question stringlengths 1 6.54k | choices listlengths 4 4 | answer stringclasses 4
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Trapping parasites using NETs is assisted by | [
"Neutrophils and Eosinophils",
"Neutrophils and Monocytes",
"Eosinophils and Monocytes",
"Nk cells"
] | A | NEUTROPHILS AND EOSINOPHILS EMPLOY NETS TO ENTRAP PARASITESIn addition to ingesting small microorganisms such as bacteria by phagocytosis, neutrophils and eosinophils can assist in the elimination of larger invaders by trapping them within webs called neutrophil extracellular traps or NETsRef: Harper&;s Biochemistry; 30th edition; Chapter 54 White Blood Cells | train | med_mcqa | null |
True about stab wounds: NEET 13 | [
"Depth is greater than breadth",
"Breadth is greater than depth",
"Length is greater than breadth",
"It has wound of entry and exit"
] | A | Ans. Depth is greater than breadth | train | med_mcqa | null |
Early strict toilet training can result in – | [
"Nocturnal enuresis",
"Encopresis",
"Night terror",
"Temper tantrums"
] | B | null | train | med_mcqa | null |
Twelve elderly residents living in an assisted care facility suffered from sinusitis, otitis media, and mild pneumonias during midwinter. Despite the fact that they had all received the 13-valent pneumococcal conjugate vaccine recently licensed for adults, S. pneumoniae was isolated from 10 of the patients. Which of the following is the best explanation for the pneumococcal infections? | [
"Elderly patients do not mount good immune responses to vaccines",
"Some patients will not respond to the vaccine",
"The capsular type responsible was not present in the vaccine",
"The vaccine was defective"
] | C | There are more than 90 capsular immunotypes of Streptococcus pneumoniae. Immunity to S. pneumoniae is conveyed by antibodies against the specific capsular type. Vaccines have been formulated to contain the most commonly isolated capsular types. Originally, the S. pneumoniae conjugated vaccine contained seven serotypes. Unfortunately, the serotype replacement phenomenon occurred in which a nonvaccine strain began to cause disease among the vaccinated population. Over time this lead to the licensing of a 13-valent pneumococcal conjugated vaccine (PCV-13), which was recommended for children. A 23-valent nonconjugated vaccine (PV-23) was developed for children over age 2 and adults who are at risk for the disease. Recent research showed that older adults vaccinated with PCV-13 elaborated higher protective antibody titers than those immunized with PV-23. PCV-13 has now been licensed for adults 50 and older. The failure of the vaccine to protect these individuals is most likely due to the replacement phenomenon-the capsular type responsible was not present in the vaccine (c). Elderly patient do mount good immune responses to vaccines so (a) is not the likely cause. Some patients will not respond to the vaccine (b), but the effectiveness of the vaccine is higher than 17% (10/12, the number of patients who became infected). In fact, recent analyses of strains causing illness in those over 65 suggest that over 70% of the cases of invasive pneumococcal disease are covered by PCV-13. It is unlikely that the vaccine was defective (d), although this can occur. | train | med_mcqa | null |
The most abundant extracellular cation is? | [
"Chloride",
"Sodium",
"Calcium",
"Potassium"
] | B | Potassium is the most abundant cation in intracellular fluid.
Phosphate is the most abundant intracellular anion.
Sodium is the most abundant extracellular cation.
Chloride is the most abundant extracellular anion. | train | med_mcqa | null |
The drug NOT used in acute asthma is- | [
"Salbutamol",
"Ipratropium",
"Monteleukast",
"Hydrocoisone"
] | C | Ans. is 'c' i.e., Monteleukast Monteleukast and zafirleukast are indicated for prophylactic therapy of mild to moderate asthma as an alternative to inhaled coicosteroids. However they are not used to terminate acute attack of asthma. | train | med_mcqa | null |
All of them are true about Optokinetic Nystagmus (OKN) EXCEPT | [
"Jerk nystagmus induced by moving repetitive targets",
"Useful for localising cause of isolated homonymous hemianopia",
"Slow phase is a pursuit, fast phase is saccade",
"Type of pathological nystagmus"
] | D | Optokinetic nystagmus It is a physiological jerk nystagmus ( not pathological) Useful in localizing cause of an isolated homonymous hemianopia. Induced by presenting to gaze the objects moving serially in one direction, such as strips of a spinning optokinetic drum. The eyes will follow a fixed strip momentarily and then jerk back to reposition centrally to fix up a new strip. Similar condition occurs while looking at outside things from a moving train. note- - Saccade are Rapid jerky conjugate eye movements,to direct the fovea to a target as the gaze shifts from one object to another Contralateral frontal lobe initiates it & Flocculus(Lobule IX of cerebellum) controls it. - Pursuit is slow tracking eye movements to direct target on fovea.Ipsilateral parieto-occipital lobe controls it & Fastigial nuclei initiates it | train | med_mcqa | null |
Griffith experiment was done on ? | [
"Streptococcus",
"Pneumococcus",
"Enterococcus",
"Staphylococcus"
] | B | Ans. is 'b' i.e., Pneumococcus In 1928, Frederick Griffith's experiment first demonstrated transformation in streptococcus pneumoniae.Frederick Griffith's experiment on pneumococcus (streptococcus pneumoniae) proved that genetic characters are transmitted from one generation to the other through transformation. | train | med_mcqa | null |
Root completion in primary teeth is by the age of | [
"1 - 3years",
"5 -6 years",
"3 - 4 years",
"7 -8 years"
] | C | null | train | med_mcqa | null |
Prosopagonsia is - | [
"Inability to recognize familier face",
"Impaired calculation",
"Inability to recognine objects by feeling",
"Onawareness of neurological deficity"
] | A | Ans. is 'a' i.e., Inability to recognize familier face o Prosopagnosia (face blindness): Inability to recognize known people by faces.o Dyscalculia:- Impaired ability to perform mathematical calculations.o Agnosia:- Inability to recognize objects by a particular sensory modality even though the sensory modality itself is intact.o Astereognosis:- Inability to recognize object by feeling them.o Anosognosia:- Unawareness or denial of disability or neurological deficit.o Dvsgraphia or agraphia:- Deficiency in the ability to write, regardless of ability to read. | train | med_mcqa | null |
Which of the following of drugs is not recommended in septic shock ? | [
"Normal saline",
"Activated protein C",
"Steroids",
"Rituximab"
] | C | null | train | med_mcqa | null |
APC gene is involved in? | [
"Colorectal carcinoma",
"Gastric carcinoma",
"Gastric lymphoma",
"Esophageal adenocarcinoma"
] | A | Ans. is 'a' i.e., Colorectal carcinoma Molecular pathogenesis of colorectal carcinoma* Two distinct genetic pathways have been described, both of which involve the stepwise accumulation of multiple mutations:1) APC/b-Catenin pathway (Adenoma-Carcinoma Sequence)# It accounts for up 80% of sporadic colon tumours. In includes mutation ofAPC early in the neoplastic process. APC protein normally binds to and promotes the degradation of b-catenin. When both copies of the APC gene are inactivate by mutation, loss of APC function results in b-catenin accumulation.# b-catenin translocates to the nucleus where it inactivates the transcription of genes, such as those encoding MYC and Cyclin D1, which promote proliferation. This is followed by additional mutation in K-RASy which also promote proliferation.# Neoplastic progression is also associated with mutation in other tumour suppressur genes such as those encoding SMAD2 and SMAD4, which are effectors of TGF-b signaling. The tumor suppressor p53 is mutated in 70-80% of colon cancers.# Expression of telomerase is also increased as lesions become more advanced.2) Microstatellite instability pathway (DNA mismatch repair deficiency)# Mutations accumulate in microsatellite repeat, a conditions referred to as microsatellite instability. In this, MLH-1, MSH-2 genes in early stages and TGF (3-RII, BAX, BRAF, TCF-4, IGF2R in late stages are involved. | train | med_mcqa | null |
Digoxin toxicity is increased by all except | [
"Hyperkalemia",
"Hypercalcemia",
"Hypomagnesemia",
"Renal impairment"
] | A | PRECAUTIONS AND CONTRAINDICATIONS (a) Hypokalemia, hypomagnesemia, hypercalcaemia: enhances digitalis toxicity. (b) Elderly, renal or severe hepatic disease: patients are more susceptible to digoxin toxicity. (c) Myocardial ischaemia: severe arrhythmias are more likely. (d) Thyrotoxicosis: patients are more prone to develop digitalis arrhythmias. (e) Myxoedema: these patients eliminate digoxin more slowly; cumulative toxicity can occur. (f) Ventricular tachycardia: digitalis is contraindicated because it may precipitate ventricular fibrillation. (g) Paial A-V block: may be conveed to complete A-V block by digoxin. (h) Acute myocarditis: Diphtheria, acute rheumatic carditis, toxic carditis--inotropic response to digitalis is poor, more prone to arrhythmias. (i) Wolff-Parkinson-White syndrome: Digitalis is contraindicated because it decreases the ERP of bypass tract in 1/3 patients. In them rapid atrial impulses may be transmitted to ventricles - VF may occur. Digitalis can increase the chances of reentry by slowing conduction in the normal A-V bundle and accelerating it in the aberrant pathway. Ref:- kd tripathi; pg num:-516,517 | train | med_mcqa | null |
