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All the following are non-contraceptive benefits of OC pills except | [
"Reduces dysmenorrhea",
"Reduces fibroadenomas",
"Reduces ovarian cancer risk",
"Decreased risk for venous thrombosis"
] | D | Established and Emerging Noncontraceptive Benefits of Oral ContraceptivesEstablished BenefitsMenses-relatedIncreased menstrual cycle regularityReduced blood lossReduced iron-deficiency anemiaReduced dysmenorrheaReduced symptoms of premenstrual dysphoric disorderInhibition of ovulationFewer ovarian cystsFewer ectopic pregnanciesOtherReduced fibroadenomas/fibrocystic breast changesReduced acute pelvic inflammatory diseaseReduced endometrial cancerReduced ovarian cancerEmerging BenefitsIncreased bone massReduced acneReduced colorectal cancerReduced uterine leiomyomataReduced rheumatoid ahritisTreatment of bleeding disordersTreatment of hyperandrogenic anovulationTreatment of endometriosisTreatment of perimenopausal changesWomen who use estrogen-containing hormonal contraceptives are at increased risk for venous thrombosis and thromboembolism. Reference: Novak's gynaecology; 14th edition; Chapter 10; Family planning | train | med_mcqa | null |
A 2 month baby presents with history of jaundice, turmeric colored urine and pale stools since bih. Examination reveals liver span of 10 cms, firm in consistency and spleen of 3 cms. The most specific investigation for establishing the diagnosis would be: | [
"Liver function tests",
"Ultrasound abdomen",
"Peroperative cholangiogram",
"Liver biopsy"
] | C | All patients suspected of having biliary atresia should undergo exploratory laprotomy and direct cholangiography to determine the presence and site of obstruction. Ref: Kliegman, Behrman, Jenson, Stanton (2008), Chapter 353, "Cholestasis", In the book, "NELSON TEXTBOOK OF PEDIATRICS", Volume 2, 18th Edition, New Delhi, Page 1673; Harrison's Internal Medicine, 18th Edition, Page 2624. | train | med_mcqa | null |
Psychogenic amnesia is characterized by: | [
"Anterograde amnesia",
"Retrograde amnesia",
"Both with confabulation",
"Patchy impairment of personal memories"
] | D | In psychogenic amnesia (or dissociative amnesia), usually memory is lost for events which have some personal significance, whereas memories for neutral events (e.g. national events) is intact. Hence, the memory loss is patchy and mostly for personal memories. | train | med_mcqa | null |
All of the following agents are used in obesity EXCEPT : | [
"Orlistat",
"Sibutramine",
"Olestra",
"Neuropeptide Y analogues"
] | D | Drugs used for the treatment of obesity are:
Fenfluramine
Sibutramine (serotonin and NA reuptake inhibitor)
Sucrose polyester (olestra)
β3 agonists
Dexfenfluramine
Orlistat (a Pancreatic lipase inhibitor)
Neuropeptide Y antagonists | train | med_mcqa | null |
The following enzyme defect causes acute intermittent porphyria | [
"Uroporphyrinogen III synthase",
"Uroporphyrinogen decarboxylase",
"Hydroxymethylbilane synthase",
"Protoporphyrinogen oxidase"
] | C | The defective enzyme in acute intermittent porphyria is hydroxymethylbilane synthase (uroporphyrinogen I synthase)ALA and porphyrobilinogen accumulate in body tissues and fluids.It is an autosomal dominant disorder.While most porphyrias are inherited in an autosomal dominant manner, congenital erythropoietic porphyria is inherited in a recessive mode. The defective enzyme in congenital erythropoietic porphyria is uroporphyrinogen III synthase,Harper 30th edition pg: 329 | train | med_mcqa | null |
Which of the following local anaesthetics belongs to the ester group ? | [
"Procaine",
"Bupivacaine",
"Lignocaine",
"Mepivacaine"
] | A | null | train | med_mcqa | null |
In Takayasu infiltrates of mucosa and submucosa of stomach is characteristically seen in Eosinophilic gastroenteritis. | [
"Common carotid artery",
"Subclavian artery",
"Renal artery",
"Inferior mesenteric artery"
] | B | (Refer: Robbins Pathologic Basis of Disease, 8thedition, pg no: 513-514)
Takayasu arteritis (PULSELESS DISEASE)
Granulomatous vasculitis of medium and larger arteries.
Ocular disturbances.
Diminished pulses in the upper extremities.
Transmural fibrous thickening of the aorta (aortic arch andgreat vessels).
Aortic lesions share many attributes with giant-cell aortitisincluding clinical features and histology; indeed, the distinctionis typically made only on the basis of the age of the patient.
In age > 50 years designated as giant-cell aortitis, while thoseunder 50 have Takayasu arteritis.
Morphology - Irregular thickening of the vessel wall with intimal hyperplasia
Histological appearance
Adventitial mononuclear infiltrates.
Perivascular cuffing of the vasa vasorum.
Mononuclear inflammation in the media.
Granulomatous inflammation and Giant cells.
Patchy medial necrosis.
In late stages, collagenous scarring, with admixed chronic inflammatory infiltrates, occurs in all three layers of the vessel wall.
Aortic root involvement causes aortic insufficiency.
Frequency of Arteriography Abnormalities in Takayasu’sArteritis | train | med_mcqa | null |
True about Delivery, of HIV +vewoman - | [
"Vaginal delivery has lower risk for transmission of HIV to child than CS",
"Vaginal delivery has higher risk for transmission of HIV to child than CS",
"Instrumentation has no risk of increased infection",
"Veical transmission is less in cases with preterm bih"
] | B | Ans.(b) Vaginal delivery has higher risk for transmission of HIV to child than CS Vaginal and emergency caesarean section deliveries, prematurity, and low CD4 cell count were most strongly associated with infants infection status in univariate analyses .Children delivered vaginally or by emergency caesarean section were more likely to be infected than those delivered by elective caesarean section, with a reduction in risk of 79% associated with the latter (P<0.001).Similarly, infants delivered before 37 weeks were more than twice as likely to be infected than infants who were not premature.Caesarean section before onset of labour and rupture of membranes approximately halves the risk of mother-to-child transmission.Transmission rate:During pregnancy: 5-10%During labour and delivery:10-15%During breastfeeding:5-20%Overall without breastfeeding:15-25%Overall with breastfeeding to six months:20-35%Overall with breastfeeding to 18-24 months:30-45% | train | med_mcqa | null |
A lesion in the paracentral lobule causes - | [
"Contralateral foot weakness",
"Seizures only",
"Migraine",
"Cognitive Loss"
] | A | null | train | med_mcqa | null |
The following statement about Gomez classification is True ? | [
"Based on height retardation",
"Based on median weight for age",
"Between 75 and 89% implies mild malnutrition",
"This classification has prognostic value for hospitalization of children"
] | B | Gomez classification of Undernutrition Index Grading 90-75% Grade I <75-60% Grade 2 <60% Grade 3 Ref: Nelson Textbook of Paediatrics; 20th edition; Chapter 46 Nutrition, Food Security, and Health | train | med_mcqa | null |
All of the following drug are used for management of Post Herpetic Neuralgia except | [
"Noriptyline",
"Capsaicin cream",
"Gabapentin",
"Cycloplegics"
] | D | -Cycloplegics have no role in neuropathic pain, provide relief in ocular pain due to spasm of muscles such as uveitis. -Simple analgesics such as paracetamol -Stronger analgesics such as codeine -Tricyclic antidepressants, e.g. noriptyline, amitriptyline -Carbamazepine for lancinating pain -Gabapentin (300-600 mg up to three times daily), sustained-release Oxycodone or both. -Capsaicin cream (active ingredient of chillie paper) is also used to relieve pain. | train | med_mcqa | null |
Malaria is transmitted in Rural areas by ? | [
"Anopheles stephensi",
"Anopheles dirus",
"Anopheles culicifacies",
"None"
] | C | Ans. is 'c' i.e., Anopheles culicifacies | train | med_mcqa | null |
Kamla, a 30 yrs old lady examined for infeility by hysterosalpingography, reveals 'Bead - like' fallopian tube & clubbing of ampulla. Most likely cause is : | [
"Gonococcus",
"Mycoplasma",
"Chlamydia",
"Mycobacterium tuberculosis"
