question stringlengths 1 6.54k | choices listlengths 4 4 | answer stringclasses 4
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True regarding Na+ ion - | [
"Responsible for Donnan effect",
"Responsible for Resting membrane potential",
"Responsible for Depolarization",
"Does not help other ions in transport"
] | C | Depolarization occurs due to sodium ions influx.
Potassium ions maintain the resting membrane potential.
Sodium ions are not responsible for Gibbs-Donnan effect. It is due to the non-diffusible anions.
Sodium ions take part in many co-transports. | train | med_mcqa | null |
A 4-year-old child presented with palpable purpura and polyahralgia without any frank ahritis along with colicky abdominal pain associated with nausea, vomiting, diarrhea and the passage of blood and mucus per rectum. Urine examination revealed proteinuria and microscopic haematuria. Laboratory studies revealed mild leucocytosis, normal platelet count, normal PT and aPTT, eosinophilia, normal serum complement components and elevated IgA levels. Skin biopsy specimen was taken. | [
"Clotting disorder",
"Septic emboli",
"HSP",
"Uicarial vasculitis"
] | C | Perivascular neutrophils, leukocytoclasis and fibrinoid degeneration involving the small dermal blood vessels with subsequent hemorrhage in a skin biopsy of a patient with HSP. Skin biopsy showing positive immunofluorescence of the small blood vessels for IgA. Henoch-Schonlein purpura (HSP) Acute immunoglobulin A (IgA)-mediated Generalized vasculitis involving the small vessels of the skin, the gastrointestinal (GI) tract, the kidneys, the joints, and, rarely, the lungs and the central nervous system (CNS). It is the most frequent vasculitis in childhood, the incidence decreasing with age. Subsequently, symptoms develop, of which the following are the most common: Rash, especially involving the legs; this is the hallmark of the disease Abdominal pain and vomiting Joint pain especially involving the knees and ankles Subcutaneous edema Scrotal edema Bloody stools | train | med_mcqa | null |
Drug of choice for Herpes simplex Endophthalmitis is – | [
"Acyclovir",
"Vidarabine",
"Amantidine",
"Interferon"
] | A | Acyclovir is the drug of choice for HSV infection. | train | med_mcqa | null |
Type A' growth pattern is | [
"Middle third of face grows faster than lower third",
"Lower third of face grows faster than middle third",
"Prognosis is poor",
"Equal growth is seen"
] | D | null | train | med_mcqa | null |
Child with cavernous sinus meningioma shows presence of? | [
"Ptosis left eye",
"Phthisis bulbi right eye",
"Exophthalmos right eye",
"Bell sign left eye"
] | A | Ans. (a) Ptosis left eye.* Cavernous sinus meningioma can impinge on oculomotor nerve leading to paralysis of Levator palpebral superioris and can explain the ptosis seen in the image on the left eye.* Bell sign is seen in seventh nerve paralysis, and leads to up-rolling of eyeball on forcible closure of eye on same side of seventh nerve palsy. | train | med_mcqa | null |
A 24-year-old woman with leukemia receives an allogeneic bone marrow transplant. Three weeks later, she develops a skin rash and diarrhea. Liver function tests show elevated serum levels of AST and ALT. A skin biopsy discloses a sparse lymphocytic infiltrate in the dermis and epidermis, as well as apoptotic cells in the epidermal basal cell layer. Skin rash and diarrhea in this patient are caused primarily by which of the following cells? | [
"Donor lymphocytes",
"Donor plasma cells",
"Fixed tissue macrophages",
"Recipient lymphocytes"
] | A | The advent of transplantation of bone marrow into patients whose immune system has been ablated or into otherwise immunodeficient patients has resulted in the complication of graft-versus-host disease (GVHD). GVHD occurs when lymphocytes in the grafted tissue recognize and react to the recipient. GVHD can also occur when an immunodeficient patient is transfused with blood containing HLA-incompatible lymphocytes. The major organs affected in GVHD include the skin, gastrointestinal tract, and liver. Clinically, GVHD manifests as rash, diarrhea, abdominal cramps, anemia, and liver dysfunction. None of the other cells mediates GVHD. Diagnosis: Graft-versus-host disease | train | med_mcqa | null |
Nausea and vomiting are common in pregnancy. Hyperemesis gravidarum, however, is a much more serious and potentially fatal problem. Findings that should ale the physician to the diagnosis of hyperemesis gravidarum early in its course include. | [
"Electrocardiographic evidence of hypokalemia",
"Metabolic acidosis",
"Jaundice",
"Ketonuria"
] | D | Hyperemesis gravidarum- Hyperemesis gravidarum is intractable vomiting of pregnancy. Early signs of the disorder include weight loss and ketonuria. Vomiting causes potassium loss, electrocardiographic evidence of potassium depletion, such as inveed T waves and prolonged QT and PR intervals, is usually a later finding. Liver dysfunction maybe a problem and is probably due to fatty infiltration of the liver; occasionally, acute hepatic necrosis occurs. Metabolic acidosis is uncommon. | train | med_mcqa | null |
The parietal peritoneum covering the inferior surface of the diaphragm transits its sensory information via the phrenic nerve. In the case of peritonitis in the parietal peritoneum on the inferior surface of the diaphragm, pain may be referred through which of the following nerves? | [
"A",
"B",
"C",
"D"
] | D | Ans. D. Supraclavicular nervesThe phrenic nerve consists of contributions from spinal nerve levels C3 to 5.Therefore, when sensory information comes from the parietal peritoneum on the inferior diaphragmatic surface, it may refer through spinal nerves at the same levels.a. Supraclavicular nerve shares levels with the C3 and C4 levels.b. The greater and lesser occipital nerves both originate at the C2 level.c. Great auricular nerve root value is C2, C3 | train | med_mcqa | null |
A 59-year-old man is admitted to the hospital with severe chest pain. During examination a slight rhythmic pulsation on the chest wall at the left fifth intercostal space is noted in the midclavicular line. What part of the heart is responsible for this pulsation? | [
"Right atrium",
"Left atrium",
"Aortic arch",
"Apex of the heart"
] | D | The apex of the heart is located in the left fifth intercostal space, about 3 1/2 inches to the left of the sternum. When this area of the heart is palpated, any pulsations would be generated by throbbing of the apex of the heart against the thoracic wall. This is also the location for performing auscultation (listening) of the mitral valve, not associated with palpation. The right atrium is located to the right of the sternum. The left atrium is located on the posterior aspect of the heart, thus no direct palpation is realized. The aortic arch would be located posterior to the manubrium of the sternum, above the second intercostal space. | train | med_mcqa | null |
A 70 kg old athlete was posted for surgery, Patient was administered succinylcholine due to unavailability of vecuronium. It was administered in intermittent dosing (total 640 mg). During recovery patient was not able to respire spontaneously & move limbs. What is the explanation | [
"Pseudocholinesterase deficiency increasing action of syccinylcholine",
"Phase 2 blockade produced by succinylcholine",
"Undiagnosed muscular dystrophy and muscular weakness",
"Muscular weakness due to fasciculation produced by succinylcholine"
] | C | Xenon [Ref: Morgan's Anaesthesia 4/e p 781, 166, 167; Miller's Anaesthesia p 626, 6491 Xenon seems to be the best answer because all other inhalational anaesthetics mentioned in the question produce some cardiovascular effects that may harm the patient with mitral stenosis. Mitral stenosis is a disorder where cardiac output remains relatively fixed. Decrease in cardiac output should he avoided at any cost. - Any drug that increases the hea rate will reduce the cardiac output in patient with M.S. All the inhalational agents mentioned in the question decrease systemic vascular resistance and also increase the hea rate. Decrease in systemic vascular resistance leads to fall in blood pressure. Moreover, they may also decrease B.P. by their cardiodepressant action on myocardium. Therefore these drugs should not be used in patients with M.S. "Xenon has no effects on cardiac output or cardiac rhythum and is not thought to have significant effect on systemic vascular resistance It also does not affect pulmonary function and is not known to have any renal or hepatic toxicity". The main drawback of Xenon is its high cost and insufficient availability. -Xenon is an ine gas which is quite difficult to obtain and hence extremely expensive. - Xenon has received considerable interest in the last few years because it has many characteristics approaching those of an "ideal" inhaled anaesthetics. Mitral stenosis Due to mitral stenosis less blood .flows through the mitral valve to left ventricle. Left ventricle functions normally but is small and poorly.filled. Initially the left ventricle dilates keeping the pulmonary aery pressure low. As disease progresses pulmonary aery pressure increases and medial hyperophy develops resulting in chronic reactive pulmonary hypeension. The right hea hyperophies to pump against a pressure overload, then.fails. The pressure gradient across the narrow mitral orifice increase with the square of cardial output. Rapid hea rates, especially with atrial fibrillation decreases diastolic .filling time and markedly decreases cardiac output. Li / .filling is optimized by slow hea rate. Hemodynamic goals Low normal hea rate 50-70/min, treat tachycardia aggressively with /8 blockers. Maintain sinus rhythmus if possible. Maintain adequate preload Maintain high normal systemic vascular resistance Avoid hypercarbia, acidosis and hypoxia which may exacerbate pulmonary hypeension. The cardiac output is relatively fixed, maintain adequate afterload, slow the hea rate and avoid hypovolemia. Measure CVP and PAOP and maintain high preload. Avoid rapid decrease in afterload. | train | med_mcqa | null |