Which of the following should be injected in and around the wound in class III rabies bite? | [
"Tetanus toxoid",
"Antibiotic solution",
"Anti rabies serum",
"None of the above"
] | C | null | train | med_mcqa | null |
Sacubitril is a/an | [
"ACE inhibitor",
"Neutral endopeptidase inhibitor",
"Renin inhibitor",
"Angiotensin receptor antagonist"
] | B | (B) Neuro-endopeptidase inhibitor[?]Sacubitril is a pro-drug used in combination with valsartan to reduce the risk of cardiovascular events in patients with chronic heart failure (NYHA Class II-IV) and reduced ejection fraction.oIt acts by inhibiting neprilysin (neutral endopeptidase) which is responsible for the degradation of atrial and brain natriuretic peptide.oANP & BNP are released under atrial and ventricle stress, which activate downstream receptors leading to vasodilation, natriuresis and diuresis.oInhibition of neprilysin leads to reduced breakdown and increased concentration of endogenous natriuretic peptides in addition to increased levels of vasoconstricting hormones such as angiotensin II.oIt is given in combination with valsartan which is an aangitensin receptor blocker, resulting in a decrease in vascular resistance and blood pressure.oMost common adverse reactions (>=5%) are hypotension, hyperkalemia, cough, dizziness, & renal failure.oCardiovascular & renal effects of sacubitril is a result of the increased levels of peptides that are normally degraded by neprilysin. PHARMACOKINETICS OF SACUBITRIL* ClassAntiotensin-receptor nepilysin inhibitor* ForumulationSacubitril/valsatran-24/26mg,49/51mg,97/103mg tablets* RouteOral* Tmax0.5 hrs (Sacubitril); 2 hours (LBQ657)*; 1.5 hrs (Valsartan)* EliminationSacubitril (52-68% urine 37-48% feces; Valsartan (-13% urine; 86% feces)* Half-life1.4 hrs (sacubitril); 11.5 hrs (LBQ657)*; 9.9 hrs (valsartan)* Active metabolite of sacubitril.[?]VALSARTANois mainly used for treatment of high blood pressure, congestive heart failure, & to increase the chances of living longer after a heart attack. It is an angiotensin II receptor antagonistoSACUBITRILoSacubitril blocks the activity of an enzyme called neprilysin. When neprilysin is active, it breaks down helpful peptides Sacubitril inhibits nepnlysin so peptide levels can go up. These peptides help relax blood vessels & decrease sodium and fluid in the body.[?]ACE inhibitoroAn angiotensin-converting-enzyme inhibitor (ACE inhibitor) is used primarily for the treatment of hypertension (elevated blood pressure) and congestive heart failure.[?]Renin inhibitorsoRenin inhibitors are used primarily in treatment of essential hypertension (high blood pressure).oThese drugs inhibit the first and rate-limiting step of the renin-angiotensin-aldosterone system (RAAS), namely the conversion of angiotensinogen to angiotensin[?]Angiotensin receptor antagonist: Angiotensin II receptor blockers (ARBs) are medications that block the action of angiotensin II by preventing angiotensin II from binding to angiotensin II receptors on muscles surrounding blood vessels | train | med_mcqa | null |
True about Juvenile Myoclonic Epilepsy | [
"Focal seizure",
"Generalised seizure",
"Myoclonus",
"Response to sodium valproate"
] | B | Juvenile myoclonic epilepsy (JME) is an idiopathic generalised epileptic syndrome characterized by myoclonic jerks, generalized tonic-clonic seizures (GTCSs), and sometimes absence seizures. JME is relatively common and responds well to treatment with appropriate anticonvulsants. Ref : Ghai - 8th edition , pg no : 559 , 560 ( table 18.5) | train | med_mcqa | null |
Which of the following structures constitutes pa of ventricle of hea? | [
"Auricle",
"Crista terminalis",
"Fossa ovalis",
"Trabeculae carneae"
] | D | Trabaculae carnae is in right ventricle.fossa ovalis is in intratrial septum.crista terminalis and auricle are is in atrium. BD CHAURASIA's human anatomy VOLUME 1. 6th edition.page no-254,255,256. | train | med_mcqa | null |
An alcoholic is brought to the Emergency OPD with the complaint of irrelevant talking. He had stopped using alcohol three days back. On examination, He is found to be disoriented to time, place and person. He also has visual illusions and hallucinations. There is no history of head injury. Most likely diagnosis is - | [
"Demetia praecox",
"Delirium tremens",
"Schizophrenia",
"Korsakoff's psychosis"
] | B | History of alcohol withdrawal with signs and symptoms of delirium suggest the diagnosis delirium tremens. | train | med_mcqa | null |
On biopsy, characteristic finding of malignant mesothelioma is - | [
"Myelin",
"Desmosin",
"Weibel-palade bodies",
"Branching microvilli"
] | D | Ref:Textbook of pathology (Harsh mohan)6th edition, page no.506 Malignant (Diffuse) Mesothelioma Malignant or diffuse mesothelioma is rare. It is a highly malignant tumour associated with high moality. The tumour is significant in view of its recognised association with occupational exposure to asbestos (paicularly crocidolite) for a number of years, usually 20 to 40 years . About 90% of malignant mesotheliomas are asbestos-related. Mechanism of carcinogenicity by asbestos is not quite clear but it appears that prolonged exposure of amphibole type of asbestos is capable of inducing oncogenic mutation in the mesothelium. However, prolonged asbestos-exposure is considered more significant rather than heavy exposure as documented by occurrence of malignant mesothelioma in the family members of asbestos workers. Although combination of cigarette smoking and asbestos exposure greatly increases risk to develop bronchogenic carcinoma, there is no such extra increased risk of developing mesothelioma in asbestos workers who smoke. Recently, SV40 (simian vacuolating virus) antigen has also been implicated in the etiology of mesothelioma. Grossly, the tumour is characteristically diffuse, forming a thick, white, fleshy coating over the parietal and visceral Grossly Microscopically, malignant mesothelioma may have epithelial, sarcomatoid or biphasic patterns. SECTION III Systemic Pathology Malignant (diffuse) mesothelioma, gross appearance. The tumour is seen to form a thick, white, fleshy coat over the parietal and visceral surfaces. osteoahropathy or hypoglycaemia. Removal of the tumour is generally curative. Malignant (Diffuse) Mesothelioma Malignant or diffuse mesothelioma is rare. It is a highly malignant tumour associated with high moality. The tumour is significant in view of its recognised association with occupational exposure to asbestos (paicularly crocidolite) for a number of years, usually 20 to 40 years (page 492). About 90% of malignant mesotheliomas are asbestos-related. Mechanism of carcinogenicity by asbestos is not quite clear but it appears that prolonged exposure of amphibole type of asbestos is capable of inducing oncogenic mutation in the mesothelium. However, prolonged asbestos-exposure is considered more significant rather than heavy exposure as documented by occurrence of malignant mesothelioma in the family members of asbestos workers. Although combination of cigarette smoking and asbestos exposure greatly increases risk to develop bronchogenic carcinoma, there is no such extra increased risk of developing mesothelioma in asbestos workers who smoke. Recently, SV40 (simian vacuolating virus) antigen has also been implicated in the etiology of mesothelioma. Grossly, the tumour is characteristically diffuse, forming a thick, white, fleshy coating over the parietal and visceral surfaces . i)Epithelial pattern resembles an adenocarcinoma, consisting of tubular and tubulo-papillary formations. The tumour cells are usually well-differentiated, cuboidal, flattened or columnar cells. ii)Sarcomatoid pattern consists of spindle cell sarcoma resembling fibrosarcoma. The tumour cells are arranged in a storiform pattern with abundant collagen between them. iii)Biphasic pattern shows mixed growth having epithelial as well as sarcomatoid pattern. Usually, there are slit-like or gland-like spaces lined by neoplastic mesothelial cells separated by proliferating spindleshaped tumour cells . Asbestos bodies are found in the lungs of most patients with malignant mesothelioma of any histologic type On biopsy, mesothelioma is seen as branching microvilli like appearance. | train | med_mcqa | null |
A patient presents with trismus which of the following technique will block mylohyoid nerve, incisive, and long buccal nerve | [
"Akinosis technique",
"Gowgates technique",
"V block technique",
"Conventional inferior alveolar nerve block"
] | A | null | train | med_mcqa | null |
In this curve, maxilla follow which tissue closely? | [
"Lymphoid",
"Neural",
"General",
"Genital"
] | B | The growth of the jaws is intermediate between the neural and general body curves, with the mandible following the general body curve more closely than the maxilla (which follows the neural growth more closely). The acceleration in general body growth at puberty, which affects the jaws, parallels the dramatic increase in development of the sexual organs. | train | med_mcqa | null |
The gene for Breast Cancer (BRCA) is present on chromosome: | [
"21",
"17",
"15",
"9"
] | B | Women with hereditary breast-ovarian cancer susceptibility have mutation in tumor suppressor BRCA genes—
BRCA-1 (located on chromosome 17q)
BRCA-2 (located on chromosome 13q)
The risk in BRCA-1 carriers is higher compared to that in BRCA-2 carriers.
