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Which of the following is not a 'heterophile reaction': | [
"Weil Felix test",
"Paul Bunnell test",
"Frei's test",
"Cold agglutinin test"
] | C | Frei's test is not a heterophile reaction Frie's test is used in the diagnosis of LGV. Antigen made from sterile pus aspirated from previously unruptured LGV abscesses, produces a reaction in patients with lymphogranuloma inguinale when injected intradermally. Heterophile reactiion Similar antigens on dissimilar organisms are called heterophile antigens Antibodies reacting with such antigens are called heterophile antibodies. Serologic tests employing such antigens are called heterophile tests. Heterophile agglutination tests include- Sheep RBCs agglutinate in the presence of heterophile antibodies and are the basis for the Paul-Bunnell test in Infectious mononucleosus. Agglutination of horse RBCs on exposure to heterophile antibodies is the basis of the Monospot test in Infectious mononucleosus. Patients suffering from some rickettsial diseases develop agglutinins against ceain nonmotile strains of Proteus. This is the basis of Weil Felix test. Patients suffering from some Mycoplasma pneumoniae infection develop agglutinins against human blood group O RBC's. This is the basis of cold agglutination test. Patients suffering from some Mycoplasma pneumoniae infection develop agglutinins against Group F Streptococcus. This is the basis of Streptococcus MG test | train | med_mcqa | null |
Whipworm among the following is | [
"Enterobius vermicularis",
"Trichuris trichiura",
"Necator americanus",
"Strongyloides stercoralis"
] | B | Species Disease/Most affected Form/Transmission Diagnosis Treatment Trichuris trichiura WhipwormCecum, appendicitis, andrectal prolapse EggsIngested Barrel-shaped eggs with bipolar plugs in stools Albendazole Ref: Ananthanarayana textbook of Microbiology 9th edition Pgno : 172-175 | train | med_mcqa | null |
True statement regarding synovial fluid in Gout | [
"Decreased sugar",
"Urate crystal",
"Pyrophosphate crystal",
"White cells"
] | B | (Urate crystal) (22-A)Examination of svnovial fluidSuspected conditionAppearanceViscosityCellsCrystalsBiochemistryNormalClear yellowHighFew-As for plasmaSeptic arthritisPurulentLowWhite cells +++-Glucose lowTuberculous arthritisTurbidLowWhite cells +-Glucose lowRheumatoid arthritisCloudyLowWhite cells ++--GoutCloudyNormalWhite cells +++ urate-PseudogoutCloudyNormalWhite cells+ pyrophosphate-Osteo arthritisClear yellowHighFewOften +-* Blood stained fluid - After injury, Acute inflammatory disorders pigmented villonodular synovitis* Marked reduction of synovial glucose suggests infections.* A High white cell count (more then 100,000/mm3) is usually indicative of infection, but a moderate leucocylosis is also seen in gout and other types of inflammatory arthritis. | train | med_mcqa | null |
A 2-year-old girl was withdrawn from a day care center for excessive irritability On physical examination, she has multiple, small superficial ulcers of the oral mucosa. The ulcerations heal spontaneously over the next 5 days. Which of the following is the most likely diagnosis? | [
"Aphthous stomatitis",
"Candidiasis",
"Gingivitis",
"Ludwig angina"
] | A | Aphthous stomatitis describes a common disease that is characterized by painful, recurrent, solitary or multiple, small ulcers of the oral mucosa. The causative agent is unknown. Microscopically, the lesion consists of a shallow ulcer covered by a fibrinopurulent exudate. Candidiasis (choice B) features white plaques.Diagnosis: Aphthous stomatitis | train | med_mcqa | null |
True about dentition - | [
"Hypothyroidism causes delayed dentition",
"Premolar is not seen in primary dentition",
"3rd molar is the last to appear in secondary dentition",
"All"
] | D | Ans. is 'a' i.e., Hypothyroidism causes delayed dentition; 'b' i.e., Premolar is not seen in primary dentition; 'c' i.e., 3rd molar is the last to appear in secondary dentition | train | med_mcqa | null |
A 32-year-old teacher presents at her physician's office complaining of hearing loss in her right ear. Physical examination reveals cerumen completely obstructing the ear canal. Ear wax removal is recommended using which of the following? | [
"Jet irrigation (Water Pik)",
"3% hydrogen peroxide ear drops",
"Irrigation of the eardrum if perforated",
"Aqueous irrigation if a bean is present"
] | B | Jet irrigation (e.g., Water Pik) should be avoided to remove cerumen impaction. Detergent ear drops (such as 3% hydrogen peroxide) may be used. Aqueous irrigation should be avoided if organic material is present because further swelling will be induced. | train | med_mcqa | null |
All of the following statements are true about Hemolytic uremic syndrome except | [
"Uraemia",
"Hypofibrinogenemia",
"Thrombocytopenia",
"Positive coomb's test"
] | D | Answer is D (Positive coomb's test): Coomb's test is negative in HUS Laboratory findings in HUS - CMDT 2002 / 556 Anemia: - Microangiopathic hemolytic - Red blood cell fragmentation on peripheral smear - Helmet cells / Burr cells Thrombocytopenia WBC counts rise (Nelson le/ 1587) LDH levels are elevated out of propoion to degree of hemolysis Coomb's test is negative Tests of coagulation are normal (exclude DIC) with the exception of -- elevated fibrin degradation products (explains hypofibrinogenemia) | train | med_mcqa | null |
The monoclonal antibody useful in the treatment of PNH is: | [
"Rituximab",
"Eculizumab",
"Infliximab",
"Adalimumab"
] | B | By blocking the complement cascade downstream of C5, eculizumab abolishes complement-dependent intravascular hemolysis in all PNH patients, and significantly improves their quality of life. Reference: Harrisons Principles of Internal Medicine, 18th Edition, Page 884 | train | med_mcqa | null |
Which receptors are blocked in Myasthenia Gravis? | [
"Ach receptor",
"Ca++ receptors",
"Na+ receptors",
"Opioid receptors"
] | A | Auto-antibodies destroy some of the Nicotinic acetylcholine receptors and bind others to neighbouring receptors, triggering their removal by endocytosis. | train | med_mcqa | null |
Which one of the following provides haemodynamic stability and prolong survival in congestive hea failure | [
"Lisinopril",
"Furosemide",
"Digoxin",
"Milrinone"
] | A | Lisinopril is a medication of the angiotensin-conveing enzyme (ACE) inhibitor class used to treat high blood pressure, hea failure, and after hea attacks. For high blood pressure it is usually a first line treatment, although in black people calcium-channel blockers or thiazide diuretics work better. It is also used to prevent kidney problems in people with diabetes. Lisinopril is taken by mouth.Full effect may take up to four weeks to occur Refer kDT 6/e p486 | train | med_mcqa | null |
Acclimatization to a high altitude is associated with which of the following changes? | [
"Hyperventilation",
"Polycythemia",
"O2 dissociation curve shifts to right",
"Decreased concentration of systemic capillaries"
] | C | Oxygen hemoglobin dissociation curve, is the curve relating percentage saturation of the oxygen carrying power of hemoglobin to the PO2. It has a characteristic sigmoid shape due to the T-R interconversion. In deoxyhemoglobin, globin units are tightly bound in a tense (T) configuration which reduces the affinity of the molecule for oxygen. When the first oxygen is bound, the bonds holding the globin units are released, producing a relaxed (R) configuration which exposes more oxygen binding sites. Thus, binding of one oxygen molecule increases the affinity of hemoglobin to bind other O2 molecules. Ascent to high altitude triggers a substantial rise in 2,3 DPG concentration in red blood cells. Factors causing shift of the curve to right includes: Fall in pH Rise in temperature Increase in 2, 3 BPG pH of the blood falls as its CO2 content increases, so that when PCO2 rises the curve shifts to right. Ref: Textbook of Medical Physiology By Guyton, 10th Edition, Page 466 ; Ganong's Review of Medical Physiology, 23rd Edition, Page 667-9 | train | med_mcqa | null |
Which of the following is supplied by two nerves? | [
"Quadriceps",
"Triceps",
"Digastric",
"FDS"
] | C | MuscleOriginInseionNerve supplyActionDigastricHas 2 bellies united by an intermediate tendonAnterior belly from digastric fossa of mandibleBoth heads meet at the intermediate tendon which perforates stylohyoid and is held by a fibrous pulley to the hyoid boneNerve to mylohyoidDepresses mandible when the mouth is opened widely or against resistanceIt is secondary to lateral pterygoidElevates Hyoid bonePosterior belly from the mastoid notch of temporal boneFacial nerveRef: BD Chaurasia; 6th edition; volume 3; Page no: 158; Table no: 11.1 | train | med_mcqa | null |
26 years old G1, P0 comes to the OG department with complains of moderate amount of vaginal bleed which she noticed while she was bathing. On examinations, there are no uterine contractions or pain or abdominal cramps. Blood pressure-120/76 mmHg, Pulse rate- 84/min, temperature- 37.6 C, Respiratory rate-16/ min. On speculum examination, small clot was noted at the level of vault. There was no bleeding or abnormal mass. Cervix was closed. Bimanual examination is uneventful. Diagnosis is | [
