question stringlengths 1 6.54k | choices listlengths 4 4 | answer stringclasses 4
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Insulin stress test assay estimates - | [
"Diabetes mellitus",
"Growth hormone",
"Glucagon assay",
"Catecholaines"
] | B | An insulin tolerance test (ITT) is a medical diagnostic procedure during which insulin is injected into a patient's vein, after which blood glucose is measured at regular intervals. Normally, both coisol and GH serve as counterregulatory hormones, opposing the action of insulin, i.e. acting against the hypoglycemia . When used to assess insulin sensitivity, a standard dose of insulin is administered, and blood glucose is monitored with frequent sampling; the plasma glucose disappearance rate (KITT) indicates the degree of whole-body insulin sensitivity . Ref - pubmed.com | train | med_mcqa | null |
Medical management of hyperparathyroidism includes which of the following? | [
"Bisphosphonates",
"Calcitonin",
"Plicamycin",
"All the above"
] | D | Ans. is 'd' i.e., All the above Medical management for hyperparathyroidism* Medical management rather than corrective surgery is still acceptable, but it is clear that surgical intervention is the more frequently recommended option.* When surgery is not selected, or not medically feasible, there is interest in the potential value of specific medical therapies.* There is no long-term experience regarding specific clinical outcomes such as fracture prevention, but it has been established that bisphosphonates increase bone mineral density significantly without changing serum calcium (as does estrogen, but the latter is not favored because of reported adverse effects in other organ systems).* Expansion of intravascular volume, administration of loop diuretics, pharmacotherapy which reduces osteoclastic bone resorption (like Bisphosphonates, Calcitonin, and Plicamycin) are useful in the medical management of hyperparathyroidism. | train | med_mcqa | null |
Venous air embolism is most common in which position in surgery - | [
"Sitting",
"Prone",
"Lateral",
"Lithotomy"
] | A | Ans, is 'a' i.e., Sitting o Venous air embolism is a potential hazard whenever the operative site is above the level of patients heart,o The 'sitting' position and its modification "beach chair" positions are associated with a greater incidence of venous air embolism. | train | med_mcqa | null |
Which type of articulators permit horizontal as well as vertical motion, but do not orient the motion to the TMJ via facebow transfer? | [
"Class I",
"Class II",
"Class III",
"Class IV"
] | B | Class II articulator:
Articulator which permit horizontal and vertical motion but they do not orient the movement to TMJ with a facebow.
Three types. | train | med_mcqa | null |
Egg on side appearance is seen in: | [
"TAPVC",
"Ebstein anomaly",
"TGA",
"TOF"
] | C | Ans: C (TGA) DisordersSnowmann appearance Cottage leaf appearance Figure of 8 silhoutteFallots TetralogyCoeur-en-sabot i.e. Boot shapedTricuspid AtresiaBox shaped heartASDHilar Dance3 (Pulmonary Plethora)Transposition of great vesselsEgg on side appearanceSmall VSD (<0.5 cm dia)Maiacide de Roger defectCoarctation of AortaQDock's sign (Rib notching/ but it does not involve I & IInd ribs)E sign. Figure of 3 signE sign. Figure of 3 signPericardial EffusionWater bottle/ Pear shaped heartConstrictivePericarditisEgg in cup appearancePrimary PulmonaryHypertensionjug Handle appearances | train | med_mcqa | null |
Ponds fracture is most common in | [
"Children",
"Adult",
"Old age",
"No relation with age"
] | A | .The Ping-Pong skull fracture or a pond skullfracture refers to a depressed skull fracture of the infant skull caused by inner buckling of the calvarium. | train | med_mcqa | null |
Precapillary Pulmonary hypeension is caused by all Except: | [
"Mitral stenosis",
"Pulmonary vasculitis",
"Primary pulmonary hypeension",
"Thromboembolism"
] | A | Answer is A (Mitral stenosis) Mitral stenosis is a cause of post-capillary pulmonary hypeension or passive pulmonary hypeension. Causes of pulmonary hypeension: Precapillary pulmonary hypeension Primary pulmonary hypeension Disorders of ventilation Congenital hea disease with pulmonary vascular disease Pulmonary embolism Schistosmiasis Collagen vascular disease Pulmonary vasculitis Sickle hemoglobinopathies Poal hypeension Ingestion of drugs and herbal remedies Passive (Post-capillary) pulmonary hypeension Left ventricular failure Mitral valve disease Cor triatriatum Obstruction of major pulmonary veins Congenital pulmonary vein stenosis Left atrial myxoma or thrombosis Reactive pulmonary hypeension Some patients with mitral valve disease Rarely, other cause of pulmonary venous hypeension, including pulmonary veno-occlusive disease | train | med_mcqa | null |
Resting membrane potential in cardiac muscle ? | [
"-70 mV",
"+70 mV",
"-90 mV",
"+90 mV"
] | C | Ans. is 'c' i.e., -90 mVNormal RMP in myocardial fibers is about -90 mV. | train | med_mcqa | null |
Which one of the following is the common cause of Congenital Hydrocephalus is ? | [
"Craniosynostosis",
"Intra uterine Meningitis",
"Aquedectal stenosis",
"Malformations of Great vein of Galen"
] | C | Aqueductal stenosis is the most common cause of congenital hydrocephalus. | train | med_mcqa | null |
Enzyme deficient in occulocutaneous albinism type 1 is - | [
"Tyrosinase",
"Pink protein",
"Tyrosinase related protein 1",
"Membrane associated transport protein (MATP)"
] | A | Ans. is 'a' i.e., Tyrosinase Characteristics of AlbinismDiseaseChromosomeGene locusProtein {Biogenesis of lysome-related Organelles complex (BLOC)]Distinguishing signsOculocutaneous albinism type 11 lq21TYRTyrosinase/TYRType lA-no pigment Type 1 B-some pigmentOculocutaneous albinism type 215q11 2-q12PPink protein/PSome pigmentation apparent: nevi and freckles possibleOculocutaneous albinism type 39p23TYPR1Tyrosinase-related protein 1/TYRP1Similar to OCAZ phenotype includes rufous (red) albinism phenotypeOculocutaneous albinism type 45pMATPMembrane-associated transporter protein/MATPSimilar to OCAZ phenotype most common in individuals with Asian biogeographic ancestry.Chediak-Higashisyndromelq43LYSTLysosome trafficking/LYSTGiant peroxidase-positive lysosomal granules in neutrophils | train | med_mcqa | null |
Chromosome-associated with bipolar disease - | [
"Chromosome 16",
"Chromosome 13",
"Chromosome 18",
"Chromosome 11"
] | C | Chromosomes involved in bipolar disorder are chromosome 18, 21, and 22. | train | med_mcqa | null |
Which of the following statements concerning Hassall corpuscles is true? | [
"They are located in the thymic coex of young individuals.",
"They are located in the thymic coex of old individuals.",
"They are derived from mesoderm.",
"They are located in the thymic medulla"
] | D | Hassall corpuscles are epithelial reticular cells (derived from endoderm) found only in the medulla of the thymus. | train | med_mcqa | null |
Detection of aneuploidy in 1st trimester: | [
"hCG and PAPP-A",
"hCG and AFP",
"hCG, PAPP-A and AFP",
"AFP and estriol"
] | A | Ans. A. hCG and PAPP-ARef: William's 24th/ed, p289Table 2: Selected Down syndrome screening strategies and their detection rateStrategyAnalytesDetection Rate3 (%)First-trimester screenNT, PAPP-A, and hCG or free p-hCG79-87NTNT alone64-70Triple testMSAFP hCG OR free p-hCG, uE361-70Quadruple (Quad) testMSAFP, hCG or free p-hCG, uE3, inh74-81Integrated screenFirst-trimester screen and Quad test; results withheld until Quad test completed94-96Stepwise sequentialFirst-trimester screen and Quad test 1% offered diagnostic test after first-trimester screen 99% proceed to Quad test, results withheld until Quad test completed90-95Contingent sequential screenFirst-trimester screen and Quad test 1 % offered diagnostic test after first-trimester screen 15% proceed to Quad test; results withheld until Quad test completed84% have no additional test after first trimester screen88-94Cell-free fetal DNA testing (high-risk pregnancies)No analytes--massively parallel genomic sequencing98aBased on a 5% positive screen rate.Free b-hCG = free b-subunit hCG; hCG = human chorionic gonadotropin, inh = dimeric inhibin a;MSAFP = maternal serum alpha-fetoprotein; NT = nuchal translucency; PAPP-A = pregnancy-associated plasma protein-A; uE3 = unconjugated estriol. | train | med_mcqa | null |
Cells charcteristic of Hodgkin's disease are- | [
"Lacunar cells",
"Reed - Sternberg cells",
"Giantcells",
"Eosiphils"
] | B | <p>The classical diagnostic feature of Hodgkin's disease is the presence of Reed -Sternberg cell.Classic RS cell is characterised by
bilobed nucleus appearing as mirror image of each other, each nucleus contains a prominent , eosinophilic, inclusion like nucleolus with a clear halo around it,
giving it an owleye appearance . | train | med_mcqa | null |
High energy phosphate is not produced in: | [
"TCA cycle",
"Hexose monophosphate pathway",
"Glycolysis",
"Beta oxidation of fatty acid"
] | B | Ans. B. Hexose monophosphate pathwayPathways which do not synthesize ATP are:HMP pathwayRapoport Luebering cycleUronic acid pathwayAlpha oxidation of fatty acidOmega Oxidation of fatty acid | train | med_mcqa | null |
Inhalation method preferred for Bronchial asthma in a child of 3 years old is:- | [
"MDI with spacer with face mask",
"MDI with spacer preferred",
"Only MDI directly",
"Rotacap"
] | A | Inhalation method should be chosen on individual basis, but a guideline is as follows:- Children < 4 years old: - MDI with spacer with face mask Children > 4 years old:- MDI with spacer preferred Children > 12 years old: MDI used directly. use of spacer improves drug deposition. | train | med_mcqa | null |
Case-control study is a type of - | [
"Descriptive epidemiological study",
"Analytical study",
"Longitudinal study",
"Experimental epidemiological study"
] | B | Ans. is 'b' i.e., Analytical study | train | med_mcqa | null |
Grevious hu comes under section: | [
"319",
"320",
"324",
"326"
] | B | 320 | train | med_mcqa | null |
Which of the following is investigation of choice for Zenker's diveiculum? | [
"CECT",
"Endoscopy",
"Esophageal manometry",
"Barium swallow"
] | D | When suspected, the diagnosis is established by a barium swallow.. Endoscopy is usually difficult in the presence of a cricopharyngeus diveiculum and potentially dangerous, owing to the obstruction of the true esophageal lumen by the diveiculum and the associated risk of diveicular perforation. Ref: Schwaz 9/e, Page 848. | train | med_mcqa | null |
Child wakes up at night sweating and terrified does not remember the episode-diagnosis? | [
"Narcolepsy",
"Nightmares",
"Night terrors",
"Somnambulism"
] | C | Ans. is 'c' i.e., Night terrors Sleep terror or night terrors (pavor nocturnus) : - The patient suddenly gets up screaming, with autonomic arousal (tachycardia, sweating). Sleep terrors are rarely remembered in the morning (in contrast to night mares). No treatment is required only reassurance is required. However, in severe cases benzodiazepine can be used. | train | med_mcqa | null |
A material which partially transmits light & partially scatters it: | [
"Reflector",
"Translucent",
"Transparent",
"Opaque"
] | B | When light passes through a transparent medium such as plain glass, it is neither reflected nor absorbed but totally transmitted through.
