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A 37-year-old woman is suffering from carcinoma of the uterus(fundus area) . Cancer cells are likely to metastasize directly to which of the following lymph nodes?, | [
"External iliac nodes",
"Internal iliac nodes",
"Superficial inguinal nodes",
"Aoic (lumbar) nodes"
] | C | The superficial inguinal nodes receive lymph from the buttocks, labium majora, upper uterus and the lower pas of the vagina and anal canal. These nodes have efferent vessels that drain primarily into the external iliac and common iliac nodes and ultimately to the lumbar (aoic) nodes. The internal iliac nodes receive lymph from the upper pa of the rectum, vagina, uterus, and other pelvic organs, and they drain into the common iliac nodes and then into the lumbar (aoic) nodes. Pa of uterus Draining lymph nodes Fundus Pre and para aoic lymph nodes Isthmus Round ligament lymphatics- superficial ingiunal LN Mid uterus External iliac LN lower uterus(cervix) everywhere except inguinal LN | train | med_mcqa | null |
Ahritis involving DIP, PIP, 1st carpometacarpal with sparing of MCP and wrist joints is typical of: | [
"Osteoahritis",
"Rheumatoid ahritis",
"Ankylosing spondylitis",
"Psoriatic ahritis"
] | A | Osteoahritis characteristically involves distal interphalangeal joint (Heberden's node), proximal interphalangeal joint (Bouchard's node), 1st carpometacarpal joint (base of thumb) of hand with sparing of metacarpophalangeal joint and wrist joint. Fig. Joints involved in osteoahritis | train | med_mcqa | null |
A child with three days history of upper respirotory tract infection presents with stridor, which decreases on lying down postion. What is the most probable diagnosis | [
"Acute Epiglottitis",
"Laryngotracheobronchitis",
"Foreign body aspiration",
"Retropharyngeal abscess"
] | B | Biphasic stridor usually originates from subglottic or proximal tracheal lesions. laryngotracheobranchitis presents in children of 1-5 years of age with biphasic stridor,brassy cough&low grade fever. Ref : Essential Paediatrics,O.P.Ghai,7 th edition,Pg No:339 | train | med_mcqa | null |
Man is the only reservoir of -a) Rabiesb) Measlesc) Typhoidd) Japanese B encephalitis | [
"a",
"bc",
"ac",
"ad"
] | B | Measles
The only source of infection is a case of measles. Carriers are not known to occur. There is some evidence to suggest
that subclinical measles occurs more often than previously thought.
Typhoid
Man is the only known reservoir of infection, case or carrier.
Rabies
In urban Rabies dog acts as a reservoir.
In Wild-life rabies jackal , fox and other animals act as reservoir.
Japanese Encephalitis
Animal and birds act as reservoir. | train | med_mcqa | null |
Pleomorphic adenoma has? | [
"Columnar cells enclosing lymphoid stroma",
"Exclusively myoepithelial cells",
"Epithelial cells in chondroid matrix",
"Nests of squamous cells & vacuolated cells containing mucin"
] | C | Mixed tumour of salivary gland (pleomorphic adenoma) is derived from a single clone (either myoepithelial or ductal reserve cell) and giving rise to two components, namely epithelial and myoepithelial (stromal elements) cells Pleomorphic adenoma: Encapsulated but pseudopodia (fingerlike projections) into the surrounding gland. | train | med_mcqa | null |
Transmission assessment survey is for? | [
"Plasmodium vivax",
"Plasmodium falciparum",
"Leishmania donovani",
"Wuchereria bancrofti"
] | D | TAS or Transmission Assessment Survey is done for lymphatic Filariasis - caused by Wuchereria bancrofti. The line listing of lymphoedema and hydrocele cases were initiated since 2004 by door-to-door survey in filaria endemic districts. The updated figure till December 2014 reveals about 12 lac cases with clinical manifestation of lymphoedema (8 lacs) and hydrocele (4 lacs). Initiation has also been taken to demonstrate the simple washing of foot to maintain hygiene for prevention of secondary bacterial and fungal infection in chronic lymphoedema cases, so that the patients get relief from frequent acute attacks. Extra edge: - Criteria for Elimination of lymphatic filariasis : Microfilaria carriers being < 1% of population. Children born after initiation of ELF are free from circulating antigenaemia (presence of adult filaria worm in human body). - WHO recommends triple therapy of Ivermectin + Diethylcarbamazine + albendazole to achieve the target, set to eliminate lymphatic filariasis by 2020. | train | med_mcqa | null |
All of the following are true about Ramsay hunt syndrome except | [
"Geniculate ganglion of facial nerve is involved",
"Vesicles on tympanic membrane, EAC & TONGUE",
"Due to herpes zoster",
"Paralysis of facial muscles on contralateral side of face"
] | D | It cause the paralysis of facial muscle on the side of the face as the infection. | train | med_mcqa | null |
Massive splenomegaly is least likely to occur in | [
"CML",
"Primary thrombocytosis",
"PCV",
"Primary myelofibrosis"
] | B | Thrombocytosis is defined as a platelet count greater than 400 x 109/L. ... The presence of chronic thrombocytosis, thrombohemorrhagic complications, microvascular symptoms, or splenomegaly ors the diagnosis of primary thrombocytosis. Spleenomegaly is least likely to occur. Ref ganong's review of medical physiology 25e | train | med_mcqa | null |
All are true about Raynauds phenomena except- | [
"Exposure to cold aggravates",
"Spasm of vessels",
"More common in females",
"Atherosclerosis of vessels"
] | D | null | train | med_mcqa | null |
Creatine is made up of all, except ? | [
"Glycine",
"Alanine",
"Methionine",
"Arginine"
] | B | Ans. is 'b' i.e., Alanine | train | med_mcqa | null |
Baby with recurrent infection of ear & discharge & seborrheic dermatitis with hepatosplenomegaly with cystic skull lesions. Diagnosis is ? | [
"Hemophagocytic lymphohistiocytosis",
"Langerhans cell histiocytosis",
"ALL",
"Multiple myeloma"
] | B | Ans. is 'b' i.e., Langerhans cell histiocytosis | train | med_mcqa | null |
Most diffusable ion in excitable tissue is - | [
"Na+",
"K+",
"PO4-",
"Cl-"
] | B | Points to note
Concentration of ions
Na+ concentration higher in ECF
K+ concentration higher in ICF
Cl- concentration higher in ECF
K+ leak channels allow K+ to move from ICF to ECF
Na+ is prevented from entering the cell.
