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Hypertonic dysfunctional labour is generally characterized by: | [
"Rapid cervical dilatation",
"Less pain in labour",
"Responds favourably to oxytocin stimulation",
"Needs adequate pain relief"
] | D | Types of Uterine Dysfunction
There are two types of uterine dysfunction:
In the more common hypotonic uterine dysfunction, there is o basal hypertonus and uterine cotractions have a normal gradient pattern (synchronous), but the slight rise in pressure during a contraction is insufficient to dilate the cervix.
In the other, hypertonic uterine dysfuctio or incoordinate uterine dysfunction, either the basal tone is elevated appreciably or the pressure gradient is distorted. Gradient distortion may result from contraction of the mid-segment of the uterus with more force than the fundus or from complete asynchronism of the impulses originating in each cornu, or from a combination of these two.
Pain is present before, during and after contractions. This results in fetal hypoxia in labor. Placental abruption is often associated with high baseline tone (> 25 mm Hg). On CTG the FHR shows reduced variability and late decelerations.
Effect on the fetus: Fetal distress appears early due to placental insufficiency caused by inadequate relaxation of the uterus.
Management: There is no place of oxytocin augmentation with this abnormality. Cesarean section is done in majority of cases. Adequate pain relief or sedation is helpful. | train | med_mcqa | null |
Most common cause of chronic granulomatous disease in children is: | [
"Myeloperoxidase deficiency",
"Defective phagocytosis",
"Defective H2O2 production",
"Job's disease"
] | C | Answer is C (Defective H2O2 production) Chronic granulomatous disease is a 'disorder' of microbial killing' characterized by decreased ability of neutrophils to produce H4)-Q * Chronic granulomatous disease is a 'disorder' of microbial killing' characterized by decreased ability of neutrophils to produce H,O2.Q Patients, here become susceptible to disease caused by organisms that produce `catalase', which destroys the small amount of H2O, present in these cells and leads to failure of bacterial killing. * The disease is called so, because granulomas, are formed in various tissues, as a second line defence against organisms, that normally would be removed by the acute inflammatory response. Manifestations: * Recurrent infections with which catalase +ve Pyogenic bacteria e.g. staph/coliforms. Q - catalase negative bacteria e.g. streptococcus, Pneumococcus are often handled normally.Q * Normal humoral immune response? but * Defective killing process: Leucocytes are unable to kill bacteria after phagocytosis the major reason being decreased production of H-O2.Q Screening method: * NBT test: Nitroblue retrazolium dye is not reduced by neutrophils in vitro. Q | train | med_mcqa | null |
All of the following statements are true regarding hyperplasia, except: | [
"Seen in cells capable of dividing (labile cells)",
"There is an increase in the number of cells",
"Pathological hyperplasia can be a risk factor for malignancy",
"Bone marrow hyperplasia is not seen in response to peripheral blood cytopenias"
] | D | Hyperplasia It takes place if the tissue contains cells capable of dividing. Defined as an increase in the number of cells in an organ or tissue in response to a stimulus. Most forms of pathologic hyperplasia are caused by excessive or inappropriate actions of hormones or growth factors acting on target cells. Pathologic hyperplasia may eventually lead to cancerous proliferations. Endometrial hyperplasia is an example of abnormal hormone-induced hyperplasia and patients with endometrial hyperplasia are at increased risk for developing endometrial cancer. Bone marrow can undergo rapid hyperplasia in response to a deficiency of terminally differentiated/mature blood cells (anemia, leucopenia and/or thrombcytopenia). | train | med_mcqa | null |
True about uterus are all except: | [
"Normally the uterus is retroveed",
"Angle of anteflexion is 125 degree",
"Long axis of uterus corresponds to the axis of pelvic inlet",
"Posterior surface is related to the sigmoid colon"
] | A | Normally the long axis of the uterus is bent forward on the long axis of the vagina. This position is referred to as anteversion of the uterus.The long axis of the body of the uterus is bent forward at the level of the internal os with the long axis of the cervix. This position is termed anteflexion of the uterus.Thus, in the erect position and with the bladder empty, the uterus lies in an almost horizontal plane.If the fundus and body of the uterus are bent backward on the vagina so that they lie in the rectouterine pouch (pouch of Douglas), the uterus is said to be retroveed.If the body of the uterus is, in addition, bent backward on the cervix, it is said to be retroflexed. | train | med_mcqa | null |
Best test for oesophageal varices is | [
"CT- scan",
"Gastro- oesophagoscopy",
"Tomography",
"Ultrasound"
] | B | B. i.e. (Gastro - oesophagoscopy) (1089 - B &L) (897 - S. Das 5th)Endoscopy - upper GI endoscopy represents the most reliable single technique as it shows the oesophageal varix and bleeding point* Dilated longitudinal veins running a Zig- Zag course*** Diffuse esophageal spasm is best diagnosed by Manometry**Management of bleeding oesophageal varices* Blood transfusion* Correct coagulopathy* Oesopageal balloon tamponade (Sengstaken - Blakemore tube)*** Drug therapy (Vasopressin /Octreotide)* Endoscopic sclerotherapy or banding* Assess portal vein potency (Doppler USG or CT)* Transjugular intrahepatic portosystemic stent shunts (TIPSS) (Contraindicated in portal vein occlusion)* Surgery- Portosystemic shunts- Oesophageal transaction- Splenectomy and gastric devascularisation* Commonest cause of acute upper GI haemorrhage - Peptic ulcer** | train | med_mcqa | null |
The major difference between X-Rays and Light is: | [
"Energy",
"Mass",
"Speed",
"Type of wave"
] | A | The main difference between an X-ray photon and a visible light photon lies in the energy of each photon. Xray photon has approximately 5000 times the energy of an ordinary light photon, allowing the Xray photon to pass through materials more readily than a regular light photon. Ref: Techniques in Microscopy for Biomedical Applications By Terje Dokland, Page 289 | train | med_mcqa | null |
Which is a minor criteria for diagnosis of RF according to modified Jones criteria? | [
"ASO titre",
"Past History of Rheumatic Fever",
"Fever",
"Subcutaneous nodules"
] | C | Answer is C (Fever) The Jones Criteria Jones criteria were first proposed in 1944. The most recent modification of the Jones criteria was published in 1992 and these were termed updated Jones criteria. Updated Jones Criteria for Rheumatic fever Major Criteria Minor Criteria * Carditis * Fever (clinical) * Migratory polyahritis * Ahralgia (clinical) * Sydenham's chorea * Elevated acute phase reactions (LAB) * Subcutaneous nodules * Prolonged PR internal (LAB / ECG) * Erythema marginatinn Essential Criteria Suppoing evidence of recent group A streptococcal infection. Positive throat culture or rapid antigen detection test and /or Elevated or increasing streptococcal antibody test. To fulfill the Jones Criteria, Two major criteria or One major criteria And Two minor criteria PLUS Essential criteria are required. | train | med_mcqa | null |
Endothelium derived relaxation factor is supposed to be: (Repeat) | [
"Nitric oxide",
"Angiotensin",
"Serotonin",
"Norepinephrine"
] | A | Ans: A (Nitric oxide) Ref: Pal GK. Synaptic transmission in CNS: ami Neurotransmitters. In: Textbook of medical physiology. 2nd ed. Ahuja publishing house. 2011; 100: 794.Explanation:Nitric oxide is also called as EDRF (Endothelial derived relaxation factor)Formed from arginine by NO synthase which needs NADPHIt mediates the action of many other vasodilators - Histamine, Ach, hradykinin. VIP, substance P | train | med_mcqa | null |
Anti-carcinogens are: (PGI Dec 2007) | [
"Carotenoids",
"Flavenoids",
"Curcumoids",
"Benzene"
] | A | Ans: A (Carotenoids) Cancer Chemoprevention: Agents used Harrison 17th/488-89 # Premalignant lesions in the oropharyngeal area have responded to retinal/ a-tocopherol (vitamin E)Q, and selenium Q b carotene( a carotenoid) may decrease the incidence of lung, esophagus, and stomach cancer (in accordance with various trials, but the definite evidence is lacking)- CMDT09/1424 Nonsteroidal anti-inflammatory drugs (NSAIDs). such as piroxicam, sulindac, and aspirin, may prevent adenoma formation or cause regression of adenomatous polyps. Diets high in calcium lower colon cancer risk Atrial comparing tamoxifen Q with another selective estrogen receptor modulator, raloxifene, showed that raloxifene is comparable to tamoxifen in cancer prevention. FinasterideQ, a 5-a-reductase inhibitor is used in prostate cancer prevention. Selenium is being tested as a prostate cancerQ preventive based on laboratory studies, epidemiologic data, and a small randomized skin cancer prevention trial that showed a significantly decreased number of prostate cancers in men taking selenium | train | med_mcqa | null |
