxical movement. The affected side of the diaphragm moves upwards during inspiration, and downwards during expiration. A unilateral diaphragmatic paralysis is usually asymptomatic, and is most often an incidental finding on x-ray. If both sides are paralysed, the patient may experience poor exercise tolerance, orthopnoea and fatigue. Lung function tests will show a restrictive deficit. Management of diaphragmatic paralysis is two-fold. Firstly, the underlying cause must be identified and treated (if possible). The second part of treatment deals with symptomatic relief. This is usually via non-invasive ventilation, such as a CPAP (continuous positive airway pressure). By Ratnayake et al via BioMed Central Ltd Fig 1.3 - Chest x-ray, showing paralysis of the right hemidiaphragm. | train | med_mcqa | null |
Skull of a male differs from that of a female by all of the following except: | [
"Capacity greater than 1500 c.c",
"Muscular markings over occiput are less marked",
"Orbits square",
"Frontal eminence small"
] | B | B i.e. Muscular markings over occipit are less marked | train | med_mcqa | null |
Most common symptom of ectopic pregnancy NOT RELATED - GYN | [
"Bleeding",
"Pain",
"Aboion",
"Infection"
] | B | Ectopic pregnancy is characterised by the triad of amenorrhoea, pain and BPV of which the most common symptom is pain. The diagnosis is based on clinical features and ultrasound, though laparoscopy is the gold standard. When diagnosis is in doubt serial estimation of HCG is done over 48 hrs. A rise < 66% is s/o ectropic pregnancy. | train | med_mcqa | null |
During spermiogenesis, mitochondrion of spermatid forms which pa of the sperm | [
"Acrosomal cap",
"Middle piece",
"Axial filament",
"Head of the sperm"
] | B | Nuclear body forms Head of the sperm Golgi body forms Acrosomal cap Mitochondrion forms Middle piece of sperm Microtubules form Axial filament of sperm. | train | med_mcqa | null |
In neonates most sensitive audiometric screening is: | [
"Electrocochleography",
"OAEs",
"BERA",
"Tympanometry"
] | B | (b) Otoacoustic emissions (OAEs).(Ref. Cummings, 6th ed., 2074)OAE is considered to be the best audiometric test to screen hearing in neonates. Absent OAE indicate cochlear lesions.For screening purposes the test has to be easy to do, less time consuming, results should be available immediately and cost effective.For these reasons OAE is better than BERA for screening hearing in neonates and children.If OAEs are absent, the child is taken up for BERA for confirmation.Electrocochleography is an invasive test. It is done for Meniere's, which is not the pathology, at this age.Tympanometry is used to detect middle ear lesions which are also unusual at this age.Developmental anomalies of the cochlea are to be ruled out at this age, if found, the child can be taken up for cochlear implantation as early as one year of age for proper speech development. | train | med_mcqa | null |
The tensile strength of wound after laparoscopic cholecystectomy in a 30 years old woman depends upon: | [
"Replacement of type 3 collagen",
"Macrophage aetivity/snvasion",
"Extensive crosslinking of tropocollagen",
"Granulation tissue"
] | C | The recovery of tensile strength results from the excess of collagen synthesis over collagen degradation during the first 2 months of healing, and, at later times, from structural modifications of collagen fibers (cross-linking, increased fiber size) after collagen synthesis ceases.
'Recovery of Tensile Strength: Fibrillar collagens (mostly type I collagen) form a major portion of the connective tissue in repair sites and are essential for the development of strength in healing wounds. Net collagen accumulation, however, depends not only on increased collagen synthesis but also on decreased degradation. When sutures are removed from an incisional surgical wound, usually at the end of the first week, wound strength is approximately 10% that of unwounded skin.
