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In cholangiography CBD stone appears as ? | [
"Meniscus sign",
"Cut off sign",
"Slight flow of dye from the sides of stone",
"Chain of lake appearance."
] | A | Ans is a ie Meniscus sign | train | med_mcqa | null |
The principle that in spinal cord, the dorsal roots are sensory and the ventral roots are motor, is known as: | [
"Bell-Magendie law",
"Dale's principle",
"Monro-Kellie hypothesis",
"Muller's doctrine"
] | A | Bell Megendie Law: States that in spinal cord, the dorsal roots are sensory and the ventral roots are motor. Dale's principle: Same neurotransmitter is released at all branches of a neuron. Monro Kellie hypothesis: The blood volume in the cranial cavity is approximately constant. As the cranium is rigid (except in a young child) and as the brain is viually incompressible the combined volume of brain tissue, cerebrospinal fluid (CSF), and intracranial blood is nearly constant. Muller's doctrine of specific nerve energies: When a paicular nerve pathway from a paicular sense organ is stimulated, the sensation produced is that for which the receptor is specialized, no matter how the pathway was stimulated. | train | med_mcqa | null |
A female presents with persistent painful oral lesions, with acanthOlYtIZ cells. Most likely dipiosisiS | [
"Pemphigus vulgaris",
"Dermatitis herpetiformis",
"Epidermolysis bullosa",
"Bullous pemphigoid"
] | A | In pemphigus vulgaris skin involvement stas in the form of flaccid blisters. Cutaneous lesions are usually preceded by blisters and erosions of oral mucosa. HP shows a suprabasal cleft with bulla formation just above the basal layer with a tomb stone appearance and with blister cavity containing acantholytic cells and inflammatory cells. page no.280.282. Reference IADVL's concise textbook of dermatology | train | med_mcqa | null |
Teriparatide is used in treatment of: | [
"Osteoporosis",
"Breast cancer",
"PCOD",
"Hyperthyroidism"
] | A | Ans. A. OsteoporosisTeriparatide is recombinant PTH. It is given in osteoporosis as it increases the new bone formation and increase the bone mineral density. | train | med_mcqa | null |
Which of the following is present at the beginning of third week | [
"Notochord",
"Primitive streak",
"Mesoderm",
"Neural crest cells"
] | B | Epiblast cells give rise to several structure 1. Primordial germ cells by end of 2nd week. 2. Endoderm - by 3rd week 3. Mesoderm 4. Ectoderm 5. neural crest cells by IIIrd week. The most characteristic event occurring during the third week of gestation is gastrulation, the process that establishes all three germ layers (Ectoderm, mesoderm, endoderm) in the embryo. Gastrulation begins with formation of the primitive streak on the surface of epiblast. (by End of 2nd week) Epiblast gives us all three germ layers. Notochord is a derivative of mesoderm. | train | med_mcqa | null |
Evidence not used in rape is | [
"Semen in vagina",
"Semen on clothes",
"Presence of smegma bacilli in vagina",
"Presence of smegma under prepuce"
] | D | In the uncircumcised penis the presence of smegma under the prepuce and on the corona glandis rules out complete penetration because smegma will be rubbed off during intercourse. Smegma usually requires 24 hours to redeposit. Presence of smegma indicates that no sexual intercourse with full penetration is taken place within 24 hours but absence of smegma will not indicate intercourse. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 305 | train | med_mcqa | null |
Maxillary sinus drains into - | [
"Inferior meatus",
"Middle meatus",
"Superior meatus",
"Sphenoethmoidal recess"
] | B | Ans. is 'b' i.e.. Middle meatus Part of lateral nasal wallOpeningsInferiorNasolacrimal ductMiddleFrontal sinus, Maxillary sinus, Anterior ethmoidal sinusSuperiorPosterior ethmoidal sinusSphenoethmoidal recessSphenoid sinus | train | med_mcqa | null |
Three days after undergoing an operation for an abdominal aortic aneurysm, a patient has moderate fever, abdominal pain, and rectal bleeding. What is the most helpful investigation? | [
"Angiography",
"Upper GI endoscopy",
"Abdominal ultrasound",
"Sigmoidoscopy"
] | D | In a patient with abdominal aortic aneurysm resection, the most worrisome complication is inadequate blood supply to the sigmoid colon through the marginal artery. Sigmoid ischemia should be ruled out by sigmoidoscopy. In the clinical picture described, sigmoidoscopy should be the most important test. | train | med_mcqa | null |
Best way to prevent infection after cataract surgery is | [
"Antibiotics",
"Eye brow shaving",
"Through irrigation",
"None of the above"
] | A | Topical antibiotics such as tobramycin or gentamicin or ciprofloxacin QID for 3 days just before surgery is advisable as prophylaxis against endophthalmitis.Ref: Khurana; 4th edition; Pg- 184 | train | med_mcqa | null |
PCR detects | [
"Antigen",
"Antibody",
"Nucleic acid",
"All of the above"
] | C | Polymerase chain reaction (PCR) is a technique used in molecular biology to amplify a single copy or a few copies of a piece of DNA across several orders of magnitude, generating thousands to millions of copies of a paicular DNA sequenceRef: DM Vasudevan, 7th edition, page no: 638 | train | med_mcqa | null |
Tumor markers of ovarian cancer is- | [
"CA125",
"CA19-9",
"AFP",
"hCG"
] | A | Ans. is 'a' i.e., CA 125 | train | med_mcqa | null |
A 7-year old male child presents with normal vision 6/6 in the right eye and hand movement perception close to the face in the left eye. On fundoscopy, his right eye was normal and left eye showed retinal detachment, subretinal yellowish exudates and telangiectatic vessels. The most likely diagnosis is: | [
"Coats' disease",
"Sympathetic ophthalmitis",
"Familial exudative vitreoretinopathy",
"Retinopathy of prematurity"
] | A | Ans. a. Coats' disease | train | med_mcqa | null |
A 31 year old male, with mood disorder, on 30 mg of haloperidol and 100 mg of lithium, is brought to the hospital emergency room with history of acute onset of fever, excessive sweating, confusion, rigidity of limbs and decreased communication for a day. Examination reveals tachycardia and labile blood pressure and investigations reveal increased CPK enzyme levels and lecocytosis. He is likely to have developed. | [
"Lithium toxicity",
"Tardive dyskinesia",
"Neuroleptic malignant syndrome",
"Hypeensive encephalopathy"
] | C | C i.e. Neuroleptic malignant syndrome | train | med_mcqa | null |
A 48 year old woman was admitted with a history of weakness for two months. On examination, she has enlarged cervical lymph nodes and spleen. Her hemoglobin was 10.5 g/dl, platelet count 2.7 x 109/L and total leukocyte count 40 x 109/L, which included 80% mature lymphoid cells with coarse clumped chromatin. Bone marrow revealed a nodular lymphoid infiltrate. The peripheral blood lymphoid cells were positive for CD 19, CD5, CD20 and CD23 and were negative for CD79B and FMC-7. The histopathological examination of the lymph node in this patient, will most likely exhibit effacement of lymph node arachitecture by: | [
"A pseudofollicular pattern with proliferation centers",
"A monomorphic lymphoid proliferation with a nodular pattern",
"A predominantly follicular pattern",
"A diffuse proliferation of medium to large lymphoid cells with high mitotic rate"
] | D | Patient in the question stem is showing features of chronic lymphocytic leukemia. Histopathological examination in a case of CLL shows diffuse effacement of lymphocyte architecture by small to medium sized lymphocytes with clumped chromatin, indistinct or absent nucleoli and scanty cytoplasm. Chronic lymphocytic leukemia (CLL) is a clonal malignancy of B lymphocytes. It is manifested clinically by immunosuppression, bone marrow failure, and organ infiltration with lymphocytes. Ref: Current Medical Diagnosis and Treatment, 2012, Chapter 13 | train | med_mcqa | null |
Regular drinking of which of the following can help prevent Urinary tract infection (UTI)? | [
"Grape juice",
"Orange juice",
"Cranberry juice",
"Raspberry juice"
