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Prolonged parasitism in malaria is due to - | [
"Antigenic variation",
"Intracellularity of parasite",
"Immunosuppression",
"Sequestration"
] | B | null | train | med_mcqa | null |
Gamma gandy bodies are seen in all except ? | [
"Cirrhosis with poal hypeension",
"Chronic myeloid leukemia",
"Sickle cell anemia",
"Thalassemia"
] | D | Ans. is 'd' i.e., Thalassemia | train | med_mcqa | null |
Low-pressure receptors that play role in Minimal arterial pressure changes, due to volume changes are located in | [
"Left Atrium",
"Right Atrium",
"Pulmonary arteries",
"All of above"
] | D | Low pressure receptors that play role in Minimal arterial pressure changes, due to volume changes are located in right atrium, left atrium and pulmonary arteries. | train | med_mcqa | null |
Bolam test is related to? | [
"Medical negligence",
"Contributory negligence",
"Priviledged communication",
"Negligence by patient"
] | A | Ans. is 'a' i.e., Medical negligence [Ref judgment given by Mr. Justice Mc Nair in Bolam vs. Frien hos ,ital management committee (19511 IS a landmark decision in deciding cases of medical negligence and is known as the "Bolam test.Actions of doctors are to be judged by actions of other doctors skilled in that paicular a under similar circumstances and at a material time. | train | med_mcqa | null |
Black scab is formed at | [
"4-5 days",
"6-7 days",
"Less than 24 hours",
"After 7-10 days"
] | B | Age of abrasion Less than 24 hours bright red - reddish scab 2-3 days reddish- brown scab 4-5 days dark brown scab 6-7 days black scab ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 114 | train | med_mcqa | null |
Which of the following bone tumors occurs in young age group, arises in medullary cavity, and characteristically shows sheets of small uniform sized round cells and Homer Wright rossets? | [
"Osteosarcoma",
"Ewing's tumor",
"Chondrosarcoma",
"Osteoid osteoma"
] | B | Ans. b (Ewing's tumor) (Ref. Robbin's pathology, 7th/pg. 1301; 558).The four main types of rosettes in pathology :1. Homer Wright rosette: typically seen in neuroblastomas, medulloblastomas, and primitive neuroectodermal tumors (PNETs). It consists of a halo of tumor cells surrounding a central region containing neuropil.2. Flexner-Wintersteiner Rosette: characteristic of retinoblastomas. It consists of tumor cells surrounding a central lumen that contains cytoplasmic extensions from the tumor cells.3. True Ependymal Rosette: consists of tumor cells surrounding an empty lumen. Are characteristic of ependymoma, but not seen in all cases.4. Perivascular Pseudorosette: consists of tumor cells collected around a blood vessel. It's called a pseudorosette because the central structure isn't part of the tumor. These rosettes are common in ependymomas, but you also see them in medulloblastoma, PNET, central neurocytomas, and glioblastomas.EWING'S SARCOMA# Incidence: Constitutes ~10 to 15% of all bone sarcomas.# Age: Peak incidence in the second decade of life.# Origin: Arises in the medullary cavity of the bones.# Location:involves the diaphyseal region of long bones (especially femur) & flat bones (especially pelvis).# X-ray: permeative destructive lytic lesion with "onion peel" periosteal reaction with soft tissue mass.# Histopathology:- It is composed of sheets of monotonous, small, round, blue cells and can be confused with lymphoma, embryonal rhabdomyosarcoma, and small-cell carcinoma.- The cells are rich in glycogen (PAS positive cells).6- The presence of "Homer-Wright rosettes" is indicative of neural differentiation.- Most PNETs arise in soft tissues; they include:* Peripheral neuroepithelioma,* Askin's tumor (chest wall), and* Esthesioneuroblastoma.- The presence of p30/32, the product of the mic-2 gene (which maps to the pseudoautosomal region of the X and Y chromosomes) is a cell-surface marker for Ewing's sarcoma (PNETs).- The classic cytogenetic abnormality associated with this disease (and other PNETs) is t(11;22).- CD99 +.# It is very aggressive tumor and considered a systemic disease and mimics acute osteomyelitis.# Common sites of metastases are lung, bones (bone to bone metastases/), and bone marrow.# Rx:# Systemic chemotherapy is the mainstay of therapy, often being used before surgery.# Local treatment for the primary tumor includes surgical resection, usually with limb salvage or radiation.# Ewing's is a curable tumor, even in the presence of obvious metastasis, especially in children <11 years old.Also Know:TranslocationTtimor# (22q11)Chronic myelogenous leukemia# (12;22)(q 13 ;q 12)Malignant melanoma of soft parts (MMSP)# (11;14)(q13;q32)Mantle cell lymphoma# (14; 18)(q32;q21)Follicular lymphoma# (1;22)(q24;q12)Ewing's sarcoma# (1;7)(p34;q35)T cell acute lymphocytic leukemia (ALL)# (8;14)(q24;q32)Burkitt's lymphoma, B cell ALL# (11;22)(pl3;q12)Desmoplastic small round cell tumor (DSRCT)# (2;13)(q35;ql4)Alveolar rhabdomyosarcoma# (1; 13)(p36;q 14)Alveolar rhabdomyosarcoma# (10; 17)(q 11.2;q23)Papillary thyroid carcinomas# (x, 18)Synovial cell sarcoma | train | med_mcqa | null |
Which disorder is most likely associated with erythroid hyperplasia in the bone marrow? | [
"Anemia of chronic disease",
"Thalassemia minor",
"7 to 10 days after a GI bleed",
"Iron deficiency"
] | C | Erythroid hyperplasia in the bone marrow is a response of the erythroid series to erythropoietin stimulation. These stimuli include hypoxemia (e.g., chronic, obstructive pulmonary disease), anemia less than 7 gm/ dl, a left-shifted oxygen dissociation curve (e.g., carbon monoxide poisoning), a bleed more than 5 to 7 days, and testosterone. Anemia of chronic disease, thalassemia minor, and iron deficiency have problems in hemoglobin synthesis, so these would not be expected to have a reticulocyte response. In chronic renal disease, there is a decreased concentration of erythropoietin, which results in a normocytic anemia and no reticulocyte response. Ref - Harrison's internal medicine 20e pg 391, 391f, 684, 696 | train | med_mcqa | null |
SGPT is found in: | [
"Cytoplasm of hepatocytes",
"Mitochondria of hepatocytes",
"Nucleus of hepatocytes",
"All of above"
] | A | SGPT and SGOT are found in cytoplasm of hepatocytes whereas SGOT is also found in mitochondria of hepatocytes. SGPT can be raised in other forms of tissue damage, such as: Myocardial infarction Muscle necrosis Renal disorders Cerebral disorders Intravascular hemolysis. In these diseases, serum SGOT levels are much higher than SGPT levels. However, in liver disease, generally SGPT increases more than SGOT. | train | med_mcqa | null |
Actinomycosis is sensitive to - | [
"Streptomycin",
"Nystatin",
"Pencillin",
"Iodox - uridine"
] | C | • Actinomycosis is a granulomatous suppurative bacterial disease caused by Actinomyces.
• Usually results following tooth extraction, odontogenic infection, or facial trauma.
Clinical Features
• Oral-cervicofacial disease is the MC form, characterized by a painless "lumpy jaw."
• Pelvic actinomycosis is a rare but proven complication of use of intrauterine devices.
Diagnosis
• Accurate diagnosis depends on careful histologic analysis.
• Presence of sulfur granules within purulent specimen is pathognomonic.