A translucent material, on the other hand, gains its transmitted color by the resultant spectrum it transmits. As a beam of light passes through a translucent material such as glass, it can be changed by adding fine particles that scatter the light giving a milky appearance.
Reference: Materials Used in Dentistry, S Mahalaxmi first ed page no 47 | train | med_mcqa | null |
HbH is characterized by: | [
"Deletion of three alpha chain genes",
"Deletion of three alpha chains and one beta chain genes",
"Deletion of two alpha and two beta chain genes",
"Deletion of four alpha chain genes"
] | A | Ans. A. Deletion of three alpha chain genesAlpha-ThalassemiaSilent carrier state1 gene deletion-aaaa thalassemia trait2 gene deletion-a-aHbH disease3 gene deletion---aHydrops fetalis4 gene deletion---- | train | med_mcqa | null |
All except one are true for hepatitis B: | [
"Veical transmission is more impoant than horizontal",
"Age of onset determines prognosis",
"Period of communicability lasts several months",
"Virus can be found in blood one month before"
] | A | Ans. a. Veical transmission is more impoant than horizontal "According to American journal of gastroenterology, the most common mode of transmission of hepatitis B in the world is horizontal transmission Hepatitis B Virus The mode of transmission of HBV depends upon the prevalence of hepatitis B in the region. Only serum, saliva and semen is truly infectiousQ Children usually acquire infection indirectlyQ, through parenteral route from hepatitis B virus contaminated blood transfusiondeg. Adolescent boys and girls may acquire the virus through sexual contact with an infected paner. HBsAg positive mothers may infect their fetus in third trimester or during early post-paum period. Only 5-10% are infected in utero, rest at the time of deliveryQ. Association of HBeAg in maternal blood is correlated with a high transmission rateQ. HBV Transmission In Endemic areas In areas with Low Prevalence Veical transmissionQ Transmission is generally horizontal(percutaneous, sexualQ) Most individuals are infected perinatallyby veical transmission Prognosis: Most acute infections in hepatitis B produce no symptoms and clears spontaneouslyQ. Only few individuals develop chronic disease or some serious complicationsQ The rate of progression to chronic infection, cirrhosis or HCC depends upon several factors, most impoant of which is age at the time of infection and immune status at the time of infectionQ | train | med_mcqa | null |
Trophic ulcers are seen in a/e -a) Poliob) Syringomyeliac) Leprosyd) TB. Meningitis | [
"b",
"c",
"ad",
"ab"
] | C | null | train | med_mcqa | null |
Which of the following condition does not contain fat on mammography? | [
"Hamaoma",
"Galactocele",
"Post-traumatic cyst",
"Seborrheic keratosis"
] | D | Seborrheic keratosis are the most common skin lesion that is visible on the mammogram. These are benign skin lesions that are associated with aging. They appear wa like with a verrucoid surface, with air trapped in the irregular cracks in the surface of the lesion. Ref: Breast Imaging By Daniel B Kopans, Pages 481-482; Radiology Review Manual By Wolfgang Dahne, 7th Edition, Page 555 | train | med_mcqa | null |
Anxiety disorder does not include | [
"Generalized anxiety disorder",
"Panic disorder",
"Social phobia",
"None of the above"
] | D | (D) None of the above # Generalized Anxiety Disorder: This is characterized by an insidious onset in the third decade and a stable, usually chronic course which may or may not be punctuated by repeated panic attacks (episodes of acute anxiety).# Panic Disorder: This is characterized by discrete episodes of acute anxiety.> The onset is usually in early third decade with often a chronic course.> The common types of phobias areA. Agoraphobia; 2. Social phobia, and; 3. Specific (simple) phobia | train | med_mcqa | null |
Adenoacanthoma is which type of uterine cancer? | [
"Poorly differentiated adenocarcinoma",
"Well differentiation Adenocarcinoma",
"Mucinous carcinoma",
"Papillary serous carcinoma"
] | B | Ans. B. Well differentiation AdenocarcinomaBetween 75 and 80% of all endometrial carcinomas are adenocarcinomas, and the prognosis depends on stage, histologic grade, and extent of myometrial invasion. Grade I tumors are highly differentiated adenocarcinomas, grade II tumors contain some solid areas, and grade III tumors are largely solid or undifferentiated. Adenocarcinoma with squamous differentiation is seen in 10% of patients; the most differentiated form is known as adenoacanthoma, and the poorly differentiated form is called adenosquamous carcinoma. Other less common pathologies include mucinous carcinoma (5%) and papillary serous carcinoma (<10%). | train | med_mcqa | null |
Epiglottis is Embryologically developed from | [
"2nd pharyngeal arch",
"Hypobranchial eminence",
"4th pharyngeal arch",
"None of the above"
] | B | EMBRYOLOGICAL DEVELOPMENT Laryngeal mucosa develops from the endoderm of the cephalic pa of foregut. Laryngeal cailages and muscles develop from the mesenchyme. Development of other structures is as follows: Epiglottis:- Hypobranchial eminence. Upper pa of thyroid cailage:- 4th arch . Lower pa of thyroid cailage , Cricoid cailage , Corniculate cailage, Cuneiform cailage, Intrinsic muscles of larynx:- 6th arch. Upper pa of body of hyoid bone , Lesser cornua of hyoid bone ,Stylohyoid ligament :- 2nd arch. Lower pa of body of hyoid bone and greater cornua:- 3rd arch. Ref:- Dhingra; pg num:-285 | train | med_mcqa | null |
Calcium dobesilate used in treatment of varicose veins because of all except | [
"Reduces oedema",
"Improves macrophage mediated proteolysis",
"Improves lymph flow",
"Increases release of MMPs"
] | D | Increases release of MMPs results in varicose venous ulcer. | train | med_mcqa | null |
A child has Adenoidectomy done but he has effusion in middle ear. What is done next: | [
"Grommet insertion",
"Mastoidectomy",
"Tympanoplasty",
"None"
] | A | (a) Grommet insertion(Ref. Scott Brown, 8th ed., Vol 2; 125)Since Eustachian tube function takes time to come back to normal Myringotomy with grommet should have been done along with adenoidectomy in the mentioned child. | train | med_mcqa | null |
In anklyosing spondylitis joint involvement is least in? | [
"Wrist and hand",
"Sacroiliac joint",
"Acromio-clavicular joint",
"Costochondral junction"
] | A | Ans. is 'a' i.e., Wrist and hand Ankylosing spondylitis (marie - strumpell disease) Ankylosing spondylitis is a chronic progressive inflammatory disease of the sacroiliac joints and the axial skeleton. Prototype of seronegative (absence of rheumatoid factor) spondyloahropathies. Inflammatory disorder of unknown cause. Usually begins in the second or third decade with a median age of 23, in 5% symptoms begin after 40. Male to female ratio is 2-3 : 1 Strong correlation with HLA-B27 90-95% of cases are positive for HLA - B27. Joints involved in ankylosing spondylitis Primarily affects axial skeleton. The disease usually begins in the sacro-iliac joints and usually extends upwards to involve the lumbar, thoracic, and often cervical spine In the worst cases the hips or shoulders are also affected. o Hip joint is the most commonly affected peripheral joint. o Rarely knee and ankle are also involved. Pathology Enthesitis i.e. inflammation of the inseion points of tendons, ligaments or joint capsule on bone is one of the hallmarks of this entity of disease. Primarily affects axial (spinal) skeleton and sacroiliitis is often the earliest manifestation of A.S.. Involvement of costoveebral joints frequently occur, leading to diminished chest expansion (normal 5 cm) Peripheral joints e.g. shoulders, and hips are also involved in 1/3rd patients. Extraaicular manifestations like acute anterior uveitis (in 5%); rarely aoic valve disease, carditis and pulmonary fibrosis also occur. Pathological changes proceed in three stages? Inflammation with granulation tissue formation and erosion of adjacent bone. Fibrosis of granulation tissue Ossification of the fibrous tissue, leading to ankylosis of the joint. Inflammatory bowel disease (CD, UC) may also be seen. Clinicalfeatures (symptoms) Low back pain of insidious onset Duration usually less than 3 months Significant morning stiffness and improvement with exercise Limited chest expansion Diffuse tenderness over the spine and sacroiliac joints Loss of lumbar lordosis, increased thoracic kyphosis Decreased spinal movements (especially extension) in all directions. Radiological features of an kvlasing spondylitis Radiographic evidence of sacroiliac joint is the most consistent finding in ankylosing spondylitis and is crucial for diagnosis. The findings are :- D Sclerosis of the aiculating surfaces of SI joints Widening of the sacroiliac joint space Bony ankylosis of the sacroiliac joints Calcification of the sacroiliac ligament and sacro-tuberous ligaments Evidence of enthesopathy - calcification at the attachment of the muscles, tendons and ligaments, paicularly around the pelvis and around the heel. X-ray of lumbar spine may show :- Li Squaring of veebrae : The normal anterior concavity of the veebral body is lost because of calcification of the anterior longitudinal ligament. Loss of the lumbar lordosis. Bridging 'osteophytes' (syndesmophytes) Bamboo spine appearance In the early disease process, plain x-rays may be read as normal. More accurate and early diagnosis can be done by using MR1 and/or CT scan. Dynamic MRI with fat saturation, either sho tau inversion recovery (STIR) sequnece or TI weighted images with contrast enhancement is highly sensitive and specific for identifying early intra-aicular inflammation, cailage changes, and underlying bone marrow edema in sacroilitis. Magnetic resonance imaging allows for visualization of acute sacroilitis, spondylitis, and spondylodiscitis, and can also detect acute inflammation of the entheses, bone and synovium. The ability to detect early inflammatiion and acurately visualize cailaginous and enthesal lesions makes magnetic resonance imaging a useful assessment tool in the spondyloahropathies. | train | med_mcqa | null |
