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A patient is suffering from pneumonia. Laboratory study shows acid-fast filamentous bacterium. The causative organism is - | [
"M. tuberculosis",
"Actinomyces",
"Nocardia",
"Mycobacterium Avium intracellulare"
] | C | Ans. is 'c' i.e., Nocardia o Symptoms of pneumonia by a filamentous acid fast bacterium suggest the diagnosis of Nocardia.NOCARDIAMorphologyo Gram positiveo Acid fast(N. astroidesandN. brasiliensis)o Crooked, branching, beaded, filamentous.Cultureo Use paraffin as a carbon source:o Paraffin baiting is used for isolation.o Strict aerobeo They take 2 weeks to appear and show their characteristic appearance at about 4 weeks.Clinical manifestationNocardia infectionRespiratoryExtra pulmonaryAfter transcutaneousKeratitiso Pneumonia is most commono Empyemao Lung abscesso S.V.C. syndromeo Pericarditiso M.C. site is braino Other organs: kidney bone muscleo Typical manifestation is subacute abscessinoculationo Cellulitis\o Lymphocutaneous syndromeo Actinomycetomao Usually byN. asteroides Treatment# Sulfonamide---Drug of choice# Cotrimoxazole---Equivalent# Minocycline---Best alternative# Amikacin---DOC for parenteral useRemembero N. asteroides is the species most commonly associated with invasive disease. | train | med_mcqa | null |
Incomplete fractures are called as | [
"Woodcrumble fractures",
"Compression fractures",
"Greenstick fractures",
"Salter fractures"
] | C | Although in adults, the fracture line is generally complete, i.e. it extends through both cortices, in children the different mechanical qualities of the bone may lead to other patterns, in which the fracture line is incomplete. These are termed torus and greenstick fractures. | train | med_mcqa | null |
Indication for tracheostomy are all, EXCEPT: | [
"Flail chest",
"Head injury",
"Cardiac Tamponade",
"Foreign body"
] | C | Indications for tracheostomy are Flail chest, Head injury, Foreign body, Tetanus etc. Cardiac tamponade is not an indication for tracheostomy. | train | med_mcqa | null |
True about lung carcinoma - | [
"More than 75% of lung cancers are squamous cell type",
"Oat cell carcinoma frquently show cavitation",
"Lung calcification is characteristically seen in oat cell carcinoma",
"Oat cell carcinoma is commonly associated with bilateral hilar lymphadenopathy"
] | D | Ref:Textbook of pathology (Harsh mohan) 6th edition,page no.500 Oat cell carcinoma is composed of uniform, small cells, larger than lymphocytes with dense, round or oval nuclei having diffuse chromatin, inconspicuous nucleoli and very sparse cytoplasm (oat = a form of grain). These cells are organised into cords, aggregates and ribbons or around small blood vessels forming pseudorosettes.Theyare commonly associated with bilateral hilar lymphadenopathy. | train | med_mcqa | null |
True of carotid body tumor is ? | [
"Non-chromaffin paraganglioma",
"Good prognosis",
"Rarely metastasises",
"All"
] | D | Answer is 'a' i.e. Non-chromaffin Paraganglioma; 'b' i.e. Good Prognosis; 'c' i.e. Rarely metastasises | train | med_mcqa | null |
Bitten by krait. Manifestation would be: | [
"Neurotoxic",
"Myotoxic",
"Vasculotoxic",
"Cardiotoxic"
] | A | Ans. (a) NeurotoxicRef: The Essentials ofFSM by K.S. Narayan Reddy 31st ed. / 523Snakes and their respective poisoningSnakeType of poisoningVipersVasculotoxic, HemotoxicSea snakesMyotoxicCobra, KraitNeurotoxic | train | med_mcqa | null |
The protective effects of breast milk are known to be associated with ___________ | [
"IgM antibodies",
"Lysozyme",
"Mast cells",
"IgA antibodies"
] | D | Human milk contains high concentrations of secretory IgA that prevent microorganisms from adhering to the intestinal mucosa. These protect against many infections. Ref: Page 215; Nelson textbook of pediatrics; 18th edition | train | med_mcqa | null |
All are risk factors for HCC except:- | [
"HBV",
"HCV",
"Alcohol",
"IBS"
] | D | Conditions associated with hepatocellular carcinoma:- 1. Cirrhosis 2. Metabolic disease 3. Environmental Condition Condition Condition HBV HCV Alcohol Autoimmune chronic active hepatitis Cryptogenic cirrhosis Cirrhosis due to NAFLD Primary biliary cirrhosis Hereditary hemochromatosis Hereditary tyrosinemia Alpha-1 antitrypsin deficiency Ataxia telangiectasia Types 1 and 3 glycogen storage disease Galactosemia Hereditary hemorrhagic telengiectasia Porphyria cutanea tarda Wilson's disease Orotic aciduria Alagille's syndrome (congenital cholestatic sydnrome) Thorotrast( Thorium dioxide) Androgenic steroids Cigarette smoking Aflatoxin | train | med_mcqa | null |
Autism is characterised by all EXCEPT | [
"Motor abnormalities",
"Less eye contact",
"High intelligence",
"Unusual gestures"
] | C | (C) High intelligence # AUTISM is a neurodevelopmental disorder characterized by impaired social interaction, verbal and non-verbal communication, and by restricted and repetitive behavior.> Autistic infants show less attention to social stimuli, smile and look at others less often, and respond less to their own name.> Sensory abnormalities are found in over 90% of those with autism, and there is no good evidence that sensory symptoms differentiate autism from other developmental disorders.> 60%-80% of autistic people have motor signs that include poor muscle tone, poor motor planning, and toe walking, deficits in motor coordination are pervasive across ASD and are greater in autism proper. | train | med_mcqa | null |
Crepitus will be seen in the tissues surrounding an
infection by: | [
"Staphylococcus",
"Streptococcus",
"Clostridium tetani",
"C. perfringens"
] | D | CLOSTRIDIAL SKIN AND SOFT-TISSUE INFECTIONS
Histotoxic clostridial species such as C. perfringens, C. histolyticum, C. septicum, C. novyi, and C. sordellii cause aggressive necrotizing infections of the skin and soft tissues. These infections are attributable in part to the elaboration of bacterial proteases, phospholipases, and cytotoxins. Necrotizing clostridial soft-tissue infections are rapidly progressive and are characterized by marked tissue destruction, gas in the tissues, and shock; they frequently end in death. Severe pain, crepitus, brawny induration with rapid progression to skin sloughing, violaceous bullae, and marked tachycardia are characteristics found in the majority of patients. | train | med_mcqa | null |
Absent lateral third of clavicle is seen in | [
"Hypoparathyroidism",
"Turner's syndrome",
"Fibrous dysplasia",
"Cleidocranial dysostosis"
] | D | CLEIDOCRANIAL DYSPLASIA/DYSOSTOSIS (CCD)Autosomal recessive disease with faulty intramembranous bone ossificationLarge head with small face, abnormal dentition and drooping hypermobile shouldersRadiological features:Skulla. Platybasia b. Large foramen magnum c. Wormian bonesd. Persistent metopic suture e. 'Hot cross bun' skull f. BrachycephalyThoraxa. Agenesis or hypoplasia of clavicles b. Small winged scapulaePelvisa. Underdeveloped pelvis b. Coxa valgus earlySpinea. Biconvex veebrae b. HemiveebraeExtremitiesElongated 2nd metacarpalD/d: pyknodysostosis (confused with CCD because of similar clavicular and skull changes, and pyknodysostosis is also confused with osteopetrosis because generalized increase in bone density, however these patients are not sho which differentiate it from CCD) | train | med_mcqa | null |
Third window effect is seen in: | [
"Perforated tympanum",
"Dehiscent superior semicircular canal",
"Round window",
"Oval window"
] | B | Ans. b. Dehiscent superior semicircular canal (Ref: www.utmb.edu/otoref/gmds/third%20window-061108/third-window-slides-061108.pdf)Third window effect is seen in dehiscent superior semicircular Canal.Absence of the bone overlying the superior semicircular canal resulting in a third window to the membranous labyrinth that may result in a syndrome of vestibular and auditory symptomsQ.Superior Canal DehiscenceAbsence of the bone overlying the superior semicircular canal resulting in a third window to the membranous labyrinth that may result in a syndrome of vestibular and auditory symptomsQ.Syndrome was first described by Minor in 1988.Sound or pressure induced vertigo due to bone dehiscence of the superior semicircular canalQ (Arch of Otolaryngology, Head and Neck Surgery)Third Window Hypothesis:In superior semicircular canal dehiscence, it is hypothesized that some fractions of the perilymphatic volume displaced by the oscillating stapes is shunted through the superior canal away from the cochlea, resulting in a decrease in the sound conducted to cochlea.Dehiscence of Superior Semicircular Canal Results inSound and pressure induced vestibular symptomsIncreased sensitivity of bone conducted soundDecreased sensitivity of air conducted sound | train | med_mcqa | null |
HACEK group of organism includes all except | [
"Haemophilus aphrophilus",
"Acinctobacter baumannii",