"Threatened abortion",
"Missed abortion",
"Inevitable abortion",
"Incomplete abortion"
] | A | Answer: a) threatened abortionABORTION (miscarriage)Expulsion of the fetus before viability (< 500gms/20weeks)Abortion< 12 weeks: first trimester abortion.75% abortions occur < 16th week & about 75% of these occur before the 8th week of pregnancy.Types of AbortionDefinitionThreatened abortionThe process of abortion has started, but has not progressed to a state from which recovery is impossible.Inevitable abortionProcess of abortion has progressed to a state from where continuation of pregnancy is impossible.Complete abortionProducts of conception are expelled en masse.Incomplete abortionProducts of conception are not expelled but a part is left inside the uterine cavity.Missed abortionFetus is dead and retained inside the uterus for a variable periodCAUSES OF ABORTION:First trimesterSecond trimester* Genetic factors (50%)* Endocrine disorders* Immunological disorders* Infections* Anatomic abnormalities- Cervical incompetence- Mullerian fusion defects- Uterine synechiae- Uterine fibroid* Maternal medical illness.ETIOLOGY OF SPONTANEOUS ABORTIONS (15%):GENETIC FACTORS:(50% of abortions are due to chromosomal abnormalities in the conceptus)Autosomal trisomy is the commonest (50%) cytogenetic abnormality.M/C/ cause of autosomal trisomy: meiotic non-dysjunction during gamete formation.Trisomy for all the chromosomes except Chr.1 has been reportedThe most common trisomy is trisomy 16, followed by trisomy 22.Turner syndrome is the single most frequent specific chromosomal abnormality.Autosomal monosomy is rare and incompatible with life.Triploidy is often associated with hydropic or molar placental degeneration.ENDOCRINE AND METABOLIC FACTORS (10-15%)Luteal Phase Defect (LPD)Hypo & Hyper ThyroidismUncontrolled DiabetesANATOMICAL ABNORMALITIES: (10-15%, mostly related to llnd trimester abortions)Cervical incompetence- Commonest cause for llnd trimester & recurrent abortionsCongenital uterine malformations & Uterine fibroidsIntra-uterine adhesions, Asherman SyndromeINFECTIONS (5%)Viral-rubella, cytomegalo virus, variola, vaccinia, HIVParasitic-Toxo plasma, MalariaBacterial- Ureaplasma, Chlamydia, BrucellaIMMUNOLOGICAL DISORDERS (5-10%)Recurrent (habitual) abortionThree or more spontaneous abortions in a sequence.Causes:Parental chromosomal abnormalitiesAntiphospholipid antibody syndromeSubset of uterine abnormalities.Other suspected but not proven causes are alloimmunity, endocrinopathies, and environmental toxinsTYPES OF ABORTIONSAbortionBleedingPainOn examinationManagementThreatenedSlight, bright red Stops spontaneouslyUsually painless; occasional back pain +OS: closed Uterus & cervix: softSedation & pain relief. ObservationInevitableMoreSevereOS: dilatedCorrection of shock & termination of pregnancyCompleteTrace/absentSubsidesOS: closed Uterus: smallerSupportive management D&C if neededIncompletePresentContinuation of pain, colicky typeOS: patulous. Uterus: smallerCorrection of shock & terminationMissedBrownish vaginal discharge OS: closed Uterus: smaller | train | med_mcqa | null |
“Call-Exner bodies” are seen in | [
"Yolk sac tumor",
"Granulosa cell tumor",
"Hilus cell tumor",
"Brenner tumor"
] | B | GRANULOSA CELL TUMOR
■ It is a sex cord stromal tumor that occurs at any age but most common\y in postmenopausal woman (2/3rd).
■ It is a virilizing tumor, produces estrogen, causing precocious puberty in prepubertal girls and endometrial hyperplasia, cystic disease of breast and endometrial carcinoma.
■ These are potentially malignant tumors.
■ The tumor cells are arranged in sheets punctuated by small follicle like structures filled with an acidophilic material, known as Call-Exner bodies. Classification of Ovarian Tumors | train | med_mcqa | null |
The proximal pa of the aoa is derived from which of the following? | [
"Truncus aeriosus",
"Bulbus cordis",
"Primitive ventricle",
"Primitive atrium"
] | A | Proximal pa / arch of aoa is fromed by: 1. Left horn of aoic sac 2. Left 4th phyrangeal arch aery 3. Left dorsal aoa - Neural crest cells migrate to truncus aeriousus and forms AP septum (spiral septum) which divides Truncus into anterior Aoa and posterior Pulmonary trunk. Thus the proximal pa of the aoa is derived from the truncus aeriosus. - From truncus aeriosus develops aoic sac with left and right horns . - Truncus aeriosus forms the outflow tract and blood is pumped by hea into phrangeal arch aeries and dorsal aoa | train | med_mcqa | null |
Which of following is used to monitor respiration in neonate (not intubated) ? | [
"Capnography",
"Impedence pulmonometry",
"Chest movements",
"Infrared End Tidal CO2"
] | B | B i.e. Impedence pulmonometry | train | med_mcqa | null |
Laminin is present in? | [
"Liver",
"Lungs",
"Bone marrow",
"Basement membrane"
] | D | Laminin is present in Basement membrane of various tissue. Basement membrane contains type IV collagen, Laminin, nidogen and perlecan. | train | med_mcqa | null |
Massive aminoaciduria without a corresponding increase in plasma amino acid level is characteristic of which one of the following diseases ? | [
"Homocystinuria",
"Hanup disease",
"Tyrosinemia",
"Maple syrup urine disease"
] | B | Hanup disease (also known as "pellagra-like dermatosisand "Hanup disorder") is an autosomal recessive metabolic disorder affecting the absorption of nonpolar amino acids (paicularly tryptophan that can be, in turn, conveed into serotonin, melatonin, and niacin). Niacin is a precursor to nicotinamide, a necessary component of NAD+ The causative gene, SLC6A19, is located on chromosome 5.It is named after the English family, Hanup, who suffered from this disease. Reference: GHAI Essential pediatrics, 8th edition | train | med_mcqa | null |
Which among the following is decreased in twin pregnancy compared to singleton pregnancy | [
"Blood loss at delivery",
"Blood pressure at term",
"Blood volume expansion",
"Systemic vascular resistance"
] | D | Multifetal pregnancy is characterized by augmented hypervolemia and decreased vascular resistance. | train | med_mcqa | null |
Which of the following nuclei belongs to the general visceral efferent column? | [
"Facial nerve nucleus",
"Trigeminal motor nucleus",
"Dorsal nucleus of vagus",
"Nucleus ambigous"
] | C | The general visceral efferent fibres (GVE) arises from nuclei of general visceral efferent column and supply the glands and the smooth muscles of vessels and viscera. These fibres form the CRANIAL OUTFLOW of the parasympathetic nervous system. The GVE nuclei are: Edinger Westphal nucleusLacrimatory nucleusSuperior salivatory nucleus Inferior salivatory nucleus Dorsal nucleus of vagus nerve (Ref: Vishram Singh textbook of clinical neuroanatomy, second edition, pg-92) | train | med_mcqa | null |
Which of the following is true about pterygium | [
"Elastotic degeneration with distoion of the Descemet' s membrane is seen",
"Probe can be passed underneath the pterygium at the limbus",
"Associated with exposure to infrared radiation",
"Bare sclera technique has 30-60% re-currence"
] | D | PTERYGIUM Pterygium (L. Pterygion = a wing) is a wing-shaped fold of conjunctiva encroaching upon the cornea from either side within the interpalpebral fissure, usually on the nasal side. Etiology: environmental factors such as exposure to sun (ultraviolet rays), dry heat, high wind and abundance of dust. Pathology: Pathologically pterygium is a degenerative and hyperplastic condition of conjunctiva. The subconjunctival tissue undergoes elastotic degeneration and proliferates as vascularised granulation tissue under the epithelium, which ultimately encroaches the cornea. The corneal epithelium, Bowman&;s layer and superficial stroma are destroyed. Complications: like cystic degeneration and infection are infrequent. Rarely, neoplastic change to epithelioma, fibrosarcoma or malignant melanoma, may occur. Treatment: Surgical excision is the only satisfactory treatment. Recurrence of the pterygium after surgical excision is the main problem (30-50%). However, it can be reduced by any of the following measures: 1. Transplantation of pterygium in the lower fornix (McReynold&;s operation) is not performed now. 2. Postoperative beta irradiations (not used now). 3. Postoperative use of antimitotic drugs such as mitomycin-C or thiotepa. 4. Surgical excision with bare sclera. 5. Surgical excision with free conjunctival graft taken from the same eye or other eye is presently the preferred technique. 6. In recurrent recalcitrant pterygium, surgical excision should be coupled with lamellar keratectomy and lamellar keratoplasty. Reference :- A K KHURANA; 6th edition, page:-80,81 | train | med_mcqa | null |
What is the percentage of immunoglobulins present in proteins? | [
"5%",
"10%",
"15%",
"20%"
] | D | Immunoglobulins constitute 20 to 25% of total serum proteins. Based on physiochemical and antigenic differences, five classes of immunoglobulins have been recognized: IgG, IgA, IgM, IgD, and IgE.(Ref: Ananthanarayan 9th edition, p93) | train | med_mcqa | null |