] | D | Ans. is d i.e. Mycobacterium tuberculosis The following findings on hysterosalpingogram strongly suggest tubercular salpingitis : A rigid nonperistaltic pipe like tube. called lead pipe appearancedeg Beading and variation in filling densitydeg Calcification of the tubedeg Cornual blockdeg A jagged fluffiness of the tuba! outlinedeg Vascular or lymphatic intravasation of the dyedeg Tobacco - pouch seen at naked eye examination. Also Note : * In a proven case of genital tuberculosis, hysterosalpingography is contraindicated as it may spread the infection. In TB Endometritis on HSG : the uterine cavity is shrivelled and obliterated by adhesions. On USG : Incomplete septation of the tubal wall "Cogwheel sign" is a marker for acute disease. Thin wall and beaded string appearance is a marker for chronic disease. | train | med_mcqa | null |
SLE like syndrome is most commonly associated with administration of- | [
"Rifampicin",
"Procainamide",
"Digitalis",
"Phenytoin"
] | B | Ans. is 'b' i.e., Procainamide o Several drugs can cause a syndrome resembling SLE. o This syndrome is rare with all except Procainamide and Hydralazine, which are the most frequent offenders. | train | med_mcqa | null |
Traumatic iridodialysis may cause: | [
"Antiflexion of the iris",
"Retroflexion of the iris",
"Iridoplegia",
"All of the above"
] | A | Ans. Antiflexion of the iris | train | med_mcqa | null |
Which of the following is associated with cystic hygroma | [
"Down's syndrome",
"Marfans syndrome",
"Turner's syndrome",
"Cushing's syndrome"
] | C | Cystic Hygroma Cystic Hygroma are multiloculated cystic spaces lined by endothelial cells It results due to sequestration of a poion of jugular lymph sac from the lymphatic system Cysts are filled with clear lymph and are lined by endothelium Turner's syndrome is associated with cystic Hygroma Most cystic Hygroma involve the lymphatic jugular sacs MC site: Posterior neck region Other common sites : Axilla, mediastinum, inguinal & retroperitoneal regions Approximately 50% of them present at bih It may show spontaneous regression Ref: Sabiston 20th edition Pgno :1819 | train | med_mcqa | null |
Basic laboratory service is not available at PHC for which disease ? | [
"TB",
"Malaria",
"Syphilis",
"Leprosy"
] | D | Ans. is 'd' i.e., Leprosy Basic laboratory services at PHC Routine urine, stool and blood tests. Bleeding time, clotting time. Diagnosis of 1/STDs with wet mounting, Grama stain, etc. Sputum testing for tuberculosis (if designated as a microscopy center under RNTCP). Blood smear examination for malarial parasite. Rapid tests for pregnancy. RPR test for Syphilis/YAWS surveillance. Rapid diagnostic tests for typhoid (Typhi Dot) and malaria. Raid test kit for faecal contamination of water. Estimation of chlorine level of water using ohotoludine reagent. | train | med_mcqa | null |
As per RNTCP guidelines, Multi drug resistance (MDR) TB is defined as resistance to: | [
"Rifampicin",
"Rifampicin and isoniazide",
"Rifampicin, isoniazide and ethambutol",
"None of the above"
] | B | Confirmed MDR-TB case: MDR-TB suspect is one who is sputum culture positive and whose TB is due to Mycobacterium tuberculosis that are resistant in-vitro to at least isoniazid and rifampicin (the culture and DST result being from an RNTCP accredited laboratory). Ref: Park 21st edition, page 178. | train | med_mcqa | null |
The mechanism of action of the exotoxin produced by Corynebacterium diphtheriae can be characterized by which of the following? | [
"Acting as a superantigen that binds to MHC class II protein and the T-cell receptor",
"Blocking the release of acetylcholine causing anticholinergic symptoms",
"Blocking the release of glycine",
"Inhibits protein synthesis EF-2 adenosine diphosphate (ADP) ribosylation."
] | D | C. diphtheriae Produces a potent exotoxin encoded by a lysogenic beta-prophage. The toxin has a mol. Wt of 61,150 daltons 2 pas; A: 21,150 & B:40,000; A: active; B: binding Following proteolytic cleavage, the A segment is released into the host cell where it inhibits protein synthesis ADP ribosylation of elongation factor/ EF-2 (which is a t RNA translocase). Inhibition of protein synthesis disrupts normal cellular physiologic functions that are believed to be responsible for the necrotizing and neurotoxic effects of diphtheria toxin. | train | med_mcqa | null |
Most com mon neuropathy in DM is - | [
"Distal symmetric neuropathy",
"Autonomic neuripathy",
"Mononeuropathy",
"Amyotrophy"
] | A | Ans. is 'a' i.e,, Distal symmetric neuropathy o Diabetic neuropathy may manifest as polyneuropathy, mononeuropathy and autonomic neuropathy. but the most common form of diabetic neuropathy is distal symmetric polyneuropathyQ. | train | med_mcqa | null |
A young male patient presented with prolonged bleeding time. You take a detailed history and ask the patient for intake of NSAIDs as these can prolong the bleeding time. The patient refuses the intake of any form of NSAIDs. No other drug history was obtained. All of the following drugs can prolong bleeding time except | [
"Cephalosporins",
"Multivitamins containing Vitamin K",
"Methylxanthines",
"Anti-depressants"
] | B | Ans. (B) Multivitamins containing Vitamin K(Ref: Goodman and Gilman 12/e p1806)Vitamin K is involved in activation of clotting factors II, VII, IX and X. It thus, decreases the risk of bleeding. | train | med_mcqa | null |
Which of the following is not associated with thymoma: | [
"Red cell aplasia",
"Myasthenia gravis",
"Hypergammaglobulinemia",
"Compression of the superior mediastinum"
] | C | Thymoma associated autoimmune diseases are: ? Myasthenia gravis ? Phemphigus ? Systemic lupus erythematosus ? Pure red cell aplasia ? Hypogammaglobulinemia Ref: Illustrated Dictionary of Immunology By M.P. Arora, Pages 257-258 ; Cancer and Autoimmunity By Yehuda Shoenfeld, M. Eric Gershwin, Page 249 ; Harrison's Principle of Internal Medicine, 16th Edition, Page 1946 | train | med_mcqa | null |
Which of the following is the commonest nephropathy seen in a patient with cancer? | [
"Minimal change disease",
"IgA nephropathy",
"Membranous nephropathy",
"Focal segmental glomerulosclerosis"
] | C | Membranous nephropathy Most common cause of nephrotic syndrome in elderly patients. M.c.c. of nephrotic syndrome associated with solid cancers. | train | med_mcqa | null |
Which of the following helps to anchor an epithelial cell to the basement membrane? | [
"Adherent junction",
"Connexon",
"Gap junction",
"Hemidesmosome"
] | D | Hemidesmosomes are multiprotein complexes that facilitate the stable adhesion of basal epithelial cells to the underlying basement membrane. The mechanical stability ofhemidesmosomes relies on multiple interactions of a few protein components that form a membrane-embedded tightly-ordered complex. Ref ganong's review of medical physiology 25e | train | med_mcqa | null |
A 38-year-old woman with a long history of shoulder pain is admitted to a hospital for surgery. Which of the following muscles becomes ischemic soon after ligation of the superficial or ascending branch of the transverse cervical aery? | [
"Latissimus dorsi",
"Multifidus",
"Trapezius",
"Rhomboid major"
] | C | The trapezius receives blood from the superficial branch of the transverse cervical aery. The latissimus dorsi receives blood from the thoracodorsal aery. The rhomboid major receives blood from the deep or descending branch of the transverse cervical aery. The multifidus and longissimus capitis receive blood from the segmental aeries. | train | med_mcqa | null |
Giant hypertrophy of gastric mucosa similar to brain surface is seen in - | [
"Peptic ulceration",
"Carcinoma stomach",
"Menetrier's disease",
"Liomyosarcoma"
] | C | Menetrier disease
It is characterized by giant cerebriform (similar to brain surface) enlargement of rugal folds of gastric mucosa.
Enlargement of rugal folds is due to profound hyperplasia of surface mucous cells → gastric secretion & contain excessive mucus.
There is accompanying glandular atrophy → gastric disease is more common in males in the fourth to sixth decades.
The hypertrophic change may predominanty involve the body, fundus or antrum or may affect the entire stomach.
Patients develop protein-losing gastropathy accompanied hypoalbuminemia and edema.