"Cardiobacterium hominis",
"Eikenella corrodens"
] | B | Acinetobacter baumannii Repeat from May 2008 | train | med_mcqa | null |
Sodium channel is | [
"Trimeric",
"Pentameric",
"Heterotrimeric",
"Pseudoterameic"
] | C | Ans. (c) HeterotrimericNa K pump has 2 subunits and both the subunits are different. That's why it is called as a heterodimerIt can contain one alpha, one beta and one gamma subunit also - so, heterotrimeric | train | med_mcqa | null |
All are true regarding interleukin-1 except ? | [
"Primary source is monocyte-macrophage system",
"Endogenous pyrogens",
"Inhibit IL-2 production by T-cells",
"All are true"
] | C | Ans. is 'c' i.e., Inhibit IL-2 production by T-cells Interleukin -1 Also known as leucocyte activating factor (LAF) or B cell activating factor (BAF). Principally secreted by macrophages and monocytes; and epithelial cells. Other sources are B lymphocytes, fibroblasts and endothelial cells. Immunological effects- Activation of T cells for the production of IL - 2. B cell proliferation and antibody synthesis Neutrophil chemotaxis and increased PMN release from bone marrow. Increases body temperature (impoant endogenous pyrogen). Bone marrow cell proliferation Induction of acute phase protein. | train | med_mcqa | null |
The orifice of the parotid duct is located: | [
"At the hamular notch",
"In proximity to the incisive papillae",
"On the buccal mucosa near the maxillary second molar",
"Slightly posterior to the mandibular central incisors"
] | C | null | train | med_mcqa | null |
Sensory organ for responding to texture is: September 2009 | [
"Meissner corpuscles",
"Merkel cells",
"Ruffini corpuscles",
"Pacician corpuscles"
] | A | Ans. A: Meissner corpuscles Sensory organs and their responses: Meissner corpuscles-Responds to changes in texture and slow vibrations Merkel cells-responds to sustained pressure and touch Ruffini corpuscles-respond to sustained pressure Pacician corpuscles-respond to deep pressure and fast vibration | train | med_mcqa | null |
A gangster was brought to the casualty after a fight. He had multiple injuries. Some stab wound were showing 'Fish tailing'. This appearence of the wound is seen in injury with: | [
"Single edged knife",
"Double edged knife",
"Bayonet",
"Blunt object"
] | A | When a single-edged weapon is used, the surface wound will be triangular or wedge-shaped, and one angle of the wound will be sharp, the other rounded, blunt or squared off. Blunt end of the wound may have small splits (often in two places) in the skin, so called "fish tailing", if the back edge of the blade is stout. Ref: The Essentials of Forensic Medicine and Toxicology by Dr. K. S. Narayan Reddy, 27th edition, Page 176. | train | med_mcqa | null |
Anti-phospholipid antibodies are not tested in? | [
"IUGR",
"Mild Pre eclampsia",
"Recurrent abortion",
"Polyhydramnios"
] | D | ANSWER: (D) PolyhydramniosREF: Danforth's Obstetrics and Gynecology, 10th Edition P. 335Clinical Features of Antiphospholipid syndrome:Original descriptions of women with APS featured fetal losses (>1G menstrual weeks gestation). In addition, APS is associated with other pregnancy complications, including gestational hypertension or preeclampsia and uteroplacental insufficiency as manifested by fetal growth restriction, oligohydramnios, and nonreassuring fetal surveillance. Obstetric complications other than pregnancy loss appear to persist despite treatment. There have been some attempts to link infertility and failure of in vitro fertilization (IVF) to the presence of aPL antibodies. However, the preponderance of evidence fails to support such a relationship. | train | med_mcqa | null |
Which of the following will manifest as "patchy meningitis" heamorrhaegica Interna | [
"Epidural haematoma",
"Subdural haematoma",
"Subarachonoid haemorrhage",
"Brain infraction"
] | B | Chronic subdural hematoma Virchow, in 1857, denied a traumatic origin, gave the name of "patchy meningitis hemorrhagica intern" to this pathology which he explained by Inflammatory processes The traumatic etiology of Chronic subdural hematoma was recognized in the 20th century, especially by Trotter in 1914 Ref: www.ncbi.nlm.nih.gov/pubmed/11915757 by M Guenot - 2001 | train | med_mcqa | null |
Clinical signs of Hydramnios can be demonstrated when fluid collection is more than : | [
"1 Itr.",
"2 ltr.",
"3 ltr.",
"4 ltr."
] | B | 2 ltr. | train | med_mcqa | null |
Recurrent laryngeal nerve supplies all of the following muscles except: September 2005 | [
"Cricothyroid",
"Lateral cricoarytenoid",
"Posterior cricoarytenoid",
"Thyroepiglotticus"
] | A | Cricothyroid | train | med_mcqa | null |
Which of the following is not seen in exudative type of ascites? | [
"Protein > 2.5 gm/dl",
"Specific gravity > 1.016",
"SAAG> 1.1 gm/dl",
"None of the above"
] | C | Ans: c (SAAG >1.1 gm/dl) Ref: Harrison, 16th ed, p. 245,17th ed, p.In exudative ascites SAAG <1.1SAAG is serum ascites albumin gradient. It is the difference between serum albumin and ascitic fluid albumin. In exudative ascites, the ascitic fluid albumin is more so S AAG is less than 1.1 gm/dlExudative ascitesProtein concentration > 2.5 gm/dlSpecific gravity >1.016SAAG< 1.1 gm/dlTransudative ascitesProtein concentration < 2.5 gm/dlSpecific gravity < 1.016S AAG > 1.1 gm/dlCauses of exudative ascitesTuberculousMalignantBacterial peritonitisPancreatic ascitesCauses of transudative ascitesCirrhosis and portal hypertensionCongestive cardiac failureNephrotic syndromeConstrictive pericarditisBeriberiHypoproteinaemiaInferior venacaval obstructionCauses of chylous ascitesTraumaTumorTuberculosisFilariasisNote:Ascitic amylase activity > 1000 U/l is suggestive of pancreatic ascitesIn spontaneous bacterial peritonitis polymorphonuclear leucocyte count > 250/cubic mm-Mucinous ascites is seen in Pseudomyxoma peritonei | train | med_mcqa | null |
p ANCA associated vasculitis is - | [
"Temporal arteritis",
"Microscopic polyangitis",
"Takayasu arteritis",
"Polyarteritis nodosa"
] | B | Arts, is 'b' i.e., Microscopic polyangitis Classification of VasculitisLarge-VesselMedium-VesselSmall-VesselTemporal arteritisTakayasu arteritisPolyarteritis nodosaKawasaki disease ANCA-positiveANC A-n egativeWegener .V granulomatosisM icroscopic polyarteritisChurg-strauss syndromeRenal-limited vasculitisHenoch-Scholien purpuraEssential cryoglobidinemic vasculitisCutaneous leucocyto angitisBehcets syndrome cANCA predominant ANCA inWegener s granulomatosispANCA Predominant ANCA inMicroscopic polyangitisChwg-Strauss syndromeCrescentric glomerulonephritisRenal-limited vasculitisGood pasture syndrome | train | med_mcqa | null |
False about hepatic adenoma | [
"Chance of malignancy in 10% cases",
"Rupture in 20% cases",
"Hepatic architecture is maintained",
"Most patients are symptomatic"
] | C | Clinical features Symptomatic ( upper abdominal pain) in 50-75%, related to hemorrhage or local compressive symptoms Two major risks - Rupture and malignant transformation Pathology Composed of cords of benign hepatocytes containing increased glycogen and fat, without bile ductules, fibrous septa, poal tracts or central vein Normal architecture of the liver is not seen in these lesions Central large plates of hepatocytes separated by dilated sinusoids which are perfused solely by peripheral aerial feeding vessels(lack poal venous supply), under aerial pressure Hemorrhage and necrosis are commonly seen | train | med_mcqa | null |
Protoporphyrin levels >100 mg/dl indicates: | [
"Iron overload",
"Lead poisoning",
"Porphyria",
"All of the above"
] | B | Protoporphyrin is an intermediate in the pathway to heme synthesis. Under conditions in which heme synthesis is impaired, protoporphyrin accumulates within the red cell. This reflects an inadequate iron supply to erythroid precursors to suppo haemoglobin synthesis. Normal values are <30 mg/dL of red cells. In iron deficiency, values in excess of 100 mg/dL are seen. The most common causes of increased red cell protoporphyrin levels are absolute or relative iron deficiency and lead poisoning. Ref: Harrison's principle of internal medicine 17th edition, chapter 98. | train | med_mcqa | null |
Loss of pulmonary surfactant in premature infant ? | [
"Pulmonary edema",
"Collapse of alveoli",
"Elastic recoil of lungs",
"All"
] | D | Ans. is 'a' i.e., Pulmonary edema; 'b' i.e., Collapse of alveoli & 'c' i.e., Elastic recoil of lungs Effects of surfactant deficiency o Decreased compliance Increased elastic recoil o Atelectasis o Interstitial edema o Hyaline membrane formation | train | med_mcqa | null |
A patient presents in coma for 20 days, what will be the best way to give him nutrition? | [
"Parenteral nutrition",
"Ryle's tube feeding",
"Feeding via jejunostomy",
"Oral feeding"