Mohan H. Textbook of pathology. Jaypee Brothers Medical Publishers; 2015. Edition 7. Page 731 | train | med_mcqa | null |
Granisetron is used in? | [
"Motion sickness",
"Sedation in endoscopy",
"Chemotherapy induced nausea & vomiting",
"Gastroesophageal reflux disease"
] | C | Ans. is 'c' i.e., Chemotherapy induced nausea & vomiting 5-HT3 blockers (e.g. ondansetron, granisetron etc) are the drugs of choice for chemotherapy induced nausea and vomiting. | train | med_mcqa | null |
An important non-respiratory function of lungs | [
"Anion balance",
"Sodium balance",
"Potassium balance",
"Calcium balance"
] | B | Extracellular ACE on the surface endothelial cells in pulmonary circulation activates Angiotensin I to Angiotensin II.
It also directly affects sodium balance through epithelial sodium channels. | train | med_mcqa | null |
Circular DNA is found in: | [
"Virus",
"Chloroplast",
"Bacteria and Mitochondria both",
"All"
] | D | Circular DNA is found in viruses (eg polyoma virus has double stranded & porcine virus has single stranded circular genome), prokaryotes (most bacterial DNA is circular), blue green algae as well as in eukaryotic cells like mitochondrial DNA or plasmid DNA and in chloroplast.A distinguishing characteristic of prokaryotes is their capacity to exchange small packets of genetic information carried on plasmids. Plasmid are small, specialized genetic element that are capable of replication within at least one cell line or exhibit broad hoast range and may carry sets of specialized genetic information (eg drug resistance) through a population. Plasmids were identified as small genetic elements carrying genes and capable of independent replication in prokaryotes (bacteria & yeast). Unlike viruses, plasmids are naked DNA and donot carry genes necessary to encase genetic material for transfer to new host. Sometimes plasmids may be found in eukaryotes like saccharomyces cerevisiae). In genetic engineering, plasmid is a small genetic (DNA) element that is separate from and can replicate independently of the chromosoml DNA. So introduction of DNA restriction fragment into a plasmid allows the fragment to be amplified many times. | train | med_mcqa | null |
Retention in a stainless steel crown is achieved primarily by: | [
"Chamfer",
"Cement",
"Parallel distal and mesial walls",
"Crimping the crown to engage buccal & lingual undercuts"
] | D | null | train | med_mcqa | null |
True statements are all except - | [
"Chromosome 6 harbours the gene for MHC",
"Genes encoding compliments are located adjacent to class- I molecules",
"Monocytes have MHC class II antigens on their surfaces",
"Class III MHC does not encode complement"
] | D | Ans. is 'd' i.e., Class III MHC does not code for complement | train | med_mcqa | null |
Sudden discontinuation of which of the following drugs can cause agitation, anxiety and insomnia? | [
"Imipramine",
"Valproate",
"Olanzapine",
"Venlafaxine"
] | D | Venlafaxine is the most common drug associated with discontinuation syndrome. | train | med_mcqa | null |
Cow milk as compared to human milk has more - | [
"Lactose",
"Lactoferrin",
"Antibodies",
"Proteins"
] | D | Ans. is 'd' i.e., Proteinso In comparison to cow milk, human milk contains more : Lactose (7 g/100 ml or 7%), antibodies, lactoferrin and other antiinfective factors.o In comparison to cow milk, human milk contains less amount of: Proteins (1 gm/100 ml), salts (sodium, chloride, potassium), fat (3.4 gm/100 ml), and minerals (calcium, phosphate)o Though, the amount of mineral and salts is less in human milk, they are in correct amount, where as they are in excess in cow milk. The coefficeint of uptake of iron in breast milk is 70%.o Human milk protein constitute mainly whey protein, where as casein is the main protein in cow's milko Different constituents of human breast milk provides evergy in following percentage. Carbohydrate 30-40%, protein 7-10% and fat 45-60%.Nutritive value of milks compared (value per 100 grams) BuffaloCowGoatHumanFat (g)6[?]54[?]14[?]53[?]4Protein (g)4[?]33[?]23[?]31[?]1Lactose (g)5[?]14[?]44[?]67[?]4Calcium (mg)21012017028Iron (mg)0[?]20[?]20[?]3 Vitamin C (mg)1213Minerals (g)0[?]80[?]80[?]80[?]1Water (g)81[?]08786[?]888Energy (kcal)117677265 | train | med_mcqa | null |
PICA is associated with poisoning of - | [
"Lead",
"Arsenic",
"Mercury",
"Phosphorus"
] | A | Ans. is 'a' i.e., Leado Pica involves repeated or chronic ingestion of non-nutritive substances, which includes plaster, charwal, clay, wool, ashes, patent & earth.o It can result in serious health problems like iron deficiency anemia and lead poisoning. | train | med_mcqa | null |
Anaesthetic agent of choice in renal failure – | [
"Methoxyflurane",
"Isoflurane",
"Enflurane",
"None"
] | B | Amongst the given options isoflurane is best.
Overall, Desflurane is best in renal failure. | train | med_mcqa | null |
Most of the medico legal importance of the seeds shown bellow | [
"Arrow poison",
"Artificial bruise",
"Infanticide",
"None of the above"
] | B | Image shows seeds od semicarpus anacardium(also marking nut) used to produce crtifical bruise. | train | med_mcqa | null |
Common toxin through vegetables: DNB 08 | [
"Boric acid",
"Carbolic acid",
"Taaric acid",
"Oxalic acid"
] | D | Ans. Oxalic acid | train | med_mcqa | null |
Which of the following drugs is most likely to be effective against multidrug-resistant strains of M. tuberculosis, including those resistant to streptomycin? | [
"Amikacin",
"Clarithromycin",
"Gentamicin",
"Spectinomycin"
] | A | Amikacin is the second line antitubercular drug.Kanamycin, Amikacin and Capreomycin are more toxic antibiotics used as reserve drugs in rare cases not responding to the usual therapy, or infection by atypical mycobacteria. Any one of these is used at a time in combination with the commonly employed drugs to which resistance has not developed. Because all exhibit similar ototoxicity and nephrotoxicity, they are not combined among themselves or with streptomycin. Capreomycin, in addition, can induce electrolyte abnormalities. All act by inhibiting protein synthesis. None is effective orally; none penetrates meninges. All are excreted unchanged by the kidney. All are given in a dose of 0.75-1 .0 g i.m. per day. ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION Page NO:744 | train | med_mcqa | null |
Basic lesion in tobacco amblyopia is | [
"lschaemia of optic nerve fibres",
"Degeneration of ganglion cells especially of macular region",
"Degeneration of foveal cones",
"All of the above"
] | B | Tobacco amblyopia It typically occurs in men who are generally pipe smokers, heavy drinkers and have a diet deficient in proteins and vitamin B complex; and thence also labelled as 'tobacco-alcohol-amblyopia. Pathogenesis: The toxic agent involved is cyanide found in tobacco. Ref:- A K KHURANA; pg num:-296 | train | med_mcqa | null |
Patients of Wiskott-Aldrich syndrome exhibit the classical triad of:- | [
"Thrombocytopenia, recurrent infections and psoriasis",
"Thrombocytopenia, recurrent infections and lichen planus",
"Thrombocytopenia, recurrent infections and seborrheic dermatitis",
"Thrombocytopenia, recurrent infections and eczema"
] | D | Wiskott-Aldrich syndrome Immunodeficiency Triad: Thrombocytopenia, Eczema Recurrent infection X-linked recessive condition. Mutation- gene (XLT), WASP gene C/F - early life with bruising, petechiae and bleeding, congenital neutropenia | train | med_mcqa | null |
False about optic nerve glioma | [
"May be a part of von recklinghausen's disease",
"Unilateral axial proptosis",
"Most common primary orbital tumour among children",
"CT shows fusiform enlargement of optic nerve"
] | C | M/c primary orbital tumour among children is Rhabdomyosarcoma. | train | med_mcqa | null |
The folds of Hoboken are found in : | [
"Amnion",
"Placenta",
"Uterus",
"Umbilical cord"
] | D | Folds of Hoboken are transverse intimal folds protruding into the lumen of umbilical aeries. | train | med_mcqa | null |
A 37-year-old woman, Maimuz, presents with 3 days of progressive joint pain in her ankles, knees, and wrists. She recalls three similar episodes over the past several years. On examination, she has a temperature of 38.7 C, her blood pressure is 110/70 mm Hg, and her hea rate is 90/min. She has a diffuse petechial rash over her trunk and extensor surfaces. Her ankles and knees are swollen, red, and tender with decreased range of motion, and there is tenderness over the tendon sheaths of her hands and forearms. Blood cultures are negative. Aspiration of joint fluid reveals a white cell count of 22,000/mm3 with no visible organisms, but culture on chocolate agar is positive. Which of the following is an attribute of the causative organism that allows it to produce recurrent infections? | [
"It is an intracellular pathogen",
"It is resistant to ceftriaxone",
"It is resistant to complement-mediated lysis",
"Its pili undergo antigenic and phase variation"
] | D | This is a case of Neisseria gonorrhoeae ahritis. Patients are continuously susceptible to reinfection because of antigenic variation and phase variation of the pili. N. gonorrhoeae is not an intracellular pathogen, although it may be found intracellularly in neutrophils after it has been phagocytized. Ceftriaxone is the drug of choice for N. gonorrhoeae. Gonococci are especially susceptible to complement-mediated lysis, not resistant to it. | train | med_mcqa | null |
Ionophores have following action except: | [
"Abolish proton gradient",
"Inhibit ADP to ATP conversion",
"Hydrophilic in character",
"Abolish pH gradient"
] | C | C i.e. Hydrophilic in characterIonophoresaillCeain microbes synthesize small organic molecules called ionophores, that function as shuttle for the movement of ions across membrane. | train | med_mcqa | null |
Pagets disease of breast is associated with which of the following? | [
"Ductal carcinoma in situ",
"Lobular carcinoma in situ",
"Phyllodes tumor",
"Mondors disease"
] | A | Ans. is 'a' i.e., Ductal carcinoma in situ * Paget disease of the nipple is a rare manifestation of breast cancer - 1% to 4% of cases.* It presents as a unilateral erythematous eruption with a scale crust. Pruritus is common, and the lesion may be mistaken for eczema.* Malignant cells (Paget cells) extend from ductal carcinoma in situ (DCIS) within the ductal system via the lactiferous sinuses into nipple skin without crossing the basement membrane. | train | med_mcqa | null |
____________ is an example for rapidly acting
neurotransmitter | [
"Somatostatin",
"Calcitonin",
"Substance P",
"Glycine"
] | D | null | train | med_mcqa | null |
Which of the following drug used in asthma is not a branchodilator ? | [
"Salbutamol",
"Beclomethasone",
"Theophylline",
"Ipratropium"
] | B | Ans. is 'b' i.e., Beclomethasone | train | med_mcqa | null |
Apgar scores were 3, and 6 at 1 and 5 minutes. At 10 Apgar scores were 3, and 6 at 1 and 5 minutes. At 10 minutes child shows features of breathlessness,on CXR-mediastinal shift was there, possible causes –
a) Bilateral choanal atresiab) Pneumothoraxc) Congenital diaphragmatic herniad) Hyaline membrane disease | [
"a",
"bc",
"ac",
"ad"
] | B | Congenital diaphragmatic hernia and pneumothorax cause respiratory distress with mediastinal shift to contralateral side.