Infrequently, the mucosal hyperplasia becomes metaplastic, providing a soil for the development of gastric carcinoma. | train | med_mcqa | null |
Most common cause of menorrhagia in childbear-ing period: | [
"Fibroid",
"Dysfunctional uterine bleeding",
"Pelvic endometriosis",
"Adenomyosis"
] | B | null | train | med_mcqa | null |
Anti HER 2/ neu antibody is: | [
"Bevacizumab",
"Trastuzumab",
"Rituximab",
"Abciximab"
] | B | The determination of tumor HER-2/neu expression for all newly diagnosed patients with breast cancer is now recommended. It is used for prognostic purposes in node-negative patients to assist in the selection of adjuvant chemotherapy because response rates appear to be better with doxorubicin-based adjuvant chemotherapy in patients with tumors that overexpress HER-2/neu, and as baseline information in case the patient develops recurrent disease that may benefit from anti-HER-2/neu therapy (trastuzumab). Patients with tumors that overexpress HER-2/neu may benefit if trastuzumab is added to paclitaxel chemotherapy. Cardiotoxicity may develop if trastuzumab is delivered concurrently with doxorubicin-based chemotherapy. Ref: Schwaz's principle of surgery 9th edition, chapter 17. | train | med_mcqa | null |
All the following are true about osteoporosis except | [
"There is bending of long bones",
"There is hypercalcemia",
"There is veebral compression fractures",
"Milkman's fracture"
] | B | Bending of bones and milkman's fracture is very much related to osteomalacia but they are also seen in osteoporosis. Whereas veebral compression fracture is related to osteoporosis but also seen in osteomalaciaOsteoporosis OOsteoporosis is defined as a reduction of bone mass (or density) or the presence of a fragility fracture. OSeveral noninvasive techniques are now available for estimating skeletal mass or density. These include *Dual-energy X-ray absorptiometry (DXA), *Single-energy X ray absorptiometry (SXA), *Quantitative computed tomography (CT), and *Ultrasound. The diagnosis of Osteoporosis is made when a patient has a characteristic osteoporotic fracture. In absence of such a fracture, evaluation of osteoporosis is done by T score measurement based on bone mass T scoreDiseaseT score > - 1Normal T score - 1 and - 2.5 Osteopenia T score < - 2.5 Osteoporosis (Refer: Mercer's Textbook of Ohopedics, 9thedition, pg no: 310-313) | train | med_mcqa | null |
Vitiligo is commonly associated with ? | [
"Celiac sprue",
"PCOD",
"Diabetes",
"Alpha -1 antitrypsin deficiency"
] | C | Ans. is 'c' i.e., Diabetes * Vitiligo is associated with the following autoimmune diseasesi) Alopecia areataii) Pernicious anemiaiii) Diabetes mellitusiv) Addison diseasev) Hyperthyroidism (Grave's disease)vi) Hypothyroidism (Hashimoto thyroiditis)vii) Multiple endocrinopathy syndromes (MEN) | train | med_mcqa | null |
During surgical treatment of poal hypeension in a 59-year-old man with liver cirrhosis, a surgeon inadveently lacerates the dilated paraumbilical veins. The veins must be repaired to allow collateral flow. Which of the following ligaments is most likely severed? | [
"Lienorenal ligament",
"Lienogastric ligament",
"Gastrophrenic ligament",
"Ligamentum teres hepatis"
] | D | The paraumbilical veins and the ligamentum teres hepatis are contained in the free margin of the falciform ligament. The lienorenal ligament contains the splenic vessels and a small poion of the tail of the pancreas. The lienogastric ligament contains the left gastroepiploic and sho gastric vessels. The gastrophrenic ligament contains no named structures. The hepatoduodenal ligament, a pa of the lesser omentum, contains the bile duct, proper hepatic aery, and poal vein in its free margin. | train | med_mcqa | null |
Test for detection of old blood stain is | [
"Gel diffusion",
"Precipitin test",
"Absorption elution test",
"Benzidine test"
] | D | D i.e. Benzidine test | train | med_mcqa | null |
Purpura is a feature of- a) Disseminated Intravascular Coagulation b) Henoch Schonlein Purpura c) Meningococcemia d) Schamberg's disease | [
"abc",
"abd",
"acd",
"ac"
] | A | null | train | med_mcqa | null |
Most common ocular foreign body is | [
"Chisel and hammer",
"Glass",
"Plastic",
"Stone"
] | A | most common occular foreign body is iron. And the most common mode is chissel and hammer Refer khurana 6/e p 421 | train | med_mcqa | null |
Which is not a metastatic complication of gonococci | [
"Endocarditis",
"Meningitis",
"Nephritis",
"Ahritis"
] | C | Blood invasion may occur from the primary site of infection and may lead to metastatic lesions such as ahritis, ulcerative endocarditis and very rarely, meningitis. Occasional cases of pyemia have been repoed. Reference: Textbook of Microbiology; Anathanarayan and panicker's; 10th edition; Page no: 235 | train | med_mcqa | null |
A neonate had suffered from a teratogenic insult during embryonic growth that has affected the mesencephalic pa of his developing neural tube. In the presented cast of his ventricular system (left lateral view), which of the following areas might have suffered | [
"Area B",
"Area C",
"Area D",
"Area E"
] | C | The cerebral aqueduct (D) is the cavity of the midbrain that develops from the mesencephalon. The lateral ventricle (A) is the cavity of telencephalon and the third ventricle (C) is the cavity of diencephalon. The interventricular foramen of Monro (B) serves as the communication between the two. The fouh ventricle (E) is the cavity of the rhombencephalon. | train | med_mcqa | null |
Which of the following play most important role in memory | [
"Synaptic network",
"Electric conduction network",
"Conductivity circuit",
"Conductivity network"
] | A | Ans. (a) Synaptic network(Ref: Ganong, 25th ed/p.284)Memory information is stored across diffuse network of neurons in brainSynapses across those neuronal network is strengthened by repetition of what is learned | train | med_mcqa | null |
Familial polyposis coli is associated with following genetic defect? | [
"MLH1",
"MSH2",
"APC",
"RET"
] | C | Ans is ;c' i.e., APC * Familial adenomatous polyposis (FAP) syndrome (familial polyposis coli) is caused by mutation in adenomatous polyposis coli gene(APC) located on long arm of chromosome 5 (5q21). Risk of malignancy is 100%, i.e. all patients develop colorectal carcinoma if left untreated. | train | med_mcqa | null |
The common side effect with fluoxetine therapy is - | [
"Seizure",
"Anxiety",
"Hypotension",
"Loose stools"
] | D | Amongst the give options, option d i.e. is the best answer (read below).
Most common side effects on long-term treatment are sexual dysfunction. However, you should keep in mind that sexual dysfunction is the most common side effects on long-term use. Otherwise, nausea and GI disturbances are the most common side effects.
"Transient nausea is the most frequent complaint with the SSRIs".
"The prominent side effects with SSRIs are gastrointestinal".
The most frequent GI complaints are nausea, diarrhea, anorexia, flatulence, dyspepsia".
The most common side effect of SSRIs is transient nausea.
If nausea is not given in options, then any other GI symptom (diarrhea, vomiting, anorexia) is the best answer.