Horner syndrome causes all of the following signs, EXCEPT: | [
"Enophthalmos",
"Mydriasis",
"Anhidrosis",
"Narrowed palpebral fissure"
] | B | Horner's syndrome occur secondary to a lesion of the sympathetic system. Features of Horner's syndrome are miosis, ptosis, facial anhidrosis,enophthalmos and heterochromia iridis. Three types of Horner's syndrome are: Central: Lesion is located between hypothalamus and the ciliospinal center of Bodge. Pre ganglionic: Lesion is located from C8 to T2 and the superior cervical ganglion. Post ganglionic: Lesion involves the third order neurons from the superior cervical ganglion to the dilator pupillae. Ref: Textbook of Ophthalmology edited by Sunita Agarwal, page 306. | train | med_mcqa | null |
Cavitating lesion in lung is seen in - | [
"PAN",
"SLE",
"Wegeners granulomatosis",
"Sjogren's syndrome"
] | C | null | train | med_mcqa | null |
All of the following may be used to differentiate Central Retinal Venous Occlusion (CRVO) from Ocular Ischemic Syndrome due to Carotid Aery Stenosis, Except: | [
"Dilated Retinal Vein",
"Touous Retinal Vein",
"Retinal Aery Pressure",
"Opthalmodynamometry"
] | A | A i.e. Dilated Retinal Vein Central Retinal Vein Occlusion and Ocular Ischemic Syndrome due to carotid aery stenosis are both associated with dilated retinal veins and hence this feature cannot be used to distinguish these conditions. However, ophthalmic aery pressure (measured by ophthalmo dynamometry) and retinal aery pressure is usually normal in CRVO and decreased (low) in carotid aery obstruction. And to differentiate both conditions other features include presence of swollen optic disc & touous retinal veins in CRVOQ. Ophthalmodynamometry is a non invasive method of estimating ophthalmic aery pressure. Features Ocular Ishemic Syndrome (Carotid Aery Obstruction) CRVO (Non Ischaemic) (Central Retinal Vein Obstruction) Definition Ocular Ischemic Syndrome is a condition with variable spectrum of sign and symptoms resulting from chronic ocular hypoperfusion usually secondary to severe carotid aery obstruction. Pathogenesis of this syndrome is decreased aerial inflow on a chronic basis CRVO is an ocular syndromes with ocular signs and symptoms resulting from an occlusion of the central retinal vein - Ischemic : Complete obstruction (20? 25% of cases) - Non ischaemic : Incomplete obstruction (70-75% of cases) Laterality Unilateral (80%) Unilateral Age (years) 50-80 50-80 Fundus signs Veins Dilated, nontouous Dilated, touous Optic disc Normal Swollen Retinal aery perfusion pressure Decreased Normal Retinal hemorrhages Mild Mild to severe Microaneurysms Mid-periphery Variable Hard exhudates Absent unless in association with diabetes Rare Fluorescein Angiography Choroidal filling Delayed, patchy Normal Aeriovenous transit time Prolonged Prolonged Retinal vessel staining Prominent aerial staining Prominent venous staining Ophthalmodynamometry (non invasive) Ophthalmic aery pressure is usually lowQ Ophthalmic aery pressure is usually normal or elevated | train | med_mcqa | null |
Which of the following is not enclosed in mesorectal fasica? | [
"Pararectal nodes",
"Superior rectal vein",
"Inferior rectal vein",
"Inferior mesenteric plexus"
] | C | Ans. c. Inferior rectal vein Inferior rectal vein is not enclosed in mesorectal fascia. `Mesorectum is enclosed by mesorectal fascia which is derived from the visceral peritoneum, and is also known as visceral fascia of mesorectum, fascia propria of rectum or presacral wing of hypogastric sheath. Upper rectum is derived from the embryological hind gut, it is surrounded by mesorectum and its contents namely superior rectal aery and its branches, superior rectal vein and tributaries, lymphatic vessels and nodes along superior rectal aery, branches from inferior mesenteric plexus to innervate rectum and loose adipose connective tissue down to the level of levator ani (pelvic floor).' Mesorectal Fascia Mesorectum is enclosed by mesorectal fascia which is derived from the visceral peritoneumQ, and is also known as visceral fascia of mesorectum, fascia propria of rectum or presacral wing of hypogastric sheathQ. Upper rectum is derived from the embryological hind gut, it is surrounded by mesorectumQ. Contents of Mesorectal fascia Superior rectal aery and its branchesQ Superior rectal vein and tributariesQ Lymphatic vessels and nodes along superior rectal aeryQ Branches from inferior mesenteric plexus to innervate rectumQ Loose adipose connective tissueQ down to the level of levator ani (pelvic floor) | train | med_mcqa | null |
Zero order kinetics is independent of ? | [
"Plasma concentration",
"Clearance",
"Volume of distribution",
"Half life"
] | A | Ans. is 'a' i.e., Plasma concentration o Rate of elimination in zero order kinetics is independent of plasma concentration (see above explanation). | train | med_mcqa | null |
Which of the following is a specific sign of fetal death characterized by overlapping of skull bones? | [
"Spalding's sign",
"Buddha sign",
"Helmer's sign",
"Any of the above"
] | A | Ans. a (Spalding's sign) (Ref. Reddy FMT 23rd ed., p 87)Intrauterine fetal death# A specific sign of fetal death is absent cardia Somatic motion# Non specific signs of fetal death (not seen before 48 hours after death):- Spalding sign--overlapping fetal skull bones- 'Halo ' sign of head--due to scalp edema- Dolichocephaly- Same/decreased BPD measurement compared with prior exam- Gas in fetal vascular system- Skin edema and fetal maceration- Increased echoes in amniotic fluid# Vanishing Twin--disappearance of one twin in utero due to complete resorption /anembryonic pregnancy# Fetus papyraceus--compression and mummification of one fetus with risk also to the surviving fetus. | train | med_mcqa | null |
Which of the following enzymes is deficient in Niemann- Pick disease? | [
"Aryl sulfatase",
"Glucose-6-phosphatase",
"Sphingomyelinase",
"Beta glucosidase"
] | C | Ans.c (Sphingomyelinase) (Ref. Harper Biochemistry, 26th ed. 203; Table 24-1; OP Ghai 6th ed. 542, 616) SphingolipidosesInheritanceEnzyme DeficientCNS InvolvementVisceral Involvement1Fabry diseaseXLRAlpha-Galactosidase_+2Krabbe's diseaseARBeta-Galactosidase++3Farber diseaseARCeramidase+/--4Gaucher diseaseARBeta-Glucosidase+/-+5Metachromatic leukodystrophyARSulfatide sulfatase+-6Niemann-pick diseaseARSphigomyelinase++7Tay-sachs diseaseARHexosaminidase A+-8Sandhoff diseaseARHexosaminidase A,B++# NIEMANN-PICK DISEASE- Due to deficiency of sphingomyelinase- Stored material = sphingomyelin- C/f:* Enlarged liver and spleen,* Mental retardation,* Cherry-red spots,* Foam cells in blood,* Pulmonary infiltrates.# GAUCHER'S DISEASE- Due to deficiency of Acid b-Glucosidase- Stored material = Glucosylceramide- C/f:* Enlarged liver and spleen,* MR,* Erosion of long bones (Pathological of bones)* Foam cells in blood.# VON-GIERKE'S DISEASE (Type I - glycogenosis)- Due to deficiency of glu-6-phosphatase- C/f:* Growth retardation,* Liver and kidney enlarged due to increased glycogen content,* Hypoglycemia,* Hyperuricemia,* Hyper lipidemia, and* Lactate acidosis.Selected Lysosomal Storage DiseasesDisorderEnzyme Deficiency Stored MaterialInheritanceNeurologicLiver Spleen Enlarg- mentSkeletal DysplasiaOphthalmo- logicUnique featuresMucopolysaccharidoses (MPS)MPSIHHurleralpha-L-Iduro- nidase Dermatan sulfate Heparan sulfateARMental retardation Mental retardation None++++ + + +Corneal cloudingCoarse facies; cardiovascular involvement; joint stiffnessMPS II, HunterIduronate sulfataseDermatan sulfate Heparan sulfateX-linkedMental retardation, less in mild form++++ + + +Retinal degenera- tion, no corneal cloudingCoarse facies; cardiovascular involvement; joint stiffness; distinctive pebbly skin lesionsMPS III A, Sanfilippo AHeparan-N- sulfataseHeparan sulfateARSevere mental retardation++NoneMild coarse faciesMPS III B, Sanfilippo BN-Acetyl-a- glucosaminidaseHeparan sulfateARSevere mental retardation++NoneMild coarse faciesMPS III C, Sanfilippo CAcetyl-CoA: a- glucosaminide N-acetyltrans- feraseHeparan sulfateARSevere mental retardation++NoneMild coarse faciesMPS IIID, Sanfilippo DN-Acetylglucosa- mine-6-sulfate sulfataseHeparan sulfateARSevere mental retardation++NoneMild coarse faciesMPS IV A, MorquioN-Acetylgalacto- samine-6-sulfate sulfataseKeratan sulfate Chondroitin-6 sulfateARNone++ + + +Corneal cloudingDistinctive skeletal deformity; odontoid hypoplasia; aortic valve diseaseMPS VI B, Morquiob-Galactosidase ARNone+-+ + + + MPS VI,Maroteaux- LamyArylsulfatase BDermatan sulfateARNone+++ + + +Corneal cloudingCoarse facies; valvular heart diseaseMPS VIIb-GlucuronidaseDermatan sulfate Heparan sulfateARMental retardation, absent in some adults++++++Corneal cloudingCoarse facies; vascular involvement; hydrops fetalis in neonatal