Bilateral choanal atresia and HMD cause respiratory distress, but no mediastinal shift. | train | med_mcqa | null |
Steroids act via nuclear receptors which interact with DNA through | [
"Helix turn helix",
"Zinc finger motif",
"Histidine",
"Leucine zipper"
] | B | Binding of transcription regulatory proteins to DNA is regulated by several motifs :
Helix turn helix
Leucine zipper
Zinc finger
Binding motif for steroid receptor family & thyroid (nuclear) receptor family is a zinc finger.
In proteins with zinc - finger motif, the binding site is repeated 2-9 times.
Proteins with helix-turn-helix and leucine zipper motifs form symmetrical palindromes and their DNA binding sites are symmetrical palindromes.
In leucine - zipper motif, there is a periodic repeat of a leucine residue at every 7th position | train | med_mcqa | null |
The renal biopsy of a 6-year-old boy with recurrent gross hematuria shows IgA nephropathy. The urinary protein excretion is 130 mg/day. Which of the following is the most appropriate next step in the management - | [
"Administer coicosteroids",
"Give Azathioprine",
"Sta Cyclosporine",
"Urinary bag sample"
] | A | Ans. is 'a' i.e., Administer coicosteroids T/T of IgA nephropathy ? o There is no proven t/t for IgA nephropathy. o The primary t/t is proper blood pressure control. The drugs which have been proved useful are :? i) Fish oil (It contains omega - 3 fatty acids). It is an antiinflammatory agent and it prevents the rate of renal progression. ii) Immunosuppressive therapy - It is done with coicosteroids with or without cytotoxic therapy. iii) ACE inhibitors and Angiotensin II receptor antagonists - Their role in reducing proteinuria and retarding the rate of renal progression is still to be determined. iv) Prophylactic antibiotics and tonsillectomy - It may reduce frequency of gross hematuria but they have no effect on progression of renal disease. | train | med_mcqa | null |
Strangulation by keeping neck between angle of elbow - | [
"Burking",
"Smothering",
"Mugging",
"Gagging"
] | C | Ans. is 'c' i.e., Mugging o Strangulation is the form of asphyxia caused by constriction of neck by ligature or some other method, but without suspension of the body. So the force constricting the neck is external force (not the weight of the body as occurs in hanging).o Depending upon the method used to constrict the neck, strangulation can be divided into :Ligature strangulation : Neck is compressed by a ligature of which usually multiple rounds are given and no knot is tied.Throttling (manual strangulation): Neck is compressed by one or both hands. When neck is compressed by two palms, it is known as palmar strangulation.Bansdola : Compression of neck with one or two wooden sticks or bamboo.Garrotting: It is compression of neck by a rope thrown from behind. Spanish windlass is a type of garrotting, which used to be the official mode of execution in spain. In this, an iron collor around the neck was tightened by a screw for strangulation.Mugging (choke hold) : It is compression of neck by forearm or in the bend of elbow.Strangulation by knee/foot: In this, neck is compressed by knee or foot. | train | med_mcqa | null |
Carnitine required for which process in fatty acid cycle? | [
"Fatty acid synthesis",
"Fatty acid oxidation",
"Fatty acid storage",
"Ketone body synthesis"
] | B | Ans. is 'b' i.e., Fatty acid oxidation * As fatty acid is nonpolar, it passively diffuses into a cell across cell membrane. As soon as it has reached cytoplasm, fatty acid has a propensity to passively diffuses back into circulation again for the same reason - it is non polar. Fatty acid has gotten into a cell for a purpose. We can't afford to miss fatty acid. So, Fatty acid has to be trapped in a polar form. That is done by acyl CoA synthetase (three types of this enzyme are available - for short chain, medium chain and long chain), which uses two high energy phosphates (ATP - AMP + PPi) and it converts fatty acid into polar acyl CoA.* Further fate of fatty acid which is in the acyl CoA depends upon the energy status of the cell. If the energy status of the cell is already high, the fatty acid need not be oxidised but has to be stored as triacylglycerol. If the energy status of the cell is low, fatty acid has to be oxidised - for which fatty acid has to get into mitochondria. As polar acyl CoA long chain fatty acids can not cross mitochondria. They need a carrier, Carnitine (SHORT CHAIN AND MEDIUM CHAIN FATTY ACIDS ARE NOT DEPENDENT ON CARNITINE TO CROSS MITOCHONDRIA)* So carnitine is a carrier of long chain fatty acids and is involved in fatty acid oxidation.* The enzyme involved in the conversion of long chain fatty acyl co A to Acyl carnitine is Carnitine Acyl T ransferase-I (CAT-I)1. This enzyme is placed in the outer mitochondrial membrane.* After Acyl carnitine crosses the inner mitochondrial membrane, Carnitine acyl transferase II converts acyl carnitine to acyl coA and this acyl coA is oxidised.* Other facts about carnitine:# Carnitine is Beta hydroxyl gamma trimethyl ammonium butyrate.# It is synthesised from lysine and methionine in liver and kidney.# Vitamin C is required for the synthesis of carnitine.'CAT I is the enzyme which commits fatty acid to oxidation. Because, until CATI acts, the fatty acids can either get into fatty acid oxidation or they can be stored as triacylglycerol. Hence CATI is considered as the rate limiting emzyme of fatty acid oxidation | train | med_mcqa | null |
Which is the earliest symptom of benign hypertrophy of prostate | [
"Increased Frequency",
"Nocturia",
"Narrow stream",
"Incontinence"
] | A | Earliest feature of BPH is increased frequency. | train | med_mcqa | null |
Which of the following not a glycoprotein? | [
"FSH",
"LH",
"TSH",
"ADH"
] | D | Ans: D (ADH) Ref: Harper's Illustrated Biochemistry, 28th edition.Explanation:The Antidiuretic hormone (ADH) (vasopressin) is peptide consisting of nine amino acids (non- u peptides) and not a glycoproteinHormones that are glycoproteins include:Follicle-stimulating hormone (FSH)Luteinizing hormone (LH)Thyroid-stimulating hormone (TSH)Human chorionic gonadotropin (HCG)Alpha-fetoprotein (AFP)Erythropoietin (EPO) (See Table 5 )Chemical Nature of HormonesInsulin family* Insulin* IGF* RelaxinGlycoprotein family* LH* hCG* FSH* TSHGH family* GH* Prolactin* hPLSecretin family* Secretin* G1P* Glucagon* VIPPeptide hormones* ANP* ADH* ACTH* Calcitonin* Inhibin* PTH* CCK* Somatostatin Table 5 : Some important glycoproteins FunctionGlycoproteinsStructural moleculeCollagensLubricant and protective agentMucinsTransport moleculeTransferrin, ceruloplasminImmunologic moleculeImmunoglobins, histocompatibility antigersHormoneHCG. TSH, FSH, LH, EPO, AFPEnzymeVarious, e.g., alkaline phosphatase, patatinCell attachment-recognition siteVarious proteins involved in cell-cell (e.g., sperm-oocyte), virus-cell, bacterium-cell, and hormone-cell interactionsInteract with specific carbohydratesLectins, select ins (cell adhesion lectins), antibodiesReceptorVarious proteins involved in hormone and drug actionAffect folding of certain proteinsCatnexin. calreticulinRegulation of developmentNotch and its analoqs, key proteins in developmentHemostasis (and thrombosis)Specific glycoproteins cn the surface membranes of platelets | train | med_mcqa | null |
A newborn with ambiguous genitalia and a 46,XY karyotype develops vomiting, low serum sodium concentration, and high serum potassium. Which of the following proteins is most likely to be abnormal? | [
"21-hydroxylase",
"An ovarian enzyme",
"5a-reductase",
"An androgen receptor"
] | A | Sex steroids are synthesized from cholesterol by side chain cleavage (employing a P450 enzyme) to produce pregnenolone.Pregnenolone is then conveed to testosterone in the testis, to estrogen in the ovary, and to coicosterone and aldosterone in the adrenal gland. The enzymes 3b-hydroxysteroid dehydrogenase, 21-hydroxylase, 11b-hydroxylase, and 18-hydroxylase modify pregnenolone to produce other sex and adrenal steroids. Deficiencies in adrenal 21-hydoxylase can thus lead to inadequate testosterone production in males and produce ambiguous external genitalia. Such children can also exhibit low sodium and high potassium due to deficiency of the more distal steroids, coisol and aldosterone. 5a-reductase conves testosterone to dihydrotestosterone, and its deficiency produces milder degrees of hypogenitalism without salt wasting. Deficiency of the androgen receptor is called testicular feminization, producing normal-looking females who may not seek medical attention until they present with infeility. | train | med_mcqa | null |
Cobra head deformity is seen in | [
"Ureterocele",
"Ureteric fistula",
"Retrocaval ureter",
"Urethral stricture"
] | A | Ureterocoele due to distal ureter dilation looks like cobra head. | train | med_mcqa | null |
Biological amnesia is - | [
"Lack of interest",
"Presenile dementia",
"Opioid addiction",
"Hypothyroidism"
] | B | Biological amnesia:- Head injury (concussion/brain bruises), drugs (Marijuana, alcohol), brain disease (Korsokoff syndrome, Brain tumors, multiple sclerosis, presenile dementia), temporary disturbances in brain blood supply, and transient global amnesia.