] | C | Cranberry juice Proanthocyanidins in Cranberry juice prevent bacterial fimbriae from attaching to wall of urinary bladder and urinary tract . Thus, drinking cranberry juice helps in preventing UTI. - Also remember, E.coli is the most common cause of UTI. | train | med_mcqa | null |
Transplantation of an organ to other than its normal location
is called as | [
"Isograft",
"Allograft",
"Heterotopic graft",
"Orthotopic graft"
] | C | Transplantation of an organ to other than its normal location is called as heterotopic transplant. Ex- kidney in iliac fossa, liver in subhepatic space. | train | med_mcqa | null |
The movement at the following joint permits a person to look towards the right or left : | [
"Atlanto-occipital joint",
"Atlanto-axial joint",
"C2-C3 joint",
"C3-C4 joint"
] | B | B. i.e. Atlanto - Axial Joint Atlanto - occipital (b/w skull & C1) joint permit nodding of head (as when indicating approval or yes)& Atlantoaxial joint permits the head to be turned from side to side i.e. rotation (as indicating disapproval, the no movement) | train | med_mcqa | null |
The commonest tumor of parotid is - | [
"Mucoepidermoid",
"Mixed parotid tumour",
"Adenolymphoma",
"Squamous cell carcinoma"
] | B | null | train | med_mcqa | null |
Asymptomatic Gall stone> 3cm what is the treatment - | [
"Laparoscopic cholecystectomy",
"Cholecystectry",
"Dissolution therapy",
"ERCP"
] | A | Ans. is 'a' i.e., Laparoscopic cholecystectomy Indications of cholecystectomy in asymptomatic gallstones:1) Large stone, >3 cm in diameter2) Multiple small stones (more chances of passing into CBD and causing obstruction)3) Stone associated with polyp.4) Calcified gall bladder (Porcelain gall bladder).5) Congenitally anomalous gall bladder.6) Gall stones with diabetes (because emphysematous cholecystitis is common in diabetics with gall stones).7) Immuno compromised patients (because complication rate is high).8) Transplant patients (because they are on immuno suppressants).* Few authorities are now also recommending routine cholecystectomy in all young patients with silent stones. | train | med_mcqa | null |
An auto rickshaw ran over a child's thigh, there is a mark of the tyre tracks, it is an example of: AIIMS 10 | [
"Patterned bruise",
"Patterned abrasion",
"Pressure abrasion",
"Graze abrasion"
] | B | Ans. Patterned abrasion | train | med_mcqa | null |
About Hepatitis A vaccine schedule, true are all of the following EXCEPT? | [
"Recommended at age of 12 months",
"2 dose of killed vaccine 6 months apa",
"1 dose of live vaccine",
"Recommended only in immunocompromised children"
] | D | As per IAP, dose of Hepatitis A vaccine is: - Inactivated vaccine - given in child >1yr of age - 2 doses; 6 months apa - Live attenuated vaccine - given in child >1yr of age - 1 dose of H2 strain - IAP recommends Hep-A vaccination to all children | train | med_mcqa | null |
"Snowman" sign is seen in: | [
"TGV",
"TOF",
"TAPVC",
"Aoic dissection"
] | C | C i.e., TAPVC | train | med_mcqa | null |
Spores are disinfected by - | [
"Ethylene oxide",
"Betapropiolactone",
"Formaldehyde",
"Hexachlorophen"
] | C | Ananthanarayan & Panicker's Textbook of Microbiology 9th edition pg no:34 Formaldehyde is active against the amino group in a protein molecule. In aqueous solution, it is markedly bactericidal and sporicidal and also has a lethal effect on viruses | train | med_mcqa | null |
Which of the following does not represent a fascial space for the spread of infection? | [
"Superficial temporal space",
"Pterygomandibular space",
"Masseteric space",
"Rhinosoteric space"
] | D | The superficial temporal, pterygomandibular, masseteric, and submental spaces are potentially involved in the odontogenic infection. There is no rhinosoteric space. | train | med_mcqa | null |
Cricothyroid joint is a | [
"Hinge joint",
"Hyaline joint",
"Atavistic joint",
"Synol joint"
] | D | Cricothyroid joint is a synol joint. Each is formed by inferior cornu of thyroid cailage with a facet on cricoid cailage. Cricoid cailage rotates at these joints on a transverse axis which passes transversely through these joints. | train | med_mcqa | null |
In "bounce home" test of knee joint, end feel is described as all except? | [
"Bony",
"Empty",
"Springy",
"Firm"
] | B | End point in bounce home test may be :-
(i) Springy,
(ii) Bony hard,
(iii) Firm.
Empty end-feel is not seen in bounce home test.
Empty end-feel implies: the examiner feels no restriction to movement, the patient stops the movement due to severe pain. An example is shoulder impingement, in which pain from the supraspinatus tendon being compressed will limit how far the arin can be abducted. Mechanically there is no further restriction, but the pain will prevent the individual from allowing further motion. | train | med_mcqa | null |
White infarct is seen in - | [
"Lung",
"Intestine",
"Liver",
"Ovary"
] | C | Ans. is 'c' i.e., Liver | train | med_mcqa | null |
Hardness of drinking w ater should be? | [
">3",
"l",
"3-Jan",
">6"
] | C | Ans. is 'c' i.e., 1-3 o Drinking water should be moderately hard (1-3 meq/Lit) Park 2la/ep. 672o Softening of water is recommended when the hardness exceeds 3meq/L (150 mg'L).Hardness of watero Hardness of water is defined as the soap-destroying power of water,o Water is considered to be bard if large amounts of soap are required to produce lather.o The hardness is caused by high mineral content, Mainly calcium and magnesium cations,o Hardness may be : -i) Temporary (Carbonate) hardness - Calcium bicarbonate & Magnesium bicarbonate.# It is called temporary because it can be removed by boiling or addition of lime.ii) Permanent (Non-Carbonate) hardness - Calcium Sulfate, magnesium sulfate, Calcium chloride, magnesium chloride# It is called permanent because it cannot be removed by boiling,o Hardness is expressed in terms of mili-equilents per litre (mEq/L).o One mEq/L of hardness - producing ion is equal to 50 mg CaCO3 (50ppm) in one litre of water.Classification of hardness in waterClassificationLevel of hardness (mEqjlitre)a) Soft waterb) Moderately hardc) Hard waterd) Very hard waterLess than 1 (< 50 mg/L)1-3(50- 150 mg/L)3-6(I50-300mg/L)Over 6 (> 300 mg/L) | train | med_mcqa | null |
All of the following drugs are useful in destrussor instability EXCEPT: | [
"Solefenacin",
"Tolterodine",
"Flavoxate",
"Duloxetine"
] | D | Ref:KD Tripathi pharmacology 7th edition (page.no: 117,118, 462) Vesicoselective drugs are used for detrusor instability resulting in urinary frequency and urge incontinence. It selectively blocks M1/M3 subtypes. Example are Oxybutynin, Tolterodine, Flavoxate, Darifenacin, Drotaverine, Solifenacin. Duloxetine is an SNRI. it is neither sedative nor anticholinergic, nor antihistaminic, nor a blocker | train | med_mcqa | null |
Which of the following is the earliest finding seen in Diabetic nephropathy? | [
"Hematuria",
"Macroalbuminuria",
"Microalbuminuria",
"Exudates"
] | C | Sequence of changes in Diabetic nephropathy: Increase in GFR (EARLIEST MANIFESTATION) Microalbuminuria (30-300 mg/gm (moderately | albuminuria)) Macroalbuminuria End stage renal disease. NOTE: Microalbuminuria is the Most Reliable marker of diabetic nephropathy. | train | med_mcqa | null |
Local anaesthesia causing methemoglobinemia ? | [
"Procaine",
"Prilocaine",
"Etodicaine",
"Ropivacaine"
] | B | Ans. is 'b' i.e., Prilocaine Prilocaine and benzocaine can cause methemoglobinemia. Impoant facts Chlorprocaine is the shoest acting LA. Dibucaine is the longest acting, most potent and most toxic LA. Bupivacaine is the most cardiotoxic LA (Ropivacaine is a newer bupivacaine congener with less cardiotoxicity). o Levobupivacaine (The S (-) enantiomer of bupivacaine) is less cardiotoxic and less prone to cause seizure. o Prilocaine can cause Met haemoglobinemia. Lignocaine is the most commonly used LA. Bupivacaine has the highest local tissue irritancy. Chlorprocaine is contraindicated in spinal anaesthesia as it can cause paraplegia due to presence of neurotoxic preservative sodium metabisulphite. Procaine is the LA of choice in malignant hypehermia | train | med_mcqa | null |