] | C | ANSWER: (C) Feeding via jejunostomyREF: European Journal of Anaesthesiology: January 1998 - Volume 15 - Issue - pp 94-96Oral feeding is rarely applicable to comatose patients. Early enteral (EN) nutrition through a nasoduodenal or nasojejunal tube will overcome the problem of delayed gastric emptying. Patients requiring enteral feeding on a long-term basis should have a gastrostomy or gastrojejunostomy tube placed,Parenteral nutrition (PN) is indicated when a patient's gastrointestinal tract does not tolerate full enteral feeding or when the access to the GI tract is difficult after head and neck trauma. Parenteral nutrition may be administered as central venous nutrition (expected duration of PN > 7 days) or as peripheral venous nutrition (short-term PN < 7 days).(Note: When GI tract is healthy, use it) Sabiston Textbook of Surgery, 18th ed.OPTIONS FOR ENTERAL FEEDING ACCESSAccess OptionCommentsNasogastric tubeShort-term use only (<30 days); aspiration risks; nasopharyngeal trauma; frequent dislodgmentNasoduodenal/nasojejunal tubeShort-term use (<30 days); lower aspiration risks in jejunum; placement challenges (radiographic assistance often necessary)Percutaneous endoscopic gastrostomy (PEG)Endoscopy skills required; may be used impaired swallowing mechanisms, oropharyngeal or esophageal obstruction, and major facial trauma; aspiration risks; can last 12-24 months; slightly higher complication rates with placement and site leaksSurgical gastrostomyRequires general anesthesia and small laparotomy; procedure may allow placement of extended duodenal/jejunal feeding ports; laparoscopic placement possibleFluoroscopic gastrostomyBlind placement using needle and T-prongs to anchor to stomach; can thread smaller catheter through gastrostomy into duodenum/jejunum under fluoroscopyPEG-jejunal tubeJejunal placement with regular endoscope is operator dependent; jejunal tube often dislodges retrograde; two-stage procedure with PEG placement, followed by fluoroscopic conversion with jejunal feeding tube through PEGDirect percutaneous endoscopic jejunostomy (DPEJ)Direct endoscopic tube placement with enteroscope; placement challenges; greater injury risks. Used in patients who cannot tolerate gastric feedings or who have significant aspiration risksSurgical jejunostomyCommonly carried out during laparotomy; general anesthesia; laparoscopic placement usually requires assistant to thread catheter; laparoscopy offersFluoroscopic jejunostomydirect visualization of catheter placementDifficult approach with injury risks; not commonly doneINDICATIONS OF PARENTERAL NUTRITION:Schwartz's Principles of Surgery 9th edition chapter 2 SystemicResponse to Injury and Metabolic Support1. Newborn infants with catastrophic gastrointestinal anomalies, such as tracheoesophageal fistula, gastroschisis, omphalocele, or massive intestinal atresia2. Infants who fail to thrive due to gastrointestinal insufficiency associated with short-bowel syndrome, malabsorption, enzyme deficiency, meconium ileus, or idiopathic diarrhea3. Adult patients with short-bowel syndrome secondary to massive small-bowel resection (<100 cm without colon or ileocecal valve, or <50 cm with Intact ileocecal valve and colon)Patients with enteroenteric, enterocolic, enterovesical, or high-output enterocutaneous fistulas (>500 mL/d)Infants who fail to thrive due to gastrointestinal insufficiency associated with short-bowel syndrome, malabsorption, enzyme deficiency, meconium ileus, or idiopathic diarrheaPatients with normal bowel length but with malabsorption secondary to sprue, hypoproteinemia, enzyme or pancreatic insufficiency, regional enteritis, or ulcerative colitisAdult patients with functional gastrointestinal disorders such as esophageal dyskinesia after cerebrovascular accident, idiopathic diarrhea, psychogenic vomiting, or anorexia nervosaPatients with granulomatous colitis, ulcerative colitis, or tuberculous enteritis in which major portions of the absorptive mucosa are diseasedPatients with malignancy, with or without cachexia, in whom malnutrition might jeopardize successful use of a therapeutic optionPatients in whom attempts to provide adequate calories by enteral tube feedings or high residuals have failedCritically ill patients wfio are hypermetabolic for > 5 days or for whom enteral nutrition is not feasible | train | med_mcqa | null |
Which of the following statement about thiamine is true? | [
"It is a co-enzyme of lactate dehydrogenase",
"Its deficiency is associated with scurvy",
"Its co-enzyme function is done by thiamine monophosphate",
"It is co-enzyme for pyruvate dehydrogenase and a-ketoglutarate dehydrogenase"
] | D | Ans. is 'd' i.e. it is co-enzyme for pyruvate dehydrogenase and a-ketoglutarate dehydrogenase Thiamine was the first vitamin to be identified and is therefore called as vitamin Bl.Thiamine has a central role in energy-yielding metabolism and especially the metabolism of carbohydrates.Thiamine pyrophosphate (also k/a thiamine diphosphate) is the biologically active form of the vitamin.Thiamine diphosphate is the coenzyme for:3 multi-enzyme complexes that catalyzes oxidative decarboxylation reactions.pyruvate dehydrogenase complex (catalyzes oxidative decarboxylation of pyruvate to acetyl-CoA)a-ketoglutarate dehydrogenase in the citric acid cycle andbranched chain keto-acid dehydrogenase involved in the metabolism of leucine, isoleucine and valine.Transketolase, in the pentose phosphate pathway.The oxidative decarboxylation of pyruvate and a-ketoglutarate play a key role in energy metabolism of most cells.In thiamine deficiency, the activity of these two dehydrogenase reactions is decreased, resulting in a decreased production of ATP and thus, impaired cellular function.Thiamine DeficiencyThiamine deficiency in its early stages causes anorexia, muscle cramps, paraesthesias, and irritability.Prolonged thiamine deficiency causes beriberi, which is classically categorized as wet or dry, though there is considerable overlap.Wet beriberi primarily presents with cardiovascular symptoms characterized by marked peripheral vasodilation resulting in high-output heart failure with dyspnea, tachycardia, cardiomegaly, and pulmonary and peripheral edema, with warm extremities mimicking cellulitis.Dry beriberi presents with a symmetric peripheral neuropathy of the motor and sensory systems with diminished reflexes. The neuropathy affects the legs more than the arms.Alcoholic patients with chronic thiamine deficiency may also have central nervous system manifestations known as Wernicke's encephalopathy, consisting of horizontal nystagmus, ophthalmoplegia, cerebellar ataxia, and mental impairment. When there is additional loss of memory and a confabulatory psychosis, the syndrome is known as Wernicke-Korsakoff syndrome.The laboratory diagnosis of thiamine deficiency is usually made by enzymatic assay of transketolase activity measured before and after the addition of thiamine pyrophosphate.A more than 25% stimulation of the transketolase activity by the addition of thiamine pyrophosphate is taken as abnormal. | train | med_mcqa | null |
Leptospirosis, all are true except | [
"Faeces & urine of rodents is the cause",
"onset of IgM in 2 days",
"Incubation period is 10 days",
"It is sensitive to penicillin"
] | B | null | train | med_mcqa | null |
Which of the following is not true regarding this intracranial haematoma? | [
"Lucid interval may be seen",
"Bridging veins are ruptured",
"Mostly traumatic in origin",
"Contre coup injury not seen"
] | B | Ans. (B). Bridging veins are rupturedPhotograph shows extra dural hematoms; bleeding outside the dura and compressing the underlying brainparenchyma.The source of extradural hematoma is middle meningeal artery | train | med_mcqa | null |
Inspissation is used for - | [
"Sputum",
"Protein containing culture medium",
"Serum containing culture medium",
"Plasma sterilization"
] | B | Ans. is "b' i.e., protein containing culture medium Inspissationo It is heat exposure method that is employed with high protein material, like egg containing media, that cannot withstand the high temperature used in autoclaving,o The medium is exposed to 80degC for 30 minutes for three successive days in inspissator.o It can be used for LJ medium and loeffler serum slop. | train | med_mcqa | null |
A knife wound has severed the oculomotor nerve in a 45 year old man. Which of the following conditions will occur because of this injury? | [
"Constricted pupil",
"Abduction of the eyeball",
"Complete ptosis",
"Paralysis of the ciliary muscle"
] | D | Paralysis of III NERVE Ptosis Mydriasis Ophthalmoplegia Diplopia Loss of accomdation reflex CHOICE EXPLANATION & ELIMINATION REASON 1 Constricted pupil - due to dilator pupil lesion sympathetic fibres lesion 2 Abduction - due to medial rectus injury 3 Lesion of III nerve will not cause complete Ptosis . elevation of eyelid also by tarsal muscles - supplied by sympathetic fibres 4 Ciliary muscles supplied by III Nerve | train | med_mcqa | null |
