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What is the rate of uterine blood flow at term in a primigravida? | [
"50-75 ml/min",
"150-200 ml/min",
"350-400 ml/min",
">500 ml/min"
] | D | At term, uterine blood flow represents about 10% of the cardiac output, or 600-700 mL/min (compared with 50 mL/min in the nonpregnant uterus). Eighty percent of uterine blood flow normally supplies the placenta; the remainder goes to the myometrium. Pregnancy maximally dilates the uterine vasculature, so that autoregulation is absent, but the uterine vasculature remains sensitive to -adrenergic agonists. Also know: Uterine blood flow is not usually significantly affected by respiratory gas tensions, but extreme hypocapnia (PaCO2 Three major factors decrease uterine blood flow during pregnancy: (1) systemic hypotension, (2) uterine vasoconstriction, and (3) uterine contractions. Ref: Butterwoh IV J.F., Mackey D.C., Wasnick J.D. (2013). Chapter 40. Maternal & Fetal Physiology & Anesthesia. In J.F. Butterwoh IV, D.C. Mackey, J.D. Wasnick (Eds), Morgan & Mikhail's Clinical Anesthesiology, 5e. | train | med_mcqa | null |
Cause of ITP is - | [
"Vasculitis",
"Antibody to vascular epithelium",
"Antibody to platelets",
"Antibody to clotting factors"
] | C | Idiopathic thrombocytopenic purpura
There are two clinical subtypes of primary I.T.P, acute and chronic both are autoimmune disorders in which platelet destruction results from the formation of antiplatelet antibodies.
Pathogenesis
Chronic ITP is caused by the formation of autoantibodies against platelet membrane glycoproteins most often IIb-IIIa or Ib-IX.
In the overwhelming majority of cases, the antiplatelet antibodies are of the IgG class.
The mechanism of platelet destruction is similar to that seen in autoimmune hemolytic anemias. Opsonized platelets are rendered susceptible to phagocytosis by the cells of the mononuclear phagocyte system.
The spleen is the major site of the destruction of platelets.
Pathology
The principal morphologic lesions of thrombocytopenic purpura are found in the spleen and bone marrow but they are not diagnostic.
The point to stress is that despite the increased destruction of platelets in the spleen, the spleen size remains normal.
On histological examination, there is congestion of the sinusoids and hyperactivity and enlargement of the splenic follicles manifested by the formation of prominent germinal centres. Sometimes scattered megakaryocytes are found within the sinuses and sinusoidal walls. This represents a very mild form of extramedullary hematopoiesis. These splenic findings are not sufficiently distinctive to be considered diagnostic.
Bone Marrow
Bone marrow reveals a modestly increased number of megakaryocytes.
These findings are not specific for autoimmune thrombocytopenic purpura but merely reflect accelerated thrombopoiesis, being found in most forms of thrombocytopenia resulting from increased platelet destruction.
The importance of bone marrow examination is to rule out thrombocytopenias resulting from bone marrow failure.
A decrease in the number of megakaryocytes goes against the diagnosis of I.T.P. | train | med_mcqa | null |
A recognised cause of stridor in newborn – | [
"Cystic hygroma",
"A Vascular ring",
"Laryngomalacia",
"All are true"
] | D | Stridor
Stridor refers to the physical finding of excessively noisy breathing and is generally due to airway obstruction.
Causes of Stridor in a child.
Infections
Croup (laryngotracheobronchitis)
Epiglottitis
Bacterial tracheitis
Retropharyngeal abscess
Congenital
Laryngomalacia
Vocal cord palsy
Subglottic stenosis
Vascular ring
Saccular cyst
Neoplasms
Subglottic hemangioma
Laryngeal papillomas
Cystic hygroma, when it occurs in larynx then it can cause respiratory tract obstruction - Nelson 18th/ep. 1773 | train | med_mcqa | null |
HLA is present on - | [
"Sho term of chromosomes 3",
"Sho arm of chromosomes 6",
"Long arm of chromosomes 3",
"Long arm of chromosomes 6"
] | B | Ans. is 'b' i.e., Sho arm of chromosomes 6 o HLA complex of genes is located on the sho arm of chromosome 6. | train | med_mcqa | null |
Which of the following is an absolute contraindication to adrenal steroid therapy? | [
"Severe hypeension",
"Osteoporosis",
"Diabetes mellitus",
"Cushing's syndrome"
] | D | Cushing's syndrome is an absolute contraindication to coicosteroid therapy. Relative contraindications includes peptic ulcer, hypeension, hypeension with congestive hea failure, diabetes mellitus, herpes simplex infection, osteoporosis and glaucoma. Ref: Textbook of Pharmacology By Seth 3rd edition page 61 | train | med_mcqa | null |
Marker for seminoma testis is - | [
"Alfa - fetoprotein",
"Carcinoembryonic antigens",
"HCG",
"Acid phosphatase"
] | C | Normally seminoma cells do not contain AFP and HCG.
"Approximately 15% of seminomas contains syncytiotrophoblasts which secret HCG" ------ Robbin's 1042
Seminoma is positive for placental alkaline phosphatase and keratin. | train | med_mcqa | null |
A patient presented with episodes of flushing and hypotension. His urinary 5HIAA levels were found to be increased. The diagnosis is | [
"Pheochromocytoma",
"Carcinoid syndrome",
"Addison's disease",
"SIADH"
] | B | (B) Carcinoid syndrome # Carcinoid syndrome-Clinical findings include:> Flushing of the skin> Diarrhea and abdominal cramps> Right sided heart disease> Bronchoconstriction> Abdominal pain due to desmoplastic reaction of the mesentery in most patients, increased urinary excretion of 5-HIAA (5-hydroxy-indoleacetic acid), a degradation product of serotonin> Serotonin causes fibrosis of the tricuspid valve and pulmonary valve> "TIPS" - Tricuspid Insufficiency, Pulmonic Stenosis (fibrosis of tricuspid and pulmonary valves) | train | med_mcqa | null |
All the following are features of cerebellar disease except: | [
"Intention tremors",
"Past pointing",
"Hypeonia",
"Ataxia"
] | C | Answer is C (Hypeonia): Hypotonia is a feature of cerebellar disease (not Hypeonia). | train | med_mcqa | null |
Ispilateral optic atrophy with contralateral papilloedema is a feature of - | [
"Fischer syndrome",
"Foster kennedy syndrome",
"Vogt- kayanagi- Harada syndrome",
"WAGR syndrome"
] | B | Foster - Kennedy syndrome: - The frontal lobe, pituitary and middle ear tumor such as meningiomata of the oflactor groove are sometimes associated with Ipsilateral pressure atrophy of the optic nerve and contralateral papilloedema. | train | med_mcqa | null |
All the following are tricyclic antidepressants except | [
"Mianserin",
"Imipramine",
"Protriptyline",
"Maprotiline"
] | A | there are several types of antidepressants namely tri cyclic antidepressent=== amitriptilline, clomipramine, imipramine, noriptilline SSRI=================fluoxetine, paroxetine, fluvoxamine, seraline, citalopram, escitalopram SNRI=================venlafaxine, desvenlafaxine, duloxetine Mianserin is tetracyclic and atypical antidepressant Ref: Essentials of postgraduate psychiatry By JN Vyas 1st ed Pg 607 | train | med_mcqa | null |