Increased Reid index is classically associated with? | [
"Chronic Bronchitis",
"Emphysema",
"Bronchiectasis",
"Interstitial lung disease"
] | A | The diagnostic feature of chronic bronchitis in the trachea and larger bronchi is enlargement of the mucus secretinggland . The magnitude of the increase insize is assessed by the ratio of the thickness of the submucosal gland layer to that of the bronchial wall (the Reid index--normally 0.4). Chronic smoking causes submucosal gland hyperophy and hyperplasia, leading to a Reid Index of >0.5 indicating chronic bronchitis. | train | med_mcqa | null |
Anaesthesia used in microlaryngoscopy is | [
"Pollarad tube of 10 mm diameter with heavy sedation",
"Pollarad tube of 15 mm diameter with topical xylocaine",
"Pollarad tube with infiltration block",
"Heavy sedation on and Endotracheal intubation"
] | C | C i.e. Pollarad tube with infiltration block When fire breaks out during laser vocal cord surgery, oxygen should be turned off, ventilation stopped, tracheal tube removed and submerged in water and the patient should be ventilated with facemasK. Airway damage is assessed with bronchoscopy and bronchial lavage, steroids, can be used for treatment. Anesthesia for Endoscopic Surgeries of Airway Endoscopy includes laryngoscopy, microlaryngoscopy (i.e. aided by an operating microscope), bronchoscopy & oesophagoscopy. These procedures may be accompanied by laser surgery. Microlaryngoscopic surgeries include biopsy / surgery of laryngeal malignancy, vocal cord polyps etc. It is associated with some specific problems as - common field for anesthetist & surgeon, already reduced glottic opening d/t growth, laryngospasm (mediated by superior laryngeal nerve) d/t laryngeal stimulation, very high chances of aspiration and myocardial ischemia (- 4% due to sympethetic stimulation). Preoperative Considerations - Sedative premedication is contraindicated in any patient with any significant degree of upper airway obstructionQ, d/t fear of aspiration. Glycopyrrolate, 1 hour before surgery minimize secretions, thereby facilitate ventilation. Pethidine & promethazine are only given if there is no airway obstruction. Laser Precautions General laser precautions include wearing protective spectacles to prevent retinal damage and evacuation of toxic fumes (laser plume) from tissue vaporization which may have potential to transmit microbacterial diseases. Greatest fear during laser airway surgery is a tracheal tube fire. This can be avoided by using a technique of ventilation that does not involve a flammable tube or catheter (eg intermittent apnea or jet ventilation through the laryngoscope side po). The potential fuel source should have laser resistant propeies (laser tubes or wrapping a tracheal tube with metallic tape) or be removed (supraglottic jet ventilation technique). The only non inflammable, laser proof tube is the all metal. Noon tube, which has no cuff. Most laser tubes have laser resistant propeies around the shaft, but the cuff is not protected and can ignite. So there are double cuffs to seal the airway- if upper cuff is struck by laser and saline escapes, the lower cuff will continue to seal the airway. No cuffed tracheal tube, or any currently available tube protection is completely laser proof. Therefore, whenever laser airway surgery is being performed with a tracheal tube in place, the following precaution should be observed. - Inspired 02 conc. should be as low as possible may be upto 21% - N20 suppo combustion & should be replaced with air (N2) or heliumQ - Tracheal tube cuffs should be filled with saline dyed with methylene blue to dessipate heat & signal cuff rupture - A cuffed tube will minimize 02 conc. in the parynx. The addition of 2% lidocaine jelly (1:2 mixture with saline) can seal small laser induced cuff leaks, potentially preventing combustion - Laser intensity & duration should be limited as much as possible. - Saline soaked pledgets (completely saturated) should be placed in the airway to limit risk of ignition. - A source of water (60 ml) should be immediately available in case of fire. Muscle Relaxation Profound muscle relaxation is the aim to provide masseter muscle relaxation for introduction of suspension laryngoscope & an immobile surgical field. - Anesthesia is induced with IV induction agent followed by a non depolarizing muscle relaxant; the vocal cords are sprayed with 3 ml lidocaine 4% to assist smooth anesthesia & to minimize the possibility of postextubation laryngospasmQ - Alternatively the cords may be painted with 3% cocaine at the end of procedure, which has the added advantage of reducing bleeding from operative site. Oxygentation & Ventilation - Microlaryngoscopy tubes are long, have a small internal and external diameter, and are designed specifically for endoscopic procedures (but not suitable for laser surgery). Typically 4 to 5 mm internal diameter tubes with high volume, low pressure cuffs are used in nasal or oral versions. The most popular anesthetic technique use a Coplan's microlaryngoscopy tube (5mm ID, 31cm long, 10m1 cuff volume and constructed from soft plastic). It is designed for micro laryngeal surgery or for patient whose airway has been narrowed to such an extent that a normal sized tracheal tube cannot be inseed. The small tube diameter provides better visibility and access to surgical field but may lit incomplete exhalation and occlusion. - Most commonly the patients are intubated with small diameter (4 - 6 mm) tracheal tubesQ; - Standandard tracheal tubes of this size, however, are designed for pediatric patients. They tend to be too sho for adult trachea (in length)Q with a low volume cuff that will exe high pressure against it - A 4 - 6 mm microlaryngea tracheal (MLT) tubes (Mallinckrodt critical Care) is the same length as the adult tube, has dispropoionately large high volume low pressure cuff, and is stiffer and less prone to compression than a regular tracheal tube. - The advantages of intubation include - protection against aspiration, and the ability to administer inhalational anesthetics and enable monitoring of ventilation by capnography and spirometry, by measuring end tidal CO2Q - In some cases (eg those involving posterior commissure), intubation may interfere with surgeon's visualization and then alternatives are: 1.Insufflation of high flows of oxygen through small catheter placed in the trachea 2. Intermittent apnea technique. Jet ventilation through laryngoscope High frequency positive pressure ventilation (HFPPV) | train | med_mcqa | null |
A 63-year-old woman has noticed weakness in her right hand such that she is having difficulty writing and doing up buttons. On examination, there is marked atrophy of the forearm and hand muscles with fasciculations. Tone is increased and reflexes are brisk. Sensory testing in the hand is normal. There are also fasciculations on her thighs, which she has never noticed before.For the above patient with muscle weakness, select the most likely anatomic site for the disorder | [
"anterior horn cell",
"peripheral nerve",
"neuromuscular junction",
"muscle"
] | A | In diseases of the anterior horn cell (such as ALS), atrophy is marked and early. Muscle disease can result in marked atrophy, but much later in the course of the disease. Atrophy is generally moderate in peripheral nerve disease and absent in disorders of the neuromuscular junction. | train | med_mcqa | null |
The chemical used to etch enamel is: | [
"Zinc oxide",
"Methyl methacrylate",
"Phosphoric acid",
"Eugenol"
] | C | Etchants are relatively strong acids (pH = 1–2) used to remove smear layers and to dissolve the mineral phase to allow formation of micromechanical interlocking in enamel and in dentin. A number of acidic agents have been used to produce the required microporosity. However, phosphoric acid at a concentration between 30% and 50%, typically 37%, is the preferred etching agent to produce consistent etching patterns while not damaging the pulp.