Psychological amnesia :- Childhood amnesia, dream amnesia, defensive amnesia | train | med_mcqa | null |
About cushing syndrome, true Is - | [
"Low dose dexamethasone suppress coisone secretion",
"CA of adrenal is more common than adenoma",
"Pituitary adenoma size > 2 cm (usually)",
"ACTH secretion is the commonest cause"
] | D | most cases the cause is bilateral adrenal hyperplasia due to hyper secretion of pituitary ACTH or ectopic production of ACTH by a non pituitary source ( Harrison 17 pg 2255) | train | med_mcqa | null |
Metabolically active layer of cornea is –a) Endotheliumb) Stromac) Descemet membrane d) Epithelium | [
"b",
"c",
"ad",
"ab"
] | C | The most actively metabolizing layers of the cornea are epithelium and endothelium. | train | med_mcqa | null |
Man is intermediate host of- | [
"Filariasis",
"Hydatid cyst",
"Both",
"None"
] | B | Ans. is 'b' i.e., Hvdatid cyst Man acts as intermediate host for : ? Plasmodium (malaria) Toxoplasma Echinococcus granulosus (hydatid disease) | train | med_mcqa | null |
Micro-organism used as weapon in biological terrorism - | [
"Small pox V",
"Rabies V",
"Ebola V",
"Influenza CV"
] | A | null | train | med_mcqa | null |
A patient with salicylic acid poisoning has the following arterial blood gas analysis report: pH = 7.12; PCO2 = 18 mmHg; HCO3 = 12 mmol/L. The resulting acid-base abnormality can be best labeled as: | [
"Metabolic acidosis with respiratory alkalosis",
"Metabolic acidosis with respiratory acidosis",
"Respiratory acidosis with metabolic alkalosis",
"Metabolic acidosis"
] | A | Ans. is 'a' i.e. Metabolic acidosis with respiratory alkalosisRef. Harrison 17th/e p 288 & 16th/e p 2591, 266 (15th/e page 284, 286,187)Also see June 2000 Q. No. 94.In patients with salicylate poisoning, initially the acidic metabolites of salicylic acid accumulate and cause metabolic acidosis.This causes the following acid base reaction to shift to left (because of addition of H) CO2 + H20 = H2CO3 = H+ + HCO3-This causes decrease in extracellular HCO3* This in turn stimulates the medullary chemoreceptors to increase ventilation and return the ratio of / PaCO2 and thus pH towards normal* The formula given to predict the degree of compensation required for simple form of metabolic acidosis is PaCO2 = 1.5 x + 8 or you can say that the PaCO2 is expected to decrease 1.25 mm of Hg for each mmol/L decrease in The normal values of PCO2 and HCO3-Arterial PC02 - 40 +- 2 mm HgArterial - 24 +- mm HgThus a patient with metabolic acidosis and of 12 mmol/L would be expected to have a PaCO2 between 24 and 28 mm Hg. (to compensate for the acidosis)Values of PaCO2 below 24 or greater than 28 mm Hg will mean mixed disturbance.If PaCO2 is < 24 it means metabolic acidosis + respiratory alkalosis (hyperventilation has led to excess CO2 washout causing respiratory alkalosis)If PaCO2 > 28 it means - metabolic acidosis respiratory acidosisHere is a table giving predictions of compensatory response on simple acid base disturbance. Prediction of Compensatory Responses on Simple Acid-Base DisturbancesDisorderPrediction of CompensationMetabolic acidosisPaCO2 =(1.5xHCO3-) +8 OrPaCO2 will | 1.25mmHg per mmol/L | in OrPaCO22 = + 15Metabolic alkalosisPaCO2 will | 0.75 mmHg per mmol/L | in orPaCO2 will | 6 mmHg per 10-mmol/L | in OrPaCO2 = + 15Respiratory AlkalosisAcute will | 2 mmol/L per 10-mmHg | in PaCO2Chronic will | 4 mmol/L per 10-mmHg | in PaCO2Respiratory acidosisAcute will | 1 mmol/L per 10-mmHg T in PaCO2Chronic will | 4 mmol/L per 10-mmHg | in PaCO2 | train | med_mcqa | null |
A patient presenting with Volkmann's Ischaemia all of the following are done except | [
"Split open the plaster of Paris cst and bandage",
"Decompression by fasciotomy",
"Exploration",
"Sympathetic ganglion blockade"
] | D | D i.e. Sympathetic ganglion Blockade | train | med_mcqa | null |
In caloric test left jerk nystagmus occurs when: | [
"Cold water is poured in right ear",
"Hot water is poured in right ear",
"Cold water is poured in left ear",
"All of the above"
] | A | Ans. Cold water is poured in right ear | train | med_mcqa | null |
Sacrococcygeal teratoma is a derivative of | [
"Primitive streak",
"Hypoblast",
"Ectoderm",
"Cranial neuropore"
] | A | Sacrococcygeal teratoma: - Sometimes remnants of the primitive streak persist in the sacrococcygeal region. Then cluster of pluripotent cells proliferate & form tumor, known as sacrococcygeal teratomas Which commonly contain tissues derived from all three germ layers. Occurrence 1: 37,000 Most common tumor in a new born. Teratomas may also arise from abberent migration of primordial germ cells. | train | med_mcqa | null |
Bony clival erosion with inta-cranial calcification is seen in - | [
"Sella chordoma",
"Craniopharyngioma",
"Medulloblastoma",
"Papilloma of the choroids plexus"
] | A | Chordomas
Chordomas are rare, slow growing, locally aggressive neoplasms of bone that arise from embryonic remnants of the notochord.
These tumors typically occur in the axial skeleton and are most common in the sphenooccipital region of the skull base and in the sacral regions.
In adults, 50 percent of chordomas involve the sacrococcygeal region, 35 percent occur at the base of the skull, and 15 percent are found elsewhere in the vertebral column,
Craniocervical chordomas most often involve the dorsum sella, clivus, and nasopharynx.
They are associated with bone erosion.
Purely intrasellar chordoma without bony erosions are very' uncommon.