Treatment
• Penicillin and sulfonamides are typically effective against these infections. | train | med_mcqa | null |
A patient after heavy drinking of alcohol presents with too much vomiting & haematemesis. Most likely diagnosis could be: March 2012, March 2013 | [
"Mallory Weiss syndrome",
"Oesophageal carcinoma",
"Achalasia cardia",
"Boerhaave syndrome"
] | A | Ans: A i.e. Mallory Weiss syndromeEsophagus disorders & presentationIn Mallory Weiss syndrome, vigorous vomiting produces a veical split in gastric mucosa, immediately below the squamo-columnar junction at the cardia in 90% of cases. The condition presents with haematemesisMost oesophageal neoplasms presents with mechanical symptoms, principally dysphagia, but sometimes also regurgitation, vomiting, odynophagia & weight lossAchalsia cardia presents with dysphagia, although pain (often mistaken for reflux) is common in the early stages.In Boerhaave's syndrome, vomiting occurs against a closed glottis, and pressure builds up in the oesophagus | train | med_mcqa | null |
A 4-year-old male child is admitted to the hospital with severe vomiting. Radiographic examination and history taking reveals that the boy suffers from an annular pancreas. Which of the following structures is most typically obstructed by this condition? | [
"Pylorus of the stomach",
"First part of the duodenum",
"Second part of the duodenum",
"Third part of the duodenum"
] | C | In normal pancreatic development a bifid ventral pancreatic bud rotates around the dorsal side of the gut tube and fuses with the dorsal pancreatic bud. Rarely, a portion of the ventral bud rotates around the ventral side of the gut tube, resulting in an annular pancreas. The portion of the gut tube is the same where the main pancreatic duct enters the second part of the duodenum (along with the common bile duct). The incidence of annular pancreas is about 1 in 7000. | train | med_mcqa | null |
In a patient of unilateral loss of vision, the patient had injury to opposite eye leading to corneal opacification. The patient was operated by corneal grafting, he could see clearly again with one eye. The injury is said to be - | [
"Simple",
"Grievous",
"Dangerous",
"Hazardous"
] | B | The synopsis of forensic medicine & toxicology;Dr k.s narayan reddy; 28th edition; pg.no.155; There is permanent privation (loss) of sight of one eye,therefore its a grievous hu. | train | med_mcqa | null |
Which of the following is not a component of Rotterdam criteria for diagnosing polycystic ovarian syndrome (PCOD) | [
"Multiple cysts in ovaries seen on USG",
"Anovulation",
"Clinical or biochemical hyperandrogenism",
"Hyperinsulinism"
] | D | Hyperinsulinism is not among Rotterdam criteria, although insulin resistance is seen in POCD. | train | med_mcqa | null |
Hampton hump is feature of? | [
"Pulmonary tuberculosis",
"Pulmonary embolism",
"Pulmonary hemorrhage",
"Bronchogenic carcinoma"
] | B | B i.e., Pulmonary embolism Pulmonary Thrombo - Embolism (PTE) Chest X Ray *. Normal/Near-normal in dyspneic patientQ Focal (localized peripheral) oligemia (westermark sign) Peripheral pleural based wedge shaped density above the diaphragm (Hampton's humpQ) Enlarged right descending pulmonary aery (Palla sign) Long curvilinear densities reaching pleural surface (Fleischner lines) Pleural effusion on left > right (Felson's sign) Peripheral air space opacification, linear atelectasis, enlargement of central pulmonary aeries, consolidation & cavitation. | train | med_mcqa | null |
One of the following is a characteristic of Henoch- Schonlein Purpura - | [
"Blood in stool",
"Thrombocytopenia",
"Intracranial hemorrhage",
"Susceptibility to infection"
] | A | null | train | med_mcqa | null |
The gold standard Lab test for diagnosis of PNH (Paroxysmal Nocturnal Hemoglobinuria) is? | [
"Ham test",
"Haptoglobin",
"Flow cytometry",
"Sucrose Lysis test"
] | C | 1.)CD59 -It is also given the name ofMIRL(Membrane Inhibitor of Reactive Lysis). 2.)CD55 -It is given the name ofDAF(Decay Accelerating Factor) . It is responsible for breakdown ofC3. -Flow cytometry of RBC showing absence of CD55 and CD59 is gold standard diagnostic test for PNH. Other tests used are: Sucrose hemolysis test: patient's whole blood is mixed with isotonic sucrose solution , which promotes binding of complement to red blood cells, then incubated and examined for hemolysis; greater than 10percent hemolysis indicates PNH Acidified serum (Ham test): Acidification of serumactivates complement alternate pathway and causes haemolysis of red cells if they are abnormally sensitive to complement. | train | med_mcqa | null |
The Y chromosome carries a gene on its sho arm that codes for | [
"Testosterone",
"MIF",
"Testes-determining factor (TDF)",
"Progesterone"
] | C | The SRY (sex region Y chromosome) gene present on the sho arm of the Y chromosome codes for TDF (Testes Determining Factor). Presence or absence of this chromosome decides whether the fetus will be male or female. Sex determination is not possible till week 6 i.e. why the embryo is called indeterminate embryo till week 6. External sex differentiation completes after week 11. USG sex determination can be done at this time. | train | med_mcqa | null |
A 69-year-old man is admitted to the emergency department with an acute UGI hemorrhage following a bout of repeated vomiting. Fiberoptic gastroscopy reveals three linear mucosal tears at the GE junction. What is the diagnosis? | [
"Reflux esophagitis with ulceration",
"Barrett's esophagus",
"Carcinoma of the esophagus",
"Mallory-Weiss tear"
] | D | A Mallory-Weiss tear is characterized by acute and sometimes massive UGI hemorrhage. It accounts for up to 10%. of UGI bleeds. It is due to arterial bleeding following repeated vomiting (which causes mucosal tears at the GE junction). The cause is the same as that for spontaneous rupture of the esophagus (i.e., an increase in intra-abdominal pressure against a closed glottis). Causes other than vomiting such as paroxysmal coughing or retching, may sometimes lead to this condition. Upper endoscopy confirms the diagnosis. Surgery may occasionally be necessary to stop the bleeding. | train | med_mcqa | null |
Niacin dificiens causes all except - | [
"Dermatitis",
"Dactvlis",
"Diarrhoea",
"Dementia"
] | B | Ans. is 'b' i.e., Dactylis Niacino Vitamin B3o Niacin incorporated into NAD & NADPo Both are co-enzyme for oxydation-reduction reactiono Deficiency cause pellagra characterised by3D- 1) Dermatitis2) Diarrhoea3) Dementia | train | med_mcqa | null |
Natural habitat of Schistosoma (blood flukes) ? | [
"Veins of the urinary bladder",
"Poal & pelvic veins",
"Vesical plexuses",
"All of the above"
] | D | Ans. is 'd' i.e., All of the above | train | med_mcqa | null |
Anterior interventricular artery is a branch of - | [
"Right coronary artery",
"Left coronary artery",
"Circumflex artery",
"Left anterior descending artery"
] | B | Branches of Right Coronary artery are
- Acute marginal
- Posterior descending/interventricular
- Infundibular
- Nodal branch (in 65%)
- Atrial, anterior and posterior ventricular
Branches of Left coronary artery are
- Anterior descending/interventricular
- Circumflex
- Left diagonal
- Obtuse marginal
- Left conus
- Nodal (in 35%)
- Atrial, anterior and posterior ventricular | train | med_mcqa | null |
A patient presents with a lower gastrointestinal bleed. Sigmoidoscopy shows ulcers in the sigmoid. Biopsy from this area shows flask-shaped ulcers. Which of the following is the most appropriate treatment - | [
"Intravenous ceftriaxone",
"Intravenous metronidazole",
"Intravenous steroids and sulphasalazine",
"Hydrocortisone enemas"
] | B | null | train | med_mcqa | null |
All of the following muscles of the tongue are supplied by hypoglossal nerve except | [
"Genioglossus",
"Styloglossus",
"Hyoglossus",
"Palatoglossus"
] | D | Ans: d) All intrinsic and extrinsic muscles of the tongue are supplied by hypoglossal nerve except the palatoglossus which is supplied by the cranial part of the accessory nerve through the pharyngeal plexus. Important points 1) There are 8 intrinsic and 8 extrinsic muscles of the tongue 2) The main bulk of the tongue is formed by genioglossus 3) Muscles of the tongue are developed from occipital myotomes 4) In unilateral weakness tongue deviates to side of lesion or protrusion due to the action of genioglossus muscle | train | med_mcqa | null |
An average-sized hen egg would provide - | [
"50 kcal",
"70 kcal",
"90 kcal",
"110 kcal"
] | B | An egg weighing 60 grams contain about 70kcal of energyREF.PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE.Editon-21.Page no.-582. | train | med_mcqa | null |
All of the following are described surgical procedures for CTE V except - | [
"Dwyer's osteotomy",
"Posteromedial soft tissue release",
"Triple Arthrodesis",
"Salter's osteotomy"
] | D | Ans. is 'd' i.e., Salter's osteotomy | train | med_mcqa | null |
Mechanism of action of diphtheria toxin - | [
"ADP ribosylation",
"Activation of adenylyl cyclase",
"Activation of guanylyl cyclase",
"Inhibition"