Reference: PHILLIPS’ SCIENCE OF DENTAL MATERIALS, 12th ed page no 262 | train | med_mcqa | null |
Reed sternberg cells are found in | [
"Hodgkin's disease",
"Sickle cell anaemia",
"Thalassemia",
"CML"
] | A | * Reed-Sternberg cells * They are usually derived from B lymphocytes, classically considered crippled germinal center B cells. * Seen against a sea of B cells, they give the tissue a moth-eaten appearance. * They are named after Dorothy Reed Mendenhall and Carl Sternberg, who provided the first definitive microscopic descriptions of Hodgkin&;s disease. * Reed-Sternberg cells are large and are either multinucleated or have a bibbed nucleus (thus resembling an "owl&;s eye" appearance) with prominent eosinophilic inclusion-like nucleoli. * Reed-Sternberg cells are CD30 and CD15 positive, usually negative for CD20 and CD45. * The presence of these cells is necessary in the diagnosis of Hodgkin&;s lymphoma - the absence of Reed-Sternberg cells has very high negative predictive value. * They can also be found in reactive lymphadenopathy (such as infectious mononucleosis, carbamazepine associated lymphadenopathy) and very often in other types of non-Hodgkin lymphomas. * A special type of Reed-Sternberg cells is the lacunar histiocyte, whose cytoplasm retracts when fixed in formalin, so the nuclei give the appearance of cells that lie with empty spaces (called lacunae) between them. These are characteristic of the nodular sclerosis subtype of Hodgkin&;s lymphoma REF : HARRISONS 21ST ED | train | med_mcqa | null |
Insulin release is by: | [
"Endocytosis",
"Exocytosis",
"Active transport",
"Facilitated diffusion"
] | B | Ans: b (Exocytosis) Ref: Vasudevan, 4th ed, p.107Insulin is secreted by exocytosis.Secretion of insulin:The insulin is packed in to granules in the Golgi apparatus.The insulin molecules associate into a hexamer with two zinc ions and one calcium ion. The contents of granules are released by exocytosis; both insulin and C-peptide are released into circulation.Degradation of insulin:Insulin is rapidly degraded in liver. Plasma half life is less than 5 minutes.An insulin specific protease (insulinase) and a hepatic glutathione- insulin- trans hydrogenase are involved in degradation of insulin.Note:Glucose is the major stimulant of insulin secretion.Pro insulin has about one third biological activity of insulin. | train | med_mcqa | null |
Which of following is not derived from first pouch? | [
"Auditory tube",
"External acoustic meatus",
"Tympanic cavity",
"Mastoid antrum"
] | B | Ans. is'b' i.e., External acoustic meatus Ref: Langman's Medical Embryology 12th/e p. 326,366 | train | med_mcqa | null |
Which of the following is not true about Brugada syndrome | [
"SCN5A defect",
"Asymptomatic ST segment elevation",
"Sudden death",
"Pacemaker is the treatment of choice"
] | D | Brugada syndrome (BrS) is a genetic disorder in which the electrical activity within the hea is abnormal. It increases the risk of abnormal hea rhythms and sudden cardiac death. Diagnosis is typically by electrocardiogram (ECG), however, the abnormalities may not be consistently present. About a quaer of those with Brugada syndrome have a family member who also has the condition.Some cases may be due to a new genetic mutation or ceain medications. The most commonly involved gene is SCN5A which encodes the cardiac sodium channel.Diagnosis is typically by electrocardiogram (ECG), however, the abnormalities may not be consistently present.Medications such as ajmaline may be used to reveal the ECG changes.Similar ECG patterns may be seen in ceain electrolyte disturbances or when the blood supply to the hea has been reduced. There is no cure for Brugada syndrome.Those at higher risk of sudden cardiac death may be treated using an implantable cardioveer defibrillator (ICD) In those without symptoms the risk of death is much lower, and how to treat this group is less clear. Isoproterenol may be used in the sho term for those who have frequent life-threatening abnormal hea rhythms, while quinidine may be used longer term.Testing people's family members may be recommended While many of those with Brugada syndrome do not have any symptoms, Brugada syndrome may cause fainting or sudden cardiac death due to serious abnormal hea rhythms such as ventricular fibrillation or polymorphic ventricular tachycardia.Blackouts may be caused by brief abnormal hea rhythms that reve to a normal rhythm spontaneously. If a dangerous hea rhythm does not stop by itself and is left untreated, the person may have a fatal cardiac arrest. However, blackouts can occur in those with Brugada syndrome despite a normal hea rhythm due to a sudden drop in blood pressure, known as vasovagal syncope. The abnormal hea rhythms seen in Brugada syndrome often occur at rest, following a heavy meal, or even during sleep.These situations are linked to periods when the vagus nerve is activated, referred to as periods of high vagal tone. Abnormal hea rhythms may also occur during fever or following excessive alcohol. Ceain medications may also worsen the tendency to abnormal hea rhythms in patients with Brugada syndrome and should be avoided by these patients. Ref Davidson 23rd edition pg 440 | train | med_mcqa | null |
The least radio sensitive tissue is | [
"Nervous tissue",
"Bone",
"Kidney",
"Thyroid"
] | B | Ans. is 'b' i.e., Bone | train | med_mcqa | null |
Echinococcus granulosus are commonly seen in which of the given animals: | [
"Dog",
"Cat",
"Fox",
"Pig"
] | A | Ans. a. DogRef: Jawetzs Medical Microbiology 27th Ed; Page No-727 &736E. granulosus is a small, three-segmented tapeworm found only in the intestine of dogs and other canids.It is called as dog tapeworm.E. granulosus eggs are morphologically similar to Taenia eggs, consists of an oncosphere with six hooklets surrounded by an embryophore.The larva of E. granulosus is called a hydatid cyst. It is unilocular, sub spherical, shape and size varies from few millimeters to more than 30 cm. (Usually 5-8 cm). It appears as fluid filled bladder like cyst.E. granulosus: IH: herbivores; rare: humans DH: carnivores in sheep-raising areas. Definitive host = adult tapeworm develops in; intermediate host=cysticerci or larvae develop in; cysticerci=encysted larvae found in intermediate host. Common name is in parentheses.Parasite/Disease: Echinococcus granulosus (larval)/Hydatid disease, hydatid cystSite of infection: Hydatid cyst in liver, spleen, lungs, brain, peritoneumMechanism of infection: Contact with dogs, foxes, other canids; eggs from fecesDiagnosis: CT scans, MRI, X-rays, serologyTreatment: Albendazole, surgical removalGeographic Area: Worldwide, especially sheep-raising area | train | med_mcqa | null |
A 48-year-old lady presented with hepatosplenomegaly with pancytopenia. On bone marrow examination, a tissue paper crumpled appearance is seen. Which is the most likely product to have accumulated? | [
"Glucocerebroside",
"Sphingomylin",
"Sulfatide",
"Ganglioside"
] | A | Ans. (a) Glucocerebroside(Ref: R 9th/pg 151; 8th/pg 151)The clinical feature and bone marrow feature is typical of Gauchers disease. This results due to accumulation of cerebroside Q inside mononuclear phagocytic cells due to deficiency of b-glucocerebrosidase. | train | med_mcqa | null |
A child had hematuria and nephrotic syndrome (minimal change disease) was diagnosed. True about it is - | [
"A type of focal segmental GN",
"IgA deposition on basement membrane",
"Foot process of glomerular membrane normal",
"Glomerular function is lost due to loss of poly charge on both sites of glomerular foot process."
] | D | null | train | med_mcqa | null |
An absolute contraindication for extraction of teeth is: | [
"Hypertension",
"Myocardial infarction",
"Thyrotoxicosis",
"Central hemangioma"
] | D | null | train | med_mcqa | null |
All are indication of evoked potential monitoring except:- | [
"Cerebral tumor resection",
"Brachial plexus repair",
"Mastoid surgery",
"Spinal fusion and instrumentation"
] | C | Indications for intraoperative monitoring of evoked potential include surgical procedures with possible neurological insult. 1. Spinal fusion & instrumentation 2. Spine & spinal cord tumor resection 3. Brachial plexus repair 4. Thoracoabdominal aoic aneurysm repair 5. It also facilitate probe localization during stereotactic surgery | train | med_mcqa | null |
All are complements of the basement membrane except | [
"Nidogen",
"Laminin",
"Entactin",
"Rhodopsin"
] | D | Basement membrane is periodic acid schiff (PAS) positive amorphous structures that lie underneath epithelia of different organs and endothelial cells .it consists of laminin ,proteoglycand ,collagenref Robbins 7/e p103 ,9/e p24 | train | med_mcqa | null |
The following is not true of candida albicans - | [
"Yeast like fungus",
"Forms chlamydospores",
"Blastomeres seen in isolates",
"Causes meningitis in immunocompromised"
] | C | Candida (GPOBYC) is yeast like fungi. Chlamydospores are typically produced by C. albicans on cornmeal agar at 25degC, but not by other Candida species. C. albicans can cause meningitis in immunocompromised patients. Blastomere - seen in Hookworm egg | train | med_mcqa | null |
Vaccine associated paralytic poliomyelitis is suspected if AFP develops within how many days of receipt of OPV? | [
"30",
"45",
"60",
"90"
] | B | Vaccine associated paralytic poliomyelitis: Acute onset flaccid paralysis within 4 to 30 days of receipt of OPV or within 45 to 75 days of contact with a vaccine recipient and neurological deficits remaining 60 days after onset or death. Ref: Park 21st edition, page 105. | train | med_mcqa | null |
Misoprostol has been found to be effective in all of the following, EXCEPT: | [
"Medical method of aboion",
"Induction of labor",
"Menorrhagia",
"Prevention of postpaum hemorrhage (PPH)"
] | C | Misoprostol is a prostaglandin E1 analog having positive effect on myometrial contractility irrespective of duration of gestation. Hence, it helps in expulsion of fetus in aboion, as well as to control hemorrhage from opened sinuses in an atonic postpaum uterus (800 micrograms per rectally). It effects cervical ripening and is used for induction of labor. misoprostol does not hold any value for menorrhagia management. | train | med_mcqa | null |
Colour change in metamorphic calcification | [
"Yellowish discoloration",
"Pinkish discoloration",
"Brownish discoloration",
"Greyish discoloration"
] | A | null | train | med_mcqa | null |
According to the location, a pulp stone partly surrounding by pulp and fused to dentine is called as: | [
"Attached pulp stone.",
"Embedded pulp stone.",
"Free pulp stone.",
"None."