Chordoma of the clivus causes erosion of the clivus and extend in the direction of the nasopharynx as well as posteriorly. | train | med_mcqa | null |
In which stage of the sleep we can see spindle complexes and sleep spindles in EEG? | [
"Stage N1",
"Stage N2",
"Stage N3",
"REM"
] | B | Ans. B. Stage N2Sleep is scored in epochs of 30 seconds, with stages of sleep defined by visual scoring of 3 parameters: electroencephalogram (EEG), electrooculogram (EOG) & electromyogram (EMG) recorded beneath chin.1. NREM:* Stage 1: 1st stage, light sleep, loss of alpha waves (eyes closed but awake) and predominant theta waves* Stage 2: Maximum time spent. Findings in EEG include- Sleep spindles: bursts of waves of frequency of 11-16Hz- K-complexes: high voltage spikes, negative sharp waves followed by positive waves* Stage 3: Deepening of sleep, appearance of delta waves.* Stage 4: Deep sleep characterized by delta waves- New NREM stages: N1 (stage 1), N2 (stage 2), N3 (stage 3+4)2. REM sleep: (aka paradoxical sleep)* EEG: beta wave (similar to awake state), alpha wave | train | med_mcqa | null |
A man takes peanut and develop stridor, neck swelling, tongue swelling and hoarseness of voice. Most probable diagnosis is - | [
"Foreign body bronchus",
"Parapharyngeal abscess",
"Foreign body larynx",
"Angioneurotic edema"
] | D | Angioedema is an area of swelling of the lower layer of skin and tissue just under the skin or mucous membranesThe swelling may occur in the face, tongue, larynx, abdomen, or arms and legs.Often it is associated with hives, which are swelling within the upper skin.Onset is typically over minutes to hours The underlying mechanism typically involves histamine or bradykinin. The version related to histamine is due to an allergic reaction to agents such as insect bites, foods, or medications. The version related to bradykinin may occur due to an inherited problem known as C1 esterase inhibitor deficiency, medications known as angiotensin-conveing enzyme inhibitors, or a lymphoproliferative disorder. Effos to protect the airway may include intubation or cricothyroidotomy. Histamine-related angioedema can be treated with antihistamines, coicosteroids, and epinephrine.In those with bradykinin-related disease a C1 esterase inhibitor, ecallantide, or icatibant may be used.Fresh frozen plasma may be used insteadIn the United States the disease affects about 100,000 people a year. Ref Davidson 23rd edition pg 451 | train | med_mcqa | null |
Fluoride recharging of a glass ionomer cement restoration is more effective by which of the following agents? | [
"0.02% NaF solution for 2-3 minutes",
"0.02% NaF solution for 2-5 minutes",
"1.23% APF solution for 4-5 minutes",
"1.23% APF solution for 2-3 minutes"
] | C | The ability of a restorative material to be recharged and serve as a fluoride reservoir depends on the type and permeability of the material, the frequency of fluoride exposure, and the concentration of the fluoridating agent. For example, recharging is more effective by acidic fluoridating agents such as APF.
Ref: Phillip’s Science of Dental Materials ed 12 pg 334 | train | med_mcqa | null |
A 40-year-old female who underwent subtotal thyroidectomy developed respiratory distress 8 hours after the operation. The skin sutures were opened in the ward but the distress persisted. What is next likely step in management? | [
"Immediately shift the patient to operation theatre",
"Patient should be intubated in the ward",
"External pressure should be applied over the neck to stop bleeding",
"Open the layers of the wound in the ward."
] | D | The most impoant cause of respiratory distress is tension hematoma. (reactionary haemorrhage)Generally, the distress is relieved by opening the skin suture.On rare occasions, it may be necessary to open the layers of the wound, not simply the skin closure, to relieve tension before taking the patient to the theatre to evacuate the hematoma & secure the bleeding vessel. | train | med_mcqa | null |
Gallows traction is used for ? | [
"Fracture shaft femur",
"Fracture shaft tibia",
"Fracture shaft humerus",
"Fracture neck femur"
] | A | Ans. is 'a' i.e., Fracture shaft femur Fracture of shaft femur in infant and young children It is published that upto one half of infants and young children who sustain femur fractures are victims of childabuse and child abuse occurs in 50 - 80% of children (< 2 years of age) with femoral fracture. Other causes of fracture are osteogenesis imperfecta (blue sclera, hearing loss, multiple fracture), bone tumors(eosinophilic granuloma, aneurysmal bone cyst). Fracture heals within 2 weeks in infant and children upto 2 years of age. Treatment depends upon the age of the patient : ? 1. Conservative : - It is the treatment of choice in children. 0-2 yeas : - Plaster spica or modified Bryant or tallow's traction or pavllic harness (< 6 month of age). 2-10 years : - Split Russel traction 10-15 years : - 90-90deg femoral skeletal traction. 2. Surgical Surgery is done less commonly in children. It is indicated in older children when closed reduction by conservative treatment is not possible. Intramedullar titanium elastic nailing is the surgery of choice. | train | med_mcqa | null |
Which of the following acts as cofactor after it&;s modification? | [
"Vit-C",
"Pantothenic acid",
"Biotin",
"Zinc"
] | B | The functions of pantothenic acid are exeed through coenzyme A or CoA (A for acetylation). Coenzyme A is a central molecule involved in all the metabolisms (carbohydrate, lipid and protein). Coenzyme A may be regarded as a coenzyme of metabolic integration since acetyl CoA is a central molecule for a wide variety of biochemical reactions ref Satyanarayana 4th ed page 149 | train | med_mcqa | null |
The lip is supported by | [
"Relation of lip edge and facial surfaces of teeth",
"Labial sulcus between teeth and lip",
"Relationship of tongue and teeth",
"None"
] | A | null | train | med_mcqa | null |
The energy requirement of an infant, for planning aificial feeding is: | [
"50 kcal per kg body weight, per day",
"70 kcal per kg body weight, per day",
"100 kcal per kg body weight, per day",
"120 kcal per kg body weight, per day"
] | C | Aificial Feeding - Principles 1. Energy requirement - 100 kcal per kg body weight, per day. 2. Protein requirement of: Age 0-6 months 2 g per kg body weight per day 6-12 months 1.5 g per kg body weight per day 3. Carbohydrate requirement of 10 g per kg body weight per day. 4. Undiluted boiled and cooled milk to be given after 4 months of age. 5. Feeding frequency of 6-8 times a day in infants, and 5 times a day in older children. 6. Increased calorie demand during illnesses (e.g. fever) should be considered. | train | med_mcqa | null |
In a child,Purposeful movement is staed at______ | [
"6 month",
"Infant",
"8 month",
"9 month"
] | A | A child develops head control by 4 months, and attains neck control by 5 months (20 wks) of age. Hence the child flexes his head onto chest i.e moves purposefully when pulled to sit by the age of 5 months. And also the baby moves his feet,and takes his foot to mouth at this age. Ref- Ghai , 9th edition, chapter 3 | train | med_mcqa | null |
Which laser is used in the management of after cataracts - | [
"Argon",
"Krypton",
"YAG",
"Excimer"
] | C | After cataract, if thin, can be cleared centrally by a YAG laser capsulotomy. | train | med_mcqa | null |
What is the value of poisons ratio for ideal isotropic material: | [
"0.3",
"0.4",
"0.5",
"0.6"
] | C | For most engineering materials poisons ratio is 0.3 | train | med_mcqa | null |
The incubation period for polio is | [
"3 - 7 days",
"7 - 14 days",
"2 - 3 weeks",
"1 - 2 years"
] | B | The incubation period of Polio is 7 to 14 days (Range 3-35 days)In 91-96% there is inapparent (subclinical) infectionIn 4-8% Aboive polio or minor illnessIn 1% Non-paralytic polioIn less than 1% paralytic polio occursPark 23e pg: 205 | train | med_mcqa | null |
Which antimalarial drug is known to cause neuropsy-chiatric adverse reaction? | [
"Aesunate",
"Aimisnin",
"Quinine",
"Mefloquine"
] | D | Adverse effects :Mefloquine is bitter in taste; common reaction is dizziness, nausea, vomiting, diarrhoea, abdominal pain and sinus bradycardia. These are usually mild and largely dose related, but may be severe in some. Major concern has been a variety of neuropsychiatric reactions (disturbed sense of balance, ataxia, errors in operating machinery, strange dreams, anxiety, hallucinations, rarely convulsions) occurring in some recipients. These are dose related and subside in 1-3 weeks. Rare events are haematological, hepatic and cutaneous toxicity. Mefloquine appears to be safe during pregnancy, but should be avoided in 1st trimester unless absolutely essential. ESSENTIALS OF PHARMACOLOGY page no.824 | train | med_mcqa | null |
Less gastrointestinal bleed is seen in the following NSAID. | [
"Meloxicam",
"Naproxen",
"COX2 specific inhibitors",
"Ibuprofen"
] | C | null | train | med_mcqa | null |
Urease negative is - | [
"E. coli",
"Proteus",
"Klebsiella",
"Staphylococci"
] | A | null | train | med_mcqa | null |
During performing routine blood test among members of a family, abnormally high potassium values was noticed. Which hematological anomaly is known to cause such a finding? | [
"ITP",
"Polycythemia rubra vera",
"Bernard soulier syndrome",
"Hereditary elliptocytosis"
] | D | Hereditary elliptocytosis is autosomal domiantly inherited and runs in families. It is usually asymptomatic and detected during blood tests as it can produce pseudohyperkalemia. Ref: Harrisons principles of internal medicine, 18th edition, Page 876. | train | med_mcqa | null |
Where is onion bulb appearance on nerve biopsy seen in? | [
"Amyloid neuropathy",
"Diabetic neuropathy",
"CIDP",
"Leprous neutitis"
] | C | . CIDP | train | med_mcqa | null |
A Most common elbow injury in adolescents is- | [
"Dislocation",
"Physeal injury",
"Supracondylar fracture",
"Olecranon fracture"
] | B | Some guides have given, supracondylar humerus fracture as the answer. But they are wrong as the supracondylar humeral fracture is the most common elbow injury in children (not an adolescent). Most common age group for supracondylar fracture is 5-7 years.