Hyper parathyroidism is characterised by the following except - | [
"Generalised osteoporosis",
"Renal calculi",
"Hypercalcaemia",
"osteosclerosis"
] | D | null | train | med_mcqa | null |
Carcinoma cervix is associated with all except : | [
"Multipay",
"Herpes simplex virus",
"Early coitus",
"Diabetes mellitus"
] | D | Diabetes mellitus | train | med_mcqa | null |
Which of the following anesthetic agent lacks analgesic effect: March 2013 | [
"N20",
"Thiopentone",
"Ketamine",
"Fentanyl"
] | B | Ans. B i.e. Thiopentone Thiopentone Ultra sho acting barbiturate (because of rapid redistribution), Lacks analgesic effect, First sign on intra-aerial injection: - White hands I/V injection presents as: - Pain, - Hypotension etc. C/I in: Porphyria (may precipitate porphyria) | train | med_mcqa | null |
The pacemaker of hea is: | [
"SA node",
"AV node",
"Both",
"None"
] | A | The primary pacemaker of hea is SA node. It shows restless membrane potential similar to Interstitial cells of cajal,Pre-botzinger complex Ref:Guyton and Hall textbook of medical physiology 12th edition,page number:177 | train | med_mcqa | null |
Which one of the following is not used as a tumor marker in testicular tumors | [
"AFP",
"LDH",
"hCG",
"CEA"
] | D | Refer Robbins page no 979 ble 21-5 Pathologic Classification of Common Testicular Tumors Germ Cell Tumors Seminomatous tumors Seminoma Spermatocytic seminoma Nonseminomatous tumors Embryonal carcinoma Yolk sac (endodermal sinus) tumor Choriocarcinoma Teratoma Sex Cord-Stromal Tumors Leydig cell tumor Seoli cell tumor | train | med_mcqa | null |
Not true about gyneocamastia is | [
"Can be drug induced",
"Klinefelter's syndrome",
"Seen in cryptoorchidism",
"None of the above"
] | D | Gynaecomastia is hyperophy of male breast more than usual due to increase in ductal (epithelial) and connective tissue (stromal) elements often attaining features of female breast. It can be unilateral or bilateral. Bilateral can be symmetrical or asymmetrical. Etiology is Oestrogen excess--increased estradiol secretion due to testicular tumour (Leydig cell) or nontesticular tumours from adrenal coex, lung, liver; hypehyroidism (increases conversion of androgen to estrogen), liver diseases, oestrogen therapy for prostate cancer. Androgen deficiency--aging, Klinefelter's/Kallmann syndromes, eunuch, ACTH defi ciency. Secondary testicular failure--cryptorchidism, orchitis, trauma, CRF, etc. Drugs (25%):Increases estrogen activity (digitalis, anabolic steroid)/estrogen synthesis (reserpine, theophylline, frusemide). Inhibition of testosterone synthesis--cimetidine, phenytoin, spironolactone. Ref; (page no; 527 ) 5th edition of SRB&;S manual of Surgery. | train | med_mcqa | null |
A four year old boy presented with secondaries all over the body including his eyes. Which one is the commonest cause of orbital metastasis in children? | [
"Neuroblastoma",
"Ca lung",
"Ca breast",
"Ca thyroid"
] | A | The most common metastatic tumor in children is neuroblastoma. It is the commonest cause of orbital metastasis. Bilateral eyelid ecchymosis and proptosis are the most common presenting signs of orbital neuroblastoma. Ca lung is the commonest cause of metastasis in males and Ca breast is the commonest cause in females. | train | med_mcqa | null |
The following statement is not true about the use of clonidine in treatment of hypeension | [
"Reduction in Central sympathetic outflow",
"Increase in LDL cholesterol on prolonged use",
"Sedation and xerostomia are the common side effects",
"It can be combined with vasodilators"
] | B | Clonidine is a selective alpha 2 agonist the acts by decreasing Central sympathetic outflow. Vasodilators can increase in reflex increase in renin release. This can be prevented by combining the vasodilators with clonidine or beta blockers. Sedation and dry mouth are the prominent adverse side effects of clonidine and Alpha methyldopa. These drugs LDL decrease and HDL increase cholesterol. Refer kDT 6/e p546 | train | med_mcqa | null |
Low birth weight baby is the one whose birth weight is? | [
"Less than 1800 g",
"Less than 2000 g",
"Less than 2500 g",
"Less than 3000 g"
] | C | ANSWER: (C) Less than 2500 gREF: Nelson essentials of pediatrics, 17th editionLow birth weight (LBW) infants, defined as infants having birth weights of less than 2500 gt represent a disproportionately large component of the neonatal and infant mortality rates. Although births of LBW infants make up only about 6% to 7% of all births, they account for greater than 70% of neonatal deaths. IUGR is the most common cause of LBW in developing countries, whereas most LBW in infants in developed countries is secondary to prematurity.Very low birth weight (VLBW) infants, weighing less than 1500 g at birth, represent about 1% of all births, but account for 50% of neonatal deaths. Compared with infants weighing 2500 g or more, LBW infants are 40 times more likely to die in the neonatal period; VLBW infants have a 200-fold higher risk of neonatal death.Extremely low birth weight, weighing less than 1000 g at birth. | train | med_mcqa | null |
Following is true about behcet's disease except - | [
"It shows presence of aphthous ulceration, genital ulceration and uveitis",
"Uveitis is bilateral, acute recurrent iridocyclitis with hypopyon",
"It has good visual prognosis",
"Chlorambucil can be used to control the disease"
] | C | Ans. is 'c' i.e., It has good visual prognosis BEHCET'S DISEASEo It is an idiopathic multisystem disease characterised by recurrent, non-granulomatous uveitis, aphthous ulceration, genital ulcerations and erythema multiforme.Etiology# It is still unknown; the basic lesion is an obliterative vasculitis probably caused by circulating immune complexes. The disease typically affects the young men Who are positive for HLA-B51.Clinical featuresUveitis seen in Behcet *s disease is typically bilateral, acute recurrent iridocyclitis associated with hypopyon. It may also be associated with posterior uveitis, vitritis, periphlebitis retinae and retinitis in the form of white necrotic infiltrates.TreatmentNo satisfactory treatment is available, and thus the disease has got comparatively poor visual prognosis. Corticosteroids may by helpful initially but ultimate response is poor. In some cases the disease may be controlled by chlorambucil. | train | med_mcqa | null |
A patient presents with compound fracture of Tibia with 1 cm opening in skin. Which grade it belongs? | [
"Grade I",
"Grade II",
"Grade IIIA",
"Grade IIIB"
] | A | A i.e. Grade I | train | med_mcqa | null |
Which type of pelvis is associated with increased incidence of ‘face to pubis’ delivery? | [
"Gynaecoid pelvis",
"Anthropoid pelvis",
"Android pelvis",
"Platypelloid pelvis"
] | B | As discussed in the text in Table 1.1 face-to-pubis delivery is common in anthropoid pelvis. | train | med_mcqa | null |
Which of the following statement regarding cell ageing is TRUE? | [
"Free radicals injury",
"Mitochondria are increased",
"Lipofuscin accumulation in the cell",
"Size of cell increased"
] | C | Lipofuscin is a complex pigment that is thought to result from end stage lipid peroxidation probably by the oxidation of fat with free radical reactants. Its exact composition varies from cell to cell. It appears to accumulate in cells with highest metabolic activity. It is associated with atrophy of an organ. Lipofuscin is a mixture of lipids and proteins containing a golden brown pigment called ceroid. It tends to accumulate by accretion of oxidized, cross linked proteins and is not digestible. It occurs mainly in terminally differentiated cells (neurons and cardiac myocytes) or in cells that cycles infrequently(hepatocytes). Ref: Physiology Secrets edited by Hershel Raff page 317 | train | med_mcqa | null |
Most common infections after splenectomy are: | [
"Uncapsulated bacteria",
"Capsulated bacteria",
"Gram-positive sepsis",
"Gram-negative bacteria"
] | B | Overwhelming post splenectomy infection MC late(after 2-5 years) fatal complication of splenectomy After splenectomy, ability to filter and phagocytose bacteria, paicularly encapsulated bacteria (Streptococcus pneumonia, Hemophilus influenza, Neisseria meningitides) and parasitized blood cells is lost. MC infection after splenectomy : Streptococcus pneumonia (50-90% cases) Neisseria meningitidis (Meningococcus) H. influenza type B Prevention- By vaccination Best time for vaccination 2 weeks before elective splenectomy * As early as possible after emergency splenectomy | train | med_mcqa | null |
Which one of the following is not a pa of the Revised Trauma score? | [
"Glasgow coma scale",
"Systolic blood pressure",
"Pulse rate",
"Respiratory rate"
] | C | - Revised trauma score (S) - Mnemonic- GB Road G-GCS - B-Bp (systolic) - Road -Respiratory rate - Trauma scoring systems Revised trauma score (S) Trauma & injury severity score (TRISS) Mangled Extremity severity score (MESS) Mnemonic- GB Road G-GCS B-Bp (systolic) Road -Respiratory rate Mnemonic- ISS + RAM ISS- Injury severity score R- Revised trauma score A-Age M-Mechanism(blunt/penetrating) Mnemonic-ELISA E- Energy Li-Limb Ischemia S-Shock A-AGE | train | med_mcqa | null |
Which organism cannot be cultured in cell free media -a) Klebsiella rhinoscleromatisb) Klebsiella ozaenaec) Treponema pallidumd) Pnemocystis jirovecie) Rhinosporidium seeberi | [
"abd",
"cde",
"bde",
"ade"
] | B | Treponema pallidum is an abligate intracellular organism. Thus it cannot be cultivated in cell free medium.