] | A | null | train | med_mcqa | null |
Behavioral therapy is done in - | [
"Schizophrenia",
"Agoraphobia",
"Delirium",
"Neurotic depression"
] | B | Ans. is 'b' i.e., Agoraphobia o Most important use of behavioral therapy:- Phobia & OCD.o Other uses are:- Other anxiety disorders (including panic), eating disorders, Autism, ADHD, some personality disorders, sexual dysfunctions, depression.# Behaviour therapy is based on the assumption that all behaviours (normal or abnormal) are learning response. Normal and abnormal behaviours are subject to the laws of learning and the same laws can be used to change them. Behaviour therapty is based on theories of learning and aims at changing the maladaptive behaviour and substituting it with adaptive behaviour. Some common behavioral techniques are:-a) Systemic desensitizaiton:- It is based on the principle of reciprocal inhibition, i.e., if a response is incomaptible with anxiety is made to occur at the same time as an anxiety provoking stimulus then anxiety is reduced by reciprocal inhibition. In this technique first the patient is trained by relaxation technique to decrease anxiety and muscular tension. Then the patient is exposed serially to a predetermined list of anxiety - provoking stimuli graded in a hierarchy from the least to most anxiety provoking stimuli. The patient is advised to signal whenever anxiety occurs. With each signal, patient is asked to relax (as during relaxation technique). After a few trials patient is able to control anxiety. Then the patient moves up to next stimulus level (according to Hierarchy). Thus, gradually the hierarchy climbed till the maximum anxiety provoking stimulus can be faced in the absence of anxiety. Systemic desensitization are used in phobia and OCD.b) Therapeutic-graded exposure:- Therapeutic-graded exposure is similar to systemic desensitization, except that relaxation training is not involved and treatment is usually carried out in a real-life context. This means that the individual must be brought in contact with (i.e., be exposed to) the warning stimulus to learn firsthand that no dangerous consequences will ensue. Exposure is graded according to a hierarchy. For example, Patient afraid of cats might progress from looking at a picture of cat to holding one.c) Exposure & response prevention:- Patient is exposed to a situation (intentional contamination of hand) which ordinarily produces in him a strong urge to carry out rituals (for example hand washing). However, he is prevented from carrying out rituals (e.g., by shutting of water). The anxiety which mounts up dissipates after sometime. It is particularly useful for OCD and some types of phobias.d) Flooding:- This is based on the assumption that fear dissipates when the subject is not allowed to escape from the scene. The subject is exposed to the fear provoking situations abruptly and not in a graded way as in systemic desensitization and without any attempt to reduce anxiety. The sessions continue till fear dissipates.e) Aversion therapy:- Aversion therapy is used for the treatment of conditions which are pleasant but undesirable (e.g., alcoholism, sexual deviation, drug abuse, smoking). The underlying principle is the pairing of the pleasant stimulus (e.g., alcohol) with an unpleasant response (e.g., brief electric stimulus).f) Operant conditioning procedure for decreasing a behavior:-i) Positive punishment:- On performing an undesired behavior an aversive stimulus is given.ii) Negative punishment:- On performance of an undesired behavior, reward is avoided. | train | med_mcqa | null |
A patient with ischemic heart disease, diagnosed with migraine; indicated drug in this case is: | [
"Propranolol",
"Triptans",
"Ergotamines",
"Butorphanol"
] | D | For patients with a history of CAD, triptans or ergotamine are contra-indicated, therefore opioids like intranasal butorphanol should be used for acute severe migraine. | train | med_mcqa | null |
Fleischer ring is characteristic of – | [
"Megalocornea",
"Diabetes",
"Chalcosis",
"Keratoconus"
] | D | Some guides have also given option c as the answer, which is incorrect.
Some confusion exists between Fleisher rings and kisser- Fleischer (KF) ring. Kayser- Fleischer(KF) rings are caused by copper deposits and are indicative of Wilson's disease, whereas Fleischer rings are caused by iron deposits and are indicative of keratoconus.
Cornea is thin (not thick).
Rigid gas permeable contact lenses (not soft contact lenses) are used. | train | med_mcqa | null |
Antagonist which generates an action opposite to a substance but by binding to the different receptors is known as: | [
"Physical antagonist.",
"Chemical antagonist.",
"Physiological antagonist.",
"Pharmacologic antagonist."
] | C | null | train | med_mcqa | null |
MDRD (Modification of Diet in Renal Disease) formula for estimation of GFR does not include which of following? | [
"Age",
"Sex",
"Race",
"Body weight"
] | D | Answer- D. Body weightMDRD Formula includes:AgeSex (Multiply by 0.742 for women)Race (Multiply by l.2l for African Americans) | train | med_mcqa | null |
All but one are true regarding levator ani musle | [
"Levator ani muscles constitute pelvic diaphragm",
"Contraction of levator pulls rectum and vagina towards symphysis pubis",
"Insertion of the muscle is fixed",
"Internal rotation of presenting part during delivery is assisted by levator muscles"
] | C | The origin of levator muscle is fixed because muscle arises anteriorly from bone (pubis) and is inserted into anococcygeal raphe or coccyx, both of which are moveable. | train | med_mcqa | null |
"Figure of 8" on chest X-ray is a sign associated with- | [
"Fallot's tetralogy",
"TAPVC",
"TGA",
"Ebstein's anomaly"
] | B | Ans. is 'b' i.e., TAPVC * Snowman" or figure of 8" or "Cottage loaf sign" is seen in supracardiac TAPVC.Radiological features of Congenital heart diseasesVentricular septal defect(VSD)1) Small:- Normal chest x-ray2) Large :-a. Cardiomegalyb. Enlarged left atrium with widening of carina.c. Increased pulmonary vascularity (pulmonary plethora)d. Pulmonary edemae. Small aortic knobAtrial septal defect1) SmallNormal2) Largea. Mild cardiomegalyb. Normal or enlarged pulmonary arteryc. Increased pulmonary vascularity (Pulmonary plethora)d. Enlarged right atrium and right ventriclee. Left atrium is not enlarged (in contrast to VSD)f. Small aortic knobTransposition of greatArteries (TGA)a. Cardiomegaly (Globular heart)b. "Egg on Side" appearancec. Pulmonary plethorad. Absent thymic shadowTotal anamalous pulmonary venous connection (TAPVC)a. Cardiomegalyb. Pulmonary plethorac. "Snowman" or figure of 8" or "Cottage loaf sign" (In supracardiac TAPVC),d. "Ground glass" lung (in obstructive TAPVC)Tetralogy of Fallota. Boot shaped heart (Coeur en Sabot)b. Pulmonary oligemiac. Normal sized heart (no cardiomegaly)d. Right aortic arch (in 25% cases)Patient ductus arteriosus (PDA)a. Cardiomegalyb. Enlarged left atriumc. Increased pulmonary vascularity (pulmonary plethora)d. Pulmonary edemae. Prominent aortic knob (in contrast to VSD)f. Ductus bump (due to enlarged PDA) at the level of aortic knobCoarctation of Aorta (CoA)a. Reverse figure of 3 sign or double bulge sign or 'E' sign on left border of aortic shadow is formed by (above downward) : - Prestenotic dilatation; coarctation itself (indentation); poststenotic dilatation.b. Double aortic knucklec. Dock's sign:- There is bilateral notching of inferior margins of 3-8 ribs. Rib notching is absent in the 1st & 2nd ribs because first and second intercostal arteries do not take part in the collateral circulation. Rib notching increases with age and after the age of 7 years, rib notching is present in almost all the cases. | train | med_mcqa | null |
The probable cause of sudden death in a case superficial Injury to neck is : | [
"Injury to phrenic nerve",
"Air embolism through external jugular vein",
"Bleeding from subclavian artery",
"Injury to trachea"
] | B | Ans. (b) Air embolism through external jugular vein* Air gets sucked inside due to negative pressure in Major venous injuries in neck | train | med_mcqa | null |
True statement regarding Brain Tumor in children is - | [
"Mostly is infra - tentorial",
"Papilledema is rare",
"Is the most common tumour in children",
"Hydrocephalus is rare"