formGM2 GangliosidosesTay-Sachs diseaseb-Hexosamini- dase AGM2 gangliosidesARMental retardation; seizures; later juvenile formNoneNoneCherry red spot in infantile formMacro-cephaly; hyperacusis in infantile formSandhoff's- diseaseb-Hexosamini- dases A and BGM2 gangliosidesARMental retardation; seizures+++-Cherry red spotMacro-cephaly; hyperacusis Neutral GlycosphingolipidosesFabry'sDiseasea-Galactosi- dase AGlobotriaosyl- ceramideX-linkedPainfulAcropares- thesiasNoneNoneCorneal dystrophy, vascular lesionsCutaneous angiokeratomas; hypo- hydrosisGaucher's diseaseAcid b-glucosi- daseGlucosyl- ceramideARNone+ + + ++ + + +NoneAdult form highly variableGaucher's cells in bone marrow; cytopenias++++++++Eye movements+++ + + ++ + + + Niemann- Pick disease A and BSphingomye - linaseSphingo- myelinARMental retardation; seizures+ + + +None Osteopo- rosisMacular degenerationPulmonary infiltrates Lung failure Foam cells in bone marrowLeukodystrophiesKrabbe's diseaseGalactosyl- ceramidaseGalactosy-IceramideGalactosyls- phingosineARMental retardationNoneNoneNoneWhite matter globoid cellsMetachro- matic leukody - strophyArylsulfatase ACerebroside sulfateARMental retardation; dementia; and psychosis in adultNoneNoneOptic atrophyGait abnormalities in late infantile formMultiple sulfatase deficiencyActive site cysteine to C-a formylglycineconverting enzymeSulfatides; mucopoly - saccharidesARMental retardation+++Retinal degenerationAbsent activity of ail known cellular sulfatasesDisorders of Neutral LipidsWolman's diseaseAcid lysosomal lipaseCholesteryl esters; triglyceridesARMild mental retardation+++NoneNoneAdrenal calcificationCholesteryl ester storage diseaseAcid lysosomal lipaseCholesteryl estersARNoneHepato - megalyNoneNoneFatty liver disease; cirrhosisFarber's diseaseAcid ceramidaseCeramideAROccasional mental retardation+NoneMacular degenerationArthropathy, subcutaneous nodulesDisorders of GlycogenPompe's diseaseAcid a-glucosidaseGlycogenARNeuromuscular+-NoneNoneMyocar-diopathy | train | med_mcqa | null |
Thromboangitis obliterans involves which vessels - | [
"Ant and Post tibial",
"Femoral",
"Aooiliac",
"Popliteal"
] | A | Thromboangiitis obliterans, also known as Buerger diseaserecurring progressive inflammation and thrombosis (clotting) of small and medium aeries and veins of the hands and feet. It is strongly associated with use of tobacco products,primarily from smoking, but is also associated with smokeless tobacco. There are characteristic pathologic findings of acute inflammation and thrombosis (clotting) of aeries and veins of the hands and feet (the lower limbs being more common). The mechanisms underlying Buerger's disease are still largely unknown, but smoking and tobacco consumption are major factors associated with it. It has been suggested that the tobacco may trigger an immune response in susceptible persons or it may unmask a clotting defect, either of which could incite an inflammatory reaction of the vessel wall.This eventually leads to vasculitis and ischemic changes in distal pas of limbs.mainly anterior and posterior tibial vessels A possible role for Rickettsia in this disease has been proposed Ref Davidson 23rd edition pg 455 | train | med_mcqa | null |
Etheromanias refer to - | [
"Acute psychosis post ether anaesthesia",
"Ether addiction",
"Excessive ether use drug anaesthesia",
"None"
] | B | Ether addiction or etheromania is the addiction to inhalation or drinking of diethyl ether. | train | med_mcqa | null |
In case of sudden death in a young football player, the first clinical suspicion would rest on which of the following differentials? | [
"Arrythmogenic right ventricular dysplasia",
"Takotsubo cardiomyopathy",
"Atrial septal defect",
"Eisenmenger complex"
] | A | The most impoant cause of sudden death in professional footballer in setting of beta myosin testing being available is not HOCM but arrythmogenic right ventricular dysplasia. The Desmin gene is responsible for a defect in muscle of right ventricle leading to fibro fatty replacement of the muscle. These patients in setting of adrenergic stimulation can develop a VT or Torsades de Pointes leading to death on the football field. Takotsubo cardiomyopathy presents in setting of catecholamine surge like an emotional break-up or getting stuck in an elevator during an eahquake. ASD presents with exercise intolerance due to secondary pulmonary aery hypeension. An Eisenmenger patient will be so sick that he cannot be expected to be a football player. | train | med_mcqa | null |
Enterovirus causes all, except - | [
"Hemorrhagic fever",
"Pleurodynia",
"Herpangina",
"Aseptic meningitis"
] | A | Ans. is 'a' i.e., Haemorrhagic fever | train | med_mcqa | null |
The following statements about thyroglossal cyst are true, except . | [
"Frequent cause of anterior midline neck masses in the first decade of life",
"The cyst is located within 2 cm of the midline",
"Incision and drainage is the treatment of choice",
"The swelling moves upwards on protrusion of tongue"
] | C | null | train | med_mcqa | null |
Bioavailability ? | [
"Area of oral/ area of IV",
"Area of IV/ area of oral",
"Area of oral/ area of IV x 100",
"Area of IV/ area of oral x 100"
] | C | Ans. is 'c' i.e., Area of oral/ area of IV x 100 Bioavailability Refers to the rate and extent of absorption of drug from a dosage form as determined by its concentration-time curvein blood or by its excretion in urine. It is the measure of fraction (F) of drug, which reaches the systemic circulation in unchanged form. Bioavailability of a drug given by i.v.route is 100%. So the bioavailability of drug dosage form is determined by comparing it with the i.v.route. | train | med_mcqa | null |
Which of the following is the classical triad of Budd-Chiari syndrome? | [
"Fever, jaundice, abdominal pain",
"Fever, ascites, jaundice",
"Hepatomegaly, abdominal pain, ascites",
"Abdominal pain, jaundice, hepatomegaly"
] | C | Classical triad of Budd - Chiari syndrome is Ascites Hepatomegaly (Mnemonic - AsHA) Abdominal pain Etiology of Budd - Chiari syndrome: Hepato-venous outflow obstruction caused by Hepatic venous Thrombosis /IVC obstruction Acutely obstruction results in tender hepatomegaly. Chronically liver is atrophied but caudate lobe will be hyperophied IOC for diagnosis - venography TOC in hepatic failure - liver transplantation TOC in Hepatic vein thrombosis - shunt - preferred shunt is side to side poocaval shunt | train | med_mcqa | null |
Most common benign salivay gland tumor - | [
"Pleomorphic adenoma",
"Warthin's tumor",
"Mucoepidermoid",
"Adenoid cystic"
] | A | Ans. is 'a' i.e., Pleomorphic adenoma "Pleomorphic adenomas account for 40% to 70% of all tumors of the salivary glands, most commonly occurring in the tail of the parotid " __ SabistonAlso knowo IInd MC tumor of parotido MC malignant tumor of salivary glando The parotid tumor which spread through neural sheatho Best diagnostic modality for parotid swelling iso Open incisional biopsy is contraindicated.----WarthinsMucoepidermoid CaAdenoid cystic CaFNAC | train | med_mcqa | null |
In the earliest stages of carious Lesion. There is loss of: | [
"Enamel cuticle",
"Interprismatic substance",
"Organic matrix",
"Enamel lamellae"
] | B | null | train | med_mcqa | null |
All are found in Small Intestine except? | [
"Stem cells",
"Goblet Cells",
"Neck Cells",
"Paneth Cells"
] | C | Neck cells are present in stomach . Goblet cells secrete mucus Paneth cells provides immunity by secreting cytokines Stem Cells are pleuripotent cells which help in repair | train | med_mcqa | null |
ova form in stool is not diagnostic in | [
"strongyloides",
"ancylostoma",
"ascaris lumbricoides",
"nector americanus"
] | A | strongyloides is oviviviparous hence eggs hatch immediately to produce rhabditi form larva which is the diagnostic form in stool ref : paniker 8th ed | train | med_mcqa | null |
Which one of the following imaging modalities is most sensitive for localization of extra adrenal pheochromocytoma? | [
"USG",
"DOPA-PET",
"MRI",
"MIBG scan"
] | B | Ans. B. DOPA-PETPheochromocytoma* MRI has been the primary method of diagnosis for adrenal pheochromocytoma which shows light bulb appearance on a T2 weighted MRI. MIBG scanning can play a complementary role in evaluating intra adrenal pheochromocytoma.* It is 80-90% sensitive for adrenal one. MIBG scintigraphy is extremely valuable in imaging of extra adrenal and recurrent pheochromocytoma. MIBG is a precursor of catecholamines and therefore, is actively taken up in catecholamines producing tissues, recently introduction of F-DOPA PET has markedly increased the diagnostic accuracy of imaging investigation for localization of both intra as well as extra adrenal pheochromocytoma. | train | med_mcqa | null |
Dehydrogenases of HMP shunt are specific for: | [
"TPP",
"NADP+",
"FMN",
"FAD"
] | B | Dehydrogenases of HMP shunt use NADP+ as a coenzyme and produces NADPH after reduction. | train | med_mcqa | null |