Pneumocystis Jiroveci and Rhinosporidium seeberi can not be cultivated. | train | med_mcqa | null |
Which one of the following is a rickettsial disease | [
"Weils disease",
"Rocky mountain fever",
"Relapsing fever",
"Pontaic fever"
] | B | Rocky mountain spotted fever is caused by R.ricketsii.vector is dermacentar andersonii it is prevalent in noh america and South America. It is the most serious type of spotted fever Ref: AnanthNarayan and paniker's 10th edition | train | med_mcqa | null |
Starvation and diabetes mellitus can lead on to ketoacidosis which of the following features is in our of ketoacidosis due to diabetes mellitus? | [
"Increase in glucagon/insulin ratio, increased CAMP and increased blood glucose",
"Decreased insulin, increased free fatty acid which is equivalent to blood glucose",
"Decreased insulin, increased free fatty acid which is not equivalent to blood glucose",
"Elevated insulin and free fatty acid, equivalent to b... | A | Ketoacidosis is a high anion gap metabolic acidosis due to an excessive blood concentration of ketone bodies. Ketone bodies (acetoacetate, beta-hydroxybutyrate, acetone) are released into the blood from the liver when hepatic lipid metabolism has changed to a state of increased ketogenesis. The three major types of ketosis are: Starvation ketosis Alcoholic ketoacidosis Diabetic ketoacidosis Starvation Ketoacidosis: Occurs secondary to starvation, is due to a diminished insulin secretion, that leads to an increase in lipolysis and ketogenesis. The acidosis even with prolonged fasting is only mild to moderate. Diabetic ketoacidosis (DKA) is a state of absolute or relative insulin deficiency and is defined by the American Diabetes Association's (ADA) diagnostic criteria of Hyperglycemia , Acidosis (aerial pH Ketosis (moderate ketonuria or ketonemia) The metabolic differences between diabetes and starvation include- Insulin levels: The level of insulin is decreased in both diabetes and starvation. It is more decreased in case of diabetes (viually absent in type I diabetes). There is relative excess of glucagon in both the cases. Glucagon acts through elevation in CAMP level. Blood glucose levels: Diabetics exhibit a characteristic hyperglycemia where as in starvation the individual maintain a blood glucose level that is near to normal Ketosis: The mobilization of fatty acids from adipose tissue and hepatic ketogencsis are greater in diabetes than in starvation. As a result the ketoacidosis observed in diabetes in much more severe than that observed during starvation. Factors DKA Starvation pH | normal Plasma glucose | normal Glycosuria + + ---- Total plasma ketones || Mild | Anion gap | Mild | Osmolality | normal Ref: Lippincott's illustrated reviews Biochemistry, 2nd Edition, Page 297. | train | med_mcqa | null |
Mechanism of action of theophylline - | [
"Mast cell stabilization",
"Phosphodiesterase inhibition",
"Leukotriene antagonist",
"b2-sympathomimetic"
] | B | Ans. is 'b' i.e., Phosphodiesterase inhibition | train | med_mcqa | null |
Case of 30 year chronic smoker male, visited your clinic with this condition. Diagnosis: | [
"Diabetic gangrene",
"Buerger's disease",
"Atherosclerotic plaque",
"Clostridium welchii infection"
] | B | Ans. (b) Buerger's disease.Buerger's disease is also known as thromboangiitis obliterans. An inflammatory and obliterative disease of blood vessels of the extremities, mainly lower extremities. Occurring chiefly in smoker young men and leading to ischemia of the tissues and gangrene. Involvement of artery vein and nerve, most commonly involved is tibial artery. Intermittent claudication, pain at rest relieved by dangling legs. Dry gangrene in toes shows shriveled woody induration.IOC: Duplex USG (ankle brachial index: 0.5 to 0.9)Treatment: For Claudication pain, reducing the viscosity of blood pentoxifylline is used. For resting pain, lumbar sympathectomy. If gangrene, amputation done.Image source- style="font-family: Times New Roman, Times, serif"> | train | med_mcqa | null |
A patient with microcytic hypochromic anemia. Hb9%, serum iron-20 micro/di, ferritin level-800mg/ ml, transferrin percentage saturation-64. What is possible diagnosis? | [
"Atransferrinemia",
"Iron deficiency anemia",
"DMT 1 mutation",
"Hemochromatosis"
] | A | Ans. is 'a' i.e., Atransferrinemia Information provided in the question are :? i) Microcytic hypochromic anemia ift Low serum iron --> Normal (50-170 microgm/dl) iii) High serum ferritin Normal ( 30-400ng/m1) iv) High serum transferrin -4 Normal (30-50%) o In iron deficiency anemia, serum ferritin is low ( in question it is high) and in hemochromatosis, serum iron is increased (in question it is normal). So, option b and d are ruled out. o Now we are left with option a and c, both of which are genetic forms of iron deficiency anemia. Genetic forms of iron deficiency anemia o Iron deficiency anemia is an acquired disease. It is generally associated with low cost diet and bleeding. o Recent advances in iron metabolism led to the recognition of new entitities of iron deficiency anemia in non bleeding and "high cost diet" nourished individuals. These are known as genetic forms of iron deficiency anemia. o Apparently rare these genetic forms of iron deficiency anemia should be recognized by hematologists as they are refractory to classical oral or intravenous iron administration. GENETIC FORMS OF IRON DEFICIENCYANEMIA DMT 1 Mutation Atransferrinemia Glutaredoxin 5 Acceruloplasminemia Age at diagnosis At bih Late onset Midlife Late onset Anemia Microcytic Microcytic Microcytic Microcytic hypochromic Hypochromic hypochromic hypochromic Serum iron High Low High Low Transferrin saturation High High or Non-measurable High Low Serum ferritin Low or normal High High High Ferritin Ringed sideroblasts No No Yes No Liver iron obverload Yes Yes Yes Yes Brain damage No No No Yes Hepcidin levels Low Not yet measured Not yet measured Not yet measured Coming back to the question o The serum iron indices of the patient match those of Atransferrinemia i.e., low serum iron, increased serum ferritin, increased transferrin saturation. o DMT 1 can be ruled out as it has low ferritin level and high iron level. | train | med_mcqa | null |
A newborn presents with an early onset of dyspnea with chest retractions, expiratory grunting and cyanosis following an uneventful normal preterm labor. On examination no cardiac murmurs are heard and the lungs appear clear. On a plain X-ray there is evidence of prominent pulmonary vascular markings and fluid lines in the fissures. The cyanosis improves with minimal oxygen. The most probable diagnosis is: | [
"Meconium aspiration syndrome",
"Fetal aspiration syndrome",
"Transient tachypnea of the newborn",
"Hyaline membrane disease"
] | C | Transient tachypnea of the newborn * The clinical case given above indicates the likely diagnosis of transient tachynea of the newborn, which is otherwise called Respiratory distress syndrome type II. * It is characterized by the early onset of dyspnea with chest retractions, expiratory grunting and cyanosis. Neonates usually recover within 3 days. * The syndrome is believed to be secondary to slow absorption of fetal lung fluid resulting in decreased pulmonary compliance and tidal volume. * The distinctive feature of transient tachypnea of the newborn from hyaline membrane disease is sudden recovery of the infants and the absence of a radiographic reticulogranular pattern on CXR. | train | med_mcqa | null |
Cholecysto-caval line impoance | [
"Line that divides the Right and left liver surgical anatomy wise",
"Line that divides the Left liver into medial and lateral segments",
"Line that runs along the Poal vein",
"Line that divides Right liver into anterior and posterior segments"
] | A | * Cholecystocaval line also known as Cantle's line is an imaginary line running from Gallbladder fossa to left side of IVC. * It's an imaginary line that is drawn by Coiunaud for surgically dividing the liver into Right and left liver. * Middle hepatic vein runs on this line. Ref:- Surgery Sixer 3rd Edition; Pg num:- 628 | train | med_mcqa | null |
Allergic reactions to radiological contrast agents are - | [
"Anaphylactic reactions",
"IgE mediated reactions",
"Urticaria",
"Edema"
] | A | Acute non-renal reaction to a radiocontrast agent may be -
Non-IgE mediated anaphylactic reactions
Vasomotor / vasovagal reactions. | train | med_mcqa | null |
DOC for belladona poisoning | [
"Neostigmine",
"Physostigmine",
"Pyridostigmine",
"Edrophonium"
] | B | Physostigmine is an anticholinesterase & chemically it is a tertiary amine which can cross BBB.
It is DOC for Belladona, Datura & Atropine poisoning. | train | med_mcqa | null |
Which not true regarding coeliac disease ? | [
"Total and sub-total villous atrophy",
"Increased chance of lymphoma",
"Anti-gliadin antibody persists even after gluten free diet",
"Tdi sacharidases"
] | D | Ans. is 'd' i.e., T disacharidasesIn coeliac sprue : Total or subtotal villous atrophy Increased chance of lymphoma q Association with dermatitis herpetiformis Antigliadin antibody Secondary lactase deficiency No mucosal atrophy Lymphocytes in lamina propria | train | med_mcqa | null |
Treatment of nasopharyngeal carcinoma T1 - | [
"Radiation therapy",
"Surgery",
"Local resection",
"Chemotherapy"
] | A | Overall treatment of choice for nasopharyngeal carcinoma → radiotherapy.
Treatment of choice for early (stage I & II) nasopharyngeal carcinoma → radiotherapy.