Which of the following is not included in "Cleans" in the conduct of delivery? | [
"Clean cord",
"Clean hands",
"Clean surface",
"Clean perineum"
] | D | Five cleans' (practices) under strategies for elimination of neonatal tetanus include,-Clean delivery surface-Clean hands (of bih attendants)-Clean cord cut (blade or instrument)-Clean cord tie-Clean cord stump (no applicant) Ref : Park 23rd edition Pgno : 310 | train | med_mcqa | null |
A person presents with hemorrhagic fluid in tense blister at dermoepidermal junction. Most probable diagnosis is? | [
"Pemphigoid",
"Pemphigus vulgaris",
"Pemphigus vegetans",
"Drug induced pemphigus"
] | A | ANSWER: (A) PemphigoidREF: Rooks dermatology 7th ed p. 41.3-41.19Intraepidermal BullaBlister at Dertnoepidermal JunctionGranular layerJunctionalPemphigus foliaceousJunctional EBSubcorneal pustular dermatosisBullous pemphigoidStaphylococcal scalded skin syndrome Bullous pemphigoidDermolyticSpinous layerEpidermoiytic bullosa dystrophicansFamilial benign pemphigusEpidermolytic bullosa aquisticaSuprabasalDermatitis herpetiformisPemphigus vulgarisDarier s diseaseBasal layerErythema multiformeLupus erythematosusLichen planusEBSPemphigus vegetans is a localized form of pemphigus vulgarisThe most common variant of pemphigus associated with drug exposure is pemphigus foliaceus, although pemphigus vulgaris has also been described | train | med_mcqa | null |
Which of the following anti TB drugs acts on extracellular organisms and is bactericidal drug? | [
"Isoniazid",
"Streptomycin",
"Rifampicin",
"Ethambutol"
] | B | Streptomycin is the only anti-TB drug which acts on extracellular organisms and is bactericidal. All first line antitubercular drugs are bactericidal except ethambutol which is bacteriostatic. Impoant points about first line ATT: Drug Action Hepatotoxic Bacteria Inhibited Isoniazid CIDAL Yes Both Rifampicin CIDAL Yes Both Pyrazinamide CIDAL Yes Intracellular Ethambutol STATIC No Both Streptomycin CIDAL No Extracellular | train | med_mcqa | null |
Prepatent period&; in lymphatic filariasis is defined as the time interval between inoculation of infective larvae and - | [
"Blockage of lymphatics",
"First appearance of detectable microfilaria",
"Development of lymphoedema",
"Development of adult worm"
] | B | <p> lymphatic filariasis:- Pre patent period-Time interval between inoculation of infective larvae and first appearance of detectable microfilaria. Clinical incubation period-Time interval from invasion of infective larva to development of clinical manifestation. 8-16 months. {Reference: park&;s textbook of preventive and social medicine, 23rd edition, pg no.272}</p> | train | med_mcqa | null |
Drug not causing hemolysis in G6PD deficiency? | [
"Primaquinc",
"Chloroquine",
"Nalidixic acid",
"Nitrofurantoin"
] | B | Ans. is 'b' i.e., Chloroquine Among the given options, chloroquine is the best answer (though it can also cause hemolysis, but very rarely). | train | med_mcqa | null |
Size of uterus in inches is : | [
"5x4x2",
"4x3x1",
"3x2x1",
"4x2x1"
] | C | 3x2x1 | train | med_mcqa | null |
Olliers disease also known as? | [
"Osteosarcoma",
"Enchondromatosis",
"Multiple myeloma",
"Enchondrosis"
] | B | Ans. (b) Enchondromatosis(Ref: Robbins 9th/pg)Ollier disease is a rare, non inherited disease of unknown cause characterized by multiple enchondromas. | train | med_mcqa | null |
Increase urine levels of 5-HIAA is associated with which condition? | [
"Liver Cirrhosis",
"Papillary carcinoma of the Thyroid",
"Carcinoid tumor",
"Small cell carcinoma of the lung"
] | C | CARCINOID TUMOR/ Neuroendocrine tumors Arising from enterochromaffin / neuroendocrine cells of respiratory/ gastrointestinal tracts Resulting in over production of Serotonin . | train | med_mcqa | null |
Which of the following endocrine tumors is mocommonly seen in MEN-I: | [
"Insulinoma",
"Gastrinoma",
"Glucagonoma",
"Somatostatinoma"
] | B | Answer is B (Gastrinoma): Amongst the options provided Gastrinomas are the most common association with MEN I. | train | med_mcqa | null |
Footling presentation with normal baby at 39 weeks of gestation, what is the best line of management? | [
"Caesarean section",
"Vaginal delivery",
"External cephalic version",
"Expectantmanagement"
] | A | Ans. is'a'i.e., Caesarean sectionElective caesarean section is preferred in woman with > 38 weeks of gestation with breech when:Estimatedfetal weight is > 3.5 KgHyperextendedheadFootlingpresentationPelvic inadequacyAssociated complication (obstetric and/ or medical)Absence ofexpeisefor delivery | train | med_mcqa | null |
Which is a serine protease: | [
"Pepsin",
"Trypsinogen 1",
"HIV enzyme",
"Chymotrypsin"
] | B | Ans. b. Trypsinogen 1Inherited predisposition to pancreatitisGene (chromosome location)Protein productFunctionPRSSl (7q34)Serine protease 1 (trypsinogen 1)Cationic trypsin. Gain-of-function mutations prevent self- inactivation of trypsinSPINK1 (5q32)Serine peptidase inhibitor, Kazal type 1Inhibitor of trypsin. Mutations cause loss-of-function, increasing trypsin activityCTRC (lp36)Chymotrypsin C (caldecrin)Degrades trypsin, protects the pancreas from trypsin-relatedinjuryCPA1 (7q32)Carboxypeptidase A1Exopeptidase involved in regulating zymogen activation | train | med_mcqa | null |
"Smudge cells" in the peripheral smear are characteristic of- | [
"Chronic myelogenous leukemia",
"Chronic lymphocytic leukemia",
"Acute myelogenous leukemia",
"Acute lymphoblastic leukemia"
] | B | Smudge cells are seen in CLL. The blood contains large numbers of small round lymphocytes with scant cytoplasm. Some of the cells are usually disrupted in the process of making smears,producing so called smudge cells Ref : Robbins and Cotran Pathologic basis of disease.South Asia Edition volume 1.Page no.593 | train | med_mcqa | null |
Which nerve needs to be carefully identified during parotid gland surgery? | [
"Trigeminal nerve",
"Facial nerve",
"Chorda tympani",
"Greater petrosal nerve"
] | B | The basic principle of facial nerve dissection is to avoid any unnecessary stimulation of the nerve. Specific tools used in dissection vary from surgeon to surgeon and include cold, bipolar electrocauterization, and ultrasonic dissection. Most surgeons caution against the use of a monopolar cautery in close proximity to the facial nerve.Ref: PL Dhingra, Diseases of Ear, Nose & Throat, 7th edition, pg no. 99 | train | med_mcqa | null |
Which of the following drug should not be used to treat Klebsiella infection? | [
"Ampicillin",
"Amikacin",
"Imipenem",
"Tigecycline"
] | A | Ampicillin It is active against all organisms sensitive to PnG; in addition, many gram-negative bacilli, e.g. H. influenzae, E. coli, Proteus, Salmonella and Shigella are inhibited. However, due to widespread use, many of these have developed resistance; usefulness of this antibiotic has decreased considerably. Ampicillin is more active than PnG for Streptoccus viridans and enterococci; equally active for pneumococci, gonococci and meningococci (penicillin.resistant strains are resistant to ampicillin as well); but less active against other gram-positive cocci. Penicillinase producing Staph. are not affected, as are other gram-negative bacilli, such as Pseudomonas, Klebsiella, indole positive Proteus and anaerobes like Bacteroides fragilis ESSENTIALS OF MEDICAL PHARMACOLOGYU K.D.TRIPATHI SIXTH EDITION PAGE NO:700 | train | med_mcqa | null |
Pronator drift test is done for lesion of | [
"Pyramidal tract",
"Oliva rubral tract",
"Tractus cuneatus",
"Antero lateral tract"
] | A | When the patient extends both arms upright in the supinated position and holds them at shoulder height for at least 10 seconds (Patients should be asked to keep eyes open initially and later test again with eyes closed):Normal response:Palm will remain flat, elbows straight and the limbs horizontal ORSymmetrical detion from this position (i.e. on both the sides - dominant hand may pronate slightly more than the non-dominant hand)Positive pronator drift: Components of pronator drift as mentioned above is seen in the weaker side (asymmetric response) which indicates a lesion in contralateralPseduodrift:Slight pronation, without downward drift of the dominant armNot necessarily abnormal - must be interpreted in clinical context InterpretationPositive with eyes open: Motor deficitPositive with eyes closed: Sensory deficit (Posterior column)Outward and upward drift: Cerebellar drift"Updrift" (involved arm rising overhead without patient awareness): Parietal lobe lesions (loss of position sense)Drift without pronation: Functional upper limb paresis (Conversion disorder)Ref: Ganong&;s review of medical physiology, 23rd edition, Page no:242 | train | med_mcqa | null |
Which of the following is not a true statement regarding dentin | [
"Dentinal tubules are not secretory products of the odontoblast",
"Dentinal tubules are the path taken by Odontoblasts",
"Dentinal tubules represent path taken by odontoblast from DEJ to pulp",
"1st convexity from pulp face towards incisal direction."