] | A | Ans. is 'a' i.e., Mostly is infra-tentorial` Brain tumors in children o Brain tumors are the second most common malignancy of childhood next only to leukemia. o Brain tumors are the most common solid cancer of childhood. o Over two-thirds of brain tumors are infratentoterial. o Most of these tumor occur near the midline --/ commonly obstruct CSF circulation and cause hydrocephalus early in disease. These can also cause T ICT and papilledema (In infants papilledema may be absent because of open sutures and bulging fontanelle). o There is age related differences in primary location of tumor - 1) Infant (Is' year of life) --->Mostly supratentorial, most common are choroidal plexus tumor and teratoma. 2) 1-10 years --> Mostly infratentorial, most common are medulloblastoma and cerebellar astrocytoma (juvenile pilocytic astrocytoma). 3) After 10 years --> mostly supratentorial, most common is diffuse astrocytoma. | train | med_mcqa | null |
During the following procedure, optimum interval between uterine incision and delivery should be less than ______ seconds. | [
"30 seconds",
"45 seconds",
"60 seconds",
"90 seconds"
] | D | Ans. D 90 secondsRef: Datta, 8th ed. pg. 673The image shows LSCS being performed, with the head being delivered by hooking fingers carefully between the lower uterine flap. The head is delivered by elevation and flexion using the palm as fulcrum and the optimum time between the uterine incision and delivery should be less than 90 seconds. | train | med_mcqa | null |
WHO global target for prevention and control of oncommunicable disease by 2025 is to decrease hypertension by: | [
"25%",
"35%",
"55%",
"75%"
] | A | Ans. a. 25%Ref: WHO guidelineWHO "Global monitoring framework on NCDs" tracks implementation of the "NCD global action plan" through monitoring and reporting on the attainment of the 9 global targets for NCDs, by 2025, against a baseline in 2010.WHO GLOBAL ACTION PLAN FOR THE PREVENTION AND CONTROL OF NCDSLabelInterventionTarget 1A 25% relative reduction in the overall mortality from cardiovascular diseases, cancer, diabetes, or chronic respiratory diseasesTarget 2At least 10% relative reduction in the harmful use of alcohol, as appropriate, within the national contextTarget 3A 10% relative reduction in prevalence of insufficient physical activityTarget 4A 30% relative reduction in mean population intake of salt/sodiumTarget 5A 30% relative reduction in prevalence of current tobacco use in persons aged 15+ yearsTarget 6A 25% relative reduction in the prevalence of raised blood pressure or contain the prevalence of raised blood pressure, according to national circumstancesTarget 7Halt the rise in diabetes and obesityTarget 8At least 50% of eligible people receive drug therapy and counseling (including glycemic control) to prevent heart attacks and strokesTarget 9An 80% availability of the affordable basic technologies and essential medicines, including generics, required to treat major NCDs in both public and private facilities | train | med_mcqa | null |
Posterior capsulotomy after cataract is done using | [
"Argon Laser",
"Nd YAg",
"Holmium",
"Diode laser"
] | B | (Refer: AK Khurana Comprehensive Ophthalmology, 6th edition, pg no. 214 - 215)After cataract, if thin, can be cleared centrally by Nd: YAG laser capsulotomy. Dissection with cystitome or Zeigler&;s knife also be used. Thick membranous after cataract needs surgical membranectomy. | train | med_mcqa | null |
A nurse develops clinical symptoms consistent with hepatitis. She recalls sticking herself with a needle approximately 4 months ago after drawing blood from a patient. Serologic tests for HBsAg, antibodies to HBsAg, and hepatitis A virus (HAV) are all negative; however, she is positive for lgM core antibody. The nurse | [
"Does not have hepatitis B",
"Is in the late stages of hepatitis B infection",
"Is in the \"window\" (after the disappearance of HBsAg and before the appearance of anti-HBsAg)",
"Has hepatitis C"
] | C | In a small number of patients with acute hepatitis B infection, HBsAg can never be detected. In others, HBsAg becomes negative before the onset of the disease of before the end of the clinical illness. In such patients with acute hepatitis, hepatitis B virus infection may only be established by the presence of antihepatitis B core lgM (anti- HBc lgM), a rising titer of anti-HBc, or the subsequent appearance of anti-HBsAg. | train | med_mcqa | null |
A 40 year old man presented with painless haematuria. Bimunual examination revealed a ballotable mass over the right flank. Subsequently right nephrectomy was done and the mass was seen to be composed of cells with clear cytoplasm. Areas of haemorrhage and necrosis were frequent. Cytogenetic analysis of this mass is likely to reveal the abnormality of- | [
"Chromosome 1",
"Chromosome 3",
"Chromosome 11",
"Chromosome 17"
] | B | Ans. is 'b' i.e., Chromosome 3 | train | med_mcqa | null |
A 30 year old pregnant woman presents to a physician with painful oral ulcers. Physical examination demonstrates widespread erosions of her mucous membranes. Close examination reveals a friable mucosa, but no well-defined aphthous ulcers. Biopsy of perilesional mucosa demonstrates acantholysis; direct immunofluorescence demonstrates an intraepidermal band of IgG and C3. Which of the following is the most likely diagnosis? | [
"Bullous pemphigoid",
"Dermatitis herpetiformis",
"Herpes simplex I",
"Pemphigus vulgaris"
] | D | This is pemphigus vulgaris, in which autoantibody directed against transmembrane cadherin adhesion molecules induced acantholysis (breakdown of epithelial cell-cell connections) with resulting intraepidermal blister formation. It may develop spontaneously or following triggers such as drugs (thiols, penicillamine), physical injury (burns), cancer, pregnancy, other skin diseases, and emotional stress. Pemphigus vulgaris is a relatively rare blistering disease; it is seen more commonly in patients with Jewish or Mediterranean heritage. In addition to the usually prominent oral ulcers, uncomfoable skin erosions can also occur when the blisters rupture rapidly and are not observed. The epidermis at the edge of these erosions is often easily disrupted by sliding pressure (Nikolsky sign). Bullous pemphigoid is characterized by deeper blisters, occurring at the dermal-epidermal junction. Dermatitis herpetiformis is characterized by severe, intense pruritus and groups of papules and vesicles. Herpes simplex I or II can show multinucleated giant cells on scrapings of the ulcer base. Ref: Suurmond D. (2009). Section 34. Disorders of the Mouth. In D. Suurmond (Ed), Fitzpatrick's Color Atlas & Synopsis of Clinical Dermatology, 6e. | train | med_mcqa | null |
Which one of the following muscle relaxant has the maximum duration of action? | [
"Atracurium",
"Vecuronium",
"Rocuronium",
"Doxacurium"
] | D | null | train | med_mcqa | null |
Most important for diapedesis | [
"PECAM",
"Selectin",
"Integrin",
"Mucin like Glycoprotein"
] | A | Diapedesis or Transmigration-process of leukocyte recruitment is migration of the leukocytes through the endothelium.
Most important for diapedesis is PECAM- 1 and CD31 molecules | train | med_mcqa | null |
Increased temperature after ovulation is due to | [
"Estrogen",
"Progesteron",
"FSH",
"LH"
] | B | Ovulation is the release of egg from the ovaries. In humans, this event occurs when the de Graaf&;s follicles rupture and release the secondary oocyte ovarian cellsThe follicle proper has met the end of its lifespan. Without the oocyte, the follicle folds inward on itself, transforming into the corpus luteum(pl. corpora lutea), a steroidogenic cluster of cells that produce estrogen and progesterone. These hormones induce the endometrial glands to begin production of the proliferative endometrium and later into secretory endometrium, the site of embryonic growth if implantation occurs. The action of progesterone increases basal body temperature by one-quaer to one-half degree Celsius (one-half to one degree Fahrenheit). The corpus luteum continues this paracrine action for the remainder of the menstrual cycle, maintaining the endometrium, before disintegrating into scar tissue during menses.Ref: Ganong&;s review of medical physiology;24th edition; page no:-401 | train | med_mcqa | null |
Mechanism of cyanide poisoning? | [
"Inhibition of cytochrome C",
"Inhibition of complex I",
"Inhibition of carbonic anhydrase",
"Inhibition of cytochrome oxidase."