Treatment of choice for advanced (stage III & IV) nasopharyngeal carcinoma → radiotherapy combined with chemotherapy. | train | med_mcqa | null |
consider the following: 1. Reactive NST 2. Absence of deceleration 3. Sinusoidal pattern Which of the above findings in an antepaum CTG indicate fetal well-being: | [
"1 and 2 only",
"2 and 3 Only",
"1 and 3 only",
"1.2,3"
] | A | A reactive NST is defined as the presence of two or more fetal hea rate acceleration during a 20 min period,with acceleration of 15 beats or more and lasting 15 or more second.No late deceleration or significant variable deceleration also indicates good cardiac activity. refer pgno:510 sheila textbook of obstetrics 2 nd edition | train | med_mcqa | null |
A 35-year-old G3P3 with a Pap smear showing high-grade squamous intraepithelial lesion of the cervix (CIN III) has an inadequate colposcopy. Cone biopsy shows squamous cell cancer that has invaded only 1 mm beyond the basement membrane. There are no confluent tongues of tumor, and there is no evidence of lymphatic or vascular invasion. The margins of the cone biopsy specimen are free of disease. What is your Diagnosis? | [
"Carcinoma of low malignant potential",
"Microinvasive cancer",
"Atypical squamous cells of undeermined significance",
"Carcinoma in situ"
] | B | Microinvasive carcinoma of the cervix Invasion depth limited to no greater than 5 mm , Not visible to Naked eye. Stage I Limited to Cervix IA : Microscopic cancer IA1 :Stromal invasion <3 mm in depth IA2 :Stromal invasion 3 mm-5 mm in depth | train | med_mcqa | null |
Following pelvic gynecologic surgery, a 34-year-old woman becomes dyspneic, her peripheral aerial O2 saturation falls from 94% to 81%, and her measured PaO2 is 52 on a 100% non-rebreather mask. She is hemodynamically stable. A CT angiogram is consistent with a right lower lobe pulmonary embolus. Which of the following is the next step in her management? | [
"Systemic anticoagulation with heparin infusion",
"Systemic anticoagulation with warfarin",
"Placement of an inferior vena cava filter",
"Thrombolytic therapy"
] | A | The initial treatment for venous thromboembolism (VTE) which includes deep venous thromboses (DVTs) and pulmonary emboli (PEs) is systemic anticoagulation with either unfractionated heparin--by bolus and infusion-- or low molecular weight heparins--by subcutaneous administration. Transition is then made to oral warfarin, which is a vitamin K antagonist. Warfarin is not the initial treatment because it requires several days to become therapeutic and proteins C and S (which are anticoagulants) are inhibited first resulting in a procoagulant state. Inferior vena cava (IVC) filters are indicated in patients for whom anticoagulation is contraindicated or in patients who develop recurrent VTE in the setting of adequate anticoagulation. Thrombolytic therapy and pulmonary embolectomy are typically reserved for patients with massive PEs with hemodynamic instability. | train | med_mcqa | null |
All are features of Intravascular hemolysis except - | [
"Thrombocytopenia",
"Hemosiderinuria",
"Decreased haptoglobin",
"Raised indirect bilirubin"
] | A | Hemolytic anemia
Hemolytic anemia is anemia due to hemolysis, i.e. the abnormal breakdown of red blood cells.
Hemolytic anemia has the following features -
A shortened red cell lifespan, i.e. premature destruction of red cells.
Elevated erythropoietin level and increased erythropoiesis in the marrow and other sites, to compensate for the loss of red cells→ characterized by increased reticulocyte count.
Accumulation of the products of hemoglobin catabolism due to an increased rate of red cell destruction.
Hemolysis may occur either inside the blood vessels (intravascular hemolysis) or within the mononuclear phagocytic system of spleen, liver or bone marrow (extravascular hemolysis).
Intravascular hemolysis
Due to the destruction of RBC, hemoglobin is released into blood → Hemoglobinemia.
Excess of hemoglobin may be excreted by kidney → hemoglobinuria.
Some of the hemoglobin is reabsorbed in kidney and is converted to hemosiderin which is then excreted → hemosiderinuria.
Free hemoglobin in plasma bound to haptoglobin and this complex is rapidly cleared by mononuclear phagocytic system Decreased haptoglobin.
When haptoglobin is depleted, free hemoglobin is oxidized to methemoglobin → methemoglobinemia.
Excess heme groups are catabolized to bilirubin within the mononuclear phagocytic system → Increased indirect bilirubin and jaundice.
LDH is stored in the blood. During hemolysis this enzyme is released in the blood → Increased serum LDH. | train | med_mcqa | null |
Earliest tumor to appear after birth is | [
"Cystic hygroma",
"Lymphoma",
"Branchial cyst",
"Sternomastoid tumor"
] | A | null | train | med_mcqa | null |
Amount of calcium is maximum in which milk: | [
"Cow",
"Buffalo",
"Human",
"Goat"
] | B | Amount per 100 ml Cow's milk Human milk Buffalo milk Goat milk Fat 4.1 g 3.4 g 6.5 g 4.5 g Protein 3.3 g 1.1 g 4.3 g 3.3 g Lactose 4.4 g 7.4 g 5.1 g 4.6 g Calcium 120 mg 28 mg 210 mg 170 mg Iron 0.2 mg 0.2 mg 0.3 mg Ref: Park, 22nd edition pg: 584 | train | med_mcqa | null |
According to biomedical waste rule 2016, incineration/deep burial/plasma pylorysis is done for bag having colour code: | [
"Blue",
"Red",
"Yellow",
"White"
] | C | C. YellowTable 5: Biomedical waste rule 2016 guidelineCat.Type of Bag/ Container usedType of WasteTreatment /DisposaloptionsYellownon-chlorinated plastic bags Separate collection system leading to effluent treatment systema) Human Anatomical Wasteb) Animal Anatomical Wastec) Soiled Wasted) Expired or Discarded Medicinese) Chemical Wastef) Micro, Bio-t and other clinical lab wasteg) Chemical Liquid WasteIncineration or Plasma Pyrolysis or deep burialRednon-chlorinated plastic bags or containersContaminated Waste (Recyclable) tubing, bottles, intravenous tubes and sets, catheters, urine bags, syringes (without needles) and gloves.Auto/ Micro/ Hydro and then sent for recycling, not be sent to landfill.White(Translucent) Puncture, Leak, tamper proof containersWaste sharps including MetalsAuto or Dry Heat sterilization followed by shredding or mutilation or encapsulationBlueCardboard boxes with blue colored markingGlasswareDisinfection or auto/ Micro/hydro and then sent for recycling. | train | med_mcqa | null |
Non sedating Antidepressant is | [
"Fluoxetine",
"Mianserine",
"Amoxaprine",
"Imipramine"
] | A | A i.e. Fluoxetine | train | med_mcqa | null |
The presumption of legitimacy of a child is defined under:- | [
"112 IEA",
"112 Cr P C",
"113 IEA",
"113 Cr P C"
] | A | Section 112 Indian evidence act - Bih during marriage, conclusive proof of legitimacy. The fact that any person was born. during the continuance of a valid marriage between his mother and any man, or within two hundred and eighty days (280 days)after its dissolution, the mother remaining unmarried, shall be conclusive proof that he is the legitimate son of that man, unless it can be shown that the paies to the marriage had no access to each other at any time when he could have been begotten. | train | med_mcqa | null |
A CSF/serum glucose ratio of <0.4 is highly suggestive of: | [
"Bacterial Meningitis",
"Viral Meningitis",
"Carcinomatous Meningitis",
"None of the above"
] | A | a. Bacterial Meningitis(Ref: Nelson's 20/e p 2936-2948, Ghai 8/e p 563-565)Hypoglycorrhachia (Low CSF: serum glucose ratio) is commonly seen in Bacterial meningitis. | train | med_mcqa | null |
CA - 125 increased in all EXCEPT : | [
"T.B. of genital organ",
"Ovarian cancer",
"Endometriosis",
"Stein - leventhal syndrome"
] | D | Stein - leventhal syndrome | train | med_mcqa | null |
Persistent and inappropriate repetition of response beyond the point of relevance is called | [
"Thought insertion",
"Thought block",
"Perseveration",
"Neologism"
] | C | The patient repeats same response beyond the point of relevance.
Example :
What is your name? – Darshan
What you ate in the morning? – Darshan
Where do you live? – Darshan | train | med_mcqa | null |
The components of fourth generation dentin bonding systems are described as | [
"Self etching adhesive",
"Self etching primer/adhesive",
"Total etch, multi bottle",
"Total etch, single bottle"
] | C | As in the fourth-generation adhesives, enamel and dentin are etched simultaneously; these systems were initially called the “total-etch” technique, now they are commonly known as the “three-step etch-and-rinse” technique.