"Most common site of injury in the adolescent's elbow is the epiphyseal plate (physis or growth plate)".-- Operative treatment of elbow injuries
During adolescent growth spurts, the physeal plate is weaker than the surrounding bone, therefore it is the most common site of injury. | train | med_mcqa | null |
Floor of 4th ventricle is not formed by? | [
"Posterior surface of pons",
"Sulcus limitans",
"Posterior surface of medulla",
"Inferior medullary velum"
] | D | Inferior medullary velum | train | med_mcqa | null |
Muller's muscle is supplied by: | [
"3rd cranial nerve",
"4th cranial nerve",
"Sympathetic fibers",
"Parasympathetic fibers"
] | C | Each eyelid from anterior to posterior consists of thefollowing layers:1. Skin2. Subcutaneous areolar tissue3. Layer of striated muscle (orbicularis oculi andlevator palpebrae superioris in upper lid only)4. Submuscular areolar tissue5. Fibrous layer (tarsal) plate and septum orbitale6. Layer of non-striated muscle fibres (Muller'smuscle)7. Conjunctiva Layer of striated muscle. consists of orbicularis muscle which forms an oval sheet across the eyelids. It closes the eyelids and is supplied by zygomatic branch of the facial nerve. in paralysis of facial nerve there occurs lagophthalmos which may be complicated by exposure keratitis. Levator palpebrae superioris muscle (LPS).(main muscle ) It arises from the apex of the orbit and is inseed by three pas on the skin of lid, anterior surface of the tarsal plateand conjunctiva of superior fornix. It raises the upper lid. It is supplied by a branch of oculomotor nerve Layer of non-striated muscle fibres. It consists of the palpebral muscle of Muller (ascessory muscle)which lies deep to the septum orbitale in both the lids. In the upper lid it arises from the fibres of LPS muscle in the lower lid from prolongation of the inferior rectus muscle and is inseed on the peripheral margins of the tarsal plate. It is supplied by sympathetic fibres it helps in initial 15o opening of eye . | train | med_mcqa | null |
A 24-year-old woman has clear evidence of bipolar disorder. An adequate trial of lithium therapy has proved unsuccessful. Which of the following drugs would be most reasonable for her psychiatrist to prescribe next? | [
"Chlorpromazine",
"Carbamazepine",
"Alprazolam",
"Amitriptyline"
] | B | A recent development in the pharmacologic treatment of affective disorders, especially bipolar disorder, has been the use of anticonvulsant drugs. The first to be tried, carbamazepine (Tegretol) often is the next line of treatment for bipolar disorder for persons unresponsive to lithium therapy. Carbamazepine has various side effects, although most are dose related and can be avoided by judicious clinical practice. The most worrisome side effect is aplastic anemia, which occurs very rarely but in an idiosyncratic manner. Ref: Kaplan et al, Page 553- 554 | train | med_mcqa | null |
What is the most likely diagnosis in a patient with generalized weakness and this finding? | [
"Lichen planus pigmentosus",
"Smoker's melanosis",
"Cushing's disease",
"Diffuse melanosis cutis"
] | D | Answer D. Diffuse melanosis cutisDiffuse melanosis cutis is the correct answer. It is a rare presentation of malignant melanoma with progressive discoloration of the skin. Diffuse melanosis cutis is typically associated with poor prognosis. | train | med_mcqa | null |
All are TRUE about Meckel's diveiculum, EXCEPT: | [
"It occurs in 2% population",
"It is a true diveiculum",
"It always contains gastric mucosa",
"It arises from antimesenteric border"
] | C | Meckel's diveiculum is the most prevalent congenital anomaly of the GI tract, affecting approximately 2% of the general population. A 3:2 male-to-female prevalence ratio has been repoed. Meckel's diveicula are designated as true diveicula because their walls contain all of the layers found in normal small intestine. Approximately 60% of Meckel's diveicula contain heterotopic mucosa, of which over 60% consist of gastric mucosa. It arises from the antimesenteric border of ileum. A useful mnemonic describing Meckel's diveiculum is the "rule of twos": 2% prevalence, 2:1 female predominance, location 2 ft proximal to the ileocecal valve in adults, and one half of those who are symptomatic are under 2 years of age. Ref: Tavakkolizadeh A., Whang E.E., Ashley S.W., Zinner M.J. (2010). Chapter 28. Small Intestine. In F.C. Brunicardi, D.K. Andersen, T.R. Billiar, D.L. Dunn, J.G. Hunter, J.B. Matthews, R.E. Pollock (Eds), Schwaz's Principles of Surgery, 9e. | train | med_mcqa | null |
Cholesteatoma commonly perforates: | [
"Lat. Semicircular canal",
"Sup. semicircular canal",
"Promontory",
"Oval window"
] | A | Ans. is a i.e. Lateral semicircular canal Cholesteatoma has the propey to destroy the bone by viue of the various enzymes released by it. Structures immediately at the risk of erosion are: - Long process of incus.deg - Fallopian canal containing facial nerve.deg - Horizontal/lateral semicircular canal.deg | train | med_mcqa | null |
Kraft poisoning is - | [
"Vasculotoxic",
"Neurotoxic",
"Cardiotoxic",
"Haemotoxic"
] | B | null | train | med_mcqa | null |
A 6 months old child woke up in night, crying with ahdominal pain, which got relieved on passing red stool. What is the most likely diagnosis? | [
"Meckel's diverticulum",
"Intussusception",
"Malrotation",
"Intestinal obstruction"
] | B | Ans. b. Intussusception (Ref; Ghai 8/e p287; Sabiston 19/e p1851; Schwartz 9/e p1433-I434; Bailey 26/e 1184. 1187, 1193. 25/e p1191, 1196. 1198; Shackelford 7/e p1059-106)Most likely diagnosis in a 6 months old child, who woke up in night, crying with abdominal pain, which got relieved on passing red stool, is intussusception.'Intussusception refers to the telescoping of a proximal segment of intestine (intussusceptum) into a distal segment (intussuscipiens). This is a common cause of intestinal obstruction in children between 3 months and 6 years. Most cases occur in infants during the weaning period following introduction of a new food, vaccination or upper respiratory tract infection. The classic triad of abdominal pain, red current jelly stools (blood and mucus) and palpable mass is seen only in a small percentage of children. Ultrasound is the investigation of choice that confirms the diagnosis ('dough nut' sign) and provides information about presence of a mass as lead point. Early reduction either with saline (under ultrasound guidance), barium contrast (both diagnostic and therapeutic) or with air insufflation is advisable. Reduction with air is safer with lower recurrence rates. Failure of radiological reduction or suspected intestinal gangrene may necessitate surgery and resection.'- Ghai 8/e p287IntussusceptionTelescoping of one portion of the intestine into the other.Middle layer is isolated between two sharp bends and first to become gangrenousQ.Highest incidence between 4 and 10 monthsQ of ageApprox. 80-90% of cases occurs between 3 and 36 monthsQ.Mostly idiopathic in infants and toddlersQ (no clear etiology).MC type: IleocolicQEtiology and Predisposing Factors:Upper respiratory tract infections or gastroenteritisQ (adenovirus and rotavirus have been implicated) have been thought to be contributory to the development of 'idiopathic' intussusception. Hypertrophy of Peyer's patchesQ can be seen at surgery, but no single etiologic factor predominates.Approximately 5-10% of cases have a true pathologic lead point. The older the toddler, the more likely there will be a lead pointQ.MC lead point is Meckel's diverticulumQ.Other lead points include polyps, the appendix, intestinal duplication, foreign bodies, and tumors such as hamartomas associated with Peutz-Jeghers syndrome.Henoch-Schonlein purpura: Submucosal hemorrhage acts as a lead pointQ.Cystic fibrosis: Risk for recurrent intussusceptionQClinical Features:Typical history: Sudden, short-duration, cyclic crampy abdominal painQ.During these episodes the infant cries inconsolably with the knees drawn upQ.Between episodes the infant is asymptomaticQ.Vomiting is almost universalQ.Initially the passage of stools may be normal while later on blood mixed with mucus is evacuated- red currant jelly stool.An abdominal mass may be palpated- a sausage shaped abdominal massQ (increase in size and firmness during the paroxysm of pain)There may be an associated feeling of emptiness in the right iliac fossa (Sign of Dance)QOccult or gross blood in 60-90% of cases on rectal examinationQApex may be palpable or even protrude from anus in extensive ileocolic or colocoiic intussusceptionQDiagnosis:USG: Kidney-shaped mass in the longitudinal view or a target sign in the transverse viewHydrostatic reduction by contrast agent or air enema (preferred) is the diagnostic and therapeutic procedure of choiceQ.Successful reduction is confirmed by reflux of airQ (or barium) into the small bowel.Treatment:Hydrostatic reduction by contrast agent or air enema is the diagnostic and therapeutic procedure of choiceQ.The success rate with air or barium reduction should exceed 70%Q.Failure of reduction or the presence of peritonitis mandates operative interventionQ, which can be performed laparoscopically or by a standard approach.Definitive surgical procedure: Ileocolectomy with primary anastomosisQRecurrence:Recurrence after successful hydrostatic reduction is 5-10%, recurrence rate after operative reduction is 1-4%.Recurrence is usually managed by hydrostatic reductionQ.Third recurrenceQ is an indication for operative intervention to look for a lead point. | train | med_mcqa | null |
