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30 years old 3 gravida reaches Gynaec OPD with amenorhea 6 months and bleeding PV since 1 day and pallor ++. Her USG findings are 28 weeks. IUFD with abruption placenta. What is her best line of management:- | [
"Immediate caesarean section",
"ARM + Oxytocin drip",
"ARM + syntodrip + arrange blood",
"Wait for spontaneous onset of labour"
] | C | Abruptio placenta carries a risk of DIC in pregnant patient & ARM plays a therapeutic role by draining thromboplastin & procoagulants rich blood from retroplacentac clots outside uterine cavity. | train | med_mcqa | null |
In a surgical post-op ward, a pt. developed wound infection. Subsequently 3 other pts. developed similar infections in the ward. What is the most effective way of preventing the spread of infection: | [
"Give IV antibiotics to all pts. in the ward",
"Proper handwashing of all ward personnel's",
"Fumigation of the ward",
"Wash OT instrumens with 1% perchlorate"
] | B | Ans. is 'b' ie. Proper hand washing of all ward personnel's "Given the prominence of cross infection, hand washing is the single most important preventive measure in the hospital" - Harrison 15/eHarrison 17/e writes- "Given the prominence of cross-infection, hand hygiene is the single most important preventive measure in hospitals. Use of alcohol hand rubs between patient contacts is now recommended for all health care workers except when the hands are visibly soiled, in which case washing with soap and water is still required" | train | med_mcqa | null |
Which of the following is the most effective intravesical therapy for superficial bladder cancer? | [
"Mitomycin",
"Adriamycin",
"Thiotepa",
"BCG"
] | D | Ans. is 'd' i.e. BCG | train | med_mcqa | null |
A pregnant lady went into shock immediately after normal delivery; the likely cause is ________ | [
"Amniotic fluid embolism",
"Post paum hemorrhage",
"Uterine inversion",
"Eclampsia"
] | C | Uterine inversion is the likely cause of shock immediately after delivery. Uterine inversion: A rare cause of postpaum collapse; acute in onset and occurs immediately after delivery. If the question would have been "shock after delivery" the answer would be PPH which is more common than uterine inversion. Causes: Mismanagement of 3rd stage of labor: Delivering a yet to be seperated placenta(Creede&;s method): Most common Spontaneous Placenta accreta Features: Shock immediately after delivery, degree of shock out of propoion to amount of bleeding Shock is both neurogenic and hemorrhagic Per abdominal examination: Fundus of uterus is felt to be absent. Management: vaginal operations Abdominal operations Hydrostatic method Kustner Huntingtons O sullivan Spinelli Haultain Oguch Amniotics fluid embolism causes shock but not immediately. . Ref: Williams Obstetrics 24th edition Pgno: 787 | train | med_mcqa | null |
Dehiscence of anterior wall of the external auditory canal cause infection to the parotid gland known as: | [
"Fissure of santorini",
"Notch of rivinus",
"Petrous fissure",
"Retropharyngeal fissure"
] | A | (Fissure of santorini): Ref: 220-LT (4-D 4th)* In the tympanic membrane, above the short process the pars flaccida, or shrapnell's membrane, filled the gap in the tympanic ring known as the notch of Rivinus (241- LT)* There is a deficiency superiorly of both the cartilaginous annulus and the bony annulus known as the notch of Rivirus (22-LT)* The Dehiscences in the anterior wall of external auditory canal (fissure of santorini) are important as infection can travel from external auditory canal to the parotid gland and vice versa (MaQbool) (220-LT) | train | med_mcqa | null |
Breast conservation surgery for breast cancer is indicated in which one of the following conditions? | [
"T1 breast tumor",
"Multicentric tumor",
"Extensive in situ cancer",
"T4b breast tumor"
] | A | Indications for breast conserving surgery : 1. Patient's desire for breast conservation 2. Tumor less than 4 cm in size (T1 or T2) 3. Good Breast vs. tumor volume ratio 4. Availability of radiotherapy and mammographic facilities 5. Patients with N0 or N1 axillary nodes 6. Non-pendulous breast to allow a uniform radiation dosage distribution Contraindications for BCS: 1. Multicentric breast cancer 2. Diffuse malignant looking micro calcifications on mammogram 3. Matted (N2) axillary lymph nodes 4. Recurrence in a previously conserved breast 5. Collagen vascular disease 6. Early pregnancy 7. H/o previous irradiation to chest wall 8. Positive surgical margins Relative Contraindications for BCS: 1. Tumor size >5cm. (T3) 2. High risk of residual tumor or surgical margin positivity on resection 3. Large tumor in a small breast 4. Poor histological differentiation 5. Extensive intraductal component (>25% of tumor is DCIS) Advantages : Breast conserving surgery over Mastectomy Improved body image and higher treatment satisfaction No greater fear of recurrence compared with Mastectomy Lower rates of major depression, anxiety and Insomnia | train | med_mcqa | null |
Glucose transporter in (S-cells of pancrease- | [
"GLUT1",
"GLUT2",
"GLUT3",
"SGLT1"
] | B | Ans. is 'b' i.e., GLUT2 * Glucose enters the B cells of pancreatic islets via GLUT2 transporter and this stimulate the release of insulin. | train | med_mcqa | null |
Most impoant from of carbon-dioxide transpo in the blood | [
"It is mostly transpoed as carboxy hemoglobin",
"As dissolved CO2",
"As bicarbonates",
"Due to CO2 molecules attached to hemoglobin"
] | C | The route by which most of the carbon dioxide is carried in the bloodstream. Once dissolved in the blood plasma, carbon dioxide combines with water to form carbonic acid, which immediately ionizes into hydrogen and bicarbonate ions. The bicarbonate ions serve as pa of the alkaline reserve.Ref: Ganong&;s Review of Medical Physiology; 24th edition; page no: 644 | train | med_mcqa | null |
Bilabial consonants are | [
"P, B, 9",
"P, B, M, W",
"M, L, W",
"T, L, M, W"
] | B | Pronounced or aiculated with both lips, as the consonants b, p, m, and wBaby stas producing bilabial words by the 4th month of age(Refer: OP Ghai's Textbook of Pediatrics, 8th edition, pg no. 32) | train | med_mcqa | null |
Hypercalcemia in ECG is diagnosed by: | [
"Increased QT interval",
"Decreased QT interval",
"Increased PR interval",
"Tall T waves"
] | B | Answer is B (Decreased QT interval) Hypercalcemia is characterized by a decreased QT interval. | train | med_mcqa | null |
Macrophage is- | [
"Monocytes",
"Eosinophils",
"Neutrophils",
"Lymphocytes"
] | A | The monocytes migrate to tissues and become part of the tissue (fixed) macrophages.
Blood macrophages → Monocytes
Tissue macrophages → Histiocytes Tissue macrophages (histiocytes) in different tissue are mentioned below –
Lung: ‘Alveolar macrophages’ or ‘Dust’ cells
Placenta: Hoffbauer cells
Brain: Microglia
Kidney: Mesangial cells
Liver: Kupffer cells
Spleen: Littoral cells
Bone: Osteoclasts
Synovium: Type-A lining cells
Skin: Langerhans cells
Spleen: Red pulp sinusoidal lining cells
Connective tissue: Histiocytes (tissue macrophages)
Lifespan of monocytes in circulation is 1-3 days whereas tissue macrophages have life span of 3 months to years | train | med_mcqa | null |
A 35 year old female, hospitalized after a motor vehicle accident, develops acute gastric stress ulcers. Increases in which of the following normal physiological parameters may have contributed to this condition? | [
"Bicarbonate transpo",
"Epithelial regenerative capacity",
"Mucosal blood flow",
"Pepsin production"
] | D | Pepsin production is a normal physiologic activity of the stomach that, in conditions of stress, may overwhelm the stomach's weakened defenses and result in gastric ulceration. Gastric acid production is another condition that may increase and cause acute ulceration. Fuhermore, these two factors may remain unchanged and still result in gastric ulcers if the gastric defenses are weakened by stress. All of the other choices represent normal defensive forces in the stomach. Increased bicarbonate transpo would protect the gastric epithelium from the potentially harmful acidity of the gastric contents. The adherent mucus is relatively alkaline, providing local protection to the superficial mucosa. Gastric epithelial cells can normally replicate rapidly, allowing mucosal defects to be rapidly repaired. Increasing the regenerative capacity of the epithelium would have a protective effect against ulceration. The gastric mucosa is richly supplied with blood, providing the epithelial cells with an ample supply of nutrients, oxygen, and bicarbonate to contend with the harsh gastric microenvironment. Stress ulcers are associated with compromised gastric blood flow, not increased flow. Ref: Mills J.C., Stappenbeck T.S., Bunnett N. (2010). Chapter 13. Gastrointestinal Disease. In S.J. McPhee, G.D. Hammer (Eds), Pathophysiology of Disease, 6e. | train | med_mcqa | null |
True statement among the following is: | [
"The intercalated duct of the parotid gland is short.",
"The intercalated duct of the parotid gland is long and branching.",
"The parotid gland has poorly developed intercalated duct.",
"None"
] | B | The intercalated ducts of the parotid are long and branching and the pale-staining striated ducts are numerous and stand out conspicuously against the more densely stained acini. | train | med_mcqa | null |
A 15 year old male patient presents with the chief complaint of pain in abdomen. General examination reveals xanthomas present in clusters on back, buttocks and arms, legs. On percussion, hepatomegaly and splenomegaly can be appreciated. What is the most probable diagnosis for this child? | [
"Type I Hyperlipoproteinemia",
"Autosomal Dominant Hypercholesterolemia Type I (ADH Type I)",
"Autosomal Recessive Hypercholesterolemia (ARH)",
"Abetalipoproteinemia"
] | A | Primary Hyperlipoproteinemias Causing Hypertriglyceridemia
Familial Chylomicronemia Syndrome (Type I Hyperlipoproteinemia)
Biochemical abnormalities:
Lipoprotein Lipase (LPL) or Apo CII defect.