Retinal detachment is preceeded by: | [
"Floaters and flashes",
"Eales' disease",
"Trauma",
"All of the above"
] | D | Ans. All of the above | train | med_mcqa | null |
What does Gettlers test detects - | [
"Diatoms in drowning",
"Chloride content of blood in drowning",
"Weight in drowning",
"None"
] | B | Reff: The synopsis of forensic medicine & Toxicology 28th edition pg: 194 In 1921, Gettler published a test for drowning from right and left hea chambers, a difference of 25mg/100ml between the chlorides concentrations of the two sides of the hea indicated that the death was due to drowning. In freshwater drowning the chloride level in the blood in the left side of the hea was lower than in the right side; the reverse situation was noted in saltwater drowning. Positive is seen in seawater drowning due to hemoconcentration and negative in fresh water drowning due to hemodilution. | train | med_mcqa | null |
A patient of head injury was brought to the hospital. Patient was conscious having clear nasal discharge through right nostril. NCCT head was done which revealed non-operable injury to frontobasal area. What is the most appropriate management? | [
"Wait and watch for 4-5 days to allow spontaneous healing",
"Do an MRI to localize the leak and control the discharge endoscopically",
"Put a dural catheter to control CSF leak",
"Approach transcranially to repair the damaged frontobasal region"
] | A | Ans. a. Wait and watch for 4-5 days to allow spontaneous healing The most appropriate management of a conscious patient of head injury with clear nasal discharge through right nostril with non-operable injury to frontobasal area on NCCT head is wait and watch for 4-5 days to allow spontaneous healing. `Early cases of post-traumatic CSF rhinorrhea are managed conservatively by placing the patient in the semi-sitting position, avoiding blowing of nose, sneezing and straining. Prophylactic antibiotics are also administered to prevent meningitis. Persistent cases of CSF rhinorrhea are treated surgically by nasal endoscopic or intracranial approach. Nasal endoscopic approach is useful for leaks from the frontal sinus, cribriform plate, ethmoid or sphenoid sinuses.'] CSF Rhinorrhea The underlying defect responsible for CSF leaks, regardless of the etiology: disruption in the arachnoid and dura mater coupled with an osseous defect and a CSF pressure gradient that is continuously or intermittently greater than the tensile strength of the disrupted tissue. Etiology: Penetrating and closed-head trauma are responsible for 90% of all cases of CSF leaksQ Clinical features: CSF rhinorrhea following a traumatic injury is classified as immediate (within 48 hours) or delayedQ The majority of patients with a CSF leak due to accidental trauma (e.g., motor vehicle accident) present Most of the patients (95%) with a delayed CSF leak present within 3 months after the injuryQ The typical history of a CSF leak is that of clear, watery discharge, usually unilateralQ Diagnosis is made more easily in patients with recent trauma or surgery than in others Treatment Early cases of post-traumatic CSF rhinorrhoea are managed conservatively by placing the patient in the semi-sitting position, avoiding blowing of nose, sneezing and straininge. Prophylactic antibiotics are also administered to prevent meningitis. Persistent cases of CSF rhinorrhoea are treated surgically by nasal endoscopic or intracranial approache. Nasal endoscopic approach is useful for leaks from the frontal sinus, cribriform plate, ethmoid or sphenoid sinuses | train | med_mcqa | null |
The rate adjusted to allow for the age distribution of the population is | [
"Age- standardized mortality rate",
"Peri-natal mortality rate",
"Fertility rate",
"Crude mortality rate"
] | A | null | train | med_mcqa | null |
A 26-year-old primigravida diagnosed with severe rheumatic heart disease (Mitral stenosis with mitral regurgitation) is in early labour. The obstetrician wants to try a normal labour. Which of the following is the best labour analgesia for this patient? | [
"Parenteral opioids",
"Neuraxial analgesia",
"Inhalational anesthesia",
"Spinal anesthesia"
] | B | Ans- B Neuraxial analgesia Neuraxial analgesia reduces preload and afterload and reduces catecholamine surge and reduces heart rate. It also gives perineal analgesia and removes the urge to push. | train | med_mcqa | null |
Hydroxyethyl starch is used as: | [
"Plasma expander",
"Inotropic agent",
"Vasodilator",
"Type of dextran"
] | A | It is a blood volume expander used in treatment of hypovolemia; adjunct in leukapheresis to improve harvesting and increase the yield of granulocytes by centrifugation. Mechanism of Action: Produces plasma volume expansion by viue of its highly colloidal starch structure. Onset of action: Volume expansion: I.V.: Approximately 30 minutes. Contraindications: Renal failure with oliguria or anuria (not related to hypovolemia); any fluid overload condition (eg, pulmonary edema, congestive hea failure); pre-existing coagulation or bleeding disorders. Ref: Wang S. (2012). Chapter 116. Paracentesis. In G.V. Lawry, S.C. McKean, J. Matloff, J.J. Ross, D.D. Dressler, D.J. Brotman, J.S. Ginsberg (Eds), Principles and Practice of Hospital Medicine. | train | med_mcqa | null |
Tubocurarine action is easily reversed by | [
"Atropine",
"Neostigmine",
"Edrophonium",
"Galamin"
] | B | . | train | med_mcqa | null |
Pheochromocytoma is the disease of: | [
"Pituitary gland",
"Adrenal medulla",
"Pancreas",
"Adrenal cortex"
] | B | b. Adrenal medulla(Ref: Nelson's 20/e p 2227-2729, Ghai 8/e p 525)Pheochromocytoma is a neoplasms of chromaffin cells in medulla that release catecholamines. | train | med_mcqa | null |
Which of the following does not dependent on insulin GLUT4 for glucose uptake? | [
"Brain",
"Skeletal muscles",
"Cardiac muscle",
"Adipose tissue"
] | A | Tissue-like brain is still able to impo glucose from the serum through maintaining a basal level glucose receptors on the cell surface.The general picture is as follows :Glucose is hydrophilic and cannot cross cell membrane most cell have membrane proteins that can shuttle glucose from one side to otherRef: DM Vasudevan, 7th edition, page no: 318 | train | med_mcqa | null |
Vector for Kala-azar- | [
"Flea",
"Tsetse fly",
"Sand fly",
"Tick"
] | C | 2 hosts Man and dog-veebrate host Female sandfly of the genus phlebotomous-intermediate host (refer pgno:39 baveja 3 rd edition) | train | med_mcqa | null |
Time interval between inoculation of infection to maximum infectivity is - | [
"Lead time",
"Median incubation period",
"Generation time",
"Serial inverval"
] | C | An infection becomes apparent only after a ceain incubation period which is defined as the time interval between invasion by an epidemiological agent and the appearance of first sign or symptoms. During incubation period the infectious agent undergoes multiplication in the host Incubation period is of fundamental impoance in epidemiological study tracing the source of infection and contacts Period of surveillance Immunization Identifying point source or propagated epidemics Prognosis (refer pgno:100 park 23rd edition) | train | med_mcqa | null |
First PM change in a dead body:- | [
"Maggot formation",
"Putrefaction",
"Greenish discoloration of right iliac fossa",
"Mummification"
] | C | First postmoem change in dead body is greenish discoloration of right iliac fossa * It's because of presence of caecum * Its first external site of putrefaction (Right Iliac Fossa) | H2S + Hb - sulf. Hb - green. * 1st internal site - Intima of aoic lumen (Reddish brown discoloration) * Most imp. bacteria involved in putrefaction - Clostridium welchi | train | med_mcqa | null |
Marquis test is done for: BHU 08 | [
"Mercury poisoning",
"Arsenic poisoning",
"Morphine poisoning",
"Cyanide poisoning"
] | C | Ans. Morphine poisoning | train | med_mcqa | null |
Which of the following indicators involve repro ductive woman | [
"G.F.R",
"Birth Rate",
"T.F.R",
"Maternal mortality rate"
] | A | null | train | med_mcqa | null |
What is the most likely diagnosis in a neonate with multiple, healed fractures of long bones? | [
"Osteomalacia",
"Osteogenesis imperfecta",
"Osteopetrosis",
"Congenital rickets"
] | B | Osteogenesis imperfecta (Fragilitas ossium, Vrolik's disease) is a condition characterised by frequent fractures (which unite normally) because of weak and brittle bones resulting from defective collagen synthesis. It is commonly inherited as an autosomal dominant disorder. It also affects skin, sclera, teeth, ligaments etc. leading to the blue sclera, joint laxity and otosclerosis in adulthood.