] | A | Ans. is 'a' i.e., ADP ribosylation IMPORTANT BACTERIAL TOXINSToxinsMechanism of actionBotulinum toxin* Acts on the peripheral nervous system (i.e. neuromuscular junctions) by inhibiting myoneural junction acetylcholine release and cause flaccid paralysis (many strains of Clostridium botulinum synthesized C2 toxin, that ADP-ribosylates actin, thereby inhibiting its polymerization, affecting the shape of target cells, and resulting in enterotoxin activity in vivo).Diphtheria toxin* Inhibits protein synthesis in target cells by catalyzing the ADP ribosylation of a novel amino acid (diphthamide) on elongation factor 2, a host protein required for translocation of ribosomal messenger RNA.Pertussis toxin* Acts by ADP ribosylation of several members of the family of guanine nucleotide-binding (G) proteins involved in signal transduction, inhibiting their function and affecting a variety of effector systems, such as adenylate cyclase, phospholipases, and several types of ion channels.ST of E. coli* Activates guanylyl cyclase to increase cGMP.V. cholerae toxin LT of E. coli* Activates adenylate cyclase of the intestinal epithelial cell by AD ribosylation of the stimulatory G. protein, Gs -|cAMP.Shiga toxin* Inhibits protein synthesis by enzymatic inactivation of the28S RNA within the 60S ribosomal subunit.Verocytotoxin of E. coli toxin)* Inhibit protein synthesis by inhibiting ribosomal function (same as shiga | train | med_mcqa | null |
Esophageal carcinoma is not predisposed by - | [
"Achalasia",
"Scleroderma",
"Corrosive intake",
"Barret's esophagus"
] | B | Answer is 'b' i.e. Scleroderma | train | med_mcqa | null |
It has been hypothesized that their exists a strong association between haemolytic uraemic syndrome: | [
"Salmonellae",
"Bacteriophages and corynebacteria",
"Verocytotoxin producing E. coli",
"Clostridium difficle"
] | C | Ans. is 'c' i.e., Verocytotoxin producing E. coliEHEC (Enterohemorrhagic E. coliA/erocytotoxin producing E coli) - produces verotoxin (VT) whose major target is vascular endothelial cells - Hemolytic uremic syndrome (HUS), Hemorrhagic colitis - . | train | med_mcqa | null |
Outermost nuclei of the basal ganglia includes | [
"Putamen",
"Globus pallidus",
"Substantia Niagra",
"Subthalmic nucleus"
] | A | Ans. is 'a' i.e., Putamen * Basal ganglia include following nuclei:- caudate nucleus, putamen, globus pallidus, subthalamic nucleus and substantia nigra.* Putamen is the outermost basal ganglia nucleus lying just lateral to globus pallidus | train | med_mcqa | null |
Arrange the enzyme categories as per increasing order of their enzyme commission numbers: A. Isomerases B. Hydrolases C. Hydratase D. Transferases | [
"A- C - D - B",
"D- B-C - A",
"C- B - D - A",
"B- D - A - C"
] | B | Enzyme Commission Number Name of Enzyme EC No. 1 Oxidoreductase EC No. 2 Transferase EC No. 3 Hydrolase EC No. 4 Lyase EC No. 5 Isomerase EC No. 6 Ligase EC no. 7 Translocase | train | med_mcqa | null |
A male patient came to the hospital with complaints of progressive swelling of the upper limb. On examination, the limbs are more swollen proximally than distally as shown below and is non-pitting. The skin over the swelling is thickened. What is the next best step in the management of this patient? | [
"PCR",
"X-Ray",
"Night blood test for worms",
"Lymphoscintigraphy"
] | C | The given clinical picture is suggestive of lymphatic filariasis (elephantiasis). The best next step would be to test the night blood for worms since the filarial species is nocturnally periodic (between 10 pm and 4 am) in India. Lymphatic filariasis is caused by Wuchereria bancrofti and Brugia malayi. Elephantiasis is a delayed sequel to repeated lymphangitis, obstruction and lymphedema. Repeated leakage of lymph into tissues first results in lymphedema, then to elephantiasis. Treatment: Diethylcarbamazine is the drug of choice. Other options: PCR is negative in chronic filariasis. Lymphoscintigraphy is principally a research tool. X-ray is useful only if worms are calcified. Reference: Paniker&;s Textbook of Medical Parasitology 8th edition | train | med_mcqa | null |
A 'string of pearls' appearance is seen in - | [
"Small Bowel Obstruction",
"Toxic Megacolon",
"Ulcerative Colitis",
"Ischaemic Colitis"
] | A | Ans. is 'a' i.e., Small Bowel Obstruction o The string of pearls (or beads) sign can be seen on upright or decubitus abdominal radiographs as well as on CT in patients with small bowel obstruction, increased intraluminal fluid, and slow resorption of intraluminal gas.o It consists of an obliquely or horizontally oriented row of small gas bubbles in the abdomen, which represent small pockets of gas along the superior wall of the small bowel that are trapped between the valvulae conniventes. The inferior margins of these bubbles have an ovoid appearance due to the meniscal effect of the intraluminal fluido The string of pearls sign, when present in the appropriate clinical setting, is virtually diagnostic of small bowel obstruction. | train | med_mcqa | null |
Which of the following drugs is not used in Juvenile Myoclonic Epilepsy (JME)? | [
"Topiramate",
"Zonisamide",
"Carbamazepine",
"Valproate"
] | C | Juvenile myoclonic epilepsy (JME) is a generalized seizure disorder of unknown cause that appears in early adolescence and is usually characterized by bilateral myoclonic jerks that may be single or repetitive.The myoclonic seizures are most frequent in the morning after awakening and can be provoked by sleep deprivation. Consciousness is preserved unless the myoclonus is especially severe.Carbamazepine useful in focal seizures.Ref: Harrison; 19th edition; Page no: 2544 | train | med_mcqa | null |
First local anesthetic used in clinical anaesthesia was: | [
"Bupivacaine",
"Procaine",
"Lidocaine",
"Cocaine"
] | D | Cocaine was the first agent to be isolated by Niemann in 1860. Procaine was synthesized in 1905. From padmaja Fouh edition Page no 199 | train | med_mcqa | null |
Non-caseating granuloma is characteristically seen in: | [
"Syphilis",
"Sarcoidosis",
"Tuberculosis",
"Cat-scratch disease"
] | B | In granulomas associated with ceain infectious organisms (most classically Mycobacterium tuberculosis), a combination of hypoxia and free radical-mediated injury leads to a central zone of necrosis. Grossly, this has a granular, cheesy appearance and is therefore called caseous necrosis. Microscopically, this necrotic material appears as amorphous, structureless, eosinophilic, granular debris, with complete loss of cellular details. The granulomas in Crohn disease, sarcoidosis, and foreign body reactions tend to not have necrotic centers and are said to be non-caseating. | train | med_mcqa | null |
A 45 year old male presents to the dental clinic with black spot. He also gives the history of previous dental treatments of other teeth and wants gold to be filled in this tooth. On examination, it is revealed that 16 no. tooth has pit and fissure caries. During the condensation of the restorative material, the compacted surface should be: | [
"Saucer shaped, with the compaction on the external walls slightly ahead of the center",
"Convex in the center with the compaction on the external walls slightly ahead of the center",
"Flat in the center with the compaction on the external walls slightly ahead of the center",
"Flat throughout the floor"
] | A | Generally the line of force is perpendicular to the pulpal floor in the center of the mass and at a 45-degree angle to the pulpal floor as the external walls are reached. At this stage and during all building of the restoration, the compacted surface should be saucer-shaped, with the compaction of gold on the external walls slightly ahead of the center.
The surface should never be convex in the center because this may result in voids in the gold and poor adaptation of the gold along the external walls when the condenser nib is “crowded out” along the wall by the center convexity.
The operator continues building the restoration until the cavosurface margin is covered with foil. One needs to exercise extreme care that gold is always present between the condenser face and the cavosurface margin; otherwise, the condenser may injure (i.e., fracture) the enamel margin.
The central area of the restoration surface is filled into the desired level. Tooth surface contour of the gold is created to simulate the final anatomic form, and a slight excess of gold is compacted on the surface to allow for the finishing and polishing procedures.
Sturdevant operative dentistry 7th E D I T I O N, Page No:131 | train | med_mcqa | null |
Which aminoacid is absent in Carisolv | [
"Glycine",
"Glutamic acid",
"Leucine",
"Lysine"
] | A | null | train | med_mcqa | null |
Validity includes | [
"Sensitivity and specificity",
"Precision",
"Acceptibility",
"None"
] | A | null | train | med_mcqa | null |
An 18-year-old woman comes to the emergency room with recurrent facial edema, especially around her lips. She also has recurrent bouts of intense abdominal pain and cramps, sometimes associated with vomiting. Laboratory examination reveals decreased C4, while levels of C3, decay-accelerating factor, and IgE are within normal limits. A deficiency of which of the following substances is most likely to be associated with these findings? | [
"C1 esterase inhibitor",
"Complement components C3 and C5",
"Decay-accelerating factor",
"None of the above"
] | A | This women is suffering from hereditary angioedema.
C1 inhibitor blocks the activation of C1, the first protein of the classical complement pathway. Inherited deficiency of this inhibitor is the cause of hereditary angioedema.
Deficiency of decay accelerating factor (DAF), which breaks down the C3 convertase complex, is seen in paroxysmal nocturnal hemoglobinuria (PNH).