Thus diffusion is highest for K+, then Cl- and least for Na+, when the cell is at rest. | train | med_mcqa | null |
Which of the following is not true regarding Nested PCR | [
"Two sets of Primers are used",
"Specificity of DNA amplification is increased",
"When DNA to be amplified is present in low concentration compared to total DNA this technique is most suitable",
"Sensitivity of DNA amplification is decreased"
] | D | In Nested PCR, both sensitivity and specificity is increased. | train | med_mcqa | null |
Which of the following condition presents with purulent urethral discharge September 2011 | [
"Syphilis",
"Chancroid",
"Gonorrhoea",
"Lymphogranuloma venerum"
] | C | Ans. C: Gonorrhoea Symptomatic gonococcal infection in males most commonly manifests as anterior urethritis which presents as painful micturition; urethral discharge, which is purulent, profuse, thick and creamy and redness and edema od urethral meatus. | train | med_mcqa | null |
What is the type of voice in antrochoanal polyp- | [
"Hyponasal voice",
"Hoarse voice",
"Low pitched voice",
"High pitched voice"
] | A | Ans. is 'a' i.e., Hyponasal voice Clinical features of antrochoanal polypo Unilateral Nasal blockage (more on expiration than on inspirationo Obstruction may become bilateral when polyp grows into nasopharynx and starts obstructing opposite choana.o Hyponasal voiceo Mucoid nasal dischargeo Conductive deafness due to eustachian tube dysfunction.o On examination polyp may not be visible on anterior rhinoscopy as it grows posteriorlyo On posterior rhinoscopy - smooth, greyish white, spherical mass is seen in choana. | train | med_mcqa | null |
Which of the following is not true about Epidural anaesthesia in pregnancy? | [
"Given through Epidural space",
"Increased cardiac output",
"Decreased venous retutn",
"Hypotension"
] | B | In epidural anaesthesia, the anesthetic drug is injected in epidural space. CVS changes that occur in epidural anaesthesia are vasodilation which leads to peripheral pooling of blood, reduced venous return, reduced cardiac output and hypotension. | train | med_mcqa | null |
Anesthetic agent (s) safe to use in TICP | [
"Halothane",
"Thiopentone",
"Ketamine",
"Ether"
] | B | B i.e. Thiopentone Anesthetic agents safe to use in raised intracranial pressure (ICP) are thiopentone, propofol & etomidateQ | train | med_mcqa | null |
The use of succinylcholine is not contraindicated in: | [
"Tetanus",
"Closed head injury",
"Cerebral stroke",
"Hepatic failure"
] | C | Cerebral stroke | train | med_mcqa | null |
IPC321: | [
"Grievous hurt",
"Hurt",
"Punishment of hurt",
"Voluntarily causing hurt"
] | D | Ans. (d) Voluntarily causing hurtRef: The Essentials ofFSM by K.S. Narayan Reddy 31st ed. /270-71Some Important IPC sections and their definitionsINDIAN PENAL CODE:CRIMINAL PROCEDURE CODE:IPC SectionDefinitionSec 82A child under 7 yrs is incapable of committing an offence. Not applicable to railway act.Sec 83A child >7 &< 12 is presumed to be mature enough to be capable of committing an offence.Sec 84Act of a person of unsound mind/McNaughten's ruleSec 85Act of a person who's intoxicated against will.Sec 87A person less than 18 yrs cannot give valid consent to suffer any harm which may result from an act not intended or not known to cause death or grievous hurt. E.g. consent for wrestling contestSec 88 to93Legal protection to medical doctors. Sec 89 - a child < 12 yrs cannot give valid consent to suffer any harm which can occur by an act done in good faith or for itsbenefi t e.g. consent for operationSec 174Police inquestSec 176Magistrate's inquestSec 179Punishment for refusal to answer question by the policeSec 191Definition of perjurySec 193Punishment for perjurySec 197Issuing false certificate (3-7 years of punishment)Sec 201Disappearance of evidence (2 years of punishment)Sec 297Trespassing of burial placeSec 299Definition of Culpable homicideSec 300MurderSec 302Punishment for murder/infanticideSec 304Culpable homicide not amounting to murderSec 304 ACausing death by negligenceSec 304 BDowry death307Attempt to murder308Attempt to culpable homicide309Attempt to suicideSec 317Abandoning of infantsSec 318Concealment of death of childSec 319HurtSec 320Grievous hurtSec 321Voluntarily causing hurtSec 322Voluntarily causing grievous hurtSec 323Punishment for voluntary causing hurtSec 324Punishment for voluntary causing hurt by dangerous weapon/meansSec 325Punishment for voluntarily causing grievous hurtSec 326Punishment for voluntarily causing grievous hurt by a dangerous weapon/meansSec 351AssaultSec 354Assault to outrage the modesty of a woman.Sec 375Definition of rapeSec 376Punishment of rapeSec 377Unnatural sexual offenceSec 497Adultery | train | med_mcqa | null |
All of the following factors accelerate the development of rigor mois in a dead body, EXCEPT: | [
"Thin body built",
"Aerobic exercise",
"Cold temperature",
"Strychnine poisoning"
] | C | Cold temperature slows the onset and progression of rigor mois. It is because of the slow onset and breakdown of ATP in cold weather. Rigor mois usually has an onset 1-2 hours after death and gets well established in the entire body in about 9-12hrs. Factors accelerating the onset of rigor mois are: Warm temperature Thin body built Aerobic exercise Strychnine poisoning (produces convulsions) Ref: Forensic Science: Fundamentals & Investigations By Anthony J. Beino, page 315. | train | med_mcqa | null |
Which of the following does not cause hypoglycemia? | [
"Insulin",
"Glitmepiride",
"Nateglinide",
"Acarbose"
] | D | Ans. d. Acarbose Acarbose towers glucose by inhibiting intestinal enzymes that digest carbohydrate by reducing carbohydrate digestion.Because of its mechanism of action, acarbose, when administered alone does not cause hypoglycemia in the fasting or postprandial states.Glimepiride and Nateglinide are an insulin secretogogue and it is a well known fact that insulin secretogogues are associated with hypoglycemia.""All the insulin secretogogues increase insulin secretion from the pancreas through the same mechanism, i.e. by interfering with potassium channel. All the insulin secretogogues have the potential to cause profound and persistent hypoglycemia especially in elderly individuals. "Acarbose {Alpha Glucosidase Inhibitor)* Acarbose is alpha glucosidase inhibitor, lowers glucose by inhibiting intestinal enzymes that digest carbohydrate there by reducing carbohydrate digestion.* Because of its mechanism of action, acarbose, w hen administered alone does not cause hypoglycemia in the fasting or postprandial states.* Acarbose only produces hypoglycemia when used along with other oral hvpoglycemics.Indications:* Acarbose can decrease blood glucose in both ty pe I and type 2 DM.* Apart from insulin, acarbose is the only drug approved for the treatment of both ty pe 1 and type 2 DM.Adverse Effect:* Major adverse effect is flatulence due to fermentation of unabsorbed carbohydrates | train | med_mcqa | null |
Spleenic injury is diagnosed on X–ray by – a) Half stomach shadowb) Obliteration of spleenic shadowc) Rib fractured) Gas under diaphragm | [
"a",
"c",
"bc",
"ad"
] | C | Signs of spleenic rupture on plain X-ray are :- Obliteration of spleenic outline, loss of psoas outline, fracture of lower ribs on left side, elevation of left hemidiaphragm, indentation of gastric air bubble. | train | med_mcqa | null |
Simplest cone form of teeth with a single root is seen in: | [
"Bunodont.",
"Haplodont.",
"Homodont.",
"Monophyodont."
] | B | null | train | med_mcqa | null |
The major fuel for the brain after several weeks of starvation | [
"Glucose",
"Fatty acid",
"Beta hydroxybutyrate",
"Glycerol"
] | C | The major fuel for brain in prolonged starvation is ketone bodies (Beta hydroxybutyrate, acetoacetate). | train | med_mcqa | null |
In order to replace maxillary canine, which of the following pontic should be used: | [
"Modified ridge lap.",
"Ovate.",
"Both of the above.",
"Sanitary."