Wound strength increases rapidly over the next 4 weeks, slows down at approximately the third month after the original incision, and reaches a plateau at about 70% to 80% of the tensile strength of unwounded skin. Lower tensile strength in the healed wound area may persist for life. The recovery of tensile strength results from the excess of collagen synthesis over collagen degradation during the first 2 months of healing, and, at later times, from structural modifications of collagen fibers (cross-linking, increased fiber size) after collagen synthesis ceases.'- Robbins 8/e p105-106 | train | med_mcqa | null |
The most important cause of failure of patient to wear RPD is due to: | [
"Indifferent patient education",
"Faulty laboratory procedures",
"Poor framework design",
"Improper preliminary rehabilitative restorative procedures"
] | D | null | train | med_mcqa | null |
EMLA constituent is - | [
"Lidocaine + Cocaine",
"Lidocaine + Prilocaine",
"Lidocaine + Bupivacaine",
"Bupivacaine + Prilocaine"
] | B | Ans. is 'b' i.e., Lidocaine + Prilocaine Eutectic mixture of local Anaestheticso This is unique topical preparation which can anaesthetise intact skin.o It is a mixture of 2.5% lidocaine and 2.5 prilocaine.o It acts slowly and the cream must held in contact with skin for at least l hour.o EMLA is used : to make venepuncture painless especially in children, and for procedure like skin grafting & circumcision.o As systemic absorption of prilocaine can cause methemoglobinemia, EMLA should not be used on mucocutaneous membrane or in very small child. | train | med_mcqa | null |
Isotope used for liver scan is: | [
"Technetium",
"Its'",
"Cobalt 60",
"None"
] | A | Ans. Technetium | train | med_mcqa | null |
Useful screening test for lead is measurement of | [
"Amino-laevulinic acid in urine",
"Coproprophyrin in urine",
"Lead in blood",
"Lead in urine"
] | B | Diagnosis of lead poisoning: | train | med_mcqa | null |
felon most commonly present at - | [
"Index finger",
"Ring finger",
"Little finger",
"Middle finger"
] | A | Ans. is 'a' i.e., Index finger Felono Infection of the terminal pulp space is known as 'Felon', which is common and potentially serious,o Dull pain and swelling are the first symptoms, and if untreated by the third day there are severe nocturnal exacerbations of throbbing pain, interfering with sleep, o Light pressure over the affected pulp increases the pain,o In the early acute phase antibiotic treatment is often successful.o If localization of the pus has occured, which is indicated by persistent pain, localized tenderness, then it should be drained by a lateral incision which opens all compartments and avoids damage to the tactile tissue in front of the finger.o If neglected, it may lead to necrosis of distal 4/5 of the terminal phalanx due to occlusion of the vessels by- tension. The proximal 1/5 (epiphysis) escapes because its artery does not transverse the fibrous septa. | train | med_mcqa | null |
The primary difference between MTA and Portland cement is that, MTA | [
"Lacks potassium",
"lacks Al",
"lacks Mg",
"lacks Fe"
] | A | The primary difference between both types of MTA and Portland cement are a lack of potassium and presence of bismuth oxide. White MTA contains lower amounts of Fe, Al and Mg than grey MTA.
ref. MTA review, JOE 2010, pg 17 | train | med_mcqa | null |
Which of the following virus has negative sens RNA? | [
"Rabies",
"Reovirus",
"Coronavirus",
"Calci"
] | A | Ans. is 'a' i.e., Rabies Types of RNA viruses There are three types of RNA viruses :? 1. Positive sens --> Virus RNA can immediately be translated by host's ribosomes into protein. Positive RNA _ > Protein Translation 2. Negative sens ---> Virus RNA is not able to begin translation immediately. Negative strand RNA first transcribed into positive strand RNA by viral RNA dependent RNA polymerase. Negative RNA__________________ (+)ve RNA__________ > Proteins Viral RNA dependent Translation RNA polymerase 3. Retroviruses They have reverse transcriptase which causes transcription to occur in reverse fashion i.e. synthesis of DNA from RNA (normally in transcription, RNA is synthesized from DNA). This DNA is transcripted into RNA. | train | med_mcqa | null |
5 g mannitol was injected intravenously. 40% of mannitol is excreted. After equilibrium, plasma concentration of mannitol is 30 mg%. Calculate extracellular fluid volume. | [
"10 L",
"14 L",
"18 L",
"24 L"
] | A | The volume of water in different compament can be measured by volume of distribution principle (indicator dilution principle). Where v = Volume of fluid Q = Quantity of indicator given C = Concentration of the indicator e = The amount of indicator which has either been lost or metabolized 30 mg% = 30 mg/ 100 mL = 300 mg/ L = 0.3g/L Quantity of mannitol excreted = 5 * 40/100 = 2 g ECF volume = 5 - 2 / 0.3 = 3 / 0.3 = 10 L | train | med_mcqa | null |
A patient presented to the clinic with deafness and tinnitus in his right ear. On examination he was found to have right sided facial paralysis and loss of taste sensation on the anterior half of the right side of the tongue. Which of the following aery is most likely to be occluded in this patient? | [
"Paramedian aery",
"Anterior inferior cerebellar aery",
"Posterior inferior cerebellar aery",
"None of the above"
] | B | This patient is showing features of occlusion of anterior inferior cerebellar aery which supplies the structures in the inferior pons such as fibers of the seventh nerve, solitary nucleus and tract and cochlear nuclei. Patients with occlusion of anterior inferior cerebellar aery develops tinnitus, deafness, ipsilateral facial paralysis and loss of taste on ipsilateral half of tongue anteriorly. Ref: Waxman S.G. (2010). Chapter 12. Vascular Supply of the Brain. In S.G. Waxman (Ed), Clinical Neuroanatomy, 26e. | train | med_mcqa | null |
Primordial prevention for CAD is: March 2011 | [
"Screening",
"Regular checkups",
"Preserving traditional lifestyle",
"Treatment for raised BP"