] | D | Option D is incrorrect as 1st convexity from pulp face towards root and 2nd convexity from pulp face towards incisal/occlusal direction. | train | med_mcqa | null |
Epidemic dropsy is caused by | [
"Sanguinarine",
"Ergot",
"Alkaloid",
"BOAA"
] | A | Ans. (a) Sanguinarine | train | med_mcqa | null |
A 67 year male smoker presents with haemoptysis and cough. Brochoscopic biopsy revealed undifferented tumour. The immunohistochemical marker that can be most helpful is: | [
"Calretinin",
"Vimentin",
"Cytokeratin",
"GGT"
] | C | Cytokeratin | train | med_mcqa | null |
Chandu a 15 year aged boy presents with unilateral nasal blockade, mass in the cheek and epistaxis; likely diagnosis is - | [
"Nasopharyngeal ca",
"Angiofibroma",
"Inverted papilloma",
"None of the above"
] | B | Recurrent epistasis, nasal obstruction and swelling over cheek in a 15 years boy suggest the diagnosis of NFA. | train | med_mcqa | null |
17 hydroxylase dificiency causes - increase production of | [
"Aldosterone",
"Coisol",
"Androstene",
"All of above"
] | A | Deficiency of 17 alpha hydroxylase leads to increased production of aldosterone. Progesterone synthesised from cholestrole is normally acted upon by 21 alpha hydroxylase which is fuher conveed to coicosterone and aldosterone . Some amount of progesterone is channeled to production of coisol and estradiol by the action of 17 alpha hydroxylase through a separate pathway. So in the absence of 17 alpha hydroxylase progesterone is entirely channeled to the production of aldosterone by the action of 21 alpha hydroxylase Reference: Ghai TB of pediatrics 8th edition pg 527 fig 17.11 | train | med_mcqa | null |
After an operation on femur bone, chest x-ray shows widespread mottling throughout the lung field like a snowstorm, the likely cause | [
"Air embolism",
"Bacterial pneumonitis",
"Fat embolism",
"Pulmonary embolism"
] | C | null | train | med_mcqa | null |
All of the following are true about nosocomial infections except | [
"May manifest within 48 hours of admission",
"May develop after discharge of patient from the hospital",
"Denote a new condition which is unrelated to the patient's primary conditions",
"May already present at the time of admission"
] | D | Nosocomial infection occurs in a patient already suffering from a disease and a new infection is set up from another host or another external source. It occurs 48hours after admission or discharge from the hospital. Ref: Ananthanarayan& Paniker&;s textbook of microbiology, 9th edition. Pg no.71 | train | med_mcqa | null |
Monu, 30 year old male, a chronic alcoholic presents with sudden onset of epigastric pain that radiates to the back. All are seen except | [
"Low serum lipase",
"Increased LDH",
"Hypocalcaemia",
"Increased serum amylase"
] | A | Clinical features of acute pancreatitis Cardinal symptoms : Epigastric and /or peri umbilical pain that radiates to the back, relieved by sitting & leaning forward Upto 90% of patients have nausea and/or vomiting that typically does not releive on pain Nature of the pain is constant Dehydration, poor skin turgor, tachycardia, hypotension & dry mucous membranes are commonly seen in patients with AP Mild-pancreatitis: Abdomen may be normal of reveal only mild epigastric tenderness Severe pancreatitis : Significant abdominal distension, associated with generalised rebound tenderness and abdominal rigidity Flank (Grey Turner), peri umbilical (cullen's sign) & inguinal ecchymosis (Fox sign) are indicative of retro peritoneal bleeding associated with severe pancreatitis Dullness to percussion and decreased breathing sounds in left or less commonly, in the right hemithorax suggest pleural effusion Diagnosis Corner Stone of the diagnosis of AP: Clinical findings +elevation of pancreatic enzyme level in the plasma Pancreatic enzymes A threefold or higher elevation of amylase & lipase levels confirms the diagnosis Amylase's serum half - life is shoer as compared with lipase Lipase is also a more specific marker of AP because serum amylase levels can be elevated in a number of conditions, such as peptic ulcer disease, mesentric ischaemia, salpingitis and microamylasemia Patients with AP are typically hyperglycemic; they can also have leukocytosis and abnormal elevation of liver enzyme levels Elevation of ALT levels in the serum in the context of AP has a positive predictive value of 95% in the diagnosis of acute biliary pancreatitis X-Ray abdomen Localized ileus of duodenum and proximal jejunum (sentinel loop) or that of transverse colon up to its mid point (colon cut off sign) IOC for acute pancreatitis : CECT Ref: Sabiston 20th edition Pgno :1524-1528 | train | med_mcqa | null |
Arousal response is mediated by | [
"Dorsal column",
"Reticular activating system",
"Spinothalamic tract",
"Vestibulo cerebellar tract"
] | B | Arousal response in cerebral cortex is activated by stimulation of Reticular activating system. | train | med_mcqa | null |
Earliest sign of fetal life is best detected by | [
"X-Ray",
"Feto scopy",
"Real time USG",
"Doppler"
] | D | D i.e. Doppler Doppler is an interpretation of audible signals of USG By listening fetal hea sounds and seeing blood flow, we can detect fetal life at earliest. | train | med_mcqa | null |
Queckensted test is done for ? | [
"Glomus tumor",
"CSF rhinorrhea",
"Otosclerosis",
"Acoustic neuroma"
] | B | Ans. is 'b' i.e., CSF rhinorrhea Detection of CSF Leak 1. Biochemical tests Concentrations of Glucose are higher in CSF than in nasal discharge. Glucose value > 30-40 mg% and protein value < 100 mg % (max 200 mg %) suppo a diagnosis of CSF leak. Presence of I3,transferrin is the most definitive test for detection of CSF and I32transferrin assay is the test of choice when a confirmatory test is needed, because of high sensitivity as well as specificity. I3-trace protein (prostaglandin D synthase) is also used, however it is nonspecific as it is also present in human testes, hea and seroma. 2. Basic clinical tests Tissue test (Handker chief test) : - Unlike nasal mucous, CSF does not cause a tissue to stiffen. Filter paper test : - Sample of nasal discharge on a filter paper exhibits a light CSF border and a dark central area of blood, i.e., double ring sign or halo sign. Queckensted test : - Compression of the jugular vein leas to increased CSF leak due to increase in ICP. Rhinoscopy : - Visualization of CSF leak from paranasal sinus. 3. CSF tracers Intrathecal fluorescein dye adminstration, radionuclide cisternography, CT cisternography. | train | med_mcqa | null |
Bronchial adenoma commonly present as : | [
"Recurrent hemoptysis",
"Cough",
"Dysponea",
"Chest pain"
] | A | Answer is A (Recurrent haemoptysis): Bronchial adenomas are hypervascular, and can bleed profusely. Recurrent haemoptysis is the most common manifestations. Bronchial adenomas include: Carcinoids : 80-90% Adenocystic tumors (cylindromas): 10 to 15%) Mucoepidermoid tumors : 2-3% Broncheal adenomas are hypervascular, and can bleed profusely. Recurrent haemoptysis is the most common manifestations. Others being, chronic cough, obstruction with atelectasis, lobar collapse, pneumonitis and abscess formation. | train | med_mcqa | null |
Natural history of disease can be studied from | [
"Community trials",
"Quasi-controlled trials",
"Cross-sectional studies",
"Longitudinal studies"
] | D | Longitudinal studies There is an increasing emphasis on the value of longitudinal studies in which observations are repeated in the same population over a prolonged period of time by means of follow-up examinations. Cross-sectional studieshave been likened to a photograph, and longitudinal studies to a cine film. Longitudinal studies are useful (i) to study the natural history of disease and its future outcome {ii) for identifying risk factors of disease, (iii) for finding out incidence rate or rate of occurrence of new cases of disease in the community. Longitudinal studies provide valuable information which the cross-sectional studies may not provide, but longitudinal studies are difficult to organize and more time-consuming than cross-sectional studies. Measurement can also be extended to health states and events. For example, the study of blood pressure levels in a population will reveal the normal values, rather than abnormal ones related to disease. Ref : Park 23rd edition Pgno : 69 | train | med_mcqa | null |
Renal artery lumen is reduced by half, what will be the blood flow? | [
"Reduce by 1/2",
"Reduce by 1/4",
"Reduce by 1/16",
"Come to normal after autoregulation"