74yr old female was diagnosed to have rheumatic hea disease. She underwent valve replacement surgery, after few days she staed to complain of numbness and inability to move her left leg. Femoral, popliteal & pedal impulses were not felt on left side of pt. but . side examination of lower leg was normal. What is most appropriate management in this patient? | [
"CT angiogram of bilateral lower extremities",
"Embolectomy of the left femoral aery",
"Duplex imaging of the left lower extremity aeries",
"CT angiogram of the left lower extremity"
] | B | It is a case of Acute aerial insufficiency leading to neurological compromise Other non invasive testing is not required (Duplex scan/CT Angiography) as they will delay the treatment process. Embolectomy of femoral aery can be performed under local anesthesia and has minimum risk to pt. Exploration of contralateral side is not required in absence of signs and symptoms of other side. | train | med_mcqa | null |
A 60-year-old woman is recovering from a major pelvic cancer operation and develops severe abdominal pain and sepsis. Following a positive HIDA scan, laparotomy is performed. The gallbladder is severely inflamed and removed. There is no evidence of gallbladder stones (acalculous cholecystitis). Cholecystectomy is performed. Which is true of acalculous cholecystitis? | [
"It is usually associated with stones in the CBD.",
"It occurs in 10-20% of cases of cholecystitis.",
"It has a more favorable prognosis than calculous cholecystitis.",
"It is increased in frequency after trauma or operation."
] | D | Acute acalculous cholecystitis is most commonly encountered in critically ill patients after trauma, other unrelated surgical operations, burns, sepsis, and multiorgan failure. The HIDA scan fails to visualize the gallbladder, and a sonogram may show a distended gallbladder with wall thickening and pericholecystic fluid. Acalculous cholecystitis carries a mortality rate of 10-30%. Delay in diagnosis and hence treatment is accompanied by severe complications, such as gangrene and perforation of the gallbladder in a patient who usually has other debilitating illnesses. | train | med_mcqa | null |
Submucosal fibroid is detected by : | [
"Hysteroscopy",
"Hysterosalpingography",
"USG (Transabdominal)",
"All"
] | D | Ans. is a, b and c i.e. Hysteroscopy; Hysterosalpingography; and USG (Transabdominal) USG * Ultrasound is the main diagnostic tool in case of fibroid.deg It checks the numberdeg, locationdeg and sizedeg of fibroids and helps to reduce overlooking small fibroids during surgery (which might lead to persistence or recurrence of symptoms). USG findings in case of Fibroid Enlarged and distoed uterine contour Depending on connective tissue amount -- fibroid may have varying echogenecity (hypoechoic or hyperechoic. Vascularisation is seen at periphery. Hysteroscopy or hysterosalpingography : These methods are useful to detect submucous fibroid in unexplained infeility and repeated pregnancy wastage. The presence and site of submucous fibroid can be diagnosed by direct visualization during hysteroscopy or indirectly as a filling defect on HSG. Hysteroscopy also allows its excision under direct vision. Uterine Curettage : It can also help in diagnosis of submucous fibroid by feeling of a bump during curettage.deg Laparoscopy : is helpful if uterine size is less than 12 weeks, for detection of a subserous fibroid. It can also differentiate a pedunculated fibroid from an ovarian tumour not revealed by clinical examination and ultrasound. Investigation which can be done is MRI.deg Role of Doppler in diagnosis of Fibroid : Leiomyomas have characteristic vascular patterns which can be identified by color flow doppler. A peripheral rim of vascularity from which a few vessels arise and penetrate into the centre is seen. Doppler imaging can be used to differentiate an extrauterine leiomyoma from other pelvic masses or a submucous leiomyoma from an endometrial polyp or adenomyosis. Also know : Best investigation for submucous fibroid - Hysteroscopydeg Best investigation to detect fibroid (in general)deg -- USG (Pt choicer -- MRI (2f'd choicer | train | med_mcqa | null |
For a given population, minimum no. of newborns to be examined for calculating percentage of LBW of babies | [
"100 babies",
"500 babies",
"1000 babies",
"10,000 babies"
] | B | Low bih weight (LBW): Bih weight less than 2500grams (2.5 kg) . It includes both pre-term (<37 weeks POG) and full-term (>37 weeks POG) babies. Prevelence of LBW: 15% (World); 18% (India); If cutoff for LBW is reduced to 2.0 kg, expected prevelence of LBW inn India will be 5.5% LBW is regardless of gestational age. Depending on the population, the percentage of LBW be based on measurements of atleast 500 babies. Goal for LBW in National Health Policy 1983: Reduce LBW to <10% by 2000. Ref: Park 22th edition Pgno: 495 | train | med_mcqa | null |
Which of the following is consistent with diagnosis of De-Quervain thyroiditis? | [
"45 year female with 2 week history of painful thyroid gland with elevated T4, T3 and low TSH. RAIU shows increased uptake",
"25 year female with painless enlarged thyroid with elevated T4,T3 and undetectable TSH. RAIU shows increased uptake",
"45 year female with fatigue and low T4, T3 and Low TSH",
"45 year... | D | De Quervain thyroiditis is characterised by fever, constitutional symptoms and painful enlarged thyroid due to viral etiology. Initially T4 and T3 are elevated due to damage to follicles. RAIU uptake is reduced. Subsequently hypothyroid phase sets in and RAIU becomes normal. Option A is wrong due to increased RAIU uptake which is never possible in viral thyroiditis. Option B is consistent with Grave's disease with increased RAIU. Option C indicates Central hypothyroidism. Option D indicates late phase of De Quervain thyroiditis. | train | med_mcqa | null |
All the statements regarding LDL receptors are true except | [
"Present only in the extra hepatic tissue",
"Clathrin coated pits receptor on cell membrane",
"It is taken into the cells by endocytosis",
"Increased cellular cholesterol down regulate the synthesis of LDL receptors"
] | A | from extrahepatic tissues LDL receptors also present in liver(apo B100, E receptors) | train | med_mcqa | null |
Maternal Antibody responsible for heartblock in a baby born to mother suffering from SLE | [
"Anti-La antibody",
"Anti-dsDNA antibody",
"Anti-Ro antibody",
"Anti-La antibody"
] | C | Anti-Ro antibody crosses placenta and affects conducting system of fetal heart leading to Heart block. | train | med_mcqa | null |
Ekbom's syndrome is seen in | [
"Cocaine intoxication",
"Amphetamine",
"Severe depression",
"Acute psychosis"
] | A | Ekbom's syndrome or Delusional parasitosis is seen in cocaine intoxication where patient feels a sensation of insects crawling over the body. | train | med_mcqa | null |
All of the following glucocorticoids lack mineralocorticoid activity, except: | [
"Beclomethasone",
"Triamcinolone",
"Prednisolone",
"Dexamethasone"
] | C | null | train | med_mcqa | null |
Nontoxic form of storage and transpoation of ammonia: | [
"Aspaic acid",
"Glutamate",
"Glutamine",
"Glutamic acid"
] | C | Catabolism of amino acid give rise to ammonia which get transferred to glutamate. From glutamate, NH3 is ultimately taken up by glutamine which is Non-toxic form of storage and transpoation of ammonia in blood (see fig below). Glutamine is neutral in nature and can readily move across cell membrane by facilitative diffusion. Glutamine is formed from glutamate by following reaction: | train | med_mcqa | null |
Phlegmon; all are true except | [
"The tissue is tender, painful and hard to touch.",
"Pain, fever, malaise are aggressive.",
"It is rapidly spreading infection of subcutaneous tissue due to micro-organism like staphylococci.",
"Is caused due to micro-organism which are capable to produce hyaluronidase which breakdown intercellular cementing... | C | Cellulitis (Phlegmon)
→ Diffuse swelling of face with no defined margins.