] | C | Ans. C: Preserving traditional lifestyle Preserving traditional lifestyles is a primordial level of prevention Levels of Prevention Model This model, advocated by Leaven and Clark in 1975, has influenced both public health practice and ambulatory care delivery worldwide. This model suggests that the natural history of any disease exists on a continuum, with health at one end and advanced disease at the other. The model delineates three levels of the application of preventive measures that can be used to promote health and arrest the disease process at different points along the continuum. The goal is to maintain a healthy state and to prevent disease or injury. It has been defined in terms of four levels: Primordial prevention Prevention of the emergence or development of risk factors in population or countries in which they have not yet appeared. Effos are directed towards discouraging children from adopting harmful lifestyles. Primary prevention An action taken prior to the onset of disease, which removes the possibility that the disease will ever occur. It includes the concept of positive health, that encourages the achievement and maintenance of an "acceptable level of health that will enable every individual to lead a socially and economically productive life. A holistic approach Secondary prevention Action which halts the progress of a disease at its incipient stage and prevents complications. The domain of clinical medicine An imperfect tool in the transmission of disease More expensive and less effective than primary prevention Teiary prevention All measures available to reduce or limit impairment and disabilities, minimize suffering caused by existing depaures from good health and to promote the patient's adjustment to irremediable conditions. Modes of intervention Health promotion Specific protection Early diagnosis and treatment Disability limitation Rehabilitation Health promotion The process of enabling people to in areas to control over and to improve health Health education Environmental modifications Nutritional interventions Lifestyle and behavioral changes Specific protection Immunization Specific nutrients Chemoprophylaxis Protection against occupational hazards Protection from carcinogens Avoidance of allergens Rehabilitation The combined and coordinated use of medical, social, educational and vocational measures for training and retraining the individual to the highest possible level of functional ability. Examples-schools for blind, reconstructive surgery in leprosy, provision of aids for the crippled | train | med_mcqa | null |
Haab's striae is seen in? | [
"Trachoma",
"Congenital glaucoma",
"Scletitis",
"Cataract"
] | B | Haab's striae are horizontal breaks in the Descemet membrane associated with congenital glaucoma. It is named after Otto Haab. Haab striae are curvilinear breaks in Descemet's membrane, resulting acutely from stretching of the cornea in primary congenital glaucoma. They are typically oriented horizontally or concentric to the limbus in contrast to Descemet's tears, resulting from birth trauma, that are usually vertical or obliquely oriented. differential diagnosis Band-like structures, clinically similar to Haab's striae, occur in posterior polymorphous dystrophy (PPMD) and are often confused with them. The difference in clinical appearance based on difference in histopathology allows a clear differentiation. The edge of Haab's striae are thickened, curled, and secondarily proliferate Descemet's membrane, while the area between the edge is thin and smooth. Posterior polymorphous dystrophy bands are the exact opposite. The band is a thickening of Descemet's membrane between the edges with thinner, more normal Descemet's membrane outside of them. PPMD bands may be associated with typical vesicles or appear as the only sign of dystrophy, even in the eyes of patients with a known family history. | train | med_mcqa | null |
About fibrolamellar carcinoma, TRUE is : | [
"Diffuse in nature",
"Occurs after 60 years of age",
"Cirrhosis is the most common presenting feature",
"Has better prognosis"
] | D | Answer is D (Has better prognosis) Fibrolamellar carcinoma grows slowly and is associated with a longer survival if treated. It has a distinctly better prognosis. Characteristic features of fibrolamellar carcinoma Distinctive variant of Hepatocellular carcinoma Occurs in young adults (20 to 40 years of age) Equal sex incidence (Robbins); More common in females-Chandrasoma Taylor No association with HBV or cirrhosis Well circumscribed mass (localized) Non encapsulated but well circumscribed. Grossly encapsulated -- Chandrasoma Taylor No AFP elevation -Chandrasoma Taylor Better prognosis: Slow growth and longer survival. | train | med_mcqa | null |
Selenocysteine is similar to | [
"Arginine",
"Alanine",
"Cysteine",
"Lysine"
] | C | Selenocysteine is similar to cysteine. Selenocysteine arises co-translationally during its incorporation into peptides. The UGA anticodon of the unusual tRNA designated tRNAsec normally signals to STOP. The ability of the protein synthesizing apparatus to identify a selenocysteine-specific UGA codon involves the selenocysteine inseion element, a stem-loop structure in the untranslated region of the m-RNA. Selenocysteine-tRNAsec is first charged with serine by the Ligase that charges tRNAsec. Subsequent replacement of the serine oxygen by selenium involves seleno- phosphate formed by Selenophosphate synthetase.Ref: Textbook of medical biochemistry, MN Chatterji, 8th edition, page no: 80 | train | med_mcqa | null |
The following can be used to antagonise the action of heparin in case of overdose | [
"Heparan sulfate",
"Dextran sulfate",
"Ancrod",
"Protamine sulfate"
] | D | HEPARIN ANTAGONIST Protamine sulfate Given i.v. it neutralises heparin weight for weight, i.e. 1 mg is needed for every 100 U of heparin. For the treatment of heparin induced bleeding, due consideration must be given to the amount of heparin that may have been degraded by the patient's body in the mean time. However, it is needed infrequently because the action of heparin disappears by itself in a few hours, and whole blood transfusion is needed to replenish the loss when bleeding occurs. Protamine is more commonly used when heparin action needs to be terminated rapidly, e.g. after cardiac or vascular surgery. Ref:- kd tripathi; pg num:-620 | train | med_mcqa | null |
Flumazenil is - | [
"Diazepam inverse agonist",
"Diazepam antagonist",
"Opioid antagonist",
"Opioid inverse agonist"
] | B | Ans. is 'b' i.e., Diazepam antagonist | train | med_mcqa | null |