Nutrition for ameloblasts after 1st layer of enamel is laid is | [
"Dental sac",
"Odontoblastic process",
"REE",
"Dental papilla"
] | A | null | train | med_mcqa | null |
An afroamerican kid of 6 years of age presented with abdominal pain, chronic hemolysis and abnormal RBC shape on peripheral smear. Most likely disorder responsible for this condition: | [
"Trinucleotide repeat",
"Point mutation",
"Antibodies against RBC membrane",
"Genetic imprinting"
] | B | Ans. b. Point mutation (Ref: Ghai 7/e p310-312; Harper's 27/e p368-371)An afroamerican kid of 6 years of age presented with abdominal pain, chronic hemolysis and abnormal RBC shape on peripheral smear. This patient is suffering from sickle cell anemia. Most likely disorder responsible for this condition point mutation.'Sickle cell anemia is an autosomal recessive disease that results from the substitution of valine from glutamic acid at position 6 of the beta-globin gene (Point mutation).'- Ghai 7/e p310Point mutations within coding sequences:A point mutation may alter the code in a triplet of bases and lead to the replacement of one amino acid by another in the gene product.An excellent example of this type is the sickle mutation affecting the b-globin chain of hemoglobinQ. Here the nucleotide triplet CTC for GAG in mRNA), which encodes glutamic acid, is changed to CAC (or GUG in mRNA), which encodes valine. This single amino acid substitution alters the physicochemical properties of hemoglobin, giving rise to sickle cell anemia.Sickle Cell DiseaseSickle cell disease is a common hereditary hemoglobinopathy that occurs primarily in individuals of African descentQ.Caused by a point mutation in the sixth codon of b-globin that leads to the replacement of a glutamate residue with a valine residueQ.In certain populations in Africa the prevalence of heterozygosity is as high as 30%. This high frequency probably stems from protection afforded by HbS against falciparum malariaQ.Pathogenesis:HbS molecules undergo polymerization when deoxygenated.Initially the red cell cytosol converts from a freely flowing liquid to a viscous gel as HbS aggregates form.With continued deoxygenation aggregated HbS molecules assemble into long needle-like fibers within red cells, producing a distorted sickle or holly-leaf shapeQ.Presence of HbS underlies the major pathologic manifestationsChronic hemolysisQMicrovascular occlusionsQTissue damageQMorphology:Peripheral blood demonstrates variable numbers of irreversibly sickled cells, reticulocytosis, and target cells, Howell-Jolly bodiesQ (small nuclear remnants).The bone marrow is hyperplastic as a result of a compensatory erythroid hyperplasiaQ.Expansion of the marrow leads to bone resorption and secondary new bone formation, resulting in prominent cheekbones and changes in the skull that resemble a crew-cut in X-raysQ.Increased breakdown of hemoglobin can cause pigment gallstones and hyperbilirubinemiaQ.Splenic infarction, fibrosis, and progressive shrinkage (autosplenectomy)Q. | train | med_mcqa | null |
In a person acclimitalized for high altitude, O2 saturation is maintained because of? | [
"Hemiconcentration",
"Decresed CO2 saturation",
"More O2 delievery to tissue",
"Hypoxia"
] | C | ANSWER: (C) More O2 delievery to tissueREF: Ganongs 22nd ed p. 686Acclimatization at high altitude is due to following compensatory mechanismsIncreased RBC 23 BPG which causes decreased affinity of hemoglobin for oxygen, making more oxygen available for tissue.Increased erythropoietinIncrease in number of mitochondriaIncrease in myoglobin contentIncrease in content of cytochrome oxidase | train | med_mcqa | null |
All of the following are example of nominal scale except | [
"Race",
"Body weight",
"Sex",
"Socio-economic status"
] | B | null | train | med_mcqa | null |
Antral sign is seen in ? | [
"Juvenile angiofibroma",
"CSOM",
"Sinusitis",
"Otoscelrosis"
] | A | Investigations of JNA Following investigations are used in JNA :- i) Soft tissue lateral film of nasopharynx :- shows soft tissue mass in the nasopharynx. ii) X-rays paranasal sinus and base of skull :- findings have been explained in previous explanation. iii) CT scan of head with contrast :- is the investigation of choice. It shows the extent of tumour, bony destruction, or displacement. Anterior bowing of the posterior wall of maxillary sinus (antral sign or Hohnan-Miller sign) is pathgnomonic of JNA. iv) MR1 complementory to CT when soft tissue extensions are present intracranially, in infratemporal foss or in orbit. v) Carotid angiography :- shows extension of tumor, its vascularity and feeding vessels. Biopsy should be avoided as it can cause severe bleeding. | train | med_mcqa | null |
An infeile women has bilateral tubal block at comua diagnosed on hysterosalpingography. Next step in treatment is: | [
"IVF",
"Laparoscopy and hysteroscopy",
"Tuboplasty",
"Hydrotubation"
] | B | Shaw's textbook of Gynaecology- 16th edn- pg no 253. A hysteroscopy must be combined with laparoscopy for cornual pathology. Mucus plug, polyps and synechiae can be managed. Dense adhesions can not be dealt with this way. | train | med_mcqa | null |
Mechanism of action of statins: | [
"Inhibit HMG CoA synthase",
"Stimulate HMG CoA reductase",
"Inhibit HMG CoA reductase",
"Stimulate HMG CoA synthase"
] | C | Ref: KDT 6th ed. pg. 614* HMG-CoA Reductase Inhibitors (statins): This class of compound is the most efficacious and best tolerated hypolipidaemic drugs.* MOA: Competitively inhibit conversion of HMG-CoA to mevalonate by the enzyme HMG-CoA reductase.* Drugs (Statins): Lovastatin, Simvastatin, Pravstatin, Atorvastatin, Rosuvastatin* All statins are given at night except: Rosuvastatin, Atorvastain (can be given at anytime)* Major side effects of statins: Myopathy* Most potent statin: Pitavastain | train | med_mcqa | null |
Increasing severity of mental retardation of male members over generations is a result of- | [
"Mitochondrial DNA mutation",
"Frameshift mutation",
"Y linked disorder",
"Trinucleotide repeat mutation"
] | D | Trinucleotide repeat disorders (also known as trinucleotide repeat expansion disorders, triplet repeat expansion disorders or codon reiteration disorders) are a set of genetic disorders caused by trinucleotide repeat expansion, a kind of mutation where trinucleotide repeats in ceain genes exceed the normal, stable threshold, which differs per gene. The mutation is a subset of unstable microsatellite repeats that occur throughout all genomic sequences. If the repeat is present in a healthy gene, a dynamic mutation may increase the repeat count and result in a defective gene. | train | med_mcqa | null |
The following local anaesthetic raises BP instead of tending to cause a fall: | [
"Cocaine",
"Dibucaine",
"Lignocaine",
"Procaine"
] | A | (Ref: KDT 6/e p356, 357) All LAs cause hypotension except cocaine. Cocaine increases blood pressure by inhibiting the reuptake of catecholamines. | train | med_mcqa | null |
Which of the following cranial nerve Ganglion is delivered form the neural crest cell ? | [