→ The tissue are tender, painful, hard to touch.
→ Pain, fever, malaise, exhaustion, all features are more aggressive.
→ It takes 3-7 days to develop.
→ Spreading factor of Duran and Reynals.
→ Rapidly spreading infection of subcutaneous tissue due to micro-organism which are capable to produce hyaluronidase which breakdown intercellular cementing substance hyaluronic acid.
→ Streptococci is more involved in causing cellulitis than staphylococci.
→ Streptocci produce enzymes such as : Streptokinase (fibrinolysin), hyaluronidase, and streptodornase.
→ These enzymes breakdown fibrin and connective tissue ground substance and lyse cellular debris. Thus facilitate rapid spread of bacteria along the tissue planes. | train | med_mcqa | null |
When a person comes in contact with other there is transfer of material from one to another. This is called: | [
"Locard's principle",
"Quetlets rule",
"Petty's principle",
"None of the above"
] | A | Locards principle of exchange states that when two objects come into contact with each other, there is always some transfer of maternal from one to the other. Ref: Parikh's Textbook of Medical Jurisprudence Forensic Medicine and Toxicology, 6th Edition, Pages 5.35, 7.35 | train | med_mcqa | null |
Which of the following is not a cause of features of primary hyperaldosteronism? | [
"Cushing syndrome",
"Adrenal adenoma",
"Adrenal hyperplasia",
"Chronic CCF"
] | D | Chronic CCF will lead to low GFR. The subsequent activation of RAAS will lead to increased renin and secondary aldosteronism. Causes of primary hyperaldosteronism : Conn syndrome (adrenal adenoma): 60% Bilateral adrenal hyperplasia (Micronodular): 60% Cushing syndrome Syndrome of apparent mineralocoicoid excess Adrenocoical carcinoma Congenital adrenal hyperplasia | train | med_mcqa | null |
The transpyloric plane passes through the | [
"Pylorus of the stomach",
"Fundus of the stomach",
"Fundus of the uterus",
"Fundus of the gallbladder"
] | A | It is also said to lie roughly a hand's breadth beneath the xiphoid process of the human sternum. The plane in most cases cuts through the pylorus of the stomach, the tips of the ninth costal cailages and the lower border of the first lumbar veebra. Ref - researchgate.net | train | med_mcqa | null |
Colorado stain is related to | [
"Fluorosis",
"Intrinsic Stain",
"Extrinsic Stain",
"Hidden Caries"
] | A | null | train | med_mcqa | null |
Emesis receptor is | [
"5HT1",
"5HT2",
"5HT3",
"5HT4"
] | C | ANSWER: (C) 5HT3REF: Goodman Gillman manual of pharmacology and therapeutics 2008 edition, page 646Iheprocessofnauseaandvomiting appears to be coordinated by a central emesis center in the lateral reticular formation of the mid-brainstem adjacent to both the chemoreceptor trigger zone (CTZ) in the area postrema (AP) at the bottom of the fourth ventricle and the solitary tract nucleus (STN) of the vagus nerve.The lack of a blood-brain barrier allows the CTZ to monitor blood and cerebrospinal fluid constantly for toxic substances and to relay information to the emesis center to trigger nausea and vomitingThe CTZ has high concentrations of receptors for serotonin (5-HT3), dopamine (D2), and opioids, while the STN is rich in receptors for enkephalin, histamine, and ACh, and also contains 5-HT3 receptors.The most effective agents for chemotherapy-induced nausea and vomiting are the 5-HT3 antagonists and metoclopramidePharmacological view of emetic stimuli | train | med_mcqa | null |
A 5-month old child rushed into hospital with complaint of colicky pain, bilious vomiting and red current jelly like appearance of stools. On examination, these was sausage shaped mass in right lumbar region. Which of the following is used as both diagnostic and therapeutic? | [
"Barium enema",
"Air enema",
"MRI",
"Anoscopy"
] | B | Intussusception Most common cause of intestinal obstruction in children Clinical features At time of attack child cries a lot, pulls legs towards abdomen Colicky pain Bilious vomiting In between attacks, patient is normal Small amount of stools with blood (Red current jelly appearance) Investigation and treatment Diagnostic + therapeutic - Enema (air > barium) Enema creates pressure by which there will be reduction of bowel back to normal. | train | med_mcqa | null |
Collagen 17 is | [
"Hemi-desmosome BPAG1",
"Hemi-desmosome BPAG2",
"Anchoring filaments",
"Anchoring fibrils"
] | B | INFERIOR POION OF BASAL KERATINOCYTE Hemidesmosome (HD):- * Appears as thickened area interspersed along plasma membrane of basal keratinocyte; provides attachment between basal keratinocyte and extracellular matrix. * Composed of following macromolecules: BPAG1, BPAG2, integrin, and plectin . * Tonofilaments (or keratin filaments) inse into hemidesmosomes . BPAG1 (230 kDa) :- * Intracellular glycoprotein in plakin family which is associated with the cytoplasmic plaque domain of hemidesmosomes; promotes adhesion of intermediate filaments with plasma membrane (likely binds or anchors filaments to HD). BPAG2 (180kDa, Collagen XVII) :- * Transmembrane (mainly extracellular) protein belonging to collagen family; interacts with BPAG1, b4 integrin, and plectin. Ref:- Sima Jain; pg num:- 7 | train | med_mcqa | null |
Hemoperfusion with charcoal is useful in | [
"Barbiturate poisoning",
"Methyl alcohol",
"Lithium",
"Ethylene glycol"
] | A | Amongst the given options, hemoperfusion is used in barbiturate poisoning. | train | med_mcqa | null |
An increase in the size of a cell in response to stress is called hyperophy. Which of the following does not represent the example of smooth muscle hyperophy as an adaptive response to the relevant situation? | [
"Urinary bladder in urine outflow obstruction",
"Gall bladder in chronic cholecystitis",
"Triceps in body-builders",
"Uterus enlargement during pregnancy"
] | C | The enlargement of the triceps is an example of skeletal muscle hyperophy (not smooth muscle hyperophy). | train | med_mcqa | null |
A 25 year old pregnant female with gestational diabetes came to OPD at 30 weeks of gestation for routine antenatal checkup. Her sugars are uncontrolled. Her fundal height was found to be 36 cm and abdominal skin appears excessively stretched and shiny. Her previous antenatal USG repos were normal. What could be the most probable diagnosis? | [
"Uterine fibroids",
"Polyhydramnios",
"Twin gestation",
"Oligohydramnios"
] | B | Fundal height normally correlates (in cms) with gestational age in weeks (from 16 to 36 weeks). The possible reason for increased fundal height could be : Polyhyramnios, Fibroids, Twin pregnancy, H. Mole, Big baby (Fetal macrosomia) Normal previous USGs rules out fibroid, twin pregnancy and H. Mole. According the above given case scenario the most probable cause is polyhydramnios (as the patient is a known case of gestational diabetes which is a risk factor for polyhydramnios). | train | med_mcqa | null |
Disinfection of water is not required if the source is from – | [
"Tube well",
"Step well",
"Draw well",
"River"
] | A | null | train | med_mcqa | null |
Measles vaccination compagin between 9-14 years age for elimination is - | [
"Keep up",
"Follow up",
"Mop up",
"Catch up"
] | D | WHO's measles elimination strategy comprises a three part vaccination strategy, i.e. :-
i) Catch-up → One-time, nationwide vaccination campaign targeting usually all children aged 9 months to 14 years regardless of history of measles disease or vaccination status.
ii) Keep-up → Routine services aimed at vaccinating more than 95% of each successive birth cohort.
iii) Follow-up → Subsequent nationwide vaccination campaign conducted every 2-4 years targeting usually all children born after catch-up campaign.
