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According to the National Programme for Control of Blindness, who are supposed to screen the school students for vision problems? | [
"Health assistants",
"School teachers",
"Medical officers of health centers",
"Ophthalmologists"
] | B | In general vision problems present with difficulty in learning at school. These children with eye sight problems undergo screening by their school teachers. These children if they tend to have refractive errors, are then referred to the health assistants and ophthalmologists. The National Programme for Control of Blindness was staed in the year 1986 - 1989 in collaboration with WHO with the main aim of reducing the prevalence of blindness from 1.4% to 0.3% of population by 2000 AD. By this programme it was facilitated to provide comprehensive health care facilities for primary, secondary and teiary levels of eye health care. According to the NPCB, the major causes of blindness in India are cataract, trachoma, smallpox, infections, injuries, vitamin A deficiency, glaucoma, aphakia, refractive errors, central corneal opacification and posterior segment disorders. The objectives of National Programme for Control of Blindness are as follows: 1. Through mass communication and extensive education programmes, people were to be educated about eye health care. 2. Ceain units of eye care facilities were established in order to restore sight and allete eye ailments. 3. As a pa of general health services, at peripheral, central and intermediate levels various permanent eye health care centres were established. Ref: Park's Textbook of Preventive and Social Medicine, 19th Edition, Pages 76 - 78; Postgraduate Ophthalmology, Zia Chaudhari, Pages 2 - 17; Concise Textbook Of Ophthalmology By Sharma, Pages 208 - 211. | train | med_mcqa | null |
You have given ViPS vaccine to a person. How often will you ask him to take booster doses? | [
"Every year",
"Every 2 year",
"Every 3 year",
"Every 4 year"
] | C | The injectable typhoid vaccine ViPS is a single dose vaccine which requires booster doses every 3 year. Ty21a vaccine is the oral typhoid vaccine. 3 doses are taken on day 1,3 and 5. It is effective for up to 7 years after last dose. It is recommended in people travelling to endemic areas and during out breaks. Ref: Park, Edition 21, Page - 215 | train | med_mcqa | null |
The technique to produce limited removal of epithelial tissue in the sulcus while a chamfer finish line is being created in tooth structure is called | [
"Soft tissue modification",
"Gingettage",
"Gingival displacement",
"Electrosurgery"
] | B | null | train | med_mcqa | null |
Infant Eye is – | [
"Myopic",
"Astigmatism",
"Hypermetropic",
"None"
] | C | At birth, the eyeball is relatively short, having +2 to +3 hypermetropia.
This is gradually reduced until by the age of 5-7 years the eye is emmetropic (optically normal). | train | med_mcqa | null |
Bronchogenic carcinoma commonly metastasise to which endocrine organ - | [
"Ovaries",
"Testes",
"Thyroid",
"Adrenals"
] | D | null | train | med_mcqa | null |
A 19-year-old woman complains of swelling of her eyelids, abdomen, and ankles. At bedtime, there are depressions in her legs at the location of the elastic in her socks. A chest X-ray shows bilateral pleural effusions. Urine protein electrophoresis demonstrates 4+ proteinuria. A percutaneous needle biopsy of the kidney establishes the diagnosis of minimal change nephrotic syndrome. Soft tissue edema in this patient is most likely caused by which of the following mechanisms of disease? | [
"Active hyperemia",
"Chronic passive congestion",
"Decreased intravascular oncotic pressure",
"Hyperalbuminemia"
] | C | The pressure differential between the intravascular and the interstitial compartments is largely determined by the concentration of plasma proteins, especially albumin. Any condition that lowers plasma albumin levels, whether from albuminuria in nephrotic syndrome or reduced albumin synthesis in chronic liver disease, tends to promote generalized edema.Diagnosis: Minimal change nephrotic syndrome | train | med_mcqa | null |
Surgical treatment of congenital hydrocele is done at the age of: | [
"1 year",
"2 years",
"3 years",
"4 years"
] | C | Ans. (c) 3 yearsRef: Bailey and Love 27th Edition, Page 125* Congenital hydrocele may resolve spontaneously as the processus vaginalise continues to obliterate up to age of 3 years. If not resolves in 3 years - operate by herniotomy. | train | med_mcqa | null |
The Most common cause of vocal cord palsy is | [
"Total thyroidectomy",
"Bronchogenic carcinoma",
"Aneurysm of aoa",
"Tuberucular lymph nodes"
] | A | Thyroid surgery is the most common cause when both recurrent and external laryngeal nerves of one side may be involved. It may also occur in lesions of nucleus ambiguous or that of the vagus nerve proximal to the origin of superior laryngeal nerve. Thus, the lesion may lie in the medulla, posterior cranial fossa, jugular foramen or parapharyngeal space. Ref: PL Dhingra Textbook of Ear, Nose and Throat, Edition 6, page - 301 | train | med_mcqa | null |
Tumor lysis syndrome is associated with all of he following laboratory feature except- | [
"Hyperkalemia",
"Hypercalcemia",
"Hyperuricemia",
"Hyperphosphatemia"
] | B | Ans. is 'b' i.e., Hypercalcemia Tumour lysis svndrome|Destruction of large number of rapidly proliferating cellsHyperuricemiaHyperphosphatemiaHyperkalemia|||Uric acid pptCauses reciprocalArrhythmiasin tubulesdecrease in calcium || Renal failure-Hypocalcemia | train | med_mcqa | null |
A lady presented with recurrent attacks of giddiness and abdominal pain since three months. Endoscopy was normal. Her fasting blood glucose level was 40 mg and insulin levels were elevated. CT abdomen showed a well defined 8mm enhancing lesion in the head of pancreas, with no other abnormal findings. The treatment plan should be- | [
"Enucleation",
"Enucleation with radiotherapy",
"Whipple's operation",
"Administration of streptozotocin"
] | A | Ans is 'a' i.e. Enucleation "Enucleation is usually sufficient to remove the entire tumor as these are typically benign lesions. More extensive resections are required for complete excision of malignant insulinomas, which are typically much larger (approximately 6 cm), and in patients with MEN-I or multifocal disease. These patients may require subtotal pancreatectomy, with enucleation of lesions in the head of the pancreas or pancreaticoduodenectomy with local resections of tumors in the body or tail. Tumor debulking may be useful even if all disease is not removed since some residual disease may not be functional."-Maingot's 11/e chapter 42 Demonstration of inappropriately elevated levels of plasma insulin and fasting hypoglycaemia suggest the diagnosis of insulinoma. Since most insulinomas are benign and in this patient the insulinoma is well defined, quite small in size, an enucleation would be sufficient. Streptozotocin selectively destroys pancreatic islet cells by inhibiting DNA synthesis. It is the chemotherapeutic agent of choice for metastatic insulinomas. | train | med_mcqa | null |
Her2/neu gene is on which chromosome? | [
"13",
"14",
"15",
"17"
] | D | Answer- D. 17ERBB2, a known proto-oncogene, located at the long arm of human chromosome 17 (17q12)HER2 is a member of the human epidermal growth factor receptor (HER/EGFR/ERBB) which is plasma membrane-bound receptor tyrosine kinase. | train | med_mcqa | null |
Annular herald’s patch is seen in | [
"Psoriasis",
"Pityriasis alba",
"Pityriasis rosea",
"Nocardiasis"
] | C | Herald’s patches are seen in Pityriasis rosea Some patients develop single patch 2 or 3 days earlier than the main eruption this is called Herald’s patch.