The most common side effect of SSRIs on long-term use is sexual dysfunction. | train | med_mcqa | null |
A 68-year-old male patient with 3rd degree burn wounds affecting 25% TBSA was admitted in the hospital and treated with intravenous fluids and analgesics. After 8 days of hospital admission, the patient develops fever and leukocytosis. On examination, there is erythema and swelling around the wound. Exudate from this wound is positive for gram negative, oxidase positive bacilli, which does not ferment sugars. Culture is shown below. Drug of choice for this infection is: - | [
"Amoxicillin-Clavulinic acid",
"Cefepime",
"Ceftriaxone",
"Streptomycin"
] | B | Infection of a burn wound after 8 days of hospital admission by gram negative, oxidase positive, non-fermenter bacilli point towards diagnosis of a pseudomonas infection. Culture plate shows the pigment production by P. aeruginosa Cefepime has good activity against PSEUDOMONAS aeruginosa Enterobacteriaceae Methicillin-susceptible Staphylococcus aureus Streptococcus pneumonia Hemophilus species Neisseria species It penetrates well into CSF. It is excreted by the kidneys. Half-life is 2 hours. The standard dose for cefepime : 1-2 g infused every 12 hours more complicated infections or immune-compromised patient : 2 g every 8 hours. List of anti-pseudomonal drugs- treasure 30 (pharmacology) | train | med_mcqa | null |
All of the following can be involved in an injury to the head of the fibula, EXCEPT? | [
"Anterior tibial nerve",
"Common peroneal nerve",
"Superficial peroneal nerve",
"Tibial nerve"
] | D | The common peroneal nerve is extremely vulnerable to injury as it winds around the neck of the fibula. At this site, it is exposed to direct trauma or is involved in fractures of the upper pa of the fibula. While passing behind the head of the fibula, it winds laterally around the neck of the bone, pierces peroneus longus muscle, and divides into two terminal branches: the superficial peroneal nerve and deep peroneal nerve (anterior tibial nerve). Injury to common peroneal nerve causes foot drop. | train | med_mcqa | null |
Amide type of local anesthetic agents undergo bio transformation primarily in the | [
"Kidney",
"Liver",
"Plasma",
"Excreted in unaltered form"
] | B | null | train | med_mcqa | null |
Whichof the following is NOT true about the use of Beta blocker in CHF | [
"These should be staed at very low dose and sowly titrated upwards",
"Carvedilol is most widely used beta blocker",
"These are drug of choice in acute decompensated hea failure.",
"These can reduce moality in CHF patients"
] | C | Ref KDT 6/e p544 Beta blockers are contra-indicated in acute decompensated hea failure. | train | med_mcqa | null |
5-year-old male brought to casualty by his mother because of episode of sudden vomiting. He has been behaving strangely according to mother. Laboratory findings showed microcytic hypochromic anemia with the above finding. The most probable poisoning is: | [
"Chronic arsenic poisoning",
"Chronic lead poisoning",
"Chronic mercury poisoning",
"Chronic copper poisoning"
] | B | Ans. (B). Chronic lead poisoningThe above blood picture shows basophilic stippling of RBCs.Basophilic stippling (dots in the red blood cells) is due to the inhibition of 5 pyrimidine nucleotidase enzyme resulting in aggregation of ribosomes.Other findings in blood: Microcytic hypochromic anemia, anisocytosis, poikilocytosisBasophilic stippling is also seen in megaloblastic anemia. | train | med_mcqa | null |
The first to appear in a cause of acute intestinal obstruction is | [
"Colicky pain",
"Constipation",
"Vomiting",
"Distension"
] | A | Symptoms of intestinal obstruction Symptoms of intestinal obstruction : Pain, vomiting, distension and constipation Pain is the first symptom encountered ; it occurs suddenly and is usually severe Pain in intestinal obstruction It is colicky in nature and is usually centered on the umbilicus(small bowel) or lower abdomen (large bowel) The pain coincides with increased peristaltic activity With increasing distension, the colicky pain is replaced by a mild constant diffuse pain The development of severe pain is indicative of the presence of strangulation Pain may not be a significant feature in post operative simple mechanical obstruction and does not usually occur in paralytic ileus Ref: Bailey and love 27th edition Pgno : 1285 | train | med_mcqa | null |
All of the following are features of exstrophy of the bladder, except: | [
"Epispadias",
"Cloacal membrane is resent",
"Posterior bladder wall protrudes through the defects",
"Umbilical and inguinal hernia"
] | B | Ans. (b) Cloacal membrane is present* Basic defect in ectopia vesical is abnormal overdevelopment of Cloacal membrane and its rupture | train | med_mcqa | null |
Antigen binding site in immunoglobulin is | [
"Variable region",
"Hypervariable region",
"Constant region",
"all"
] | B | Ans. is 'b' i.e., Hypervariable region | train | med_mcqa | null |
All of the following are included in the laboratory criteria of APLA except | [
"LA",
"anticardiolipin (aCL)",
"ANA",
"anti-beta2 glycoprotein antibodies"
] | C | Laboratory criteria include (1) Lupus anticoagulant (2) anticardiolipin (aCL), and/or (3) anti-b2GPI antibodies, at intermediate or high titers on two occasions, 12 weeks apa. Laboratory criteria Venous thrombosis (e.g., deep vein thrombosis, pulmonary embolism, unusual site venous thromboembolism) Aerial thrombosis (e.g., coronary aery disease, transient cerebral ischaemia or stroke, peripheral aery disease) Obstetric complications: * Three or more unexplained consecutive spontaneous aboions <10," week of gestation. * One or more unexplained deaths of a morphologically normal fetus ?10," week of gestation. * One or more premature bihs of a morphologically normal neonate <34," week of gestation due to eclampsia, severe pre-eclampsia, or placental insufficiency Lupus anticoagulant, detected according to international guidelines Anti-cardiolipin antibodies, IgG, or IgM isotype, at high titre (>99," percentile of normal controls) Anti-82 glycoprotein-I antibodies, IgG, or IgM isotype, at high titre (>99th percentile of normal controls) Reference: Harrison&;s Principles of Internal Medicine; 20th edition; Chapter 350; Antiphospholipid Syndrome pg2527 | train | med_mcqa | null |
A adolescent was bitten by a stray dog. To rule out rabies in the animal, brain tissue sample was taken. Which of the pa of brain tissue should be taken to see the characteristic Negri bodies? | [
"Hippocampus",
"Hypothalamus",
"Medulla",
"Midbrain"
] | A | Rapid diagnosis of rabies infection in the animal is usually made by examination of brain tissue by using either PCR assay, fluorescent antibody to rabies virus or histologic staining of Negri bodies in the cytoplasm of hippocampal neurons. Negri bodies are sharply demarcated, more or less spherical, and 2-10 mm in diameter, and they have a distinctive internal structure with basophilic granules in an eosinophilic matrix. Negri bodies contain rabies virus antigens. Ref: (2012). Chapter 39. RNA-Enveloped Viruses. In Levinson W (Eds), Review of Medical Microbiology & Immunology, 12e. | train | med_mcqa | null |
Example of artificial passive immunity? | [
"Infection",
"Mother to child",
"Vaccine",
"Readymade immunoglobulin"
] | D | Infection - Natural active
Mother to child - Natural passive
Vaccine - Artificial active
Immunoglobulins - Artificial passive | train | med_mcqa | null |
Newborn male baby presented with congestive heart failure. On examination enlarged fontanelles, a loud cranial bruit and following radiological finding was noted -the most likely diagnosis is: | [
"Sinus pericranii",
"Vein of Galen malformation",
"Arachnoid cyst",
"Dandy walker malformation"
] | B | Ans. B Vein of Galen malformationCongenital malformation of median prosencephalic veinQ which shows dilated midline vascular channel in posterior part of cranium. Commonest cause of high output cardiac failure in paediatric age groupQ. | train | med_mcqa | null |
A 7-month-old, paially immunized child presented with cough ending in characteristic whoop. Which of the following is considered the best type of specimen to isolate the organism and confirm the diagnosis | [
"Nasopharyngeal swab",
"Cough plate culture",
"Tracheal-aspirates",
"Sputum"
] | A | Ans. (a) Nasopharyngeal swab Culture of nasopharyngeal secretion is the gold standard for diagnosis. The best specimen is collected by nasopharyngeal aspirations. An alternative to the aspirate is a dacron or rayon nasopharyngeal swab. Note PCR, due to its quick result, is replacing culture in many laboratories | train | med_mcqa | null |
Gene not associated with Diabetes malitus - | [
"PPARy",
"KCNJ11",
"CTLA4",
"PDGF-R"
] | D | Ans is 'd' i.e. PDGF-R PDGF-R gene is associated with glioma.Genelocus HLA-DQB1/IDDM16p21.3INS (insulin)11p15. 5CTLA4 (cytotoxic T lymphocyte-associated 4)2q31-35 | train | med_mcqa | null |