Lipoprotein Lipase is required for hydrolysis of TGs in Chylomicrons and VLDL. Apo CII is the cofactor for Lipoprotein Lipase.
Lipoprotein accumulated is Chylomicron and VLDL, but chylomicron predominates.
Fasting Triglycerides is > 1000 mg/dL.
Fasting cholesterol is elevated to a lesser degree.
Clinical Presentation:
Present in childhood with recurrent abdominal pain due to acute pancreatitis.
On fundoscopic examination, opalescent retinal blood vessels (lipemia retinalis).
Lactescent plasma.
Eruptive xanthoma (small yellowish-white papules appear in clusters on backs, buttocks, extensor surfaces of arms and legs. These are painless skin lesions may become pruritic).
Hepatosplenomegaly.
Premature CHD is not a feature of FCS.
Diagnosis:
Assaying triglyceride lipolytic activity in post heparin plasma (IV heparin injection to release the endothelial-bound LPL).
Key Concept:
Xanthomas (present in clusters on back, buttocks and arms, legs) and hepatomegaly and splenomegaly (on percussion) with the chief complaint of pain in abdomen in children is the clinical presentation of Type I Hyperlipoproteinemia. | train | med_mcqa | null |
The commonest focus of Scrofuloderma is - | [
"Lung",
"Lymph node",
"Larynx",
"Skin"
] | B | null | train | med_mcqa | null |
Antigen presenting cells are all of the following except- | [
"Astrocytes",
"Endothelial cells",
"Epithelial cells",
"All"
] | D | Ans. is 'a' i.e., Astrocytes; 'b' i.e., Endothelial cells; 'c' i.e., Epitehlial cells | train | med_mcqa | null |
A chronic alcoholic blames the family environment as a cause of his alcoholism. This is phenomenon of: | [
"Projection",
"Denial",
"Rationalization",
"Sublimation"
] | C | Rationalization: Offering rational explanations to justify own unacceptable behavior. For example, an alcoholic blamed his family environment for his habit of excessive drinking. It is a commonly used defense mechanism in substance use disorders. | train | med_mcqa | null |
Significant bacteriuria is defined as presence of_____ bacteria per ml of urine. | [
"100-1000",
"1000-10,000",
"10,000-1,00,000",
">1,00,000"
] | D | Ans. d (> 1,00,000) (Ref. H-18th, Chapter 288; Ananthanarayan Microbiology 7th/pg. 276)Hass and other investigators have established that in the presence of active infection in the urinary tract the urine will contain 1,00,000 or more/mL. The level is, therefore, considered to represent significant bacteriuria.SIGNIFICANT BACTERIURIA# Counts of 10,000 or less/mL are due to contamination during voiding and are of no significance.# In most instances, growth of >105 organisms per milliliter from a properly collected midstream "clean-catch" urine sample indicates infection - significant bacteriuria.# When carefully sought by chamber-count microscopy, pyuria is a highly sensitive indicator of UTI in symptomatic patients.# Pyuria is demonstrated in nearly all acute bacterial UTIs, and its absence calls the diagnosis into question.# The leukocyte esterase "dipstick" method is less sensitive than microscopy in identifying pyuria but is a useful alternative when microscopy is not feasible.# Pyuria in the absence of bacteriuria (sterile pyuria) may indicate infection with unusual agents such as C. trachomatis, U. urealyticum, or Mycobacterium tuberculosis or with fungi.# Alternatively, sterile pyuria may be documented in noninfectious urologic conditions such as calculi, anatomic abnormality, nephrocalcinosis, vesicoureteral reflux, interstitial nephritis, or polycystic disease. | train | med_mcqa | null |
Which of the following in spermatic is not damaged during vasectomy | [
"Testicular aery",
"Ilioinguinal nerve",
"Autonomic nerve",
"Pampiniform plexus"
] | B | Ilioinguinal nerve is not a constituent of spermatic cord, hence it is not damaged during vasectomy Ref: Grays 40th edition Pgno : 1262 Vasectomy for sterilisation Vasectomy for sterilisation is a common and effective contraceptive procedure. It should be undeaken only after the couple has been carefully counselled. Both paners need to know that the operation is performed to make the man permanently sterile. They should be warned that normal contraceptive precautions should continue until the success of the operation is confirmed by semen analysis performed 12-16 weeks after surgery. They should also be warned of the possibility of spontaneous recanalisation, which may restore feility unexpectedly and of the possibility of chronic testicular pain that may occur in up to 5% of men. Vasectomy is easily and painlessly performed under local anaesthetic. The vasa are delivered through tiny bilateral scrotal incisions or through a single midline scrotal incision. For medico-legal reasons it is wise to remove a segment of each vas to prove that it has been successfully divided. Burying the cut ends, fascial interposition or turning them back on themselves helps to prevent them rejoining. Reversal of vasectomy may not restore feility even if the surgery is technically successful because of damage to the testis secondary to the vasectomy. Although patency rates of 80% or more are commonly repoed, successful feility rates are much lower, and diminish with increasing delay from the time of vasectomy. Ref: Bailey and love 27th edition Pgno : 1512 | train | med_mcqa | null |
Main drawback of Be in Ni-Cr alloys | [
"Health hazard",
"Increase flow of alloy",
"Reduce fusion temp",
"Refine grain bending"
] | A | Although beryllium is known to be highly toxic, it is used in some Ni-Cr alloys in concentrations of 1% to 2% by weight (approximately 5.5% to 11% atomic content) to increase the castability of these alloys and lower their melting range. It also tends to form thin adherent oxides that are required to promote atomic bonding of porcelain.
Base metal alloys containing both beryllium and nickel exhibit high beryllium release rates, which may pose a health risk.
Beryllium-containing particles that are inhaled and reach the alveoli of the lungs may cause a chronic inflammatory condition called berylliosis.
Berylliosis occurs only in individuals with a hypersensitivity to beryllium and may occur from inhalation of beryllium dusts (from grinding or polishing alloys), salts, or fumes such as those encountered in casting beryllium-containing alloys. Thus, dental lab technicians would presumably be at the highest risk of adverse effects from exposure to beryllium dusts and vapors.
Ref: Phillip’s 12th edition page 128. | train | med_mcqa | null |
All these structures are found in the lateral nasal wall except - | [
"Superior Turbinate",
"Vomer",
"Agger nasi",
"Hasner's valve"
] | B | Vomer bone forms the medial wall (nasal septum), and not the lateral wall of nasal cavity.
All other options are part of lateral nasal wall :- Superior turbinate; Agger nasi (an elevation anterior to middle turbinate); and Hasner's valve (a mucosal flap closing the opening of nasolacrimal duct into the inferior meatus). | train | med_mcqa | null |
Children can reach for objects by: | [
"4 months",
"6 months",
"8 months",
"10 months"
] | A | Ans: A (4 months) Ref: Nelson Textbook of Pediatrics, 19th edition. Pg 27. Explanation: (See following table) Fine motor milestones MilestoneAverage age of attainment (in months)Developmental implicationsGrasps rattle3.5Object useReaches for objects4Visuomotor coordinationPalmar grasp gone4Voluntary releaseTransfers object hand to hand5.5Comparison of objectsThumb-finger grasp8Able to explore small objectsTurns pages of book12Increasing autonomy during book timeScribbles13Visuomotor coordinationBuilds tower of 2 cubes15Uses objects in combinationBuilds tower of 6 cubes22Requires visual, gross, and fine motor coordination | train | med_mcqa | null |
The intra-abdominal pressure during laparoscopy should be set between : | [
"5-8 mm Hg",
"10-15 mm Hg",
"20-25 mm Hg",
"30-35 mm Hg"
] | B | During laproscopy about 100 mL/min of gas is instilled into the peritoneal cavity, maintaining intraperitoneal pressure 15 mmHg. About 1000 mL is required for adequate pneumoperitoneum. Reference: Shaw's Textbook of Gynaecology,16th edition page no 94. | train | med_mcqa | null |
An enzyme that makes a double stranded DNA copy from a single stranded RNA template molecule is known as | [
"DNA polymerase",
"RNA polymerase",
"Reverse transcriptase",
"Phosphokinase"
] | C | Reverse transcriptase is an RNA dependent DNA polymerase that produces ds DNA from RNA template. It moves along the template in 3' → 5' direction, synthesizing DNA is 5' → 3' direction.