Rickets is characterised by failure of mineralisation, seen prominently at the growth plates, resulting in softening of the bones and development of deformities. Osteomalacia is the adult counterpart of rickets. Osteopetrosis is characterised by dense but brittle bones(marble bones) with a tendency to fracture. | train | med_mcqa | null |
What is the clearance of a substance when its concentration in the plasma is 10mg/dl, its concentration in the urine is 100mg/dl and urine flow is 2ml/min? | [
"0.2ml/min",
"2ml/min",
"20ml/min",
"200ml/min"
] | C | The Clearance of a Substance &;X&; is equal to the concentration of substance X in urine (UX) times the urine flow per unit of time (V) divided by the aerial plasma level of X (PX), or UXV/PX.This value is called the clearance of X (CX).Coming to the above question: 100 mg/dl X 2 ml/min / 10 mg/dl = 20 ml/min. | train | med_mcqa | null |
Drug of choice for whooping cough | [
"Azithromycin",
"Erythromycin",
"Rifampicin",
"Tetracyclin"
] | B | null | train | med_mcqa | null |
In which of the following location, carcinoid tumor is most common | [
"Esophagus",
"Stomach",
"Small bowel",
"Appendix"
] | C | Ans is 'c' ie Small bowel | train | med_mcqa | null |
All are louse borne diseases except: | [
"Epidemic relapsing fever",
"Epidemic typhus",
"Endemic typhus",
"Trench fever"
] | C | Ans. C. Endemic typhusFlea borne endemic typhus is caused by Rickettsia typhi. Trench fever - Bartonella Quintana, Epidemic relapsing fever -Borrelia recurrentis, Epidemic typhus - Rickettsia prowazekii | train | med_mcqa | null |
What is the rate of BER in the stomach? | [
"About 1.5/min in the stomach.",
"About 15/min in the stomach.",
"About 4/min in the stomach.",
"About 0.4/min in the stomach."
] | C | About 4/min in the stomach. Basic Electrical Rhythm (BER): Smooth muscle cells of the gastrointestinal tract have spontaneous rhythmic fluctuations in membrane potential between about -65 and -45 mV. BER initiated by Pacemaker cells called "Interstitial cells of Cajal" Metrics: The threshold for the action potential is -50 mV. The rate of BER: About 4/min in the stomach. About 12/min in duodenum About 8/min - distal ileum (falls down) In Colon: Rate rises from about 2/min at Cecum -----------> about 6 min at the Sigmoid colon. | train | med_mcqa | null |
Muscles of tongue develop from? | [
"Occipital myotome",
"Cervical myotome",
"Thoracic myotome",
"Pharyngeal arches"
] | A | ANSWER: (A) Occipital myotomeREF: Langman's Medical Embryology 11th edition pg. 150 table 10.2The number of somites is one of the criteria for determining age of the embryo. Somites further differentiate into these components:Sclerotome forms the cartilage and bone components of the vertebral column.Myotome forms epimeric and hypomeric muscles.Dermatome forms dermis and subcutaneous area of skin.All voluntary muscles of the head region are derived from paraxial mesoderm (somitomeres and somites), including musculature of the tongue (somite 2 to 5 constituting the occipital myotome)Cervical myotomes, after dividing into primaxial and abaxial domains, develop into the upper limb musculatureThoracic myotomes mainly develop the chest wall and abdominal muscles.Muscular component of the pharyngeal arches gives rise to the muscles of mastication, facial expression, pharyngeal and intrinsic laryngeal muscles, palatine muscles, stapedius, tensor tympani, cricothyroid. | train | med_mcqa | null |
In congenital dystrophic variety of epidermolysis bullosa, mutation is seen in the gene conding for – | [
"Laminin 4",
"Collagen type 7",
"Alpha 6 integerin",
"Keratin 14"
] | B | Dystrophic epidermolysis bullosa (dermal type EB) there is defect in the enzyme collegenase and type 7 collegan. | train | med_mcqa | null |
In pin retained amalgam restoration, failure is more likely to occur at the | [
"Pin restoration interface",
"Pin dentin interface",
"Both of the above",
"Inside of restoration (Restoration fracture)"
] | B | null | train | med_mcqa | null |
An 18-year-old male presented with acute onset descending paralysis of 3 days duration. There is also a history of blurring of vision for the same duration. On examination, the patient has quadriparesis with are flexia. Both the pupils are non-reactive. The most probable diagnosis is : | [
"Poliornyelitis",
"Botulism",
"Diphtheria",
"Porphyria"
] | B | Answer is B (Botulism) The clinical picture of the patient in question is consistent with a diagnosis of botulism. Symmetric descending paralysis is characteristic. Dizziness, Blurred vision and thy mouth are common. Ptosis is frequent. The papillary reflexes may be depressed and fixed or dilated pupils are noted in half of patients. - Regarding clinical manifestations of Botulism; Harrison 16th / 843 Characteristics of Botulism : CMDT 2006 / 1410; Harrison 16th / 843 History ofrecent ingestion of home canned or smoked food or injection of drug. Symmetric descending paralysis with prominent bulbar palsy 'D' of Bulbar palsy: `D'iplopia 'D 'ysahria `D'ysphonia `D'ysphogia Pupils are fixed and dilated in most cases - CMDT Ttosis, cranial nerve palsies with impairment of extraocular muscles and fixed dilated pupils are characteristic signs' - CMDT Normal sensory examination normal sensorium (not confused) Afebrile (Temperature remains normal)Q (Because Botulism is not an 'infection' but on 'intoxication' manifestation are due to the effect of toxin. Patient remains without fever until secondary infection is acquired). Diphteria Poliomyelitis, & Porphyria may all present with descending paralysis and bulbar palsy but fixed dilated pupils are characteristic of Botulism. | train | med_mcqa | null |
Most crucial part of tuberculosis control programme is - | [
"Contact tracing",
"BCG vaccination",
"Treatment of sputum positive cases",
"Treatment of X-ray positive cases"
] | C | The most powerful weapon in tuberculosis control is → case finding and lit.