Diverticulosis appearance on barium enema as shown is called: | [
"Saw Tooth Appearance",
"Cork screw appearance",
"Bird of prey appearance",
"Claw sign"
] | A | Ans. (a) Saw tooth Appearance | train | med_mcqa | null |
The anti–arrhythmic drug of choice in most of the cases of acute paroxysmal supraventricular tachycardia is: | [
"Adenosine",
"Amiodarone",
"Propranolol",
"Quinidine"
] | A | null | train | med_mcqa | null |
Exposure to noise above ----- cause permanent hearing loss | [
"85 db",
"90 db",
"100 db",
"160 db"
] | C | Repeated or continuous exposure to noise around 100 decibels may result in a permanent hearing loss. In this, the inner ear damage may vary from minor changes in the hair cell endings to complete destruction of the organs of coi.Exposure to noise above 160dB may rupture the tympanic membrane and cause permanent hearing lossPark 23e pg: 742 | train | med_mcqa | null |
What is meant by "Suppositions child" - | [
"Child born out of wedlock",
"Child fictitiously claimed by a woman",
"Second born of a twin pregnancy",
"Child is born after artificial insemination homologous"
] | B | Suppositious child : Child presented by the mother to have been delivered by her, though she has not delivered. | train | med_mcqa | null |
Missing cases are detected by? | [
"Active surveillance",
"Passive surveillance",
"Sentinel surveillance",
"Monitoring"
] | C | ANSWER: (C) Sentinel surveillanceREF: Park 20th edition page 38The word surveillance is the French word for "watching over"Sentinel surveillance is useful for answering specific epidemiologic questions because sentinel sites may not represent the general population or the general incidence of disease, they may have limited usefulness in analyzing national disease patterns and trends. (REF: http://www.usaid. gov/our_work/global_health/id/surveillance/sentinel.html)SURVEILLANCE:Continuous scrutiny of factors that determine the occurrence and distribution of diseases and other conditions of ill healthTypes:1. Active Surveillance:* One way to overcome the limitations of passive surveillance and get a better picture of disease burden in the community is for health workers to visit health facilities and communities to seek out cases. This is known as active surveillance.Eradication and elimination programmes may require a very active surveillance programme aimed at detecting every case.During outbreak situations surveillance must be intensified with the introduction of active case findingPassive Surveillance:Passive surveillance yields only limited data because many sick people do not visit a health facility and because those cases that do show up may not be correctly classified, recorded, or reportedSentinel Surveillance:A method of identifying the missing cases and thereby supplementing the notified casesFor example, in HIV/AIDS surveillance the proportion of the population positive for HIV7 must be monitored as well as the number of new cases of AIDS. This requires special HIV seropre vale nee surveillance usually done in a few representative sites ('sentinel surveillance"). | train | med_mcqa | null |
Maximum Biological value is for | [
"Egg",
"Soya",
"Milk",
"Rice"
] | A | null | train | med_mcqa | null |
Simplest measure of dispersion-a) Rangeb) Standard deviationc) Mean deviationd) Co-efficeint of range | [
"a",
"ad",
"ac",
"ab"
] | A | The range
o Range is the simplest measure of dispersion.
o It is defined as the difference between the largest and smallest values of the variable.
Range (R) = Largest value (L) - Smallest value (S) | train | med_mcqa | null |
Most common muscle affected by fibrosis is | [
"Serratus anterior",
"Trapezius",
"Sternocleidomastoid",
"Tendocalcaneous"
] | C | Fibrosis of sternocleisomastoid occurs in Less than 0.4 percnt of all newborns but it&; is the most common cause of congenital toicollis The sterno-mastoid muscle on one side of the neck is fibrosed and fails to elongate as the child grows, and thus results in a progressive deformity. The cause of fibrosis is not known, but it is possibly a result of ischaemic necrosis of the sterno-mastoid muscle at bih. Evidence in our of this theory is the presence of a lump in the sterno-mastoid muscle in the first few weeks of life, probably a swollen ischaemic muscle. Ref: Maheshwari and Mhaskar 9th ed pg 321. | train | med_mcqa | null |
Agar impression materials differ from alginate impression materials in that the former sets by: | [
"Mechanical action of saliva",
"Physical change",
"Evolution",
"Chemical change"
] | B | null | train | med_mcqa | null |
Treatment of high-lying ulcer near gastro-oesophageal junction is | [
"Pauchet's procedure",
"Kelling- Madlenger operation",
"Csendes procedure",
"Total gastrectomy"
] | A | Type 4 proximal gastric ulcer is difficult to manage.it is treated by subtotal gastrectomy.often distal gastrectomy with selective sleeve-like extension cut along the lesser curve to remove the ulcer is done-Pauchet&;s procedure Ref: SRB &;s manual of surgery, ed 5, pg 825 | train | med_mcqa | null |
What % of submandibular salivary gland stones are radiopaque? | [
"10%",
"70%",
"80%",
"90%"
] | C | 80% of submandibular salivary gland stones are radiopaque. SIALOLITHIASIS 80% of all salivary gland stones occur in submandibular glandQ, 10% occur in parotid, 7% in sublingual and the remainder in minor salivary glands. MC site is Whaon's ductQ > submandibular gland substance Composition of stone: Calcium and magnesium phosphate or carbonateQ Due to deposition of calcium salts, 80% stones are radio opaqueQ | train | med_mcqa | null |
The limit of loudness expressed as decibels that people can tolerate without substanial damage to their hearing is - | [
"55",
"65",
"75",
"85"
] | D | Sound in dB Effect 20 Whispering 40 Quiet library 60 Normal conversation 70 heavy street traffic 80 printing press 85 Recommended maximum 110 Train passing through station 120 Motor car horn 140 Threshold of pain 150-160 Mechanical damage Park's Textbook of Preventive and Social Medicine, 25th edition, Page No. 802 | train | med_mcqa | null |
Cu 380A should be replaced once in | [
"4years",
"6years",
"8years",
"10years"
] | D | Change of IUDs Ine IUDs such as Lippes Loop may be left in place as long as required, if there are no side-effects. Copper devices cannot be used indefinitely because copper corrodes and mineral deposits build up on the copper affecting the release of copper ions. They have to be replaced periodically. The same applies to the hormone-releasing devices. This is an inherent disadvantage of medicated devices when they are used in large national family planning programmes. The Cu-T -380A is approved for use for 10 years. However, the Cu-T -380A has been demonstrated to maintain its efficacy over at least 12 years of use. The Cu-T -200 is approved for 4 years and the Nova T for 5 years. The progesterone-releasing IUD must be replaced every year because the reservoir of progesterone is depleted in 12-18 months. The levonorgestrel IUD can be used for at least 7 years, and probably 10 years. The progesterone IUD has a slightly higher failure rate, but the levonorgestrel device that releases 15-20 ug levonorgestrel per day is as effective as the new copper IUDs Ref : Park 25th edition Pgno : 531-548 | train | med_mcqa | null |
Denominator while calculating the secondary attack rate includes- | [
"All the people living in next fifty houses",
"All the close contacts",
"All susceptible among close contacts",
"All susceptible in the whole village"
] | C | The denominator consists of all persons who are exposed to the case. More specifically the denominator may be restricted only to susceptible contacts if means are available to distinguish the susceptible persons from the immune. (refer pg no 100 park 23rd edition) | train | med_mcqa | null |
The first step in fructose metabolism in the liver is | [
"Isomerization of glucose",
"Phosphorylation to fructose 1, 6 bisphosphate by ATP",
"Phosphorylation to fructose 6 phosphate by ATP",
"Phosphorylation to fructose 1 phosphate by ATP"
] | D | Fructose metabolism The first step isFructose| ATP to ADP| FructokinaseFructose-1-Phosphate Second step: Fructose-1-Phosphate can conve into Glyceraldehyde or DHAP with the help of Aldolase (Fructose-1-Phosphate aldolase)Glyceraldehyde conveed to Glyceraldehyde-3-Phosphate with the help of Triose kinase and ATP conveed to ADPDHAP conveed to Glyceraldehyde-3-Phosphate with help of Triose-phosphate isomerase. | train | med_mcqa | null |
The preferred treatment of verrucouse carcinoma of the larynx is | [
"Endoscopic removal",
"Electron beam therapy",
"Pulmonary surgery",
"Total laryngectomy"