It is seen in retro viruses (e.g. HIV). | train | med_mcqa | null |
In a head injury patient, Mannitol should not be used for control of increased intracranial pressure when | [
"Serum osmolality is more than 320 mOsmol/kg",
"Aerial PaCO2 is less than 34 mm Hg",
"Aerial PaO2 is more than 100 mg Hg",
"Aerial pH is less than 7.35"
] | A | Mannitol Mannitol is widely used to reduce ICP Commonly used preparation : 20% solution, 0.25-1 gm/kg is given IV as bolus. Serum osmolality should not be allowed to go >320 mOsm/L, to avoid systemic acidosis and renal failure Uses of Mannitol To reduce increased ICT or intra ocular tension To maintain GFR and urine flow in impending renal failure Forced diuresis in hypnotic or other poisoning To counteract low osmolality of plasma/ECF due to rapid haemodialysis or peritoneal dialysis Contraindications of Mannitol Acute tubular necrosis Anuria Pulmonary edema Acute left ventricular failure. CHF Cerebral hemorrhage Ref: Harrison's 19th edition Pgno : 1779-1780 | train | med_mcqa | null |
Moro's reflex stas during intrauterine life. Persistence of Moro's reflex is abnormal beyond the age of: | [
"3rd month",
"4th month",
"5th month",
"6th month"
] | A | The Moro reflex is present in normal infants. A sudden stimulus (eg, a loud noise) causes abduction and extension of all extremities, with extension and fanning of digits except for flexion of the index finger and thumb. This is followed by flexion and adduction of the extremities. Moro's reflex disappear at three month of age and persistence of this reflex beyond three months is abnormal. Ref: Essential paediatrics by OP Ghai, 6th edition, Page 146. | train | med_mcqa | null |
All of the following statements are true regarding principles of development except? | [
"Development is a continuous process",
"Specific responses replace mass activity as the child matures",
"It progresses in cephalocaudal direction",
"In the extremities, development occurs in distal to proximal"
] | D | In the extremities, development occurs proximal to distal. Growth Development Denotes a net increase in size/mass of tissues Denotes maturation of functions Cephalocaudal Head = Neck = Trunk and upper limbs = Lower limbs Cephalocaudal Head = Neck = trunk and upper limbs = Lower limbs Distal = Proximal Hands increase in size before upper arms Proximal = Distal Hand use is learnt before the use of fingers Rules of Development: It is a continuous process It depends on the functional maturation of the nervous system The sequence of attainment of milestones is the same in all children It progresses in cephalocaudal direction and proximal to distal Ceain primitive reflexes have to be lost before relevant milestones are attained The initial disorganised mass activity is gradually replaced by specific actions Ref: Ghai Essential pediatrics 9th edition Pgno: 38 | train | med_mcqa | null |
A 45-year-old farmer has itchy erythematous papular lesions on face, neck, 'V' area of chest, dorsum of hands and forearms for 3 years. The lesions are more severe in summers and improve by 750/a in winters. The most appropriate test to diagnose the condition would be: | [
"Skin biopsy",
"Estimation of IgE levels in blood",
"Patch test",
"Intradermal prick test"
] | A | A i.e. Skin biopsy - Presence of itchy papules or papulovesicles on sun-exposed areas paicularly! of forearm with a history of seasonal variations ie more severe in summer and improved in wintersQ - for long duration suggest the diagnosis of - Polymorphic light reaction. Diagnosis of PLR is confirmed by skin biopsy and by performing photo-test procedures (i.e. photo-patch test & photo provocative tests)Q. Phototoxicity - is a non-immunological reaction caused by photo toxic drugs - amiodarone, dacarbazine, fluroquinolones, 5-FU, furosemide, nalidixic acid, phenothiazines, psoralens, retinoids, sulfonamides, sulfonylureas, tetracyclines, thiazides, vinblastin. The usual clinical manifestations include erythema resembling a sunburn reaction that quickly desquamates, or "peels", within several days. In addition, edema, vesicles and bullae may occur. Photo allergy - is immune mediated, less common reaction caused by - 6-methyl-coumarin, aminobenzoic acid and esters, bithionol, chlorpromazine, diclofenac, fluroquinolones, halogenated salicylanilides, hypericin (st John's Wo), Musk ambrette, piroxicam, promethazine, Sulfonamides and Sulfonylureas. The clinical manifestations typically differs from those of phototoxicity in that an intensely pruritic eczematous dermatitis tends to predominate and evolves into lichenified, thickened, "leathery" changes in sun exposed areas. A small subset of patients (5-10%) may develop a persistent equisite hypersensitivity to light even when the offending drug or chemical is identified and eliminated, a condition known as persistent light reaction. - A very uncommon type of persistent photosensitivity is known as chronic actinic dermatitis. These patients are typically elderly men with a long history of preexisting allergic contact dermatitis or photosensitivity. They are usually exquisitely sensitive to UV-B, UV-A and visible wave lengths (ie manifest a broad spectrum of UV - hyperresponsiveness). - Diagnostic confirmation of phototoxicity & photoallergy can be done by using photo test procedures. For phototoxicity & photoallergy UV-A radiation (MED = minimal erythema dose) is used. Patients with persistent light reaction characteristically show diminished threshold to erythema evoked by UV -B. In solar uicaria, lesions occur within minutes of sun exposure, on exposed areas. | train | med_mcqa | null |
The following are the myeloproferative disorders except- | [
"Polycythemia vera",
"Essential thrombocytosis",
"Chronic myeloid leukemia",
"Hairy cell leukemia"
] | D | Hairy cell leukemia is a B-cell malignancy characteised by the presence of hairy cells in the blood & bone marrow & splenomegaly. Myeloproliferative diseases include chronic myeloid leukaemia ,polycythaemia vera, essential thrombocythaemia,chronic idiopathic myelofibrosis,chronic neutrophilic leukaemia ,chronic eosinophilic leukaemia .Reference :Harsh mohan textbook of pathology 6th edition pg no 357 & 378. | train | med_mcqa | null |
Cross sectional study is associated with: | [
"Indicates prevalence",
"Incidence",
"Positive predictive value",
"Relative risk"
] | A | Ans. (a) Indicates prevalenceRef : K. Park 23rd ed. / 75-77Cross sectional study is the simplest form of observational epidemiological study which is based on single examination of a cross section of a population at one point of time, results of sample are then projected to the whole populationAdvantages* Provides prevalence of a disease* Provides a whole picture of population at one point of time* More useful for chronic diseaseDisadvantages* Tells about distribution of a disease rather than the etiology* Establishment of time sequence of a disease is not possible* Provides little information of a natural history and incidence of a disease | train | med_mcqa | null |
Anterior draw er test is for - | [
"ACL",
"PCL",
"Medial meniscus",
"Lateralmeniscus"
] | A | Ans. is 'a' i.e., ACLSigns and Testso Adson's test: for thoracic outlet syndromeo Allen's test: for testing patency of radial and ulnar arterieso Alli's test: for CDHo Anvil test: for testing tenderness of the spineo Ape thumb: for median nerve injuryo Apley's grinding test :for meniscus injuryo Apprehension test: for recurrent dislocation of the shouldero Barlow 's test: for CDHo Blue sclera : Osteogenesis imperfecto Bryant's test: for anterior dislocation of the shouldero Callways' test: for anterior dislocation of the shouldero Chovstek's sign : for tetanyo Claw hand: for ulnar nerve injuryo Coin test: for dorso lumbar tuberculosis of spineo Cozen's test: for tennis elbowo Drawer test: for ACL and PCL injutries# Anterior: for ACL injury#Posterior: for ACL injuryo Finkelstein's test: for de Quervain's tenovaginitiso Foot drop : for common peroneal nerve injuryo Froment's sign : for ulnar nerve injuryo Gaenslen's test: for SI joint involvemento Galleazzi sign : for CDHo Gower's sign : for musular dystrophyo Hamilton ruler test: for anterior dislocation of the shouldero Kanavel's sign : for infection in ulnar bursao Lasegue's test: for disc prolapseo Lachmann test: for ACL injuryo Ludloffs sign: for avulsion of lesser trochantero McMurray's test: for meniscus injuryo Nagffziger test: for disc prolapseo Ober's test: for tight ilio- tibial band (eg., in polio)o O' Donoghue triad: traid of MCL, ACL & medial meniscus injuries occurring togethero Ortolani's test: for CDHo Pivot shift test: for ACL injuryo Policeman tip : for Erb's palsyo Runner's knee: Patellar tendinitiso Sulcus sign: for inferior dislocation of the shouldero Thomas' test: for hip flexion deformityo Trendelenburg's test: for unstable hip due to any reaseon (e.g., CDH)o Tinel's sign: for detecting improving neive injuryo Volkmann's sign : for ischaemic contracture of forearm muscleso Wrist drop: for radial nerv e injury | train | med_mcqa | null |
Branching posterior spoke like cataracts (Propeller) are seen in: | [
"Down's syndrome",
"Fabry's disease",
"Neuro fibromatosis",
"Atopic keratoconjunctivitis"
] | B | Ans. Fabry's disease | train | med_mcqa | null |
Ham test is used for diagnosis of: | [
"Breast carcinoma",
"Asthma",
"Rheumatoid ahritis",
"Paroxysmal nocturnal haemoglobinuria"
] | D | The definitive diagnosis of paroxysmal nocturnal hemoglobinuria (PNH) must be based on the demonstration that a substantial propoion of the patient's red cells have an increased susceptibility to complement (C), due to the deficiency on their surface of proteins (paicularly CD59 and CD55) that normally protect the red cells from activated C. The sucrose hemolysis test is unreliable, and the acidified serum (Ham) test is carried out in few labs. The gold standard today is flow cytometry, which can be carried out on granulocytes as well as on red cells. A bimodal distribution of cells, with a discrete population that is CD59-, CD55-, is diagnostic of PNH. Ref: Harrison's principle of internal medicine 17th edition, chapter 101. | train | med_mcqa | null |
To rule out rheumatoid ahriis, most impoant among the followings is - | [
"HLA DR8",
"HLA DR4",
"HLA DQ1",
"HLA B27"
] | B | Answer- B. HLA DR4DR4 is strongly associated with RA (also with Type 1 DM Pemphigus vulgaris). | train | med_mcqa | null |
Zero order kinetics is followed by all of the following drugs EXCEPT | [
"Phenytoin",
"Barbiturates",
"Alcohol",
"Theophylline"
] | B | Zero order (linear) kinetics; The rate of elimination remains constant irrespective of drug concentration, Clearance decreases with increase in concentration, or a constant amount of the drug is eliminated in unit time, e.g. ethyl alcohol, methanol. The elimination of some drugs approaches saturation over the therapeutic range, kinetics changes from first order to zero order at higher doses. As a result plasma concentration increases dispropoionately with an increase in dose, as occurs in case of phenytoin, tolbutamide, theophylline, warfarin, aspirin, digoxin Barbiturates follow first order kinetics. Ref:KD Tripathi pharmacology 7th edition (page.no: 31) | train | med_mcqa | null |
Treatment of erythematous skin rash with multiple pus lakes in a pregnant woman is: | [
"Coicosteroids",
"Retinoids",
"Methotrexate",
"Psoralen with PUVA"
] | A | A i.e. Coicosteroids | train | med_mcqa | null |
During laryngoscopy and endo-tracheal intubation which of the maneuver is not performed: | [
"Flexion of the neck",
"Extension of Head at the atlanto-occipital joint.",
"The laryngoscope is lifted upwards levering over the upper incisors.",
"In a straight blade laryngoscope, the epiglottis is lifted by the tip."