Cases are defined by WHO as a patient whose sputum is positive for tubercle bacilli. | train | med_mcqa | null |
Brucella melitensis is commonly found in which animal? | [
"Pig",
"Dog",
"Cattle",
"Goat"
] | D | Most human infections in various pas of India are due to B.melitensis acquired from goat and sheep. Ref: Textbook of microbiology; Ananthanarayan and paniker's; 10th edition; Pg:348 | train | med_mcqa | null |
Untrue about mivacurium | [
"Metabolized by pseudocholinesterase",
"Releases histamine",
"Onset of action is early",
"Sho duration of action"
] | C | Onset of action is early Mivacurium is the non-depolarizing muscle relax, metabolized by pseudocholinesterase. The main advantage is its sho duration of action (5-10 minutes) but onset is slow (2-3 minutes). Rerf: KD Tripathi 8th ed. | train | med_mcqa | null |
In which of the following tissues, is glycogen incapable of contributing directly to blood glucose: | [
"Liver",
"Muscle",
"Both",
"None"
] | B | Ans. B. Muscle(Ref: Harper 29/e page 180, Harper 31/e page 164)Differences between liver Glycogen and Muscle GlycogenFeaturesLiverMuscleTotal Body Glycogen contentLessHighestPercentage by tissue weightHighestLessRegulation of blood glucoseContributes to blood GlucoseDoes not contribute to blood Glucose | train | med_mcqa | null |
Kamla, age 48 yrs, presents with unilateral mild axial proptosis. There is no redness or pain. Investigation of choice is: | [
"T3&T4 measurements to rule out thyrotoxicosis",
"CT scan to rule out meningioma",
"Doppler to rule out hemangioma",
"USG to rule out orbital pseudotumor"
] | A | All of the above conditions can cause proptosis. But, Graves' ophthalmopathy is the most common cause of unilateral or bilateral proptosis in adults or children. Orbital inflammation and engorgement of the extraocular muscles, paicularly the medial rectus and the inferior rectus, account for the protrusion of the globe. The accompanying upper eyelid retraction, manifesting as dispropoionately greater exposure of sclera superiorly than inferiorly, and lid lag, manifesting as impaired descent of the upper eyelid on downward gaze, distinguishes it from other causes of proptosis. Ref: Sullivan J.H. (2011). Chapter 13. Orbit. In P. Riordan-Eva, E.T. Cunningham, Jr. (Eds), Vaughan & Asbury's General Ophthalmology, 18e. | train | med_mcqa | null |
Which of the following is not derivative of mesoderm ? | [
"Ureter",
"Gall bladder",
"Uterus",
"Epididymis"
] | B | null | train | med_mcqa | null |
Dietary fibres are rich in: March 2005 | [
"Collagen",
"Proteoglycan",
"Pectin",
"Starch"
] | C | Ans. C: Pectin Chemically, dietary fiber consists of non-starch polysaccharides such as arabinoxylans, cellulose and many other plant components such as dextrins, inulin, lignin, waxes, chitins, hemi-cellulose pectins, beta-glucans and oligosaccharides. It acts by changing the nature of the contents of the gastrointestinal tract, and by changing how other nutrients and chemicals are absorbed. Soluble fiber absorbs water to become a gelatinous, viscous substance and is fermented by bacteria in the digestive tract. Insoluble fiber has bulking action and is not fermented | train | med_mcqa | null |
Two weeks later, the results of the patient's prenatal labs come back. Her blood type is A, with an anti D antibody titer of 1:4. What is the most appropriate next step in the management of this patient? | [
"Schedule an amniocentesis for amniotic fluid bilirubin at 16 weeks",
"Repeat titer in 4 weeks",
"Repeat titer in 28 weeks",
"Schedule PUBS to determine fetal hematocrit at 20 weeks"
] | B | In the same patient–blood grouping shows A negative, with an anti D antibody titer of 1:4- the most appropriate next step
in the management –Since this patient is a primi patient and her antibody titre is 1:4 so we should follow it by doing a repeat titre after every 4 weeks.
If this pregnancy would not have been her first affected pregnancy, then amniocentesis i.e. option a would have been the correct response. | train | med_mcqa | null |
Statuary rape is - | [
"Less than 15 years",
"Less than 16 years",
"Less than 18 years",
"Less than 20 years"
] | C | Ref:Textbook of Forensic medicine and toxicology (V.V.Pillay) 17th edition, page no.388 Minimum age at which female can give consent for sex by what age is 18 years. As per Sec.375IPC unlawful sexual intercourse by man with a woman with or without her consent when she is under 18 years of age. The criminal law (Amendment) Act,2013 has increased the previous recomended age of consent from 16 to 18 years, which means any sexual activity irespective of presence of consent with a woman below the age of 18 will constitute statutory rape. | train | med_mcqa | null |
Staphylococcal infection causes all disease except – | [
"Impetigo",
"Erysipelas",
"Ecthyma",
"Scaldy skin syndrome"
] | B | Erysipelas is caused by streptococcus pyogenes β - hemolytic streptococci).
Important skin infections cause by streptococcus pyogenes β - hemolytic streptococci) are Impetigo contagiosa, Ecthyma, Erysipelas, Cellulitis. | train | med_mcqa | null |
Salivary gland stone most commonly involves | [
"Submandibular gland",
"Parotid gland",
"Sub lingual glands",
"Lingual glands"
] | A | null | train | med_mcqa | null |
Adjuvant therapy after mastectomy is needed in all of the following except: | [
"High risk, node positive",
"Low risk, no node",
"ER/PR -ve",
"Her-2-neu +ve"
] | B | Criteria for adjuvant chemotherapy: (adverse prognostic factors) High histological grade Lymphovascular invasion Lymph nodes positive ER / PR negative Her - 2 - neu positive. | train | med_mcqa | null |
With respect to development of nephron arrange the stages in order of there development: 1.Vesicle stage 2.Pre-tubular aggregates 3.Comma shaped 4.S-shaped | [
"1-3-4-2",
"2-3-1-4",
"1-4-2-3",
"2-1-3-4"
] | D | Kidney develops from metanephros. Pronephros degenerates and never forms functional nephrons. Stages in order of nephron development Ureteric bud Pretubular aggregates Renal vesicle Comma Shaped S Shaped Mature nephron | train | med_mcqa | null |
Which of the following anti-asthma drug is not indicated by oral route of administration in pregnancy - | [
"Salbutamol",
"Prednisolone",
"Theophylline",
"Ipratropium bromide"
] | D | Ans. is 'd' i.e., Ipratropium bromide o Ipratropium, if used is administered only by inhalation route, not orally. | train | med_mcqa | null |
An elderly diabetic has left sided orbital cellulitis, CT scan of paranasal sinuses shows evidence of left maxillary sinusitis. A Gram-stained smear of the orbital exudates shows irregularly branching septate hyphae. The following is the most likely aetiological agent | [
"Aspergillus",
"Rhizopus",
"Mucor",
"Candida"
] | A | Infection caused by inhalation of the Aspergillus conidia or mycelial fragments resulting in respiratory diseases, disseminated aspergillosis in brain, kidney and hea.and superficial infection like sinusitis, mycotic keratitis and otomycosis. Sinusitis is caused by A.flavus and A.fumigatus On microscopy, it shows non pigmented septate hyphae with characteristic dichotomous branching at an angle of approximately 45 degrees. Ref: Textbook of Microbiology, Ananthanarayan and Paniker; 9th edition . | train | med_mcqa | null |
Radiological findings of Congestive Cardiac failure except: | [
"Prominent Lower lobe vessels",
"Kerley B Lines",
"Cardiomegaly",
"Perihilar haze"
] | A | Prominent upper lobe vessels - due to diversion of blood to upper lobe veins. | train | med_mcqa | null |
Which of the following is found in secondary granules of neutrophils | [
"Catalase",
"Gangliosidase",
"Proteolytic enzyme",
"Lactoferrin"
] | D | Ref Robbins 8/e p54 ;7/e p61; 9/e p80 Granules may be classified on the basis of their size, morphology, or electron density or with reference to a given protein. The initial classification into two major types of granules was based on the content of MPO. However, the granules can be fuher subdivided on the basis of other intragranular proteins, as observed in Fig . It should be emphasized that, according to the targeting-by-timing hypothesis that will be discussed later, classification of granules is arbitrary, because granules form a continuum from azurophil granules to gelatinase granules, sharing some proteins, eg, lysozyme, whereas other proteins can be chosen to serve as specific markers of one paicular subset, eg, MPO, lactoferrin, and gelatinase. | train | med_mcqa | null |
Renal stones which are laminated and irregular in outline are | [
"Uric acid",
"Calcium oxalate",
"Struvite",
"Cystine"
] | B | Calcium oxalate stones are laminated and irregular in shape and covered with sharp projections which cause bleeding. The surface of these stones are thus discoloured by altered blood- brown in colour- mulberry stones Reference : page 1296 Bailey and Love's sho practice of surgery 25th edition | train | med_mcqa | null |
A 3-week-old neonate who began vomiting 2 days after birth, usually within 30 minutes after breastfeeding. He also has abdominal distension with enlargement of liver, with jaundice. The consulting doctor did two urine dipstick test, one specific for glucose was negative, second test specific for reducing sugar was positive. What is the diagnosis? | [
"Hereditary fructose intolerance",
"Classic galactosemia",
"Essential fructosuria",
"Essential pentosuria"
] | B | Ans. B. Classic GalactosemiaIdentifying features* Classic galactosemia is a serious disease with onset of symptoms typically by the 2nd half of the 1st wk of life.* With jaundice, vomiting, seizures, lethargy, irritability, feeding difficulties, poor weight gain or failure to regain birth weight.* Hepatomegaly Oil drop cataracts, Hepatic failure.* Mental retardation.* Demonstrating a reducing substance in several urine specimens collected while the patient is receiving human milk, cows milk, or any other formula containing lactose.* Benedict's Test PositiveQ* Clinistix urine test results are usually negative because the test materials rely on the action of glucose oxidase, which is specific for glucose and is nonreactive with galactose (Glucose Oxidase Test is negative) | train | med_mcqa | null |
The X-ray which are mostly like to be absorbed by the
tissues and produce an injury: | [
"X-rays of long wavelength",
"X-rays of short wavelength",
"Filtered X-rays",
"Central rays"
] | A | null | train | med_mcqa | null |
A 58-year-old male presents with persistent fullness of left ear for 3 months and hearing loss. On examination, there is fluid behind the tympanic membrane. Impedance audiometry shows a type B audiogram. The next step for the management of the patient would be: | [
"Myringotomy with grommet inseion",
"Endoscopic examination for any nasopharyngeal pathology",
"Valsalva manoeuvre",
"Antihistaminics"
] | B | Ans. b. Endoscopic examination for any nasopharyngeal pathology | train | med_mcqa | null |
Which of the following is a negative stain - | [
"Negrosin",
"Fontana",
"ZN stain",
"Albert stain"
] | A | Negative staining is used in diagnostic microscopy, for contrasting a thin specimen with an optically opaque fluid. In this, the background is stained, leaving the actual specimen untouched, and thus visible. Whereas in 'positive staining', the actual specimen is stained.