Arnold Chiari malformation is characterized by all except | [
"Hypoplasia of cerebellar vermis",
"Herniation of cerebellum",
"Flattened base of skull",
"Adulthood syndrome not associated with hydrocephalus"
] | A | Ans. is 'a' i.e., Hypoplasia of cerebellar vermis Arnold-chiari malformation* Arnold-Chiari malformation consists of herniation of the cerebellum and fourth ventricle into the foramen magnum, flattening of the base of the skull, and spina bifida with meningomyelocele.* Chiari malformation is divided intoi) Type I: Produce symptoms during adolescence or adulthood is usually not associated with hydrocephalus. The deformity consists of displacement of cerebellar tonsils into the cervical canal,ii) Type II: It is characterized by progressive hydrocephalus with a myelomeningocele in newborns. There is a failure of pontine flexure during embryogenensis, which results in elongation of 4th ventricle; kinking of brainstem and breaking of quadrigeminal plate (tectum); along with displacement of inferior vermis, pons and medulla into cervical canal. This causes widening of cervical canal (syringomyelia),iii) Type III: Usually associated with occipital encephalocele and causes abundant neurological deficit,iv) Type IV: Characterised by lack of cerebeller development and usually not compatible with life. | train | med_mcqa | null |
IUGR babies on delivery are called: | [
"Growth retarded",
"Small for date",
"Low bih weight",
"Preterm"
] | B | Small for date | train | med_mcqa | null |
Stage of labor lasting from full dilatation of cervix to complete bih of baby is? | [
"1st stage",
"2nd stage",
"3rd stage",
"4th stage"
] | B | 2nd stage. | train | med_mcqa | null |
A child presents with brown coloured urine and oliguria for last 3 days. He has mild facial and pedal edema. His blood pressure is 126/90. He has +3 proteinuria with 100 red cell and a few granular casts. His creatinine is 0.9, urea is 56. What is his diagnosis? | [
"PSGN",
"Nephrolithiasis",
"ESGN",
"Infection associated glomerulonephritis"
] | A | Ans. (A) PSGN(Ref: Nelson Text book of Pediatrics 20th Ed; Page No-2498 & Ghai's Essential Pediatrics 9th Ed; Page No-469)Most common cause of glomerulonephritis is immune mediated injury caused by immune complexes and glomerular antigen mediated damage. It is characterized by the triad of hematuria, azotemia and hypertension.The most common cause of acute glomerulonephritis is following streptococcal infection (PSGN-Post streptococcal Glomerulonephritis).Post Streptococcal Glomerulonephritis (PSGN)Acute post streptococcal Glomerulonephritis is caused by autoimmune injury only due to selective nephritogenic strains of streptococcus.The patient develops glomerulonephritis with streptococcal pharyngitis usually in winter after 1-2 weeks of infection and with streptococcal pyoderma in summer after 3-6 weeks of infection.Nephritogenic strains include types 4 and 12 (pharyngitis) and type 49 (pyoderma).Clinical Features#The most common age o presentation is 5-12 years (school-age children) and is rarely seen before 3 years of age.#The onset is rapid, with puffiness around the eyes and pedal edema.#The patient presents with gross hematuria with smoky, cola or tea colour urine and hypertension.#Peripheral edema typically results from salt and water retention.#Complications that can be seen are hypertensive encephalopathy, pulmonary haemorrhage, cerebral vasculitis, hyperkalemia, hypophosphatemia and acidosis.Diagnosis#Light microscopy: Proliferation of endothelial & mesangial cells#Fluorescence: Ig G, Ig M, and C3 deposits in mesangium.#RBCs casts on urine analysis is a characteristic feature#Urine shows 1-2+ proteinuria#Elation ASO titer (In skin infection ASO titre remains normal-here elevated anti-DNAse B titers help in diagnosis).Management#The treatment is usually suppurative most of the cases get resolved spontaneously and rarely and progress to renal failure.#Close monitoring of blood pressure and diet (should be low in sodium and potassium).#Fluid restriction#Diuretics (e.g. frusemide) for edema.#Penicillin is usually given for infection however, it does not alter the course of glomerulonephritis.#Antihypertensive drugs (Amlodipine, nifedipine or diuretics); hypertensive emergencies need treatment with IV nitroprusside or labetalol. | train | med_mcqa | null |
Danger area of neck is situated between | [
"Buccopharyngeal and preveebral fascia",
"Pharyngobasilar and preveebral fascia",
"Preveebral and alar fascia",
"Buccopharyngeal and alar fascia"
] | C | The space between Alar fascia & Preveebral fascia proper is called danger area as the infection or pus in this place can spread to posterior mediastinum. | train | med_mcqa | null |
What is the proof of eyes being open for few hours after death - | [
"Kevokian sign",
"Tache noir",
"Both of the above",
"None of the above"
] | B | If eyes are open for few hours after death a film of cell debris and mucus forms two yellow triangles on sclera which turns brown then black. This is tache noir. Kevorkian sign is fragmentation of blood column in retinal vessels which occur in few minutes after death and last for an hour. Ref: K.S.Narayan Reddy's Synopsis of Forensic Medicine and Toxicology, 29th edition, Chapter 7, page 83. | train | med_mcqa | null |
True about pulmonary embolism -a) ECG shows right ventricular strain patternb) PAO2-PaO2 difference in normalc) ECG also shows typical S1Q3 T3 patternd) Not a medical emergency | [
"a",
"bc",
"ad",
"ac"
] | D | null | train | med_mcqa | null |
Cushing's disease is associated with: | [
"Increased ACTH and increased coisol",
"Increased urinary Catecholamines",
"Increased ADH",
"Decreased ACTH and increased coisol levels"
] | A | Answer is A (Increased ACTH and increased Coisol) Cushing's disease refers to increased production of Coisol (T Coisol) by Adrenals secondary to an ACTH producing tumor (1st ACTH) in the pituitary gland. It is thus associated with increased levels of ACTH and Coisol. Only an individual who has (increased coisol due to) an ACTH producing pituitary tumor is defined as having Cushing's disease, whereas Cushing's syndrome refers to all causes of excess coisol' - Harrison Increased urinary catecholamines is a feature of pheochromocvtoma and not Cushing's disease. | train | med_mcqa | null |
Pseudohypoparathyroidism is characterized by: | [
"Normal serum Ca++ and decreased serum PTH",
"Decreased serum Ca++ and decreased serum PTH",
"Decreased serum Ca++ and Increased serum PTH",
"Normal serum Ca++ and Increased serum PTH"
] | C | c. Decreased serum Ca++ and Increased serum PTH(Ref: Nelson's 20/e p 2695-2697, Ghai 8/e p 521-524)Pseudohypoparathyroidism (PHP)Parathyroid glands are normal or hyperplastic and they can synthesize and secrete parathyroid hormone (PTH)Serum levels of immunoreactive PTH are elevated even when the patient is hypocalcemic normocalcemicNeither endogenous nor administered PTH raises the serum levels of calcium or lowers the levels of phosphorus. | train | med_mcqa | null |
Primary hyperaldosteronism (Conn's syndrome) is characterized by- | [
"High renin, high aldosteorone",
"Low renin, high aldosterone",
"Low renin, low aldosterone",
"High renin, low aldosterone"
] | B | high aldosterone and low renin because as there is hypo secretion of renin that fails to increase appropriately during volume depletion and hyper secretion of aldosterone that does not suppress in response to volume expansion (Harrison 17 pg 2260) | train | med_mcqa | null |
Efficiency of pasteurization of milk is determined by the following method: | [
"Methylene blue reduction test",
"Phosphatase test",
"Turbidity test",
"Resazurin test"
] | B | hosphatase test is widely used to check the efficiency of pasteurization. The test is based on the fact that raw milk contains an enzyme called phosphatase which is destroyed on heating at a temperature which corresponds closely with the standard time and temperature required for pasteurization. Other tests of pasteurized milk are, Standard plate count Coliform count Ref: Park's textbook of Preventive and Social Medicine, 19th edition, Page 522. | train | med_mcqa | null |
Most important nerve for cremastric reflex - | [
"Genitofemoral nerve",
"Femoral nerve",
"Ilioinguinal nerve",
"Posterior scrotal nerve"
] | A | Ans. is 'a' i.e., Genitofemoral nerve o Afferent of cremasteric reflex - Femoral branch of genitofemoral nerveo Efferent of cremasteric reflex - Genital branch of genitofemoral nerve. | train | med_mcqa | null |
Emysema aquosum is found in - | [
"Dry drowning",
"Wet drowning",
"Immersion syndrome",
"Secondary drowning"