] | C | Both modified ridge lap and ovate pontics are superior esthetically and hygienic, and hence, they are used in maxillary canine replacement. But only modified ridge lap is indicated for replacement of missing mandibular canine. | train | med_mcqa | null |
Amount of water lost in stools | [
"50ml",
"200ml",
"300ml",
"350ml"
] | B | Normal" Output: 1400-2300 mL/d Urine: 800-1500 mL Stool: 200 mL-250mL Insensible loss: 600-900 mL (lungs and skin). (With fever, each degree above 98.6degF adds 2.5 mL/kg/d to insensible losses; insensible losses are decreased if a patient is undergoing mechanical ventilation; free water gain can occur from humidified ventilation.)Ref: <a href=" | train | med_mcqa | null |
Clinical features of pyloric stenosis in infants are all except: | [
"Abdominal lump",
"Constipation",
"Weight loss",
"Metabolic acidosis"
] | D | Ans. (d) Metabolic acidosisRef: Sabiston 20th Edition, Page 1869* Weight loss can occur on longstanding cases* Constipation may occur due to persistent vomiting. | train | med_mcqa | null |
In pigmented basal cell carcinoma, treatment of choice is: | [
"Chemotherapy",
"Radiotherapy",
"Cryosurgery",
"Excision"
] | D | Treatment of Melanoma * Non-aggressive tumor on trunk or extremities : Excision or electrodissection & curettage * Large, aggressive , located at vital areas or recurrent : Moh's micrographic surgery | train | med_mcqa | null |
In fracture of the body of mandible the miniplate is given | [
"Upper border",
"Lower border",
"between upper and lower border",
"One at the upper and lower border"
] | C | null | train | med_mcqa | null |
Breath sounds are decreased in all the following except | [
"Lobar pneumonia",
"Pneumothorax",
"Pleural effusion",
"Atelectasis"
] | A | In pleural effusion, pneumothorax and in atelectasis the breath sounds become absent or reduced. While in lobar pneumonia breath sounds increases. Reference : Davidson, 23rd Edition, page no : 547. | train | med_mcqa | null |
Pulses paradoxus can be seen in the following clinical states except- | [
"Pericardial tamponade",
"Acute severe asthma",
"Acute myocardial infarction",
"COPD"
] | C | Pulsus paradoxus refers to a fall in systolic pressure >10 mmHg with inspiration that is seen in patients with pericardial tamponade but also is described in those with massive pulmonary embolism, hemorrhagic shock, severe obstructive lung disease, and tension pneumothorax. Pulsus paradoxus is measured by noting the difference between the systolic pressure at which the Korotkoff sounds are first heard (during expiration) and the systolic pressure at which the Korotkoff sounds are heard with each heabeat, independent of the respiratory phase. Between these two pressures, the Korotkoff sounds are heard only intermittently and during expiration. The cuff pressure must be decreased slowly to appreciate the finding. It can be difficult to measure pulsus paradoxus in patients with tachycardia, atrial fibrillation, or tachypnea. A pulsus paradoxus may be palpable at the brachial aery or femoral aery level when the pressure difference exceeds 15 mmHg. This inspiratory fall in systolic pressure is an exaggerated consequence of interventricular dependence. ref : ( Harrison&;s principle of internal medicine,20th edition,pg no.1824 ) | train | med_mcqa | null |
A 6-year old child who presented with perianal pruritus, excoriation of skin and nocturnal enuresis was found to be infected with a parasite causing auto infection. The causative agent is - | [
"Trichinella spiralis",
"Giardialamblia",
"Enterobius vermicularis",
"Wuchereria bancrofti"
] | C | Enterobius vermicularis (threadworm) This helminth is common worldwide and affects mainly children.After the ova are swallowed, development takes place in thesmall intestine but the adult worms are found chiefly in the colon. Clinical features The female lays ova around the anus, causing intense itching, especially at night. The ova are often carried to the mouth on the fingers and so reinfection or human-to-human infection occurs . In females, the genitalia may be involved. The adult worms may be seen moving on the buttocks or in the stool. Investigations Ova are detected in stool samples or by applying the adhesive surface of cellophane tape to the perianal skin in the morning. This is then examined on a glass slide under the microscope. A perianal swab, moistened with saline, also allows diagnosis. Management A single dose of mebendazole (100 mg), albendazole (400 mg), pyrantel pamoate (11 mg/kg) or piperazine (4 g) treats infection and is repeated after 2 weeks to control auto-reinfection. If infection recurs in a family, each member should be treated. All nightclothes and bed linen are laundered during treatment. Fingernails must be kept sho and hands washed carefully before meals. Subsequent therapy is reserved for family members with recurrent infection. Ref Harrison20th edition pg 1077 | train | med_mcqa | null |
Prevention of developing risk factors in CAD comes under: September 2007 | [
"Primary prevention",
"Secondary prevention",
"Primordial prevention",
"Teiary prevention"
] | C | Ans. C: Primordial prevention | train | med_mcqa | null |
Human Development Index is | [
"Infant mortality, Longevity and Income",
"Knowledge, Longevity and Income",
"Infant mortality, Health infrastructure and Income",
"Environment, Longevity and Income"
] | B | Ans. b (Knowledge, Longevity and Income). (Ref. Park PSM 22nd /pg. 16).# HUMAN DEVELOPMENT INDEX- Consist of three dimensions:- Longevity (life expectancy at birth);- Knowledge (Adult literacy rate and mean years of schooling); and- Income (real GDP per capita in purchasing power).- The HDI ranges between 0 to 1.- In India HDI is 0.602# PHYSICAL QUALITY OF LIFE INDEX (PQLI)- Consists of:- Infant mortality,- Life expectancy at age one, and- Literacy.- National and international comparison can be done- Kerala has highest PQLI# KUPUSWAMY INDEX- Kupuswamy index of social classification includes:# Education# Occupation# Income# SULLIVAN'S INDEX- This index (expectation of life free of disability is computed by subtracting from life expectancy the probable duration of bed disability and inability to perform major activities.- It is considered one of the most advanced indicators/measures of disability rate, currently available.# DALY (Disability Adjusted Life Years)- Measure of burden of disease in defined population and effectiveness of intervention.- 1 DALY = 1 lost year of healthy life.- HALE (Health Adjusted Life Years)- It consists of life expectancy at birth and adjustment of time spent in poor health. | train | med_mcqa | null |
Patellar plexus is formed by which aery - | [
"Descending genicular",
"Anterior tibial recurrent",
"Posterior tibial recurrent",
"Alloftheabove"
] | D | Ans. is 'd' i.e., All of the above Anastomosis around the knee joint o It is also called as patellar network patellar anastomosis, genicular anastomose or rete aiculare genus.It is divided into two pas -Superficial plexus: Lies in superficial fascia around patella and in fat behind patella.Deep pa: Lies an femur and tibia around their adjoining aicular surfaces. It is formed by:-A. Medial and above the condylesDescending genicular branch of femoral aery and its saphenous branch.Superior medial genicular.B. Medial and below the condylesSaphenous branch ofdescending genicular.Inferior medial genicular. C. Lateral andabovethecondylesDescending branch of lateral circumflex aery.Superior lateral genicular.D. Lateral and below the condylesInferiorlateralgenicularAnterior tibial recurrentPosterior tibial recurrentCircumflex fibular | train | med_mcqa | null |
Precocious pubey is seen in - | [
"Hypothyroidism",
"CNS irridation",
"Mc cune-Albright syndrome",
"All"
] | D | Ans. is 'a' i.e., Hypothyroidism; 'b' i.e., CNS irradiation; 'c' i.e., Mc Cune Albright syndrome Precocious pubey o Pubey before the age of 8 years in girls or 9 years in boys is considered precocious pubey. o Menarche before the age of 10 years in girls is also considered as precocious. o Precocious pubey is of two types 1. Central or true precocious pubey Results from excessive GnRH, gonadotropins and target sex hormone elaborated by premature activation of hypothlamic pituitary-gonadal (HPG) axis. 2. Peripheral or pseudo-precocious pubey Due to increased sex steroid secretion from either the adrenal gland or the gonads. It is independent of HPG axis activation Causes of Precocious pubey A. Central precocious pubey 1. Idiopathic : Sporadic or familial. 2. Central nervous system abnormalities i) Congenital anomalies of CNS: Hypothalamic hamaoma, hydrocephalus, porencephaly, arachnoid cysts. ii) Acquired lesions of CNS : Inflammation, granuloma, trauma, surgery, radiation, chemotherapy. iii) Tumors of CNS : Pineal tumors, optic glioma, ependymoma, camiopharyngioma. iv) Hypothyroidism B. Peripheral precocious pubey : Isosexual Girls 1. Ovarian causes : McCune-Albright syndrome, benign follicular cysts, granulosa-theca cell tumors; Gonadoblastoma 2. Adrenal causes : Feminizing adrenal neoplasia 3. Exogenous estrogen administration Boys 1. Testis : Leydig cell tumor, adrenal rest tumor, testotoxicosis. 2. Adrenal: CAH (21 or 11-(3 hydroxylase deficiency), virilizing tumors. 3. hCG secreting tumors : Hepatoma, hepatoblastoma, choriocarcinoma, chorionepithelioma, teratoma, dysgerminoma. Exogenous testosterone C. Heterosexual precocity 1. Girls : Virilization in girls due to virilizing CAH, ovarian or adrenal neoplasia, polycystic ovarian disease. 2. Boys : Feminization due to estogen producing adrenal tumors, exogenous estrogen, marijuana smoking. Note - Hypothyroidism usually causes delayed pubey, but juvenile hypothyroidism some times can cause precocious pubey. | train | med_mcqa | null |
Commonest site of occurrence of chondrosarcoma is: | [
"Pelvis",
"Femur",
"Ribs",
"Proximal tibia"
] | A | CHONDROSARCOMA It occurs over a broad age range: Peaks between 40 and 60 years for primary chondrosarcoma,and Between 25 and 45 years for secondary chondrosarcoma. Most are located in a proximal location such as: pelvis (most common site) proximal femur proximal humerus They occur in bones derived from enchondral ossification. Usually metaphyseal and central i.e. arising in the medullary cavity | train | med_mcqa | null |
Which border of scapula is not palpable ? | [
"Medial",
"Lateral",
"Inferior",
"Superior"
] | D | "The medial border, inferior angle and pa of the lateral border of scapula can be palpated on a patient as can the spine and acromian. The superior border and angle of the scapula are deep to soft tissue and are not readly palpable" | train | med_mcqa | null |
Cause for nipple retraction in breast carcinoma is | [
"Blocking of lymphatics",
"Involvement of the Cooper's ligament",
"Infiltration of ducts",
"Skin infiltration"
] | C | Infiltration of the Cooper’s ligament will give rise to dimpling of skin.