Ref : Talal A, Nasim HM, Khan AS. Enamel etching and dental adhesives. InAdvanced Dental Biomaterials 2019 Jan 1 (pp. 229-253). Woodhead Publishing | train | med_mcqa | null |
Cholesterol crystals are occasionally present in which of the following Zone? | [
"Zone of contamination",
"Zone of irritation",
"Zone of necrosis",
"Zone of stimulation"
] | B | null | train | med_mcqa | null |
Arrange the following developmental milestones in order of appearance (age wise) (first to last) a. Immature pincer grasp b. Rolls over c. Laugh loud d. 1-2 words with meaning | [
"c- b, a- d",
"d- b, a- c",
"a- b, c- d",
"c- d, a- b"
] | A | Option c - laugh out loud - 4 months Option b - rolls over - 5 months Option a - immature pincer grasp - 9 months Option d - 1-2 words with meaning - 12 month Table:- key groups motor development milestones Age Milestone 3 months Neck holding 5 months Rolls over 6 months Sits in tripod fashion (sitting with own suppo) 8 months Sitting without suppo 9 months Stands holding on (with suppo) 12 months Creeps well; walks but falls; stands without suppo 15 months Walks alone; creeps upstairs 18 months Runs; explores drawers 2 year Walks up and downstairs (2 feet/step); jumps 3 years Rides tricyclic; alternate feet going upstairs 4 years Hops on one foot; alternate feet going downstairs Table:- Key fine motor milestones Age Milestone 4 months Bidextrous reach (reaching out for objects with both hands) 6 months Unidextrous reach (reaching out for objects with one hand); transfers objects 9 months Immature pincer grasp; p[robes with forefinger 12 months Pincer grasp mature 15 months Imitates scribbling; tower of 2 blocks 18 months Scribbles; tower of 3 blocks 2 years Tower of 6 blocks; veical and circular stroke 3 years Tower of 9 blocks; copies circle 4 years Copies cross; bridge with blocks 5 years Copies triangle: gate with blocks Table: Key social and adaptive milestones Age Milestones 2 months Social smile (smile after being talked to) 3 months Recognizes mother; anticipates feeds 6 months Recognizes strangers, stranger anxiety 9 months Waves "bye bye" 12 months Comes when called; plays simple ball game 15 months Jargon 18 months Copies parents in task (e.g. sweeping) 2 years Asks for food, drink, toilet; pulls people to show toys 3 years Shares toys; knows full name and gender 4 years Plays cooperatively in a group; goes to toilet alone 5 years Helps in household tasks, dresses and undresses Table: key language milestones Age Milestone 1 month Ales to sound 3 months Coos(musical vowel sounds) 4 months Laugh loud 6 months Monosyllables (ba, da, pa), ah-goo sounds 9 months Bisyllables (mama, baba, dada) 12 months 1-2 words with meaning 18 months 8-10 word vocabulary 2 years 2-3 word sentence, uses pronouns "I", "me", "you" 3 years Asks questions; knows full name and gender 4 years Says song or poem; tells stories 5 years Asks meaning of words | train | med_mcqa | null |
In gastric secretion, gastrin acts on ________ receptor on parietal cells | [
"G receptor",
"H receptor",
"CCKb receptor",
"M receptor"
] | C | Gastrin acts on cholecytokininB ( CCK B) receptor on parietal cells for gastric secretion. | train | med_mcqa | null |
The pathogenesis of hypochromic anemia in lead poisoning is due to - | [
"Lead blocks transferrin receptors of erythroid precursors",
"Binding of lead to transferrin, inhibiting the transpo of iron",
"Inhibition of enzymes involved in heme biosynthesis",
"Inhibiting breakdown of ferritin into hemosiderin"
] | C | Iron should be combined with protoporphyrin to synthesize Heme. To synthesize protoporphyrin and combine it with iron, enzymes like ALA synthase, ALA dehydratase & Ferrochelatase are required. Lead inhibits heme synthesis by inhibiting enzymes ALA dehydratase & Ferrochelatase resulting in microcytic hypochromic anemia. | train | med_mcqa | null |
DNA epairs defect associated with malignancy in - | [
"Xeroderma pigmentosum",
"Icthyosis",
"Mosaicism",
"??"
] | A | . Xeroderma pigmentosum | train | med_mcqa | null |
Chest pain from pericardial inflammation in pericarditis is referred by: | [
"Vagus nerve",
"Phrenic nerve",
"Trigeminal nerve",
"Sympathetic nerves"
] | B | Answer is B (Phrenic nerve) The phrenic nerve (C3, 4, 5) provides sensory innervation to the fibrous and parietal layers of the pericardium. When pain sensitive areas of pericardium are stimulated by disease, pericardial pain is perceived as pain in the neck and around the trapezius muscle the phrenic nerve (The skin above the clavicle (C3, 4, 5 dermatomes)) Note: The phrenic nerve does not innervate the hea but does give off somatosensory branches to the pericardium (pericardial branches) in the middle mediastinum on its way to the diaphragm Note: The phrenic nerve only innervates the pericardium and does not innervate the hea | train | med_mcqa | null |
Most common site of Ewing's sarcoma - | [
"Upper end of tibia",
"Shaft of tibia",
"Lower end of femur",
"Shaft of femur"
] | D | Ans. is 'd' i.e., Shaft of femur Commonest siteo Ivory osteoma-Frontal sinuso Osteoid osteoma-Tibiao Admantinoma (Ameloblastoma)-Mandibleo Chordoma-Sacrum and cervical spineo Osteoclastoma-Lower end of femuro Ewing's sarcoma-Femur diaphysis > tibia diaphysiso Osteosarcoma-Distal femur (45%), Proximal tibia (25%)o Simple bone cyst-Proximal humeruso Aneurysmal bone cyst-Bones around knee (Femur, tibia)o Osteochondroma-Bones around knee (distal femur > proximal tibia)o Fibrous dysplasia-Proximal femur > Tibiao Enchondroma-Phalanges of hando Multiple myeloma-Vertebraeo Metastasis-Vertebrae | train | med_mcqa | null |
1st product of tryptophan Catabolism | [
"Kynurenine",
"Xantheurenic acid",
"Bradykinin",
"Melatonin"
] | A | Kynurenine is formed from tryptophan in presence of enzyme tryptophan pyrrolaseRef: DM Vasudevan - Textbook of Biochemistry, 7th edition, page no: 239, fig 18.8 | train | med_mcqa | null |
A one year old boy presented with hepatosplenomegaly and delayed milestones. The liver biopsy and bone marrow biopsy revealed presence of histiocytes with PAS-positive Diastase-resistant material in the cytoplasm. Electron-microscopic examination of these histiocytes is most likely to reveal the presence of: | [
"Birbeck's granules in the cytoplasm",
"Myelin figures in the cytoplasm",
"Parallel rays of tubular structures in lysosomes",
"Electron dense deposit in the mitochondria"
] | C | PAS stain is a widely used stain which gives positive reaction with glycogen (primarily) and non glycogen substances like glycoprotein, glycolipids, proteoglycans and neutral mucins. Whether the PAS positivity of a paicular cell is due to presence of glycogen or due to latter can be differentiated with diastase (glycogen digesting enzyme). If the cell is PAS positive due to glycogen, the pretreatment with diastase will make it PAS negative. But if the cell is PAS positive due to non glycogen substances, the cell will retain its PAS positivity even after pretreatment with diastase. So, in the given question, the presence of PAS positive and diastase resistant material indicates presence of non glycogen substances. * The clinical feature of delayed milestones and hepatosplenomegaly in 1 year old boy is suggestive of some lysosomal storage disorder (like Niemann Picks disease). * This disease is characterized by the presence of large foam cells in bone marrow, liver and spleen. There is presence of pleomorphic inclusion of lipids in lysosomes enclosed in concentric or parallel lamellae. | train | med_mcqa | null |
Leptospira in diagnostic labs is grown in | [
"Skirrows medium",
"EMJH medium",
"BYCE agar",
"Pike medium"
] | B | Leptospira can be grown in media enriched with rabbit serum. several liquid and semi-solid media, such as Kohof's, Stua's and Fletcher's media, have been described. Semisynthetic media such as EMJH are now commonly used. They are aerobic and microaerophilic. Ref: Textbook of microbiology; Ananthanarayan and paniker's; 10th edition; Pg: 388 | train | med_mcqa | null |
All of the following parasites causes malabsorption, EXCEPT: | [
"Giardiasis",
"Ascaris lumbricoides",
"Strongyloides",
"Capillaria philippinensis"
] | B | Parasites causing malabsorption are Giardia lamblia E.histolytica Strongyloides Cyclospora Capillaria philippinensis Adult Ascaris are large: females are 20-50 cm long, and males are 15-30 cm long. Humans acquire the infection after eggs are ingested; larvae hatch in the duodenum, penetrate through the mucosa, migrate in the circulatory system, lodge in lung capillaries, penetrate the alveoli, and migrate from the bronchioles to the trachea and pharynx; larvae are swallowed and return to the intestine and mature into adults. If present in high numbers, adult worms may cause mechanical obstruction of the bowel and bile and pancreatic ducts. Worms tend to migrate if drugs such as anesthetics or steroids are given, leading to bowel perforation and peritonitis, anal passage of worms, vomiting, and abdominal pain. Larvae migrating through lungs induce an inflammatory response (pneumonitis), especially after second infection, leading to bronchial spasm, mucus production, and Loeffler syndrome (cough, eosinophilia, and pulmonary infiltrates). It does not cause malabsorption. | train | med_mcqa | null |
Adreneric b receptors having lipolysis propey in fat cells is? | [
"Alpha 1",
"Alpha 2",
"Beta 1",
"Beta 3"
] | D | Beta -3. Beta 3 receptors are present on adipose tissue. Hence, cause lipolysis. Also present in, Coronary aeries - Causing vasodilation Urinary bladder - Causing relaxation. | train | med_mcqa | null |
The force of muscle contraction can be increased by all of the following except: | [
"Increasing the frequency of activation of motor units",
"Increasing the number of motor units activated",
"Increasing the amplitude of action potentials in the motor neurons",
"Recruiting larger motor units"
] | C | Action potential follows an all or none law. When sufficient amplitude is reached to produce a motor response, increasing the amplitude fuher will not have any effect on the motor response. Ref: Review of Medical Physiology by William F Ganong, 19th Edition Page 70 ; Biomechanics and Biology of Movement By Benno Maurus Nig, Page 275. | train | med_mcqa | null |
All of the mesentric cyst except | [
"Enterogenous cyst",
"Chylolymphatic cyst",
"Desmoid cyst",
"Desmoid cyst"
] | C | Types of mesentric cyst :
Chylolymphatic cyst.