About Pityriasis Rosea Commonly seen in young adults
* Commonly found on upper trunks along cleavage lines
* The lesions are Scaly and erythematous* (cigarette paper scales are found) | train | med_mcqa | null |
Which of the following is not a criteria suggesting casuality in non communicable diseases ? | [
"Strength of association",
"Dose response relationship",
"Specificity of association",
"Lack of temporal association"
] | D | Ans. is 'd' i.e., Lack of temporal association It is the presence of temporal association (not lack or absence) that forms a criteria for causal relationship. Criteria that suggest causal relationship (Bradford Hill's criteria) o Likehood of a causal relationship is increased by the presence of the following criteria. 1) Temporal association 2) Strength of association 3) Specificity of association 4) Consistency of association 5) Biological plausibility 6) Coherence of association o Hill's criteria (sometimes also known as 'Surgeon general's Criteria' of causal association): in epidemiology are Analogous to Koch Postulates (of causal association between a microbe and disease) in microbiology. | train | med_mcqa | null |
Study of disease in a traveller from one part to another | [
"Eugenics",
"Ergonomics",
"Emporiatrics",
"None"
] | C | null | train | med_mcqa | null |
False about Yellow fever Vaccine | [
"Live attenuated",
"Reconstitution is with cold physiological saline",
"Dose is 0.5 ml",
"Route is Instramuscular"
] | D | Route is Subcutaneous. | train | med_mcqa | null |
Which of the following stain is used for Acidic mucin? | [
"Alcian blue",
"PAS",
"Masson's trichrome stain",
"PTAH"
] | A | (a) Alcian blueRef: Quick Reference Handbook for Surgical Pathologists, 2011, pg. 69-74* Alcian blue stain is used for acidic mucin.* Acid mucins are present in goblet cells and esophageal submucosal glands. They are Alcian Blue (AB.-positive (blue color).* Neutral mucins are present in gastric foveolar cells, duodenal Brunner glands and prostate glands. They are PAS-positive (pink color).* Acid mucins are further subdivided into 2 groups:0 Sialomucins are the simplest form; they are present in small and large bowel detected at pH2.5 of Alcian blue.0 Sulfomucins are the more complex sulfated forms, which are present only in the large bowel detected at pH2.5 and 0.5 of alcian blue.* Myxoid Material /Stromal mucin is Negative for mucicarmine and PAS, while positive for alcian blue (Hyaluronidase-sensitive) and Hale's colloidal iron.* PAS stains glycogen and mucin; also stains basement membranes and fungi.* Masson Trichrome can be used to differentiate collagen from smooth muscle . It is routine stain in evaluation of liver and kidney diseases.* PTAH (Phostphotungstungstic Acid-Hematoxylin) is used to stain Muscle cross-striations, fibrin and Nemaline rods, present in some skeletal muscle diseases. | train | med_mcqa | null |
Isotope used in RAIU | [
"I131",
"I123",
"I125",
"I127"
] | D | B i.e. I123 | train | med_mcqa | null |
All are true about duodenal diverticula except: | [
"Whenever found, should be treated due to increased risk of complications",
"Most common site is periampullary region",
"Can cause acute pancreatitis",
"Most are asymptomatic"
] | A | Ans. (a) Whenever found, should be treated due to increased risk of complicationsRef: Sabiston 19th edition, Pages 1265-1266 Incidentally found:* Meckel's -- resect* Jejunal diverticula -- leave it* Duodenal diverticula -- leave it* Colon diverticula -- leave it | train | med_mcqa | null |
Fracture seen in judicial hanging called | [
"Jefferson's fracture",
"Hangman's fracture",
"Boxer's fracture",
"Greenstick fracture"
] | B | Fracture of the pedicles of axis resulting in anterior dislocation of C2 on C3 with or without fracture of odontoid process, that occurs in hanging is called Hangman's fracture. This injury is typically seen in judicial hanging. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 178 | train | med_mcqa | null |
Mid tracheostomy is done at which of the following level? | [
"3-4 rings of tracheal cartilage",
"5-6 rings",
"1-2 rings",
"2-3 rings"
] | D | Ref: Diseases of the Ear Nose and Throat by PL Dhingra 5th edn .2010 page page 337 Explanation:TracheostomyTracheostomy is making an opening in the anterior wall of trachea and converting it into a stoma on the skin surfaceIndications areRespiratory obstructionSuction of retained secretionsRespiratory insufficiencyTypes areElective EmergencyBased on the siteHigh tracheostomyOpening Made above the isthmus of thyroid glandThrough the 1st tracheal ringDone in malignancy of the larynxincreased risk of perichondritis and suglottic stenosisMid tracheostomyDone through the 2nd and 3rd tracheal ringsMost commonly doneIsthmus has to be retracted or divided Low tracheostomyDone below the isthmusThrough 4th and 5th tracheal ringsDone when the airway is blocked at the upper tracheal levelRisk of injuring the great vessels of neck | train | med_mcqa | null |
The following statement about pilonidal sinus is true: | [
"More common in females",
"Mostly congenital",
"Prognosis after surgery is poor",
"Treatment of choice is surgical excision of sinus tract"
] | D | Ans. (d) Treatment of choice is surgical excision of sinus tract* MC in males* Acquired due to entry of hair follicles into skin.* Prognosis is good after surgery* Recurrence is common but there are surgeries for recurrent Jeeper's bottom like - Limberg's flap and Bascom technique | train | med_mcqa | null |
Trachea is lined by? | [
"Simple columnar",
"Pseudostratified columnar",
"Simple cuboidal",
"Stratified squamous, non-keratinized"
] | B | Ans. (b) Pseudostratified columnar | train | med_mcqa | null |
Primary atypical pneumonia is caused by | [
"Legionella",
"Streptococcus",
"Mycoplasma",
"Listeria"
] | C | Ans. c (Mycoplasma). (Textbook of Microbiology by Anantanarayan 6th/365)MYCOPLASMA# Bacteria devoid of cell walls# Highly pleomorphic# Eaton agent# Pleuropneumonia like organisms. Smallest free living micro-organisms.# Do not produce spores, flagella or fibria.# Gliding motility present.# 'Fried egg' appearance of colonies positive.# Colonies best studied by staining with Diene's method.# Cold agglutination test (streptococcus MG).# Pathogenicity- M. pneumonia -Primary atypical pneumonia.- Ureaplasma urealyticum and M.hominis -genital infection# Treatment--tetracycline & erythromycin. | train | med_mcqa | null |
True about Neonatal sepsis – | [
"Meningitis commonly occur lately",
"Fever",
"Jaundice is a common feature",
"All of these"
] | D | Clinical features of neonatal septicemia
The most common and characteristic manifestations is an alteration in the established feeding behaviour baby refuses to suck and becomes lethargic, inactive or unresponsive. | train | med_mcqa | null |
A55-year-old male has a 5 cm cavitating lesion of unknown duration at the apex of the right lung. The investigation to be carried out: | [
"CT scan",
"FNAC",
"Bronchography",
"Trans bronchial biopsy"
] | D | Ans. Trans bronchial biopsy | train | med_mcqa | null |
National Guinea worm Eradication Programme was launched in - | [
"1972-73",
"1975-76",
"1980-81",
"1983-84"
] | D | Ans. is 'd' i.e., 1983-84 | train | med_mcqa | null |
A child has a vocabulary of 4–6 words however the main mode of communication and social interaction continues to be non-verbal what is the most likely developmental age of the child – | [
"12 months",
"15 months",
"18 months",
"24 months"
] | B | Vocabulary of 4-6 words in addition to jargon is achieved by 15 months of age. However <20% of speech is understood and hence main mode of communication continnues to be non-verbal. | train | med_mcqa | null |
Glucose tolerance test is indicated in pregnancy becasue of:a) Big babyb) Eclampsiac) Previous GDMd) H/O diabetes in maternal uncle | [
"abc",
"ad",
"acd",
"bde"
] | C | null | train | med_mcqa | null |
The pain around the hip with flexion, adduction & internal rotation of lower limb in a young adult after a road traffic accident is suggestive of: | [
"Intracapsular fracture of the femoral neck",
"Extra capsular fracture of the femoral neck",
"Posterior dislocation of hip",
"Anterior dislocation of hip"
] | C | C i.e. Posterior dislocation | train | med_mcqa | null |
Most common side effect of haloperidol - | [
"Hypotension",
"Akathasia",
"Dryness of mouth",
"Tic disorder"
] | B | Ans. is 'b' i.e., Akathasiao 75% of patients experience extrapyramidal symptoms (Akathisia, Parkinsonism, acute muscular dystonia) with all classical (typical) antipsychotics.o Haloperidol is a typical antipsychotic.Important side effects of antipsychoticsI) Based on pharmacological actions (dose dependent)1. CNSo Drowsiness, lethargy, mental confusion.o Increased appetite and weight gain due to H1 and 5HT2 blockade. (It is least with haloperidol).o Seizures - with clozapine and olanzapine.2. CVSo Postural hypotension, palpitation, inhibition of ejaculation (due to a blockade) - maximum with chlorpromazine, thioridazine and clozapine - Goodman & Gilmen 11th/e p. 463o Minimum hypotension - Aripiprazole - Goodman & Gilmen llth/ep. 464.o QTprolongation and cardiac arrhythmia - Thioridazine, pimozide and ziprasidone.3. Anticholinergic side effects.o Maximum with thioridazine.o Clozapine causes hypersalivation despite anticholinergic property.4. Endocrineo Hyperprolactinemia is common with typical neuroleptics amongst atypical neuroleptics risperidone causes hyperprolactinemia - Amenorrhea, galactorrhea, infertility, impotence, gynaecomastia.o Worening of diabetes - Clozapine, olanzapine.5. Extrapyramidal disturbanceso These are major dose limiting side effects.o Maximum with haloperidol.o Least with clozapine (among all antipsychotics).o Amongst typical antipsychotics, least with thioridazine.o Amongst atypical antipsychotic, resperidone has maximum tendency to cause extrapyramidal disturbances.o Different syndromes are :Parkinsonism, Acute muscular dystonia, Akathisia, Malignant neuroleptic syndrome, Tardive dyskinesia, Rabbit syndrome.II. Other side effects.o Corneal and lenticular deposites - chlorpromazine - Katzung 10th/e p. 467.o Retinal deposits - Thioridazine - Katzung 10th/e p. 467.o Blue pigmentation of exposed skin - Thioridazine,o Agranulocytosis - Clozapine."Because of the risk of agranulocytosis, patients, recieving clozapine must have weekly blood counts for the first 6 months and every 3 weeks thereafter".o Myocarditis - Clozapine.o Hypersensitivity - Cholestatic jaundice, skin rash, urticaria, contact dermatitis, photosensitivity,o Cataract - Quetiapine. | train | med_mcqa | null |