Blocking of subcutaneous lymph nodes will give rise to peau d'orange appearance. | train | med_mcqa | null |
Which muscle is inserted into the floor of the intertubercular sulcus of the humerus? | [
"Latissimus dorsi",
"Teres major",
"Pectoralis major",
"Deltoid"
] | A | Ans. is 'a' i.e., Latissimus dorsi o The shaft of humerus is cylindrical in the upper half and triangular on cross-section in the lower half. The upper part has intertnbercular sulcus {bicipital groove) anteriorly. Bicipital groove contains long head of biceps w ith its synovial sheath and an ascending branch of anterior circumflex humeral artery. Middle third of posterior surface of shaft of the humerus has a spiral groove {radial groove) which contains radial nerve and profunda brachi vessels.o Attachment to shafts are -Insertions of pectoralis major (on lateral lip of bicipital groove), latissimus dorsi (on floor of bicipital groove), teres major (on deltoid tuberosity) and coracobrachialis (medially on mid shaft).Origin of brachialis (anterior surface); Lateral and medial head of triceps (posterior surface); pronater teres (from medial supracondylar ridge); brachioradialis (from lateral supracondylar ridge) and ECRL (from lateral supracondylar ridge). | train | med_mcqa | null |
A boil is due to staphylococcal infection of - | [
"Hair follicle",
"Sweat gland",
"Subcutaneous tissue",
"Epidermis"
] | A | • Folliculitis, carbuncles and furuncles are all types of localized (superficial) skin infections that fall under the category of boils.
• Hair follicles serve as portals for a number of bacteria, although S. aureus is the MC cause of localized folliculitis. | train | med_mcqa | null |
A 30 year old woman with a bad obstetric history presents with fever. The blood culture from the patient grows gram-positive small to medium coccobacilli that are pleomorphic, occurring in short chains. Direct wet from the culture shows tumbling motility. The most likely organism is - | [
"Listera monocytogenes",
"Corynebacterium sp.",
"Enterococcus sp.",
"Erysipelothrix rhusiopathiae"
] | A | Listeria in pregnancy can lead to abortion.
Febrile woman with a bad obstetric history presents with gram-positive coccobacilli and tumbling motility is suggestive of Listeria monocytogenes. | train | med_mcqa | null |
Nitric Oxide Synthase | [
"Is inhibited by Ca++",
"Catalyzes a dioxygenase reaction",
"Accepts electrons from NADH",
"Requires NADH, FAD, FMN & Heme iron"
] | D | Nitric oxide is formed from arginine by the enzyme nitric-oxide synthase (NOS).It contains heme, FAD, FMN and tetrahydrobiopterin. The enzyme utilizes NADPH and molecular oxygen. Calmodulin is required to modulate its activity.The guanidino nitrogen of arginine is incorporated into NO.. From the molecular oxygen, one atom is added to NO. and the other into citrulline. Therefore, the enzyme is a di-oxygenase Ref: D M Vasudevan 7th edition Page no: 228 | train | med_mcqa | null |
Drug of choice in interstitial lung disease is | [
"Antibiotics",
"Steroid",
"Bronchodilators",
"none"
] | B | Glucocoicoids are the mainstay of therapy for suppression of the alveolitis present in ILD.Glucocoicoid therapy is recommended for symptomatic ILD patients with eosinophilic pneumonias,sarcoidosis,hypersensitivity pneumonitis,acute inorganic dust exposures,acute radiation pneumonitis,drug-induced ILD.In organic dust disease,glucocoicoids are recommended for both the acute and chronic stages.A common staing dose of steroid is prednisone,0.5-1 mg/kg in a once-daily oral dose.This dose is continued for 4-12 weeks,at which time the patient is reevaluated.If the patient is stable or improved,the dose is tapered to 0.25-0.5 mg/kg and is maintained at this level for an additional 4-12 weeks,depending on the course.If the patient's condition continues to decline on glucocoicoids,a second agent like cyclophosphamide,azathioprine,methotrexate,colchicine,pencillamine ,etc can be added, and the prednisolone dose is lowered to or maintained at 0.25 mg/kg per dose. Ref:Harrison's medicine-18th edition,page no:2164-2165. | train | med_mcqa | null |
Subclan steal syndrome is due to | [
"Blockage of first pa of subclan aery",
"Blockage of second pa of subclan aery",
"Blockage of third pa of subclan aery",
"Thrombosis of subclan vein"
] | B | Subclan steal syndrome refers to steno-occlusive disease of the proximal subclan aery with retrograde flow in the ipsilateral veebral aery and associated cerebral ischaemic symptoms.CausesClinical presentationIpsilateral upper limbNeurological, radiationCongenital Weak or absent pulseDecreased blood pressure (>20 mmHg)Arm claudication (rare due to collateral perfusion)DizzinessVeigoSyncopeAtaxiaVisual changesDysahriaWeaknessSensory disturbancesRadiographic featuresUltrasoundCT angiographyMR angiographyRetrograde flow in ipsilateral veebral aeryEarly changes prior to reversal of flow: decreased velocity, biphasic flow (in veebral aery)Changes can be augmented with arm exercise or inflation of BP cuff above systolic pressureProximal subclan aery usually can't be seen well enough to assessDistal subclan aery shows parvus-tardus waveform and monophasic waveformSubclan aery stenosis or occlusion easily identifiedDelayed enhancement of ipsilateral veebral aeryDirection of flow in veebral aery cannot be determinedOther intracranial or extracranial cerebral vascular lesions can be identifiedSubclan aery stenosis or occlusion easily identifiedDelayed enhancement of ipsilateral veebral aeryRetrograde direction of flow in ipsilateral veebral aeryOther intracranial or extracranial cerebral vascular lesions can also be identifiedTreatmentEndovascular: angioplasty & stent inseionSurgical: bypass surgery | train | med_mcqa | null |
Moist heat kills of the following except- | [
"Brucella",
"Mycobacteria",
"Salmonella",
"Coxiella burnetti"
] | D | Ans. is 'd' i.e., Coxiella Burnetti . Heat sterlization is done either by dry heat or by moist heat. . Pasteurisation is a type of sterilization by moist heat. . Pasteurisation is done by two methods. a) Holder method 63degC for 30 minutes b) Flash method 72degC for 15-20 seconds . All nonsporing pathogens such as mycobacteria, brucella and salmonellae are destroyed. Coxiella burnetii is relatively heat resistant and may survive the holder method. Note : The best answer of this question would have been none of the above, as pasteurization is not the only method of moist heat sterilization. Autoclaving is also a type of moist heat sterilization, and it kills all the microorganisms. | train | med_mcqa | null |
Drug of choice of paroxysmal supraventricular tachycardia is - | [
"Adenosine",
"Digitalis",
"Procainamide",
"Mexiletine"
] | A | Ans. is 'a'i.e., Adenosine Drugs of PSVT-1st choice - Adenosine2nd choice - CCBs (verapamil, diltiazem) or b-blockers. | train | med_mcqa | null |
Maximum amount of essential fatty acids is found in: | [
"Coconut oil",
"Sunflower oil",
"Mustard oil",
"Groundnut oil"
] | B | Remember the list given below Safflower oil > corn oil > sunflower oil > soyabean oil > groundnut oil > mustard oil > palm oil > coconut oil. Ref: Park 21st edition, page 566. | train | med_mcqa | null |
Which of the following is not a co-factor for pyruvate dehydrogenase complex? | [
"Thiamine pyrophosphate",
"FAD",
"NAD",
"Biotin"
] | D | Co-factor for PDH complex are:
Thiamine pyrophosphate (vit B1), FAD (vit B2), NAD (vit B3), coA (vit B5), Lipoic acid. | train | med_mcqa | null |
What is involved in formation of d-TMP from d-UMP | [
"N5, N10-methylene tetra hydrofolate",
"Form imino folate",
"N5 formyl folate",
"Dihydrofolate"
] | A | null | train | med_mcqa | null |
"Herald patch" is a characteristic feature of Repeated | [
"Pityriasis rubra pilaris",
"Psoriasis",
"Lichen planus",
"Pityriasis rosea"
] | D | Herald patch or mother patch is a characteristic feature of Pityriasis rosea Pityriasis rosea is a type of skin rash.Classically, it begins with a single red and slightly scaly area known as a "herald patch". This is then followed, days to weeks later, by a pink whole body rash. It typically lasts less than three months and goes away without treatment. Sometime a fever may occur before the sta of the rash or itchiness may be present, but often there are few other symptoms The symptoms of this condition include: An upper respiratory tract infection may precede all other symptoms in as many as 69% of patients. A single, 2- to (rarely) 10-cm oval red "herald" patch appears, classically on the abdomen.Occasionally, the "herald" patch may occur in a 'hidden' position (in the armpit, for example) and not be noticed immediately. The "herald" patch may also appear as a cluster of smaller oval spots, and be mistaken for acne. Rarely, it does not become present at all. 7-14 days after the herald patch, many small (5-10 mm) patches of pink or red, flaky, oval-shaped rash appear on the torso. The more numerous oval patches generally spread widely across the chest first, following the rib-line in a characteristic "christmas-tree" distribution. Small, circular patches may appear on the back and neck several days later. In 6% of cases an "inverse" distribution may occur, with rash mostly on the extremities. In children, presentation can be atypical or inverse, and the course is typically milder. About one in four people with PR have mild to severe symptomatic itching. (Moderate itching due to skin over-dryness is much more common, especially if soap is used to cleanse the affected areas.) The itching is often non-specific, and worsens if scratched. This tends to fade as the rash develops and does not usually last through the entire course of the disease. The rash may be accompanied by low-grade fever, headache, nausea and fatigue Ref Harrison 20th edition pg 1290 | train | med_mcqa | null |
Which are the cells of olfactory bulb that act as local integrator? | [
"Sustentacular cells",
"Hair cells",
"Granular cells",
"Mitral cells"
] | D | Ans. is 'd' i.e., Mitral cellsIn olfactory bulb axons of olfactory nerve synapse with dendrites of mitral cells to form the olfactory glomeruli.Mitral cells are the principal output neurons of olfactory bulb anil their axons form the olfactory tract | train | med_mcqa | null |
Treatment of H. pylori is required in all of the following expect ? | [
"Gastro esophageal reflex disease",
"Gastric ulcers",
"Duodenal ulcers",
"Gastric lymphoma"
] | A | null | train | med_mcqa | null |
Classical complement activated by: | [
"C1",
"C3 Convease",
"lgA",
"Ag - Ab complex"
] | D | Antigen-antibody complex lead to activation of classical complement pathway. MAC - Membrane attack complex (C5 - C9) MAC-attack on Antigen & make pores and finally antigen killed Alternate Complement pathway - staing from C3QQ Note : - Compliment 1,4,2 is by passed Lectin pathway sta from C4 C1 will not be consumed in lectin pathway | train | med_mcqa | null |
Which amongst the following is the indication for parenteral iron therapy? | [
"Compliant patient",
"Intolerance to oral iron",
"When an immediate rise of Hb is required such as a patient in labour",
"To decrease the duration of oral medication"
] | B | Indications of parenteral iron therapy: 1. Oral therapy is contraindicated 2. Patient is non compliant to take oral iron 3. Non-tolerance to oral iron 3. Malabsorption Syndrome. 4. Moderate anemia in third trimester NOTE: the rate of increase of Hb is almost same as that with oral iron therpy. Therefore in any condition where quick Hb build up is required, blood transfusion should be considered. | train | med_mcqa | null |
Excretory poion of kidney is formed by? | [
"Urogenital sinus",
"Mullerian duct",
"Mesonephric duct",
"Genital tubercle"
] | C | DERIVATIVES OF MESONEPHRIC DUCT Both in Males and a Females Collecting tubules Minor and major calyces Pelvis Ureter Trigone of bladder In Males Epidydymis Vas derferens Seminal vesicles Mesoderm of prostate Ejaculatory duct In Females Ganers duct | train | med_mcqa | null |
In infection involving the submandibular space when extra oral incision drainages are necessary, which of the following structures should be divided | [
"Skin only",
"Skin superficial fascia only",
"Skin, superficial fascia, platysma and masseter muscle",
"Skin, superficial fascia, platysma, masseter muscle and deep cervical fascia"
] | D | null | train | med_mcqa | null |
Sarcomere extends between | [
"A band & I band",
"Two Z lines",
"Two I bands",
"None"
] | B | The area between two adjacent Z lines is called a sarcomere. The thick filaments are lined up to form the A bands, whereas the array of thin filaments extends out of the A band and into the less dense staining I bands.(REF.GANONG'S REVIEW OF MEDICAL PHYSIOLOGY -23rd EDITION. Page No-95.) | train | med_mcqa | null |
Not a common cause of night blindness: | [
"Cataract",
"RP",
"Oguchi disease",
"Pathological myopia"
] | A | Cataract is not a common cause of night blindness. Other causes are more recognized causes. Causes of Night Blindness Vitamin A deficiency (first symptom is red-green differentiation anomaly) Pathological myopia Tapetoretinal degenerations{eg. Retinitis pigmentosa(RP)} Familial congenital night blindness Oguchi's disease | train | med_mcqa | null |
'Learned behaviour which is socially acquired' is known as:- | [
"Customs",
"Acculturation",
"Standard of living",
"Culture"
] | D | Culture : is the learned behavior which is socially acquired. Acculturation : Is 'culture contact' or mixing of two cultures. It can occur through; Trades & commerce Industrialization Propagation of religion Education Conquest Custom : the established pattern of behavior that can be objectively verified within a paicular social setting Folkwares : Right ways doing thing in less vital areas of human conduct. Mores: More stringent customs. Attitude : A relatively enduring organization of beliefs around an object or concept, which predisposes one to respond in a ceain manner Attitude are acquired characteristics which are more or less permanent ways of behaving. | train | med_mcqa | null |
Which is the most common cranial nerve involved in pituitary apoplexy? | [
"Optic nerve",
"Oculomotor nerve",
"Abducens",
"Facial nerve"
] | B | Pituitary Apoplexy: Hemorrhagic infarction of large pituitary adenomas or pituitary infarction consequent to traumatic major blood loss Ocular paresis in pituitary apoplexy results from compression of the cavernous sinus, which makes cranial nerves III, IV, and VI vulnerable to compression. Most common cranial nerve involved in pituitary apoplexy is: Occulomotor nerve | train | med_mcqa | null |
Oseltamivir dose is - | [
"75 mg BD x 5 days orally",
"75mg BD x 5 days i.v.",
"200 mg BD x 5 days orally",
"200 mg BD x 5 days i.v."