] | C | Ans:C i.e. The laryngoscope is lifted upward levering over the upper incisiors. Procedure of Endotracheal Intubation: The correct position is with the lower pa of the cervical spine flexed (by placing a pillow or other suitable pad under the patient's occiput), and the atlanto-occipital joint extended(by tilting the head back) - the so-called "sniffing position". This position aligns the axes of the mouth, pharynx and trachea, and will give the best visualization of the cords during laryngoscopy. In a Straight Blade Laryngoscope,lift the epiglottis with the tip of the blade. | train | med_mcqa | null |
Acoustic shadow is produced by the following except- | [
"Bone",
"Calculus",
"Fat",
"Gas"
] | C | Ultrasound waves are reflected at the surfaces between the tissues of different density The reflection being propoional to the difference in If the difference in density is increased, the propoion of reflected sound is increased, and the propoion of transmitted sound is propoionately decreased. If the difference in tissue density is very different, then the sound is completely reflected, resulting in total Acoustic shadowing is present behind bones, calculi (stones in kidneys, gallbladder, etc.) and air (intestinal gas) Ref : Physical principles of ultrasound (Dr Daniel J Bell and Ass. Pr. Mirjan M. Nadrljanski et al.) | train | med_mcqa | null |
A child presents with antimongoloid slant, pulmonary stenosis, short stature and undescended testis. The likely diagnosis is – | [
"Hypoparathyroidism",
"Noonan syndrome",
"Klinefelter syndrome",
"XYY sex chromosomes"
] | B | Noonan Syndrome : -
Autosomal dominant
Male or female with turner phenotype
Karyotype is normal
Congenital heart disease (Supravalvular pulmonary stenosis)
Abnormalities of cardiac conduction and rhythum
Downslanting palpebral fissure (Antimongoloid slant)
Pectus carinatum or Pectus excavatum
Hypertelorism
Cryptorchidism (small testes)
Sensorineural hearing loss
Cardiac abnormality in Noonan's Syndrome
Most common → pulmonary stenosis (Supravalvular)
Hypertrophic cardiomyopathy
Abnormalities of cardiac conduction and rhythum
Short stature
Webbed neck
Low set ears
Cubitus valgus
Ptosis
Micrognathia
Clinodactyly
Delayed puberty
ASD
Coarctation of Aorta (rare) | train | med_mcqa | null |
Unequivocal evidence of hea disease in pregnancy is all except : | [
"Systolic murmur",
"Diastolic murmur",
"Diastolic thrill and murmur",
"Systolic thrill and murmur"
] | A | Systolic murmur | train | med_mcqa | null |
Which of the following drugs has maximum chances of causing hyperprolactinemia? | [
"Clozapine",
"Olanzapine",
"Ziprasidone",
"Risperidone"
] | D | Ans. (D) Risperidone(Ref: KDT 8th/469)Among the atypical antipsychotic drugs, risperidone has highest risk of causing hyperprolactinemia and extrapyramidal symptoms | train | med_mcqa | null |
Isthmus of the thyroid gland is across tracheal ring - | [
"2nd to fourth",
"3rd to fifth",
"5th and 6th",
"4th only"
] | A | The isthmus extends from the second to the fourth tracheal ring. | train | med_mcqa | null |
A Child with increased Ca++ & hyperphosphatemia is seen in | [
"Vitamin D dependent rickets",
"Vitamin D resistant rickets",
"Renal osteodystrophy",
"Hypophosphatasia"
] | C | Ans. c (Renal osteodystrophy). (Ref. Harrison Medicine, 18th/Ch.44, 279, Nelson, Paediatrics, 17th/223)# The principal clinical consequences of hyperphosphatemia are hypocalcemia and systemic calcification.# Ectopic calcification occurs in untreated, chronic renal failure with severe hypercalcemia and in vitamin D intoxication.# Tumor calcinosis is rare inherited disorder in which hyperphosphatemia is associated with ectopic calcification.# Vitamin D intoxication causes excessive gastrointestinal absorption of both Ca++ and Ph++ and suppression of PTH by hypercalcemia causes decrease in renal phosphorous excretion.# Hyperphosphatemia in hyperthyroidism or acromegaly is also associated with hypercalcemia. | train | med_mcqa | null |
Sulfasalzine is used in: March 2011 | [
"Gout",
"Irritable bowel disease",
"Ulcerative colitis",
"Idiopathic osteoahritis"
] | C | Ans. C: Ulcerative Colitis The mainstay of drug therapy for mild and moderate ulcerative colitis is sulfasalazine and other aminosalicylic acid (ASA) compounds and coicosteroids Sulfasalazine It is a sulfa drug, a derivative of mesalazine (also called 5-aminosalicylic acid, or 5-ASA) Sulfasalazine is used in the treatment of inflammatory bowel disease, including ulcerative colitis and Crohn's disease. It is also indicated for use in rheumatoid ahritis and used in other types of inflammatory ahritis (e.g. psoriatic ahritis) where it has a beneficial affect. It is often well tolerated compared to other DMARDS. It is usually not given to children under 2 years of age. It yields the metabolite sulfapyridine which gives rise to side-effects such as agranulocytosis and hypospermia. The other metabolite of sulfasalazine, 5-aminosalicylic acid (5-ASA) is attributed to the drug's therapeutic effect. Therefore, 5-ASA and other derivatives of 5-ASA, are now usually preferred and given alone (as mesalazine), despite their increased cost, due to their more ourable side-effect profile. Sulfasalazine, and its metabolite 5-ASA, are poorly absorbed from the gut. | train | med_mcqa | null |
A biopsy was performed for a patient with recurrent chalazion involving the upper lid. The most likely diagnosis on histopathology is: | [
"Sebaceous cell carcinoma",
"Basal cell carcinoma",
"Squamous cell carcinoma",
"Malignant Melanoma"
] | A | Ans. (a) Sebaceous cell carcinomaRef: Kanski 7/e, p. 21, 4Sebaceous Gland Carcinoma* Typically arises from meibomian glands or glands of ZeisQ* Most frequently arises from the upper eyelids[?] where meibomian gland are most frequent (in contrast to basal cell and squamous cell carcinoma)* Highly malignant with mortality of 5-10%* Elderly females are typically affected.* Nodular SGC masquerades a 'chalazion' and hence any patient with recurrent chalazion with an unusual consistency should undergo a full thickness resection and histological examination to exclude SGC. | train | med_mcqa | null |
Hydatiform mole -characterized histologically by: | [
"Hyaline membrane degeneration",
"Hydropic degeneration of the villous stroma",
"Non-proliferation of cytotrophoblasts",
"Non proliferation of syncytiotrophoblasts"
] | B | (Hydropic degeneration of the villous stroma) (193, 197, 201-Duta 6th)Hvdatidiform mole (vesicular mole) - It is abnormal condition of placenta where there are partly degenerative & partly proliferative changes in the young chorionic villi* It is best regarded as a benign neoplasm of the chorion with malignant potential* Vaginal bleeding is the commonest presentation (90%) "White currant in red currant juice"* Expulsion of grape like vesicles (rich in HCG) pe vaginum is diagnostic of vesicular mole.* Histology shows hydropic degeneration of the villous stroma with absence of blood vessels and trophoblastic proliferation.RISK FACTORS FOR MALIGNANT CHANGE* Patient above the age of 40 irrespective of parity* Patients having previous 3 or more births irrespective of age is more important than the parity.* Initial serum hCG > 100,000 mIU/ml.* Uterine size >20 weeks* Previous history of molar pregnancy* Large (> 6 cm) theca-leutin cyst | train | med_mcqa | null |
NOT included in schizophrenia: AIIMS 07 | [
"Formal thought disorder",
"Third person hallucination",
"Mood swings",
"Persistent depressive disorder"
] | D | Ans. Persistent depressive disorder | train | med_mcqa | null |
Which of the following statements on lymphoma is not True? | [
"A single classification system of Hodgkin's disease is almost universally accepted",
"HD tends to remain localized to a single group of lymph nodes and spreads by contiguity",
"Several types of Non-Hodgkin's lymphoma may have a leukemic phase",
"In general follicular NHL has worse prognosis compared to diffu... | D | Ans. is 'd' i.e., In general follicular NHL has worse prognosis compared to diffuse NHL o Multiple classification system exist for Non-Hodgkin's lymphoma.o The prognosis of Non-Hodgkins lymphoma varies markedly with various histological types of Non Hodgkin's lymphoma, In general lymphomas with a follicular histological pattern are of lower grade {longer survival than those ofdiffuse pattern).Clinical difference between Hodgkins and Non Hodgkins LymphomaHodgkins lymphomaHon Hodgkins lymphomao More often localized to a single axial group of cervical mediastinal, para-aortic nodes.o Orderly spread by contiguityo More frequent involvement of multiple peripheral nodeso Waldeyer ring and mesenteric nodes commonly involvedo Mesenteric nodes and Waldeyerring rarely involvedo Extra-nodal involvement uncommono Extranodal involvement common | train | med_mcqa | null |
Time required for development of parasite from the gametocyte to sporozite stage in mosquito is called as - | [
"Extrinsic incubation period",
"Intrinsic incubation period",
"Generation time",
"Median incubation period"
] | A | <p> The time required for the development of the parasite from the gametocyte to sporozoite stage in the body of mosquito is about 10-20 days . This period is also referred to as the &; extrinsic incubation period&;. Park&;s textbook of preventive and social medicine,K.Park,23rd edition,page no:258 <\p> | train | med_mcqa | null |
CBNAAT is | [
"Category Based Nucleic Acid Amplification Test",
"Case Based Nucleic Acid Amplification Test",
"Clinical Based Nucleic Acid Amplification Test",
"Caridge Based Nucleic Acid Amplification Test"
] | D | Caridge Based Nucleic Acid Amplification Test Ref: Park 25th Edition;Pg. No:197 | train | med_mcqa | null |
Plethoric lung field is seen in which CHD – | [
"Ebstein's anomaly",
"Tricuspid atresia",
"AS",
"VSD"
] | D | Plethoric lung fields → If the pulmonary blood flow is increased, the lung fields appear plethoric throughout and in addition cardiomegaly is present.