Which of the following are features of diffuse sclerosing variant of papillary carcinoma? | [
"Occurs in young individuals including children",
"Extensive fibrosis throughout the gland",
"Associated with lymphocytic infiltrate",
"All of the above"
] | D | Diffuse sclerosing variant of papillary carcinoma occurs in younger individuals, including children. This tumor has prominent papillary growth pattern intermixed with solid areas containing nests of squamous metaplasia. As the name suggests, there is extensive, diffuse fibrosis throughout thyroid gland, often associated with prominent lymphocytic infiltrate, simulating Hashimoto thyroiditis. | train | med_mcqa | null |
Alopecia aerata is: | [
"Cicatricial scar",
"Non cicatricial scar",
"Fungal infection",
"None"
] | B | B. i.e. Non Cicatrial | train | med_mcqa | null |
Stress-induced hyperglycemia is due to: | [
"Glucocoicoids",
"GH",
"Epinephrine",
"All"
] | D | A i.e. Glucocoicoids; B i.e. GH; C i.e. Epinephrine | train | med_mcqa | null |
Decidua in puerperium is normally shed as : | [
"Decidual cast",
"Lochia",
"Placental remnants",
"Clots"
] | B | Lochia | train | med_mcqa | null |
Blood supply of brain is ? | [
"1500 ml/min",
"2000 ml/min",
"750 ml/min",
"250 ml/min"
] | C | Ans. is 'c' i.e., 750 ml/minThe cerebral blood flow (CBF) is about 750 ml/min (15% of total cardiac output), or 54 ml/100 gm brain tissue per minute. | train | med_mcqa | null |
Tone of the anal sphincter in maintained by | [
"Nervi erigentes",
"Inferior hypogastric plexus",
"Inferior rectal nerve",
"Pelvic splanchnic nerves"
] | C | The anal sphincters and puborectalis are the primary muscles responsible for continence. There are two sphincters: the internal anal sphincter, and the external anal sphincter. The internal sphincter is responsible for 85% of the resting muscle tone and is involuntary. ref - BDC 6e vol2 pg413-416 | train | med_mcqa | null |
A 40-year-old woman presents to the clinic for evaluation of symptoms of light-headedness associated with sweating, palpitations, and hunger. The symptoms are most pronounced whenever she misses a meal.On physical examination, her vital signs are normal, as is the heart, lungs, and abdominal examination. Her past medical history is negative and she is not taking any medications. During one such episode, while in hospital, her blood glucose level was 30 mg/dL and the symptoms resolved with drinking some juice. Which of the following is the most likely diagnosis? | [
"excess growth hormone",
"Cushing disease",
"thyrotoxicosis",
"tumor of the pancreatic beta-cells"
] | D | Tumor of the pancreatic beta cells, such as an insulinoma, is the cause of her symptoms. Classification of hypoglycemia includes spontaneous causes such as reactive or fasting hypoglycemia and pharmacologic or toxic causes. The diagnosis of insulinoma is most certain when Whipple triad is fulfilled: symptoms consistent with hypoglycemia, low plasma glucose, and relief of symptoms with elevation of plasma glucose to normal. Cushing disease and excess growth hormone will result in elevated blood glucose levels and diabetes (not decreased glucose values). Thyrotoxicosis and gastrin deficiency do not cause hypoglycemia. | train | med_mcqa | null |
Anticholinergic used in all EXCEPT: | [
"Uvietis",
"Fundus examination",
"OPC poisoning",
"Glaucoma"
] | D | ANSWER: (D) GlaucomaREF: khurana 4th ed p. 213"Anticholinergic are contraindicated in glaucoma" | train | med_mcqa | null |
Visual analog scale is a - | [
"Pain scale",
"Pressure scale",
"Vision scale",
"Auditory scale"
] | A | Ans. is 'a' i.e., Pain scale Visual analog Scaleo The visual analogue scale or visual analog scale (VAS) is a psychometric response scale which can be used in questionnaires.o It is a measurement instrument for subjective characteristics or attitudes that cannot be directly measured,o When responding to a VAS item, respondents specify their level of agreement to a statement by indicating a position along a continuous line between two end-points,o VAS is the most common pain scale for quantification of severity of pain. | train | med_mcqa | null |
False regarding Neonatal herpes simplex infection is: | [
"Cesarean section is mandatory if there is history of prior maternal genital infection",
"Affected infant should be isolated",
"Affected neonate should receive acyclovir",
"Steroids may exacerbate HSV infection"
] | A | Neonatal herpes simplex infection It is recommended that infants be delivered by cesarean section if genital lesions are present at the sta of labour. If there is a history of prior maternal genital infection, but if there are no lesions when labour commences then vaginal delivery is appropriate. Antenatal cervical screening cultures taken prior to labour fail to predict active excretion of the virus at delivery. | train | med_mcqa | null |
All are true about Lyon's hypothesis except? | [
"Only one of X chromosomes is genetically active",
"Only X chromosome from the mother undergoes pyknosis",
"Inactivation occurs on 16th day of embryonic life",
"Gene Xist causes gene silencing"
] | B | Ans. (b) Only X chromosome from the mother undergoes pyknosisRef: Robbin's pathology 9th ed. /164Lyon hypothesis is:* Only one of the X chromosome is genetically active* Other X chromosome which can be of paternal or maternal origin undergoes pyknosis and is rendered inactive.* Inactivation of either paternal or maternal X chromosomes occurs at random among the cells of blastocyst by about 16th day of embryonic life* Inactivation of X is because of a gene called Xist which is causing gene silencing DNA methylation. | train | med_mcqa | null |
Without external cue, the sleep-wake cycle in humans | [
"Unchanged",
"Continues with cycle length of > 24 hours",
"Continues with cycle length of < 24 hours",
"Continue with cycle length of > 12 hours"
] | B | Normal sleep-wake cycle in humans- 24 hrs
When external cues (Light and darkness) removed, sleep-wake cycle- Slightly increased (>24hrs) | train | med_mcqa | null |
Maximum conduction occurs in which fibres | [
"B fibres",
"A alpha fibers",
"Sympathetic fibres",
"C fibres"
] | B | SENSORY NERVE FIBERS | train | med_mcqa | null |
Best test to see capsule of Cryptococcus neoformans in a sample of CSF: | [
"Gram staining.",
"Giemsa staining.",
"Indian ink.",
"Methylene blue."