] | A | Verrucous Carcinoma 1) Verrcous carcinoma makes up only 1-2% of laryngeal carcinomas. 2) The larynx is the second most common site of occurence in the head and neck after the oral cavity. 3) Most common site of involvement is vocal cord. 4) Grossly, verrucous carcinoma appears as a fungating, papillomatous, grayish white neoplasm. 5) Microscopically, it is well differentiated squamous cell carcinoma with minimal cytological atypia. 6) It has low metastatic potential . 7) Hoarseness is the most common presented symptom. Pain and dysphagia may occur but are less common. 8) Treatment of most verrucous tumors is primary surgery. Endoscopic laser surgery is appropriate as the tumor is less aggressive than usual squamous cell carcinoma. Ref:- Current otolaryngology; pg num:- 444 | train | med_mcqa | null |
During childbih, which of the following muscles is most often injured by a tear of the perineum? | [
"Coccygeus",
"Iliococcygeus",
"Pubococcygeus",
"Puborectalis"
] | C | The fetal head is suppoed during childbih by the pelvic floor. If injury occurs during the passage of the child through the dilated uterine cervix, this injury most frequently involves a tear of the perineum between the vagina and anus. This tear usually involves the pubococcygeus, which is the main pa of the levator ani. The pubococcygeus runs from the pubic bone anteriorly to the coccyx posteriorly, and contains an anterior opening for the urethra and vagina and a posterior opening for the rectum. Tears to this muscle that heal poorly may consequently predispose for uterine prolapse, cystocele, and rectocele. The coccygeus is a relatively small muscle of the pelvic floor that runs from the ischial spine to the inferior end of the sacrum. The iliococcygeus is another pa of the levator ani, and runs from the iliac bone to the coccyx, forming pa of the more lateral aspects of the pelvic floor. The puborectalis is the third pa of the levator ani, and runs from pubic bone to pubic bone, forming a sling-like structure around the wall of the anal canal Ref: Lippincott's Illustrated Q&A Review of Anatomy and Embryology - Page 85 | train | med_mcqa | null |
Motile spermatozoa found in wet mount of vaginal secretions indicates of intercourse within the past: | [
"3 hours",
"12 hours",
"24 hours",
"48 hours"
] | B | Motile spermatozoa should be found in vagina for 6-12 hrs they are likely to be found upto 3 days later,and occasionally they are found 7 days later. | train | med_mcqa | null |
A 17 year-old female is suffering from insomnia from last 6 months. She also informs about her changed eating habit . She eats alot of food even after eating her evening meals and also wakes up frequently at night to eat again . Due to such behaviour she usually skips her breakfast . She doesn't seem much concerned about her appearance and weight gain . What shall be your probable diagnosis ? | [
"Night eating syndrome",
"Bulimia nervosa",
"Anorexia nervosa",
"Binge eating disorder"
] | A | From the symptoms enlisted above , it seem to be a Night eating syndrome Night-eating syndrome Consuming significant amount of caloric intake after an evening meal Diagnostic points : Symptoms persist for >=3 months Recurrent episodes of hyperphagia(At night ) Insomnia In the morning ,lack of desire for food Unconcerned about appearance and weight gain . Binge Eating disorder and other Eating disorders are shoer in duration | train | med_mcqa | null |
The most common site of Berry aneurysm is: | [
"Junction of anterior communication aery with anterior cerebral aery",
"Junction of posterior communicating aery with internal carotid aery",
"Bifurcation of middle cerebral aery",
"Veebral aery"
] | A | Occurence of Berry aneurysm in order of frequency Anterior communicating aery anterior cerebral junction (29%) Posterior communicating aery internal carotid junction (28%) Middle cerebral bifurcation (18%) Intracranial carotid bifurcation (8%) Veebrobasilar or basilar bifurcation (3%) | train | med_mcqa | null |
Type I membranoproliferative glomerulonephritis is commonly associated with all except: | [
"SLE",
"Persistent hepatitis C infections",
"Paial lipodystrophy",
"Neoplastic diseases"
] | C | MPGN Type 1 : Characterised by subendothelial deposits. Basement membrane covers subendothelial deposits on both sides which is responsible for Tram Track appearance . Paial lipodystrophy is associated with C3 nephritic factor (C3NeF)- Type II MPGN | train | med_mcqa | null |
Suppose a body is lying in a dese and the person had been suffering from chronic arsenic poisoning while alive. Which one of the following is the MOST possible finding in the body? | [
"Adipocere formation",
"Mummification",
"Aseptic acetolysis",
"Saponification"
] | B | The conditions ideal for mummifications are high temperature, dry environment and freely circulating air around the body. Chronic arsenic and antimony poisoning also inhibit bacterial growth and promote mummification. So in this scenario mummification is most likely. Also know Saponification or adipocere formation occurs in warm and humid region in the absence of free circulation of air. Ref: Textbook of Forensic Medicine and Toxicology by Narayan Reddy, Edition 23, Page - 138. | train | med_mcqa | null |
Children of parents with which of the following
blood group combinations have the highest risk of
erythroblastosis fetalis: | [
"Rh+ father and Rh+ mother",
"Rh+ father and Rh- mother",
"Rh- father and Rh+ mother",
"Rh- father and Rh- mother"
] | B | null | train | med_mcqa | null |
Drug of choice in scabies in pregnant woman is? | [
"Lindane",
"Ivermectin",
"Sulphur ointment",
"Permethrin"
] | D | ANSWER: D. Safest is 6% sulfur ointment but still, the DOC is 5% permethrin both in infants and pregnant females. REF: IADVL 2nd edp. 428 Treatment of scabies in pregnancy is of much debate. International authors and textbooks like ROOK'S says: Scabicides in pregnancy and breastfeeding. The literature is replete with cautionary advice relating to the use of scabicides in pregnancy, but having indicated which scabicides are best avoided, authors rarely commit themselves to stating what they recommend. This is understandable in view of concern about potential toxic effects on the fetus but, to this author's knowledge. there is no documented evidence that any of the currently available scabicides has been responsible for harmful effects in pregnancy. Current UK Clinical Knowledge Summaries (CKS) guidelines suggest using permethrin, with malathion as an alternative. However Indian authors traditionally suggest using 6% precipitated sulfur in petrolatum applied to the entire body for 3 days as an alternative to GBH. | train | med_mcqa | null |
A 4-yr old male child presents with muscle weakness. His mother tells that her child has difficulty in climbing stairs and getting up from the floor. On muscle biopsy, small muscle fibrils and absent of dystrophin was found. what is the diagnosis out of given options? | [
"Becker's muscle dystrophy",
"Duchenne muscular dystrophy",
"Myotonic dystrophy",
"Limb-girdle muscular dystrophy"
] | B | Duchenne Muscular Dystrophy Progressive weakness Calf muscle involvement Pseudo hyperophy Difficulty in climbing stairs Gower sign present (+) Wheel chair bound Patient Death - CHF/ Pneumonia CPK MM: Increased IOC: - PCR for dystrophin gene (Dystrophin gene absent) Rx: - Chest Physiotherapy NOTE:Immunohistochemical studies for dystrophin show Absence of the normal sarcolemma staining pattern in Duchenne muscular dystrophin Reduced staining in Becker muscular dystrophy. | train | med_mcqa | null |
Which of the following is derived from cailage of the third arch- | [
"Styloid process",
"Malleus",
"Incus",
"Greater cornu of hyoid"
] | D | D i.e. Greater cornu of hyoid | train | med_mcqa | null |
Succinyl Co-A is formed by: | [
"Histidine",
"Leucine",
"Valine",
"Lysine"
] | C | Succinyl COA is formed by Valine, Isoleucine, Methionine. | train | med_mcqa | null |
UV radiation has which of the following effects on the cells | [
"UV radiation has which of the following effects on the cells",
"Stimulates formation of pyrimidine dimers",
"Prevents formation of purine dimers",
"All of the above"
] | B | Direct quote from Robbins.. “The carcinogenicity of UV-B light is attributed to its formation of pyrimidine dimers in DNA”. This type of DNA damage is repaired by the nucleotide excision repair pathway. The importance of the nucleotide
excision repair pathway of DNA repair is illustrated by the high frequency of cancers in individuals with the hereditary disorder xeroderma pigmentosum.. | train | med_mcqa | null |
Keshan disease is seen in deficiency of - | [
"Selenium",
"Chromium",
"Molybdenum",
"Copper"