The priorties of countries persuing measles control include :-
Improve routine vaccination coverage level to at least 90%.
Active coverage of more than 90% in catch-up and follow-up campaigns or active coverage of more than 90% with routine second dose of measles vaccine.
Establish case - based surveillance with laboratory confirmation of suspected cases and virus isolation from all chains of transmission.
Conduct supplementary vaccination campaign together with administration of vitamin 'A' in high risk areas.
In India, measles is a major cause of morbidity and a significant contributor to childhood mortality. Prior to the immunization programme, cyclical increase in the incidence of measles were recorded every third year. With the increase in immunization coverage levels, the intervals between cyclic peaks has increased and the intensity of the peak minimized.
Epidemic of measles occur if proportion of susceptible children is > 40%
If measles is introduced in a virgin community, it infects > 90% of children.
Eradication of measles requires vaccine coverage > 96%
Following information has been added in 22nd/e of Park
At the 2010 World Health Assembly, member states endorsed the following targets to be met by 2015 as milestones towards eventual global measles eradication: - (i) Raise routine coverage with the first dose of measles vaccine to ≥ 90% nationally and ≥ 80% in every district; (2) Reduce and maintain annual measles incidence to < 5 cases per million; and (3) Reduce measles mortality by ≥ 95% in comparison with estimated level in the year 2000. | train | med_mcqa | null |
Which among the following is TRUE regarding mallet finger? | [
"Avulsion of tendon at the base of the middle phalanx",
"Avulsion of extensor tendon at the base of the distal phalanx",
"Fracture of distal phalanx",
"Fracture of the proximal phalanx"
] | B | The mallet finger deformity is characterized by a loss of full active distal interphalangeal joint extension with full passive ROM evident. The mallet finger reflects the loss of normal extensor force transmission the terminal tendon inseion onto the distal phalanx. The unopposed flexor digitorum profundus pulls the distal joint into flexion. The usual mechanism of injury involves sudden passive flexion of the actively extended distal interphalangeal joint. Disruption of the terminal tendon may be entirely confined to the tendon or may involve an avulsed fracture fragment from the dorsal lip of the distal phalanx proximal aicular surface. Ref: Bednar M.S., Light T.R. (2006). Chapter 10. Hand Surgery. In H.B. Skinner (Ed), CURRENT Diagnosis & Treatment in Ohopedics, 4e. | train | med_mcqa | null |
Which is not seen in hypeensive disorders of pregnancy | [
"Macrosomia",
"Eclampsia",
"HELLP syndrome",
"Proteinuria"
] | A | Hypeensive disorders are more associated with growth restriction rather than macrosomia as it is a condition of reduced placental perfusion. Following are seen in hypeensive disorder: Growth restriction Proteinuria(preeclampsia) Seizures(Eclampsia) End-organ damage (elevated serum creatinine, liver enzymes, LDH, decreased platelet count- HELLP syndrome) | train | med_mcqa | null |
A 24-year-old woman with a large appetite for salt consumes about 25g of salt each day. What is the approximate amount of salt (in grams) that is excreted each day by her kidneys? | [
"4",
"12",
"23",
"50"
] | C | About 95% of the salt (sodium chloride) that is consumed by a person is excreted by the kidneys; the remaining 5% is excreted in the sweat and feces. The total intake of salt (amount of salt consumed each day) must equal the total output of salt (amount of salt excreted each day) under normal steady conditions, ie, salt intake = salt output. Therefore, it is clear that 25g of salt must be excreted by the kidneys each day when 25g of salt is consumed each day. 95% of 25 is around 23g. | train | med_mcqa | null |
Not involved in damage to cerebellum: March 2010 | [
"Posture",
"Equilibrium",
"Asthenia",
"Tone"
] | C | Ans. C: Asthenia Signs of Cerebellar Disorders Ataxia, Reeling, wide-based gait- decomposition of movements, Inability to correctly sequence fine, coordinated acts Dysahria-Inability to aiculate words correctly, with slurring and inappropriate phrasing Dysdiadochokinesia-Inability to perform rapid alternating movements Dysmetria-Inability to control range of movement Hypotonia-Decreased muscle tone Nystagmus-Involuntary, rapid oscillation of the eyeballs in a horizontal, veical, or rotary direction, with the fast component maximal toward the side of the cerebellar lesion Scanning speech-Slow enunciation with a tendency to hesitate at the beginning of a word or syllable Tremor-Rhythmic, alternating, oscillatory movement of a limb as it approaches a target (intention tremor) or of proximal musculature when fixed posture or weight bearing is attempted (postural tremor) Asthenia: (Weakness/Lack of energy and strength/Loss of strength). It is a prominent pa of myasthenia gravis | train | med_mcqa | null |
What is the purpose of using Hasse's formula in pregnancy? | [
"Estimate fetal age",
"Identify fetal blood group",
"Identify fetal sex",
"Identify fetal congenital malformations"
] | A | Hasse's rule is employed in calculating the age of fetus by its length. During first five months of pregnancy, the length in cms is square of the age in months. During the second five months of pregnancy, length in cms divided by 5 gives age in months. Ref: Textbook of forensic medicine and toxicology by Krishan Vij, 3rd edition, Page 558. | train | med_mcqa | null |
The region where internal and external epithelia meet at the rim of the enamel organ is known as: | [
"Zone of reflexion.",
"Enamel Knot.",
"Dental follicle.",
"Enamel cord."
] | A | The region where the internal and external dental epithelia meet at the rim of the enamel organ is known as the zone of reflexion or cervical loop. | train | med_mcqa | null |
Autoimmune hemolytic anemia is seen in - | [
"CML",
"CLL",
"ALL",
"AML"
] | B | Clinical features of CLL
Most patients present at ages over 50 with a male predominance
Patients with CLL are often asymptomatic.
When symptoms appear, they are nonspecific and include easy fatigability, weight loss and anorexia.
Other symptoms are : -
Hepatosplenomegaly
Lymphadenopathy
Hypogammaglobulinemia Increased susceptibility to infections.
Autoimmune hemolytic anemia or thrombocytopenia
CLL has a tendency to transform into more aggressive lymphoid neoplams : -
Prolymphocytic leukemia → Characterized by worsening of cytopenia, marked splenomagaly and appearance of prolymphocytes in the peripheral blood.