] | B | Reff: The synopsis of forensic medicine & Toxicology 28th edition pg: 193 Lungs are voluminous, completely covering the pericardial sac and bulge out of the chest when the sternum is removed. Passive collapse, which usually occurs in death, does not occur due to the fact that edema fluid blocks the bronchi. Due to distension rib impression on surface of lungs is seen and when they are removed and kept on a table they don't collapse.On cut section they may appear dry, but large amount of water, sometimes foamy, ooze from the surface on squeezing. This has been described as emphysema aquosum. It occurs when water is inhaled into the lungs i.e. in wet drowning. | train | med_mcqa | null |
The expression of the following oncogene is associated with a high incidence of Medullary carcinomas of thyroid | [
"p53",
"Her 2 neu",
"Ret proto-oncogene",
"Rb gene"
] | C | null | train | med_mcqa | null |
what is the other name for anakastic personality disorder | [
"obsessive compulsive personality disorder",
"paranoid",
"histirionic personality disorder",
"schizotypal personality disorder"
] | A | * ANAKSTIC * Also known as OCPD( obsessive compulsive personality disorder) * Perfectionism * Rigidity * Punctuality * indecisiveness * Conscientiousness * excessive attention to detail extreme orderliness in one area of life Ref.Kaplon and Sadock, synopsis of psychiatry, 11 th edition, pg no.744 | train | med_mcqa | null |
All are disorders of Phagocytosis except | [
"Chronic granulomatous disease",
"Myeloperoxidase deficiency",
"Chediak-Higashi Syndrome",
"Nezelof Syndrome"
] | D | Nezelof Syndrome is autosomal recessive condition characterised by cellular immunodeficiency. | train | med_mcqa | null |
Radio opacity to composite resins is rendered by | [
"Silica glass",
"Organic matrix",
"Barium glass and strontium glasses",
"Fluoride particles"
] | C | null | train | med_mcqa | null |
With which of the following receptors theophylline has an antagonistic interaction ? | [
"Histamine receptors",
"Bradykinin receptors",
"Adenosine receptors",
"Imidazoline receptors"
] | C | null | train | med_mcqa | null |
False about sweet syndrome body sensation in eye. The most probable diagnosis is | [
"May be a/w high fever",
"Neutrophilia not present",
"May be a/w hematological malignancy",
"Pseudovesication"
] | B | B i.e. Neutrophilia not present | train | med_mcqa | null |
Recurrent fibroma refers to Desmoid tumor arising in | [
"Uterus",
"Scar tissue",
"Ovary",
"Muscle"
] | B | null | train | med_mcqa | null |
K - complex and sleep spindles are seen in which stage of sleep | [
"REM",
"Stage 1 NREM",
"Stage 2 NREM",
"Stage 3 NREM"
] | C | Ans. (c) Stage 2 NREM(Ref: Ganong, 25th ed/p.273)Stage 2 NREMWaves with frequency 12-14Hz called sleep spindles seenhigh voltage biphasic waves called K complexes also seen | train | med_mcqa | null |
Clubbing is least common in - | [
"Squamous cell carcinoma",
"Adenocarcinoma",
"Small cell carcinoma of lung",
"Mesothelioma"
] | C | null | train | med_mcqa | null |
Which of the following predisposes to placenta previa? | [
"Primigravida",
"Singleton pregnancy",
"Diabetesmellitus",
"Past cesarean pregnancy"
] | D | Ans: D | train | med_mcqa | null |
Selenium is a cofactor in following enzyme | [
"Glutathione peroxidase",
"Cytochrome oxidase",
"Cytochrome reductase",
"Xanthine oxidase"
] | A | Selenium21st amino acid = Selenocysteine RDA = 50 - 100 mcg/daySelenium as a co-factorSelenium deficiencySelenium toxicityGlutathione peroxidaseDeiodinase Thioredoxin reductase Keshan's cardiomegaly Kashin-beck disease Peripheral neuropathy Garlic odor to breathDermatitis (Refer: DM Vasudevan, Textbook of Biochemistry, 7th edition, pg no: 523) | train | med_mcqa | null |
Which of the following test is done to detect the presence of urobilinogen? | [
"Guthrie test",
"Fouchet's test",
"Ehrlich's test",
"Alcian blue spot test"
] | C | Ehrlich's aldehyde test: Ehlich's aldehyde reagent consists of para dimethyl amino benzaldehyde in acid solution. Equal volumes of urine and Ehrlich's reagent are mixed. Formation of pink colour indicates the presence of urobilinogen. Other Options:- Test Detects Guthrie test Screening of phenylketonuria Fouchet's test bile pigments (Bilirubin) in urine Alcian blue spot test mucopolysaccharides in urine Additional information: Watson-Schwaz testis a qualitative screening test for the detection and differentiation of urobilinogen and porphobilinogen. Step 1: Urine + Ehrlich reagent + Sodium acetate - Pink or red colour - Positive test - Urobilinogen or Porphobilinogen present. Step 2:Above test solution + Chloroform Step 3:Pink/Red layer + Butanol Note:If the pink color develops in the first step, then continue fuher. In the second step, if the colour develops in the aqueous layer, then proceed with the addition of butanol. | train | med_mcqa | null |
Which of the following is the tributary of inferior vena cava? | [
"Right gonadal vein",
"Splenic vein",
"Left supra renal vein",
"Left gonadal vein"
] | A | Tributaries of Inferior vena cava: Common iliac vein Lumbar vein Renal vein Phrenic vein Right gonadal vein Right suprarenal vein Hepatic vein CHOICE EXPLANATION & ELIMINATION REASON 1 Right gonadal vein Tributary of inferior vena cava 2 Splenic vein Tributary of poal vein 3 Left supra renal vein Tributary of renal vein 4 Left gonadal vein Tributary of renal vein | train | med_mcqa | null |
Which of the following is defective in renal glycosuria: | [
"GLUT- 1",
"GLUT- 2",
"SGLT- 1",
"SGLT- 2"
] | D | Renal Glycosuria (also called Familial Renal Glucosuria or Glycosuria ) Blood glucose is normal, But still Glucose appears in urine. It is due to defect/mutation in SGLT-2, which is major glucose transpoer (90% glucose reabsorption) present in kidneys for the reabsorption and transpo of Glucose (see fig below). Mutation in SGLT-1 (10% glucose reabsoption) leads to glucose-galactose malabsorption | train | med_mcqa | null |
In a general population, antenatal screening of Down syndrome is by: | [
"USG",
"Serum biomarkers",
"Chorionic villus sampling",
"Amniocentesis"
] | B | Serum biomarker tests for Downs Syndrome screening Dual marker: PAPP-A + free b HCG (along with nuchal transluscency) Triple marker: free b HCG + AFP + unconjugated estriol quadruple marker: free b HCG + AFP + Unconjugated estriol + Inhibin A First-trimester screening at 11 to 14 weeks' gestation, using the fetal nuchal translucency measurement together with serum analytes like PAPP-A and HCG levels , has achieved Down syndrome detection rates comparable to those for second-trimester screening in women younger than 35 years. Combinations of first- and second-trimester screening yield down syndrome detection rates as high as 90 to 95 percent Maternal serum cell-free fetal DNA testing for trisomy 21, 18, and 13 has become available as a screening test for high-risk pregnancies, with a 98-percent detection rate and a false-positive rate of 0.5 percent | train | med_mcqa | null |
A patient with H. pylori infection is treated with drugs. The best method to detect presence of residual H. pylori infection in this person is - | [
"Rapid urease test",
"Urea breath test",
"Endoscopy and biopsy",
"Serum anti H. pylori titre"
] | B | <p>Davidson's principles and practice of medicine 22nd edition. *urea breath test is highly specific and sensitive.in detection of h pylori infection</p> | train | med_mcqa | null |
The dose of anti-D immunoglobulin to be given to non- immune Rh D negative women after delivery is: | [
"50 mgm",
"150 mgm",
"300 mgm",
"450 mgm"
] | C | Ans. (c) 300 mgmRef : D. C Dutta 8th ed.l 387, 721 | train | med_mcqa | null |
Which of the following drugs is effective against HIV with Y181C mutation? | [
"Festinavir",
"Lersivirine",
"Elvitegravir",
"Dolutegravir"
] | B | Lersivirine
Festinavir is a NRTI shown to be effective in adefovir and tenofovir resistance
Lersivirine is a NNRTI effective against HIV with Y181C mutation
Elvitegravir is a integrase inhibitor used for initial / naïve treatment
Dolutegravir is a integrase inhibitor approved for raltegravir-resistant infections | train | med_mcqa | null |
Which of these Is not an FDA approved indication for use of modafinil as an adjunct? | [
"Major depression and associated lethargy",
"Narcolepsy",
"Obstructive sleep apnea",
"Shift work disorder"
] | A | Ref: KD Tripathi 7th edition Page no 487 Modafinil is a newer psychostimulant and it's approved indications are narcolepsy, sleep apnea syndrome and shift work syndrome. It is being evaluated as a drug to prevent relapse of cocaine dependence. It is not used for depression | train | med_mcqa | null |
Which of the following causes least increase in IOP? | [
"Flouromethalone",
"Triamicinolone",
"Dexamethasone",
"Hydrocortisone"
] | A | Ans. (a) FlouromethaloneRef: American Academy of Ophthalmology, BSCS, Section 9, p. 186Rimexolone, Loteprednol & fluorometholone have less potential to elevate IOP. | train | med_mcqa | null |
Polysacharide pneumococcal vaccine used in all EXCEPT | [
"Sickle cell anemia",
"Less than 2 years of children",