] | A | Ans. is 'a' i.e. 75 mg BD x 5 days orallyRifampcino Oseltamivir and Zanamivir act as neuraminidase inhibitors and prevent the virion release by causing clumping of mature virions. These drugs are effective against both Influenza A and Influenza B.o Oseltamivir is drug of choice for bird flu (H5N1) as well as swine flu (H1N1).Routes of administration:o Oseltamivir - Orally (S/E - Nausea and vomiting)o Zanamivir - Inhalation (S/E - Bronchospasm)o Peramivir - Intravenous (LV. form of Zanamivir) | train | med_mcqa | null |
Drug of choice for neonatal convulsions – | [
"Valproate",
"Phenytoin",
"Phenobarbitone",
"Carbamazepine"
] | C | null | train | med_mcqa | null |
Morbid jealousy is most often seen in patients taking | [
"Alcohol",
"Amphetamine",
"LSD",
"Cannabis"
] | A | Some Complications of Alcohol Dependence Medical Complications Central Nervous System: i. Peripheral neuropathy ii. Delirium tremens iii. Rum fits (Alcohol withdrawal seizures) iv. Alcoholic hallucinosis v. Alcoholic jealousy vi. Wernicke-Korsakoff psychosis vii. Marchiaa-Bignami disease viii. Alcoholic dementia ix. Suicide x. Cerebellar degeneration xi. Central pontine myelinosis xii. Head injury and fractures. Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no. 39 | train | med_mcqa | null |
All of the following are true about Duret hemorrhage, EXCEPT: | [
"Seen in conjunctiva",
"ICT increase",
"Cushing's triad",
"Seen in brain"
] | A | Duret haemorrhage: "Progressive rise in ICP cause fuher downward herniation into the foramen magnum or coning. This result in shearing of perforators supplying the brain stem causing haemorrhage known as duret haemorrhage. Tractional damage to pituitary stalk can result in diabetes insipidus. With progressive herniation the pupils become midsize & non reacting. These are invariably irreversible events leading to brainstem death". In case of increased ICP downward herniation of brainstem occur, which cause stretching of perforators of basilar aery & may results in bleed (duret haemorrhage). The local syndrome may include cushing's triad (aerial hypeension, bradycardia & respiratory irregularity). Duret haemorrhage is small area of bleeding in ventral & paramedian pa of upper brainstem (midbrain and pons). It usually indicates a fatal outcome, however survival has been repoed. Diagnosis is made on CT or MRI". Ref: Love & Bailey, 24th Edition, Page 611; Operative Neurological Techniques by Henry, 5th Edition, Page 35 | train | med_mcqa | null |
Transcription is the process of - | [
"Protein synthesis",
"DNA replication",
"Synthesis of RNA",
"None"
] | C | Ans. is 'c' i.e., Synthesis of RNA o DNA stores genetic information Information about amino acid sequence of all the proteins is present in the form of genes in DNA.o The entire genetic material present in the DNA of an organism is known as genome.o The important role of DNA in transfer of information in living cells is called central dogma of molecular biology.o According to the central dogma, information flows from DNA to RNA to protein. This occurs in three steps:-DNA replication :- There is copying of parent DNA to form daughter DNA molecules having nucleotide sequence indentical to those of the parent DNA.Transcription:- This is the process in w'hich the genetic messages in DNA are rewritten in the form of RNA. In simple words. Synthesis of RNA from DNA is called transcription (flow of information from DNA to RNA).Translation:- In translation, the genetic message coded by RNA is translated by the ribosomes into the protein structure, i.e. synthesis of protein from RNA. | train | med_mcqa | null |
Stratified squamous epithelium is seen in all of the following EXCEPT | [
"Vagina",
"Skin",
"Gall bladder",
"Tongue"
] | C | Stratified squamous epithelium is seen in skin and all the openings since it is protective It is present in skin, vagina and in tongue but not in gall bladder which is lined by simple columnar epithelium with microvilli | train | med_mcqa | null |
All of the following structures pass through aoic opening in the diaphragm, EXCEPT : | [
"Azygos vein",
"Rt. phrenic nerve",
"Thoracic duct",
"Accessory Hemiazygos vein"
] | B | Azygos vein pass to the right and thoracic duct passes to the left of aoa through its opening in the diaphragm. Accessory hemiazygos vein and hemiazygos veins pass behind the aoa and thoracic duct to join the azygos vein opposite the seventh and eighth thoracic thoracic veebral bodies. Aoic opening in the diaphragm lies at the lower border of body of T12. Oesophageal opening of diaphragm lies at the level of lower border of T10 veebrae. Structures passing through it are: oesophagus, oesophageal branches of left gastric aery, anterior gastric nerve and posterior gastric nerve. Right phrenic nerve passes through the vena caval opening in the diaphragm which lies at level of lower border of T8 veebrae. Ref: A New Approach to Dissection of the Human Body: A Thiy Week Schedule By R. Kanagasuntheram page 71. Anatomy, Combined Edition By S. Mitra page 1-43. | train | med_mcqa | null |
Ormocers are: | [
"Organically modified ceramics",
"Inorganically modified ceramics",
"Organically modified Glass Inomer Cement",
"Inorganically modified Glass Inomer Cement"
] | A | null | train | med_mcqa | null |
Treatment of Non-union of # shaft femur - | [
"Open reduction with external fixation",
"Excision of the bone",
"Bone grafting with internal fixation with K-Nail",
"All of the following"
] | C | Treatment of choice is open the fracture site for bone grafting and internal fixation.
Internal fixation technique may be : -
Intramedullary interlock nailing (Preferred)
Intramedullary 'K' nailing
Plating (compression plaiting). | train | med_mcqa | null |
Which of the following is transmitted by mites: | [
"Endemic typhus",
"Epidemic typhus",
"Trench fever",
"Scrub typhus"
] | D | Ans. (D) Scrub typhusRef : K. Park 23rd ed. / 299-300, Park's PSMy 20/ 262Rickettsial Diseases, their Agents and Insect VectorsDiseaseRickettsial agentInsect VectorsEpidemic typhusEndemic typhusScrub typhusIndian tick typhusRocky mountain spotted feverRickettsial poxQ.feverTrench feverR. prowazekiiR. typhiR. tsutsugarnushiR. conoriiR. rickettsiiR. akariC. burnetiiRochalimae aquintanaLouseFleaMiteTickTickMiteSoft TickLouse | train | med_mcqa | null |
Berry aneurysm most commonly occurs due to? | [
"Endothelial injury of vessel due to HTN",
"Muscle intimal elastic lamina layer defect",
"Muscle and adventitial layer defect",
"Adventitia defect"
] | B | Berry aneurysm is due to defect in tunica media and intimal elastic lamina layer leading to weakening of vessel wall and outpouching in anterior poion of circle of willis. Saccular Aneurysms: is a 2nd most common cause of clinically significant subarachnoid hemorrhage is rupture of a saccular ("berry") aneurysm in a cerebral aery following trauma. Patient will describe the pain as worst headache of his life. Bloody tap on lumbar puncture is seen. Nimodipine is a cerebro-selective vasodilatory drug helpful for treatment of symptoms associated with subarachnoid hemorrhage. Berry aneurysm is associated with adult polycystic kidney disease (ADPKD). | train | med_mcqa | null |
Which component of the eye has a maximum refractive index – | [
"Anterior surface of the lens",
"Posterior surface of the lens",
"Centre of the lens",
"Cornea"
] | C | Lens has maximum refractive index among the refractive structures of eye. The refractive indices of the successive layers of lens increase from the periphery towards the nucleus. Therefore :-
Anterior lens cortex → Refractive index is 1.386.
Posterior lens cortex → Refractive index is 1.386.
Centre of lens (nucleus) → Refractive index is 1.46. | train | med_mcqa | null |
Necrosis of cells is due to : | [
"Ca2+ efflux cell",
"Fat deposition in cells.",
"Water imbibition in cells.",
"Enzymatic digestion."
] | D | • Necrosis: It refers to morphological changes that follow cell death in living tissues.
• These morphological changes are the result of 2 concurrent processes.