"VI",
"VII",
"VIII",
"X"
] | B | A basic understanding of cranial NC cell migration in the head and neck is impoant to appreciate facial nerve migration into the hyoid arch. This, of course, implies that the reader has a working knowledge of the NC in general. The NC is a pluripotent cell population that originates from the junction between the neuroepithelium of the developing neural tube and non-neural ectoderm, which later delaminates from the developing neural tube. NC cells are critical for the development of the veebrate head and neck because they give rise to most of the skull bones, the facial skeleton, the visceral skeleton, peripheral neurons, and glia . Ref - pubmed.com | train | med_mcqa | null |
A a1 selective adrenergic blocking agents used in benign prostatic hypertrophy is | [
"Prazosin",
"Terazosin",
"Doxazosin",
"Tamsulosin"
] | D | D. i.e. (Tamsulosin) (135- KDT 6th) (83- Lippincott's 3rd)* Prazosi, Terazosin, Doxazosin are useful in the treatment of hypertension. Tamsulosin is indicated for the treatment of benign prostatic hypertrophy (83- Lippincott's 3rd)* According to KDT all are used in BPH. but Tamsulosin is best answer of choice* TAMSULOSIN - is Uroselective aIA/ a1D blocker** better tolerated less side effects* Selective b1 antagonist is - Atenolol*** Selective b2 antagonist is - Butoxamine** | train | med_mcqa | null |
Which artery is involved in Wallenberg syndrome: | [
"A",
"B",
"C",
"D"
] | D | Ans. D. DWallenberg syndrome is due to obstruction/block of posterior inferior cerebellar artery.A is Posterior cerebral arteryB is Anterior inferior cerebellar arteryC is Anterior spinal arteryD is posterior inferior cerebellar artery | train | med_mcqa | null |
All of the following are mediators of acute inflammation except: | [
"Angiotensin",
"Prostaglandin E2",
"Kallikrein",
"C3a"
] | A | Kallikreins like:- Bradykinin PGs Complement components are mediators of acute inflammation. | train | med_mcqa | null |
Most commonly used for protein utilization ? | [
"NPU",
"Amino acid score",
"Biological value",
"Protein efficiency ratio"
] | A | Ans. is `a' i.e., NPU | train | med_mcqa | null |
Which of the following is drug of choice for Toxoplasmosis in pregnancy? | [
"Metronidazole",
"Pyrimethamine",
"Sulfadiazine",
"Spiramycin"
] | D | DOC for Toxoplasma.gondi : Pyrimethamine + Sulfadiazine
DOC for Toxoplasma.gondi in Immunocompromised : Cotrimoxazole
DOC for Toxoplasma.gondi in Pregnancy : Spiramycin | train | med_mcqa | null |
Most common glycogen storage disease presenting with hypoglycemia and normal glycogen structure - | [
"Von Gierke disease",
"Pompe's disease",
"Me Ardle's disease",
"Forbe's disease"
] | A | Ans. is 'a' i.e., Von Gierke disease Liver glycogenoses |Hypoglycemia| | |HepatomegalyCirrhosis|||| |RenomegalyHypoglycemia unresponsive to glucagon/epinephrineNo renomegaly Hypoglycemia corrected by glucagon/epinephrineType IV(Anderson) (Abnormal glycogen structure)||| | | Von Gierke's disease (Type I) (Normal glycogen structure)Abnormal glycogen structure Normalglycogen structure | | Type III (Cori/Forbe/limit dextrinosis)Type VI (Hers) | train | med_mcqa | null |
Enzymes found in CSF: | [
"GGT + ALP",
"ALP + CK-MB",
"CK + LDH",
"Deaminase and Peroxidase"
] | C | Ans. c. CK + LDH (Ref: Textbook of Medical Biochemistry by Dinesh Puri 2/e p154, 155)CK (Subunit composition BB) and LDH-3 (Subunit composition HHMM) are found in brain (CSF).Tissue Distribution of Lactate Dehydrogenase IsoenzymeIsoenzymeSubunit compositionTissuePercentage in serumLDH-1HHHHMyocardium, RBCQ30LDH-2HHHMMyocardium, RBCQ35LDH-3HHMMBrainQ, kidney20LDH-4HMMMSkeletal muscle, liverQ10LDH-5MMMMSkeletal muscle, liverQ5 Characteristics of CK IsoenzymesIsoenzymeSubunit compositionTissuePercentage in serumCKBBBrainQ30CKMBHeartQ35CKMMSkeletal muscleQ20 | train | med_mcqa | null |
Heparin is contraindicated in patients suffering from the following diseases except | [
"Bleeding due to defibrination syndrome",
"Pulmonary tuberculosis",
"Subacute bacterial endocarditis",
"Large malignant tumours"
] | A | HEPARIN Contraindications 1. Bleeding disorders, history of heparin induced thrombocytopenia. 2. Severe hypeension (risk of cerebral haemor rhage), threatened aboion, piles, g.i. ulcers (risk of aggravated bleeding). 3. Subacute bacterial endocarditis (risk of embolism), large malignancies (risk of bleeding in the central necrosed area of the tumour), tuberculosis (risk of hemoptysis). 4. Ocular and neurosurgery, lumbar puncture. 5. Chronic alcoholics, cirrhosis, renal failure. 6. Aspirin and other antiplatelet drugs should be used very cautiously during heparin therapy. Ref:- kd tripathi; pg num:-619 | train | med_mcqa | null |
The optimum calories to be provided by proteins should be | [
"5-10%",
"10-15%",
"15-20%",
"20-30%"
] | B | The main source of energy in the diet is carbohydrates derived largely from cereals and provide 50-80% of daily intake. Most families derive 10-12% of energy from proteins. Energy from fats may vary from 5-30%.Ref: Park; 23rd ed; Pg 634 | train | med_mcqa | null |
All are components of gun-powder except - | [
"Charcoal",
"Lead peroxide",
"Potassium nitrate",
"Sulphur"
] | B | null | train | med_mcqa | null |
Hatter's shake is seen in | [
"Phosphorus poisoning",
"Mercury poisoning",
"Arsenic poisoning",
"Lead poisoning"
] | B | Ans. is 'b' i.e., Mercury poisoning * Metallic mercury (para or quick silver) is not poisonous on ingestion, as it is not absorbed. But its vapours are poisonous. Mercuric compounds being soluble are more poisonous than mercurous compounds. Mercuric chloride (HgCl2), also called corrosive sublimate or perchloride of mercury, is most poisons salt of mercury.* Acute poisoning presents with syncope, convulsions general instability and nephrotoxicity (proximal tubular). The mouth, tongue and fauces become corroded and appears grayish white.* Signs and symptoms of chronic mercury poisoning are :1) Excessive salivation, metallic taste, loosening of teeth, and blue black lining on gums (similar to lead poisoning).2) Diphtheria like membranous colitis and dysentery.3) Anorexia, insomnia, sweating, nausea, irritability and photophobia.4) Special features are : i) Mercuria lentis: Brownish deposition of mercury on anterior lens capsule.ii) Tremors : There are moderately coarse, intentional tremors starting in fingers and hands, and legs. They are also called Danbury tremors or hatter's shake or glass blower's shake. In severe form, patient becomes unable to dress, write or walk, i.e. concussion mercurialis (shaking palsy).iii) Erethism (neuropsychiatric changes): The personality disturbance is characterized by shyness, irritability, tremors, loss of memory and insomnia. There may be depression, delusion, hallucination and MDP (mad hatter).iv) Acrodynia (Pink disease): This is idiosyncratic hypersensitivity reaction with a generalized pinkish rash described as 5P : pinkish, puffy, painful, paraesthesia hands and peeling of skin.v) Minimata disease: It is due to organic mercury poisoning due to eating fish poisoned by mercury.vi) Membranous glomerulopathy. | train | med_mcqa | null |