Oligenic lung fields → If the pulmonary blood flow is diminished there is paradoxical prominence of hilar arteries with clear or ischemic peripheral lung fields.
CHDs with plethoric lung fields Cyanotic
Truncus arteriosus
Single ventricle
TGA
TAPVR
Hyperplastic It. heart
Acyanotic
VSD
ASD
PDA
CHDs with oligemic lung fields Cyanotic
Tricuspid atresia
Eisenmenger's syndrome
Ebstein's anomaly
Truncus arteriosus with hypoplastic pulmonary artery
Single ventricle with PS
Acyanotic
As or AR
Coarctation of aorta
MR or MS
PS | train | med_mcqa | null |
Holt Gram syndrome is characterized by | [
"ASD",
"VSD",
"TGA",
"AR"
] | A | null | train | med_mcqa | null |
Which of the following is a Diploid cell Line? | [
"HeLa",
"Hep2",
"Chick embryo cell line",
"WI - 38"
] | D | Primary cell Line - Chick embryo cell line, Rhesus monkey kidney cell line.
Diploid cell Line - Human fibroblast cell line or WI - 38
Continuous cell line - HeLa, Hep2, BHK, Mcoy. | train | med_mcqa | null |
A 50-year-old male presents with a growth in the buccal mucosa. Growth measures 3 cm in its greatest dimension. He also has multiple nodes on the ipsilateral side in the submandibular region but none of the nodes is more than 3 cm. Your line of treatment is: | [
"Radiotherapy to the primary and lymph nodes of the neck",
"Radiotherapy to the primary with supraomohyoid neck dissection",
"Surgical excision of the primary growth and supraomohyoid neck dissection",
"Surgical excision of growth, supraomohyoid neck dissection and post-operative radiotherapy"
] | D | Growth which measures more than 3 cm is classified as T2 Multiple ipsilateral nodes none more than 3 cm is N2 . The growth (T2 N2 ) thus will be stage III.Treatment of stage III is surgical excision of growth with supraomohyoid (levels I, II and III nodes) neck dissection followed by post-operative radiotherapy. | train | med_mcqa | null |
Visual acuity of eye is: | [
"Refractive power of eye",
"Ability to discriminate two points",
"Ability to increase converging power of eye",
"limitaion of occular movements"
] | B | Measurement of the threshold of discrimination of two spatially separated targets (a function of the fovea centralis) is termed visual acuity. Refractive power of eye-= +60D(+45D by cornea +15 D by lens). Ability to increase converging power of eye ACCOMODATION limitaion of occular movements - Diplopia | train | med_mcqa | null |
Calcium absorption is increased by - | [
"Acidic Ph",
"Tetracyclines",
"Alkaline Ph",
"Phosphates"
] | A | Ans. is 'a' i.e., Acidic Ph o With an average intake of 1000 mg of calcium its net intestinal absorption is only 150-250 mg/day. o Calcium is absorbed mainly in the duodenum and Jejunum (proximal intestine)0 by an active transport mechanism regulated by 1,25 (OH)2 D3 (calcitriol) Q. o Parathormone indirectly promotes absorption of calcium0 by increasing the renal synthesis of 1,25 (OH) 2 D3.Dietary lactose, proteins0and an acidic environment promote calcium absorption Q.. o On the other hand, phytates, phosphates, oxalates, tetracycline and and alkaline environment impair calcium absorption Q. o Calcium is transported across the brush border of intestinal epithelial cells via channels known as transient receptor potential vantioid type 6 (TRPV6) and binds to an intracellular protein known as catbindin. o Calbindin sequesters the absorbed calcium so that it does not disturb the epithelial signaling process that involve calcium. o The absorbed Ca+2 is thereby delivered to the basolateral membrane of the epithelial cells, from where it can be transported into the blood stream by either a Sodium/Calcium exchanger (NCX1) or a calcium-dependent ATPase. | train | med_mcqa | null |
A blood donor is not considered for safe transfusion, if he has - | [
"Anti FlBsAg +ve",
"Anti HBsAg and HBcAg (+)ve",
"HBsAg +ve and IgM anti HBc +ve",
"Anti HBc +ve"
] | C | Ans. is 'c' i.e., HBs Ag + ye and IgM anti HBc +ve . HBs Ag(+)ve and IgM anti HBc (+)ve indicates acute HBV infection, which is a contraindication of blood tranfusion. About other options Option a . Anti HBs Ag antibody may be (+)ve either after immunization or after recovery from HBV infection. In both the conditions, blood can be transfused. Option b . HBc Ag can not be (+)ve as it does not appear in blood. Option c . When Anti HBe is (+)ve blood can be transfused if other markers of infection are also negative eg: HBsAg, HBV DNA, IgM anti HBC. | train | med_mcqa | null |
Most common site of sinusitis in children | [
"Maxillary sinus",
"Ethmoidal sinus",
"Frontal sinus",
"Spenoid sinus"
] | B | Acute ethmoid sinusitis Aetiology Acute ethmoiditis is often associated with infection of other sinuses. Ethmoid sinuses are more often involved in infants and young children. (Ref: Diseases of ENT, PL Dhingra, 7th edition, of no. 216) | train | med_mcqa | null |
Which of the following is a component of deltoid ligament | [
"Talofibular ligament",
"Tibiotalar ligament",
"Talonavicular ligament",
"Calcaneo-navicular ligament"
] | B | Deltoid ligament has 4 components (all with prefix 'Tibia') : * Anterior tibiotalar ligament * Posterior tibiotalar ligament * Tibio-calcaneal pa* Tibio-navicular ligament - attaching to navicular bone at medial side of the foot. - Spring ligament / calcaneo-navicular ligament which connects navicular bone's plantar surface with sustentaculum of calcaneus is not a component of deltoid ligament fig:-Deltoid ligament of ankle | train | med_mcqa | null |
Sitaram a 40-year old man, met with an accident and comes to emergency depament with engorged neck veins, pallor, rapid pulse and chest pain Diagnosis is ? | [
"Pulmonary Laceration",
"Cardiac tamponade",
"Hemothorax",
"Splenic rupture"
] | B | Ans is 'b' ie Cardiac Tamponade Road traffic accident can lead to all 4 condition but only cardiac tamponade can present the given signs & symptom. Cardiac Tamponade - It is accumulation of fluid in the pericardium in an amount sufficient to cause serious obstruction to the inflow of blood to the ventricles. Etiology: 3 most common causes are: - Neoplastic ds* - Idiopathic pericarditis* - Uremia* other causes include : Trauma, Cardiac operation, Tuberculosis The three principal feature of tamponade are elevation of intra cardiac pressures, limitation of ventricular filling and reduction of cardiac output. Clinical symptoms of tamponade Falling aerial pressure Pallor, rapid pulse Rising venous pressure Engorged neck veins Faint hea sounds Pulsus Paradoxus is an impoant clue to tamponade | train | med_mcqa | null |
Which of the following is seen in cold temperature: March 2011 | [
"Increased Thyroxine release",
"Decreased Thyroxine release",
"Unaltered Thyroxine release",
"None of the above"
] | A | Ans. A: Increased Thyroxine release Endocrine mechanisms which causes heat production (thermogenesis) are epinephrine, norepinephrine and thyroxine Thermoregulatory response activated by exposure to cold ( posterior hypothalamus) Increased heat production - Shivering Hunger - Increased voluntary activity - Increased TSH secretion - Increased catecholamines Decreased heat loss - Cutaneous vasoconstriction - Curling up - Horripilation T3 and T4 regulation The production of thyroxine and triiodothyronine is regulated by thyroid-stimulating hormone (TSH), released by the anterior pituitary. The thyroid and thyrotropes form a negative feedback loop: TSH production is suppressed when the T4 levels are high. The TSH production itself is modulated by thyrotropin-releasing hormone (TRH), which is produced by the hypothalamus and secreted at an increased rate in situations such as cold exposure (to stimulate thermogenesis). TSH production is blunted by somatostatin (SRIH), rising levels of glucocoicoids and sex hormones (estrogen and testosterone), and excessively high blood iodide concentration. | train | med_mcqa | null |
Inferior oblique is supplied by the ..... carnial nerve : | [
"3rd",
"4th",
"5th",
"6th"
] | A | A i.e., 3rd | train | med_mcqa | null |
Down's syndrome is associated with -a) Congenital heart diseaseb) A.L.L.c) Early onset Alzheimer's diseased) CNS tumoure) Infection | [
"abce",
"bcde",
"cde",
"acd"
] | A | null | train | med_mcqa | null |
Structures that passes through Foramen Magnum include all, EXCEPT: | [
"Ascending cervical aery",
"Accessory nerve",
"Veebral aeries",
"Spinal aeries"