] | C | Indian ink smear remains the method of choice for detecting cryptococcus in CSF. | train | med_mcqa | null |
A 26 years old female at 39 weeks gestation presents with gush of fluid and regular contractions. On examination, she is grossly ruptured, contraction every two minutes and a cervical dilatation of 4 cms. The fetal heart rate is 140/min and reactive. She was admitted for labor and delivery. Over the next four hours, the cervical dilatation progressed to 9 cms. In the past hour, the fetal heart rate increased from the baseline of 140/min to 160/min. There is moderate to severe variable decelerations are seen with each contraction. The fetal heart rate does not responds to scalp stimulation. It was decided to proceed for caesarean section. The most important reason for the decision is | [
"Fetal distress",
"Fetal acidemia",
"Fetal hypoxic encephalopathy",
"Non reassuring fetal heart rate tracing"
] | D | Answer: d) Non reassuring fetal heart rate tracingCardio toco graphy-Continuous electric fetal monitoring:CharacterNormalBaseline FHR110-150bpmBaseline variability5-25bpmAcceleration2 in 20 minDecelerationNone or earlyBaseline FHR is the mean level of FHR between the peaks and the depressions in beats per minute (bpm).Baseline variability is the oscillation of baseline FHR excluding the accelerations and decelerations. A base line variability of 5-25 bpm is a sign of fetal wellbeing.Accelerations are increased in FHR by 15 bpm or more lasting for at least 15 secs. Denotes healthy fetus.Deceleration is decrease in FHR below the baseline by 15 bpm or more. Three basic types of deceleration are observed:Early decelerationLate decelerationVariable decelerationType-1 dips.Due to headcompression.Type-ll dips.Due to utero-placentalinsufficiency and fetal hypoxiaIndicates cord compression and may disappear with the change in position of the patient.Pneumonic: (VEAL-CHOP)V- variable decelerationsC- cord compression/ prolapseE- early decelerationsH- Head compressionA- AccelerationsO-OKL- late acceelrationsP-Placental insuffiencyWith each uterine contraction, blood flow to the placenta decreases, and the fetus is exposed to transient hypoxia.As the labor progresses and more and more contractions occur, this hypoxia can eventually lead to a change from aerobic to anaerobic metabolism- fetal acidemia.However, the fetus has a variety of protective mechanisms, including a blood buffering system and the diving reflex (a lowering of the heart rate in times of hypoxic stress), to protect it from becoming dangerously acidemic.Electronic fetal monitoring is not a very specific tool for identifying fetal acidemia.Many fetuses with a non-reassuring fetal heart rate tracing do not have acidemia and are not in distress.However, it can be very difficult to distinguish non-acidemic fetuses with non-reassuring fetal heart rate tracings from acidemic fetuses with non-reassuring fetal heart rate tracings.Thus, the delivery of many fetuses is expedited because of the concern for fetal acidemia when, in fact, the fetus is not acidemic at all.Thus, it is most accurate to state, as is in this case, that the fetus was delivered because of the non-reassuring fetal heart rate tracing.Fetal acidemia is not the reason for delivery. In fact, there is a strong likelihood that this fetus is not acidemic at all.Fetal distress is not the reason for delivery. There is a strong likelihood that this fetus is perfectly healthy and will have high neonatal APGAR scores and no distress at all.Fetal hypoxic encephalopathy is not the reason for delivery. The desire to prevent hypoxic/acidemic damage to organs, including the brain, is the reason for expediting delivery.However, the non-reassuring fetal tracing does not indicate that hypoxic encephalopathy is necessarily occurring.Low neonatal APGAR scores can be a marker of fetal acidemia.However, many fetuses with non-reassuring fetal heart rate tracings do not have low neonatal APGAR scores. | train | med_mcqa | null |
Indication of BAHA is | [
"Congenital canal atresia",
"Bilateral hearing loss",
"Sensorineural hearing loss",
"All of the above"
] | D | Indications of BAHA (Bone anchored hearing aids):1.Conductive or mixed hearing loss due to CSOM, mastoid cavities, canal atresia, revision ossiculoplasty, otosclerosis, otitis externa2.Unilateral SNHL - Trauma, Viral infections, Sudden SNHL, Acoustic neuroma, Meniere`s disease, OtotoxicityRef: Hazarika; 3rd ed; Pg 85 | train | med_mcqa | null |
According to Faulk classification, the husband battered wife syndrome is common in: | [
"Dependent but suspicious husband",
"Normal quiet husband",
"Dependent active",
"Dependent passive"