Reference-Robbins BASIC PATHOLOGY 10th edition pg- 77 | train | med_mcqa | null |
Spastic paraplegia can be caused by the following except - | [
"Motor neuron disease",
"Chronic lead poisoning",
"Vitamin B12deficiency",
"Cervical spondylosis"
] | B | null | train | med_mcqa | null |
Accelerators and retarders are used with gypsum products mainly to control: | [
"Setting time",
"Setting expansion",
"Hardness of the set product",
"None of the above"
] | A | MODIFIERS FOR CONTROLLING SETTING TIME
Chemical modifiers have been used extensively to increase or decrease the setting time of gypsum products; they are called retarders and accelerators, respectively. The manufacturers use both types of compounds to formulate gypsum products with specific setting times.
The chemical that increases the rate of hemihydrate dissolution or precipitation of dihydrate accelerates the setting reaction. The most commonly used accelerator is potassium sulfate, which is particularly effective in concentrations greater than 2%. Slurry water flowing out from a model trimmer contains numerous fine gypsum particles that act as nuclei of crystallization and that can serve as an effective accelerator.
Key Concept:
Chemical modifiers have been used extensively to increase or decrease the setting time of gypsum products; they are called retarders and accelerators, respectively.
Reference: PHILLIPS’ SCIENCE OF DENTAL MATERIALS, 12th ed page no 186 | train | med_mcqa | null |
Vascular dementia is characterized by: a. Disorientation b. Memory deficits c. Emotional lability d. Visual hallucinations e. Personality deterioration | [
"all of the above",
"a,b,c,d",
"a,b,e",
"b,c,d"
] | B | Vascular dementia presents with memory loss, mood changes (depression, irritability, emotional lability), delusions and hallucinations confusion and disorientation. Personality changes are more commonly associated with frontotemporal dementia | train | med_mcqa | null |
Angle between diazone and parazone is: | [
"30°.",
"40°.",
"45°.",
"50°."
] | B | Parazone – dark bands produced by longitudinally cut rods.
Diazone – Light bands produced by transversely cut rods.
Angle b/w diazone & parazone = 40°. | train | med_mcqa | null |
Steroids are used in transplantation - | [
"To prevent graft rejection",
"To prevent infection",
"To speed up recovery",
"To enhance immunity"
] | A | Ans. is 'a' i.e., To prevent graft rejection | train | med_mcqa | null |
In salicylate poisoning, the treatment recommended | [
"Forced diuresis",
"Chelating agent",
"Atropine",
"Conservative management"
] | A | A salicylate poisoning, forced alkaline diuresis is used. | train | med_mcqa | null |
Intercostal vessels and nerve runs in: | [
"Upper border of the ribs",
"External intercostal and Internal intercostal muscle",
"Between the external intercostal and innermost internal, inter costal muscle",
"Between the innermost intercostal and internal intercostal muscle"
] | D | (Between the innermost intercostal and internal intercostal muscle) (208-BDC-l 4th) (57-Snell 7th)* Each intercostal space contains a large single posterior intercostal artery and two small anterior intercostal arteries.* The corresponding posterior intercostal vein drain backward into the azygos or hemiazygos vein and the anterior intercostal vein drain forward into the internal thoracic and musculophrenic veinsIntercostal nerves* The intercostal nerves are the anterior rami of the first 11 thoracic spinal nerves. The anterior ramus of the 12th thoracic nerve lies in the abdomen and runs forward in the abdominal wall as the subcostal nerve* In the costal groove the nerve lies below the posterior intercostal vessels. The relationship of structures in the costal groove from above downwards is vein-artery-nerve (VAN)*** Each intercostal nerve enters an intercostal space between the parietal pleura and the posterior intercostal membrane. It then runs forward inferiorly to the intercostal vessels in the subcostal groove of the corresponding rib, between the innermost intercostal and internal intercostal muscle | train | med_mcqa | null |
Delayed clotting in abetalipoproteinemia is due to: | [
"A Decreased VLDL",
"Reduced clotting factor synthesis",
"Decreased chylomicrons",
"Decreased fatty acid synthesis"
] | B | Ref: Harrison's Principles of Internal Medicine 18th edition, pg 3153Explanation:Lipoproteins-Transport hydrophobic lipids thro' plasma fluids to & from tissuesAbsorption of dietary cholesterol, fatty-acids & fat soluble vitamins (A. D, E, K)Transport of cholesterol, triglycerides & fat- soluble vitamins from liver to per tissuesTransport of cholesterol from peripheral tissues to liverAbetalipoproteinemiaIt is an autosomal recessive disorder.M utation i n the microsomal triglyceride transfer protein (MTTP) gene needed for transport of lipids and chplesterol & fat-soluble vitamins.Low VLDL, chylomicronsFat malabsorption-Vitamin K deficiency- coagulopathySevere vit E deficiency-neurological manifestations A can thocytoisisHypocholesterolemiaRetinitis pigmentosa, posterior column neuropathy & myopathyTreated with high dose of Vitamin E & other vitamins.Vitamin K dependent clotting factore are-II (prothrombin), VII, IX & XVit K is needed for post-translational modification of glutamate residues to a-carboxyglutamate, needed for activity of the above factors.Vit K is a fat-soluble vitamin, it is a co-factor for post-translational modification of glutamate residues to y-carboxyglutamate on the clotting factors II. VIE IX & X. Warfarin blocks the reductase & competitively inhibits the effects of vitamin K. | train | med_mcqa | null |
An of the following can induce methemoglobinemia EXCEPT : | [
"Nitroglycerine",
"Procaine",
"Prilocaine",
"Phenytoin"
] | D | null | train | med_mcqa | null |
Discoloration after death is first seen in? | [
"Dependent parts",
"Scalp",
"Face",
"Arms"
] | A | Ans. is 'a' i.e., Dependent parts o It is seen on dependent parts of the body, therefore site depends upon position of body after death:1) In supine: On posterior dependent portion of body. But not seen on back of shoulder blades, buttocks and back of calves due to contact flattening, i.e. toneless capillaries are compressed and occluded by weight and pressure of body.2) In hanging: Dependent lower half of both lower limb and upper limb (i.e. lower half of leg with feet and lower half of forearm with hands), and external genitalia.3) In drowning: Head and upper half of body as head being the heaviest part becomes the dependent part. It does not develop in running water due to constantly changing position of the body. | train | med_mcqa | null |
Which of the following is the muscle relaxant of choice in renal failure? | [
"Rapacurium",
"Pancuronium",
"Atracurium",
"Rocuronium"
] | C | Muscle relaxant of choice in renal failure is atracurium, since it is not eliminated through the kidney. It is inactivated in the plasma by spontaneous non enzymatic degradation (Hofmann elimination) in addition to that by cholinesterase. Ref: Essentials of Medical Pharmacology By K D Tripathi, 5th Edition, Page 314. | train | med_mcqa | null |
Poverty index does not include deprivation of | [
"Long life",
"Knowledge",
"Income",
"Standard of living"
] | C | null | train | med_mcqa | null |
Verruga peruana is caused by: | [
"B. Bacilliformis",
"B.Henselae",
"B.Quintana",
"B.Elizabethae"
] | A | Ans: (A) B bacilliformis..[Ref Ananthanarayan 8th/411-12: Harrison 19th/1083, 1079, 18th/ 13191Baonellosis, or Carrion's disease, is caused by B. bacilliformis. The disease is characterized by two distinct phases: (1) an acute febrile hematic phase, known as Oroya fever; and (2) an eruptive phase manifested by cutaneous lesions, known as verruga peruana" (Harrison 19th/1083,18th/1319)Verruga Peruana or Perun Wa: It is characterized by an eruptive phase, in which the patients develop a cutaneous rash produced by a proliferation of endothelial cells and is known as "Perun was" or "verruga peruana". | train | med_mcqa | null |
A child presented with history of ingestion of some unknown plant and developed mydriasis, tachycardia, dry mouth, warm skin and delirium. Which of the following group of drugs is likely to be responsible for the symptoms of this child ? | [
"Anticholinergic",
"Sympathomimetic",
"Opioid",
"Benzodiazepine"
] | A | null | train | med_mcqa | null |
Concentric hypertrophy of left ventricle is seen in- | [
"Mitral stenosis",
"Hypertension",
"Aortic regurgitation",
"None"
] | B | Ans. is 'b' i.e., Hypertension o Concentric hypertrophy - In pressure overload, e.g. hypertension and aortic stenosis.o Eccentric hypertrophy - In volume overload, e.g. in aortic regurgitation.Adaptations in hearto The cardiac myocyte is terminally differentiated cell that is not able to divide,o Myocardium cannot undergo hyperplasia, i.e. increase in the number of myocyte,o So, myocardium can adapt by increasing the size (i.e. hypertrophy) of the myocyte in response to stress,o There are two types of stresses to heart1. Pressure overloado Occur in hypertension or aortic stenosis.o Pressure overloaded ventricles develop concentric hypertrophy of the left ventricle, with increased in wall thickness Heart size may increase.o The increase in wall thickness may reduce the cavity diameter --> ratio of cavity size to wall thickness decreases,o There is increase in the transverse diameter (width) of myocytes, but cell length remains the same.2. Volume overloado As occurs in aortic regurgitationo There is dilatation of ventricular chamber along with increased thickness of ventricular wall Eccentric hypertrophy.o There is increase both in the transverse diameter (width) and the length of myocytes.o It is due to deposition of the sarcomeres (functional intracellular contractile unit of cardiac muscles) in parallel to the long axis of cells. | train | med_mcqa | null |
Cori’s cycle is another name for | [
"Oxidative decarboxylation of pyruvate",
"HMP pathway",
"TCA cycle",
"Lactic acid cycle"
] | D | It is a process in which glucose is converted to lactate in the muscle; and in the liver this lactate is re-converted into glucose.