The most sensitive test for the diagnosis of myasthenia gravis is - | [
"Elevated serum ACH-receptor binding antibodies",
"Repetitive nerve stimulation test",
"Positive edrophonium test",
"Measurement of jitter by single fibre electromyography"
] | C | null | train | med_mcqa | null |
Follow is the marker of HIV infection in blood - | [
"Reverse Transcriptase",
"DNA polymerase",
"RNA polymerase",
"None"
] | A | viral replicatin(indicate infectivity) detected by demonstration of reverse transcriptase REF:MICROBIOLOGY ANANTHA NARAYANAN NINTH EDITION PAGE.578 | train | med_mcqa | null |
A pregnant woman who has a lactase deficiency and cannot tolerate milk in her diet is concerned that she will not be able to produce milk of sufficient caloric value to nourish her baby. The best advice to her is which one of the following? | [
"She must consume pure galactose in order to produce the galactose moiety of lactose.",
"She will not be able to breastfeed her baby because she cannot produce lactose.",
"The production of lactose by the mammary gland does not require the ingestion of milk or milk products.",
"She can produce lactose directl... | C | The woman will be able to breastfeed her baby because she can produce lactose from amino acids and other carbohydrates. She will not have to eat pure galactose, or even lactose, to do so. Glucose, which can be provided by gluconeogenesis or obtained from the diet, can be converted to UDP-galactose (glucose-glucose-6-phosphate-glucose-1-phosphate-UDP-glucose-UDP-galactose). UDP-galactose reacts with free glucose to form lactose. a-Lactalbumin is a protein that serves as the modifier of galactosyl transferase, which catalyzes this reaction. The amino acids of a-lactalbumin can be used to produce glucose, but the immediate products of a-lactalbumin degradation are not lactose. Carbohydrates cannot be synthesized from fats. | train | med_mcqa | null |
In children the most frequently missing permanent teeth are: | [
"First premolars",
"Second premolars",
"Max. Lateral incisors",
"Mandibular lateral incisors"
] | C | null | train | med_mcqa | null |
The best investigation for parameningeal rhabdomyosarcoma: | [
"CSF cytology",
"MRI",
"CECT",
"SPELT scan"
] | B | Ans. MRI | train | med_mcqa | null |
Which intubation is preferred in case of bilateral mandibular fractures ? | [
"Orotracheal intubation",
"Naso tracheal intubation",
"Cricothyrotomy",
"Submental intubation"
] | B | Answer- B. Naso tracheal intubationTime of surgery should be carefully planned allowing reduction of tissue edema and avoiding development of malunion. Nasal intubation is the choice of intubation by surgeon, providing them with free access to operating field. Blind awake nasal intubation is safe and simple with some experience in difficult airway. | train | med_mcqa | null |
Citrovorum factor is given along with all the drugs except | [
"Methotrexate",
"Pemetrexed",
"Pyrimethamine",
"Cytosine arabinoside"
] | D | Citrovorum factor or rescue factor or folinic acid -active form of folic acid is given along with antifolate drugs like Methotrexate, pemetrexed,pyrimethamine, cotrimoxazole,5 fluorouracil.Ref: Tripati 6thed.Pg : 592 | train | med_mcqa | null |
The following is a regulatory protein of muscle | [
"Actin",
"Myosin",
"Troponin",
"All"
] | C | Troponin and tropomyosine are the regulatory proteins of the muscle Ref:Guyton and Hall textbook of medical physiology 12th edition, page number:89 | train | med_mcqa | null |
A person of 35 years is having firm belief about infidelity involving the spouse. And he never allow her to go out of home alone. He often locks his house, while going office. Inspite of all this he is persistantly suspicious about her character. The probable diagnosis is - | [
"Schizophrenia",
"Delusional parasitosis",
"Clerambault's syndrome",
"Othello syndrome"
] | D | When the content of delusions is predominantly jealousy (infidelity) involving the spouse, it is called as othello syndrome or conjugal paranoia. | train | med_mcqa | null |
All are derived from 1st pharyngeal pouch except: | [
"Auditory tube",
"Tympanic antrum",
"Tubotympanic recess",
"Middle ear cavity"
] | C | null | train | med_mcqa | null |
Atomoxetine is used for ? | [
"Nocturnal enuresis",
"ADHD",
"Temper tantrums",
"Patent ductusaeriosus"
] | B | Ans. is 'b' i.e., ADHD Atomoxetine it is selective norepinephrine reuptake inhibitor and is approved for use in ADHD. It is indicated in children > 6 years and in adults with concentration and attention problems. Atomoxetine absorbed orally, hydroxylated by CYP2D6 and excreted in urine, mainly as glucuronide. While majority of individuals are extensive metabolizers (EM), few are poor metabolizers (PM) due to polymorphism of CYP2D6. Inhibitors of CYP2D6 like fluoxetine, paroxetine, quinidine increase concentration and toxicity of atomoxetine. It should not be given with MAO inhibitors and is contraindicated in glaucoma. | train | med_mcqa | null |
Blood pressure in right ventricle | [
"25 mmHg",
"80 mmHg",
"95 mmHg",
"120 mmHg"
] | A | Peak pressures in theright ventricles is about 25 mm HgRef: Ganong's Review of Medical Physiology Twenty-Third Edition Page No:508 | train | med_mcqa | null |
While working in a neonatal ICU. Your team delivers a preamature infant at 27 weeks of gestation and weighing 1500gm. How soon will you request fundus examination by an ophthalmologist? | [
"Immediately",
"3 – 4 weeks after delivery",
"At 34 weeks gestational age",
"At 40 weeks gestational age"
] | C | All babies weighing less than 1.5 kg at birth or having a gestation period of less than 32 weeks should be screened with indirect ophthalmoscopy for retinopathy of prenaturity, between 32 and 36 weeks post conception. | train | med_mcqa | null |
Analgesic effect of paracetamol is mediated by action on which of the following receptor? | [
"NK 1",
"BK 1",
"Px23",
"TRPV 1"
] | D | PCM uses - Fever Pain Not for inflammation Peroxide:- Presence of peroxide at inflammation site inactivate PCM. COX3 inhibitor :- Presence of COX3 in brain, therefore fever and pain can be treated with PCM. Vanilloid receptor:-Metabolites of PCM binds with vanilloid receptor to produce analgesia. Transient Receptor Potential vanilloid 1:TRPV 1 | train | med_mcqa | null |
All of following features are similar in androgen insensitivity syndrome and Mullerian agenesis except | [
"Absent Mullerian duct",
"Absent Wolffian duct",
"Primary amenorrhea",
"Normal axillary hair"
] | D | Public and axillary hair is absent in androgen insensitivity syndrome, whereas normal in mullerian agenesis. | train | med_mcqa | null |
Which of the following has autosomal dominant inheritance – | [
"Best's disease",
"Gyrate atrophy",
"Laurence Moon Biedl syndrome",
"Bassen–Kornzweig disease"
] | A | Best's disease is extremely rare form of macular dystrophy. It is autosomal dominantly inherited.