Chromium is added to stainless steel as it provides | [
"Sensitisation",
"Corrosion resistance",
"Stabilisation",
"Hardening"
] | B | null | train | med_mcqa | null |
A 70-year-old woman with a history of veebral crush fracture presents to the osteoporosis outpatient clinic. Which of the following investigations is most useful to assess the extent of her osteoporosis? | [
"Spinal x-rays",
"DEXA scan",
"Full blood count, bone and liver biochemistry blood test",
"Vitamin D levels"
] | B | Osteoporosis is a loss of the bone mass. It is impoant to note that the mineralization of the bone is normal. This loss of bone mass means there is an increasing likelihood of fracture with increasing age. Due to the accelerated loss of bone mass following the menopause, elderly women are at a higher risk of osteoporosis than men. There are numerous risk factors for the development of osteoporosis. Among them are Caucasian and Asian ethnic groups, female sex, increasing age, early menopause, smoking, excess alcohol, coicosteroid use, hypogonadism and rheumatoid ahritis. The reduced bone mass of osteoporosis may result in veebral crush fractures, the majority of which are asymptomatic. The extent of osteoporosis is best investigated with a dual energy x-ray absorptiometry (DEXA) scan. This gives a T score, which is the number of standard detions the patient's bone mineral density differs from the population average for a young healthy adult. The World Health Organization defines osteoporosis as a T score of -2.5 or greater (i.e. the bone mineral density of more than 2.5 standard detion below that of the average for a young healthy adult). A T score of between -1.5 and -2.5 is defined as osteopenia. Spinal x-rays (A) are useful to assess veebral crush fractures but cannot assess extent of osteoporosis. Full blood count, bone and liver biochemistry tests (C) are not affected by osteoporosis, making this answer incorrect. Treatment options in osteoporosis include use of bisphosphonates, hormone replacement therapy and raloxifene (a selective oestrogen receptor modulator). | train | med_mcqa | null |
Mixed tumours of the salivary glands are: | [
"Most common in submandibular gland",
"Usually malignant",
"Most common in parotid gland",
"Associated with calculi"
] | C | null | train | med_mcqa | null |
Case control study is - | [
"Prospective",
"Retrospective",
"Cross sectional",
"None of the above"
] | B | null | train | med_mcqa | null |
The most common site for hypeensive bleed is? | [
"Pons",
"Putamen",
"Frontal lobe",
"Thalamus"
] | C | Answer is C (Putamen): The putamen (Basal Ganglia) is the most common site for hypeensive haemorrhage External capsule refers to a thin layer of white matter that separates the lateral pa of lentiform nucleus (putamen) from claustrum and is invariably damaged along with the putamen. | train | med_mcqa | null |
Which of the following lymph nodes are known as Delphic nodes? | [
"Pretracheal",
"Paratracheal",
"Supraclavicular",
"Posterior triangle"
] | A | There is extensive lymphatic network seen in thyroid. Although some lymph channels pass directly to the deep cervical nodes, the subcapsular plexus drains principally to the central compament juxta thyroid - 'Delphian' or pretracheal - and paratracheal nodes and nodes on the superior and inferior thyroid veins, and from there to the deep cervical and mediastinal groups of nodes. | train | med_mcqa | null |
Inflammatory carcinoma is classified under | [
"T4a",
"T4b",
"T4c",
"T4d"
] | D | T1<= 2cm T2>2 cm but <= 5cmT3> 5cmT4aExtension to the chest wall (invasion of pectoralis only is not extension to the chest wall)T4bSkin involvement (including peau d'orange) that doesn&;t meet criteria of skin involvementT4cBoth T4a and T4b are presentT4dInflammatory carcinomaRef: AJCC 8th edition | train | med_mcqa | null |
Not a cause of objective tinnitus - | [
"Palatal myoclonus",
"Glomus tumor",
"Carotid artery aneurysm",
"Presbyacusis"
] | D | Ans. is 'd' i.e., PresbyacusisTinnituso Tinnitus is ringing sound or noise in the ear.o The characteristic feature is that the origin of this sound is within the patient,o Two types of tinnitus have been describeda) SubjectiveI. OtologicII. Non-otologico Impacted waxo Fluid in the middle earo Acute and chronic otitis mediao Abnormally patent eustachian tubeo Meniere's diseaseo Otosclerosiso Presbyacusiso Noise traumao Ototoxic drugso Tumors of VUIth nerveo Disease ofCNSo Anaemiao Arteriosclerosiso Hypertensiono Hypotensiono Hypoglycaemiao Epilepsyo Migraineo Drugsb) Objectiveo Vascular tumours of middle ear (glomus tumour)o Aneurysm of carotid arteryo Palatal myoclonus | train | med_mcqa | null |
Best management of Vault prolapse | [
"Sacral colpopexy",
"Sacrospinous ligament fixation",
"Le fos repair",
"Anterior colporapphy"
] | A | SACRAL COLPOPEXY Vault suspension Principle:To suspend the vaginal vault to the anterior longitudinal ligament of the 3rd sacral veebra Non absorbable suture material is used. Most common complication is stress urinary incontinence Ref: D.C.DUTTA&;S TEXTBOOK OF GYNAECOLOGY; 6th edition; Pg no:221 | train | med_mcqa | null |
Which statement is true about carbamazepine? | [
"Used in trigeminal neuralgia",
"Carbamazepine is an enzyme inhibitor",
"Can cause megaloblastic anemia",
"It is the drug of choice for status epilepticus"
] | A | Ans. is 'a' i.e. Used in trigeminal neuralgia Trigeminal neuralgias are characterized by attacks of high intensity electric shock like stabbing pain, set off by even trivial stimulation of certain trigger zones in the mouth or on the face.Carbamazepine is not an analgesic but has a specific action in these neuralgias. It acts by interrupting temporal summation of afferent impulses (by a selective action on high frequency nerve impulses)."Carbamazepine has become the drug of choice for Trigeminal neuralgias "Other antiepileptic's such as phenytoin and Baclofen are less efficacious alternatives.More on carbamazepineThe most important action of carbamazepine is blockade of voltage dependent sodium ion channels, reducing membrane excitability.It is considered the drug of choice for partial seizures PharmacokineticsCarbamazepine is an extensively metabolized drug. One of the notable property of carbamazepine is its ability to induce microsomal enzymes (P450)The t 1/2 of carbamazepine decreases from 36 hrs. seen initially, to as short as 8-12 hrs due to its enzyme inducing property fit induces( its own metabolism)Due to its enzyme inducing property, carbamazepine effects the metabolism of other drugs too. ToxicityThe most common dose related adverse effects of carbamazepine are diplopia and ataxia.It may also cause hyponatremia and water intoxication.One more important adverse effect is idiosyncratic blood dyscrasias which may cause aplastic anemia and agranulocytosis. | train | med_mcqa | null |
When the pH of the stomach lumen falls below 3, the antrum of the stomach releases a peptide that acts locally to inhibit gastrin release. This peptide is: | [
"Enterogastrone",
"Intrinsic factor",
"Secretin",
"Somatostatin"
] | D | Ans. D. SomatostatinWhen the pH of the stomach falls below 3, the antrum secretes somatostatin, which acts locally to inhibit gastrin release; therefore, somatostatin inhibits gastric secretion. Enterogastrones are hormones produced by the duodenum that inhibit gastric secretion and motility. Intrinsic factor is involved in the absorption of vitamin B12 and is not involved in the release of gastrin. Secretin is a hormone secreted by the duodenal and jejunal mucosa when exposed to acidic Chyme and is responsible for stimulating pancreatic secretion rich in bicarbonate. CCK stimulates the gallbladder to contract and the pancreas to secrete some juice rich in enzymes. | train | med_mcqa | null |
Primary prevention is - | [
"Prevention of emergence of risk factors",
"Specific protection",
"Early diagnosis",
"Rehablitation"
] | B | Ans. is 'b' i.e., Specific protection | train | med_mcqa | null |
Second gas effect is ? | [
"Displacement of N20 by Oxygen",
"Displacement of oxygen by N20",
"Facilitation of inhalation of Halothane by N20",
"Removal of oxygen by N20 from alveoli during recovery from general anaesthesia"
] | C | Ans. is 'c' i.e., Facilitation of inhalation of halothane by N20 | train | med_mcqa | null |
Who among the following used carbolic acid initially as an antiseptic for surgery and is known as the "Father of antiseptic surgery"? | [
"Robe Koch",
"Edward Jenner",
"Louis Pasteur",
"Joseph Lister"
] | D | Joseph Lister: He is considered to be the father of antiseptic surgery. He used carbolic acid during surgery. | train | med_mcqa | null |
Which among the following is a depolarising muscle relaxant? | [
"Decamethonium",
"D tubocurarine",
"Doxacurium",
"Atracurium"
] | A | Ans. is 'a' i.e., Decamethonium Morgan 4th/e p. 214] See explanation-4 of session-3. | train | med_mcqa | null |
A drug 'X' is an a adrenergic blocker but paradoxically produces vasoconstriction. 'X' is: | [
"Phenoxybenzamine",
"Ergotamine",
"Prazosin receptors",
"Tolazoline"
] | B | Ergot alkaloids are the alpha-blockers that can cause vasoconstriction. The vasoconstriction caused by ergot alkaloids is due to stimulation of serotonin receptors. Ergotamine It acts as a paial agonist and antagonist at a adrenergic and all subtypes of 5-HT1 and 5-HT2 receptors, but does not interact with 5-HT3 or dopamine receptors. Sustained vasoconstriction , visceral smooth muscle contraction, vasomotor centre depression are produced, and the action of NA and 5-HT on smooth muscles is antagonized. It is a potent emetic and oxytocic. At high doses CNS stimulation and paresthesias can be seen. | train | med_mcqa | null |
Commonest site of meningocele is - | [
"Lumbosacral",
"Occipital",
"Frontal",
"Thoracic"
] | A | Ans. is 'a' i.e., Lumbosacral | train | med_mcqa | null |
Mucinous ascites is seen in | [
"Stomach ca",
"Nephrotic syndrome",
"TB",
"Cirrhosis"
] | A | Mucinous ascites is seen in pseudomyxoma peritonei colloid ca of stomach or colon with peritoneal implants | train | med_mcqa | null |
The commonest site for hypertensive intracerebral bleed is: | [
"Putamen.",
"Cerebellum.",
"Pons.",
"Midbrain."