] | A | Ans: (a) Dependent but suspicious husbandRef: Faulk M. (1974, July), Men Who Assault Their Wives, Medicine, Science and the Law, Page 180-183Violence between any two "individuals" who are related / or in a relationship denote,Abuse (act of commission)Neglect (act of omission).Types of abuses / neglect:Emotional abuse / neglectPhysical abuse / neglectSexual abuse / neglectFamily is the unit of society. Marital (domestic) violence is a medico-legal problem.Battered person syndrome is a condition where a person suffers abuse from another person.Victims - persons who are dependent on others like wives, children and elderly.Perpetrators - usually males (spouse), or females (in case of children).Typically husband abuses wife (battered wife syndrome) and wife abuses children (displacement - defense mechanism) - battered baby syndrome.Several studies were carried out to identify the characteristics of people who batter.Faulk, in 1974 published a paper classifying persons who abuse others.According to Faulk, there are five types of men in a relationship:Stable / affectionateDominatingViolent / bullyingDependent passiveDependent suspiciousBattering happens in all but frequency and intensity varies.Least common with men who are stable and affectionate.Dominating husband wants to control wife.Bullying husband uses violent methods even for trivial problems.Dependent passive man tries to please wife and battering is less common.Dependent but suspicious man is jealous hence abuse wife more.Battered wife syndrome logically comes under stress related disorders in ICD-10 (Adjustment disorder, acute stress disorder, PTSD).Battered wife experiencesDepressionFear (not only with spouse but also with others)Dislike her body, aversion towards sexBelief that spouse is omnipotent (and she can't escape/others can't help).Battered baby syndrome is characterized by:Retinal bleedFracturesSoft tissue injuriesSubdural hematomaCannot be explained by accidental trauma or other medical conditions.Head injury might be due to violent shaking (syn. shaken baby head trauma).Head injury in BBS result in subdural hematoma, retinal bleeding even brain tissue damage (diffuse axonal injury) without other injuries.Long bone fractures are multiple in BBS exhibit different healing stages (indicating chronic abuse), without corresponding external injury.Domestic violence in India-Legal issues.Protection of Women from Domestic Violence Act, 2005 defines domestic violence and protects (women) victims.It is a civil law, i.e., it doesn't meant for penalizing the perpetrator (which is described in Section 498A in The Indian Penal Code)Patriarchal social structure and Dowry system are believed to be causative dynamics behind violence against women in India.Sexual Harassment of Women at Workplace (Prevention, Prohibition and Redressal) Act came into force in 2013.Sec. 354 of the Indian Penal Code describes sexual harassment offence and penalties shall be for a man committing such an offence. | train | med_mcqa | null |
Which of the following murmur increases on standing? | [
"HOCM",
"MR",
"MS",
"VSD"
] | A | On standing: The venous return is going be reduced & there is decrease blood coming to the hea, therefore intensity of murmurs get reduced. E.g.: Valsalva, Amyl nitrate (Except HOCM: louder murmur; MVP: longer murmur) Note: All murmurs increase on doing sit ups, hand grip or exercise as there is increase of peripheral resistance HOCM: soften MVP: shoer Therefore, HOCM and MVP behave opposite of normal LVOT dynamic/ Sub valvular Aoic stenosis: Volume of blood in left Ventricle is directly propoional to left ventricular output tract obstruction (LVOT) i.e. if more amount of blood coming in then aoic gap separated so less intensity of murmur. But in case of standing, volume of blood in LV is less, so the LVOTO will also be lesser and thus the intensity of murmur increases. | train | med_mcqa | null |
Vitamin D deficiency has all of the following except? | [
"Hypocalcemia",
"Increased SAP",
"Increased PTH",
"Hyperphosphatemia"
] | D | Vitamin D deficiency leads to Hypocalcemia. This results in secondary increase in PTH. This PTH now acts on proximal convoluted tubule to cause loss of phosphate. The increased bone turnover causes an increase in serum alkaline phosphate. Impoant calcium/phosphate and SAP fluctuations. Condition Rickets Hyperparathyroidism Osteoporosis Paget Disease Chronic Renal Failure Serum calcium Less Increased Normal Normal Less Serum phosphate Less Less Normal Normal Increased SAP Increased Increased Normal Dispropoionate increased Increased PTH Increased Increased Normal Normal Increased | train | med_mcqa | null |
All will predispose to atherosclerosis, except | [
"Homocystinemia",
"Fibrinogen",
"Calcium",
"Lipoprotein A"
] | C | Elevated plasma levels of homocysteine are associated with increased risk of atherosclerosis, thrombosis and hypertension.
Lipoprotein A inhibits fibrinolysis, therefore predisposes to atherosclerosis.