All other options are autosomal recessive inherited. | train | med_mcqa | null |
Foetal alcohol syndrome comprises of | [
"Microcephaly",
"Deafness",
"Sho palpebral fissure",
"All of the above"
] | D | Features of foetal alcohol syndrome Growth retardation Microcephaly Small palpebral fissure Smooth philtrum Thin upper lip Increased risk of both sensorineural and conductive deafness. Ref: Nelson's , 20th edition, page 2813,. 896 | train | med_mcqa | null |
Benzopyrene change to carcinogen in animal occurs due to all except - | [
"Epoxide formation",
"p53 activation",
"Cytochrome C activation",
"By inducing metabolism of cyt p450"
] | C | . Cytochrome C activation | train | med_mcqa | null |
All are TRUE about Mammography, EXCEPT: | [
"Low energy X rays are used",
"It is a screening and diagnostic tool",
"High positive predictive value",
"Specificity of mammography is 95%"
] | C | Mammography has a relatively low positive predictive value and result in high percentage of biopsy results negative for malignant growth. Mammography is widely used as a screening test for early identification of breast cancer. It is the most effective method for the detection of calcifying early stage breast cancer and has a high sensitivity for the detection of suspicious masses in fatty and fibroglandular breast tissue. Low energy X rays used in mammography produces high contrast images that differentiate normal breast tissue from possible abnormalities. It has a high specificity of 90-95%. | train | med_mcqa | null |
Human anatomical waste is put in: March 2007 | [
"Yellow",
"Red",
"Blue",
"Black"
] | A | Ans. A: Yellow Colour coded biomedical waste bags ? Yellow plastic bags for human anatomical, animal, microbiological and soiled waste. Red disinfected container or plastic bags microbiological waste, solid waste (IV tubes, catheters, etc.) -Blue or White plastic bag or puncture proof containers sharps, disposable tubings, etc . - Black Plastic bag or puncture proof containers discarded medicines, incineration ash, chemical waste. | train | med_mcqa | null |
A drug is more likely to cause toxicity in elderly patients due to all of the following reasons EXCEPT: | [
"decreased renal excretion of drugs",
"decreased hepatic metabolism",
"increased receptor sensitivity",
"decreased volume of distribution"
] | D | Ans. is 'd' ie decreased volume of distribution Volume of distribution is increased with aging. This leads to decreased elimination of the drug and hence increased toxicity.Other changes seen with aging which lead to increased toxicity of drugsincreased sensitivity of the target organs*decreased renal excretion of drugs *decreased hepatic metabolism of drugs*body mass is decreased* | train | med_mcqa | null |
Which of the following inhibits oxidative phosphorylation by inhibiting the transpo of ADP into and ATP out of the mitochondrion? | [
"Atractyloside",
"2,4-dinitrophenol",
"Carbon monoxide",
"Rotenone"
] | A | Atractyloside inhibits oxidative phosphorylation by inhibiting the transpoer of ADP into and ATP out of the mitochondrion. Reference: Harper; 30th edition; Page no: 132 | train | med_mcqa | null |
Antidepressant, which is selective 5HT reuptake inhibitor is: | [
"Fluoxetine",
"Imipramine",
"Desipramine",
"Amitriptyline"
] | A | Ans. is 'a' Fluoxetine Fluoxetine is a selective serotonin reuptake inhibitors Other selective serotonin reuptake inhibitor are:- Fluvoxamine* Paroxetine* | train | med_mcqa | null |
Depigmenting agent of choice in in treatment of dermatological disorders is | [
"Hydroquinone",
"Zinc",
"Kojic acid",
"Azelaic acid"
] | A | Ans. is 'a' i.e., Hydroquinone Skin depigmenting agents in clinical use are Hydroquinone - most effective and widely used Kojic acid Kojicdipalmitate Azelaic acid | train | med_mcqa | null |
Which is the intravenous anesthetic agent contributing in good analgesia:- | [
"Thiopentone",
"Propofol",
"Etomidate",
"Ketamine"
] | D | Ketamine produces very good analgesia. Ketamine can be used to reduce post operative pain as it produces profound analgesia. It inhibits nociceptive central hypersensitization. Besides, ketamine may be effective in the treatment of cancer pain, chronic neuropathic pain, phantom limb pain, fibromyalgia, complex regional pain syndrome, visceral pain, and migraine. | train | med_mcqa | null |
Asepsis means - | [
"Absence of pathogenic microbes",
"Disinfection of the surface",
"Prevention of infection",
"Destroying all forms of micro organism"
] | A | null | train | med_mcqa | null |
Which of the following is false regarding Oral Polio Vaccine (OPV)? | [
"Residual neuro-paralysis is a complication",
"It is a killed vaccine",
"Requires sub- zero temperature for storage long term",
"Induces intestinal and humoral immunity"
] | B | null | train | med_mcqa | null |
Which of the following fibers restrict extrusion of tooth in orthodontics: | [
"Alveolar crest",
"Oblique",
"Apical",
"Horizontal"
] | A | null | train | med_mcqa | null |
Acute pancreatitis causes all of the following except: March 2005, March 2013 (g) | [
"Hypercalcemia",
"Increased amylase level",
"Subcutaneous fat necrosis",
"Hyperlipidemia"
] | A | Ans. A: Hypercalcemia Complications of acute pancreatitis: Intra-abdominal: Pancreatic "collections": Phlegmon Pseudocyst Abscess Necrosis Intestinal: Paralytic ileus Gastrointestinal haemorrhage - from stress ulceration, gastric varices due to splenic vein obstruction, or rupture of pseudoaneurysm Necrotising obstruction or fistulisation of colon - Hepatic - obstructive jaundice due to oedematous narrowing of common bile duct - Renal - hydronephrosis and hydroureter of right kidney due to peripancreatic inflammation in perirenal space - Spleen - rupture or haematoma, from spread of peripancreatic inflammation Systemic complications range from minor pyrexia to rapidly fatal, multiple organ-system failure. They include: - Circulatory shock - kinin activation, haemorrhage - Disseminated intravascular coagulation - Respiratory insufficiency: Mild e.g. hypoxaemia, atelectasis, pleural effusion Severe e.g. adult respiratory distress syndrome - Acute renal failure - Metabolic: Hypocalcaemia Hyperglycaemia / diabetes mellitus Hyperiglyceridaemia - Pancreatic encephalopathy - confusions, delusions, coma - Retinal aeriolar obstruction causing sudden blindness Puscher's retinopathy - Metastatic fat necrosis A serum level three to four times above normal serum amylase level, is indicative of acute pancreatitis, but a normal level does not exclude the disease. | train | med_mcqa | null |
Radiotherapy is Rx of choice for: | [
"Nasopharyngeal Carcinoma T3N1",
"Supraglottic Carcinoma T3NO",