Reference: Vasudevan 7th ed, pg 114 | train | med_mcqa | null |
Eruption of Deciduous Mandibular Canine occur at | [
"8-9 months",
"10-11 months",
"16-18 months",
"15-16 months"
] | C | null | train | med_mcqa | null |
All of the following are useful intravenous therapy for hypeensive emergencies except? | [
"Fenodopam",
"Uradipil",
"Enalaprilat",
"Nifedipine"
] | D | Answer is D (Nifedipine) Nifedipine is used as an oral/sublingual agent. It is not available for intravenous administration. Nifedipine in Hypeensive Urgencies Nifedipine is a sho acting Dihydropyridene calcium channel blocker Nifedipine may be employed for rapid reduction of blood pressure in hypeensive urgencies but it is not recommended for such use because it has been repoed to increase the incidence of acute coronary events. According to the US Food and Drug administration Nifedipine should be used with great caution 'if at all' Nifedipine is available for oral administration only and cannot be administered intravenously Urapidil (Cardiac drug therapy by Gabriel khan 7th/128,129) Urapidil is a selective alpha 1 adrenoceptor antagonist effective in the treatment of hypeensive emergencies. It may be administerd intravenously and is also available for oral administration Fenoldopam (Hurst 12th/1626) Fenoldopam is a selective dopamine -1 Receptor Agonist effective in the treatment of hypeensive emergencies It is available for intravenous administration. Enalaprilat Enalaprilat is an ACE inhibitor effective in the treatment of hypeensive emergencies (Enalaprilat is the active of Enalapril that is available for intravenous administration. Enalapril can only be administered orally). | train | med_mcqa | null |
Neoadjuvant chemotherapy stands for - | [
"Chemotherapy along with surgery",
"Chemotherapy before surgery",
"Chemotherapy after surgery",
"Chemotherapy along with radiation therapy"
] | B | Ans. B. Chemotherapy before surgeryNeoadiuvant chemotherapy refers to Combination of Chemotherapy and surgery/radiotherapy in which chemotherapy is given prior to surgery/radiotherapy. | train | med_mcqa | null |
All of the following are contraindications to tocolysis except: | [
"Chorioamnionitis",
"Fetal distress",
"Anencephaly",
"Placenta previa"
] | D | Ans. is d, i.e. Placenta previaRef. Dutta Obs. 7/e, p 319Contraindications to tocolysis* Chorioamnionitis* Advanced labor* Abruption* Congenital anomalies not compatible with life* Preeclampsia/eclampsia* Fetal distress* IUFD* Pregnancy >34 weeksAs far as placenta previa is concerned tocolysis is not contraindicated Management of patient with placenta previa and preterm labor:Tocolytic agent: "Uterine contractions are common in patients with placenta previa. Since uterine contractions have the potential to, disrupt the placental attachment and aggravate the bleeding, most obstetricians favor the use of tocolytic agents in the expectant management of patient with placenta previa". High risk pregnancy Fernando ariasMost commonly used tocolytics in case of placenta previa.-Nifedipine-Magnesium sulphateTocolytics which are not used-Terbutaline and Ritodrine: They cause tachycardia and make the assessment of patient's pulse rate unreliable.-Indomethacin: It causes inhibition of platelet cyclo-oxygenase system and prolongs the bleeding time. | train | med_mcqa | null |
True about peripheral blood smear of plasmodium vivax? | [
"Single ring with cytoplasm condensed around in each erythrocyte",
"Mature /old erythrocytes affected",
"Parasitized erythrocytes of same size as normal erythrocytes",
"Only ring and gametocytes are seen"
] | A | Ans. is 'a' i.e.,Single ring with cytoplasm condensed around in each erythrocyte | train | med_mcqa | null |
Which vitamin deficiency is most commonly seen in a pregnant mother who is on phenytoin therapy for epilepsy: | [
"Vitamin B6",
"Vitamin B12",
"Vitamin A",
"Folic acid"
] | D | Hypotension and arrythmias occur only on iv injection.
Vitamin deficiencies associated with phenytoin: — Folic acid (most common)
– Vitamin D
– Vitamin K
These vitamin deficiencies occur in all patients an phenytoin therapy and have nothing do with pregnancy. Hence all patients on phenytoin are advised to take folic acid supplementation. | train | med_mcqa | null |
Which or face presentation : | [
"Anencephaly",
"Contracted pelvis",
"Thyroid swelling",
"All"
] | D | Ans is a, b and c i.e. Anencephaly, Contracted pelvis and thyroid I know it is difficult to mug up the causes of different malpresentations. To help you out I am telling you an easy way to remember the causes of face presentation. Causes or I-ace presentation : A. Causes similar in face and breech presentation : D - IUD A - Anencephaly M - Multiparity P - Prematurity B. Causes related to neck : Tumour of neck (Congenital branchocele, congenital goitre). Twist of the cord round the neck. Increased tone of extensor group of neck muscles. C. Other causes : Lateral obliquity of uterus Contracted pelvis/Flat pelvis Remember : Most common congenital arnomaly associated with face presentation is Anencephaly.deg | train | med_mcqa | null |
Duret's hemorrhages are seen in? | [
"Lungs",
"Spleen",
"Liver",
"Brain"
] | D | Ans. (d) BrainRef. Essenstial forensic neuropathology, p 94 | train | med_mcqa | null |
Which one of the following is the most common problem associated with the use of condom : | [
"Increased monilial infection of vagina",
"Premature ejaculation",
"Contact dermatitis",
"Retention of urine"
] | C | Contact dermatitis | train | med_mcqa | null |
A young lady presents to your office with complain of copious vaginal discharge, but there is no cervical discharge on per speculum examination. Which of the following should be given for the management? | [
"Metronidazole and fluconazole",
"Metronidazole and azithromycin",
"Metronidazole and doxycycline",
"Fluconazole only"
] | A | null | train | med_mcqa | null |
A woman noticed mass in her left breast with bloody discharge. Histopathology revealed duct ectasia. Treatment is:- | [
"Simple mastectomy",
"Microdochotomy",
"Lobectomy",
"Hadfield's operation"
] | D | DUCT ECTASIA (PERIDUCTAL MASTITIS) =Dilatation of multiple ducts, =Associated with periductal inflammation. Most common age- above 50 years Most common presenting feature:nipple discharge(Greenish) Most common discharge in duct ectasia:serous discharge Treatment of duct ectasia is Hadfield's operation. HADFIELD's OPERATION -A periareolar incision is made and a cone of tissue is removed with its apex just deep to the surface of the nipple and its base on the pectoral fascia. | train | med_mcqa | null |
Decreased glucose level in pleural effusion is found in -a) Rheumatoid arthritisb) SLEc) Pneumococcal infectiond) P.carinii infection | [
"a",
"bc",
"ac",
"b"
] | C | null | train | med_mcqa | null |
Artery to bleed in duodenal ulcer haemorrhage - | [
"Splenic artery",
"Gastroduodenal artery",
"Left gastric artery",
"Sup. mesenteric artery"
] | B | Gastro duodenal artery is the most common artery involved in duodenal ulcer hemorrhage.
Also, remember
A peptic ulcer is the most common cause of massive upper gastrointestinal bleed (Duodenal ulcers > Gastric ulcers)
Bleeding ulcers in the duodenum are usually located on the posterior surface of the duodenal bulb. | train | med_mcqa | null |
Hypothermia is used in all except – | [
"Neonatal asphyxia",
"Cardiac surgery",
"Hyperthermia",
"Arrythmia"
] | D | Induced hypothermia is used for neurosurgery, carotid artery surgery, cardiac surgery, traumatic brain injury, ARDS, malignant hyperthermia, Prolonged surgeries, neonatal encephalopathy caused by birth asphyxia.