Enterogenous cyst.
Dermoid cyst.
Urogenital remnant. | train | med_mcqa | null |
Diagnosis of x linked agammaglobulinamia should be suspected if | [
"Absent tonsils and no palpable lymph nodes on physical examination",
"Female sex",
"High iso hemagglutinin titers",
"Low CD3"
] | A | Ref Robbins 9/e p240-241 Classically, this disease is characterized by the following: * Absent or markedly decreased numbers of B cells in the circulation, with depressed serum levels of all classes of immunoglobulins. The numbers of pre-B cells in the bone marrow may be normal or reduced. * Underdeveloped or rudimentary germinal centers in peripheral lymphoid tissues, including lymph nodes, Peyer patches, the appendix, and tonsils * Absence of plasma cells throughout the body * Normal T cell-mediated responses | train | med_mcqa | null |
"Soap bubble appearance" is seen in: | [
"Simple unicameral cyst",
"Aneurismal cyst",
"Giant cell tumour",
"Osteogenic sarcoma"
] | C | [Cl (Giant cell tumour): Ref: 181-AGiant c ell tumour"Soap bubble appearance" due to ridging of the surrounding bonesThe appearance of a 'cystic" lesion in mature bone, extending right to the subchondral plate is so characteristic that the diagnosis is seldom in doubt.Aneurysmal bone evst: - well defined radio lucent cyst, often trabeculated and eccentrically placed. It usually docs not extend right upto the articular margin.Osteochondroma: - Large lesions show "cauliflower " appearance with degeneration and calcification in the centre of the cartilage cap.Chondroblastoma: - well demarcated radiolucent area in epiphysisChondromvxoid fibroma: - Rounded or ovoid radio lucent area placed eccentrically in the metaphysis. The endosteal margin may be scalloped, but is almost always bounded by a dense zone of reactive bone extending tongue - like towards the diaphysis.Chondroma (Enchondroma): - Centrally placed radiolucent area at the junction of metaphysis and diaphysis. In mature lesions there are flecks or wisps of calcification within the lucent area (Pathognomic features)Osteoblastoma (Giant osteoid osteoma): well demarcated osteolytic lesion which may contian small flecks of ossification radio isotpe scan will reveal the hot area.Osteoidosteoma: - A small radiolucent area, the so called 'Nidus' lesion in the diaphysis are surrounded by dense sclerosis and cortical thickening. | train | med_mcqa | null |
The ideal place to record body temperature in dead body is: | [
"Rectum",
"Axilla",
"Mouth",
"Groin"
] | A | The rectum is the ideal place to record temperature except in cases of sodomy. For about half to one hour after death, the rectal temperature falls little or not at all. Then the cooling rate is relatively uniform in its slope. The temperature can also be recorded by making a small opening into the peritoneal cavity and inseing the the thermometer in contact with the inferior surface of the liver. The external auditory meatus or the nasal passages also can be used to record temperature. Ref: Textbook of Forensic Medicine and Toxicology by K S Narayan Reddy, 27th edition, Page 135-136. | train | med_mcqa | null |
Inner ear is present in which bone - | [
"Parietal bone",
"Petrous part of temporal bone",
"Occipital bone",
"Petrous part of squamous bone"
] | B | Inner ear lies within the petrous part of temporal bone.
Ref. Turner 10/e, p 228; BDC 4/e, Vol. III p 264 | train | med_mcqa | null |
A 20 year old student presents with history of weight gain, irregular periods and worsening facial hair growth. What is the most likely diagnosis? | [
"Polycystic ovarian disease",
"Hypothyroidism",
"Obesity",
"Cushing's syndrome"
] | A | Hirsutism affects 5% to 10% of women The most common cause of hyperandrogenism and hirsutism is polycystic ovarian syndrome. (PCOS) Idiopathic Hirsutism is seen in 20% cases where the USG of abdomen shows a normal Ovary and adrenal with the serum androgens are of normal values. Please note: Idiopathic is not the most common cause of hirsutism! There are only two major criteria for the diagnosis of PCOS: Anovulation/ oligoovulation Hyperandrogenism as established by clinical or laboratory means With or without polycystic ovarian morphology on USG | train | med_mcqa | null |
Takayam test is used for ? | [
"To know the nature of stain",
"To know the species",
"For blood grouping",
"None of the above"
] | A | Ans. is 'a' i.e., To know the nature of stain It is a microchemical test to know the nature of stain.Microchemical tests :These tests are based on propey of haem pa of hemoglobin to form characteristic coloured crystals.Teichmann's haemin crystal testTakayama hemochromogen crystal testLuminal spray test : It is especially useful in old obscure blood stains | train | med_mcqa | null |
When solid gets wet completely, the contact angle is: | [
"90°",
"0°",
"0 — 90°",
">90°"
] | B | null | train | med_mcqa | null |
Accidents happening during weekends is - | [
"Cyclic trends",
"Seasonal trends",
"Secular trends",
"Point source epidemic"
] | A | Ans. (a) Cyclic trendsRef : K. Park 23rd ed. / 65-66, 21st ed / 61,62Time Distribution of Disease* Secular trend: it implies changes in occurrence of a disease over a period of long time, generally several years or decade.# Ex: Polio, Diphtheria, Pertusis are the diseases which are reducing in India in fast few decades; and diseases like DM, Obesity and hypertension has increased in past few decades.* Epidemic: Short term fluctuation of a Disease occur in few days, week, or months. E.g. food poisoning, Bhopal gas tragedy* Cyclic trends: some diseases occur in cycles spread over a period of time which means days, weeks, months, or years. Non-infectious condition may also show periodic fluctuations ex: automobile accidents in US are more frequent on weekends, esp: Saturday. Other examples can be measles occurring every 2-3 years, Rubella every 6-9 years.* Seasonal trend: It is seasonal variation/fluctuation in occurrence of a disease. Ex: measles, URI, GIT infection. | train | med_mcqa | null |
All of the following are true about diffuse gastric cancer according to Lauren's classification except: | [
"Familial",
"more common in males",
"undifferentiated",
"more common in the proximal pa"
] | B | Lauren Classification System for carcinoma Intestinal Diffuse - Environmental - Gastric atrophy, intestinal metaplasia - Men > Women - Increasing incidence with age - Gland formation - Hematogenous spread - Microsatellite instability - APC gene mutations - p53, p16 inactivation - Epidemic - Distal pa of the stomach - Familial - Blood group 'A' - Women > Men - Younger age group - Poorly differentiated signet ring cells - Transmural/ Lymphatic spread - Decreased E-cadherin - p53, p16 inactivation - Endemic - Proximal pa of the stomach | train | med_mcqa | null |
Biomedical waste mixing with Cement is known as: | [
"Incineration",
"Ineization",
"Vermicomposting",
"Microwaving"
] | B | Ineization: Process: Mixing biomedical waste with cement and other substance before disposal, so as to minimize risk of toxic substances contained in waste to contaminate ground / surface water. Ineization is especially suitable for pharmaceuticals and for incineration ashes with high metal content . EXTRA EDGE: - Hepatitis-B & Tetanus vaccines are recommended in health care workers handling biomedical waste. - Health check-up should be done yearly for these workers & booster doses are given if required. | train | med_mcqa | null |
Test used to compare two qualitative data is - | [
"Paired T-test",
"Unpaired T-test",
"Chi-square test",
"AVOVA"
] | C | Ans. is 'c' i.e., Chi-square test Commonly used Statistical tests Data || | Qualitative(Proportions, percentage, fractions) Quantitative(mean & SD. of BP, Sugar, cholesterol etc) | | | || |Large sample size < 20% of cells have expected value below 5Small sample size > 20% of cells have expected values below 5Two sample group comparisonMore than 2 sample groups ||||||||||||||||||||||||||||| | |Sample is smallSample is large (n > 30)|||||Chi-squaretest Fisher's exact testStudent't-test' Z-testANOVA | train | med_mcqa | null |
Propofol is used as the drug of choice for inducing anesthesia in which of the following situation? | [
"Neurosurgery",
"Day care surgery",
"Cardiac surgery",
"In neonates"
] | B | It is the induction agent of choice in day care surgery. The half life is 100 minutes, but the clinical effects of a single dose of propofol lasts only for 10 minutes due to its rapid redistribution. It has minimal residual impairment, anti emetic and anti pruritic propey, making it a suitable drug for day care surgery. Ref: Essentials of Medical Pharmacology By KD Tripathi, 5th Edition, Page 343 | train | med_mcqa | null |
Post-translation carboxylation of clotting factors requires | [
"Vitamin C",
"Vitamin K",
"Vitamin A",
"Vitamin D"
] | B | The principal role of vitamin K is in the posttranslational modification of various blood clotting factors, in which it serves as a coenzyme in the carboxylation of ceain glutamic acid residues present in these proteins. Vitamin K exists in several forms, for example, in plants as phylloquinone (or vitamin K1), and in intestinal bacterial flora as menaquinone (or vitamin K2). A synthetic form of vitamin K, menadione, is available.Function of vitamin K 1: Formation of g-carboxyglutamate (GLA): Vitamin K is required in the hepatic synthesis of prothrombin and blood clotting factors II, VII, IX, and X. These proteins are synthesized as inactive precursor molecules. Formation of the clotting factors requires the vitamin K-dependent carboxylation of glutamic acid residues to Gla residues (Figure 28.26). This forms a mature clotting factor that contains GLA and is capable of subsequent activation. The reaction requires O2, CO2, and the hydroquinone form of vitamin K. The formation of GLA is sensitive to inhibition by dicumarol, an anticoagulant occurring naturally in spoiled sweet clover, and by warfarin, a synthetic analogue of vitamin K.Ref: Lippincott, 5th edition, page no: 389 | train | med_mcqa | null |
Kuttner Tumour is a lesion of following gland | [
"Lymph gland",
"Salivary gland",
"Sebaceous gland",
"Thymus gland"
] | B | • Kuttner tumor is also called as Chronic sclerosing sialadenitis
• Benign inflammatory lesion (fibro inflammatory)
• Associated with submandibular glands in most of the cases.