] | A | The foramen magnum transmits the spinal accessory nerve, veebral aeries, the anterior and posterior spinal aeries, the membrana tectoria and alar ligaments. The foramen magnum is bounded laterally by the occipital condyles.Also Know:The foramen ovale, which transmits the third branch of the trigeminal nerve, the accessory meningeal aery, and (occasionally) the superficial petrosal nerve. Posterior to the foramen ovale is the foramen spinosum, which transmits the middle meningeal vessels. At the base of the styloid process is the stylomastoid foramen, through which the facial nerve exits. Ref: Waxman S.G. (2010). Chapter 11. Ventricles and Coverings of the Brain. In S.G. Waxman (Ed), Clinical Neuroanatomy, 26e | train | med_mcqa | null |
Aqueous humor has lower concentration of: | [
"Lactate",
"Protein",
"Hyaluronic acid",
"L-ascorbic acid"
] | B | Protein content of aqueous humor is much less than that of plasma. The ocular tissue surrounding the aqueous humor (especially the cornea and lens) take up glucose from aqueous humor; glycolysis by these tissues results in higher pyruvate and lactate (and lower glucose) in aqueous humor. L-ascorbic acid content of aqueous humor is 10-50 times higher as compared to plasma. (However, no ocular defects have been noted in prolonged scurvy.) The aqueous humor contains moderately high amounts of hyaluronic acid; it is kept in the depolymerized state by hyaluronidase present in the ciliary body | train | med_mcqa | null |
The mechanism of action of local anaesthetics is that they act on Na+ channels in their : | [
"Activated state",
"Inactivated state",
"Resting state",
"Any state"
] | A | null | train | med_mcqa | null |
Which of the following is an investigation of choice to diagnose gall stones? | [
"X ray abdomen",
"Ultrasound abdomen",
"ERCP",
"MRCP"
] | B | Ans. B. Ultrasound abdomenCholelithiasis involves the presence of gallstones which are concretions that form in the biliary tract, usually in the gallbladder. Choledocholithiasis refers to the presence of one or more gallstones in the common bile duct (CBD) Patients with uncomplicated cholelithiasis or simple biliary colic typically have normal laboratory test results, however these children should be investigated with haemoglobin, reticulocyte count, peripheral blood picture and other investigations to exclude haemolytic disease. Ultrasonography is the procedure of choice in suspected gallbladder or biliary disease. MRCP and ERCP have better accuracy than ultrasonography in diagnosing common bile duct stones. | train | med_mcqa | null |
Gonadotrophin is a : | [
"Steroid",
"Lipoprotien",
"Polypeptide",
"Glycoprotien"
] | D | Glycoprotien | train | med_mcqa | null |
Kidney secretes: March 2013 | [
"Erythropoietin",
"Angiotensin I",
"Angiotensin II",
"Thrombodulin"
] | A | Ans. A i.e. Erythropoietin | train | med_mcqa | null |
Per TCA with 3 NADH and 1 FADH2, generates how many ATP- | [
"6",
"9",
"12",
"15"
] | B | Ans. is 'b' i.e., 9 o One N ADH produces 2.5 ATP and one FADH2 produces 1.5 ATP. Thus 3 NADH and 1 FADH2 will produce 9 ATP.o There is production of ATP at substrate level also. Thus total 10 ATP molecules are produced per cycle.Energetics of TCA cycles iKreb's cycle)o One turn of the TCA cycle, starting with acetyl CoA produces 10 ATPs. When the starting molecule is pyruvate, the oxidative decarboxylation of pyruvate, the oxidative decarboxylation of pyruvate yields 2[?]5 ATPs and therefore, 12[?]5 ATPs are produced when starting compound is pyruvate. Since, two molecules of pyruvate enter the TCA cycle when glucose is metabolized (glycolysis produces 2 molecules of pyruvate), the number of ATPs is doubled. Therefore, 25 ATP molecules, per glucose molecule, are produced when pyruvate enters the TCA cycle,o Note : Previously calculations were made assuming that NADH produces 3 ATPs and FADH generates 2 ATPs. This will amount a net generation of 30 ATP molecules in TCA per molecule glucose and total 38 molecules from starting. Recent experiments shoiv that these values are overestimates and NADH produces 2[?]5 ATPs and FADH produces T5 ATPs. Therefore, net generation during TCA is 25 ATPs and complete oxidation of glucose through glycolysis plus citric acid cycle yield a net 32 ATPs.o Energy yield (number of ATP generated) per moleeule of glucose wrhen it is completely oxidized through glycolysis plus citric acid cycle, under aerobic conditions, is as follows :- Method ofATP formationNo of ATPs gained perglucose (new calculation)No of ATPs As per old calculationPathwayStepEnzymeSource Glycolysis1 Hexokinase.Minus 1Minus 1Do3Pbosphofructoki nase-Minus 1Minus 1Do5Glyceraldehyde-3-p DHNADHRespiratory chain2-5x2 = 53x2=6Do61,3-BPG kinaseATPSubstrate level1x2= 21x2=2Do9Pyruvate kinaseATPSubstrate level1x2= 21x2=2Pyruvate to-PyruvateNADHRespiratory chain2-5x2= 53x2=6Acetyl CoA Dehydrogenase TCA cycle3Isocitrate DHNADHRespiratory chain2-5x2= 53x2=6Do4Alpha keto giutarate DHNADHRespiratory chain2-5x2= 53x2=6Do5Succinate thiokinaseGTPSubstrate level1x2= 21x2=2Do6Succictnate DHFADH2Respiratory chain1-5x2= 32x2=4Do8Malate DHNADHRespiratory chain2-5x2= 53 x 2= 6Net generation in glycolytic pathway 9 minus 2=710 minus 2=8Generation in pyruvate dehydrogenase reaction=5 =6Generation in citric acid cycle=20 =24Net generation of ATP from one glucose mole=32 =38 | train | med_mcqa | null |
Bicipital aponeurosis lies over which structure in cubital fossa? | [
"Ulnar nerve",
"Radial nerve",
"Brachial aery",
"Anterior interosseous aery"
] | C | Bicipital aponeurosis passes superficial to the brachial aery and median nerve. It lies deep to superficial veins. During venipuncture, the bicipital aponeurosis provides limited protection for brachial aery and median nerve. | train | med_mcqa | null |
Tube (Cylinder) cast is applied for the fracture of - | [
"Shoulder",
"Hip",
"Pelvis",
"Knee"
] | D | Cylinder cast in full extension is given for undisplaced patella fractures. | train | med_mcqa | null |
Pyridoxine is involved in | [
"Carboxylation",
"Trans-sulfuration",
"Oxidation-reduction",
"Transketolation"
] | B | Pyridoxine is involved in trans-sulfuration.Sulfur-Containing Amino Acids PLP plays an impoant role in methionine and cysteine metabolism. a.Homocysteine + Serine - Cystathionine. (Enzyme Cystathionine synthase) b.Cystathionine - Homoserine + Cysteine (Enzyme Cystathionase) Both these reactions require PLP. Here transfer of sulphur group occurs.Ref: DM Vasudevan - Textbook of Biochemistry, 6th edition, page no: 396 | train | med_mcqa | null |
C/F of Turner&;s syndrome: | [
"Secondary amenorrhea",
"Edema of hands and feet",
"XY genotype",
"Mental retardation common"
] | B | Turner's syndrome 45,XO genotype sho strature neck is sho and webbed shield chest,high palate,low set ears lymphoedema of extremities at bih SHAW'S TEXTBOOK OF GYNAECOLOGY,Pg no:111,15th edition | train | med_mcqa | null |
Which of the following is not seen in congental rubella syndrome? | [
"Atrial septal defect",
"Ventricular septal defect",
"Patent ductus arteriosus",
"Pulmonary stenosis"
] | A | Ans. is 'a' i.e., Atrial septal defect o Cardiac anomalies in Congenital rubella (In decreasing order of frequency) - PDA (most common), PS, VSD, ASDo ASD is the best answer amongst the given options because amongst the given options, ASD is least commonly associated with congential rubella. | train | med_mcqa | null |
APGAR score is - include all except - | [
"Heart rate",
"Respiratory rate",
"Muscle tone",
"Colour"
] | B | Ans-B i.e., Respiratory rate o The Apgar score is a practical method of systematically assessing newborn infants immediately after birth to help identify those requiring resuscitation and to predict survival in the neonatal periodo The 1-min Apgar score may signal the need for immediate resuscitation, and the 5-, 10-, 15-, and 20-min scores may indicate the probability of successfully resuscitating an infant,o The Apgar score was not designed to predict neurologic outcome.Apgar score: Evaluation of Newborn InfantsSIGN012Heart rateAbsentBelow 100 Over 100 Respiratory effortAbsentSlow, irregularGood, cryingMuscle toneLimpSome flexion of extremitiesActive motionResponse to the catheter in nostril (tested after oropharynx is clear)No responseGrimaceCough or sneezeColorBlue, paleBody pink, extremities blueCompletely pink | train | med_mcqa | null |
A 7-yr-old boy with abrupt onset of pain in the hip with hip held in the abduction. Hemogram is normal. ESR is raised. What is the next line of management- | [
"Hospitalize and observe",
"Ambulatory observation",
"Intravenous antibiotics",
"USG guided aspiration of hip"
] | D | Usually the treatment of a clinically suspected case of transient synovitis of hip is Bed rest, NSAIDS and observation.