Atherosclerosis (Greek athere-mush) is a complex disease characterized by thickening or hardening of arteries due to the accumulation of lipids (particularly cholesterol, free, and esterified), collagen, fibrous tissue, proteoglycans, calcium deposits, etc. in the inner arterial wall.
Satyanarayana, Ed 3, Pg No 152 | train | med_mcqa | null |
A 40-year-old male patient presented with slowly progressive dysphagia both to solids and liquids, regurgitation, chest pain and weight loss for 2 months. Barium swallow and esophageal manometry was advised by the doctor. Upper GI endoscopy was also performed. Which of the following organism has been most commonly implicated in causing the above disease: - | [
"HSV 1",
"HSV 2",
"Varicella",
"CMV"
] | A | This is a case of achlasia cardia. Barium swallow x-ray appearance shows a dilated esophagus with poor emptying, an air-fluid level, and tapering at the les giving it a beak-like appearance. Esophageal manometry shows impaired lower esophageal sphincter (LES) relaxation and absent peristalsis and minimal pressurization of the esophageal body. UPPER GI ENDOSCOPY SHOWS a: Functional stenosis of the esophagogastric junction. b: Wrapping around the esophagogastric junction. c: Abnormal contraction of the esophageal body. d: Mucosal thickening and whitish change. e: Dilation of the esophageal lumen. f, g: Liquid and/or food remnant. Achalasia cardia It is an autoimmune process Due to loss of ganglion cells Presents with dysphagia, regurgitation and chest pain. It is attributed to latent infection with HSV-1. | train | med_mcqa | null |
Infection of CNS spread in inner ear is through: | [
"Cochlear aqueduct",
"Endolymphatic sac",
"Vestibular aqueduct",
"Hyl fissure"
] | A | Cochlear aqueduct (Aqueduct of Cochlea) is a connection between scala tympani (containing perilymph) and the subarachnoid space (containing CSF). On occassions, paicularly in young children, the Cochlear aqueduct is large and open.Infection can spread to the inner ear from the infected CSF or vice versa, the cochlear aqueduct resulting in severe profound hearing loss (meningitic labyrinthitis). | train | med_mcqa | null |
Visual fields diagnosed by - | [
"Pachymetry",
"Perimetry",
"Corneal topography",
"Optical coherence tomography"
] | B | Ans. is "B". Perimetry Field of vision o The extent of the normal visual field is limited in an individual by anatomical features such as the brow superiorly, the nose nasally (medially) and the cheek inferiorly. The field for a white target extends:- # Upwards (superior) - 50-60 degrees # Downwards (inferior) - 70-75 degrees # Inwards (nasally) - 60 degrees # Outwards (temporally) - 90-100 degrees o The tests used to measure the field of vision are i) Confrontation test. ii) Perimetry :- Kinetic perimetry, or automated perimetry. o Visual field defects are best detected by Goldmann kinetic perimetry and Humphery automated threshold perimetry. Goldman scale in perimetry. | train | med_mcqa | null |
In dacrocystorhinostomy (DCR) lacrimal sacs are directly opened into: | [
"Superior nasal meatus",
"Middle nasal meatus",
"Inferior nasal meatus",
"Nasolacrimal duct"
] | B | Ans. b (Middle nasal meatus). (Ref. Basak's, Opthalmology, 2nd ed., pg, 282, 336)DACROCYSTORHINOSTOMY (DCR)# It is surgical procedure of choice in chronic dacrocystitis, in which a communication is made between lacrimal sac and middle meatus of nose.# Contraindications: (MH'2000)- DNS- Atrophic rhinitis- Carcinoma of lacrimal gland | train | med_mcqa | null |
Which of the following is/arc didactic methods of health communication? | [
"Group discussion",
"Workshop",
"Demonstration",
"All"
] | C | Ans. is 'c' i.e., Demonstration | train | med_mcqa | null |
Coomb's +ve Hemolytic Anaemia is seen in except : | [
"Alcoholic cirrhosis",
"Chronic active hepatitis",
"Primary biliary cirrhosis",
"Primary sclerosing cholangitis"
] | A | Answer is A (Alcoholic cirrhosis) Coomb's positive hemolytic anemia may be seen in autoimmune conditions. All options other than alcoholic cirrhosis may have autoimmune etiologies and hence, may very well have coomb's positive haemolytic anemia as a .feature. Anemias which occur due to autoimmune destruction of RBCs are called autoimmune hemolytic anemia. The autoimmune destruction of RBC's is caused by the presence of autoantibodies against R.B.C. Coomb's test is used to detect the presence of these autoantibodies. So autoinimune hemolytic anemias are also known as coomb's positive hemolytic anemias. | train | med_mcqa | null |
Poal hypeension following poal vein thrombosis are guided by all except | [
"Increase in splenic pulp pressure",
"Increase in poal vein pressure",
"Increase in hepatic vein pressure",
"Poal vein Doppler study"
] | C | Splenic pulp pressure gives a measure of the poal vein pressure, it can be measured by inseing a needle percutaneously Poal vein Doppler study is the most useful Non-invasive investigation for assessing thrombosis of the main poal vein branches Ref: Sabiston 20th edition | train | med_mcqa | null |