"Glottic Carcinoma T3N1",
"Subglottic Carcinoma T3NO"
] | A | A i.e. Nasopharyngeal Carcinoma T3N1 Radiotherapy is the standard treatment of nasopharyngeal carcinomaQ, as surgery is not fesibleQ. Patient with advanced disease also receive concurrent chemotherapy. Radical Radiotherapy is preferred treatment for early supraglottic carcinomas (i.e. small (< 6m1) tumor mass and absence of cailage invasion). In unourable conditions voice preserving supraglottic laryngectomy (surgery) is preferred. Tumors involving the true vocal cords or cailage are treated with supracricoid laryngectomy & for advanced tumors total laryngectomy is required. Cord fixation is an indirect evidence of cricoarytenoid joint involvement. It upstages the tumor to T3 and precludes voice preserving surgery in all laryngeal cancers. Radiotherapy is preferred modality for definitive treatment of early glottic carcinoma (T2 NO) as it allows voice preservation. Hemilaryngectomy is the usual surgical procedure in early glottic cancers and supracricoid laryngectomy is performed if there is imaging evidence of invasion of anterior or posterior commissure, contra lateral true vocal cord, false vocal cord or parglottic fat invasion. | train | med_mcqa | null |
Substrate level phosphorylation in TCA cycle is in step? | [
"Isocitrate dehydrogenase",
"Malate dehydrogenase",
"Aconitase",
"Succinate thiokinase"
] | D | ANSWER: (D) Succinate thiokinaseREF: Murray pp 130-135, Scriver, pp 1521-1552, http://en.wikipedia.org/wiki/Substratelevel_ phosphorylationSubstrate-level phosphorylation is a type of metabolism that results in the formation and creation of adenosine triphosphate (ATP) or guanosine triphosphate (GTP) by the direct transfer and donation of a phosphoryl (PO3) group to adenosine diphosphate (ADP) or guanosine diphosphate (GDP) from a phosphorylated reactive intermediate. Note that the phosphate group does not have to directly come from the substrate. By convention, the phosphoryl group that is transferred is referred to as a phosphate group.Once the pyruvate product of glycolysis is moved to the mitochondrial matrix, the pyruvate is converted to acetate and binds Coenzyme A to form Acetyl CoA to enter the Krebs cycle. While the Krebs cycle is oxidative respiration, one more instance of substrate-level phosphorylation occurs as Guanosine triphosphate (GTP) is created from GDP by transfer of a phosphate group during the conversion of Succinyl CoA to Succinate. This phosphate is transferred to ADP in another substrate-level phosphorylation event. The reaction is catalyzed by the enzyme Succinyl- CoA synthetase.A molecule of guanosine triphosphate is synthesized from guanosine diphosphate and phosphate at the cost of hydrolyzing succinyl-CoA to succinate and CoA. This constitutes substrate-level phosphorylation, and, in contrast to oxidative phosphorylation, this is the only reaction in the citric acid cycle that directly yields a high-energy phosphate bond. The sequence of reactions from a ketoglutarate to succinate is catalyzed by the a ketoglutarate dehydrogenase complex and succinyl-CoA synthetase, respectively. Succinate thiokinase is the only enzyme that generates ATP directly by substrate-level phosphorylation.a ketoglutarate + NAD+ + acetyl-CoA - succinyl-CoA + CO2 + NADHsuccinyl-CoA + Pi + GDP - succinate + GTP + acetyl-CoA | train | med_mcqa | null |
Which of the following are alkylating agents: | [
"Cyclophosphamide",
"Ifosfamide",
"Paclitaxel",
"Methotrexate"
] | A | ALKYLATI NG AGE NTS These compounds produce highly reactive carbonium ion intermediates which transfer alkyl groups to cellular macromolecules by forming covalent bonds. The position 7 of guanine residues in DNA is especially susceptible, but other molecular sites are also involved. Alkylation results in cross linking/ abnormal base pairing/ scission of DNA strand. Cross linking of nucleic acids with proteins can also take place. >Mechlorethamine (Mustine HCL) >Cyclophosphamide >Ifosfamide >Chlorambucil >Melphalan >Thio-TEPA >Busulfan >Nitrosoureas >Dacarbazine(DTIC) ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:821,822 | train | med_mcqa | null |
Cause of unilateral dysmenorrhea | [
"One horn of malformed uterus",
"Endometriosis with unilateral distribution",
"Small fibroid at the utero tubal junction",
"All of the above"
] | D | Causes of unilateral dysmenorrhea : One horn of malformed uterus Endometriosis with unilateral distribution Small fibroid at the utero - tubal junction. Ovarian dysmenorrhea Right ovarian vein syndrome Colonic or caecal spasm. REF : gynecology book of shaw 17th | train | med_mcqa | null |
Features of Chronic mountain sickness are all except | [
"Hyperventilation",
"Increase erythropoietin",
"Increase in HCO3 excretion",
"Decrease in mitochondria"
] | D | Chronic mountain sickness: - - Occasionally, a person who remains at high altitude for too long experience chronic mountain sickness, in which the following effect occur- The red blood cell mass & hematocrit become exceptionally high due to chronic hypoxia (| in erythropoietin). The pulmonary aerial pressure become elevated due to | blood viscosity. The right side of hea become greatly enlarged as a result of pulmonary hypeension. The peripheral aerial pressure fall. Congestive hea failure ensues. Death often follow unless the person is moved to lower altitude. | train | med_mcqa | null |
Which of the following immune hypersensitivity reaction is resonsible for Myasthenia Gravis ? | [
"Type I Hypersensitivity",
"Type II Hypersensitivity",
"Type III Hypersensitivity",
"Type IV Hypersensitivity"
] | B | Ans. is `b' i.e., Type II Hypersensitivity o Myasthenia Gravis is an example of Type II Hypersensitivity reaction. | train | med_mcqa | null |
An 8-year-old boy presents with headaches, dizziness, and malaise approximately 2 weeks after a severe sore throat. His mother describes puffiness of his face and darkening of his urine. She also notes that her son is passing less urine and that he is becoming increasingly short of breath. On physical examination, there is anasarca, hypertension (190/130 mm Hg), and tachycardia. The urine is scanty and brownish red. Urinalysis shows 3+ proteinuria. Microscopic examination of the urine discloses numerous RBCs, as well as occasional granular and red cell casts. A renal biopsy is stained by direct immunofluorescence microscopy for complement C3, and the results are shown. Which of the following is the most likely cause of acute postinfectious glomerulonephritis in the patient? | [
"Escherichia coli",
"Epstein-Barr virus",
"Group A (b-hemolytic) streptococci",
"Klebsiella sp."