Richter syndrome → CLL is transformed into diffuse large B-cell lymphoma. | train | med_mcqa | null |
Nuclear bag fibre detects | [
"Sense dynamic length of muscle",
"Involved in reciprocal innervations",
"Alpha motor neuron stimulation",
"Senses muscle tension"
] | A | (Refer Q 5 AIIMS Nov'14) | train | med_mcqa | null |
All of the following muscles constitutes the rotator cuff muscles, EXCEPT? | [
"Supraspinatus",
"Infraspinatus",
"Teres major",
"Subscapularis"
] | C | The 4 muscles which constitute the rotator cuff are supraspinatus, infraspinatus, teres minor and subscapularis. They form a musculotendinous cuff around the glenohumeral joint. It provides muscular suppo primarily to the anterior, posterior, and superior aspects of the joint.Supraspinatus muscle: Its primary action is humeral abduction. The suprascapular nerve (C5-C6) and the suprascapular aery provide its innervation and blood supply.Infraspinatus muscle: Its primary action is lateral rotation of the humerus. The suprascapular nerve and the suprascapular aery provide its innervation and blood supply.Teres minor muscle: It causes lateral rotation of the humerus. The axillary nerve and circumflex scapular aery provide its innervation and blood supply.Subscapularis muscle: Causes medial rotation of the humerus with contraction. Upper and lower subscapular nerves and suprascapular, axillary, and subscapular aeries provide its innervation and blood supply. | train | med_mcqa | null |
Iron is absorbed in | [
"Stomach",
"Duodenum",
"Jejunum and ileum",
"Colon"
] | B | You should know the site of absorption of the following: | train | med_mcqa | null |
Acute cellular rejection following solid organ transplantation occurs: | [
"Within minutes to hours of transplantation",
"Within 48 hours of transplantation",
"Between 5 to 30 days of transplantation",
"Beyond 30 days after transplantation"
] | C | Ans. (c) Between 5 to 30 days of transplantationRef: Bailey 26th edition, Pages 1408-1412* Hyperacute - minutes to hours* Acute (Cellular rejection): Most common in 5-30 days (first 6 months)* Chronic rejection after 6 months (Most common cause of graft failure) | train | med_mcqa | null |
18-20 weeks Level II scan is done for | [
"Diagnosis of fetal anomaly",
"Lung maturity",
"Sex determination",
"AFI"
] | A | Level II - anomaly, targeted or dating scanAt the second trimester scan they check that your baby is developing normally, they assess the gestational age by measuring the crown-rump length and will also look for any major problems. This is a routine ultrasound examination performed at 18 to 20 weeks of gestation.During the examination, the fetus is seen by abdominal ultrasound. The fetus is now large enough for an accurate survey of the fetal anatomy. With multiple pregnancies, they can be firmly diagnosed and dates and growth can also be assessed. Placental position is also determined. Fuher scans may be necessary if abnormalities are suspected(Refer: William's Obstetrics, 23rd edition) | train | med_mcqa | null |
CT scan of a patient with history of head injury shows a biconvex hyperdense lesion displacing the grey-white matter interface. The most likely diagnosis is: | [
"Subdural hematoma",
"Diffuse axonal injury",
"Extradural hematoma",
"Hemorrhagic contusion"
] | C | C i.e. Extradural Hematoma | train | med_mcqa | null |
True statements about Appendix except | [
"Have mesentery",
"Has taenia coli",
"Develops from midgut",
"Supplied by appendicular branch of ileocolic aery"
] | B | The appendix is developes from midgut. Supplied by appendicular aery which is a branch of ileocolic aery. Which is a branch of Superior mesenteric aery The appendix is connected to the mesentry in the lower region of the ileum, by a sho region of the mesocolon known as the mesoappendix. Colon and caecum have tenia coli (3 longitudinal muscles), which converge at base of appendix on caecum. Ref - BDC 6e vol 2 Pg 269 | train | med_mcqa | null |
All are biomarkers of long standing alcohol intake, EXCEPT: | [
"Carbohydrate deficient transferrin",
"GGT",
"5' nucleotidase",
"Macrocytosis"
] | C | GGT will be elevated in long standing alcoholism, but it lack sensitivity and specificity. Elevated MCV seen in chronic alcoholism. CDT is most widely studied but it lack sensitivity and specificity. 5' nucleotidase is an cholestatic marker. Ref : AASLD Practice Guidelines 2010 | train | med_mcqa | null |
The natural history of disease is best established by: | [
"Randomized control trials",
"Clinical trials",
"Descriptive studies",
"Coho studies"
] | D | The Natural history of disease is best established by coho studies. COHO STUDY: Forward looking study Prospective study Cause to effect study Risk factor to disease study Exposure to outcome study Follow-up study Incidence study | train | med_mcqa | null |
Increased AV nodal blockade leads to termination of tachycardia in all except? | [
"Atrial tachycardia",
"Atrial flutter",
"AVN",
"Ohodromic AV re-entry"
] | B | Tachycardia can not be terminated by increased AV nodal blockade in Atrial Flutter because it will be having separate reentry circuit which bypasses the AV node. CAVOTRICUSPID ISTHUMUS DEPENDENT ATRIAL FLUTTER | train | med_mcqa | null |
Vossius ring occurs in | [
"Lens dislocation",
"Concussion injury",
"Penetrating injury",
"Extra capsular extraction"
] | B | B i.e. Concussion injury | train | med_mcqa | null |
A patient presents with keratoconjunctivitis. The differential diagnosis should include infection with which of the following viruses? | [
"Parvovirus",
"Adenovirus",
"Epstein-Barr virus",
"Respiratory syncytial virus"
] | B | Adenovirus type 8 is associated with epidemic keratoconjunctivitis, while adenovirus types 3 and 4 are often associated with "swimming pool conjunctivitis." There are also reports of nosocomial conjunctivitis with adenovirus. Herpes simplex virus can infect the conjunctiva and is among the most common causes of blindness in North America and Europe. | train | med_mcqa | null |
Which of the following combination is true about hormone and its site of action in renal tubules? | [
"Aldosterone in collecting ducts",
"Angiotensin in distal tubule",
"ANP in loop of Henle",
"ADH in proximal tubule"
] | A | Ans. A Aldosterone in collecting ductsRef: Guyton, 10th ed. pg. 290, 304Hormones and their site of ActionHormonesSite of action in kidneyAngiotensin IIConstricts afferent arterioles, helps to reduce GFRAldosteroneCortical collecting duct & distal tubulesADHMedullary collecting ductANPCollecting duct | train | med_mcqa | null |
Proopiomelanocoin is released from | [
"Hypothalamus",
"Liver",
"Adrenal",
"Lung"
] | A | Proopiomelanocoin (POMC) is the pituitary precursor of circulating melanocyte stimulating hormone (a-MSH), adrenocoicotropin hormone (ACTH), and b-endorphin released from hypothalamus. | train | med_mcqa | null |
azzoparardi effect is seen in ? | [
"squamous cell carcinoma",
"large cell carcinoma",
"small cell carcinoma",
"adenocarcinoma lung"
] | C | Azzoparrdi effect : its basophillic staining of blood vessels wall . * in small cell carcinoma blood vessels in necrotic area may show smudged hematoxophilic material in their walls, which represents DNA released from tumour cells. This is referred to as Azzopardi effect. ref : robbins 10th ed | train | med_mcqa | null |
15 months old child feeding on cow milk with water wih severe wasting and bipedal edema with poor appetite - | [
"Kwashiorkar",
"Marasmus",
"Both",
"None"
] | A | Ans. is 'a' i.e., Kwashiorkar o Kwashiorkar and marasmus are manifestations of protein energy malnutrition (PEM).o Marasmus represents the compensated phase of PEM.o Kwashiorkar represents the uncompensated phase of PEM.Kwashiorkaro It is characterized by following three essential features -EdemaEdema starts in lower extreities and later involves upper limbs and the face.Face appears moon shaped and puffy.Edema is caused by -Hypoalbuminemia Major factorIncreased capillary permeability due to infection.Free radical injury to cell membrane.Markedly retarded growthMuscles of the upper limb are wasted, but the lower extremities appear swollen due to edema.Muscle wasting is masked by edema.Psychomotor (mental) changesChild is lethargic, listless and apathetic (in contrast to marasmus, where the child is alert and irritable).Appetite is impaired (in contrast to marasmus, where children show voracious appetite).Other features of kwashiorkorHepatomegalyDue to fatty infiltrationHair changes in KwashiorkarHair is thin, dry- and brittle, easily pluckableStraight and hypopigmentedFlag sign (Alternate bands of Hypo and hyperpigmented hair corresponding to the period of under and proper nutrition).Skin changes in KwashiorkarLarge areas of skin show erythema followed by hyperpigmentationFlaky paint dermatosis Hyperpigmentation patches desquamate to expose raw hypopigmented areas. Ii gives the appearance of paint flaking off the surface of the wood.InfectionsThese children suffer from recurrent episodes of diarrhoea, respiratory and skin infections.Hepatomegaly is seen in kwashiorkor (not in marasmus).Marasmuso It is characterized by gross wasting of muscle and subcutaneous tissues resulting in emaciation and marked stunting.o There is no edema.o Body weight is less then 60% of expected.o Fat in adipose tissues is severely depleted. However the buccal pad of fat is preserved till the malnutrition becomes extreme because a higher proportion of saturated fatty acids is stored there and the saturated fat is the last to be depleted.o Skin is dry, scaly and inelastic with wrinkles,o The hair is hypopigmented.o Abdomen is distended due to wasting and hypotonia of abdominal wall muscles.o The child is alert but irritable,o Child may show voracious appetite.FeaturesMarasmusKwashiorkorIncidenceMore commonLess commonStage in PEMCompensated phaseUncompensated phaseActivityActiveApathicMuscle wastingObviousSometimes hidden by edema and fatFat wastingSevere loss of subcutaneous fatFat often retained but not firmEdemaNonePresentWeight for heightVery lowLow but may be masked by edemaAppetititeVocarious (good) appetitePoorSkin changesNoneDiffuse pigmentations, flaky paint dermatosisHair changesNoneSparse, silky, easily pulled outAnemiaUncommonCommonHepatomegalyAbsentPresentLiver biopsyNormal or atrophicFatty changesInfectionLess proneMore proneSerum albuminNormal or slightly decreasedLow (< 3g/100 ml)Insulin levelNormalLowOthersMonkey facies Baggy pant appearanceSugar baby appearance Flag sign of hairRecoveryEarlyLong timeMortalityLess than kwashiorkorHigh in early stage | train | med_mcqa | null |