Hypothermia induces arrhythmia, so it cannot be used in arrhythmia. | train | med_mcqa | null |
Thrush refers to | [
"Acute atrophic candidiasis",
"Acute pseudomembranous candidiasis",
"Chronic atrophic candidiasis",
"Chronic hyperplastic candidiasis"
] | B | null | train | med_mcqa | null |
Germ tubes are formed mainly by: | [
"Candida albicans",
"Candida stellatoidea",
"Candida tropicalis",
"Candida pseudotropicalis"
] | A | null | train | med_mcqa | null |
All of the following are causes of night blindness except | [
"Oguchi",
"Vitamin A deficiency",
"High myopia",
"Devics disease"
] | D | Devics disease is optic neuritis with myelitis It is also called neuromyelitis optica Refer Khurana 6th edition page number 329 | train | med_mcqa | null |
True about migraine | [
"U/I pain",
"Throbbing type of pain",
"A/W Nausea & vomitting",
"All"
] | D | K.D Tripathy essentials of medical pharmacology 7th edition . *Migraine is a mysterious disorder characterised by pulsating headache ,usually restricted to one side ,which comes in attacks lasting 4-48 hours and is often associated with nausea,vomiting,sensitivity to light and sound,veigo,loose motion,flashes of light. Ref Harrison20th edition pg 2345 | train | med_mcqa | null |
Most common site of clavicle fracture is: | [
"Lateral 1/3",
"Medial 2/3 and lateral 1/3",
"Medial 1/3",
"None of the Above"
] | B | Ans: B Medial 2/3 and lateral 1/3 Ref- Also , if junction of medial 2/3 and lateral 1/3 is mentioned - this would be a better option. Summary Fracture type ED management Follow-up Middle third (most common) Broad arm sling to support limb for 2 weeks or until comfortable. No evidence to support Figure of 8 bandage or brace If age >12 years and shortened >2 cm refer to orthopaedics for opinion Give parent fracture of the clavicle (collarbone) fact sheet. Advise to give regular analgesia as required If <11 years and undisplaced, follow-up by a GP or fracture clinic is usually not required. Repeat x-rays are usually not required If displaced or >=11 years, follow up with GP or fracture clinic in 1 week Lateral third Broad arm sling to support limb for 2 weeks or until comfortable. No evidence to support Figure of 8 bandage or brace If displaced, refer to the nearest orthopaedic service on call Fracture clinic in 5-7 days with x-ray Medial third If displaced, urgent referral to the nearest orthopaedic on call service To be arranged by orthopaedic service 2. How are they classified? Fractures of the clavicle can be classified by its anatomical location (Table 1): Table 1: Classification of clavicle fractures by location. Location Frequency Description Lateral third 15% Around and lateral to coracoclavicular ligaments Middle third or midshaft 80% Defined by shortening/comminution/angulation Medial third 5% Bony injury alone Associated with sternoclavicular dislocation (may be a physeal sleeve separation) 3. How common are they and how do they occur? The clavicle is one of the most common fractured bones in children. It is the most common perinatal fracture associated with birth trauma. Half of all paediatric clavicle fractures occur under the age of seven years. These heal quickly and recover fully. Injuries are usually the result of a fall on an outstretched hand with the force transmitted up the arm. A direct blow to the outer end of the clavicle (such as a fall onto the point of the shoulder during sporting activities or a striking injury) can be associated with distal third injuries and acromioclavicular joint disruption. 4. What do they look like - clinically? Most present with pain, swelling and deformity along the line of the clavicle, and a history of a fall. Toddlers and infants may present having been observed not using the arm, without a witnessed trauma. Fractures of the medial third are usually the result of direct trauma to the anterior chest (such as in a motor vehicle accident), and can be associated with neurovascular, pulmonary and cardiac (rare) injuries. Careful airway protection and neurovascular assessment is required. All fractures should be assessed using the Advanced Trauma Life Support (ATLS) principles to ensure associated and potentially significant injuries are identified. ! Careful neurological examination should be performed to define potential (but rare) associated brachial plexus injury. Vascular assessment of the arm should also be performed as the subclavian artery runs closely apposed to the clavicle in the middle third. 5. What radiological investigations should be ordered? Standard anteroposterior (AP) and AP with 15 degrees cephalic tilt x-ray of the clavicle will show the fracture in two planes and define displacement. A CT scan may be required for medial third injuries with sternoclavicular dislocation to assess tracheal impingement and thoracic anatomy. 6. What do they look like on x-ray? Middle third fracture Figure 1: Seven year old boy with fracture of the middle third of the clavicle. Lateral third Figure 2: Undisplaced lateral third fracture of the clavicle in a 12 year old boy. Sternoclavicular dislocation (posterior displaced) A B Figure 3: A) 14 year old with posterior dislocation of the medial end of right clavicle. This is difficult to see on x-ray. B) The posterior dislocation (red arrow) is more evident on CT scan. 7. When is reduction (non operative and operative) required? Reduction of the middle third is almost never required. Manipulation can lead to neurovascular injury. Displaced lateral and medial third fractures require orthopedic referral for assessment. Open fractures, severely displaced fractures with skin at risk, or fractures with neurovascular injury may require surgical reduction and fixation. These should be referred to the orthopaedic service as a matter of urgency. 8. Do I need to refer to orthopaedics now? The majority of clavicle fractures are easily managed with a sling and analgesia. Indications for prompt consultation include: Severely comminuted or shortened middle third (>2 cm if over 12 years of age) Open fractures Displaced medial third fractures Neurovascular injury with fracture Skin at risk over fracture Displaced lateral third fractures Pathological fractures Congenital pseudoathrosis of clavicle - multiple previous fractures in same location 9. What is the usual ED management for this fracture? Fracture type Type of reduction Immobilisation method & duration Middle third No reduction required Broad arm sling to support limb for 2 weeks or until comfortable No evidence to support Figure of 8 bandage or brace Regular analgesia as required Lateral third If undisplaced, no reduction required If displaced, refer to the nearest orthopaedic service on call Broad arm sling to support limb for 2 weeks or until comfortable Regular analgesia as required No evidence to support Figure of 8 bandage or brace Medial third If undisplaced, no reduction required If displaced, urgent referral to the nearest orthopaedic service on call Broad arm sling to support limb No evidence to support Figure of 8 bandage or brace 10. What follow-up is required? Children <11 years old with undisplaced fractures do not usually require follow-up by a GP or fracture clinic. Repeat x-rays are usually not required. For children >=11 years old or those with displaced fractures, follow up should occur with a GP or in fracture clinic in one week with x-ray. Radiographs are usually not required. Mobilisation out of the sling commences at two weeks depending on pain control. 11. What advice should I give to parents? The majority of uncomplicated middle third fractures will have excellent functional and cosmetic outcomes. Provide parent with fracture of the clavicle (collarbone) fact sheet. Pain from the fracture and restriction of movement are usual for 2-3 weeks and will require regular analgesia. The child should re-attend if pain is increasing, or sensation changes abruptly. Contact sports and activities should be avoided for approximately six weeks post removal of sling. A lump usually develops at the fracture site, which may be visible and palpable for at least one year. 12. What are the potential complications associated with this injury? Neurovascular complications are rare Nonunion is uncommon Malunion - palpable or visual lump, which diminishes with remodelling Degenerative arthritis if acromioclavicular joint intra-articular incongruence | train | med_mcqa | null |
Antidote for arsenic poisoning is | [
"Ferric oxide",
"Aluminium oxide",
"Magnesium oxide",
"Nickel oxide"
] | A | Ans. is 'a' i.e. Ferric oxide Treatment of arsenic poisoning includes stomach wash and use of freshly precipitated hydrated ferric oxide as an antidote (which forms ferric arsenite a harmless salt). | train | med_mcqa | null |
In fasted state gluconeogenesis is promoted by which enzyme? | [
"Acetyl-CoA induced stimulation of Pyruvate Carboxylase",
"Citrate induced stimulation of Acetyl-CoA Decarboxylase",
"Fructose 2,6 bisphosphate induced stimulation of Phosphofructokinase-1",
"Stimulation of Pyruvate kinase by Fructose 1,6 Bisphosphate"