] | C | Acute postinfectious glomerulonephritis is an immune complex disease of childhood, which occurs after an infection with group A (b -hemolytic) streptococci and is caused by the deposition of immune complexes in glomeruli. Occasional examples are caused by staphylococcal infection (e.g., acute staphylococcal endocarditis, staphylococcal abscess), and rare cases result from viral (e.g., hepatitis B) or parasitic (e.g., malaria) infections. The primary infection involves the pharynx or, in hot and humid environments, the skin. In recent years, the proportion of cases of acute postinfectious glomerulonephritis caused by staphylococcal infection (choice E) has been increasing.Diagnosis: Nephritic syndrome, acute postinfectious glomerulonephritis | train | med_mcqa | null |
Poly(A) tail translates into (i.e. on translation give rise to): | [
"Polyproline",
"Polylysine",
"Polyalanine",
"Polyglycine"
] | B | B i.e. PolylysineCodonAAAGGGCCCTTT/ UUUTranslation productLysinQGlycineProlinePhenylalanine | train | med_mcqa | null |
Not seen in Marfans syndrome | [
"Scoliosis",
"Hyperlaxity",
"Pes planus",
"Hypospadias."
] | D | null | train | med_mcqa | null |
False regarding croup is ? | [
"Disease include epiglottis, laryngitis, laryngotrachictis",
"Brassy cough is main presenting feature",
"Causes upper airway obstruction",
"All of above"
] | C | Ans. is 'c' i.e., Causes upper airway obstruction Croup is variety of condition which include acute epiglottis, laryngitis, trachiobronchitis. Infection of lower respiratory tract. Brassy cough main presenting feature. Treatment Humidified I.V. fluid Antibiotics Nebulisation Steroid. | train | med_mcqa | null |
The chief advantage of zinc phosphate cement is its: | [
"Good compressive strength",
"Film thickness",
"Lack of irritation",
"Low solubility"
] | B | Film thickness
The smaller the particle size, less is the film thickness. The thickness is lesser than the size of the particles because, during mixing the particles are crushed and dissolved. The thickness can also be reduced by applying pressure on the casting during seating.
This is the chief advantage of zinc phosphate.
Ref- Manapallil 3rd ED P:92 | train | med_mcqa | null |
The immediate treatment of 10 kg weight infants presented with tetany – | [
"IV Diazepam",
"IV calcium gluconate with cardiac monitoring",
"IV slow phenobarbitone",
"Wait and watch"
] | B | null | train | med_mcqa | null |
MRFIT clinical trial for CHD was conducted in which country? | [
"USA",
"Finland",
"Norway",
"UK"
] | A | - The Multiple Risk Factor Intervention Trial (MRFIT) was one of the coronary hea disease prevention trials recommended to the National Hea and Lung Institute in 1971 as an alternative to a national single-factor dietary trial, which was judged to be infeasible. - MRFIT carried out in USA was aimed at high risk adult males aged 35-57 years. | train | med_mcqa | null |
All of the following occur in pregnancy EXCEPT | [
"Increase in Cardiac output",
"Increase in stroke volume",
"Decrease in fibrinogen levels",
"Rise in the venous pressure in the lower limb in supine position"
] | C | (C) Decrease in fibrinogen levels # PHYSIOLOGICAL CHANGES ASSOCIATED WITH PREGNANCY:> Blood Volume increases progressively from 6-8 weeks gestation (pregnancy) and reaches a maximum at approximately 32-34 weeks with little change thereafter.> Renal plasma flow and glomerular filtration rate begin to increase progressively during the first trimester.> Increases in blood volume and cardiac output.> Elevations in plasma flow and glomerular filtration result in an elevation in creatinine clearance.> Blood urea and serum creatinine are reduced by 40%.> here is also an increase in filtered sodium, but tubular absorption is increased by an increase in aldosterone secretion, via the renin-angiotensin meChanism.There is also a decrease in plasma osmolality.# RBC & Haemoglobin: RBC volume is increased to the extent of 20-30%. Total increase in volume is about 350ml; the amount to be regulated by the increased demand of oxygen transport during pregnancy. Disproportionate increase in plasma and RBC volume produces a state of haemodilution during pregnancy. Thus, even though the total haemoglobin mass increases during pregnancy to the extent of 18-20 percent, there is apparent fall in haemoglobin concentration. At term the fall is about 2 gm5 from the non-pregnant value. There is simultaneous fall in number of red cells by 15-20% and the hematocrit level.# Blood changes in Pregnancy: Blood volume +30-40% Plasma volume + 40-50% RBC volume +20-30% Hb+18-20% Hematocrit Diminished. Changes in blood coagulation factors: Platelets Static or-15% Fibrinogen + 50% ESR 4 times increases | train | med_mcqa | null |
The etiology of anterior ethmoidal neuralgia is: | [
"Inferior turbinate pressing on the nasal septum",
"Middle turbinate pressing on the nasal septum",
"Superior turbinate pressing on the nasal septum",
"Causing obstruction of sphenoid opening"
] | B | Sluder's neuralgia or the anterior ethmoidal syndrome is pain around the bridge of the nose radiating into the forehead. It is said to originate from the middle turbinate (pa of ethmoid bone) pressing on the deted septum. This is a rare cause of headache and also k/a contact point headache. | train | med_mcqa | null |
Which of the following drug is used for medical treatment of gall stones | [
"Clemastine fumarate",
"Mizolastine",
"Lovastatin",
"Ursodeoxycholic acid"
] | D | Dissolution therapy for asymptomatic cholestrol stones can be done with ursodeoxycholic acid,which is a bile acid that dissolves cholesterol. | train | med_mcqa | null |
An 18-year-old male presented with acute onset descending paralysis after 3 days of intake of canned food. There is also a history of blurring of vision for the same duration. On examination, the patient has quadriparesis with areflexia. Both the pupils are nonreactive. The most probable diagnosis is | [
"Tetanus",
"Botulism",
"Poliomyelitis",
"Gullian Baree syndrome"
] | B | The above clinical scenario is suggestive of botulism. Points in or of botulism: History of intake of canned food, descending paralysis, history of blurred vision, quadriparesis (flaccid paralysis), areflexia, and non-reactive pupils. Tetanus causes spastic paralysis. Guillain-Barre syndrome usually associated with ascending flaccid paralysis. Polio-Weakness is generally asymmetric, is proximal more than distal, and may involve the legs (most commonly); the arms;or the abdominal, thoracic, or bulbar muscles. Reference: Ananthanarayan and Paniker&;s Textbook of Microbiology Tenth edition | train | med_mcqa | null |
Which of the following is the odd one? | [
"Dhat syndrome",
"Run amok",
"Koro",
"Briquet syndrome"
] | D | Briquet syndrome is the older name for somatoform disorder. The other three mentioned as choices are all examples of culture bound syndromes. Name of the culture bound syndrome Impoant feature Dhat syndrome Preoccupation with discharge of semen and loss of vitality Koro Preoccupation with shrinking and possible disappearance of penis Latah Sudden stimuli (commonly loud noise) can present with automatic obedience, echolalia, and echopraxia Run amok Episode of extreme rage and violence, with significant possibility of damage to other individuals and propey | train | med_mcqa | null |
Hypersensitivity vasculitis is seen most commonly in - | [
"Post capillary venules",
"Arterioles",
"Veins",
"Capillaries"
] | A | Pathology hypersensitivity vasculitis
In hypersensitivity vasuculitis, postcapillary venules are the most commonly involved vessels, capillaries and arterioles are involved less frequently.