] | A | Ans. is 'a' i.e. Putamen Most common site of hypertensive hemorrhage is-Basal Ganglia (Putamen, thalamus & adjacent deep white matter) Also RememberM.C. intracranial hemorrhage: Intracerebral or intraparenchymal hemorrhage *M.C. cause of intracerebral hemorrhage: Hypertension due to rupture of small penetrating arteries. *M.C. cause of subarachnoid hemorrhage : Trauma (IInd rupture Berry's aneurysm) * | train | med_mcqa | null |
Incudo malleal joint is an example of? | [
"Saddle joint",
"Pivot joint",
"Plane synovial joint",
"Condylar joint"
] | A | ANSWER: (A) Saddle jointREF: BDC general anatomySaddle joints* 1st carpometacarpal joints* Sternoclavicular jts* Calcaneocuboid* Incudo malleolar | train | med_mcqa | null |
Number of centre of excellence in vision 2020 – | [
"20",
"200",
"2000",
"20000"
] | A | null | train | med_mcqa | null |
A 62-year-old man with a 40-pack/year history of smoking presents with increased sputum production and marked SOB. On examination, he is using accessory muscles of respiration, and breath sounds are diminished with expiratory wheezes. Your clinical diagnosis is chronic obstructive pulmonary disease (COPD) exacerbationFor the above patients, select the characteristic arterial pulse finding. | [
"pulsus tardus",
"pulsus paradoxus",
"hyperkinetic pulse",
"bisferiens pulse"
] | B | Pulsus paradoxus, a drop of > 10 mm Hg in systolic blood pressure during inspiration, is caused by pericardial tamponade, airway obstruction, or superior vena cava obstruction. At times, the peripheral pulse may disappear completely during inspiration. | train | med_mcqa | null |
Which of the following circuit is preferred in child for spontaneous respiration: | [
"Mapleson A",
"Jackson & Rees circuit",
"Mapleson C",
"Mapleson E"
] | A | Ans. (A) Mapleson APediatric Breathing Circuits:Type E Mapleson Circuit:It is Ayre's T piece with corrugated tubing.It is a pediatric circuitAs it does not have breathing bag so it is not a complete circuit (It was made complete by attaching a breathing bag by attaching a breathing bagby Jackson & Rees).Type E is basically a circuit only for spontaneous respiration (as it does not contain breathing bag) but can be utilized for controlled ventilation by intermittently occluding the end of expiratory limb | train | med_mcqa | null |
A young patient presented with blood pressure of 190/120 mm of Hg without any clinical symptom and fundus examination is normal, treatment of choice - | [
"Oral Nitroglycerine",
"IV Nitroglycerine",
"Oral Enalapril",
"Sublingual short acting Nifedipine"
] | C | null | train | med_mcqa | null |
Brown tumor is seen with: | [
"Hyperparathyroid ism",
"Hypoparathvroidism",
"Hypothyroidism",
"Hyperthyroidism"
] | A | Ans: A (Hyperparathyroidism) Ref: Robbins Pathologic Basis of Disease, 8th edition.Explanation:Primary HyperparathyroidismMost common endocrine disorder causing hypercalcemia.The frequency of the various parathy roid lesions underlying the hyper!unction is as follows:Adenoma: 85% to 95%Primary hyperplasia (diffuse or nodular): 5% to 10%Parathyroid carcinoma: ~ 1%Primary hyperparathyroidism is usually a disease of adultsMore common in women than in men by a ratio of nearly 4:1.Most common Cause is a solitary parathyroid adenoma arising in the sporadic (nonfamitial) settingFamilial syndromes are second commonest cause >> The genetic syndromes associated with familial primary hyperparathyroidism include the following:Multiple endocrine neoplasia-1 (MFN-1):Inactivation of MEN! gene on chromosome 1 Iqla (Tumor suppressor gene jMultiple endocrine neoplasia-2 (MEN-2):Activating mutations in the tyrosine kinase receptor. RET, on chromosome lOq.Familial hypocalciuric hypercalcemiaAutosomal dominant disorderEnhanced parathyroid function due to decreased sensitivity to extracellular calcium.Inactivating mutations in the parathyroid calcium-sensing receptor gene (CASR) on chromosome 3qMorphologyParathyroid adenomasThese are almost always solitaryThe typical parathyroid adenoma averages 0.5 to 5.0 cm: well-circumscribed, soft, tan to reddish-brown nodule: and has a delicate capsule.In contrast to primary hyperplasia, the glands outside the adenoma are usually normal in size or somewhat shrunken because of feedback inhibition by elevated levels of serum calcium.Microscopically, parathyroid adenomas are mostly composed oi fairly uniform, polygonal chief cells with small, centrally placed nucleiAt least a few nests of larger oxyphil cells are present as well:Rarely, entire adenomas may be composed of this cell type (oxyphil adenomas).Primary hyperplasiaIt may occur sporadically or as a component of MEN syndrome.Classically all four glands are involvedThe combined weight of all glands rarely exceeds 1.0 gm and is often less.Microscopically, (he most common pattern seen is that of chief cell hyperplasia, which may involve the glands in a diffuse or multinodular pattern.The constituent cells contain abundant water- clear cells (' water-clear cell hyperplasia").Parathyroid carcinomasMay be circumscribed lesions that are difficult to distinguish from adenomasThese tumors enlarge one parathyroid gland and consist of gray-white, irregular masses that sometimes exceed 10 gm in weight.The cells are usually uniform and resemble normal parathyroid cells.They are arrayed in nodular or trabecular patterns with a dense, fibrous capsule enclosing the mass.Diagnosis of carcinoma based on cytologic detail is unreliableInvasion of surrounding tissues and metastasis are the only reliable criteria.Morphologic changes in other organs deserving special mention include skeletal and renal lesions.Skeletal changesIncreased numbers of osteoclasts, which erode bone matrix and b, particularly in the metaphyses of long tubular bones.Bone resorption is accompanied by increased osteoblastic activity and the formation of new- bony trabeculae.In severe cases, the cortex is grossly thinned, and the marrow contains increased amounts of fibrous tissue accompanied by foci of hemorrhage and cyst formation (osteitis fibrosa cystica)Aggregates of osteoclasts, reactive giant cells, and hemorrhagic debris occasionally form masses that may be mistaken for neoplasms (Brown tumors of hyperparathyroidism).PTH-induced hypercalcemia favors, formation of urinary tract stones (nephrolithiasis) as well as calcification of the renal inters!itium and tubules (nephrocalcinosis).Metastatic calcification secondary to hypercalcemia may also be seen in other sites, including the stomach, lungs, myoebardium. and blood vessels.Clinical CoursePrimary' hyperparathyroidism may he:Asymptomatic and identified after a routine chemistry profileAssociated with the Classic clinical manifestations of primary hyperparathyroidism.Asymptomatic Hyperparathy roidismPrimary hyperparathyroidism is the most common cause of asymptomatic hypercalcemiaMost common manifestation of primary hyperparathyroidism is hypercalcemia.Malignancy is the most frequent cause of clinically apparent hypercalcemia in adultsIn individuals with primary hyperparathyroid ism. serum PTH levels are inappropriately elevated for the level of serum calcium, whereas PTH levels are low to undetectable in hypercalcemia caused by of nonparathyroid diseasesOther laboratory alterations referable to PTH excess include hypophosphatemia and increased urinary excretion of both calcium and phosphate.Secondary renal disease may lead to phosphate retention with normalization of serum phosphates.Causes of HypercalcemiaRaised (PTH]Decreased HyperparathyroidismHypercalcemia of malignancyPrimary (Adenoma > hyperplasia)Vitamin D toxicitySecondaryImmobilizationTertiaryThiazide diureticsFamilial hypocalcsuric hypercalcemiaGranulomatous disease (sarcoidosis)Symptomatic Primary HyperparathyroidismThe signs and symptoms of hyperparathyroidism reflect the combined effects of increased PTH secretion and hypercalcemia.Classical description of symptoms in Primary hy perparathy roi d i smPainful bonesRenal stonesAbdominal groansPsychic moansThe constellation of symptoms includes:Bone disease and bone pain secondary to fractures of bones weakened by osteoporosis or osteitis fibrosa cystica.Nephrolithiasis (renal stones) in 20% of newly diagnosedpatients, with attenoant pain and obstructive uropathy. Chronic renal insufficiency and abnormalities in renal function lead to polyuria and secondary polydipsia.Gastrointestinal disturbances, including constipation,nausea, peptic ulcers, pancreatitis, and gallstones.Central nervous system alterations, including depression,lethargy, and eventually seizures.Neuromuscular abnormalities, including weakness andfatigue.Cardiac manifestations including aortic or mitral valve calcifications (or both).SECONDARY HYPERPARATHYROIDISMIt is caused by any condition that gives rise to chronic hypocalcemia, which in turn leads to compensatory overactivity of the parathyroid glands.CausesRenal failure is by far ihe most common cause of secondary hyperparathyroidismInadequate dietary intake of calciumSteatorrheaVitamin D deficiencyThe eliopathogenesis is complex and not fully understood.Chronic renal insufficiency is associated with decreased phosphate excretion, which in turn results in hyperphosphatemia.The elevated serum phosphate levels directly depress serum calcium levels and thereby stimulate parathyroid gland activity.In addition, loss of renal substance reduces the availability of a-1-hydroxylase necessary for the synthesis of the active form of vitamin D, which in turn reduces intestinal absorption of calcium Because vitamin D has suppressive effects on parathyroid growth and PTH secretion, its relative deficiency compounds the hyperparathyroidism in renal failure. | train | med_mcqa | null |