Scleritis is commonly seen with | [
"Reiter s syndrome",
"Rheumatoid arthritis",
"Ankylosing spondylitis",
"Wegners syndrome"
] | B | Ans. (b) Rheumatoid arthritisRef: A.K. Khurana 6th ed. /141, Khurana 4th ed./129* Scleritis is chronic inflammation of the sclera. Most commonly seen in elderly females (40-70 years).* Scleritis is associated with autoimmune collagen disorders, most commonly with rheumatoid arthritis.* Other causes can be PAN, SLE, ankylosis spondylitis, Wegeners granulomatosis, thyrotoxicosis, TB, syphillis. | train | med_mcqa | null |
All the following wastewater contains human excreta EXCEPT | [
"Sewage",
"Sullage",
"Faeces",
"None"
] | B | Ans. b (Sullage). (Ref. Park, PSM, 22th/pg. 707)SULLAGEThe term "Sullage" is applied to waste water which does not contain human excreta. E.g. waste water from kitchen and bathrooms.SEWAGESewage is wastewater from community containing solid and liquid excreta, derived from houses, streets and yards, washing, factories and industries. It resembles dirt water with unpleasant smell. # The average amount of sewage, which flows through sewage system in 24 hours, is called "dry weather flow". # Composition of sewage is 99.9% water.# Strength of sewage is expressed in terms of BOD, COE, suspended solids.Also remember:# Average adult person excretes daily some 100 gm of faeces.# It is estimated that 1 gram of faeces may contain about 1,000 million of E. coli, 10-100 million of faecal streptococci, and 1-10 million spores of Cl. Perfringens besides several others. | train | med_mcqa | null |
Whipple's operation is done for treatment of: | [
"Hepatocellular carcinoma",
"Carcinoma of pancreatic head",
"Small intestinal tumors",
"Acute pancreatitis"
] | B | Ans. b (Carcinoma of pancreatic head). (Ref. Bailey and Love 25th/pg. 1150)Pancreato-duodenectomy/ Whipple's operation/ Triple-ostomy# It is an extensive operation used as an attempt at a cure for pancreatic carcinoma or cholangiocarcinoma, when lesions are extrahepatic and periampullary, and occasionally, for chronic pancreatitis.# It involves resection of most of the extrahepatic biliary system, the whole of the duodenum, the distal stomach, and the head of the pancreas.# Anastomoses are then formed between the remaining structures; for example, the tail of the pancreas to the jejunal stump and the bile duct to the side of the jejunum.# Whipple's operation is only appropriate in a very select group of patients with pancreatic cancer; factors include fitness, age and absence of metastases.# Careful selection leaves about 10% of patients in whom surgery may improve prognosis, of which at best only 20% may survive to five years.# This operation is also used to treat grade V pancreatic injuries i.e., disrupted pancreaticobiliary duodenal complex | train | med_mcqa | null |
In a distribution, if the mean is less median, then the distribution is said to be - | [
"Negative skewed",
"Positively skewed",
"Normal distribution",
"No correlation"
] | A | Negative skewed ( left skewed ) : Mean less than median . Mode >median > mean Postitive skewed ( right skewed) : Mean more than median Mean > median > mode | train | med_mcqa | null |
Treatment of Advanced Proliferative Diabetic Retinopathy with extensive vitreoretinal fibrosis and tractional retinal detachment involves all of the following except | [
"Reattachment of detached or torn retina",
"Removal of epiretinal membrane",
"Vitrectomy",
"Exophotocoagulation"
] | D | Ans. (d) ExophotocoagulationRef: Oxford Textbook of Medicine 4/e, p. 350 current Geriatric Diagnosis & Treatment (2004)/127Treatment of advanced proliferative diabetic retinopathy (PDR) with extensive vitreoretinal fibrosis, tractional retinal detachment or dens recurrent vitreous hemorrhage requires a surgical procedure called vitrectomy or parsplana vitrectomyAdvanced PDR with dense vitreous hemorrhageAdvanced PDR with extensive fibrovascular epiretinal membraneAdvanced PDR with tractional retinal detachment and /or tearVitrectomy with removal of opaque vitreous gel and endophotocoagulationVitrectomy with removal of fibrovascular epiretinal membrane and endophotocoagulation (dissection of membrane)Vitrectomy and reattachment of detached or torn retina by endophotocoagulation or other methods. | train | med_mcqa | null |
Features of shock | [
"Decreased GFR",
"Increased renin",
"Decreased rennin",
"Decreased Coisol"
] | A | In early clinical septic shock, renal function was lower, which was accompanied by renal vasoconstriction, a lower renal oxygen delivery, impaired renal oxygenation, and tubular sodium reabsorption at a high oxygen cost compared with controls decrease or decline in the GFR implies progression of underlying kidney disease or the occurrence of a superimposed insult to the kidneys. This is most commonly due to problems such as dehydration and volume loss. An improvement in the GFR may indicate that the kidneys are recovering some of their function Ref Davidson 23rd edition pg 460 | train | med_mcqa | null |
Chelating agent used in mercury poisoning is - | [
"Calcium disodium edetate",
"Desferrioxamine",
"Penicillamine",
"BAL"
] | D | Ans. is 'd' i.e., BAL Use of different chelating agentsDimercaprol (BAL)o Poisoning by As, Hg, Au, Bi, Ni, Sbo As an adjuvant to EDTA in lead poisoningo As an adjuvant to penicillamine in Cuo Contraindicated in iron and cadmium poisoning.Calcium disodium edetate (Ca Na,EDTA)o Lead poisoningo Also used in Zn, Cd, Mn, Cu, Fe poisoningo Mot used in mercury poisoningDesferrioxamine (obtained from an actinomycete)o Acute iron poisoningo Transfusion siderosiso Available only in injectable formPenicillamineo Wilson's disease (Hepatolenticular degeneration)o Copper/mercury poisoningo Chronic lead poisoningo Cystinuria and cystine stoneso Sclerodermao RADeferiproneo Acute iron poisoningo Iron load in liver cirrhosiso Both oral and injectable preparation available | train | med_mcqa | null |
A group of 7 expes discussing and interacting about a topic in front of large audience is known as? | [
"Workshop",
"Symposium",
"Seminar",
"Panel discussion"
] | D | A panel discussion is designed to provide an oppounity for a group to hear several people knowledgeable about a specific issue or topic present information and discuss personal views. A panel discussion may help the audience fuher clarify and evaluate their positions regarding specific issues or topics being discussed and increase their understanding of the positions of others. A workshop describes an office or conference room meeting intended to create or generate plans, analysis, or design to suppo organizational effos. Symposium is ameeting or conference for discussion of a topic, especially one in which the paicipants form an audience and make presentations. Seminar is asmall group of advanced students in a college or graduate school engaged in original research or intensive study under the guidance of a professor who meets regularly with them to discuss their repos and findings. | train | med_mcqa | null |
Inhalational agent of choice for induction in children is | [
"Desflurane",
"Sevoflurane",
"Isoflurane",
"Halothane"
] | B | Desflurane has the lowest blood partition co-efficient and hence it is the fastest inducing agent. But it can lead to coughing & bronchospasm on inhalation.
Therefore Sevoflurane is the inhalational agent of choice for induction in children. | train | med_mcqa | null |
A 32-years old man with pelvic fracture is in urinary retention with blood at the external urinary means. Retrograde urethrogram shows prostatomembranous disruption. The most appropriate immediate treatment is: | [
"Urethral catheterization",
"Exploration and repair of urethra",
"Suprapubic cystostomy",
"Perineal urethrostomy"
] | C | Posterior Urethral injury- Posterior urethra is located in the pelvis and is fixed.- In cases of pelvic fracture- posterior urethra is more prone for injury.- Most common site of injury - bulbomembranous junction. Bulbar Urethral Injury Membranous Urethral Injury More common Less common Direct blow to the perineum (Straddle Injury) Blunt pelvic trauma with fracture pelvis Retention of urine Retention of urine Blood at urethral meatus Blood at urethral meatus Perineal hematoma Pelvic Hematoma Normal prostate High Lying prostate Superficial extravasation Deep extravasation - Gold standard Treatment for suspection of Urethral injuries- Suprapubic cystostomy - Delayed repair can be done after 3 months.- In emergency, surgical repair should not be attempted due to increased risk of stricture and incontinence.- Repeated urethral catheterization can conve paial tear to complete tear. | train | med_mcqa | null |
What is seen in luteal phase - | [
"Increased progesterone levels",
"Decreased progesterone levels",
"Decreased estrogen level",
"None of the above"
] | A | Ans. is 'a' i.e., Increased progesterone levels "Corpus luteum secretes progesterone, the level of which starts rising" | train | med_mcqa | null |
Trpohic hormones refer to: | [
"Hormones secreted from hypothalamus",
"Pituitary gland hormones",
"Hormones that stimulate the secretion of other endocrine glands",
"Hormones of posterior pituitary"
] | C | the term "TROPHIC" means , to stimulate Ref: guyton and hall textbook of medical physiology 12 edition | train | med_mcqa | null |
Enzyme responsible for complete oxidation of glucose to CO2 to water is present in | [
"Cytosol",
"Mitochondria",
"Lysosomes",
"Endoplasmic reticulum"