] | A | Ans. is 'a' i.e., Selenium Selenium* Selenium, in the form of selenocysteine, is a component of the enzyme glutathione peroxidase, which serves to protect proteins, cell membranes, lipids, and nucleic acids from oxidant molecules. As such, selenium is being actively studied as a chemopreventive agent against certain cancers, such as prostate cancer.* Selenocysteine is also found in the deiodinase enzymes, which mediate the deiodination of thyroxine to triiodothyronine.* Rich dietary sources of selenium include seafood, muscle meat, and cereals, although the selenium content of cereal is determined by the soil concentration.* Countries with low soil concentrations include parts of Scandinavia, China, and New Zealand.* Keshan disease is an endemic cardiomyopathy found in children and young women residing in regions of China where dietary intake of selenium is low (<20 g/d).* Concomitant deficiencies of iodine and selenium may worsen the clinical manifestations of cretinism.* Chronic ingestion of high amounts of selenium leads to selenosis, characterized by hair and nail brittleness and loss, garlic breath odor, skin rash, myopathy, irritability, and other abnormalities of the nervous system. | train | med_mcqa | null |
How to differentiate between psychological and organic erectile dysfunction - | [
"Nocturnal penile tumescence",
"PIPE therapy",
"Sildenafil induced erection",
"Squeeze technique"
] | A | Ans. is 'a' i.e.. Nocturnal penile tumescence o One of the important method to distinguish psychogenic impotence from organic impotence is nocturnal penile tumsescence & early morning erection which are preserved in psychogenic impotence but not in organic cause of impotence. | train | med_mcqa | null |
A 30 year old male was brought for evaluation. The history revealed that the patients 3 year old son died, 5 months back after being hit by a car. At the time of accident, patient was standing nearby and witnessed the accident. For last 5 months, he has been having symptoms of sadness of mood, crying spells, feelings of wohlessness, poor sleep and poor appetite. He has twice thought of killing himself but stopped at the end moment. He has not been attending the office of last 5 months. What is the likely diagnosis: | [
"Post traumatic stress disorder",
"Normal grief",
"Major depression",
"Adjustment disorder"
] | C | Depression: A major depressive disorder occurs without a history of a manic, mixed, or hypomanic episode. A major depressive episode must last at least 2 weeks DIAGNOSIS: Major Depressive Disorder The DSM-5 diagnostic criteria for major depression Sadness of mood Diminished interest in pleasure Significant weight loss or gain more than 5% in a month Crying spells Feeling of wohlessness Poor sleep (Insomnia or hypersomnia) Suicidal thoughts Psychomotor retardation Fatigue or loss of energy. Five or more of these symptoms present for 2 weeks or more or either depressed mood or loss of interest or pleasure. | train | med_mcqa | null |
All of the following are coverings of a mature graffian follicle, except ? | [
"Theca externa",
"Theca interna",
"Germinal cells",
"Granulosa cells"
] | C | Coverings of the mature or graffian follicle are (From inner to outer) * Innermost layer is the the granulosa cells* The theca interna* The theca externa | train | med_mcqa | null |
Tinea seen after inadvertent treatment with topical steroid is: | [
"Tinea incognito",
"Vagabond disease",
"Tinea versicolor",
"Tinea capitis"
] | A | Ans: a (Tinea incognito) Ref: Davidson, 20th ed, p. 1083Inadvertent topical steroid application leads to worsening of the signs (tinea incognito) Chronic infestation with louse results in a post inflammatory hyperpigmentation and thickening of the skin known as "vagabond disease".Tinea versicolorCaused by malazzesia furfur (mycelial stage) or Pityrosporum ovale (yeast form)KOH mount shows-sphagetti meat ball apperance. | train | med_mcqa | null |
True for Hodgkin's stage IA is - | [
"Chemotherapy is best",
"Radiotherapy is best",
"Total radiation therapy is best treatment",
"Fever and wt loss is always present"
] | B | null | train | med_mcqa | null |
False statement regarding phenytoin is: March 2007 | [
"Is highly protein bound",
"Half life decreases with decreasing dose",
"Microsomal enzyme inducer",
"Follows zero order kinetics at lower doses"
] | D | Ans. D: Follows zero order kinetics at lower doses Phenytoin acts to dampen the unwanted, runaway brain activity seen in seizure by reducing electrical conductance among brain cells by stabilizing the inactive state of voltage gated sodium channels. Absorption of phenytoin by oral route is slowit is widely distributed in the body and 80-90% bound to plasma proteins. Phenytoin is metabolized in liver by hydroxylation and glucuronide conjugation. The kinetics of metabolism is capacity limited; changes from first order to zero order over the therapeutic range-small increments in dose produce dispropoionately high plasma concentrations. The plasma half life (12-24 hours) progressively increases (upto 60 hours) when plasma concentration rises above 10 microgram/ ml as metabolizing enzyme gets saturated. Aside from seizures, it is an option in the treatment of trigeminal neuralgia as well as ceain cardiac arrhythmias. At therapeutic doses, phenytoin produces horizontal gaze nystagmus At toxic doses, patients experience sedation, cerebellar ataxia, and ophthalmoparesis, as well as paradoxical seizures. Idiosyncratic side effects of phenytoin, as with other anticonvulsants, include rash and severe allergic reactions. Phenytoin causes a reduction in folic acid levels, predisposing patients to megaloblastic anemia. Folic acid is presented as polyglutamate in foods, it is then conveed into monoglutamates by intestinal conjugase. Phenytoin acts by inhibiting this enzyme therefore causing folate deficiency. Phenytoin is a known teratogen. The syndrome consists of craniofacial anomalies (broad nasal bridge, cleft lip and palate, microcephaly) and a mild form of mental retardation (average IQ=71).This syndrome resembles the well-described Fetal Alcohol Syndrome and has also been called the "fetal hydantoin syndrome." Phenytoin may accumulate in the cerebral coex over long periods of time, as well as causing atrophy of the cerebellum when administered at chronically high levels. Despite this, the drug has a long history of safe use and it is a common "first line of defense" in seizure cases. Phenytoin has been known to cause Drug-induced Lupus. Phenytoin has been associated with drug induced gingival enlargement (hyperplasia) in the oral cavity probably due to folate defiency. Patients whose epilepsy is treated with drugs face about twice the risk of suicidal thoughts compared to placebo-takers Phenobarbitone competitively inhibits phenytoin metabolism, while by enzyme induction both enhance each other's degradation. Phenytoin induces microsomal enzymes and increases degradation of steroids (failure of oral contraceptives), digitoxin, doxycycline, theophylline. | train | med_mcqa | null |
A 41 year old male patient presented with recurrent episodes of bloody diarrhea for 5 years. Despite regular treatment with adequate doses of sulfasalazine, he has had several exacerbations of his disease and required several weeks of steroids for the control for flares. What should be the next line of treatment for him? | [
"Methotrexate",
"Azathioprine",
"Cyclosporine",
"Cyclophosphamide"
] | B | Ans. is 'b' i.e. AzathioprineRef Harrison 17th/e p 1896 & 16th/e p 1785 (15th/e p1688), Goodman Gilman 10th/eThis is a case of ulcerative colitis as suggested by the recurrent episodes of bloody diarrhoea.The pt. has been on maintenance therapy with sulfasalazine but it is not able to maintain the patient in remission and he needs corticosteroid for the control of his exacerbations.So, he now needs a drug which can maintain him in remissionFor this go through the role of immunosuppressant is ulcerative colitis.AzathioprineAzathioprine and 6 mercapto- purine are effective in long term management of ulcerative colitis. They reduce the requirement of steroids in patient as well as maintain the patient in remissionCyclosporine -It greatest value is in t/t of acute severe ulcerative colitis that does not appear to be responding adequately to glucocorticoid. However it does not reduce the rate of relapse and is not effective as maintenance therapy. So it is used for short term management of ulcerative colitis.Methotrexate Methotrexate is useful in steroid dependent on Crohn's disease but it has no use in ulcerative colitis.Cyclophosphamide has no role in the management of either Crohn's disease or ulcerative colitis. | train | med_mcqa | null |
Posterior lenticonus is seen in ? | [
"Alpo's syndrome",
"Lowe's syndrome",
"Marfan syndrome",
"Homocystinuria"
] | B | Ans. is 'b' i.e., Lowe's syndrome Lenticonus refers to cone-shaped elevation of the anterior pole (anterior lenticonus) or posterior pole (posterior lenticonus) of the lens. Anterior lenticonus is seen in Alpo's syndrome. Posterior lenticonus is seen in Lowe's syndrome. On distant direct ophthalmoscopy, lenticonus present as an oil globule lying in the center of red reflex. Slit-lamp examination confirms the diagnosis. | train | med_mcqa | null |
All the statements about nontuberculous mycobacteria (NTM), are TRUE, EXCEPT: | [
"NTM are ubiquitous in soil and water",
"No human-to-human transmission of NTM",
"Disseminated disease denotes significant immune dysfunction",
"Pulmonary disease, is usually associated with systemic immunodeficiency."