Fastest and briefest action occurs in | [
"Atropine",
"Homatropine",
"Tropicamide",
"Cyclopentolate"
] | C | (Tropicamide): (118-KDT 7th edition)TROPICAMIDE - has quickest (20-40 min) and briefest (3-6 hours) action but is a relatively unreliable cycloplgic* It is satisfactory for refraction testing in adults and as a short acting mydriatic for fundoscopy* The mydriatic action can be augmented by combining with phenylephrine | train | med_mcqa | null |
Most often used thickness of the matrix band is | [
"0.0015 cm",
"0.0015 inch",
"0.015 inch",
"0.0028 mm"
] | B | null | train | med_mcqa | null |
True about ranula | [
"Retention cyst",
"Arises from submandibular gland",
"Incision and drainage is treatment of choice",
"Can resolve spontaneously"
] | D | The term 'ranula' is applied to a mucous extravasation cyst that arises from the sublingual gland.It produces a characteristic translucent swelling that takes on the appearance of a 'frog's belly' (ranula). A ranula can resolve spontaneously, but many also require active treatment. The traditional and effective way is to remove the sublingual gland. Incision and drainage, however tempting, usually results in recurrence.Plunging ranula is a rare form of mucous retention cyst that arises from the sublingual salivary glands. Mucus collects below the gland and perforates through the mylohyoid muscle diaphragm to enter the neck. Patients present with a dumbbell-shaped swelling that is soft, fluctuant and painless in the submandibular or submental region of the neckRef: Bailey and love, page no: 799 | train | med_mcqa | null |
Nitrous oxide is contraindicated in patients with pneumothorax, pneumo pericardium or intestinal obstruction, because it: | [
"Depresses an already compromised myocardium",
"Permits the use of a limited FIO2 only",
"Is less soluble than nitrogen",
"Causes the expansion of air filled body cavities"
] | D | N20 is 35 times more soluble than N2 so when replaces N2O causes expansion of air containing cavity. Nitrous oxide has the potential to expand air containing cavities as it can diffuse into and accumulate in them. Hence it should be avoided in emphysema patients especially in those with bullae and pulmonary hypeension. Other Contraindication Pneumothorax, Acute intestinal obstruction with bowel distention, Intracranial air (pneumocephalus following dural closure or pneumoencephalograph cochlear implant surgery vitreo retinal surgery Tympanoplasty | train | med_mcqa | null |
All of the following statements rearding Clostridium tetani are true, except - | [
"Spores are resistant to heat",
"Primary immunization consists of three doses",
"Incubation period is 6-10 days",
"None"
] | D | Ans. is None Tetanus is not transmitted from person to person. ' The primary series ( of active immunization) for adults consists of three doses. The first and second dose are given 4-8 weeks apa and the third dose is given 6-12 months after the second. Thereafter a booster dose is requires every 10 years'. Active(combined) Active( monovalent vaccines) 1st dose - 6th week (DPT) 2nd dose - 10th week (DPT) 3rd dose - 14th week (DPT) 1st booster - 18th month (DPT) 2nd booster 5th completed year (DT) 3rd booster - 10th year (TT) 4th booster - 16th years (TT) Purified tetanus Toxoid ( adsorbed ) supplanted the plain Toxoid, having 3 doses Each 0.5 ml , injected into arm given at intervals of 0,2,12 months. The longer the interval b/w two doses, better is the immune response. Booster doses : After 5 yr f/b Every 10 yrs * | train | med_mcqa | null |
Glomus tumor is seen in - | [
"Retroperitoneum",
"Soft tissue",
"Distal portion of digits",
"Proximal portion of digits"
] | C | Ans. is 'c' i.e., Distal portion of digits |Ref: Robbings 8th/ep. 522]o The glomus tumor is a rare and benign vascular neoplasm that arise from the neuroarterial structure called a glomus body. The normal body is located in the dermis throughout the body, but is more concentrated in the digits. They are believed to function in thermal regulation.o The most common site of glomus tumors is subungual and 75% of the lesions occur in the hand,o The lesions present most frequently during the fourth and fifth decade of life although they can be found in any age and at any site.o The subungual tumors affect women three times more commonly than men.o The lesions are usually solitay but mulifocal tumors are also seen,o Clinically, glomus tumors are characterized by a triad of -Sensitivity to cold,Localized tenderness and,Severe intermittent pain.o Grossly, the tumors are usually less than one cm, in size and appear as small red-blue nodules. The lesion appears as a localized dark red or blue lesion beneath the finger nail, but the subnugual lesions can be difficult to detect on clinical examination.o Two usuful tests for diagnosis glomus tumors, particularly solitary painful glomus tumors (especially those under a nail) are the following.Disappearance of pain after application of a tourniquet proximallv on the arm.Eliciting pain by applying pressure to a precise area with the tip of a pencil.o Treatment of glomus tumors consists of surgical excision. | train | med_mcqa | null |
Antidepressant drug used in nocturnal eneuresis is - | [
"Imipramine",
"Fluoxetine",
"Trazdone",
"Sertaline"
] | A | Drugs used in nocturnal enuresis are imipramine and desmopressine. | train | med_mcqa | null |
Murmur increasing with Valsalva manouvre | [
"ASD",
"HOCM",
"MS",
"AS"
] | B | Ref: Harrison's 19th E pg 1568 All murmurs decreases with valsalva maneuver except that of HOCM and MVP. In hocm, blood acts as a physical barrier between hyperophied septum and anterior mitral leaflet. During valsalva, there is decreased venous return and subsequently decreased blood reaching LV. As blood flow reduces, there is more chances of obstruction, it increases the murmur (ejection systolic murmur) | train | med_mcqa | null |
Digoxin is used in congestive hea failure is associated with | [
"Hyperophic obstructive cardiomyopathy",
"High output failure",
"Atrial fibrillation with high ventricular rate",
"All the above"
] | C | Refer katzung 11e p 219 digitalis is used for the patients Who remain symptomatic even with diuretics and ACE inhibitors With hea failure who are in atrial fibrillation and acquired ventricular Control rate NOTE; digitalis is contraindicated in HOCM and high output failure | train | med_mcqa | null |
Maintenance dose depends on - | [
"Clearance",
"Volume of distribution",
"Metabolism",
"Absorption"
] | A | Ans. is 'a' i.e., ClearanceDrug dosingo For drugs with longer t 1/2 a dose that is sufficient to attain the target concentration after single administration, if repeated will accumulate according to plateau principal and produce toxicity later on.o On the other hand, if the dosing is such as to attain target level at steady state, the therapeutic effect will be delaye by about 5 half lives and this lapse of time may be undesirable some time,o Such drugs are often administered by initial loading dose and subsequent maintenance doses.o Loading dose# This is single or few quickly repeated doses given in the beginning to attain target concentration rapidly.o Maintenance dose# This dose is one that is to be repeated at specific intervals after the attainment of target steady state plasma concentration (Cpss) so as to maintain the same by balancing elimination.o Such two phase dosing (Loading and maintenance) is used in :* Digoxin# Doxycycline# Long acting sulfonamides* Chloroquine# Phenylbutazone Remembero Loading dose is governed by volume of distribution.o Maintenance dose is governed by clearance or tVi.o The drug with short tVi with loading and maintenance dose concept -Lignocaine. | train | med_mcqa | null |
Regarding furosemide true statement is : | [
"Acute pulmonary edema is an indication",
"Acts on PCT",
"Mild diuresis",
"Given only by parenteral route"
] | A | Furosemide possesses vasodilatory action which is responsible for quick relief in LVF and pulmonary edema (used i.v.).