1. Enzymatic digestion.
2. Denaturation of proteins.
• The enzymes used in the process are derived from 2 sources:
1. From the lysosomes of the dead cells themselves (Autolysis).
2. From the lysosomes of immigrant leucocytes (Heterolysis). | train | med_mcqa | null |
HAM test is based upon : | [
"GPI Anchor Proteins",
"Complement",
"Spectrin protein",
"Mannose binding proteins"
] | B | HAM test is based upon susceptibility of RBC&;s to complement mediated lysis in patients with PNH. HAM test is usedfbr the diagnosis of PNH (Paroxysmal Nocturnal Haemoglobinuria). HAM test (Acidified serum lysis test) demonstrates lysis of RBC after activation of complement by acid. In acidified serum complement is activated by the alternate pathway. In patients with PNH, RBC are unusually susceptible to complement, and undergo lysis when incubated with acidified fresh serum. REF : ananthanarayana 10th ed | train | med_mcqa | null |
All of the following are the reasons for impaired absorption of calcium except: | [
"Inositol hexaphosphate in cereals",
"High intake of oxalate",
"High concentrations of fatty acids in the intestinal lumen",
"Decreased iron intake"
] | D | Phytic acid (inositol hexaphosphate) in cereals binds calcium in the intestinal lumen, preventing its absorption. Other minerals, including zinc, are also chelated by phytate. This is mainly a problem among people who consume large amounts of unleavened whole-wheat products; yeast contains an enzyme, phytase, that dephosphorylates phytate, so rendering it inactive. High concentrations of fatty acids in the intestinal lumen, as a result of impaired fat absorption, can also reduce calcium absorption by forming insoluble calcium salts; a high intake of oxalate can sometimes cause deficiency since calcium oxalate is insoluble.
HARPERS ILLUSTRATED BIOCHEMISTRY30th, Page No: 541 | train | med_mcqa | null |
All the structures lie behind thoracic duct at the root of the neck except | [
"Veebral aery and vein",
"Medial border of the scalenus anterior",
"Right phrenic nerve",
"Thyrocervical trunk and its branches"
] | C | The thoracic duct begins as a continuation of the upper end of the cisterna chyli near the lower border of the twelfth thoracic veebra and enters the thorax through the aoic opening of the diaphragm.In the NeckThe thoracic duct forms an arch rising about 3-4 cm above the clavicle. The arch has the following relations:Anteriorly: (i) Left common carotid aery, (ii) left vagus, and (iii) left internal jugular vein.Posteriorly: (i) Veebral aery and vein, (ii) sympathetic trunk, (iii) thyrocervical trunk and its branches, (iv) left phrenic nerve, (v) medial border of the scalenus anterior, (vi) preveebral fascia covering all the structures mentioned, and (vii) the first pa of the left subclan aery.Ref: BD Chaurasia; Volume 1; 6th edition; Page no: 272 | train | med_mcqa | null |
Most important step in root canal preparation? | [
"Biomechanical preparation",
"Obturation",
"Access canal opening",
"None of the above"
] | A | null | train | med_mcqa | null |
Emergence Delirium is characteristic of? | [
"Midazolam",
"Ketamine",
"Thiopentone",
"Opioids"
] | B | ANSWER: (B) KetamineREF: Goodman & Gillman 2009 edition page 231, Lippincotts pharmacology 5th edition table 25.1Emergence delirium characterized by hallucinations is a frequent complication of ketaminethat can result in serious patient dissatisfaction and can complicate postoperative management. Delirium is most frequent in the first hour after emergence and appears to occur less frequently in children; benzodiazepines reduce the incidence of emergence delirium. | train | med_mcqa | null |
Very long chain fatty acid is oxidised in: | [
"Mitochondria",
"Cytoplasm",
"Peroxisome",
"All of the above"
] | C | A modified form of oxidation is found in peroxisomes and leads to the formation of acetyl-CoA and H2O2 (from the flavoprotein-linked dehydrogenase step), which is broken down by catalase. Thus, this dehydrogenation in peroxisomes is not linked directly to phosphorylation and the generation of ATP. The system facilitates the oxidation of very long chain fatty acids (eg, C20, C22). These enzymes are induced by high-fat diets and in some species by hypo-lipidemic drugs such as clofibrate. Ref: Harper 28th edition, chapter 22. | train | med_mcqa | null |
All are true in difinition of chronic bronchitis except- | [
"Cough 3 months",
"Productive cough",
"More than 2 consecutive months",
"Haemoptysis"
] | D | null | train | med_mcqa | null |
Which one of the following is false regarding primary adrenal hyperplasia? | [
"Hyponatremia",
"Hypernatremia",
"Water retension",
"Hypokalemia"
] | A | Primary adrenal hyperplasia leads to increased mineralocoicoid activity and hence sodium and water retention with increased potassium excretion. Primary adrenal hyperplasia (PAH) is a clinical finding that can only be realized after surgery. Findings of PAH include severe hypokalemia and hypeension responsive to spironolactone, and elevated supine plasma aldosterone and 18-hydroxycoicosterone values that did not increase after ambulation. | train | med_mcqa | null |
Obstruction at the bifurcation of aoa leads to | [
"Rubor on putting leg in dependent position",
"Retrograde ejaculation",
"Gangrene of foot",
"Pallor of lower limb"
] | C | . Obstruction at the bifurcation of aoa causes sudden,rapidly progressive ischemia in both the lower limbs,leads to gangrene of both lower limbs. Note:In aoic bifurcation thrombus,there is earlier history of claudication in the buttock often with LERICH'S SYNDROME.Symptoms are slow and gradual but not dramatic.Collaterals between aoa abd iliac aeries have wrll formed and so sudden.rapid developmet of gangrene will not occur. Refer page no 193 of SRB's manual of surgery 5 th edition. | train | med_mcqa | null |
Choriocarcinoma is differentiated from invasive mole (chorio-adenoma destruens) by: | [
"Presence of high titre of urinary chorionic gonadotrophin",
"Presence of cannon ball shadow in the lungs",
"Absence of villi structure on histological examination of the lesion",
"All of the above"
] | C | Choriocarcinoma is characterised by absence of villi
High titre of urinary chorionic gonadotrophin and cannon ball shadow in the X-ray lungs are found in both choriocarcinoma and invasive mole. | train | med_mcqa | null |
The bodies of spine are biconcave and are called "codfish spine" most commonly seen in: | [
"Scurvy",
"Osteomalacia",
"Fluorosis",
"Hyperparathyroidism"
] | B | Codfish Veebra is seen in 1. Osteoporosis > Osteomalacia 2. Sickle cell disease 3. Hereditary spherocytosis 4. Homocystinuria 5. Renal osteodystrophy 6. Osteogenesis imperfecta 7. Gaucher's disease | train | med_mcqa | null |
Point at which the ratio of K+ permeability to Na+ permeability (PK/PNa) is the greatest. | [
"A",
"C",
"E",
"F"
] | D | Point A: RMP ( memebrane potential is closest to the equilibrium potential of potassium ion) Point B: Threshold potential Point C: Due to Hodgkin cycle rapid Na+ influx from voltage gated channels Point D: Na+ permeability maximum Membrane potential is closest to Na+ equilibrium potential Ratio of (P Na+/ P K +) maximum Point E: Potassium permeability maximum Point F: Only K+ permeability, no Na+ permeability Ratio of ( P K + / P Na+) is maximum | train | med_mcqa | null |
In the fed state, major fate of glucose-6-phosphate in tissues is: | [
"Storage as fructose",
"Storage as glyceraldehyde-3-phosphate",
"Enters HMP shunt via ribulose-5-phosphate",
"Storage as glycogen"
] | D | Ans. D. Stored as Glycogen(Ref: Harper 31/e page 136,137)The uptake of glucose into the liver GLUT 2 is independent of insulin.In the well fed state, the concentration of glucose entering the liver increases, so does the rate of synthesis of glucose-6-phosphateThis is in excess of the liver's requirement for energy-yielding metabolism. So it is used mainly for synthesis of glycogen.In both liver and skeletal muscle, insulin acts to stimulate glycogen synthetase and inhibit glycogen phosphorylase. | train | med_mcqa | null |
Which of the following is not helpful in diagnosis of tubal mass in ectopic pregnancy | [
"Beta-HCG estimation",
"Hysterosalpingography",
"Transvaginal ultrasound",
"Pelvic examination"
] | B | Ans. b. Hysterosalpingography | train | med_mcqa | null |
Movement of substances prevented across intercellular space by- | [
"Zona adherens",
"Tight junction",
"Gap junction",
"Desmosomes"