] | D | Nontuberculous mycobacteria (NTM) survives in soil and water. Most NTM cause disease in humans only rarely. There is no human-to-human transmission of NTM. Disseminated disease denotes immune dysfunction eg:advanced HIV infection. Pulmonary disease is highly associated with pulmonary epithelial defects but not with systemic immunodeficiency. Ref: Harrison, Edition-18, Page-1367. | train | med_mcqa | null |
The side towards which mandible moves is called the: | [
"Tooth contact side",
"Balancing side",
"Working side",
"Non — working side"
] | C | null | train | med_mcqa | null |
Sinusoids are seen in all of the following except - | [
"Liver",
"Kidney",
"Lymph nodes",
"Spleen"
] | B | Sinusoids are present in liver, spleen, lymph nodes, endocrine glands (adrenal medulla, parathyroid), bone marrow and carotid body. | train | med_mcqa | null |
Most common cause of hematochezia in children? | [
"Rectal polyp",
"Meckel's diveiculum",
"Necrotizing enterocolitis",
"Acute gastritis"
] | A | Causes of Lower GI bleeding in children - Neonate = anal fissure 1 month - 1 year = anal fissure 1 year - 2 years = Rectal polyp 2 years = Rectal polyp | train | med_mcqa | null |
Infective stage of hook worm is: | [
"Trophozoite form",
"Filiform larva",
"Cyst",
"None"
] | B | Ans. b. Filiform larva | train | med_mcqa | null |
Most virulent variety of shigellosis is caused by ? | [
"S. Dysenteriae",
"S. Sonnei",
"S. Flexneri",
"S. Boydii"
] | A | Ans. is 'a' i.e., Shigella dysenteriae . Complications are most often seen in infection with Sh. dysenteriae type 1 and include ahritis, toxic neuritis, conjuctivits, parotitis and in children, intussusception. HUS may occur in severe cases. "Severe dysentery most likely involves infection due to S. dysenteriae type 1, occurs less commonly with S. flexneri and is least likely with S. sonnei or S. boydii" - Harrison 16/h/e p. 904. Remember :? . Incubation period of bacillary dysentry - 1-7 days, usually 48 hours. . Sh. sonnei causes the mildest form of dysentry. . Sh. flexneri is the predominant shigella species (50-85%) in India, Sh. boydii is least common (0-8%). Unique features of shigella dysentriae type-1 : a) Catalase is produced by all except sh. dysentriae type I b) Mannitol is fermented by all except sh. dysentriae type 1 c) It produces a powerful exotoxin, and is an example of an exotoxin produced by Gram (-) ve bacillus. d) Most common cause of HUS in India e) It has invasive propeies. This can be demonstrated by sereny test. | train | med_mcqa | null |
A 3 week old child presented to the pediatrician with meningitis. A presumptive diagnosis of late onset perinatal meningitis was made. The CSF culture was positive for gram positive bacilli. Which of the following characteristic of this bacteria would be helpful in differentiating it from other bacterial agents:- | [
"Ability to grow on blood agar",
"Ability to produce catalase",
"Fermentative attack on sugars",
"Motility at 25 degree Celsius."
] | D | L. monocytogenes is resposible for late onset perinatal meningitis. gram positive, non -spore forming rod tumbling motility at 22-28 degree Celsius but not at 37 degree Celsius- differentiates listeria from diphtheroids that are members of the normal microbiota of the skin. | train | med_mcqa | null |
Molar ratio of sodium & glucose in WHO reduced osmolarity ORS is: | [
"1:01",
"1:02",
"1:04",
"2:01"
] | A | Ans. A. 1:1Composition of WHO recommended ORS.Constituentg/lmmol/ion Sodium chloride2.6Sodium75Glucose, anhydrous13.5Chloride65Potassium chloride1.5Potassium20Trisodium citrate dihydrate2.9Citrate10Total Osmolarity245mosmol/L | train | med_mcqa | null |
In tumour lysis syndrome, all of the following are seen except: | [
"Hyperuricemia",
"Hypercalcemia",
"Hyperkalemia",
"Hyperphosphatemia"
] | B | Tumor lysis syndrome: -Seen at the onset of chemotherapy in rapidly dividing tumor cells. Findings: - Hyperkalemia - Hyperphosphatemia - Hyperuricemia - Hypocalcemia RASBURICASE(URATE OXIDASE) IS USEFUL to DECREASE URIC ACID LEVEL. | train | med_mcqa | null |
Multiple myeloma is characterized by all except: | [
"Presence of light chains",
"Monoclonal gammopathy",
"Polyclonal gammopathy",
"Hypergammaglobulinemia"
] | C | Answer is C (Polyclomal gammapathy) Mulitple Myeloma is characterized by monoclonal gammapathy and not polyclonal gammapathy. Multiple myeloma represents a malignant proliferation ofplasma cells derived from a single clone (monoclonal) Bone marrow cells are monoclonal | train | med_mcqa | null |
Emperical use of intravenous amphotericin is indicated in - | [
"Candida",
"Blastomycosis",
"Non-responding febrile neutropenia",
"Larva migrans"
] | C | Ans. is 'c' i.e., Non-responding febrile neutropenia o Empirical use of i. v. AMB is often made in neutropenic patients whose fever is not responding to i. v. bactericidal antibiotics.Amphotericin Bo It is a polyene antifungalo It is derived from streptomyces nodosus.o It is fungicidal at high concentrations and fungistatic at low concentrations,o It has high affinity for Ergosterol present in fungal cell wall.o It increases the permeability of the fungal cell wall by forming micropores in fungal cell wall,o Amphotericin is not absorbed orally. It is given i.v.o To prevent the toxicity, newer lipid bound i.v. preparations of amphotericin B have been prepared,o These are -(a) Amphotericin B lipid complex (ABLC) (b) Amphotericin B colloidal suspension (ABCD)(c) Liposomal amphotericin Bo Uses -It is D.O.C. fori) Cryptococcosis - used along with Flucytosine ii) Aspergillosis iii) Mucormycosis. | train | med_mcqa | null |
Long acting barbiturate is ? | [
"Thiopentone",
"Secobarbitone",
"Phenobarbitone",
"Pentobarbitone"
] | C | Ans. is 'c' i.e., Phenobarbitone Long acting barbiturates -4 Phenobarbitone, Mephobarbitone. Sho acting barbiturates-4 Butobarbitone, secobarbitone, Pentobarbitone. Ultrasho acting -4 Thiopentone, Methohexitone, Hexobarbitone. | train | med_mcqa | null |
For the treatment of deep seated tumors, the following rays are used. | [
"X- rays and Gamma- rays",
"Alpha rays and Beta -rays",
"Electrons and positrons",
"High power laser beams"
] | A | Ans. is 'a' i.e. X-rays and Gamma-rays X-rays and gamma rays are electromagnetic waves with highest penetrating power.For deep seated tumours rays with maximum penetrating power is required so x-rays and gamma rays are used.Harrison 141h/e states - "Megavoltage X-rays are used to irradiate internal deep seated lesions since high energy penetrating beams deliver a less intense superficial dose and spares the skin". | train | med_mcqa | null |
Which of the following is used to differentiate tumour recurrence and rediation necrosis? | [
"PET scan",
"MRI",
"3D CT",
"USG"
] | A | Ans. is'a'i.e., PET scanPET may be used in therapeutic monitoring after chemotherapy or radiotherapy, with a classic indication being assessment for recurrent tumor versus radiation necrosis.Conventional imaging can not differentiate recurrent tumor from radiation necrosis. | train | med_mcqa | null |
Adipocure occurs in | [
"Arsenic poison",
"Lying in water",
"Body inside car locked doors",
"Inside shallow soil"
] | B | Warm, moist climate essential.
Clostridium - lecithinase.