USG guided aspiration is indicated for :-
Temperature > 99.5° F
ESR > 20 (Raised ESR)
Severe hip pain with ROM | train | med_mcqa | null |
Regarding urinary bladder stone one is Not true ? | [
"Common in Paediatric pt in tropics than that of non tropical areas",
"Uric acid stones are dropped from above",
"Jack stone is due to urea splitting bacteria",
"Commonly distal passage obstruction cause stone"
] | B | Answer is 'b' i.e. Uric acid stones are dropped from above It is the oxalate stones that are usually dropped from above (i.e. formed in the kidney and dropped in the bladder through ureter). Uric acid stones are mostly formed within the bladder. In general most of the bladder calculi are formed within the bladder itself. Only some stones are formed in the kidney and pass into the bladder, where they grow by additional deposition of crystals. Etiology for Bladder calculi Bladder outlet obstruction is the most common cause of vesical calculi in adults. Other causes are - neurogenic bladder leading to urinary stasis - a foreign body eg. Foley catheter and forgotten DJ stent, which serve as nidi for stones. - bladder diveicula Bladder stones are commonly seen in older men (>50 yrs.) usually because of bladder outlet obstruction In the Western world bladder stones are rare in pediatric population but bladder stones are endemic in children in underdeveloped nations (in Noh Africa, Thailand, Burma, Indonesia i.e. found near the tropics). This is because of low-protein, high carbohydrate diet and chronic dehdyration. These are usually ammonium urate stones. Common vesical stones are Uric acid stones & Struvite stones Other less common stone types are Oxalate stones Cystein stones Struvite stones are also known as 'Jack stones' because of their rough surface as against the smooth surface of uric acid stones. Struvite stones are composed of ammonium, magnesium and calcium phosphates and occurs in urine infected with urea-splitting organisms, eg. proteus. Bladder stones are usually solitary but may also be multiple. | train | med_mcqa | null |
A veterinary doctor had fever for 15 days. His blood culture in special laboratory media was positive for Gram-negative sho bacilli which were oxidase positive. Which one of the following is the likely organism grown in culture? | [
"Pasteurella spp.",
"Francisella spp.",
"Baonella spp.",
"Brucella spp."
] | D | Pasteurella sp-Gram --ve bacilli oxidase +ve causes cellulitis but no fever Francisella sp-Gram --ve sho bacillus, oxidase +ve, causes Tularemia ahrosis but no PUO(Pyrexia of unknown origin) Baonella -- Gram --ve red, oxidase +ve Brucella, Gram --ve, sho bacillus causes PUO Ref : Ananthanarayana textbook of Microbiology 9th edition Pgno : 339 | train | med_mcqa | null |
A 70-year-old man with hypeension wakes up with severe chest pain and diaphoresis. On examination he has bounding pulses with wide pulse pressure. A diastolic murmur is heard along the right sternal border. Which of the following is the possible etiology? | [
"Aoic dissection",
"STEMI with papillary muscle dysfunction",
"Myocarditis with functional regurgitation",
"Flash pulmonary edema"
] | A | Option A= High B.P | Aoic dissection | Leads to Retrograde spread | develop Aoic Root dilation | Leads to develop Aoic Regurgitation- Diastolic Murmur Option B= STEMI with Papillary muscle dysfunction have systolic murmur. Option C= Myocarditis with functional regurgitation- Systolic murmur Option D= Flash Pulmonary edema related to Renal aery stenosis/Reno vascular hypeension | train | med_mcqa | null |
Time sector scanning of neonates is preferred because of the following reason most practical reason: | [
"Open fontanelles",
"Inexpensive",
"Children more co-operative",
"Better resolution"
] | A | Ans. Open fontanelles | train | med_mcqa | null |
Hamburger phenomenon deals with the following: | [
"Chloride shift",
"Oxygen uptake",
"Cellular ATP levels",
"Plasma potassium level"
] | A | Chloride shift (Hamburger phenomenon) the HCO3- diffuses out of the RBCs into the plasma, the inside of the cells become less negatively charged. Because the RBC membrane is relatively impermeable to cation, so in order to neutralize this effect, negatively charged chloride ions diffuse from the plasma into the RBCs to replace the HCO3-. The movement of chloride ions into the RBCs is called chloride shift or Hamburger phenomenon. Ref: Essentials of Medical Physiology By Khurana, 2008, Page 256. | train | med_mcqa | null |
Best treatment of atypical HUS is? | [
"Plasmapheresis",
"Antibiotics",
"IvIg",
"Dialysis"
] | A | Best treatment of atypical HUS is- Plasmapheresis Repeated plasma exchange with infusion of fresh frozen plasma is recommended for atypical HUS & performed daily until hematological remission. Atypical HUS Often lacks the prodromal history of diarrhoea or dysentery. Predisposing factors include mutations in regulators of the complement pathway (factors H, I and B, C3, membrane cofactor protein and thrombomodulin), and antibodies against complement factor H. The diagnosis is made by the combination of microangiopathic hemolytic anemia with schistocytes, thrombocytopenia, and kidney involvement. Renal biopsy is rarely required. Treatment includes management of complications of renal failure, treatment of hypeension and correction of anemia. Proper nutrition must be ensured. Repeated plasma exchange with infusion of fresh frozen plasma is recommended for atypical HUS & performed daily until hematological remission. | train | med_mcqa | null |
Rinne test is positive in: | [
"CSOM",
"Normal individual",
"Otomycosis",
"Wax in ear"
] | B | (b) Normal individual(Ref. Shambaugh, 6th ed., 181)Rinne is said to be positive when AC > BC.In normal ear air conduction is more than the bone conduction due to the transformer action of the middle ear.All the other options are conductive deafness conditions so BC > AC, i.e. Rinne will be negative. | train | med_mcqa | null |
Acantholytic cells area) Epidermal cellsb) Plasma cellsc) Keratinocytesd) Giant cells | [
"a",
"bc",
"ad",
"ac"
] | D | Acantholytic cells (Tzank cells) are separated keratinocytes, the major epidermal cells. | train | med_mcqa | null |
Biological value is maximum in: | [
"Egg",
"Milk",
"Soyabean",
"Pulses"
] | A | Egg | train | med_mcqa | null |
A patient comes with increased aPTT and PT with no bleeding tendency. Even at surgery he did not have increased bleeding. Which factor is deficient- | [
"V",
"Vn",
"xn",
"X"
] | A | If both the PT and APTT are prolonged, this indicates either deficiency or inhibition of the final common pathway(which includes factor 5,10,prothrombin and fibrinogen) or global coagulation factor deficiency involving more than one factor, as ocvurs in DIC. Reference : Davidson, 23rd Edition, page no : 921. | train | med_mcqa | null |
In a case of disputed paternity, father's blood group is A, mother's blood group is B, the child's blood group may be: Karnataka 07 | [
"A only",
"B only",
"AB only",
"A, AB, B or O"
] | D | Ans. A, AB, B or O | train | med_mcqa | null |
MC site of injury to the ureter during a hysterectomy is: March 2004 | [
"At the pelvic brim",
"In the ovarian fossa",
"Site of crossing by the uterine aery",
"As it enters the bladder"
] | C | Ans. C i.e. Site of crossing by the uterine aery | train | med_mcqa | null |
The treatment of metastatic testicular carcinoma is | [
"Bleomycin, Etoposide, Cisplatin",
"Vinblastine, Etoposide, Cisplatin",
"Doxorubicin, 5FU, Mercaptopurine",
"Methotrexate, 5FU, Vincristine"
] | A | Standard chemotherapy for Germ Cell tumour is BEP regimen B- Bleomycin (30units) Day 2, 9, 16 E- Etoposide (100mg/m2) Day 15 P- Cisplatin (20mg/m2) Day 15 ref - Harrisons internal medicine 20e pg635-36,633 | train | med_mcqa | null |
Osseocailaginous junction on the dorsum of nose is? | [
"Nasion",
"Columella",
"Rhinion",
"Glabella"
] | C | The intersection of the two nasal bones with the frontal bone is known as NASION. The junction of the lower end of the internasal suture with the lower cailaginous pa of the nose is a mid line I known as RHINION. ( Ref Cummings 6th edition, Pg no. 493 ) | train | med_mcqa | null |
Which of the following antibodies is most frequently seen in Antiphospholipid Syndrome? | [
"Beta 2 microglobulin antibody",
"Anti-nuclear antibody",
"Anti-centromere antibody",
"Anti- beta 2 glycoprotein antibody"
] | D | Ans. (d) Anti- beta 2 glycoprotein antibody(Ref: Robbins 9th/pg 124; 8th/pg 123)Anti- beta 2 glycoprotein antibody is most frequently seen in Antiphospholipid Syndrome | train | med_mcqa | null |