Skin is not involved in ? | [
"Erythropoietic porphyria",
"Porphyria cutanea torda",
"Acute intermittent porphyria",
"Hereditary coproporphyria"
] | C | Ans. is 'c' i.e., Acute intermittent porphyria Type of Porphyria Neuropsychiatric symptoms Skin symptoms/Phototoxicity Hepatic porphyrias Acute intermittent porphyri a 5-ALA dehydratase deficiency Hereditary coproporphyria Variegate porphyria Porphyria cutanea tarda + + + + _ _ _ + + + Erythropoietic porphyrias Erythropoietic protoporphyria Congenital erythropoietic porphyria X-linked sideroblastic anemia _ _ _ + + _ | train | med_mcqa | null |
What is the cause of sickling of RBC in sickle cell disease? | [
"Decreased Solubility",
"Decreased Stability",
"Altered Function",
"Altered 02 binding capacity"
] | A | In sickle cell disease glutamic acid is replaced by valine. The charge and location of this substitution cause HbS to be conveed from a soluble state into a polymer when it undergoes structural changes that accompany release of oxygen. Hypoxia, acidosis, and hypeonicity facilitate polymer formation. The polymerization of hemoglobin cause the red cell to transform from a deformable, biconcave disk into a rigid, sickle shaped cell. Ref: Rudolph's Fundamentals of Pediatrics By Abraham M. Rudolph, Pages 528-30 | train | med_mcqa | null |
Pulsatile tinnitus in ear is due to: | [
"Malignant otitis media",
"Osteoma",
"Mastoid reservoirs",
"Glomus jugulare tumour"
] | D | (d) Glomus jugulare tumour(Ref. Scott Brown, 8th ed., Vol 2 page 1283)For the tinnitus to be pulsatile the cause has to be vascular. Vascular causes to tinnitus are Glomus jugulare and internal carotid aneurysms. | train | med_mcqa | null |
Oxidase test helps in identification of each bacterium except one: | [
"Brucella",
"Vibrio",
"Neisseria",
"E. coli"
] | D | Ans. is 'd' i.e., E. coliImage description - The oxidase test is used to identify bacteria that produce cytochrome C oxidase, an enzyme of the bacterial electron transport chain. When present, the cytochrome C oxidase oxidizes the reagent (tetramethyl - p - phenylenediamine) to (indophenols) purple color end product. When the enzyme is not present, the reagent remains reduced and is colorless.Oxidase positive bacteria - Mnemonics for Oxidase Positive Organisms - PVNCH (It's just an acronyms inspired by the famous mnemonic for Urease Positive organisms-PVNCH)-P: Pseudomonas spp, V: Vibrio cholerae, N: Neisseria spp, C: Campylobacter spp, H: Helicobacter spp/Haemophilus spp, Aeromonas spp and Alcaligens, | train | med_mcqa | null |
A 26-year-old women in the first trimester of pregnancy has been admitted with retching and repeated vomiting with large hematemesis. Her pulse rate is 126/minute and blood pressure is 80 mm Hg systolic. The most likely diagnosis is: | [
"Mallory-Weiss syndrome",
"Bleeding from oesophageal varices",
"Peptic ulcer",
"Hiatus hernia"
] | A | Upper gastrointestinal bleeding:
“Occasionally, persistent vomiting may be accompanied by worrisome upper gastrointestinal bleeding. The obvious concern is that there is a bleeding peptic ulceration, however, most of these women have minute linear mucosal tears near the gastroesophageal junction. Women with these co called Mallory-Weiss tears usually respond promptly to conservative measures.”
Ref. Williams 23/e, p 1053
With persistent retching the less common but more serious oesophageal rupture – ‘Boerhaave syndrome' may develop. | train | med_mcqa | null |
Early complications of Tracheostomy are all EXCEPT | [
"Haemorrhage",
"Apnoea",
"Pneumothorax",
"Stenosis"
] | D | (Stenosis) (385-86-D)Complications of TracheostomyImmediate (at the time of operation)Intermediate (First few hours or days)LATE (Prolonged use of tubes for weeks & month)1. Haemorrhage2. Apnoea3. Pneumothorax due to injury to apical pleura4. Injury to recurrent laymgeal nerve5. Aspiration of blood6. Injury to oesophagus1. Bleeding, reactionary or secondary2. Displacement of tube3. Blocking of tube4. Subcutaneous emphysema5. Tracheitis and tracheobronchitis with crushing in trachea6. Atelectasis and lung abscess7. Local wound infection and granulations1. Haemorrhage - due to erosion of major vessels2. Laryngeal stenosis due to perichonditis of cricoid cartilage3. Tracheal stenosis4. Tracheo-oesophageal fistula5. Problems of decannulations6. Persistent tracheo cutaneous fistula7. Problems of tracheostomy scar, keloid or unsightly scar8. Corrosion of tracheostomy | train | med_mcqa | null |
Which is not a derivative of cannabis? | [
"Heroin",
"Charas",
"Ganza",
"Bhang"
] | A | Ans. (a) HeroinRef.: Parikh 6th ed. 10.54 | train | med_mcqa | null |
Which of the following is an example of Trinucleotide repeat mutation? | [
"Huntington's chorea",
"Fragile-X-syndrome",
"Friedreich ataxia",
"All of the above"
] | D | Polyglutamine Disorders Huntington Disease (HD) Spinobulbar Muscular Atrophy (SBMA) Spinocerebellar Ataxias (SCA types 1, 2, 3, 6, 7, and 17) Dentatorubro-Pallidoluysian Atrophy (DRPLA) Non-polyglutamine Disorders Fragile X Syndrome (FRAXA) Fragile XE Mental Retardation (FRAXE) Friedreich Ataxia (FRDA) Myotonic Dystrophy (DM, not MD) Spinocerebellar Ataxias (SCA types 8, and 12) Ref-D.M.Vasudevan 7/e p509 | train | med_mcqa | null |
After 50 gm of glucose is fed orally, there is | [
"Decreased ketone body production",
"Increased lactate production upon exercise",
"Decreased gluconeogenesis",
"All of these"
] | D | The examiner is asking about the metabolic change in absorptive (fed) state.
In Absorptive (fed) state there is a decrease in gluconeogenesis.
Ketogenesis (ketone body production) is also reduced in the fed state.
Exercising muscles use glucose anaerobically and produce lactate. | train | med_mcqa | null |
Most common infection causing OPSI after splenectomy | [
"Streptococcus pneumonie",
"N. Meningitidis",
"E. Coli",
"Salmonella typhi"
] | A | null | train | med_mcqa | null |
Most common complication of mumps in children is - | [
"Orchitis",
"Aseptic meningitis",
"Pancreatitis",
"Myocarditis"
] | B | Mumps has been repoed to cause about 10_15%of aseptic meningitis. Which is more severe REF:ANANTHANARYANAN TTEXTBOOKOF MICROBIOLOGY 9EDITION PGNO.508 | train | med_mcqa | null |
An epidemiologic study observes increased numbers of respiratory tract infections among children living in a community in which most families are at the poverty level. The infectious agents include Streptococcus pneumoniae, Haemophilus influenzae, and Klebsiella pneumoniae. Most of the children have had pneumonitis and rubeola infection. The study documents increased rates of keratomalacia, urinary tract calculi, and generalized papular dermatosis in these children as they reach adulthood. These children are most likely to have a deficiency of which of the following vitamins? | [
"Vitamin A",
"Vitamin B1",
"Vitamin E",
"Vitamin D"
] | A | Vitamin A is important in maintaining epithelial surfaces. Deficiency of this vitamin can lead to squamous metaplasia of respiratory epithelium, predisposing to infection. Increased keratin buildup leads to follicular plugging and papular dermatosis. Desquamated keratinaceous debris in the urinary tract forms the nidus for stones. Ocular complications of vitamin A deficiency include xerophthalmia and corneal scarring, which can lead to blindness. Vitamin B1 (thiamine) deficiency causes problems such as Wernicke disease, neuropathy, and cardiomyopathy. Vitamin D deficiency in children causes rickets, characterized by bone deformities. Vitamin E deficiency occurs rarely; it causes neurologic symptoms related to degeneration of the axons in the posterior columns of the spinal cord. Vitamin K deficiency can result in a bleeding diathesis. | train | med_mcqa | null |
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