"More than 65 years of man",
"Asplenia"
] | B | (Less than 2 years of age): (914-Nelson 19th edition) (1158-59- H 18th edition; 147-685- Davidson 21st)* Immunologic responsiveness and efficacy following administration of pneumococcal polysaccharide vaccines is unpredictable in children < 2 years of age (914- Nelson 19th/ed)* High risk children > 2yr of age, such as those with asplenia, sickle cell disease, some types of immune deficiency (eg.antibody deficiencies). HIV infections, Cochlear implant CSF leak, DM and chronic lung, heart or kidney disease (including nephritic syndrome) may benefit also from PPSV23 administered after 2 years of age following priming with the scheduled dose of 13 valent pneumococcal conjugated vaccine (PCV-13)RECOMMENDED ROUTINE VACCINATION SCHEDULE FOR 13-VALENT PNEUMOCOCCAL CONJUGATE VACCINE (PCV13) AMONG INFANTS AND CHILDREN WHO HAVE NOT RECEIVED PREVIOUS DOSE OF 7-VALENT VACCINE (PCV7) OR PCV13, BY AGE AT FIRST DOSE ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES (ACIP), USA, 2010AGE AT FIRST DOSE (M0)PRIMARY PCV13 SERIESPCV13 BOOSTER DOSE2-63 doses1 dose at age 12-15 m07-112 doses1 dose at age 12-15 m012-232 doses-24-59 (healthy children)1 dose-24-71 (children with certain chronic diseases or immunocompromising conditions)2 doses-Capsular polysaecharide vaccine* Pneumococcal polysaccharide vaccine (PPV-23)* All person >65 years of age and for those 2- 64 years of age* Revaccination 5 years after the first dose is recommended for person > 2 years of agePolysaccharide - protein conjugate vaccine (PCV) - developed especially for infants and young children | train | med_mcqa | null |
The immune complex Hypersensitivity reaction is | [
"Type-1",
"Type-II",
"Type-III",
"Type-IV"
] | C | In immediate hypersensitivity (type I hypersensitivity), the injury is caused by TH2 cells, IgE antibodies, and mast cells and other leukocytes Mast cells release mediators that act on vessels and smooth muscle and proinflammatory cytokines that recruit inflammatory cells. In antibody-mediated disorders (type II hypersensitivity), secreted IgG and IgM antibodies injure cells by promoting their phagocytosis or lysis and injure tissues by inducing inflammation In immune complex-mediated disorders (type III hypersensitivity), IgG and IgM antibodies bind antigens usually in the circulation, and the antigen-antibody complexes deposit in tissues and induce inflammation In cell-mediated immune disorders (type IV hypersensitivity), sensitized T lymphocytes (TH1 and TH17 cells and CTLs) are the cause of the tissue injury ref robbins pathology 9th ed page 201 | train | med_mcqa | null |
Which one of the following conditions is diagnosed by T99 Peechnetate Scintigraphy? | [
"Pharyngeal diveiculum",
"Duodenal diveiculum",
"Meckel's diveiculum",
"Colonic diveiculum"
] | C | Ans. is 'c' i.e., Meckel's diveiculum | train | med_mcqa | null |
Which of the following investigation is used to confirm anorchia? | [
"PET",
"MRI",
"Laparoscopy",
"USG"
] | C | Ans. (c) LaparoscopyRef: Smith 17th Edition, Page 25* Gold standard investigation for non-palpable testis is diagnostic laparoscopy* Blind ended testicular artery implies absence of testis.* Blind ended Vas doesn't conclude absent testis | train | med_mcqa | null |
What is true about branchial cyst | [
"Present in anterior triangle of neck",
"Cauterization is done",
"Arises from 2 nd cleft",
"Present in lower 3 rd of neck"
] | C | null | train | med_mcqa | null |
Best way to prevent hypotension during spinal anesthesia | [
"Preloading with crystalloids",
"Mephentermine",
"Dopamine",
"Tredelenbug's position"
] | A | A i.e. Preloading with crystalloids | train | med_mcqa | null |
Body fluid level of Substance Use at which Coma occur ..... | [
"50-100 mg%",
"100-200 mg%",
"200-300 mg%",
">350 mg%"
] | D | >350 mg% | train | med_mcqa | null |
Insulin causes lipogenesis by all except: | [
"Increasing acetyl-CoA carboxylase activity",
"Increases the transpo of glucose into the cells",
"Inhibits pyruvate dehydrogenase",
"Decreases intracellular cAMP level"
] | C | Inhibits pyruvate dehydrogenase Role of insulin in lipogenesis: Insulin promotes lipogenesis by increasing activity of acetyl-CoA carboxylase activity, the principal enzyme of lipogenesis Insulin promotes the entry of glucose in some tissues such as skeletal muscle and adipocytes and thus increases the availability of pyruvate for fatty acid synthesis and glycerol 3-phosphate for esterification of the newly formed fatty acids. [Note that glucose transpo in some cells of body are insulin-independent - hepatocytes, RBCs, cells of nerveous system, corneal Insulin also activates pyruvate dehydrogenase (only in adipose tissue, not in liver) which catalyzes pyruvate into Acetyl-CoA the building blocks of fatty acids. Insulin decreases intracellular cAMP and thus inhibits lipolysis in adipose tissue. This reduces the concentration of plasma free fatty acids and long chain acyl-CoA (an inhibitor of lipogenesis). | train | med_mcqa | null |
Cullen's sign is seen in: March 2013 | [
"Acute cholecystitis",
"Acute pancreatitis",
"Acute hemorrhagic pancreatitis",
"Blunt injury abdomen"
] | C | Ans. C i.e. Acute hemorrhagic pancreatitis Cullen's sign It is superficial edema and bruising in the subcutaneous fatty tissue around theumbilicus. It is named for Thomas S. Cullen (1869-1953), an obstetrician who first described the sign in ruptured ectopic pregnancy in 1916. This sign takes 24-48 hours to appear and can predict acute pancreatitis, with moality rising from 8-10% to 40%. It may be accompanied by Grey Turner's sign (bruising of the flank), which may then be indicative of pancreatic necrosis with retroperitoneal or intraabdominal bleeding. | train | med_mcqa | null |
Not true about streptococcus pyogenes - | [
"Gram positive",
"Bacitracin sensitive",
"Catalase positive",
"Not soluble in bile"
] | C | Ans. is 'c' i.e., Catalase positiveo Streptococcus pyogenes (group A streptococci) are gram-positive cocci arranged in chains. Chain formation is due to cocci dividing in one plane only and daughter cells failing to separate completely. Chain formation is more pronounced in broth media.o Fresh isolates form capsule which is made up of hyaluronic acid. It protects the organism from phagocytosisCultural characteristicso Virulent strains produce 'matt' (finely granular) colonyo Avirulent strains produce 'glossy' colonies.o Capsulated strains produce mucoid colonies, corresponding in virulence to the matt type.Biochemical reactionso Senstivity to bacitracin is employed as a convenient method for differentiating str. pyogenes from other hemolytic streptococci (Maxted's observation),o Catalase negativeo Not soluble in 10% bile.o Hydrolyse PYRo Ferment trehalose but not ribose. | train | med_mcqa | null |
All of the following features in the knee are recognized to be consistent with a torn medial meniscus, except | [
"Excessive forward glide",
"Giving way",
"Locking",
"Mc. Murray's sign"
] | A | A i.e. Excessive - History of twisting strain (flexion, abduction/ valgus and medial rotation of femur on fixed tibia Q/ lateral rotation of tibia on fixed femur) followed by locking of knee pintQ is diagnostic of medial meniscus tear. - Mc Murray's test, Apley grinding test and Squat tests are done to diagnose meniscus (medial & lateral) injuryQ. - Excessive forward glide is d/t anterior cruciate ligament tear (not meniscus injury)Q. Meniscal tear is the commonest knee injury that require surgery. Medial meniscal tears are 3 times more common than lateral meniscus tears . Paial meniscetomy is done for tears not amenable to repair eg. cornpex, degenerative and central/ radical tearsQ. Meniscal repair should be done for all acute lateral/ peripheral tears especially in young patient undergoing concurrent ACL reconstructionQ. Meniscal Injury *Meniscus or semilunar cailage are relatively avascular structure with poor healing potentialQ. *Medial meniscus is larger and more oval than its fellow Medial meniscus is more frequently torn than the lateral because it is securely attached and less mobileQ where as lateral meniscus is more mobile and protected by action of popliteus muscle At bih entire meniscus is vascular; by age a months, the inner one third has become avascular. This decrease in vascularity continues by age 9 years, when the meniscus closely resembles the adult meniscus. In adults , only 10- 25% of lateral meniscus and 10- 30% of medial meniscus is vascular. Because of the avascular nature of inner two thirds of the meniscusQ; cell nutrition is believed to occur mainly through diffusion or mechanical pumping. So inner avascular meniscus once torn does not healQ. *The commonest type of medial meniscal injury in a young adult is the bucket handle tearQ (i.e. complete longitudinal tear). Other types are - flap tears, radial tears, complex