] | B | Ans. is 'b' i.e., Tight junction | train | med_mcqa | null |
Second most common malignancy in a patient with retinoblastoma is: | [
"Nephroblastoma",
"Osteosarcoma",
"Neuroblastoma",
"Craniopharyngioma"
] | B | Retinoblastoma: It is the most common primary intraocular malignancy of childhood. The mutation occurs in the retinoblastoma gene (Rb) at chromosome 13q14. This is a tumor suppressor gene. One mutated copy may be inherited in an autosomal dominant fashion (germline mutation). If a second mutation spontaneously occurs in any cell, tumorigenesis is likely. Individuals with a germinal mutation are at risk for the development of tumors other than retinoblastoma (pineal tumors, osteosarcoma, and other soft tissue sarcomas). Ref: Braverman R.S. (2012). Chapter 16. Eye. In W.W. Hay, Jr., M.J. Levin, R.R. Deterding, J.J. Ross, J.M. Sondheimer (Eds), CURRENT Diagnosis & Treatment: Pediatrics, 21e. | train | med_mcqa | null |
Minamata disease is caused by toxicity of: | [
"Arsenic",
"Antimony",
"Lead",
"Mercury"
] | D | A significant example of mercury exposure affecting public health occurred in Minamata, Japan, between 1932 and 1968, where a factory producing acetic acid discharged waste liquid into Minamata Bay. The discharge included high concentrations of methylmercury. The bay was rich in fish and shellfish, providing the main livelihood for local residents and fishermen from other areas. For many years, no one realised that the fish were contaminated with mercury, and that it was causing a strange disease in the local community and in other districts. At least 50 000 people were affected to some extent and more than 2 000 cases of Minamata disease were ceified. Minamata disease peaked in the 1950s, with severe cases suffering brain damage, paralysis, incoherent speech and delirium. Ref : | train | med_mcqa | null |
Which of the following drugs does not cause drug-induced hepatitis? | [
"Isoniazid",
"Rifampidn",
"Ethambutol",
"Methyldopa"
] | C | Ans: C (Ethambutol) Ref: KD Tripathi, Essentials in Pharmacology, 6th edition, pg 742 Explanation: Causes of Drug-Induced Hepatitis NSAIDs Amiodarone Anabolic steroids OCPs Chlorpromazine Erythromycin Halothane Methyldopa isoniazid Rifampicin Methotrexate Statins Sulfa drugs Tetracyclines Adverse Effects of Ethambutol Low visual acuity, defects in color vision and field defects due to optic neuritis Nausea Rashes Fever Neurological manifestations Hyperuricemia | train | med_mcqa | null |
The organism causing destruction of skin grafts is ? | [
"Streptococcus",
"Staphylococcus",
"Pseudomonas",
"Clostridium"
] | A | Ans. is 'a' i.e., Streptococcus | train | med_mcqa | null |
A 40-year-old man with a history of alcohol consumption of 25-year duration is admitted with a history of a 6-lb weight loss and upper abdominal pain of 3-weeks duration. Examination reveals fullness in the epigastrium. His temperature is 99, and his WBC count is 10,000. Which is the most likely diagnosis? | [
"Pancreatic pseudocyst",
"Subhepatic abscess",
"Biliary pancreatitis",
"Cirrhosis"
] | A | The presence of an epigastric mass 2-3 weeks after the onset of acute pancreatitis strongly favors a pancreatic pseudocyst. The history of alcoholism points to pancreatitis as a possible etiologic factor in the differential diagnosis. Pseudocysts develop in 10% of patients following acute pancreatitis. Most of these, however, resolve spontaneously. They may also develop in patients with chronic pancreatitis or after pancreatic trauma. | train | med_mcqa | null |
The laboratory repo shows values of gonadotropin and ovarian hormones of the blood sample taken, on day 20 of the menstrual cycle of a young woman. Whether her cycle was ovulatory or not may be validly assessed by the repoed serum level of : | [
"FSH",
"LH",
"Oestradiol",
"Progesterone"
] | D | D i.e. ProgesteroneWhether the cycle is ovulatory or anovulatory can be studied by plasma level of progesterone and LHQ.Plasma Progesterone- Progesterone is secreted by Corpus luteumQ which is formed after ovulation- Its concentration rises after ovulation & peaks at mid luteal phase (around day 20) and then declines as luteum degenerates.Plasma LH- LH is secreted by anterior pituitary gland LH surge causes ovulation and formation of corpus luteum.- Its peak (LH surge) is reached about 24-36 hrs before ovulationQ. - After ovulation its level sta falling because of negative feedback of progesterone. | train | med_mcqa | null |
A 40-year-old woman presents with a long history of vague upper abdominal pain and frequent indigestion with abdominal tenderness. Serum bilirubin is elevated (4.2 mg/dL). There is a mild increase in serum AST and ALT (62 and 57 U/L, respectively) and a moderate increase in alkaline phosphatase (325 U/L). Markers for viral hepatitis are negative. Abdominal ultrasound examination shows echogenic stone-like material within the gallbladder and thickening of the gallbladder wall. An intrahepatic mass is also visualized adjacent to the gallbladder. A cholecystectomy is performed. Histologic examination shows dense fibrosis and glandular structures in the wall of the gallbladder. What is the most likely diagnosis? | [
"Carcinoma of the gallbladder",
"Hemangiosarcoma",
"Hepatic adenoma",
"Hepatocellular carcinoma"
] | A | Adenocarcinoma of the gallbladder Arises from the mucosal surface epithelium - Obstructive jaundice (as in this case) by involvement of the extrahepatic biliary tree. The other choices are not associated with a history of chronic cholecystitis and cholelithiasis and infrequently cause obstructive jaundice. | train | med_mcqa | null |
Pure Radiolucent stone | [
"Struvite",
"Cystine",
"Xanthine",
"Calcium oxalate"
] | C | Ans. (c) Xanthine StonesRadiolucent Kidney Stones:* Pure Uric Acid Stones* Xanthine* Indinavir Drug induced StoneUric Acid Stone:* 5-10% of all stones* Seen in excessive acid urine (pH<5.5)* Uric acid is an end product of purine metabolism* Dietary protein and protein excess results in increased urinary URIC acid and stone.* Myeloproliferative diseases, chemotherapy drugs induce this stone.* Uric acid stone is also formed in normal uric acid level.* Low urine volume like in IBD, Ileostomies may also stimulate uric acid stone.* Stones are hard, multifaceted, multiple.* Pure uric acid Stones are radiolucent. | train | med_mcqa | null |
The per cent of Free or Ionized Calcium in the body is | [
"10%",
"25%",
"50%",
"75%"
] | C | (C) 50% # IONIZED CALCIUM:> Total calcium consists of free or ionized calcium (50%), calcium bound to protein (40-45%), principally albumin and calcium complexed to anions (5-10%), E.g. citrate, lactate, bicarbonate. Total calcium level does not give an indication of what is available at the cellular level.> Ionized calcium (iCa) is the form of calcium that is readily available to cells, and measurement of iCa is a more accurate reflection of the physiological calcium state.> Measurement of ionized calcium requires instrumentation with ion-specific electrodes. Unlike total calcium, ionized calcium is unaffected by albumin concentration, but it is affected by acid-base balance.> Acidosis (decreased pH) increases iCa, where as Alkalosis (increased pH) decreases iCa.> The pH of blood, serum or plasma changes rapidly with storage (usually decreases with refrigeration and increases with freezing), therefore iCa is unstable in stored blood samples. | train | med_mcqa | null |
A 70-year-old male has a pathologic fracture of femur. The lesion appears a lytic on X-rays film with a circumscribed punched out appearance. The curetting from fracture site is most likely to show which of the following | [
"Diminished and thinned trabecular bone fragments secondary to osteopenia",
"Sheets of atypical plasma cells",
"Metastatic prostatic adenocarcinoma",
"Malignant cells forming osteoid bone"
] | B | History,pathologic fracture, such as lytic lesion in x - ray and punched out lesion are suggestive of multiple myeloma. Even away from overt tumour masses, the marrow contains an increased number of plasma cells.These plasma cells may infiltrate the interstitium or be present in sheets that completely replace normal elements. On cuerreting this will be obtained. | train | med_mcqa | null |
Which of the following is not a side effect of phenytoin ? | [
"Hypoglycemia",
"Osteomalacia",
"Gum hypertrophy",
"Lymphadenopathy"
] | A | null | train | med_mcqa | null |
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