] | A | Ans. A. Acetyl CoA induced stimulation of Pyruvate Carboxylase(Ref. Harper 29/e page 190 Table 20-1, Harper 31/e page 175 Table 19.1)Regulation of Carbohydrate Metabolism (NB: This table is an important topic for all exams)EnzymeInducerRepressorActivatorInhibitorGlycogen synthaseInsulinGlucagonInsulin, glucose 6-phosphateGlucagonHexokinase Glucagon Glucose 6-phosphateGlucokinaseInsulinGlucagon Phospho-fructokinase-1InsulinGlucagonQ5'AMP, fructose 6-phosphate, fructose 2,6-bisphosphateQ, PiCitrate, ATP, glucagonPyruvate kinaseInsulinGlucagonQFructose 1,6-bisphosphate, insulinATP, Alanine, Glucagon, norepinephrinePyruvate dehydrogenaseInsulinGlucagonQCoA, NAD+, insulinQ, ADP, pyruvateAcetyl-CoAQ, NADH, ATP (fatty acids, ketone bodies) GluconeogenesisEnzymeInducerRepressorActivatorInhibitorPyruvate carboxylaseGlucocorticoids, Glucagon, EpinephrineInsulinAcetyl-CoAQADPPhosphoenolpyruvate carboxy kinaseGlucocorticoids, Glucagon, EpinephrineInsulin Glucose 6-phosphataseGlucocorticoids, Glucagon, EpinephrineInsulin | train | med_mcqa | null |
Wolf Chaikoff effect - | [
"Excess iodine intake causes hypothyroidism",
"Iodine induced hyper thyroidism",
"Thyrotoxicosis due to excessive amount of iodineingestion",
"Drug induced hyperthyroidism"
] | A | Ans. is 'a' i.e., Excess iodine intake causes hypothyroidism o The effect of iodine on thyroid function is quite complex.o The most obvious effect of administering a high dose of iodine is a decrease in the release ofthyroid hormones.This effect is very prompt and is quicker than the action of antithyroid drugs.Hence, iodine ivas used in the treatment ofthyrotoxicosis and is still used in preparing patients for thyroid surgery.o However, the effect is not observed on repeated administration of iodine a phenomenon called "iodine escape" the cause of which is not understood.o Administration of iodine has a triphasic response on the organification of iodine.o Inhally there is a brief increase in iodine organification.o Shortly therafter, the high intrathyroid iodide concentration inhibits iodine organification an effect known as wolff-ch iakoffeffect.o Prolonged adminstration of high dose of iodine, however produces an escape from the wolfchiakoff effect (not to be confused with iodine escape) due to autoregulation of iodine uptake by the thyroid.When iodine organification decreases due to the wolfchiakoff effect it results in inthrathyroid accumulation of iodine.The rise in intrathyroid iodide, reduces the iodine uptake (due to autoregulation).The intrathyroid iodide therefore reduces and with it the wolf-chiakoff effect subsides.If however the autoregulation is absent due to thyroid dysfuntion the wolf-chiakoff effect will persist and keep the iodine organification suppressed.Increased concentrationof plasma iodide|Increased uptake ofiodide by thyroid|iIncreased conceniraionof intrathyroid iodine|Increased organificationof iodine|Increased synthesis of T, and T4|Increased release of F, and T, | train | med_mcqa | null |
Which of the following is present in cornea? | [
"Hyaluronic acid",
"Chondroitin sulphate",
"Dermatan sulphate",
"Heparin sulphate"
] | B | Chondroitin Sulphate - It is present in ground substance of connective tissues widely distributed in cailage, bone, tendons, cornea and skin. It is composed of repeating units of glucuronic acid - beta-1,3-N-acetyl galactosamine sulphate - beta-1, 4 and so on. POLYSACCHARIDES -These are polymerized products of many monosaccharide units. They may be 1. Homoglycans- are composed of single kind of monosaccharides, e.g. starch, glycogen and cellulose. 2. Heteroglycans are composed of two or more different monosaccharides, e.g. hyaluronic acid, chondroitin sulphate. REF:DM VASUDEVAN TEXTBOOK OF BIOCHEMISTRY,SIXTH EDITION,PG.NO.,96,98. | train | med_mcqa | null |
A teenager girl with moderate acne is also complaining of irregular menses. Drug of choice with be- | [
"Oral jsotretinon",
"Oral acitretin",
"Oral minocycline",
"Cyproterone acetate"
] | D | In Acne with associated endocrinological abnormalities like polycystic ovarian syndrome (PCOS) manifests with obesity, hirsutism, androgenetic alopecia and acne. Oestrogens and antiandrogens(cyproterone acetate, spirono lactone, flutamide) and agents designed to inhibit the endogenous production of androgens by the ovary(oral contraceptives and gonadotropin releasing agonists) or adrenal gland(low dose glucocoicoids ) are used Reference Harrison20th edition pg 1206 | train | med_mcqa | null |
Drug of choice for the following condition is (endoscopic view) | [
"Ketoconazole",
"Clotrimazole",
"Nystatin",
"Fluconozole"
] | D | The picture shows esophageal candidiasis for which azoles are used.fluconozole is preferred due to better safety profile than ketoconazole .clotrimazole, nystatin is topical antifungal drugsRef: KD Tripathi 6th ed pg 761 | train | med_mcqa | null |
An infant with a history of delayed separation of umbilical cord now presents with recurrent pneumonia. The total count is 20,000/ml. Which of the following genetic defects is most likely present? | [
"Low levels of NADPH oxidase and negative DHR test",
"Mutation of Bruton tyrosine kinase gene",
"Excessive IgM with reduced IgG and IgA",
"Reduced phagocyte surface expression of Sialyl-Lewis x"
] | D | This childs history of delayed separation of umbilical cord with recurrent pneumonia and peripheral leucocytosis is highly suggestive of leucocyte adhesion defect (LAD). Neutrophils have reduced adhesion, mobility and phagocytic ability. There are three types of LAD: LAD 1: Defective beta 2 integrin (CD18), leading to abnormal neutrophil chemotaxis and defective tight adhesion. LAD 2: Reduced phagocyte surface expression of Sialyl-Lewis x, leading to abnormal neutrophil rolling. LAD 3: Defective signaling for integrin activation, leading to abnormal neutrophil chemotaxis and adhesion. (Milder than type 1) Reference: Ananthanarayan and Paniker&;s Textbook of Microbiology Tenth edition | train | med_mcqa | null |
Le Foe II facial fracture implies: | [
"Fracture running through alveolar ridge",
"Fracture running through midline of the palate and zygomatico maxillary suture",
"Fracture running through zygomatic process of the maxilla, floor of orbit, root of nose on one side only",
"Similar to C but on both sides"
] | D | Le fo I - Fracture line runs above and parallel to palate - Effectively separates alveolus and palate from the facial skeleton above Le fo II - Pyramidal in shape - Passes through the root of nose, lacrimal bone, floor of orbit , upper pa of maxillary sinus and pterygoid plate - Orbital floor is always involved Le fo III - Complete disjunction of the facial skeleton from the skull base - Fracture line runs high through the nasal bridge, septum and ethmoids and through the bones of orbit to the frontozygomatic suture | train | med_mcqa | null |
Dinoprost is - | [
"PG El",
"PGE2",
"PGF2 alpha",
"PGI2"
] | C | Ans. is 'c' i.e., PG F2 alpha o Dinoprost - PG F2 alpha, intraamniotically for midterm aboion. o Dinoprostone - PG E2, intravaginally for midterm aboion. | train | med_mcqa | null |
In triage green colour indicates | [
"Ambulatory patients",
"Dead or moribund patients",
"High priority treatment or transfer",
"Medium priority or transfer"
] | A | Triage consists of rapidly classifying the injured on the basis of the severity of their injuries and the likelihood of their survival with prompt medical intervention. The most common classification uses the internationally accepted 4 colour code system. RED indicates high priority treatment or transfer, YELLOW signals medium priority, GREEN indicates ambulatory patients and BLACK for dead or moribund patients. Reference : page 796 Park's textbook of Preventive and Social Medicine 23rd edition | train | med_mcqa | null |
Rupak, a 22-year-old, unmarried man is suffering from sudden onset of third person hallucination for the past 12 days. He is suspicious of his relatives and close friends and is having reduced appetite and improper sleep. He is probably suffering from: September 2010 | [
"Acute depression",
"Acute mania",
"Acute Psychosis",
"Schizophrenia"
] | D | Ans. D: Schizophrenia Psychosis means abnormal condition of the mind, and is a generic psychiatric term for a mental state often described as involving a "loss of contact with reality". Psychosis is given to the more severe forms of psychiatric disorder, during which hallucinations and delusions and impaired insight may occur. | train | med_mcqa | null |
Case - control study is a type of - | [
"Descriptive epidemiological study",
"Analytical study",
"Longitudinal study",
"Experimental epidemiological study"
] | B | . case control studies are generally called "retrospective studies"are used to test casual hypothesis.they are basically comparison studies.cases and controls must be compared with respect to known "confounding factors"other kind of analytical studies include coho study. ref;park&;s textbook of preventive and social medicine,22 nd edition,pg no 66 | train | med_mcqa | null |
Apixaban is a new drug that acts by | [
"Inhibiting TNF alpha",
"Inhibiting coagulation factor Xa",
"Inhibiting platelet aggregation",
"Activating plasminogen"
] | B | Rivaroxaban and Apixaban are newer oral anticoagulants that act by inhibiting factor Xa. Newer oral anticoagulants that are currently being asked in the exams are: Direct thrombin inhibitor- Dabigatran Direct factor Xa inhibitors Apixaban Rivaroxaban Edoxaban Betrixaban | train | med_mcqa | null |