Oral medication used in the treatment of scabies. | [
"Albendazole",
"Metronidazole",
"Ketoconazole",
"Ivermectin"
] | D | Gama benzene hexachloride 1%lindane 12 -24 hrs a day/2hrs in children .used in caution in infants and children. Permethrin 5%cream -8-12 hrs at night. It act on the nerve cell membrane and disrupt sodium channel current . Used to treat scabies in pregnancy,lctation and infants more than 2 months of age. Benzoyl benzoate 25%emulsion left on body for 48hrs or 3 consecutive nights Crotamiton 10%lotion every night for 2days Malathion 0.5% liquid 6%precipitated sulphur daily night application for 3 days Oral Ivermectin 200ug/kg two doses at 10day interval GABA agonist and chloride channel opener. IADVL textbook of dermatology page 429 | train | med_mcqa | null |
Glucosylceramide is accumulated in - | [
"Tay-Sach disease",
"Krabbe's disease",
"Gaucher's disease",
"Niemanm Pick disease"
] | C | Ans. is 'c' i.e., Gaucher's disease DiseaseEnzyme DeficiencyLipid AccumulatingClinical SymptomsTay-Sachs diseaseHexosaminidase ACer--Glc--Gal(NeuAc) -- Gal NacGM2 GangliosideMental retardation, blindness, muscular weaknessFabry's diseasea-GalactosidaseCer--Glc--Gal-- Gal GlobotriaosylceramideSkin rash, kidney failure (full symptoms only in males; X-!inked recessive)Metachromatic leukodystrophyArylsulfatase ACer--Gal-- OSO3 3-SulfogalactosylceramideMental retardation and psychologic disturbances in adults; demyelinationKrabbe's diseaseb-GalactosidaseCer-- GalMental retardation; myelin almost absentGaucher's diseaseb-GlucosidaseCer-- Gal GlucosylceramideEnlarged liver and spleen, erosion of long bones, mental retardation in infantsNiemann-Pick diseaseSphingomyelinaseCer-- P--choline SphingomyelinEnlarged liver and spleen , mental retardation; fatal in early lifeFarber's diseaseCeramidaseAcyl-- Sphingosine CeramideHoarseness, dermatitis, skeletal deformation, mental retardation; fatal in early life | train | med_mcqa | null |
In Gaucher's diseases, there is deficiency of - | [
"Glucocerebrosidase",
"Glucokinase",
"Sphingomyelinase",
"G-6PD"
] | A | Ans. is 'a' i.e., Glucocerebrosidase o Gaucher's disease is due to deficiency of (3-glucosidase (glucocerebrosidase).o This question is repeat front AH MS 97.DiseaseEnzyme deficiencyLipid accumulatedTay-sach diseaseHexosaminidase AGM, gangliosideSandoff diseaseHexosaminidase BGM,gangliosideNiemann-Pick diseaseSphi ngomyel inaseSphingomyelineFarber's diseaseCeram idaseAcyl-sphingosine (ceramide)Fabry's diseasea-galactosidaseGlobotri sy IceramideKrabbe's diseaseb-galactosidase(Galactosylceramidase)GalactosvlceramideGaucher's diseaseb-gl ucosidase (gl ucoccrebrosi dase)Glueosy IceramideMetachromatic leukodystrophyArylsulfatase A3-Suffoga!actosy!ceramide | train | med_mcqa | null |
For the past week, a 65-year-old woman has been treated for a severe infection with broad-spectrum antibiotics, and she had recovered well. Over the past day, however, she has developed foul-smelling, voluminous, greenish, watery diarrhea, as well as abdominal pain and fever. She is diagnosed with pseudomembranous colitis. Which of the following is the mechanism associated with this condition? | [
"Aggregation of bacterial colonies on the lumen, forming pseudomembranes",
"Bacterial release of exotoxin, inducing necrosis of the mucosa",
"Physical invasion of bacteria into the superficial mucosa, leading to pseudomembrane formation",
"Selective killing of C. difficile bacteria by antibiotics"
] | B | - Pseudomembranous colitiis Overgrowth of C. difficile following antibiotic therapy d/t destruction of normal intestinal flora. Aka Antibiotic-associated colitis / Antibiotic-associated diarrhea Produces exotoxin that induces necrosis of superficial mucosa, -Pseudomembrane formation. Bacteria itself does not invade the mucosa. Histology : small surface erosion of superficial colonic crypts and overlying accumulations of neutrophils, fibrin, mucus, and necrotic epithelial cells Lamina propia adjoining area of necrosis has infiltrate of neutrophils and eosinophils In advanced lesion : necrosis of superficial crypts with more dense neutrophil infiltrate and plaque like pseudomembrane of neutrophil , fibrin, and cellular debris covering mucosal surface | train | med_mcqa | null |
True about obsessive compulsive disorders are all except: | [
"Obsessions are ego alien",
"Patient tries to resist against obsessions and compulsions",
"Obsessions are egosyntonic",
"Insight is present"
] | C | Obsessions are ego dystonic and not ego syntonic. Obsessive-compulsive disorder Obsessions are Recurrent, intrusive thoughts images or impulses, which cause anxiety Patient considers them as a product of their own mind (D/d thought inseion) Patient finds them excessive, irrational and senseless, at some time during the illness (D/d delusions) Patient tries to resist or neutralize them Ego dystonic (not acceptable to self) With good insight/poor insight/absent insight (delusional belief) | train | med_mcqa | null |
A sample is a subset of the population, selected so as to be representative of the larger population. All of the following are TRUE about cluster sampling, EXCEPT: | [
"Sample size is same as that of simple random sampling",
"It is a two stage sampling",
"It is cheaper than other methods of sampling",
"It has the disadvantage of higher sampling error"
] | A | A cluster random sample results from a two-stage process in which the population is divided into clusters and a subset of the clusters is randomly selected. Cluster sampling is somewhat less efficient than the other sampling methods because it requires a larger sample size. The recommended way to select a simple random sample is to use a table of random numbers or a computer-generated list of random numbers. So that the sample size is not same as that of cluster random sampling. Ref: Dawson B., Trapp R.G. (2004). Chapter 4. Probability & Related Topics for Making Inferences About Data. In B. Dawson, R.G. Trapp (Eds), Basic & Clinical Biostatistics, 4e. | train | med_mcqa | null |
Bilirubin is absent in urine because it is: | [
"Distributed in the body fat",
"Conjugated with glucuronide",
"Not filterable",
"Lipophilic."
] | D | Ans. is 'd' i.e. Lipophilic : Unconjugated bilirubin is absent in urine but conjugated bilirubin can be present in it. But I think that the examiner is talking about unconjugated bilirubin as 90% bilirubin in the serum is unconjugated.Unconjugated bilirubin is highly lipid soluble (Lipophilic) and has limited aqueous solubility thus it is not able to pass out in urine. Moreover unconjugated bilirubin is tightly bound to albumin and therefore not filtered by renal glomeruli.In contrast, conjugated bilirubin is water soluble, and easily filtered by the renal glomeruli..Metabolism of bilirubin:** Sources of bilirubinRBC's (old, senescent) 80%Ineffective erythropoiesisMetabolism of other heme containing proteinsThis unconjugated bilirubin is not water soluble so is bound to albumin for its transfer in plasmaLiver uptakes this unconjugated bilirubin and conjugates it with glucuronic acid, generating bilirubin glucuronide which is water soluble.Conjugated bilirubin (i.e. bilirubin glucuronide) is excreted in bile into the duodenum.Conjugated bilibrium is not reabsorbed by the intestinal mucosa. It is either excreted unchanged in the stools or metabolised by ileal and colonic bacteria to urobilinogen and related products.Urobilinogen can be reabsorbed from the small intestine and colon and enters the portal circulation. Some of the portal urobilinogen is taken up by the liver and reexcreted into the bile, and the remainder bypasses the liver and is excreted by the kidney.Urinary urobilinogen is a useful tool: for distinguishing possible causes of hyperbilirubinemia.Urinary urobilinogen excretion is increased in* :- * When production of bilirubin is greatly increased (eg. With hemolysis)** When the hepatic uptake and excretion of urobilinogen is impaired (eg in hepatocellular disease)*Urinary urobilinogen excretion is decreased in* :- * Cholestasis or extrahepatic biliary obstruction (Obstructive Jaundice)* | train | med_mcqa | null |
Specifivity of a test refers to its ability to detect - | [
"True positive",
"True negative",
"False negative",
"False positive"
] | B | Ref:Parks 23rd edition pg 136 specificity is defined as the ability of a test to identify those who do not have the disease. That is true negatives. | train | med_mcqa | null |
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