Negative staining is typically performed using a black ink fluid such as nigrosin. The specimen, such as a wet bacterial culture spread on a glass slide, is mixed with the negative stain and allowed to dry. When viewed with the microscope the bacterial cells, and perhaps their spores, appear light against the dark surrounding background. | train | med_mcqa | null |
EEG in anesthesia is useful in: | [
"Depth of general anesthesia",
"Depth of local anesthesia",
"Depth of neuromuscular block",
"Depth of analgesia"
] | A | Ans. a. Depth of general anesthesia (Ref: Morgan 4/144-146; Lee's 12/e p146, 286, 447)EEG in anesthesia is useful in monitoring the depth of anesthesia (GA) with 16-lead.Uses of EEG in anesthesiaTo assess the sedation and awarenessQTo monitor epileptic activityQ, and to control antiepileptic drugs infusion, especially in paralyzed patientsTo monitor the changes in conscious levelsQDuring cerebrovascular surgery, to confirm the adequacy of cerebral oxygenationQMonitoring the depth of anesthesiaQ (GA) with 16-leadHave look on some new and important techniques.Bispectral Index Scale (BIS)It is based on the principle of EEGQIt uses 3 EEG electrodes placed on frontal, parietal and temporal lobesQBIS is used to monitor:Intraoperative awarenessQDepth of anesthesiaQIts value ranges from 0-100 (0: coma: 100: awake)Target intra-operative BIS: 40-60QTarget sedation BIS: 60-80QEntropyIt is based on the principle of EEG and EMGQ | train | med_mcqa | null |
During endoscopic biopsy of a distal esophageal cancer, perforation of the esophagus is suspected when the patient complains of significant new substernal pain. An immediate chest film reveals air in the mediastinum. You would recommend | [
"Placement of a nasogastric tube to the levels of perforations, antibiotics, and close observation",
"Spit fistula (cervical pharyngostomy) and gastrostomy",
"Left thoracotomy, pleural patch oversewing of the perforation, and drainage of the mediastinum.",
"Esophagogastrectomy celiotomy and right thoracotomy"... | D | Esophagogastrectomy celiotomy ......... Perforation of the esophagus in the chest is a surgical catastrophe that requires aggressive intervention in viually all circumstances. While that intervention can usually consist of effos to patch the perforation and drain the mediastinum concomitant obstructive esophageal disease, whether inflammatory stenosis or cancer, mandates removal or bypass of the obstruction if control of the leak and its consequent persisting mediastinal and pleural contamination is to be accomplished. For distal esophageal cancers, many thoracic surgeons would use the classic Ivor-Lewis operation, which consists of mobilizing the stomach in the abdomen and then performing a right thoracotomy with mediastinal clean out, esophagectomy, and esophagogastrostomy. In some circumstances, and by some surgeons' preference, a left thoracotomy approach might be used. The transhiatal approach would probably be avoided in this situation where an unknown amount of mediastinal contamination has taken place. | train | med_mcqa | null |
Conjunctival xerosis is seen in all of the following except: March 2008 | [
"Steven-Johnson syndrome",
"Keratoconjunctivitis sicca",
"Vitamin A deficiency",
"Sarcoidosis"
] | D | Ans. D: Sarcoidosis Xerosis/xerophthalmia is a dry, lustreless condition of the conjunctiva due to a deficiency of mucin. It can be seen in: Local ocular disorders like trachoma, burns, pemphigoid, diphtheria, prolonged exposure due ectropion and proptosis etc. Systemic diseases like deficiency of vitamin A. Patients affected with sarcoidosis not infrequently show lesions in the conjunctiva. These lesions are typically nodular, translucent and orange in appearance. Keratoconjunctivitis sicca is a condition caused by deficiency of the aqueous component of the tears, i.e. the lacrimal secretion. Deficiency of conjunctival mucus occurs in stevens-Johnson syndrome. | train | med_mcqa | null |
The National Population Policy 2000 aims to achieve Total Fertility Rate of 2.1 by the year | [
"2005",
"2015",
"2010",
"2050"
] | C | National Population Policy 2000 (NPP 2000)
• Immediate objective: To address the unmet needs for contraception, health care infrastructure, and health personnel, and to provide integrated service delivery for basic reproductive and child health care.
• Mid-term objective: To bring the TFR to replacement levels (TFR = 2.1) by 2010.
• Long term objective: To achieve a stable population by 2045. | train | med_mcqa | null |
Broad cast is characteristic of - | [
"CRF",
"Ac GN",
"ARF",
"Renal TB"
] | A | Ans. is 'a' i.e., CRFHyaline casts ?o These are the most common type of casts and they can be found in normal urine samples.o They consists almost entirely of Tamm Horsfall protein.o Zero-to Two hyaline casts per low power field is considered normal.o Increased numbers of Hyaline casts can occur with exercise, heat exposure, dehydration, fever, congestive hea failure and diuretic.Renal tubular epithelial cell casts ?o These casts results when the epithelial cells of the renal tubules are being excreted along with the casts. o Renal tubular epithelial casts are most suggestive of tubular injury as in acute tubular necrosis.o They are also found in other disorders including eclampsia, heavy metal poisoning, ethylene glycol intoxication(most of these cases lead to acute tubular necrosis).Granular casts ?o These casts are fairly common and occur in both pathological and non pathological condition.o Granular casts can result either from the breakdown of cellular casts to a point where the cells that once were withinthem are no longer distinguishable or they can result from the inclusion of aggregates of plasma proteins, fibrinogenor immune complexes within the cast upon formation.o They can be fuher divided into coarse granular casts and fine granular casts.o Fine granular casts can appear in non pathological conditions such as vigorous exercise, but the presence of coarse granular cast is abnormal and presents in wide variety of clinical diseases.o They are common in renal parenchymal disease.Broad casts ?These casts ori inate rom dilated chronicall dama ed tubules or the collec in ducts there ore the are called renal failure casts. o These are formed in collecting duct as a result of urinary stasis.o Broad casts are two to six times the size of other types of casts.o Broad casts or renal failure casts are usually seen in patients with advanced renal failure.Waxy casts ?o Waxy casts are cylinders of smooth highly refractive material.o Waxy casts are seen in final stages of degeneration of fine granular casts. Since the granules need time to degrade, this implies nephron obstruction.o Waxy casts are seen in chronic renal diseases associated with renal failure seen in diabetic nephropathy, malignant hypeension, glomerulonephritis. | train | med_mcqa | null |
A mechanic working on a car accidently cut his finger and begins to bleed. Which endogenous molecule will initiate the process of hemostasis? | [
"Calcium",
"Thromboxane A2",
"Nitrous oxide",
"Endothelium"
] | D | Endothelium injury → Releases tissue factor → Procoagulants enter circulation | train | med_mcqa | null |
Salt loosing nephritis is due to | [
"Lupus nephritis",
"Streptococcal infection",
"Interstitial nephritis",
"Goodpasteures syndrome"
] | C | Salt-losing nephritis is one of many clinical situations involving electrolyte disturbance in renal disease. This type of nephropathy is characterized by hyponatremia and hypochloremia, lassitude, thirst, polyuria, azotemia, and circulatory collapse. Interstitial nephritis is a kidney disorder in which the spaces between the kidney tubules become swollen (inflamed). This can cause problems with the way your kidneys work. Refer robbins 9/e p930 | train | med_mcqa | null |
Which subtype of human papilloma virus has maximum chances of causing carcinoma cervix: September 2012, March 2013 | [