It can be used orally as well as parenterally. | train | med_mcqa | null |
Causative agent of Favus is: | [
"Tinea schoenleinii",
"Tinea rubrum",
"Malassezia furfur",
"Epidermophyton floccosum"
] | A | Ans. A. Tinea schoenleiniiFavous usually affect scalp, but occurring occasionally on any part of the skin and even at times on mucous membrane, caused by Tinea schoenleinii. | train | med_mcqa | null |
Latest oral direct thrombin inhibitor is- | [
"Ximelagatran",
"Indraparinux",
"Dabigatran",
"Fondaparinux"
] | C | Ans. is 'c' i.e., Dabigatrano Ximelagatran was the first oral direct thrombin inhibitor approved; howrever, it was subsequently withdrawn from the market because of reports of fiver failure.o Recently a new oral direct inhibitor, dabigatran, was approved for use in Europe for prevention of various thromboembolism in patients wrho have undergone hip or knee replacement surgery.Direct thrombin inhibitors (DTIs)o This is a class of medications that act as anticoagulants by directly inhibiting the thrombin (unlike heparin which inhibits thrombin indirectly through antithrombin - so, heparin is an indirect thrombin inhibitor),o Drugs in this class are :UnivalentBivalento Argatrobano Melagatrano Dabigatrano Hirudino Bivafirudino Lepirudino Desirudino Ximelagatran is prodrug of melagatran and can be given orally, all other drugs are used parenterally (IV, IM or SC), except for Dabigatran which can also be given orally,o All these drugs (except agratroban) are excreted by kidney - should be avoided in renal failure.o Agratroban is secreted in bile - safe in renal failure,o UsesThese are the anticoagulant of choice for heparin induced thrombocytopenia.Bivalent DTIs can be used in circumstances where heparin would be indicated but cannot be used, such as the acute coronary syndrome (unstable angina)Ximelagatran showed good efficacy in prevention and treatment of DVT and thromboprophylaxis in AF. However, development wras stopped by manufacturer because of reports of liver failure.Other anticoagulantso Danaparoid (mixture of 84% heparan sulfate, 12% dermatan sulfate and 4% chondrioitin sulfate) is approved for prophylaxis of DVT. It is also effective for HIT syndrome. It mainly promotes inhibition of factor Xa by antithrombin.o Rodenticides contain long acting anticoagulants like bromadiolone, brodifacoum, diphenadione, chlorphenacinone and pindone. Treatment is Vit. K.o Drotrecogin alfa is a recombinant form of human activated protein C that inhibits coagulation by proteolytic inactivation of factor Va and Villa. It also has anti-inflammatory activity. It decreases mortality in patients with severe sepsis. | train | med_mcqa | null |
Aseptate hypae and asexual spores are seen with? | [
"Phycomycetes",
"Ascidomycetes",
"Fungi imperfectii",
"Zygomycetes"
] | D | Ans. D. Zygomycetes.Mucormycosis (synonymous with phycomycosis and zygomycosis) is caused by fungi of the class Zygomycetes.Phycomycetes :# A large, important class of parasitic or saprophytic fungi, the algal or algalike fungi.# The plant body ranges from an undifferentiated mass of protoplasm to a well-developed and much-branched mycelium.# Reproduction is mainly sexual, by the formation of conidia or sporangia; but the group shows every form of transition from this method through simple conjugation to perfect sexual reproduction by egg and sperm in the higher forms.Fungi imperfectii (genera Penicillium and Aspergillus):# A heterogenous phylum of fungi which lack a sexual phase, or of which the sexual phase is not known. Some undoubtedly represent the conidium stages of various Ascomycetes. It is not considered a natural phylum, and is also called the Deuteromycota. The group is divided into the orders Sphaeropsidales, Melanconiales, and Moniliales. They reproduce asexually by means of conidia.Zygomycetes:# Fast growing, terrestrial, largely saprobic fungi with non motile cells; cosmopolitan (665 species).# Hyphae coenocytic and mostly aseptate.# Asexual spores include chlamydoconidia, conidia and sporangiospores contained in sporangia borne on simple or branched sporangiophores. Sexual reproduction is isogamous producing a thick-walled sexual resting spore called a zygospore. However, most isolates are heterothallic i.e. zygospores are absent, therefore identification is based primarily on sporangial morphology.# Medically important ones are Rhizopus, Mucor, Rhizomucor, Absidia,.ASCOMYCETES (common moulds)# Saprobes, parasites (esp. of plants), or lichen forming, mostly terrestrial; cosmopolitan.# Hyphae septate with simple septal pores, cytoplasmic and nuclear migration not inhibited.# Asexual reproduction is by conidia. Sexual reproduction is by the formation of endogenous ascospores, typically eight, in an ascus. Asci are often housed in a fruiting body or ascocarp e.g. cleistothecia or perithecia.# No classes are now recognized; although in the past they have often been grouped on how the asci were arranged (Hemiascomycetes, Plectomycetes, Pyrenomycetes, Discomycetes, Laboulbeniomycetes and Loculoascomycetes).# Medically important genera include the teleomorphs of known pathogenic fungi e.g. Arthroderma, Nannizzia, Ajellomyces, Pseudallescheria, Eurotium. | train | med_mcqa | null |
All of the following are used in management of PPH except | [
"Blood",
"FFP",
"Cryoprecipitate",
"NOVO-T"
] | D | Ans. is d, i.e. NOVO-TRef. Fernando Arias 4/e, p 393For fluid resuscitation after PPH following are used:Colloids and crystalloidsBloodFresh frozen plasma-to correct clotting factor deficiency given, if 4U of blood has been given or, if PT>1.5CryoprecipitatePlatelets (if platelet count < 50,000 or, if 4 units of blood have been transfused).NOVO-T is activated factor 7. Its role is well, established in hemophilia. Activated factor VII (NOVOT) acts by binding with tissue factor to augment intrinsic clotting pathway by activating factor IX and X. However its role is obstetrical haemorrhage is uncertain and moreover it is not used in these cases due to risk of thromboembolic events like MI. | train | med_mcqa | null |
Philadelphia (Ph) chromosome | [
"Deletion",
"Break DNA",
"Balanced translocation",
"Balanced transcription"
] | C | i.e. (Balanced translocation): (414-H17th) (493-94-CMDT-l1)The Philadelphia chromosome (Ph) is derived from a reciprocal translocation between chromosome 9 and 22 with the break point joining the sequence of ABL oncogene with the BCR gene. The fusion of these DNA sequences allows the generation of an entirely noval fusion protein with modified functionReciprocal translocation generates Ph chromosomes Fusion of BCR and ABL gene sequences Chimeric BCR-ABL *protein-- The first reproducible chromosome abnormality detected in human malignancy was the Philadelphia chromosomes detected in CMLOther example - Translocations of MYC in Burkitt's lymphoma | train | med_mcqa | null |
Which is true for glucuronidation: | [
"Water solubility is decreased",
"Phase II reaction",
"Phase I reaction",
"Done by CYP enzyme"
] | B | Ans. (b) Phase II reactionRef: Harper's Biochemistry, 30 edn. pg. 586 thMETABOLISM OF XENOBIOTICS* In phase 1, the major reaction involved is hydroxylation, catalyzed by enzymes mono-oxygenases or cytochrome P450s. The reactions are:* Hydroxylation# Deamination# Dehalogenation# Desulfuration# Epoxidation# Peroxygenation# Reduction* In phase 2, compounds produced in phase 1 are converted to various polar metabolites by conjugationwith glucuronic acid, sulfate, acetate, glutathione, or certain amino acids, or by methylation.* The overall purpose of the two phases of metabolism of xenobiotics is to increase their water solubility (polarity) and thus excretion from the body.Glucuronidation: UDP Glucuronic acid is the glucuronyl donor, and a variety of glucuronosyl transferases, present in both the endoplasmic reticulum and cytosol, are the catalysts.* Phase II reactions are:# Glucuronidation: is probably the most frequent conjugation reaction.# Sulfation# Conjugation with Glutathione# Acetylation# Methylation | train | med_mcqa | null |
Transport across nucleus is by all except? | [
"Caveolins",
"Local signals",
"Importins",
"Rat proteins"
] | D | Ans. d. Rat proteinsSource: InternetImportin - Type of karyopherinTransporting protein molecules into nucleus by binding to specific recognition sequences, called nuclear localization sequences (NLS).2 subunits, importin a and importin bCaveolinsFamily of integral membrane proteins that are principal components of caveolae membranes.Involved in receptor-independent endocytosis.Acts as scaffolding proteins within caveolar membranes by compart-mentalizing and concentrating signaling molecules.Rat proteins:Recombinant rat IFN--is a bioactive protein intended for use in cell culture applications. | train | med_mcqa | null |
Herpes zoster ophthalmicus is | [
"Reactivation of herpes in optic nerve",
"Reactivation of herpes in trigeminal nerve",
"Reactivation of herpes in occulomotor nerve",
"herpes in immunocompromised"
] | B | It is due to reactivation of herpes in ophthalmic branch of trigeminal nerve. | train | med_mcqa | null |
Rule of Nine estimates : | [
"The extent of the burn.",
"Degree of severity.",
"Degree of infection.",
"The extent of mortality."