A patient with suspected subarachnoid haemorrhage presents with blood isolated in the fourth ventricle on a CT scan. Aneurysmal rupture is likely to have resulted from - | [
"Posterior Inferior Cerebellar Artery Aneurysm",
"Anterior Communicating Artery Aneurysm",
"Posterior Communicating Artery Aneurysm",
"Basilar Artery Tip Aneurysm"
] | A | null | train | med_mcqa | null |
Gram (+)ve bacilli causing meningitis: | [
"Pneumococci",
"Listeria",
"E. coli",
"Meningococci"
] | B | Ans. (b) i.e. Listeria | train | med_mcqa | null |
Which of the following is most specific for cholestasis | [
"ALT",
"AST",
"GGT",
"5I nucleotidase"
] | D | It is most specific for cholestasis and cholestatic damage. | train | med_mcqa | null |
Periphery of retina is best visualized with the following method: | [
"Direct ophthalmoscopy",
"Indirect ophthalmoscopy",
"Retinoscopy",
"USG"
] | B | Advantages of indirect ophthalmoscopy: The brighter light source that permits much better visualization through cloudy media. By using both eyes, the examiner enjoys a stereoscopic view, allowing visualization of elevated masses or retinal detachment in three dimensions. It can be used to examine the entire retina, even out to its extreme periphery, the ora serrata. Ref: Chang D.F. (2011). Chapter 2. Ophthalmologic Examination. In P. Riordan-Eva, E.T. Cunningham, Jr. (Eds), Vaughan & Asbury's General Ophthalmology, 18e. | train | med_mcqa | null |
Which of the following drugs inhibits post translational modification of viral proteins ? | [
"Indinavir",
"Enfuvirtide",
"Lamivudine",
"Zalcitabine"
] | A | null | train | med_mcqa | null |
True about second messengers ? | [
"Act on intracellular receptors",
"Mediate response of extracellular hormones and neurotransmitter",
"Mediate response of intracellular hormones",
"Act by stimulation of transcription"
] | B | Ans. is 'b' i.e., Mediate response of extracellular hormones and neurotransmitter | train | med_mcqa | null |
Flea bitten appearance of the kidney is seen in- | [
"Malignant hypeension",
"Benign hypeension",
"Chronic pyelonephritis",
"Diabetes mellitus In an adult"
] | A | Causes of the flea-bitten kidney: Malignant hypeension Subacute bacterial endocarditis Rapidly progressive GN Henoch-Schonlein purpura. Ref: RAM DAS NAYAK EXAM PREPARATORY MANUAL FOR UNDERGRADUATES 2nd ed. pg no: 621 | train | med_mcqa | null |
A 20-year-old male presents with a rash on the scalp, (extensor) elbows, knees and umbilicus. The rash is sharply demarcated erythematous plaques with silvery scale in those locations; there is no central clearing. The soles of the feet are normal. What is the most likely diagnosis? | [
"Allergic contact dermatitis",
"Atopic dermatitis",
"Psoriasis",
"Lichen planus"
] | C | Psoriasis is chronic, immune-mediated inflammatory condition. Activation of T cells of the adaptive immune system, Th1 and Th17 cells, activate keratinocytes to proliferate and produce multiple chemokines and antimicrobial peptides. Genetic predisposition is present in Type1 Plaque psoriasis and Guttate psoriasis with HLA-C Initial Lesions Location of initial Lesions Other Findings Diagnostic Aids Treatment Psoriasis Pink-red, silvery scale, sharply demarcated Elbows, knees, scalp, presacral area, intergluteal fold Nail dystrophy, ahritis, pustules; SAPHO syndrome, especially with palmoplantar pustulosis Skin biopsy Topical glucocoicoids, Vitamin D; UV-B (narrowband) > PUVA (psoralen with UVA) Oral retinoid; MTX, Cyclosporine, Anti-TNF agents, anti-IL-12/23 Ab | train | med_mcqa | null |
Final product in anaerobic glycolysis - | [
"Pyruvate",
"Acetyl CoA",
"Lactate",
"Oxaloacetate"
] | C | Ans. is 'c' i.e.. Lactateo There are two types of glycolysis : -Aerobic glycolysis : - It occurs when oxygen is plentiful and the final product is pyruvate, i.e., final step is catalyzed by pyruvate kinase (see the cycle above). Which is later converted to acetyl CoA by oxidative decarboxylation. There is net gain oflATPs (will be discussed later). Acetyl CoA enters TCA cycle.Anaerobic glycolysis : - It occurs in the absence of oxygen. The pyruvate is fermented (reduced) to lactate in single stageQ. The reoxidation of NADH (formed in the glyceraldehyde-3-phosphate dehydrogenase step) by respiratory chain is prevented as same NADH is utilized at lactate dehydrogenase step. So. there is no net production of NADH. Thus, there is net gain of 2 ATP only. Unlike pyruvate which is converted to acetyl CoA to enter into krebs cycle, lactate cannot be further utilized by further metabolic pathways. Thus, lactate can be regareded as dead end in glycolysisQ. Anaerobic glycolysis occurs in exercising skeletal muscle, RBCs, lens, some region of retina, renal medulla, testis and leucocytes. | train | med_mcqa | null |
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.