Intrinsic lipase. | train | med_mcqa | null |
Which is not the component of carneys traid | [
"GIST",
"Pulmonary chondromas",
"Osteoma",
"Extra adrenal paraganglioma"
] | C | null | train | med_mcqa | null |
A child presented with history of unilateral purulent nasal discharge with occasional bloody discharge from the same side, the diagnosis is: | [
"Antrochoanal polyp",
"Foreign body",
"Angiofibroma",
"Rhinosporidiosis"
] | B | (b) Foreign body(Ref. Scott Brown, 8th ed., Vol 2; 243)Antrochoanal polyp usually presents with unilateral nasal obstruction. Nasal discharge if occurs is mucoid.Angiofibroma presents with repeated torrential or profuse epistaxis in pubertal males.Rhinosporidiosis presents with epistaxis and a mulberry nasal mass. | train | med_mcqa | null |
Which prevents apoptosis of Memory B Cells? | [
"Platelet derived Growth Factor",
"Nerve Growth Factor",
"Fibroblast Growth Factor",
"IGF"
] | B | . | train | med_mcqa | null |
Marker of glomus tumor? | [
"CD-57",
"Cytokeratin",
"S-100",
"CD-34"
] | A | Ans. is 'a' i.e., CD-57 Glomus tumor is a benign mesenchymal neoplasm of the subcutaneous tissue of the distal extremities and head & neck region. Immunohistochemistry shows smooth muscle actin, vimentin, collagen IV and CD-57, with little to no expression of neuroendocrine, endothelial or epithelial markers. Markers that have been proved consistently negative include cytokeratin, synaptophysin, chromogranin A, CD-31 and S-100 protein. Glomangioma (Glomuvenous malformation) Glomangioma is a variant of glomus tumor It is characterized by multiple tumors resembling cavernous hemangioma, lined by glomus cells. Glomangioma is blue-red, extremely painful vascular neoplasm. It involves a glomeriform aeriovenous anastomosis (glomus body) It may be found anywhere in the skin, most often in the distal poion offingers and toes, especially beneath the nails (subungal). Secondary thrombosis and phlebolith formation may occur in these lesions. | train | med_mcqa | null |
A 50 year old male presents with malignant hypeension. the drug of choices | [
"Sodium nitroprusside",
"Sublingual nifedipine",
"Furosemide",
"Enalapril"
] | A | It is a first choice drug for malignant hypeension Refer kDT 11e p185 | train | med_mcqa | null |
Skin over the angle of mandible is supplied by | [
"Auriculotemporal nerve",
"Lesser occipital nerve",
"Infraorbital nerve",
"Great auricular nerve"
] | D | Ans. d (Great auricular nerve) (Ref. BDC Vol. Ill 4th ed. 57)The great auricular nerve originates from the cervical plexus, composed of branches of spinal nerves C2 and C3. It provides sensory innervation for the skin over angle of mandible (parotid area) and mastoid process, and both surfaces of the outer ear.INNERVATION OF THE SKIN OF FACE# Innervation of the skin is mainly through the three branches of the trigeminal nerve (CN V).# Some skin over the angle of the mandible and anterior and posterior of the auricle is supplied by the great auricular nerve from the cervical plexus.# Some cutaneous branches of the auricular branch of the facial nerve also supply skin on both sides of the auricle.# The trigeminal nerve is the general sensory nerve to the head, particularly the face, and is the motor nerve to the muscles of mastication. | train | med_mcqa | null |
In sickle cell crisis bone pain is due to:- | [
"Bone infarction",
"Osteroporosis",
"Osteomalacia",
"Periosteal reaction"
] | A | - Abnormal shape of RBC - Occlusion of small vessels of bone - bone infarction - resulting in pain If bones of hand & feet are involved - Hand foot syndrome Long bones - Avascular necrosis of femur veebral column - 'H' shaped veebra/ cod fish veebra/ fish mouth veebra -X ray skull - crew cut appearance (Hair on end appearance) | train | med_mcqa | null |
A 40 year old female patient presents with excessive bleeding. Patient gives a history of road traffic accident 5 hours ago and had a lacerated wound on lower back region. Blood grouping test reveals presence of Anti A antibody, Anti B antibody, Anti H antibody and Anti Rh D antibody in the serum. This patient can receive transfusion from a donor having blood group- | [
"O positive",
"O negative",
"AB positive",
"Bombay blood group"
] | D | H substance is genetically different from ABO but is a precursor of A and B antigens.
An O group individual who inherits A or B genes but fails to inherit H gene from, either parent is called Oh phenotype or Bombay blood group.
People with bombay blood group can receive blood only from the same blood group and its a universal donor. | train | med_mcqa | null |
Vitamin A prophylaxis is given to children every:September 2007 | [
"3 months",
"6 months",
"12 months",
"18 months"
] | B | Ans. B: 6 monthsNational programme for prevention of nutritional blindness focuses onPromoting consumption of vitamin A rich foods by pregnant and lactating women and by children under 5 years of age.Administration of massive doses of vitamin A up to 5 years. First dose of 100,000 IU with measles vaccination at 9 months and subsequent doses of 200,000 IU each, every 6 months up to the age of 5 years should be given. | train | med_mcqa | null |
What complication should one expect when PCNL is done through 11th intercostal space? | [
"Hematuria",
"Hydrothorax",
"Injury to colon",
"Remnant fragments"
] | B | null | train | med_mcqa | null |
The best investigation for the diagnosis of amyloidosis is: | [
"Colonoscopy",
"Rectal biopsy",
"Upper GI endoscopy",
"CT scan"
] | B | The histological examination of the biopsy material is the commonest and confirmatory method for the diagnosis in a suspected case of amyloidosis. The sites for the biopsy can be:- Renal tissue Rectum Abdominal fat aspiration Gingiva. The rectum Q is the best site for taking the biopsy in the options provided. However as per Harrison latest edition, the abdominal fat aspirate is currently the best option for systemic amyloidosis. | train | med_mcqa | null |
Not a pa of firearm: | [
"Bolt",
"Piston",
"Extractor",
"Muzzle"
] | B | Firearm:- Any instrument or device that discharges a missile by the expansive force of gases produced by burning of an explosive substance.It consists of: i. Barrel: A hollow metal cylinder in which the propellant charge is placed. It is long in rifles and shotguns, and sho in pistols and revolvers. The lumen is known as bore. ii. Action: It consists of a bolt, a striker (firing pin) or hammer, and a trigger. iii. Extractor: is a pa of a gun's action which serves to remove brass cases of fired ammunition after it has been fired from the chamber of the gun. iv. Butt/grip: Rear poion of stock in a shoulder arm or bottom of a handgun containing a magazine. v. Magazine: The receptacle for the caridges in a repeating type of weapon from which the caridges are fed automatically into the chamber by the action of mechanism. Bolt-A bolt is the pa of a repeating, breech-loading firearm that blocks the rear opening of the barrel chamber | train | med_mcqa | null |
A 40 year old male was brought to the hospital with acute pain in the upper abdomen. Pateint was in shock with feeble pulse and tachycardia. There was tenderness present in the epigastrium. There is no blood in the gastric aspirate and thepatient felt better after aspiration. X-ray abdomen showed no free gas under the diaphragm. Investigations revealed TLC 13500 serum bilirubin 2.0 mg and serum amylase 800 I.U. The most likely diagnosis is - | [
"Acute cholecystitis",
"Acute pancreatitis",
"Acute appendicitis",
"Acute hepatitis"
] | B | Ans. is 'b' i.e., Acute pancreatitis | train | med_mcqa | null |
The following regarding cysticercosis are true except - | [
"Commonest sites are meninges and cerebral ventricle",
"Calcification is common",
"Causes focal neurological complication",
"Found in subcutaneous tissues"
] | A | null | train | med_mcqa | null |
Which of the following statements is FALSE regarding drugs used in the treatment of Parkinsonism? | [
"Amantadine causes ankle edema",
"Levodopa is effective in reducing tremors",
"Amantadine is more effective than levodopa",
"Anti-muscarinic agents are effective in drug induced Parkinsonism"
] | C | Levo-dopa is very effective in the treatment of Parkinsonism. It initially resolves hypokinesia and rigidity but later on tremors are also reduced. It is more effective than amantadine. Amantadine is an antiviral drug that can be used in Parkinsonism. Central anticholinergic drugs are the agents of choice for the treatment of drug-induced Parkinsonism. | train | med_mcqa | null |
Which of the following represents the most common fingerprint pattern? | [
"Arch",
"Loop",
"Whorl",
"Composite"
] | B | Loops are the most common pattern of finger prints in India. Common types of finger prints in India are as follows: Loop - 67%: radial/ulnar, Whorls - 25%, Arches - 6-7% and Composite - 1-2%. In a whorl the ridges form a series of circles or spirals around the core. In a composite, there is combination of two or more types, namely arches, loops or whorls. Ref:The Essentials of Forensic Medicine and Toxicology By Dr K S Narayan Reddy, Page 75 | train | med_mcqa | null |
In leptospirosis, the following clinical features are seen except- | [
"Jaundice which may be intense",
"Hemorrhage",
"Hepatomegaly",
"Massive splenomegaly"
] | D | Clinical features After a relatively brief bacteraemia, invading organisms are distributed throughout the body, mainly in kidneys, liver, meninges and brain. The incubation period averages 1-2 weeks. Four main clinical syndromes can be discerned and clinical features can involve multiple different organ systems . Bacteraemic leptospirosis Bacteraemia with any serogroup can produce a non-specific illness with high fever, weakness, muscle pain and tenderness (especially of the calf and back), intense headache and photophobia, and sometimes diarrhoea and vomiting. Conjunctival congestion ,massive splenomegaly is the only notable physical sign. The illness comes to an end after about 1 week, or else merges into one of the other forms of infection. Aseptic meningitis Classically associated with L. canicola infection, this illness is very difficult to distinguish from viral meningitis. The conjunctivae may be congested but there are no other differentiating signs. Laboratory clues include a neutrophil leucocytosis, abnormal LFTs, and the occasional presence of albumin and casts in the urine . Ref Harrison20th edition pg 1099 | train | med_mcqa | null |
School of fish appearance is characteristic of: | [
"Bordetella peussis",
"Yersinia enterocolitica",
"Haemophillus ducreyi",
"Legionella"
] | C | Ans. is. 'c' i. e., Haemophillus ducreyi | train | med_mcqa | null |
In which of the following infections mosquito is the main vector? | [
"Hepatitis - A",
"Cholera",
"Yellow fever",
"Leprosy"
] | C | The yellow fever virus is transmitted by the bite of female mosquitoes (the yellow fever mosquito, Aedes aegypti. After transmission of the virus from a mosquito the viruses replicate in the lymph nodes and infect dendritic cells in paicular. Hepatitis-A and Cholera are transmitted through feco-oral route. Leprosy is transmitted by fomites. | train | med_mcqa | null |
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