] | A | null | train | med_mcqa | null |
Muscle rigidity is caused by which anaesthetic | [
"Halothane",
"Ether",
"Sevoflurane",
"Alfentanil"
] | D | Opioids can increase muscle tone and may cause muscle rigidity. The incidence of rigidity noted with opioid anesthetic techniques varies significantly because of differences in dose and speed of opioid administration, the concomitant use of N2O, the presence or absence of muscle relaxants, and the patient's age. Opioid-induced rigidity is characterized by increased muscle tone that sometimes progresses to severe stiffness with the potential for serious problems. Clinically significant opioid-induced rigidity usually begins just as or after a patient loses consciousness. Mild manifestations of rigidity, such as hoarseness, can occur in conscious patients. Vocal cord closure is primarily responsible for the difficult ventilation with a bag and mask that follows the administration of opioids. The precise mechanism by which opioids cause muscle rigidity is not clearly understood. Muscle rigidity is not the result of a direct action on muscle fibers because it can be decreased or prevented by pretreatment with muscle relaxants. Mechanisms of opioid-induced muscle rigidity involving the CNS have been postulated. Pharmacologic investigation using selective agonists and antagonists suggest that systemic opioid-induced muscle rigidity is primarily caused by activation of central m receptors, whereas supraspinal d1 and k1 receptors may attenuate this effect. Some aspects of opioid-induced catatonia and rigidity (increased incidence with age, muscle movements resembling extrapyramidal side effects) are similar to Parkinson's disease and suggest similarities in neurochemical mechanisms. Patients with Parkinson's disease, paicularly if they are inadequately treated, may experience reactions such as dystonia following opioid administration. Pretreatment with or concomitant use of nondepolarizing muscle relaxants can decrease the incidence and severity of rigidity. Induction doses of sodium thiopental and subanesthetic doses of diazepam and midazolam can prevent, attenuate, or successfully treat rigidity. Rapid administration of larger doses of opioids (paicularly fentanyl, sufentanil, remifentanil, and alfentanil) can induce chest wall rigidity severe enough to make ventilation with bag and mask nearly impossible. Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e. | train | med_mcqa | null |
Pale infarct is seen in all except | [
"Lung",
"Liver",
"Spleen",
"Kidney"
] | A | . | train | med_mcqa | null |
Suprasternal space contains all except one of the following structures | [
"Jugular venous arch",
"Sternohyoid muscles",
"Interclavicular ligament",
"Sternal heads of right and left sternocleidomastoid muscles."
] | B | suprasternal space of burns contains
Sternal head of 2 sternocleidomastoid muscles
Interclavicular ligament
Jugular venous arch | train | med_mcqa | null |
Which of the following genital infections is associated with preterm labour ? | [
"Human papilloma virus",
"Trichmonas vaginitis",
"Monilial vaginitis",
"Bacterial vaginosis"
] | D | Bacterial vaginosis | train | med_mcqa | null |
Acanthosis nigricans is seen in: | [
"GIT cancer",
"Hypothyroidism",
"Diabetes",
"All of the above"
] | D | Ans. d. All of the aboveMost common association of acanthosis nigricans is obesity | train | med_mcqa | null |
Physical examination of a two year old child reveals a large abdominal mass. CT studies show that the mass arises in the kidney. Which of the following is most likely a distinctive feature of this lesion? | [
"Abundant clear cells",
"Embryonic glomerular structures",
"Eosinophilic cells packed with mitochondria",
"Hamaomatous blood vessels"
] | B | A two-year-old with a tumor of the kidney most likely has Wilms tumor. This aggressive lesion (now with a 90% survival rate ) is microscopically interesting because it contains embryonic glomerular and tubular structures embedded in a spindle cell stroma which may also contain smooth muscle, striated muscle, bone, cailage, fat, and fibrous tissue. Abundant clear cells are a feature of renal cell carcinoma. Eosinophilic cells packed with mitochondria suggests oncocytoma. Hamaomatous blood vessels suggest angiomyolipoma. Ref: Graham D.K., Quinones R.R., Keating A.K., Maloney K., Foreman N.K., Giller R.H., Greffe B.S. (2012). Chapter 31. Neoplastic Disease. In W.W. Hay, Jr., M.J. Levin, R.R. Deterding, J.J. Ross, J.M. Sondheimer (Eds), CURRENT Diagnosis & Treatment: Pediatrics, 21e. | train | med_mcqa | null |
IPHS stands for | [
"International public health services",
"Indian public health services",
"Integrated public health services",
"Indian public health standards"
] | D | Indian Public Health Standards (IPHS) for sub-centers are being prescribed to provide basic promotive, preventive and few curative primary health care services to the community and achieve and maintain an acceptable standard of quality of care.Park 23e pg: 903 | train | med_mcqa | null |
Abbey's flap is used for reconstruction of-( | [
"Breast repair",
"Upper lip repair",
"Cheek repair",
"Cheek repair"
] | B | The cross-lip flap, or Abbe flap, is a staged flap based on the labial aery. The Abbe flap is well suited for both upper and lower lip reconstructions. It is more commonly used as a lower lip flap transferred to the upper lip with both the central and lateral lower lip serving as a donor site. Ref Davidson 23rd edition pg 1209 | train | med_mcqa | null |
A 22-year-old female came with the chief complaint of significant weight loss and secondary amenorrhea. She has a high-intensity exercise regimen, is preoccupied with food, and seems to have an irrational fear of gaining weight. Decreased production of which of the following hormones leads to amenorrhea in anorexia nervosa? | [
"Gonadotropin releasing hormone (GnRH)",
"Progesterone",
"Human chorionic gonadotropin (hCG)",
"Estradiol"
] | A | In Anorexia nervosa, the severe reduction in GnRH pulsatility leads to suppression of FSH and LH secretion, possibly to undetectable levels, and results in anovulation and low serum estradiol levels. Given the severe psychologic and metabolic stress experienced by these individuals, the hypothalamic-pituitary-adrenal axis is activated. The circadian rhythm of adrenal secretion is maintained, but both coisol production and plasma coisol levels are persistently elevated secondary to increased pituitary secretion of adrenocoicotropic hormone (ACTH). Serum leptin levels in these individuals are significantly lower than normal healthy controls and correlate with the percentage of body fat and body weight. A rise in leptin levels in response to dietary treatment is associated with a subsequent rise in gonadotropin levels.""Inhibition of reproduction function-- Enhanced release of the coicotrophin-releasing hormone (CRH) and b-endorphin suppresses GnRH release directly and indirectly through the release of glucocoicoids. Elevated glucocoicoids suppress the release of GnRH, luteinizing hormone, and follicle-stimulating hormone, and produce gonadotropin resistance at the gonads. This suppression in gonadal function is evident in patients with anorexia nervosa and extreme athletes." | train | med_mcqa | null |
Arsenite inhibits | [
"Enolase",
"G-6-PD",
"Alpha ketoglutarate dehydrogenase",
"Hexokinase"
] | C | Alpha ketoglutarate dehydrogenase (alpha ketoglutarate to succinyl CoA) is inhibited by Arsenite. This is a non-competitive inhibition. Ref: DM VASUDEVAN TEXTBOOK OF BIOCHEMISTRY, SIXTH EDITION,PG.NO.,222. | train | med_mcqa | null |
ADH requires NAD+ for catalytic activity. In the reaction catalyzed by ADH, an alcohol is oxidized to an aldehyde as NAD+ is reduced to NADH and dissociates from the enzyme. The NAD+ is functioning as a (an): | [
"Apoenzyme.",
"Coenzyme-co substrate.",
"Coenzyme-prosthetic group.",
"Cofactor."