] | D | Complex IV is also called cytochrome oxidase. Inhibitors are carbon monoxide, cyanide, Hydrogen sulphide, Sodium Azide. | train | med_mcqa | null |
All are seen In myxoedema coma except - | [
"Hypothermia",
"Tachycardia",
"Hypotension",
"Hyponatremia"
] | B | Question repeatedMyxedema coma is a state of decompensated hypothyroidism. A person may have lab values identical to a "normal" hypothyroid state, but a stressful event (such as an infection, myocardial infarction or stroke) precipitates the myxedema coma state, usually in the elderly. Primary symptoms of myxedema coma are altered mental status and low body temperature. Low blood sugar, low blood pressure, hyponatremia, hypercapnia, hypoxia, slowed hea rate, and hypoventilation may also occur. Myxedema, although included in the name, is not necessarily seen in myxedema coma. | train | med_mcqa | null |
Lubrication of joint by releasing of synovial fluid under increased load is known as: | [
"Excess lubrication.",
"Weeping lubrication.",
"Boundary lubrication",
"None of the above"
] | B | null | train | med_mcqa | null |
Magnesium sulphate is contraindicated in: | [
"Placenta previa",
"Preeclampsia",
"Epilepsy",
"Myasthenia gravis"
] | D | Ans: D (Myasthenia gravis) Ref: Out to: Textbook of Obstetrics 7th ed pg 508,509,234Explanation:MAGNESIUM SULPHATEActs by competitive inhibition of calcium ion either at motor end plate.At cell membrane: It decreases calcium influx, decreases Ach release and its sensitivity at motor end plate.It acts as a direct depressant on uterine muscle causes vasodilation and increases cerebral, uterine and renal blood flow.It decreases intracranial edema.Pritchard regimen--4gm 20% soln given slow TV. over 15 to 20 min and 4 gm i.m. in each buttock {loading dose). Further 4gm given i.m. in alternate buttocks every 4 hours till 24 hoursTherapeutic level of mgso4 4 to 7 meq/1 Side effectFlushingPerspirationHeadacheMuscle weaknessPulmonary edema.In neonate it causes lethargy, hypotonia and respiratory depression.Contraindications--myasthenia gravis, impaired renal function.Antidote--Inj. calcium gluconate 109T 10ml I.V. | train | med_mcqa | null |
All of the following are used in organophosphorus poisoning except | [
"Pralidoxime",
"Atropine",
"Activated charcoal",
"Naltrexone"
] | D | Refer kDT 7/e p 110,111 Pharmacologic Treatment Atropine - The endpoint for atropine is dried pulmonary secretions and adequate oxygenation. Tachycardia and mydriasis must not be used to limit or to stop subsequent doses of atropine. The main concern with OP toxicity is respiratory failure from excessive airway secretions. Sta with a 1-2 mg IV bolus, repeat q3-5min prn for desire effects (drying of pulmonary secretions and adequate oxygenation). Consider doubling each subsequent dose for rapid control of patients in severe respiratory distress. An atropine drip titrated to the above endpoints can be initiated until the patient's condition is stabilized. Pralidoxime - Nucleophilic agent that reactivates the phosphorylated AChE by binding to the OP molecule. Used as an antidote to reverse muscle paralysis resulting from OP AChE pesticide poisoning but is not effective once the OP compound has bound AChE irreversibly (aged). Current recommendation is administration within 48 h of OP poisoning. Because it does not significantly relieve depression of respiratory center or decrease muscarinic effects of AChE poisoning, administer atropine concomitantly to block these effects of OP poisoning. Sta with 1-2 g (20-40 mg/kg) IV in 100 mL isotonic sodium chloride over 15-30 min; repeat in 1 h if muscle weakness is not relieved; then repeat q3-8h if signs of poisoning recur; other dosing regimens have been used, including continuous drip. | train | med_mcqa | null |
Which of the following nerves transmits impulses originating from the vestibular apparatus? | [
"Cranial nerve ll",
"Cranial nerve VII",
"Cranial nerve VIII",
"Cranial nerve XI"
] | C | The vestibular poion of cranial nerve VIII (vestibulocochlear nerve) carries impulses from the vestibular apparatus to the vestibular ganglion, which then conveys the impulses to the vestibular nuclei of the brainstem. | train | med_mcqa | null |
All are true about bullemia nervosa, except - | [
"Binge eating",
"Self-induced vomiting",
"Weight loss",
"Purgative abuse"
] | C | Ans. is 'c' i.e., Weight loss Bulemia Nervosao Bulimia nervosa is characterized by episodes of uncontrollable excessive eating (binges) followed by vigorous weight-reducing measures like self-induced vomiting, purgative abuse, diuretics, or abuse of emetics; and less commonly severe dieting and stemous exercise.o Episodes of binge eating occur relatively frequently (twice a week or more) for at least 3 months.o As in anorexia nervosa, there is extreme preoccupation with the shape and weight of the body. However, bulimia nervosa differs from anorexia nervosa : -Patients of bulimia are slightly older than those with anorexia i.e., Late adolescence.Most of the patients with bulimia nervosa have a weight within their normal weight rangeAmenorrhea is usually not present and most are sexually active, compared with anorexia nervosa patients.Peculiar behavior about the food of anorexia nervosa is absent.Depressive symptoms are more common - Post-binge anquish.o Patient with bulimia nervosa may have dental caries/tooth decay, Sore throat, Swollen Salivary gland (parotitis), and internal bleeding due to vomiting. | train | med_mcqa | null |
A patient, resident of Himachal Pradesh presented with a series of ulcers in a row, on his right leg. The biopsy from the affected area was taken and cultured on Sabouraud&;s Dextrose agar. What would be the most likely causative organism | [
"Sporothrix schenckii",
"Cladosporium species",
"Pseudoallescheria boydii",
"Nocardia brasilinsis"
] | A | Sporotrichosis is a chronic infection involving cutaneous, subcutaneous and lymphatic tissue. It is caused by Sporothrix schenckii. Pathogenesis: 1. Lesions on the exposed pas of the skin follow minor trauma. Nodules are first formed, followed by ulceration and necrosis of nodules. 2. From the lesions in skin and subcutaneous tissue, the infection can spread by lymphatic channels to lymph node and lymphatics are hardened and cord-like. Ref: Textbook of Microbiology, Ananthanarayan and Paniker; 9th edition | train | med_mcqa | null |
A neonate presents with bilious vomiting. What is the first investigation __________ | [
"Abdomen X-ray",
"Baby gram",
"CT",
"USG"
] | A | In contrast, intestinal malrotation, a congenital anomaly in rotation of the midgut as it forms, presents as intermittent bilious vomiting, usually with significant abdominal distension. Bilious or bile-stained vomiting should be treated as a potential surgical emergency. Reference: GHAI Essential pediatrics, 8th edition Nutrition Chapter | train | med_mcqa | null |
A 30 year old woman with sudden right–sided painful red eye associated with nausea, vomiting and headache. The diagnosis is – | [
"Acute congestive glaucoma",
"Endophthalmitis",
"Eales disease",
"Trachoma"
] | A | Sudden onset of painful red eye with associated nausea, vomiting and headache suggests the diagnosis of acute congestive glaucoma.
Endophthalmitis may also present by sudden onset of severe ocular pain with red eye. But it usually occurs within 7 days of ocular surgery or trauma. There is no history of oculary surgery or trauma in this question. | train | med_mcqa | null |
Bucket handle tear at knee joint is due to: | [
"Injury to medial collateral ligament",
"Injury to lateral collateral ligament",
"Injury to ligamentum patellae",
"Injury to menisci"
] | D | D i.e. Injury to Meniscus The commonest type of medial meniscal injury in a young adult is the bucket handle tearQ. This is veical longitudinal tear that is complete | train | med_mcqa | null |
Children surveyed in cluster sampling for coverage of national immunization programme in? | [
"30 clusters of 5 children",
"20 clusters of 5 children",
"30 clusters of 10 children",
"30 clusters of 7 children"
] | D | . | train | med_mcqa | null |
While advancing there is increased chance of developing cancers. Tumorigenesis in aging is due to: | [
"Telomerase reactivation",
"Telomerase inactivation",
"Increased apoptosis",
"Suppression of proto-oncogenes"
] | A | Telomerase is a ribonucleoprotein that is expressed in stem cells and most cancer cells, but not in somatic cells. More than 90% of human cancers express high levels of telomerase that prevent telomere shoening to critical levels and allow indefinite cell proliferation. Ref: Longo D.L. (2012). Chapter 84. Cancer Cell Biology and Angiogenesis. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e. | train | med_mcqa | null |
Most common organism responsible for pseudo membranous colitis is - | [
"Clostridium difficile",
"Clostridium botulism",
"Clostridium histolyticum",
"Clostridium butyricum"
] | A | Ans. is 'a' i.e., Clostridium difficile # Pseudomembranous colitis is the advanced form of Clostridium difficile - associated disease (CDAD).Remember:o CDAD is the most commonly diagnosed diarrheal iiiness acquired in the hospital.o C. diffiele is acquired exogenously (not as an endogenous infection), most frequently in the hospital,o C. diffiele is the most common bacterial cause of nosocomial diarrhea,o Diarrhea is the most common symptom of CDAD.Risk factors for Clostridium difficile associated disease (CDAD)o CDAD almost exclusively associated antibiotic used,o The most common antibiotics associated with CDAD are-ClindamycinAmpicillinCephalosporin (mainly cefotaxim, ceftriaxone, cefuroxime and ceftazidime)o Piperacillin/tazobactiim and ticarc i llin/clavlanate less commonly associated with CDAD.o The risk of Clostridium difficile infection is directly proportionate to the hospital stay,o Other risk factors-Old ageGreater severity of underlying illnessGasterointestinal surgeryUsed electrical thermometerCentral tube feedingAntacid useProton pump inhibitorsDiagnosis and Treatment of CDADo Diagnosis# The diagnosis is based on a combination of clinical criteria :Diarrhea (> 3 unformed stools per 24 hrs for > 2 days), with no other recognized cause.plusToxin A or B detected in the stool, toxin - producing C. difficile detected by stool culture, or pseudomembrane seen in the colon.o TreatmentMetronidazole is drug of choiceAlternatives -Vancomycin # Fusidic acidTeicoplanin # BacitracinRemembero Most sensitive test for diagnosis of CDAD-Stool culture for C. difficileo Most specific tests for diagnosis of CDAD-Cell culture cytotoxin test on stool and pseudomembrane seen on colonoscopy or sigmoidoscopy | train | med_mcqa | null |