tears etc *Ceain active spos- such as soccer, hockey, tennis, badminton, squash and skiing are commonly associated with meniscus injuries, paiculary when pivoting with all the weight on one leg with the knee flexed (i.e. twisting in flexed knee)Q. It used to be common in coal miners who had to stoop or squat in narrow seams with the knee joints flexed. *A common history is as follows: whilst involved in violent spoing activity or work with the knee in a position of flexion the patient suddenly sustains an outward twist of the foot or an inward twist of femur on the fixed foot. He immediately feels acute pain on anteromedial aspect of joint along with feeling of a tearing sensation and displacement of an internal structure. On attempting to rise, straightening of the knee is usually not possible (locking)Q *The meniscus may become completely displaced and locked between the femur and tibia, preventing full extension of the knee. More frequently the torn meniscus will cause pain, intermittent catching and occasionly locking as it flips into and out of the region of contact between the femur & the tibia. *In meniscal injury due to development of effusion (not hemahrosis) with in a few hours (not immediately) joint swells. It is impoant to note that swelling occuring immediately after injury, is d/t hemahrosis; which may be caused by an injury to cruciate or collateral ligaments or by an osteochondral fracture. The doughy feel of haemahrosis distinguishes ligment injuries from the fluctuant feel of the synol effusion of a meniscus injuryQ. *Symptoms include- joint line pain, catching, popping and lockingQ, usually and weakness & giving wayQ (instability) sometimes. Deep squatting and duck walking are usually painful. Joint line tendernessQ, pain with squatting, a positive flexion Mc Murry testQ. and positive Apley's compression-distraction testQ are all indicaive of meniscal injury. *Before the impoance of meniscus was understood and ahroscopy was available the meniscus was often removed entirely. But now attempts are made to remove only the torn poion of meniscus (if tear is in avascular poion), or repair the meniscus (in vascular peripheral poions if possible). Ahroscopy is the gold standard for making diagnosisQ and ahroscopic repair or removal is the treatment of choice. *Tears in the peripheral third of the meniscus, if small (< 15 mm), may heal spontaneously because this poion in adults has good blood supply. Larger tears require repair. Diagnostic Tests For Meniscal Injury - MC- Murray, Apley and Squat tests are useful tests to diagnose meniscal injury. All of them basically involve attempts to locate and reproduce crepitations, snaps or catches, either audible or detected by palpation that result as the knee is manipulated during flexion, extension and rotator motions of joint. Mn-" MAS Tests" -If these noises can be localized to the joint line (confirmed by palpation of posteromedial / posterolateral margin of joint), the meniscus most likely contains a tear. Whereas similar sounds from quadriceps mechanism, patella and patella femoral grove must be differentiated. Tears of one meniscus can produce pain in opposite compament of knee. This is most commonly seen with the posterior tears of lateral meniscus. Therefore these tests are valuable diagnostically but not diagnostic (confirmatory) and MRI or ahroscopy is needed for confirmation. Negative MAS tests do not rule of meniscal injury. Management of Meniscal Injury - Nonoperative management consists of groin to ankle cylinder cast or knee immobilizer worn for 4-6 weeks with crutch walking and toe touch down weight bearing. If symptoms recur after this, surgical repair or removal of damaged meniscus may be necessary and more specific diagnostic procedures (MRI, ahroscopy) are indicated. - Complete removal of meniscus is only justifiable when it is irreparably torn, and the meniscus rim should be preserved if at all possible. Total meniscetomy is better avoided in young athletes or people whose daily activity requires vigorous use of knee. Excision of only torn poion (paial, sub total meniscetomy) are better procedures. - Ideal indication for meniscal repair is an acute, 1 to 2 cm, longitudinal, peripheral tear that is repaired in conjunction with anterior cruciate ligament reconstruction in a young individual. Peripheral 1/3rd to 1/4th meniscus is vascular enough to provide vascular granulation tissue that results in healing of meniscal tears in this zone. Miller-Warner & Harrier categorized tears a/ t there location in 3 zones of vascularity : red - red, fully within peripheral vascular zone; red-white, at the border of vascular area; and white -white, within the central avascular area. They recommended repair of red-red and red white tears. Likelihood of healing or reparability, depends on several other factors in addition to vascularity specifically type of tear, chronicity and size (in same order), Longitudinal -acute and small tears heal better than radial/ flap type - chronic and large tears. In cruciate ligament injury the findings can be somewhate perverse i.e. with a complete tear the patients may have little or no pain, whereas with a paial tear the knee is painful. Swelling also is worse with paial tears, because haemorrhage remains confined with in the joint; with complete tears ruptured capsule permits leakage and diflusion. Paial tears permit no abnormal movement, but the attempt cause pain. Complete tears permit abnormal movement which sometimes is painless. | train | med_mcqa | null |
A young man presents with an accident leading to loss of hearing in right ear. On otoscopic examination the tympanic membrane was intact. Pure tone audiometry shows an Air-Bone gap of 55 dB in the right with normal cochlear reserve. Which of the following will be the likely tympanometry finding - | [
"AS type tympanogram",
"AD type tympanogram",
"B type tympanogram",
"C type tympanogram"
] | B | This is also a very interesting question:
The question says. Pure tone audiometry shows an air bone gap of 55 dB in the right ear with normal cochlear reserve.
The air-bone gap in pure tone audiometry is a measure of total conductive deafness.
Hence – it means there is a conductive deafness of 55 dB in the right ear.
Next the question says – Patient has intact tympanic membrane so we have to look for a cause of this 55 dB conductive deafness.
Average hearing loss seen in different lesions of conductive apparatus | train | med_mcqa | null |
Drug Induced Lupus is caused by all except | [
"Sulphonamides",
"Hydralazine",
"Isoniazid",
"Procaine"
] | D | Drugs metablized by acetylation can cause drug induced lupus: "D.SHIP"
Dapsone
Sulphonamides
Isoniazid
Procainamide (not Procaine). | train | med_mcqa | null |
Which of the following is not trophoblast related: | [
"Choriocarcinoma",
"H. mole",
"Placental Site tropboblast tumor",
"Chorioangioma"
] | D | Ans-D* Chorioangiomas the most common tumor of the placenta* It is a benign vascular tumor of placental origin and is usually found incidentally.* They are thought to arise as a malformation of the primitive angioblastic tissue of the placenta.* The angiomas are perfused by the fetal circulation. Therefore when they are large, they may represent a significant impediment to fetal cardiac activity.* This angiomasmay also sequester platelets and can, in turn, give a fetal thrombocytopenia* They can also cause the increase in levels of maternal serum alpha-fetoprotein (MSAFP) and may prompt sonographic evaluation.Modified WHO Classification of Gestational Trophoblastic DiseaseMolar lesionsNonpolar lesions* Hydatidiform mole# Complete# Partial* Invasive mole* Choriocarcinoma* Placental site trophoblastic tumor* Epithelioid trophoblastic tumor* Choriocarcinoma: A morphologic term applied to a highly malignant type of trophoblastic neoplasia in which both the cytotrophoblast and syncytiotrophoblast grow in a malignant fashion.# Chorionic villi are absent. These tumors tend to be hemorrhagic and necrotic* H. Mole: A placental abnormality involving swollen placental villi and trophoblastic hyperplasia with loss of fetal blood vessels. There are two types: partial and complete.# Partial: A molar pregnancy with swelling of all placental villi. Fetal tissues are absent.# Complete: A molar pregnancy with some normal and some swollen villi plus fetal, cord, and/or amniotic membrane elements.* Placental-Site Trophoblastic Tumor A rare type of GTD arising in the uterus that secretes human placental lactogen and human chorionic gonadotrophin (HCG).* NOTE: Persistent abnormal bleeding following normal pregnancy, abortion, or ectopic pregnancy should lead to a consideration of the diagnosis of GTD. The finding of pulmonary nodules on chest radiograph after normal pregnancy suggests GTD. | train | med_mcqa | null |
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