• Is basically a chronic inflammatory disease of salivary glands.
• Positive for cytokeratin CK 7, 8, 13, 19. | train | med_mcqa | null |
Use of Valproate during pregnancy may cause : | [
"Neural tube defect",
"Hydantoin syndrome",
"Respiratory depression",
"Mental retardation"
] | A | Neural tube defect | train | med_mcqa | null |
All are features of septic tank except: | [
"Ideal retention period-48 hours",
"Minimum capacity-500 gallons",
"Aerobic oxidation takes place outside",
"Sludge is solids setting down"
] | A | SEPTIC TANK: Is a water-tight masonary tank into which household sewage is admitted for treatment Is a satisfactory method of disposing liquid and excreta wastes from individuals dwellings, small groups of houses or institutions which have &;adequate water supply but donot have access to a public sewerage system&; Design features of a septic tank: Ideal retention period: 24 hours Steps of purification in a septic tank: Anaerobic digestion: Takes place in septic tank proper Aerobic oxidation: Takes place in sub-soil (outside septic tank) Ref: Park 25th edition &; Pgno: 797 | train | med_mcqa | null |
Although asthma is a heterogeneous disease, all individual with asthma would be most likely to:' | [
"Relate a personal or family history of allergic diseases",
"Conform to a characteristic personality type",
"Display a skin-test reaction to extracts of airborne allergens.",
"Demonstrate nonspecific airway hyperirritability."
] | D | Demonstrate nonspecific airway hyperirritability. The impoance of immune mechanisms in the pathogenesis of asthma is suggested by the common association between the disease and the presence of allergic diseases, skin-test sensitivity, and increased serum IgE levels. In addition, many susceptible persons develop bronchospasm after inhalation challenge with airborne allergens. A large propoion of asthmatic subjects, however, have none of these markers of immunologic activity and are classified as having idiosyncratic asthma. When tested for bronchial hyperirritability with various nonantigenic bronchoprovocational agents (e.g., histamine and cold air), asthmatic subjects are found to be more sensitive than normal, and the bronchoconstriction is generally reversible after exposure to a j3-adrenergic agonist; the reason for this airway hyperirritability, which is a common feature in all asthmatic persons, is unlmown. Although psychological factors ceainly influence the expression of asthma, no single personality type is considered "asthmatic". | train | med_mcqa | null |
Cardiac enzymes are | [
"CPK",
"LDH",
"SGOT",
"ALK. Phosphatase"
] | A | These tests can measure blood levels of the enzyme creatine phosphokinase (CPK), also called creatine kinase (CK), and a more specific form of this enzyme called CK-MB. Additionally, cardiac enzyme tests can be used to check the blood levels of the proteins myoglobin and troponin. | train | med_mcqa | null |
True about phenytoin is | [
"First pass metabolism",
"Not teratogenic",
"Drug of choice for absence seizure",
"causes nystagmus and ataxia"
] | D | null | train | med_mcqa | null |
In which of the following malignancies histological grade is a good prognostic indicator? | [
"Melanoma",
"Soft tissue sarcoma",
"Renal cell carcinoma",
"Lung cancer"
] | B | null | train | med_mcqa | null |
Dyskeratosis - | [
"Leukoplakia",
"Hyperpigmentation",
"Nail dystrophy",
"Premature keratinisation"
] | D | DEFINITIONS OF MICROSCOPIC TERMS
Hyperkeratosis Thickening of the stratum corneum, often associated with a qualitative abnormality of the keratin.
Parakeratosis Modes of keratinization characterized by the retention of the nuclei in the stratum corneum. On mucous membranes, parakeratosis is normal.
Hypergranulosis Hyperplasia of the stratum granulosum, often due to intense rubbing.
Acanthosis Diffuse epidermal hyperplasia.
Papillomatosis Surface elevation caused by hyperplasia and enlargement of contiguous dermal papillae.
Dyskeratosis Abnormal keratinization occurring prematurely within individual cells or groups of cells below the stratum granulosum.
Acantholysis Loss of intercellular connections resulting in loss of cohesion between keratinocytes.
Spongiosis Intercellular edema of the epidermis.
Hydropic swelling (ballooning) Intracellular edema of kerantinocytes, often seen in viral infections
Exocytosis infiltration of the epidermis by inflammatory or circulating blood cells.
Erosion Discontinuity of the skin exhibiting incomplete loss of the epidermis.
Ulceration Discontinuity of the skin exhibiting complete loss of the epidermis and often of portions of the dermis and even subcutaneous fat.
Vacuolization Formation of vacuoles within or adjacent to cells; often refers to basal cell-basement membrane zone area.
Lentiginous Referring to a linear pattern of melanocyte proliferation within the epidermal basal cell layer. Lentiginous melanocytic hyperplasia can occur as a reactive change or as part of a neoplasm of melanocytes. | train | med_mcqa | null |
Mifepristone & misoprostol for MTP is allowed till - | [
"6 weeks",
"7 weeks",
"9 weeks",
"12 weeks"
] | C | Ans. is c i.e., 9 weeks Medical method for first trimester MTP* It is now officially allowed in India up to 9 weeks (63 days) of gestation.* Method: a combination of RU486 followed by PGE1.* Mifepristone, also known as RU-486, is an antiprogesterone compound* It acts preferentially on target cells of the endometrium and deciduas, counteracting the effect of progesterone, which is essential for the establishment and maintenance of pregnancy.* It affects the pituitary gonadotropic cells, producing a remarkable decrease of LH secretion, leading to luteolysis.* It causes softening and ripening of the cervix and produces increased contractibility of the myometrium.* It causes a marked increase in sensitivity of the uterus to exogenous PGs.Misoprostol (PGE1)* It acts by (a) enhancing uterine contraction and thus helping expulsion of the products of contraception and (b) causing cervical ripening or priming. It is used orally as tablets and vaginally as a suppository. The success rate of this combination is 96%.* Fewer than 5% of women undergoing medical methods of abortion will need surgical intervention (check curettage) for incomplete abortion.* For the medical abortion up to 9 completed weeks since last menstrual period, mifepristone plus PGs are used; the dosage regimens recommended by the World Health Organization are as follows:* 200 mg mifepristone followed after 36-48 h by 800 mg vaginal misoprostol or 400 pg oral misoprostol | train | med_mcqa | null |
What is function of Intrinsic Factor - (NEET/DNB | [
"Increases cobalamin absorption Pattern)",
"Increases folate absorption",
"Converts prothrombin to thrombin",
"Converts fibrinogen to fibrin"
] | A | Ans. is 'a' i.e., Increases cobalamin absorption o Intrinsic factor is a small glycoprotein secreted by the parietal cells of the gastric mucosa.lt is essential for vitamin B12 absorption.o Gastric acid and pepsin release the vitamin from protein binding in food and make it available to bind to cobalophilin, a binding protein secreted in the saliva.o In the duodenum, cobalophilin is hydrolyzed, releasing the vitamin for binding to intrinsic factor,o Intrinsic factor binds only the active vitamin Bi: vitamers and not other corrinoids.o Vitamin Bn is absorbed from the distal third of the ileum via receptors that bind the intrinsic factor vitamin B12 complex, but not free intrinsic factor or free vitamin,o Vitamin Bi; is also called as ''extrinsic factor of castle". | train | med_mcqa | null |
Cherry-red colour in post moem staining is a feature of poisoning with: | [
"Nitrites",
"Aniline",
"Phosphorus",
"Carbon Monoxide"
] | D | Colour of Post Moem Staining in different conditions Condition Colour of Post moem staining Usual colour Reddish purple CO Cherry red HCN Bright Red or Dark Red or Brick Red Hypothermia, drowning Bright Pink Opium Black P or acute Cu poisoning- Dark Brown or Yellow Nitrites, Nitrates, potassium chlorate, Potassium bicarbonate, nitrobenzene, acetanilide, bromates, Aniline Red Brown or Copper Brown or Chocolate Brown or Coffee Brown Hydrogen Sulphide Bluish green CO2, Asphyxia, Aniline Deep blue (In Aniline Deep blue as well as Red Brown colour can occur) Haemorrhage, Anaemia Pale Clostridium Perfringes- Bronze | train | med_mcqa | null |
Feature(s) of Allergic conjunctivitis is/are all except: | [
"Itching",
"Papillary'hyperplasia",
"Presence of abundant eosinophils in the discharge",
"Usually present throughout year"