] | B | Ans. B. Coenzyme-co substrate.a. Coenzymes-cosubstrates are small organic molecules that associate transiently with an enzyme and leave the enzyme in a changed form.b. Coenzyme-prosthetic groups are small organic molecules that associate permanently with an enzyme and are returned to their original form by the enzyme.c. Cofactors are metal ions. Heterotropic effectors are not substrates. | train | med_mcqa | null |
Kangaroo mother care - False is? | [
"Can also be given by father",
"Especially for low bih weight body",
"Effective thermal control",
"All of above"
] | A | Ans.:A.)Can also be given by father KANGAROO MOTHER CARE* KMC is care of preterm or LBW infants by placing skin-to-skin contact with the mother* Position: veical position between the mother's breasts and under her clothes* The position is maintained until the infant no longer tolerates it (indicated by sweating or baby refuses to stay in KMC position)* Kangaroo nutrition: exclusive breast feeding* Continuous KMC is an alternative to minimal care in an incubator for infants who have already overcome major problems while adapting to extra-uterine life Able to suck and swallow properly Thriving in neutral thermal environment * Intermittent KMC (atleast 1-2 hour) when continuous KMC is not possible* All mothers can provide KMC irrespective of age, parity, education, culture or religion* Initiated in a facility and continued at homeClinical benefits* Significantly increases milk production in mothers* Increases exclusive breast feeding rates* Reduces incidence of respiratory tract and nosocomial infection* Better cardiorespiratory stability* Fewer apneic episodes* Improved weight gain* Improves thermal protection in infants and there is a reduced chance of hypothermia* Improves emotional bonding between the infant and mothers* Reduces the duration of hospital stay* Improved survival in low resource settingCriteria for eligibility for KMC* Indicated in all stable LBW babies* Very sick babies needing special care should be cared for under radiant warmer initially. KMC should be staed after the baby is hemodynamically stable* Sho KMC sessions can be initiated during recovery with ongoing medical treatment* KMC can be provided while the baby is being fed orogastric tube or on oxygen therapy * BW > 1800g: generally stable at bih and KMC initiated soon after bih* BW 1200 -- 1799 g: many babies have significant neonatal problems. It might take a few days to sta KMC* BW < 1200g: it might take days to weeks before initiating KMCWhen to stop KMC* When the baby attains a weight of 2500g and a gestation of 37 weeks* A baby who upon being put in kangaroo position, tends to wriggle out, pull limbs out or cries, is not in need of KMC any more | train | med_mcqa | null |
Sputum smear is diagnostic if? | [
"> 25 neutrophils and >10 squamous epithelial cells",
"<25 neutrophils and <10 squamous epithelial cells",
"> 25 neutrophils and <10 squamous epithelial cells",
"<25 neutrophils and >10 squamous epithelial cells"
] | C | Ans. (c) > 25 neutrophils and <10 squamous epithelial cells* Expectorated sputum is necessarily contaminated by upper respiratory secretions as it passes through the oropharynx and mouth.* When examining the Gram stain of such a specimen, the examiner should determine whether it is mostly purulent material from the lung or mainly saliva.* Since squamous epithelial cells line the upper airway but not the tracheo-bronchial tree, their presence indicates that upper airway secretions have contaminated the specimen to some degree.* Several criteria have been proposed for determining that a sputum specimen is not excessively contaminated with oropharyngeal flora and is therefore acceptable for culture.* For example:# Fewer than 10 squamous epithelial cells per field when viewed through a low-power (10x) lens (total magni- fication 100x) and more than 25 neutrophils per low-power field, or- a ratio of neutrophils to epithelial cells greater than 5:1* Even if the specimen conforms to those standards, the patient doesn't necessarily have pneumonia.* That diagnosis depends upon clinical and radiographic information. Patients with viral bronchitis, chronic obstructive lung disease, or tracheal intubation, for example, can have purulent sputum with a predominant organism in the absence of infection of the lung parenchyma.* In some clearly satisfactory sputum specimens collected from patients with pneumonia due to a single organism (e.g., Streptococcus pneumoniae), not only is the infecting organism visible with Gram stain, but often small numbers of other types of bacteria are also present.* A common mistake is to conclude that the Gram stain shows "mixed flora" and therefore does not help establish a diagnosis. | train | med_mcqa | null |
Most common complication of Caldwell-Luc operation is | [
"Oroantral fistula",
"Orbital cellulitis",
"Hemorrhage",
"Infraorbital nerve palsy"
] | D | M/C Complication of Caldwell-Luc operation is injury to infraorbital nerve which occurs is 21 % cases. Ref:- Scott Brown 7th edition; pg num:- 1494 | train | med_mcqa | null |
Carcinoma tongue most frequently develops from: | [
"Tip",
"Lateral border",
"Dorsal poion",
"All poions equally"
] | B | Most common site of carcinoma tongue is middle of lateral border or the ventral aspect of the tongue followed by tip and dorsum. | train | med_mcqa | null |
Varenicline acts by ? | [
"Paial nicotine receptor agonist",
"Nicotine receptor antagonist",
"Both agonist and antagonist at nicotine receptor",
"None of the above"
] | A | Ans. is 'a' i.e., Paial nicotine receptor agonist Varenicline It is paial agonist at the nicotine receptor. It is used in nicotine addicts. | train | med_mcqa | null |
Drug used to halt process of degeneration of dopaminegric neurons in nigrostrial pathway is - | [
"Vit E",
"Vit A",
"Propranolol",
"Levodopa"
] | A | null | train | med_mcqa | null |
30 year old primigravida presents in gynaec OPD with amenorrhea of 36 weeks with pain in abdomen off & on since 7 days, and with history of strassman's metroplasty done . What is the best line of management:- | [
"Induction of labour with PG's after pelvic assessment it.",
"Elective LSCS",
"Sta oxytocin drip and closely monitor it.",
"Give antispasmodics and send the patient back"
] | B | Unification surgical procedures (Strassman operation, Tompkins operation or Jones' wedge metroplasty operation) or hysteroscopic resection of uterine septum are the corrective procedures for Uterine anomalies The mode of delivery in all these corrective procedures is Cesarean section | train | med_mcqa | null |
Most common cause of otomycosis - | [
"Candida",
"Aspergillus",
"Histoplasma",
"Cryptococcus"
] | B | Ans. is 'b' i.e., Aspergillus Otomycosiso Otomycosis, also called acute fungal otitis externa, describes a fungal or yeast infection of the external auditory meatus.o Saprophytic fungi potentially residing in the ear canal include Aspergillus, Candida albicans, Phycomycetes, Rhizopus, Actinomyces, and Penicillium.o Under certain conditions of increased heat, humidity, glucose concentration (diabetes), immunosuppression, or overuse of systemic or topical antibiotics and steroids, these saprophytic fungi can become pathogenic,o Aspergillus niger accounts for 90% of otomycosis infections.o Othercommon organisms are Candida albicans (2nd most common) and Aspergillus fumigatus.o Less common organisms are Phycomycetes, Rhizopus, Actinomyces and Penicillium. | train | med_mcqa | null |
Pigs are important source of: | [
"Japanese encephalitis",
"Kuru",
"Yellow fever",
"Rabies"
] | A | Japanese encephalitis virus:
JE virus is a flavivirus, which causes JE, the most common cause of epidemic encephalitis. Birds and pigs are two main reservoir hosts.
JE is transmitted to humans by certain species of Culex mosquitoes widely prevalent in rice fields in Asia.
Parija SC. Textbook of Microbiology & Immunology. Elsevier Health Sciences; 2014. Page:539 | train | med_mcqa | null |
The fatal dose of absolute alcohol in an adult is | [
"30 ml",
"60 ml",
"90 ml",
"150 ml"
] | D | D i.e. 150 ml | train | med_mcqa | null |
Epithelium lining of lingual surface of epiglottis is: | [
"Simple columnar",
"Pseudostratified ciliated columnar",
"Simple cuboidal",
"Stratified squamous epithelium"
] | D | Epiglottis has two surfaces, the lingual surface is lined by oral epithelium, which is stratified squamous epithelium. The laryngeal surface has respiratory epithelium-pseudostratified ciliated columnar epithelium with goblet cells.
Larynx is lined by respiratory epithelium (pseudostratified ciliated columnar epithelium with goblet cells) except at the vocal cords, which are lined by stratified squamous epithelium. | train | med_mcqa | null |
In autism spectrum disorder, which of the following is identified as the first biomarker ? | [
"Decreased brain volume in children less than 4 years",
"Reduced latency of sleep",
"Increased level of serotonin in the platelets",
"Increased levels of dopamine"
] | C | In autism spectrum disorder, | level of serotonin in the platelets is identified as the first biomarker. Other biomarkers are mTOR pathway Increased total brain volume in children < 4 years of age g-aminobutyric acid (GABA) inhibitory system | train | med_mcqa | null |
Afferent of Cremasteric reflex includes | [
"Genitofemoral nerve",
"Ilioinguinal",
"Ingiuino hypogastric",
"Pudendal nerve"
] | A | CREMASTERIC REFLEX:-Upon stroking the skin of upper pa of medial side of thigh, there occurs a reflex contraction of muscle. It can be seen as elevation and retraction of the testis.Afferent:- genitofemoral nerve.Efferent: genital branch for cremaster muscle.More brisk in children.In UMN lesions,above segment L1 the reflex is lost.{Reference: BDC 6E pages no.206} | train | med_mcqa | null |
DOC for Cisplatin induced nausea & vomiting occuring within 24 hours is | [
"Aprepitant",
"Fosaprepitant",
"Ondansetron",
"Promethazine"
] | C | DOC for Cisplatin induced nausea & vomiting within 24 hours is Ondansetron.
DOC for Cisplatin induced nausea & vomiting after 2days is Aprepitant. | train | med_mcqa | null |
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