] | C | Ans: C. Reduce by 1/16Option c is correct because the flow of fluids can be described by Poiseuille's Law.In which flow of liquid is directly proportional to R4, So if lumen is reduced to half then blood flow will get reduce by 1/16.Other points related to blood flow...Poiseuille's Law states that the flow (Q) of fluid is related to a number of factors:The viscosity (n) of the fluidThe pressure gradient across the vessel (P)Length (L) and diameter(r) of the vesselDiameter: Doubling the diameter of tube increases the flow rate by 16 fold (r4). The larger the vessels's diameter greater is the blood flow.Viscosity: Flow is inversely proportional to the viscosity of the fluid.Viscosity of blood increases with increasing hematocrit and decreasing temperaturePressure: Increasing pressure further maximizes flow as described by Poiseuille's equation.The relationship is given by Poiseuille-Hagen formula:F=(PA -PB )x(8p )x(e1 )x(Lr4 )WhereF = FlowPA - PB = Pressure difference between two ends of the tube q = Viscosity r = Radius of tube L = Length of tubeRelationship between arterial blood pressure and blood flow given in graph below: | train | med_mcqa | null |
A 10 days female presents with a large patch of blue-gray pigmentation with irregular shape, unclear edges and normal skin texture involving buttocks and lower back. She is otherwise healthy and has no dysmorphic features. Which is the most probable diagnosis? | [
"Blue Nevus",
"Hematoma due to of physical abuse",
"Infantile hemangioma",
"Mongolian spot"
] | D | Congenital dermal melanocytosis (Mongolian spot) Congenital blue-grey macule found over the sacral skin area. Pigmentation initially deepens and then regresses completely by age 7 years Blue Nevi Benign skin lesion that is four times more common in children, typically affecting the extremities and face. Small, slightly elevated, and blue-black lesions. However, blue-black papules and nodules that are new or growing must be evaluated to rule out nodular melanoma Infantile hemangioma Strawberry, capillary, or cavernous hemangioma Benign endothelial proliferation that represents the most common tumor in infancy. Most commonly on head and neck areas. Superficial ones presents as bright red-colored plaque. Deep ones presents as a soft dermal or sub cutaneous nodule with a bluish-purple color. More than 90% of untreated hemangiomas involute, that is, attain maximal regression by 9 years of age. Up to 30% of hemangiomas leave postinvolution changes including hypopigmentation, scarring, telangiectasia, and fibrofatty tissue. | train | med_mcqa | null |
Which is not a germ cell tumour. | [
"Dysgerminoma",
"Teratoma",
"Granulosa theca cell tumour",
"Embryonal cell carcinoma"
] | C | Epithelial Ovarian Tumour | train | med_mcqa | null |
Phocomelia: | [
"Failure of calcification of cartilage",
"Failure of membranous ossification",
"Failure of development of flat bones",
"Failure of development of long bones"
] | D | D i.e. Failure of development of long bonesRef: Nelson, 20th editionExplanation:Phocomelia Syndrome (PS)Rare birth defect that causes severe birth defects, especially of the upper limbs.The bones of the arms may be extremely shortened and even absent. The fingers of the hands may be fused.Risk factors:Maternal thalidomide therapy,Genetic inheritance,Roberts syndrome.An extreme case results in the absence of the upper bones of both the arms and legs so that the hands and feet appear attached directly to the body. This is called tetraphocomelia*.Other associated anomalies:Encephalocele.Hydrocephalus,Bicornuate uterus.Short neck,Thrombocytopenia,Renal and cardiac anomalies. | train | med_mcqa | null |
Which of the following is not of prognostic significance to choroidal melanoma? | [
"Presence of retinal detachment",
"Size of the tumour",
"Cytology of the tumor cells",
"Presence of extraocular extension"
] | A | A i.e. Presence of retinal detachment Secondary non rhegmatogenous exudative retinal detachment is a common sign of choroidal melanoma and has no prognostic significanceQ. Choroidal Melanoma Melanoma of choroid is the most common primary intraocular tumor in adultsQ and accounts for 85% of uveal melanomas. | train | med_mcqa | null |
Trachoma is characterized by A/E: | [
"Epithelial Keratitis",
"Conjunctival follicles",
"Round pannus",
"Ectropion of upper eyelids"
] | D | D i.e. Ectropion of upper eyelid Sequelae of trachoina is entropion (not ectropion)Q, corneal opacity and Xerosis (dryness)(2) Trachoma/ Egyptian Opthalmia Epidemiology Clinical Features Sequelae & Complication Diagnosis * Etiological agent * Incubation pd. is 1-3 weeks * Sequelae are changes * Clinically, at least two of is chlamydia trachomatis * Sequelae occurs at least after 20 years, so peak incidence of blinding is in 4th- occurring as a pa of the natural history of these sign should be present to establish the diagnosis serotype A, B, Ba, 5th decade disease i) Presence of follicles more CQ (a Bedsonian - * Symptoms- - Lids: tylosis in the upper than lower PLT organism) - In absence of secondary infection (thickening of lid palpebral conjuctiva * 1/5th of world symptoms are minimal & include mild margin), Trichiasis ii) Epithelial keratitis in the population is foreign body sensation (inward misdirection early stages most marked in affected - In presence of 2deg infection typical of cilia), entropionQ upper pa of cornea * Predisposing symptoms of acute mucopurulent (inturning of the lid iii) Pannus in upper pa of factors conjunctivitis develop eg. lacrimation, margin), ptosis cornea - Infancy & photophobia discharge etc (drooping of upper iv) Limbal follicles or their childhood * SignsQ - eyelid), madarosis sequelae as Herbe pitsQ - Females I. Conjuctival signs (absence of cilia), v) Stellate scarring in - Dry & dusty - Congestion ankyloblepharon conjuctiva with linear weather - Concretions (adhesion between conjuctival scarring of - Low socio- - Papillary hyperplasiaQ margins of the upper upper tarsus. (Ant's line)Q economic status (Large size, typical cobble stone and lower eyelids. * Laboratory diagnosis - Unhygienic living arrangement and acidic pH of tears - Conjuctival: i) Culture of c. trachomatis in conditionsQ differentiate it from spring catarrh.) concretions, irradiated Mc Coy cells * Source of infection - Conjuctival folliclesQ : presence of pseudocyst, xerosis (expensive) is discharge, so superimposed leber cellsQ necrosis & size of >5 mm differentiate trachoma follicles from (dryness)Q, symblepharon ii) Micro immunofluorescence (micro-IF) testis bacterial infections help in others. - Conjuctival scarring: linear scar present - Corneal: opacity Q, xerosis, ectasia recommended for routine diagnostic use. transmission by increasing in sulcus subtarsalis is called, Arlt's linect (anterior staphyloma), total iii) Mc Coy cell culture, monoclonal antibody direct jcon val ucti secretion * Mode of infection II. II Corneal C Signs Sig - Superficial keratitis - Herbe folliclesQ, which form pitted corneal pannus (1/ t blindness) - Lacrinal: chronic dacryoadenitis, tests and IgA-IPA light microscopy tests form the best combination of diagnostic tools - Vector transmission by flies (m.imp.l scars after healing, known as Herbe pitsQ - Pannus i.e. infiltration of cornea chronic dacryocystitis - Glucoma iv) Cytology - Giemsa stained conjuctival smears showing - Material transfer associated with vascularization ** The only predominantly polymorpho eg. towel, handkerchief etc. between epithelium and Bowman's , membrane complication of trachoma is corneal -nuclear reaction with presence of plasma cells and - Direct spread by In progressive pannus, infiltration is ulcerQ which may Leber cells air or water ahead of vascularization In regressive pannus (pannus siccus) occur due to rubbing of concretions or - Detection of inclusion body vessels are ahead of infiltration - Corneal ulcer and opacity may develop at the advancing edge of pannus trichiasis by immunofluor escent staining v) Culture of C. trachomatis on yolk sac * SAFE strategy for trachomaQ is - Surgery for trichiasis, Antibiotics, Facial cleanliness & Environmental improvement. Treatment * Oral tetracycline, doxycycline, azithromycin, clarithromycin, erythromycin, rifampicin & sulfonamides * Oral tetracycline cannot be given to childrenyears, pregnantwomen or nursing mothers. * Sulfonamides have high risk of stevens Johnson syndrome and erythema multiforme. * Topical treatment with tetracycline or erythromycin or sulfacetamide (less preffered) is cheaper more effective and has no risk of systemic side effects. | train | med_mcqa | null |
Raised MCV in pregnancy can be due to all except | [
"Megaloblastic Anaemia",
"Alcohol use",
"Hypothyroidism",
"Iron Deficiency"
] | D | MCV > 100fl is macrocytic First sign of megaloblastic anemia in pregnancy is usually an elevated red cell MCV Causes Megaloblastic: Folate deficiency, Vitamin B 12 deficiency and Orotic aciduria Non-Megaloblastic: Liver disease, Alcoholism, Reticulocytosis, Hypothyroidism Drugs: Azathioprine, 5-Flourouracil, Zidovudine, Hydroxyurea Reference: High risk pregnancy; Fernando Arias; 4th edition; Page no: 236, 237 | train | med_mcqa | null |
the above procedure is contraindicated in ? | [