Blood bags after blood transfusion are disposed in | [
"Red bag",
"Yellow bag",
"White container",
"Blue bag"
] | B | null | train | med_mcqa | null |
Cardiolipin is an impoant component of which of the following: | [
"Mitochondria",
"Cell membrane",
"Ribosome",
"All of the above"
] | A | Phosphatidic acid is a precursor of phosphatidyl-glycerol which, in turn, gives rise to cardiolipin. This phospholipid is found only in mitochondria and is essential for mitochondrial function. Ref: Harper 28th edition, chapter 16. | train | med_mcqa | null |
Direct opening in the right atrium with | [
"Anterior cardiac vein",
"Oblique vein",
"Middle cardiac vein",
"Great cardiac vein"
] | A | All veins of hea except the anterior cardiac veins and the venae cordis minimi drain into the coronary sinus which opens into the right atrium.The anterior cardiac veins and the venae cordis minimi open directly into the right atrium. BD CHAURASIA'S HUMAN ANATOMY .VOLUME 1.FIFTH EDITION.Page no-254 | train | med_mcqa | null |
A 60-year-old man presents to his primary care physician complaining that he often feels as if the room is spinning when he gets up from a recumbent position or turns his head. He has not lost consciousness and has had no chest pain. He has no cardiac history, and a recent treadmill test showed no abnormalities. On examination, the sensation can be produced by rapidly turning the head. It can be reproduced many times, but it eventually ceases. Nystagmus is elicited. Hearing is normal. Which of the following is the MOST likely mechanism for this patient's symptoms? | [
"Aberrant stimulation of hair cells",
"Hair cell death in the semicircular canals",
"Insufficient cardiac output",
"Insufficient cerebral perfusion"
] | A | In benign paroxysmal positional veigo, calcium carbonate crystals called otoliths, which are usually fixed in a gelatinous otolithic membrane, float freely in the endolymph. Usually, movement is sensed by the movement of this heavy membrane as it stimulates hair-like projections on sensory hair cells fixed to the membrane in the inner ear. In BPPV, the loose crystals aberrantly stimulate the hair cells with ceain head movements. Thus the sensation of veigo is produced. Hair cell death does not cause veigo. Insufficient cardiac output and cerebral blood flow lead to syncope, not veigo. | train | med_mcqa | null |
Enterotest is used for diagnosis of | [
"E. histolytica",
"N. fowleri",
"T. Cruzi",
"Giardia lambia"
] | D | Stringtest / enterotest is done in Giardia lambia in which bile stained mucus is collected for examination of Trophozoites. | train | med_mcqa | null |
True about dual sex therapy is: | [
"Patient alone is not treated",
"Uses sildenafil",
"It treats sexual perversion",
"It is used for people with dual gender identities"
] | A | In dual sex therapy, the couple is treated and not an individual. It is also known as Masters and Johnson technique As per this therapy, sensory awareness between the couple needs to be improved to treat them . Communication also needs to be improved between the couple This therapy is used in cases of erectile dysfunction and premature ejaculation. Technique named as Sensate focus was given for sensory awareness | train | med_mcqa | null |
Perihilar fluffy opacities on chest X-ray is seen in – | [
"Sarcoidosis",
"Pulmonary edema",
"Silicosis",
"Lung carcinoma"
] | B | Fluffy perihilar opacities projecting into lung parenchyma is seen in pulmonary edema which gives "Bat-wing" appearance. | train | med_mcqa | null |
Most common cause of cholangitis - | [
"Viral infection",
"CBD stone",
"Surgery",
"Amoebic infection"
] | B | Gall stones are the most common cause of obstruction in cholangitis.
Other causes are
benign & malignant strictures
parasites
instrumentation of the ducts and indwelling stents
partially obstructed biliary enteric anastomosis
Most common organisms cultured from bile in patients with cholongitis include
Escherichia coli
Klebsiella pneumoniae
Streptococcus faecalis
Enterobacter
Bacteroides fragilis | train | med_mcqa | null |
Total number of dorsal interossei | [
"2",
"3",
"4",
"5"
] | C | There are 4 dorsal interossei muscles and 4 palmar interossei muscles. Dorsal and palmar interossei are supplied by the deep branch of the ulnar nerve. Dorsal interossei help in the abduction of digits. Ref: BD Chaurasia 7th edition; Page no: 182 | train | med_mcqa | null |
Mallory-Weiss tear occurs at | [
"Gastro-oesophageal junction",
"Duodeno-jejunal flexure",
"Ileo-caecal junction",
"Colo-rectal junction"
] | A | MALLORY WEISS syndrome is seen in adults with severe prolonged vomiting, causing a longitudinal tear in the mucosa of the stomach at and just below the cardia leading to severe hematemesis.Violent vomiting may be due to a migraine or veigo or following a bout of alcohol.Common in 1 o' clock position.Investigations include Hb%, PCV.Treatment includes blood transfusion, IV fluids, sedation and hemostatic agents such as vasopressin. Ref: SRB&;s manual of surgery,5th ed, pg no 803 | train | med_mcqa | null |
Under National Programme for Prevention of Nutritional Blindness, a child in the age group of 6-11 months is given a single dose of vitamin A is: March 2005 | [
"50,000 IU",
"1,00,000 IU",
"1,50,000 IU",
"2,00,000 IU"
] | B | Ans. B: 1,00,000 IU Nutritional blindness which affects over seven million children in India per year results mainly "from the deficiency of vitamin A coupled with protein-energy malnutrition. In its severest form, it often result in loss of vision. Vitamin A deficiency is assessed on the basis of conjuctival xerosis and Bitot's spot. | train | med_mcqa | null |
WHO criteria for semen analysis, which of the following is the only TRUE statement | [
"Progressive motility >15%",
"Normal morphology >25%",
"Volume of 2-5ml",
"Sperm count >39million"
] | D | World Health Organization reference values: Semen volume: 1.5 ml or more pH: 7.2-7.8 Sperm concentration: 15 million spermatozoa per ml or more Total sperm number: 39 million spermatozoa per ejaculate or more ( Range 36-42 million /ml) Total motility : 40% or more motile or 32% or more with progressive motility Round cells: <5 million /mL Vitality: 58% or more live spermatozoa Sperm morphology (Strict criteria ): 4% or more of normal forms Sperm Agglutination:<2 | train | med_mcqa | null |
Dietary changes advocated by WHO for prevention of hea diseases included all of the following except - | [
"An increase in complex carbohydrateconsumption",
"Reduction in fat intake to 20-30 percent of caloric intake",
"Consumption of saturated fats be limited to less than 10% of total energy intake",
"Reduction of cholesterol to below 100mg per 1000kcl per day"
] | A | Increase in complex carbohydrate consumption that is vegetables ,fruits,legumes and whole grains. Ref-Park&;s textbook of Preventive and Social Medicine 24th edition. | train | med_mcqa | null |
Antipseudomonals are all, except. | [
"Cephalexin",
"Carbenicillin",
"Piperacillin",
"Ceftazidime"
] | A | Ans. (A) Cephalexin(Ref: KDT 8/e p773,774,776; Goodman & Gilman 10/e p1209)Cephalexin is an orally effective first generation cephalosporin active against gram positive but not against gram negative organisms like pseudomonas. | train | med_mcqa | null |
Adenoid cystic carcinoma is also known as | [
"Cylindroma",
"Pindborg tumor",
"Warthins tumor",
"Pleomorphic adenoma"
] | A | null | train | med_mcqa | null |
Diagnostic feature of parathyroid carcinoma is- | [
"Cytology",
"Metastasis",
"Clinical features",
"All"
] | B | Ans. (b) Metastasis(Ref: Robbins 9th/pg 1104; 8th/pg 1129)Morphology in hyperparathyroidismParathyroid adenomasSolitary lesions withuniform, polygonal chief cells along with nests of oxyphil cells (oxyphil adenomas)Primary hyperplasiaChief cell hyperplasia with abundant water-clear cells ("water-clear cell hyperplasia") involving all 4 glandsParathyroid CarcinomasCircumscribed lesion in a single gland diagnosed by invasion of surrounding tissues and metastasis as the only reliable criteria. | train | med_mcqa | null |
A 17-year-old girl was evaluated for complaints of weight gain, hair loss, constipation and weakness. Her free T4 level was low and TSH was increased. Which of the following is the most likely diagnosis? | [
"Graves' disease",
"McCune-Albright syndrome",
"TSH-secreting pituitary adenoma",
"Hashimoto's thyroiditis"
] | D | The patient is having symptoms of hypothyroidism and thryoid profile reveals primary hypothyroidism. Analyzing all options, Graves' disease and McCune-Albright syndrome are associated with hypehyroidism. (excludes 'a' & 'b') In pituitary adenoma/TSH-secreting pituitary tumor - increased TSH with increased T3/T4 would be seen. (option 'c' excluded) Primary hypothyroidism is d/t defect in thyroid gland itself; associated with high TSH & low free T4 levels. Hashimoto's thyroiditis is a cause of primary hypothroidism. | train | med_mcqa | null |
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