] | B | Ans. is 'b' i.e. Mitochondria The fate of pyruvate formed at the end of glycolysis (glucose metabolism) is as follows :Under anaerobic conditions : Pyruvate is reduced by the NADH to lactate in the presence of Lactate dehydrogenaseUnder aerobic conditions : Pyruvate is taken up into mitochondria & is converted to Acetyl-CoA in the presence of pyruvate dehydrogenase complex. Now this Acetyl-CoA enters Krebs cycle.* Kreb's cycle is the final pathway where oxidative metabolism of carbohydrates, amino acids & fatty acids converge, their carbon skeleton being converted to CO2 and H20. | train | med_mcqa | null |
Right 12th nerve damage leads to? | [
"Tongue deviation to left on protrusion",
"Tongue deviation to right on protrusion",
"Nasal twang to voice",
"Scanning speech defects"
] | B | Ans. (b) Tongue deviation to right on protrusionRef: Harrison 19th ed. / Ch 367Following a lesion of the hypoglossal nucleus or nerve* ATROPHY of the muscles of the IPSILATERAL one-half of the tongue occurs.* FASCICULATIONS (tiny, spontaneous contractions) can be seen.* Upon protrusion, the tongue will deviate TOWARD the side of the lesion (i.e.} same side). This is due to the unopposed action of the genioglossus muscle on the normally innervated side of the tongue (the genioglossus pulls the tongue forward).The corticobulbar input to the hypoglossal nucleus arises from motor cortex and is predominantly CROSSED. Thus, a lesion in motor cortex will result in deviation of the tongue toward the opposite side or CONTRALATERAL to the lesion. In contrast to the atrophy and fasciculations seen in lesions of the hypoglossal nucleus and nerve (lower motor neuron), NO such signs are present after lesions of the corticobulbar tract. | train | med_mcqa | null |
Rhinitis medicamentosa is due to | [
"Nasal decongestants",
"Steroids",
"Surgery",
"Antihistaminics"
] | A | Rhinitis medicamentosa is due to the prolonged use of topical nasal decongestants like oxymetazoline and xylometazolineTreatment- Stoppage of the decongestants, topical and systemic steroids.Ref: Hazarika; 3rd ed; Pg 298 | train | med_mcqa | null |
Unmyelinated fibers differ from myelinated fibers in that they: | [
"Have increased excitability",
"Have no nodes of Ranvier",
"Have no power of regeneration",
"Have no association of Schwann cells"
] | B | null | train | med_mcqa | null |
Half life of tritium is - | [
"10.2 years",
"12.3 years",
"15.5 years",
"20.7 years"
] | B | Ans is 'b' i.e. 12.3 years * Tritium (hydrogen-3) is a radioactive isotope of hydrogen. The nucleus of tritium (sometimes called a triton) contains one proton and two neutrons.* Whereas the nucleus of protium contains one proton and no neutrons.* Tritium has a half-life of 12.3 years.* Tritium is used as a radioactive tracer, in radioluminescent light sources for watches and instruments, and, along with deuterium, as a fuel for nuclear fusion reactions with applications in energy generation and weapons.Half life of some important radioisotopes* Phosphorus (P-32) - 14.3 days* Strontium (Sr) - 28 days* Yttrium (Y-90) - 2.54 days* Radium (Ra-226) - 1622 years* Iodine (1-131) - 8 days* Iridium (Ir-192) - 74.5 days* Cobalt (Co-60) - 5.2 years* Cesium (Cs-137) - 30 years* Technitium (Tc-99) - 6 hours | train | med_mcqa | null |
All of the following are true of Eales disease except – | [
"Occurs in the young",
"Vitreous hemorrhage is present",
"Retinal detachment",
"Optic neuritis"
] | D | Eale's disease is characterized by recurrent bilateral vitreous hemorrhage in young adult (20-30 yrs) males.
Tractional retinal detachment may occur as a complication. Optic neuritis is not a feature of Eale's disease. | train | med_mcqa | null |
All are true regarding Primary CNS lymphoma except: | [
"Radiotherapy and chemotherapy is of no value",
"Occurs in AIDS pt.",
"Commonly occurs in immuno-compromised persons",
"EBV may be a cause /"
] | A | Ans is 'a' i.e. ie Radiotherapy and chemotherapy is of no value Primary CNS lymphomaThese are B cell malignancies that present within the neuraxis without evidence of systemic lymphoma.They occur most frequently in immunocompromised individuals, specifically organ transplant recipients or patients with AIDS.In immunocompromised patients CNS lymphomas are invariably associated with Epstein - Barr virus (EBV) infection of the tumor cells.Treatment:The prognosis of primary CNS lymphoma is poor compared to histologically similar lymphoma occurring outside the CNS.Many patients experience a dramatic and radiographic clinical response to glucocorticoids however it inevitably relapses within weeks.The mainstay of definitive therapy is chemotherapy including high-dose methotrexate. This is followed in patients < 60 years with radiotherapy.The mainstay of definitive therapy is chemotherapy.A single dose of rituximab is generally administered prior to cytotoxic chemotherapyChemotherapy includes high-dose methotrexate, but multi agent chemotherapy, usually adding vincristine and procarbazine, appears to be more effective than methotrexate alone.Chemotherapy is followed in patients <60 years with whole-brain radiation therapy (WBRT).Despite aggressive therapy >90% of patients develop recurrent CNS disease. | train | med_mcqa | null |
Which is not a feature of non cirrhotic poal HT?(not related-pathology) | [
"Ascites",
"Hematemesis",
"Splenomegaly",
"All are seen"
] | A | . | train | med_mcqa | null |
For the physical finding "Short stature, webbed neck, low-set ears, and epicanthal folds" select the cardiovascular disorder with which it is most likely to be associated. (SELECT 1 DISORDER) | [
"Massive tricuspid regurgitation",
"Aortic regurgitation",
"Coarctation of the aorta",
"Thoracic aortic aneurysm"
] | C | Myocarditis, aortitis, and pericarditis all have been described in association with Reiter syndrome; the original description included conjunctivitis, urethritis, and arthralgias. Although its cause is unknown, Reiter syndrome is associated with HLA-B27 antigen, as are aortic regurgitation, pericarditis, and ankylosing spondylitis.Short stature, webbed neck, low-set ears, and epicanthal folds are the classic features of patients who have Turner syndrome. Persons affected by the syndrome, which is commonly linked with aortic coarctation, are genotypically XO. However, females and males have been described with normal sex chromosome constitutions (XX, XY) but with the phenotypic abnormalities of Turner syndrome. Additional cardiac lesions associated with Turner syndrome include septal defects, valvular stenosis, and anomalies of the great vessels.The Argyll Robertson pupil, a pupil that constricts with accommodation but not in response to light, is characteristic of central nervous system syphilis and is associated with vascular system manifestations of this disease. Treponema pallidum invades the vasa vasorum and causes an obliterative endarteritis and necrosis. The resulting aortitis gradually weakens the aortic wall and predisposes it to aneurysm formation. Once an aneurysm has formed, the prognosis is grave.Massive isolated tricuspid regurgitation produces a markedly elevated venous pressure, usually manifested by a severely engorged (often pulsating) liver. If the venous pressure is sufficiently elevated, exophthalmos may result. Tricuspid regurgitation of rheumatic origin is almost never an isolated lesion, and the major symptoms of patients who have rheumatic heart disease are usually attributable to concurrent left heart lesions. Bacterial endocarditis from intravenous drug abuse is becoming an increasingly important cause of isolated tricuspid regurgitation.A Quincke pulse, which consists of alternate flushing and paling of the skin or nail beds, is associated with aortic regurgitation. Other characteristic features of the peripheral pulse in aortic regurgitation include the water- hammer pulse (Corrigan pulse, caused by a rapid systolic upstroke) and pulsus bisferiens, which describes a double systolic hump in the pulse contour. The finding of a wide pulse pressure provides an additional diagnostic clue to aortic regurgitation. | train | med_mcqa | null |
Which of the following is the most important interaction in the formation of cell membrane lipid bilayer and in lipid-protein interaction? | [
"Hydrophobic interactions",
"Both hydrophobic and convalent interactions",
"Covalent bonds",
"Hydrogen bonds"
] | A | Interactions in the cell membrane.
- Hydrophobic (most important)–
Between lipids- Information of lipid bilayer
Transmembrane proteins and lipids
- Van der walls interaction
Between lipids- Information of lipid bilayer
Transmembrane proteins and lipids
- Electrostatic bonds
Between transmembrane and peripheral proteins
- Hydrogen bonds
Between transmembrane and peripheral proteins
- Covalent bond (least important)
Peripheral protein with the hydrophilic end of phospholipid | train | med_mcqa | null |
PID does not include: | [
"Cervicitis",
"Endometritis",
"Peritonitis",
"Salpingitis"
] | A | Ans: A (Cervicitis) Ref: Dutta Textbook of Gynecology 5th Ed pg 124Explanation:PELVIC INFLAMMATORY DISEASE (PID)Infection of upper genital tract involvingEndometriumFallopian tubesOvariesPelvic peritoneum and surrounding structuresCervicitis is not included in PIDRisk factorsMenstruating teenagersMultiple sexual partnersNo OCP useIUCD usageSTDsProtective factorsCondomsOCPsPregnancyMenopauseWomen whose partner has done vasectomyHusband is azoospermicCausative organismsNeisseria gonorrhoae Chlamydia trachomatisMycoplasma hominisSymptomsLower abdominal painFeverLassitudeExcessive vaginal bleedingPurulent vaginal dischargeDyspareuniaFitz-Hugh Curtis syndrome--Acute salpingitis with perihepatitis causes pain in right hypochondiiumInvestigationsDischarge sent for stain and cultureLeucocytosisLaparoscopy USGTreatmentDoxy 100 mg bd.Erythromycin 500 mg qid.Tetracycline 500 mg qid. Metronidazole 500 mg bd.Azithromycin Ism single dose. Ofloxacin 400 mg bd for 7 to 14 days.For N. gonorrhoea Ceftriaxone 250 mg deep IM single dose, Ciproflox 500 mg orally single dose. | train | med_mcqa | null |
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