"pleural effusion",
"lung abscess",
"hemothorax",
"hydropneumothorax"
] | B | intercostal drainage (chest tube) INDICATIONS * Drainage of a pneumothorax * Under tension * With respiratory distress or failure * With significant emphysema * With failed aspiration or recurrent collapse after aspiration * Drainage of a large haemothorax of pleural effusion * Drainage of an empyema * Prophylactic inseion in a patient with chest injuries, prior to PPV or aeromedical transpo * Pleural lavage (eg rewarming) Contraindications lung abscess * Increased ICP * Unstable head or neck injury * Active hemorrhage or hemoptysis * Recent spinal injury * Rib fracture * Flail chest * Uncontrolled hypeension * Anticoagulation * Thoracic surgeries ref ; bailey and love 27th ed | train | med_mcqa | null |
Unilateral injury to hypoglossal nerve leads to all, EXCEPT: | [
"Hemiatrophy of involved side",
"Detion of tongue towards the same side",
"Loss of taste sensation over the opposite half of the tongue",
"Fasciculation of the tongue"
] | C | Hypoglossal nerve is not involved in the transmission of taste sensation.General sensation from anterior 2/3rd of tongue is carried by lingual nerve, taste sensation is carried by chorda tympani a branch of facial nerve. Glossopharyngeal nerve carries both taste and general sensation from posterior 1/3rd of tongue. Posterior most pa of tongue anterior to epiglottisis supplied by internal laryngeal nerve from vagus.Hypoglossal nerve supplies all the intrinsic and extrinsic muscles of the tongue except Palatoglossus which is supplied by cranial root of accessory nerve pharyngeal plexus.Injury to hypoglossal nerve presents as:Detion of tongue towards paralysed side (due to unopposed action of normal contralateral genioglossus muscle).Hemiatrophy of tongue on affected sideFibrillation and fasciculation on the affected half of tongue.Absent sensory loss | train | med_mcqa | null |
What % of testicular Ca is associated with cryp torchidism - | [
"10%",
"30%",
"70%",
"90%"
] | A | Answer is 'a' i.e. 10%: Approx. 10% of testicular tumours are associated with cryptorchidism and higher the location of the undescended testes (intraabdominal versus inguinal), the greater is the risk of cancer. | train | med_mcqa | null |
In disaster management all are true except- | [
"Mitigation before a disaster strikes",
"Response in pre-disaster phase",
"Yellow color is for medium priority",
"Gastroenteritis is commonest infection after disaster"
] | B | Disaster management
Management sequence of a sudden-onset disaster is as follows:-
a) Risk reduction phase before a disaster strikes
It includes:-
Mitigation: Measures designed either to prevent hazards from causing emergency or to lessen the likely effect of emergencies.
Preparedness: To ensure that appropriate systems, procedures and resources are in place to provide prompt effective assistance to disaster victims.
b) Disaster Impact
Most injuries are sustained during the impact, and thus greatest need for emergency care occurs in first few hours.
The management can be divided into
Search, rescue and first aid: Most immediate help comes from uninjured survivors.
Field care: As many injured patients come simultaneously, emergency services should be proper in terms of priorty and numbers of facilities.
Triage: Triage consists of classifying the injured on the basis of severity of injuries and the likely hood of their survival with prompt medical intervention.
The most common triage classification system used internationally is four colour code system
i) Red → High priority treatment or transfer
ii) Yellow → Medium priority
iii) Green → Ambulatory patients
iv) Black → Dead or moribund patients
4. Tagging : All patients should be identified with tags.
5. Identification of dead : Proper respect to dead is of great importance.
c) Recovery phase after disaster
It includes :-
Response : Response starts with disaster impact and extends in recovery phase.
Rheabilitation and reconstruction : These should lead to restoration of pre-disaster condition
The ‘control room’ is nodal center in terms of disaster management.
The diseases common after a disaster are: Gastroenteritis (most common), acute respiratory infections (pneumonia), leptospirosis, rabies, equine encephalitis and rickettsiosis. | train | med_mcqa | null |
Which of the following is the psychological defense mechanism by the virtue of which an individual blames others for his mistake? | [
"Rationalization",
"Compensation",
"Projection",
"Regression"
] | C | Placing unacceptable impulses in yourself onto someone else, i.e. placing blame for the unwanted event upon other is seen in projection. | train | med_mcqa | null |
Pregnant lady presents with fulminant hepatitis. Most Common Cause: March 2005, September 2010 | [
"Hepatitis D",
"Hepatitis E",
"Hepatitis B",
"Hepatitis A"
] | B | Ans. B: Hepatitis E In general, hepatitis E is a self-limiting viral infection followed by recovery. Prolonged viraemia or faecal shedding are unusual. Fulminant hepatitis occurs more frequently in pregnancy and regularly induces a moality rate of 20% among pregnant women in the 3rd trimester. Perinatal transmission is uncommon. Fulminant hepatitis is uncommon with hepatitis-C and rare with hepatitis-A. | train | med_mcqa | null |
Patch test is read after: | [
"2 hrs",
"2 days",
"2 wks",
"2 months"
] | B | Patches are commonly applied on upper back for 48 hrs. Patch test First reading is taken after 48 hrs i.e at 2 days 2nd reading on day 4 i.e 96 hrs Evaluation of patch test reading: Grading Evaluation Clinical findings +- Doubt reaction Faint erythema + Weak (non-vesicular) +ve reaction Erythema, infiltration, and discrete papules ++ Strong (vesicular) +ve reaction Erythema, infiltration, papules, and vesicles. +++ Extreme (bullous) + ve reaction Intense erythema, infiltration, and coalescing vesicles. | train | med_mcqa | null |
Duval procedure in case of chronic pancreatitis involves | [
"Distal resection of tail of pancreas with end to end pancteaticojejunostomy",
"Distal resection of tail of pancreas with longitudinal opening of duct and pancteaticojejunostomy",
"Duodenum preserving pancreatic head resection",
"Local section of pancreatic head with longitudinal pancteaticojejunostomy"
] | A | Surgical procedures in chronic pancreatitis Drainage procedure Duval procedure : Distal pancreatictomy with Roux-en-Y pancteaticojejunostomy (caudal PJ) Ref: Sabiston 20th edition Pgno : 1535 | train | med_mcqa | null |
Peroxidase enzyme is used in estimating: | [
"Hemoglobin",
"Ammonia",
"Creatinine",
"Glucose"
] | D | Ans. D. GlucoseEnzymes as diagnostic reagentsEnzymeDiagnostic test doneUreaseUrea estimationUricaseUric acid estimationGlucose oxidaseGlucoseHexokinaseGlucosePeroxidaseGlucose, cholesterolCholesterol oxidaseCholesterolCreatininaseCreatinineLipaseTriglycerides | train | med_mcqa | null |
Radiological feature of osteosarcoma is – | [
"New bone formation",
"Sunray appearance",
"Cotton wool app.",
"Osteoid formation"
] | B | null | train | med_mcqa | null |
Spermatogenesis occurs at - | [
"Body temperature",
"Temperature lower than core body temperature",
"Temperature higher than core body temperature",
"Temperature does not play a role"
] | B | null | train | med_mcqa | null |
Lowest frequency of twin pregnancy is seen in: | [
"Nigeria",
"Philippines",
"India",
"Japan"
] | D | <p> Lowest frequency of twin pregnancy is seen in Japan(2/1000). Reference:Textbook of obstetrics,Sheila Balakrishnan,2nd edition,page no:178. <\p> | train | med_mcqa | null |
The commonest bladder stone is | [
"Triple phosphate",
"Xanthine",
"Uric acid",
"Cysteine"
] | C | IInd MC vesical calculi → Sturvite stones | train | med_mcqa | null |
Hot potato voice seen in | [
"Quinsy",
"Retropharyngeal Abscess",
"Ludwig's Angina",
"Glottic carcinoma"
] | A | null | train | med_mcqa | null |
Middle superior alveolar nerve is a branch of | [
"Mandibular division of trigeminal nerve",
"Palatine division of maxillary nerve",
"Anterior nasal division of maxillary nerve",
"Interior alveolar nerve"
] | C | C i.e. Anterior nasal division of maxillary nerve | train | med_mcqa | null |
Single hea sound (S2) is heard in: | [
"Transposition of great vessels",
"Ebstein's anomaly",
"Tetralogy of Fallot",
"TAPVC"
] | C | --> Single second hea sound: It is either A2 / P2/ combination of both. Decision whether it is aoic / pulmonic / combination depends on location, intensity of S2 & clinical profile of pt Seen in: *Tetralogy of fallot --> S2 represents A2 component since pulmonic component is delayed, soft & inaudible. *Eisenmenger complex --> S2 represents combination of A2 & P2 - Thus, based on auscultation alone, it might be difficult to differentiate b/w TOF & Eisenmenger complex. History & chest X-ray can distinguish these conditions. | train | med_mcqa | null |