"HPV 16 and 18",
"HPV 6 and 11",
"HPV 31 and 32",
"HPV 1 and 2"
] | A | Ans. A i.e. HPV 16 and 18 | train | med_mcqa | null |
S 100 is a marker of? | [
"Melanoma",
"Schwannoma",
"Histiocytoma",
"All of the above"
] | D | ANSWER: (D) All of the aboveREF: Robbins 7th ed p. 1235SI00 is normally present in cells derived from the neural crest (Schwann cells, melanocytes, and glial cells), chondrocytes, adipocytes, myoepithelial cells, macrophages, Langerhans cells, dendritic cells, and keratinocytes. It maybe present in some breast epithelial cells.Several members of the S -100 protein family are useful as markers for certain tumors and epidermal differentiation. It can be found in melanomas, 50% of malignant peripheral nerve sheath tumors, schwannomas, paraganglioma stromal cells, histiocytoma and clear cell sarcomas | train | med_mcqa | null |
Cardiomyopathy is caused by | [
"Actinomycin D",
"Doxorubicin",
"Mitomycin C",
"Mitoxantrone"
] | B | Ref: Katzung 14th ed. pg. 964-65; KDTy 6th ed. pg. 826-27* Doxorubicin and daunorubicin are anti-tumor antibiotics. Activity of Daunorubicin is limited to acute leukemia while doxorubicin is effective in several solid tumors.# MOA: Cause breaks in DNA strands by activating topoisomerse II and generating quinolone type free radicals.# Doxrorubicin and daunorubicin both these antibiotics produce cardiotoxicity as a unique adverse effect.* Actinomycin D (Dactinomycin) It is a very potent antineoplastic drug, highly efficacious in Wilms' tumour and rhabdomyosarcoma# Prominent adverse effects are vomiting, stomatitis, diarrhoea, erythema and desquamation of skin, alopecia and bone marrow depression* Mitoxantrone: Recently introduced analogue of doxorubicin with lower cardiotoxicity, probably because it does not produce quinine type free radicals. Though cardiomyopathy can occur, major toxicity is marrow depression and mucosal inflammation.* Mitomycin C: This highly toxic drug is used only in resistant cancers of stomach, cervix, colon, rectum, bladder, etc# Bone marrow and GIT are the primary targets of toxicity. | train | med_mcqa | null |
A 24-year-old man is admitted to the hospital after a street fight. Radiographic examination reveals an inferior (blow-out) fracture of the orbit. Orbital structures would most likely be found inferiorly in which of the following spaces? | [
"Ethmoidal sinus",
"Frontal sinus",
"Maxillary sinus",
"Nasal cavity"
] | C | The maxillary sinus is located inferior to the orbit. Any trauma to the inferior bony wall of the orbit will likely displace the orbital structures in the compartment to the space below the orbit (maxillary sinus). The ethmoid sinus is located superiorly and medially to the orbit, whereas the frontal sinus is located superiorly to the orbit. The nasal cavity is toward the midline and is not inferior to the orbit. The sphenoid sinus is deeper into the facial region but is not inferior to the orbit. | train | med_mcqa | null |
Drugs acting on dopamine receptors are all except | [
"Dopamine",
"Fenoldopam",
"Dobutamine",
"Haloperidol"
] | C | -Dopamine It stimulates 3 receptors Receptors Dose of Dopamine for stimulation D1 <2 mg/Kg/min b1 2-10 mg/Kg/min a1 >10 mg/Kg/min -Fenoldopam is dopamine agonist -D1 Used in hypeensive emergency -Dobutamine Does not act on dopamine receptors Mainly act on beta 1 Used in CHF -Haloperidol - typical antipsychotic with D2 blocking action | train | med_mcqa | null |
The tendon running in the groove below Sustentaculum tali | [
"Tibialis posterior",
"Flexor digitoram longus",
"Flexor hallucis longus",
"Peroneus tertius"
] | C | The tendon running in the groove below Sustentaculum tali.
Flexor hallucis longus | train | med_mcqa | null |
Annular herald patch is seen in: | [
"Psoriasis",
"Nocardiasis",
"P. alba",
"P. rosea"
] | D | Ans. d. P. roseaHerald patch is first patch seen over trunk in pityriasis rosea | train | med_mcqa | null |
Which of the following short or mild acting stimuli can cause reversible pulpitis: | [
"Deep periodontal curettage.",
"Incipient caries.",
"Enamel fractures.",
"All of the above."
] | D | Mild or short-acting stimuli such as incipient caries cervical erosion, or occlusal attrition; most operative procedures; deep periodontal curettage; and enamel fractures resulting in exposure of dentinal tubules can reversible pulpitis | train | med_mcqa | null |
Which of the following is NOT an indication for blind nasal intubation? | [
"TM joint ankylosis",
"Impossible laryngoscopy",
"CSF otorrhea",
"Base of skull fracture"
] | D | Blind intubation techniques are those methods of airway management that are done without visualization of the larynx or glottis. Blind nasal intubation is contra-indicated in the presence of a base-of-skull fracture, e.g., with 'raccoon eyes' or with CSF dripping from the nose, as the endotracheal tube can enter the brain. Indications for blind nasal intubation include impossible laryngoscopy, TM joint problems or trismus due to any cause. | train | med_mcqa | null |
A 29-year-old man with acquired immune deficiency syndrome (AIDS) comes to the emergency department because of progressively increasing abdominal discomfort. Examination shows voluntary guarding in the upper abdomen. His bio-chemistry is normal except for an elevated amylase at 370 U/L (25-125 U/L). Which of the following infections can trigger this disorder in AIDS patients? | [
"toxoplasmosis",
"Mycobacterium avium complex",
"Mycobacterium tuberculosis",
"Pneumocystis carinii"
] | B | Pancreatitis in AIDS patients can be caused by cytomegalovirus and cryptosporidium as well as M. avium complex. Drugs are another cause of AIDS-related pancreatitis. | train | med_mcqa | null |
False statement about Barret esophagus is:- | [
"Goblet cells seen on histology",
"Patient may lead to malignancy after few years",
"Columnar to squamous metaplasia",
"Chronic GERD is the predisposing factor"
] | C | Option C: Squamous changes to Columnar | train | med_mcqa | null |
Exposure to noise above-causes permanent hearing loss - | [
"90 dB",
"100 dB",
"125 dB",
"160 dB"
] | D | Sound in dB Effect 20 Whispering 40 Quiet library 60 Normal conversation 70 heavy street traffic 80 printing press 85 Recommended maximum 110 Train passing through station 120 Motor car horn 140 Threshold of pain 150-160 Mechanical damage Park's Textbook of Preventive and Social Medicine, 22nd edition, Page No. 688 | train | med_mcqa | null |
Stellate cells of Von Kupffer are seen in the sinusoids of which of the following organs- | [
"Spleen",
"Bone marrow",
"Liver",
"Adrenal"
] | C | Kupffer cells (or stellate macrophages) are seen in liver. | train | med_mcqa | null |
A 24 year old man presents with multiple small hypopigmented patches around hair follicles on upper chest and back. These macules were with fine scaling which coalesced later. He had received treatment 1 year back for the same type of lesion. Which of the following investigation should be done to diagnose this condition? | [
"KOH preparation of scales",
"Tzanck test",
"Slit Skin Smear",
"Skin biopsy of coalesced lesion"
] | A | The characteristic lesion seen in this patient is typical of tinea versicolor caused by a nondermatophyte, dimorphic fungus, Malassezia furfur. It is diagnosed by making a KOH preparation from scaling lesions which demonstrate a confluence of sho hyphae and round spores known as "spaghetti and meatballs" appearance. The typical lesion of tinea versicolor consists of oval scaly macules, papules, and patches concentrated on the chest, shoulders, and back, and rarely on the face or distal extremities. In patients with dark skin they are seen as hypopigmented areas, while on light skin, they are slightly erythematous or hyperpigmented. Ref: McCall C.O. (2012). Chapter 52. Eczema, Psoriasis, Cutaneous Infections, Acne, and Other Common Skin 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 |
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