Pouch of Douglas is situated between | [
"Bladder and the uterus",
"Bladder and public symphysis",
"Bladder and the rectum",
"Uterus and rectum"
] | D | The recto-uterine pouch or pouch of douglas is the extension of the peritoneal cavity between the rectum and the posterior wall of the uterus in the female human body. imageref - semantischolar.org | train | med_mcqa | null |
A 49-year-old man suffering from depression attempts suicide by jumping out of the window of his third-floor apartment. He requires multiple operations during a prolonged, complicated hospital stay. Endotracheal intubation is attempted in the ICU but is unsuccessful because of tracheal stenosis, which is attributed to which of the following? | [
"Prolonged nasotracheal intubation",
"Orotracheal intubation",
"Tracheostomy tubes",
"High oxygen delivery"
] | A | Any object that compromises the blood supply to the tracheal mucosa or cartilage can cause stenosis. When the mean intramural pressure exceeds 20-30 mm Hg over a prolonged period, damage occurs. | train | med_mcqa | null |
Calcification is best detected by - | [
"X-ray",
"USG",
"CT scan",
"MRI"
] | C | Calcification is best detected by CT scan. | train | med_mcqa | null |
Which of the following technique is used to study current flow across a single ion channel? | [
"Patch clamp",
"Voltage clamp",
"Iontophoresis",
"Galvanometry"
] | A | Ans. a. Patch clamp (Ref: Ganong 24/e p49; http://en.wikipedia.org/wiki/Patch_clamp)Patch clamp is used to study current flow across a single ion channel.'The patch clamp technique is a laboratory technique in electrophysiology that allows the study of single or multiple ion channels in cells. The technique can be applied to a wide variety of cells, but is especially useful in the study of excitable cells such as neurons, cardiomyocytes, muscle fibers and pancreatic beta cells. It can also be applied to the study of bacterial ion channels in specially prepared giant spheroplasts.'- http://en.wikipedia.org/wiki/ Patch clampPatch Clamp TechniqueThe patch clamp technique is a laboratory technique in electrophysiology that allows the study of single or multiple ion channels in cells.The technique can be applied to a wide variety of cells, but is especially useful in the study of excitable cells such as neurons, cardiomyocytes, muscle fibers and pancreatic beta cells.It can also be applied to the study of bacterial ion channels in specially prepared giant spheroplasts.The patch clamp technique is a refinement of the voltage clamp.Erwin Neher and Bert Sakmann developed the patch clamp in the late 1970s and early 1980s.This discovery made it possible to record the currents of single ion channels for the first time, proving their involvement in fundamental cell processes such as action potential conduction.In this technique a micropipette is placed on the membrane of a cell and form a tight seal to the membrane.The patch of membrane under the pipette tip usually contains only a few transport proteins, allowing for their detailed biophysical study.The cell can be left intact (cell-attached patch clamp). Alternatively, the patch can be pulled loose from the cell, forming an inside out patch.A third alternative is to suck out the patch with the micropipette still attached to the rest of the cell membrane, providing direct access to the interior of the cell (whole cell recording). | train | med_mcqa | null |
Partogram in pregnancy includes all of the following except - | [
"Uterine contraction",
"Cervical dilatation in time scale",
"Descent of foetal head in time scale",
"Non-stress Test"
] | D | Ans: D | train | med_mcqa | null |
The following drug is used for treatment of type II lepra reaction,except- | [
"Clofazimine",
"Thaliodomide",
"Cyclosporin",
"Coicosteroid"
] | C | Rx for type 2 reaction include NSAIDS, prednisolone, clofazimine and thalidomide. Reference IADVL's concise textbook of dermatology,page2091 | train | med_mcqa | null |
The installation and usage of sanitary latrines by the general public constitutes which level of prevention? | [
"Primary",
"Primordial",
"Teiary",
"Secondary"
] | A | Primary prevention is concerned with preventing the onset of disease; it aims to reduce the incidence of disease. It involves interventions that are applied before there is any evidence of disease or injury. Examples include protection against the effects of a disease agent, as with vaccination, garbage collection, refrigeration of food, etc. Ref: 25th edition, Park's Textbook of Preventive and Social Medicine, Page no. 48 | train | med_mcqa | null |
Skin surface elevation caused by hyperplasia and projections of the epidermis form an undulating surface under microscopic examination. What is this known as? | [
"Saw toothing",
"Papillomatosis",
"Villi",
"Parakeratosis"
] | B | Papillomatosis of skin Skin surface elevation caused by hyperplasia and enlargement of contiguous dermal papillae. Papillary projections of the epidermis form an undulating surface under microscopic examination. | train | med_mcqa | null |
Which immunoglobulin crosses placenta? | [
"IgG",
"IgM",
"IgA",
"IgD"
] | A | Ans. a (IgG). (Ref. Textbook of Microbiology by Anantanarayan, 6th/82)FeaturesIgGIgAIgMIgDIgE1Sr. Cone, (mg/ml)1221.20.030.000042Half Life (Days)23652-81-53Daily Production (Meg/ Kg)34243.30.40.000234Carbohydrate (%)381213125Complement fixation - Classical++-+++--6Complement fixation - Alternative-+---7Placental Transfer+----8Heat Stability (56deg c)++++-9Synthesized earliest (phylogenetically oldest)--+--10J-chain-++- 11Secreted by seromucinous glands-+--- | train | med_mcqa | null |
Microalbuminuria is dened
as protein levels os - | [
"10-150 mg/dL",
"30-300 mg/dL",
"15-200 mg/dL",
"30-100 mg/dL"
] | B | Albuminuria in the range of 30-300 mg/24 hrs is called microalbuminuria , In patients with type 1 & 2 diabetes microalbuminuria appears 5-10 years after the onset of diabetes. | train | med_mcqa | null |
Opsomyoclonus is encountered as C/F of ? | [
"Meningioma",
"Neuroblastoma",
"Neurofibromatosis",
"Excision"
] | B | Ans. is 'b' i.e. Neuroblastoma Opsoclonus-Myoclonus Syndrome Opsoclonus is a disorder of eye movement characterized by involuntary, chaotic saccades that occur in all directions of gaze; it is frequently associated with myoclonus and ataxia. Causes of Opsoclonus-myoclonus a) Idiopathic b) Cancer-related (paraneoplastic) - cancers associated with opsoclonus-myoclonus are usually lung and breast cancers in adults and neuroblastoma in children. | train | med_mcqa | null |
Initiation of dental caries depends upon | [
"formation of large amount of acid",
"Availability of carbohydrate food",
"Viscosity of saliva",
"Localization of acid over tooth surface"
] | D | null | train | med_mcqa | null |
A newborn suffering from perforated necrotizing enterocolitis is having the very poor general condition. He is currently stabilized on a ventilator. Which of the following should be done in the management of this patient – | [
"Conservative treatment",
"Resection and anastomosis",
"Stabilization with membrane oxygenator and defer surgery",
"Peritoneal drainage by putting drains in the flanks"
] | D | Necrotizing enterocolitis (NEC) is the most common life-threatening emergency of the GIT in the newborn period.
Management of necrotizing enterocolitis
Medical treatment of NEC include
Cessation of feeding
Nasogastric decompression
Administration of i.v. fluids
Systemic antibiotic against both gram +ve as well as gram -ye bacteria (after taking samples for blood culture).
Ventilation should be assisted if distention is contributing to hypoxia.
Early surgery consultation
Surgical interventions in NEC
Evidence of perforation is an indication for laparotomy and resection of necrotic bowel.
Failure to respond to medical management, a single fixed bowel loop, erythema of the abdominal wall and a palpable mass are additional indications of exploratory laparotomy, resection of necrotic bowel and external ostomy diversion.
Peritoneal drainage may be helpful for patients with peritonitis who are too unstable to withstand surgery. It is more successful in patients with isolated intestinal perforation. In many patients, no further surgical procedure is required.
Peritoneal drainage is performed under local anaesthesia. Alpenrose drain is placed in the right lower quadrant and permitted to drain peritoneal contents and decompress the abdomen. This procedure is employed predominantly in infants less than 1000g who have severe SIRS and are viewed as too unstable to be transported or to undergo laparotomy. In experienced hands, one-third of the patients require only drain placement.
A primary anastomosis at the time of initial surgery is indicated in patients with limited localized disease who have no distal bowel involvement and in patients who have demonstrated a walled-off perforation who are no longer manifesting the SIRS.
From this discussion, we choose the answer to be peritoneal drainage because:
Patients are on a ventilator (too unstable).
Surgery for NEC is resection and creation of an ileostomy, which is not given in the options.
Primary anastomosis is done only in stable patients with walled-off perforation. | train | med_mcqa | null |
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