The 'Search lines' to detect fracture line on occipitamental radiographic view of midfacial skeleton fracture was described by | [
"Rene Lefort and Guerin",
"McGrigor and Campbell",
"Andreason and Ravn",
"Rowe and Williams"
] | B | null | train | med_mcqa | null |
A 35 year old man who recently traveled to a third world country develops chronic, severe dysentery. Colonoscopy demonstrates ulceration of the cecum, and a cecal biopsy reveals 15-to-40 micron amoebae with ingested erythrocytes and small nuclei with distinctive tiny central karyosomes. Which of the following organisms is the most likely culprit? | [
"Acanthamoeba sp",
"Balantidium coli",
"Entamoeba histolytica",
"Giardia lamblia"
] | C | Entamoeba histolytica is the usual cause of intestinal amebiasis, and has the microscopic features described in the question stem. A paicularly helpful (but not always present) feature of this organism is the presence of ingested red blood cells within the amoebae. These amoebae cause flask-shaped ulceration of the intestinal mucosa and submucosa, with a paicular propensity for involving the cecum and ascending colon. The disease manifestations range from none (asymptomatic carriers) to mild chronic diarrhea, to severe, purging dysentery. In symptomatic cases, the liver may develop destructive amoebic liver abscesses that tend to become secondarily (and potentially life-threateningly) infected by bacteria. Acanthamoeba is a free-living amoebae that can cause amoebic meningocephalitis. Balantidium coli is a large ciliated intestinal parasite that can occasionally cause colonic disease resembling that caused by Entamoeba histolytica. Giardia lamblia is a small intestinal protozoa with a distinctive pear-shaped morphology that appears to have a "face." Ref: Ray C.G., Ryan K.J. (2010). Chapter 51. Rhizopods. In C.G. Ray, K.J. Ryan (Eds), Sherris Medical Microbiology, 5e. | train | med_mcqa | null |
On MRI the differential diagnosis of spinal cord edema is - | [
"Myelodysplasia",
"Myelomalacia",
"Myeloschisis",
"Cord tumors"
] | B | In Myelomalacia, the spinal cord is small and bright due to cord atrophy and gliosis There is no extrinsic compression in myelomalacia Myelomalacia is irreversible. | train | med_mcqa | null |
A 32-year old male with no past medical history is brought to the emergency department after being injured in a bomb blast. On examination he is suspected to have a splenic injury and is supposed to undergo an emergency laparotomy. Which of the following is the ideal anaesthetic agent of choice ? | [
"Remifentanil",
"Morphine",
"Etomidate",
"Halothane"
] | C | Inducing agents of choice patients with hypotension are Ketamine and Etomidate :-
(1) If the patient is hypertensive at the time of induction → Etomidate is preferable.
(2) If the patient is normotensive or mild hypotensive → Either of two can be used.
(3) If the patient is severely hypotensive → Ketamine is preferred. | train | med_mcqa | null |
Bull's eye lesion seen with: (PGI Nov 2009) | [
"Chloroquine",
"Dapsone",
"Rifampicin",
"Ethambutol"
] | A | Ans: A (Chloroquine) akobiec 2nd / 2240.2248 }Causes of Bull's Eye MaculopathyChloroquine1?Toxicity of phenothiazine D Bardet-Biedl SyndromeInverse retinitis pigmentosaDystrophies:benign concentric annular macular dystrophyfenestrated sheem dystrophycone dystrophyStargardt disease Bulls eye maculopathy causes loss ofcentrai vision as well as constriction of peripheral fields.The two main S/E of Chloroquine are - corneal deposits & maculopathyQRetinal Toxicity of Systemic Drugs# Chloroquine/Hydroxy chloroquine : Bull's eye maculopa thyQ.Thioridazine : pigmentary retinopathyChloropromazine : Pigment clumping of retinaNiacin: bilateral maculopathy that mimics cystoids macular edema.Tamoxifen : fine refractive intraretinal crystals as well as granular deposits at the level of the pigment epithelium.Deferoxamine : macular pigmentary irregularities | train | med_mcqa | null |
Galen's anastomosis is between | [
"Recurrent laryngeal nerve and external laryngeal nerve",
"Recurrent laryngeal nerve and internal laryngeal nerve",
"Internal laryngeal nerve and external laryngeal nerve",
"None of the above"
] | B | Galen's anastomosis is the connecting branch between the Inferior laryngeal nerve (a branch of the recurrent laryngeal nerve) and the Internal laryngeal nerve (a branch of the superior laryngeal nerve). Internal laryngeal nerve is sensory above the vocal cords . Recurrent laryngeal nerve is sensory below the vocal cords, and there is overlap between the territories innervated by the two nerves at the vocal cords themselves which is called as Galens anastomosis. | train | med_mcqa | null |
A 7-year-old girl with a complaint of generalized swelling of the body. Urinary examination reveals grade 3 proteinuria and the presence of hyaline and fatty casts. She has no history of hematuria. Which of the following statements about her condition is true? | [
"No IgG deposits or C3 deposition on renal biopsy",
"Her C3 level will be low",
"IgA nephropathy is the likely diagnosis",
"Alpo's syndrome is the likely diagnosis"
] | A | Ig and C3 deposits are seen in RPGN | train | med_mcqa | null |
Most common type of amblyopia is | [
"Stimulus deprivation amblyopia",
"Anisometropic amblyopia",
"Strabismic amblyopia",
"Ametropic amblyopia"
] | C | Strabismic amblyopia
It is due to unilateral suppression in large squint.
It is the most common type.
It has best prognosis. | train | med_mcqa | null |
Keratitis is caused by - | [
"Bacteria",
"Atopy",
"Protozoa",
"All"
] | D | Ans. is 'd' i.e., AH Causes of keratitisInfective keratitisBacterialViralFungalChlamydialProtozoalSpirochaetalAllergic keratitisPhlyctenular keratitisVernal keratitisAtopic keratitisTrophic keratitisExposure keratitisNeuroparalytic keratitisKeratomalaciaAtheromatous ulcerKeratitis associated with diseases of skin and mucous membrane.Keratitis associated with systemic collagen vascular disorders.Traumatic keratitis, which may be due to mechanical trauma, chemical trauma, thermal burns, radiations.Idiopathic keratitis e.g.,Mooren's comeal ulcerSuperior limbic keratoconjunctivitisSuperficial punctate keratitis of Thygeson | train | med_mcqa | null |
In order for oxygen to diffuse from the alveolar air spaces to the site of its binding to hemoglobin, it must diffuse across how many plasma membranes? | [
"2",
"3",
"4",
"5"
] | D | The minimum gas diffusion barrier in the alveolar septum includes the highly flattened cytoplasm of a Type I pneumocyte, the fused basement membrane, the highly flattened cytoplasm of an endothelial cell making up the capillary wall, the blood plasma and finally the plasma membrane of the erythrocyte. There is a plasma membrane on each side of the flattened Type I pneumocyte and each side of the flattened endothelial cell. Therefore, there are a total of five (5) plasma membranes that must be crossed in order for the oxygen molecule to diffuse from the alveolar air space to the hemoglobin inside the cytoplasm of the erythrocyte (RBC). Two contributed by the Type I cell, 2 contributed by the endothelial cell and one by the erythrocyte. | train | med_mcqa | null |
All are true regarding Lupus anticoagulant, EXCEPT? | [
"Increased aboions",
"Aerial thrombosis",
"Rashes",
"Increased PT"
] | D | Answer is D or none(Increased PT or none) The Lupus Anticoagulant typically causes an isolated prolongation of APTT. Prothrombin time is usually normal although slight prolongation in PT may also be observed Lupus anticoagulant should be suspected in cases of markedly prolonged PTT without clinical bleeding and normal or slightly elevated PT- CMDT Lupus Anticoagulant Lupus anticoagulant is an `antiphospholipid' seen in about 5 to 10% of cases of SLE The term 'anticoagulant' is a misnomer as LA acts as a procoagulant casuing increased tendency of thrombosis and does not act as an anticoagulant. Lupus anticoagulant is a cause for antiphospholipid syndrome and may present with recurrent thrombosis and pregnancy related morbidity including Recurrent aboions. 'It is mistermed as an 'anticoagulant' because it causes prolongation of PTT in the vitro PTT assay' (This prolongation is produced because lupus anticoagulant being an antiphospholipid binds to the phospholipid used in vitro PTT assays) PT is usually not affected by the lupus anticoagulant. | train | med_mcqa | null |
Fetal blood is returned to the umbilical aeries and the placenta through the | [
"Hypogastric aeries",
"Ductus venosus",
"Poal vein",
"Inferior vena cava"
] | A | (Reece, 2/e, pp 54, 119-121.) Fetal blood is returned directly to the placenta through the two hypogastric aeries. The distal poions of the hypogastric aeries atrophy and obliterate within 3 to 4 days after bih; remnants are called umbilical ligaments. Fetal oxygenation is aided by the presence of three vascular shunts: the ductus venosus, foramen ovale, and ductus aeriosus. The ductus venosus shunts oxygenated blood from the umbilical vein into the inferior vena cava. The foramen ovale deflects the more oxygenated blood from the right atrium into the left atrium, thereby bypassing pulmonary circulation. Approximately two- thirds of the blood ejected from the right ventricle is shunted pulmonary circulation through the ductus aeriosus. | train | med_mcqa | null |