] | D | Ans: D (UsuaIly..) SIMPLE ALLERGIC CONJUNCTIVITISIt is a mild, non-specific allergic conjunctivitis characterized by itching, hyperaemia and mild papillary response. Basically, it is an acute or subacute urticarial reaction.EtiologyIt is seen in following forms:Hay fever conjunctivitis. It is commonly associated with hay fever (allergic rhinitis). The common allergens are pollens, grass and animal dandruff.Seasonal allergic conjunctivitis (SAC). SAC is a response to seasonal allergens such as grass pollens. It is of very common occurrence,Perennial allergic conjunctivitis (PAC) is a response to perennial allergens such as house dust and mite. It is not so common, results. However, a trial may be given in recurrent cases.PathologyPathological features of simple allergic conjunctivitis comprise vascular, cellular and conjunctival responses.Vascular response is characterised by sudden and extreme vasodilation and increased permeability of vessels leading to exudation.Cellular response is in the form of conjunctival Infiltration and exudation in the discharge of eosinophils, plasma cells and mast cells producing histamine and histamine-like substances.Conjunctival response is in the form of boggy swelling of conjunctiva followed by increased connective tissue formation and mild papillary hyperplasia.Clinical PictureSymptoms include intense itching and burning sensation in the eyes associated with watery discharge and mild photophobia.Signs (a) Hyperaemia and chemosis which give a swollen juicy appearance to the conjunctiva, (b) Conjunctiva may also show mild papillary reaction, (c) Oedema of lids.DiagnosisDiagnosis is made from : (1) typical symptoms and signs; (2) normal conjunctival flora; and (3) presence of abundant eosinophils in the discharge.TreatmentElimination of allergens if possible.Local palliative measures which provide immediate relief include:Vasoconstrictors like adrenaline, ephedrine, and naphazoline.Sodium cromoglycate drops are very effective in preventing recurrent atopic cases.Steroid eye drops should be avoided. However, these may be prescribed for short duration in severe and non- responsive patients.Systemic antihistaminic drugs are useful in acute cases with marked itching.Desensitization has been tried without much rewardingFig: (Khurana): Differentiating features of common types of conjunctivitis BacterialViralAllergicChlamydial(A) CLINICAL SIGNS 1. CongestionMarkedModerateMild to moderateModerate2. Chemosis+++- +-3. Subconjunctival haemorrhages++---4. DischargePurulent or mucopurulentWateryRopy/wateiyMucopurulent5. Papillae+-+++6. Follicles-+-++7. Pseudomembrane++--8.Pannus--- (Exceptvernai)+9. Pre-auricular lymph nodes+++-+(B) CYT0L0G1CAL FEATURES 1. Neutrophils++ (Early)-+2. Eosinophils--+-3. Lymphocytes-+-+4. Plasma cells---+5. Multi nuclear cells-+--6. Inclusion bodies: Cytoplasmic-+(Pox)-+Nuclear-+ (Herpes)--7. Micro-organisms+--- | train | med_mcqa | null |
A cook prepares sandwitches for 10 people going for picnic. Eight out of them develop severe gastroenteritis within 4-6 hrs of consumption of the sandwitches. It is likely that on investigations the cook is found to be the carrier of - | [
"Salmonella typhi.",
"Vibrio cholerae",
"Entamoeba histolytica",
"Staphylococcus aureus"
] | D | null | train | med_mcqa | null |
Milroy's disease is | [
"Edema due to filariasis",
"Congenital lymphedema",
"Lymphedema following surgery",
"Post cellulitic lymphedema"
] | B | Congenital lymphedema or Milroy disease (10%), that is present at bih and associated with an autosomal dominant familial history | train | med_mcqa | null |
Insertion of levator scapulae is- | [
"Lateral border of scapula",
"Suprolateral part of scapula",
"Superior part of medial scapula border",
"Inferior angle of scapula"
] | C | Ans. is 'c' i.e., Superior part of medial scapula border Levator scapulaeOriginPosterior tubercles of transverse processes of Cl - C4 vertebraeInsertionSuperior part of medial border of scapulaArterydorsal scapular arteryNervecervical nerve (C3, C4) and dorsal scapular nerve (C5)ActionsElevates scapula and tilts its glenoid cavity inferiorly by rotating scapula | train | med_mcqa | null |
Macrosomia is | [
"Large size baby",
"Big mouth",
"Large head",
"Large tongue"
] | A | The term "macrosomia" is used to describe a newborn who&;s significantly larger than average ( large size baby ). A baby diagnosed with fetal macrosomia has a bih weight of more than 4,000 grams (8 pounds 13 ounces), regardless of his or her gestational age. Another definition of macrosomia is a bih weight above the 90th percentile, corrected for gestational age and sex. Factors associated with fetal macrosomia include high blood sugar levels from gestational diabetes or diabetes mellitus, ethnicity (Hispanic women are more at risk), obesity, gaining extra weight during the pregnancy, carrying baby past term, gender of fetus (males are more prone to macrosomia), history of a previous large baby. Reference : page 137 Ghai Essential Pediatrics 8th edition | train | med_mcqa | null |
Myasthenia gravis is associated with | [
"Thymoma",
"Thymic carcinoma",
"Thymic hyperplasia",
"Lymphoma"
] | A | Some 60%of Myasthenia gravis are associated with a peculiar reactive hyperplasia of intrathymic B cells and another 20%are associated with thymoma, a tumor of thymic epithelial cells. Robbins basic pathology 9th edition page no 800,heading =Myasthenia gravis Option 4 is correct | train | med_mcqa | null |
Which of the flowing drug can induce panic disorder? | [
"Yohimbine",
"Sildenafil",
"PGE1",
"All of the above"
] | B | Neurobiological mechanisms ofpanic anxiety: biochemical and behavioral correlates of yohimbine-induced panic attacks. ... The patients repoing yohimbine-induced panic attacks had significantly larger increases in plasma MHPG, coisol, systolic blood pressure, and hea rate than the healthy subjects Ref ganong's review of medical physiology 25e 787 | train | med_mcqa | null |
Is responsible for presenile cataract: | [
"Atopic dermatitis",
"Blue dot congenital cataract",
"Dystrophica myotonica",
"All of the above"
] | D | Ans. All of the above | train | med_mcqa | null |
Aspiration of sperms from testis is done in: | [
"TESA",
"MESA",
"ZIFT",
"GIFT"
] | A | Ans. is a, i.e. TESARef: Novak 14th/ed, p1201Either IVF or IUI cannot be performed if appropriate methods for sperm recovery are not available in cases of male infertility.Sperm retrieval or recovery can be done by:* Microsurgical epididymal sperm aspiration: MESAQ* Percutaneous epididymal sperm aspiration: PESAQ* Testicular sperm extraction: TESEQ* Percutaneous testicular sperm fine needle aspiration: TESAQ* The choice of the method depends on:i. The underlying diagnosis,ii. Whether goal of the procedure is diagnostic or therapeuticiii. Whether, isolated sperm will be used immediately or cryopreserved.Note: GIFT: (Gamete Intra Fallopian Transfer)/ZIFT: (Zygote Intra Fallopian Transfer)They are alternatives to IVF in which oocytes and sperm (in GIFT) or zygote (in ZIFT) are transferred to fallopian tube instead of uterus via laparoscopy. Once commonly used, as they offered high success rates to women with normal tube anatomy (whereas IVF is mainly used in cases where tubal pathology is present), both procedures are relatively rare now. | train | med_mcqa | null |
The indications of colonoscopy in a patient with ulcerative colitis are all of the following except | [
"Diagnosis of the extent of inflammation",
"Differentiating it from Crohn's disease",
"Diagnosis of toxic megacolon",
"Monitoring the responds to treatment"
] | C | .Colonoscopy is of value to rule out carcinoma. It is easiest and most direct method in establishing the diagnosis. Colonoscopy shows mucosal nodules or ulcers; caecal and ileal strictures; deformed ileo caecal valve; mucosal oedema and pseudopolyps and occasionally diffuse colitis. Biopsy can be taken to confirm the diagnosis Contraindication-Acute ulcerative colitis. ref:SRB&;S manual of surgery,ed 3,pg no 514 | train | med_mcqa | null |
Vitamin E deficiency presents with all except - | [
"Ataxic gait",
"Peripheral neuropathy",
"Opthalmoplegia",
"Peri-follicular rash"
] | D | Answer- D. Peri-follicular rashAreflexiaProgression to an ataxic gaitDecreased vibration and position sensationsOphthalmoplegiaSkeletal myopathyPigmented retinopathy | train | med_mcqa | null |
A 20 year old male presents with chronic constipation, head ache and habitus, neuromas of tongue, medullated corneal nerve fibers and nodule of 2*2 cm size in left lobe of thyroid. This patient is a case of: | [
"Sporadic medullary carcinoma of thyroid",
"Familial medullary carcinoma of thyroid",
"MEN-2A",
"MEN-2B"
] | D | MEN-2A (Sipple Syndrome MEN) MEN-2B (MEN-3) Components Medullary carcinoma thyroid Pheochromocytoma Parathyroid hyperplasia or adenoma Hirschprung&;s Disease Cutaneous lichen amyloidosis Medullary carcinoma thyroid Pheochromocytoma Intestinal ganglioneuromas Mucosal neuromas Megacolon Marfanoid features Defect RET oncogenic (Cysteine codon) Chromosome: 10 RET oncogene (tyrosine kinase domain) Chromosome: 10 Transmission Autosomal dominant Autosomal Dominant Ref: Sabiston 20th edition Pgno: 993,1003 | train | med_mcqa | null |
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