Morphine causes all, Except | [
"Peripheral vasodilatation",
"Decrease intracranial tension",
"Nausea and vomiting",
"Decrease in gastrointestinal secretion"
] | B | Morphine is contraindicated in patients with head injury because 1. It causes increased intracranial tension. 2. Causes marked respiratory depression. 3. Causes vomiting, miosis and altered mentation that interfere with assessment of progress in head injury patients. Ref: KD Tripathi 8th ed. | train | med_mcqa | null |
By which method foreign DNA is introduced into a cell by a virus or viral vector? | [
"Transduction",
"Transcription",
"Lysogenic conversion",
"Transformation"
] | A | (A) Transduction[?]TRANSDUCTIONoTransfer of genetic information from one cell to another by means of a viral vector.oRefers to the process whereby foreign DNA is introduced into another cell via a viral vectoroTransduction does not require physical contact between the cell donating the DNA and the cell receiving the DNA (which occurs in conjugation), and it is DNase resistant.oTransduction is a common tool used by molecular biologists to stably introduce a foreign gene into a host cell's genome.Other Options[?]Lysogenic ConversionoWhen a cell becomes lysogenized, occasionally extra genes carried by the phage get expressed in the cell. These genes can change the properties of the bacterial cell. This process is called lysogenic conversion.[?]Bacteriophages: Lysogenic Conversion-Some lysogenic phage carry genes that can enhance the virulence of the bacterial host.-For example, some phage carry genes that encode toxins.-These genes, once integrated into the bacterial chromosome, can cause the once harmless bacteria to release potent toxins that can cause disease.[?]Transcription-Transcription is the process of making a complementary molecule of mRNA (messenger RNA) from a DNA template. This takes place in the nucleus.-RNA polymerase unwinds, reads and places the correct nucleotide on the mRNA strand according to base pairing rules (A to U, C to G, T to A).[?]Transformation:oIntroduction of an exogenous DNA into cell, causing the cell to acquire a new phenotype.oInfection of Bacterium by phage begins with injection of its DNA.oIt can take either of 2 causes 1 lysogenic - viral DNA becomes as part of Bacterial DNA causing cell division.oLytic-viral DNA excises from host chromosome and replicates itself, Direct synthesis of viral proteins - then lysis of host occurs with release of viri.oTransduction is the process by which foreign DNA is introduced into a cell by a virus or viral vector. An example is the viral transfer of DNA from one bacterium to another.oTransformation is one of three processes for horizontal gene transfer, in which exogenous genetic material passes from one bacterium to another, the other two being conjugation (transfer of genetic material between two bacterial cells in direct contact) and transduction (injection of foreign DNA by a bacteriophage virus into the host bacterium). In transformation, the genetic material passes through the intervening medium, and uptake is completely dependent on the recipient bacterium. | train | med_mcqa | null |
The typical appearance of "spider leg" on excretory urography is seen in: | [
"Hydronephrosis",
"Polycystic kidney",
"Medullary sponge kidney",
"Renal cell carcinoma"
] | B | Diagnosis USG: Enlarged kidney with uniformly medullary echogenicity. IVP in ADPKD Stretching of the calyces by the cysts (spider leg or ball like deformity. Bubble appearance (calyceal distoion) Swiss cheese appearance. CT scan is IOC in ADPKD | train | med_mcqa | null |
Which one of the following is the most suitable situation for prescribing the progestin only pill for the purpose of contraception? | [
"Perimenopausal patients",
"Active Liver disease",
"Lactational mother",
"Diabetes"
] | C | Progestin only pill - advantages 1. Lactating women(most suitable) 2. Older women (>35 year) 3. Diabetic 4. Hypeensive women 5. Sickle cell anemia 6. Focal migraine 7. Intolerant to Oestrogen or Oestrogen Contraindicated | train | med_mcqa | null |
Which of the following is the principal mode of heat exchange in an infant incubator ? | [
"Radiation",
"Evaporation",
"Convection",
"Conduction"
] | C | "Convection warmed incubators are being routinely used for thermal regulation of thepremature neonate's ambient air" | train | med_mcqa | null |
Genioplasty procedure is used | [
"To change the attachment of genioglossus muscle in pre-prosthetic procedure",
"To change the position of genial tubercles",
"To modify the position of the chin",
"To modify the attachment of anterior belly of digastric"
] | C | null | train | med_mcqa | null |
In plasma, if pH is 5 , what is the fraction of base to acid? | [
"0.01",
"0.1",
"1",
"10"
] | B | Ans: b (0.1)Ref: Vasudevan 4th ed/p.347According to Henderson-Hasselbach equation,pH = pKa + log (pKa= pH at which the acid is half ionised. It is a constant)The most important buffer system in plasma is bicarbonate- carbonic acid system. pKa for carbonic acid is 6.1 .pH = pKa + log rbasel5 = 6.1 + log log rbasel = -1.1 = log 10'-1 approx. | train | med_mcqa | null |
The investigation of choice for renal scarring defect in kidney: | [
"DMSA scan",
"DTPA scan.",
"Dexa scan",
"MCU"
] | A | Ans. (a) DMSA scanRef: Bailey 26th Edition, Pages 1276-1277* IOC for Renal Structure scarring - DMSA* IOC for Congenital PUJ obstruction - DTPA | train | med_mcqa | null |
Acute hepatocellular failure in a patient of cirrhosis of liver is precipitated by - | [
"Upper gastrointestinal bleeding",
"Large carbohydrate meal",
"Portal vein thrombosis",
"Intravenous albumin infusion"
] | A | null | train | med_mcqa | null |
In Hashimotos thyroiditis there is infiltration of | [
"Macrophages",
"Neutrophiks",
"Leukocytes",
"Eosinophils"
] | C | Robbins page no 1087MORPHOLOGY The thyroid is often diffusely enlarged, although more localized enlargement may be seen in some cases. The capsule is intact, and the gland is well demarcated from adjacent structures. The cut surface is pale, yellow-tan, firm, and somewhat nodular. There is extensive infiltration of the parenchyma by a mono- nuclear inflammatory infiltrate containing small lympho- cytes, plasma cells, and well-developed germinal centers (Fig. 24-11). The thyroid follicles are atrophic and are lined in many areas by epithelial cells distinguished by the presence of abun- dant eosinophilic, granular cytoplasm, termed Huhle cells. This is a metaplastic response of the normally low cuboidal follicular epithelium to ongoing injury. In fine-needle aspiration biopsy samples, the presence of Huhle cells in conjunction with a heterogeneous population of lymphocytes is character- istic of Hashimoto thyroiditis. In "classic" Hashimoto thyroiditis, interstitial connective tissue is increased and may be abundant. Unlike Reidel thyroiditis (see later), the fibrosis does not extend beyond the capsule of the glands | train | med_mcqa | null |
Walls of the CT scanner room are coated with - | [
"Lead",
"Glass",
"Tungsten",
"Iron"
] | A | Walls of the CT scanner room are coated with Lead | train | med_mcqa | null |
Increased capillary permeability is caused by all of the following except | [
"Anaphylatoxin",
"5 hydroxytryptamine",
"Renin",
"Histamine"
] | C | Renin cause the vasoconstriction and increase the BP. It is released by the RAASmechanism Robbins 9th edition page no. 329 | train | med_mcqa | null |
The cardiac output can be determined by all except | [
"Fick's principle",
"V/Q ratio",
"Echocardiography",
"Thermodilution"
] | B | Methods to determine the Cardiac output
Flowmeter
Cardiometer
- Indirect method- Used in humans
Fick’s principle method
Indicator dilution method
Thermodilution method
Doppler echocardiography
Cineradiography | train | med_mcqa | null |
Gall stone pain referred to Shoulder pain Nerve root values | [
"C3-C5",
"C2-C8",
"T8-T9",
"T4-T6"
] | A | Ans. (a) C3- C5Ref: Long Cases in Surgery by RRMBoas Sign:* In Cholecystitis, there is irritation of nociceptors present in Diaphragm which send afferent signals via C3/C4/C5 to the dorsal horn of spinal cord.* C4 dermatome covers the shoulder and converges on same area of spinal cord and hence interpreted as pain coming from shoulder in Gallbladder pain. | train | med_mcqa | null |
Complication of streptokinase a) Myocardial rupture b) Joint pain c) Intracranial bleed d) Anaphylaxis e) Parkinsonism | [
"abc",
"bd",
"cd",
"ad"
] | C | null | train | med_mcqa | null |
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