It is primarily a disease of small vessels.
It is characterized by leukocytoclasis, a term that refers to the nuclear debris remaining from the neutrophils that have infiltrated in and around the vessels during the acute stages. | train | med_mcqa | null |
CIN III progresses to carcinoma in how many % of cases: | [
"25%",
"5%",
"0%",
"60%"
] | A | CIN: Cervical intraepithelial neoplasia-part or whole of thickness of cervical squamous epithelium is replaced by cell of varying degress of atypia
CIN: Microinvasive carcinoma- invasive carcinoma cervix (over several years)
Mostly asymptomatic, diagnosed by routine screening done yearly after a women become sexually active. If 3 consecutive smears normal in a low risk woman do once in 3 years
CIN I-Abnormality in lower 1/3rd of epithelium
CIN II-Abnormality in lower 2/3rd of epithelium
CIN III-Abnormality in >2/3rd of epithelium
High risk factor--
Age <18 yr at initiation of coitus
Multiple sex partners, husband with multiple parteners
HPV infection
High oncogenic risk-type 16, 18, 31, 45, 56
Low oncogenic risk-type 6, 11
CMV, HSV II infection
Smoking
Poor socioeconomic status
Aneuploid lesion
Oral contraceptive use. | train | med_mcqa | null |
Choanal atresia is most commonly due to- | [
"Presence of gingivonasal covering",
"Presence of bucconasal membrane",
"Congenital infection",
"Due to respiratory distress at birth"
] | B | Ans. is 'b' i.e., Presence of bucconasal membrane Choanal atresiao Choana, also called posterior nares, is an opening in the posterior part of each nasal cavity, through which nasal cavity communicates with nasopharynx.o Choanal atresia is a congenital anomaly characterized by closure of one or both posterior nasal cavities (i.e., choana). It is due to persistence of bucconasal membran.o Approximately 60- 70% of cases are unilateral and are more common on right side.o Bilateral cases occurs in 20-30% of patients and 50% of these patients are associated with other congenital anomaly, i.e., CHARGE syndrome - Coloboma, Heart defects, Choanal atresia, Retraded growth, Genitourinary abnormalities and Ear defects.Diagnosiso Unilateral lesions go unnoticed until the child presents with persistent unilateral nasal discharge. There is absence of air bubbles in nasal discharge. A simple test for unilateral choanal atresia is to have the child attempt nose blowing with opposite nostril occluded by external pressure. Failure to detect any air movement is suspicious for complete obstruction.o Bilateral choanal atresia presents as respiratory distress in newborn and requires support immediately after birth.o CT scan is the preferred imaging modality | train | med_mcqa | null |
During development, the pas of ear develops at different intervals. All of the following are of adult size at bih, EXCEPT ? | [
"Oval window",
"Ear Ossicles",
"Middle ear cavity",
"Maxillary antrum"
] | D | Maxillary antrum reaches adult size by 15 yrs of age. At bih all three ossicles are of adult size and shape. Malleus and incus grow to adult size by 15 weeks and stapes by 18 weeks. The middle ear cavity is approximately adult sized at bih, as are the oval window, round window. Ref: Pediatric Otolaryngology, Volume 1, By Cuneyt M. Alper, Ellis M. Arjmand, Sylvan E. Stool, Margaretha L. Casselbrant, 2003, Page 134. | train | med_mcqa | null |
Glomus cells are derived from ? | [
"Surface ectoderm",
"Neuroectoderm",
"Mesoderm",
"Endoderm"
] | B | Glomus cells are derived from neural crest which itself is derivative of neuroectoderm. Other derivates of neural crest are? a) Neural derivatives Sensory neurons of spinal dorsal root ganglia. Sympathetic chain ganglia and plexus (celiac/preaoic/renal ganglia, enteric plexus in GIT, i.e. Auerbachs and Meissner's) Parasympathetic ganglia and plexus of GIT. Schwann cells of peripheral nerves, satellite cells of all ganglia. Adrenal medulla, chromaffin cells, para follicular C-cells of thyroid gland. Melanocytes and melanoblasts. b) Mesenchymal derivatives Dermal bones of skull : Frontal, parietal, temporal, nasal, vomer, palatine, mandible, maxillae. Leptomeninges : arachnoid and pia mater (Durameter is mesodermal). Dentine of teeth (odontoblasts). Eye : choroid, sclera, iris epithelium, pupillary muscles (sphincter and dilator pupillae, ciliary muscles). Pharyngeal arch cailages. Retinal pigmented epithelium. Connective tissues of head including dermis, tendon, ligaments. Bulbar and conal ridges of hea. | train | med_mcqa | null |
Nasal cycle is the cyclical alternate nasal blockage occurring: | [
"Every 6-12 hours",
"Every 4- 12 hours",
"Every 6-8 Hours",
"Every 12-24 hours"
] | C | Ans. C every 6-8-hours Nasal cycle: The alternate opening and closing of each side of nose is called nasal cycle - Kayser first described nasal cycle in 1895 - There is rhythmic cyclical congestion and decongestion of nasal mucosa - Nasal cycle varies every 2Y2-4 hrs and is characteristic of an individual. Note The closest answer here is 6-8 hours, hence it is being marked as the correct answer. | train | med_mcqa | null |
A 56-year-old man with 14-year history of diabetes mellitus presents with poor vision, peripheral vascular disease, and mild proteinuria. Which of the following is best monitor of control of blood sugar levels in this patient? | [
"Glycosylated hemoglobin",
"Islet cell autoantibody",
"Serum myoinositol",
"Serum sorbitol"
] | A | - Glycemic control is assessed clinically by measuring percentage of glycosylated hemoglobin, known as HbA1C -HbA1C Formed by nonenzymatic addition of glucose moieties to hemoglobin in red cells & is irreversible. Best monitor for glycemic control. Measure of glycemic control over long periods of time (2-3 months) Relatively unaffected by day-to-day variations. ADA recommends maintenance of HbA1C levels at less than 7% to reduce risk for long-term complications. | train | med_mcqa | null |
which of the SSRi is used in the management of panic disorder | [
"paroxetine",
"seraline",
"trazadone",
"escitalopram"
] | A | SSRI * IMPOANCE Most widely prescribed antidepressant * MECHANISM Specifically acts on serotonin transpoers and increases serotonin in synapse. DRUGS FLUOXETINE FLUVOXAMINE DAPOXETINE CITALOPRAM ESCITALOPRAM ESCITALOPRAM SERALINE PAROXETINE USE FLUOXETINE=============CHILDHOOD DEPRESSION FLUVOXAMINE===========OCD DAPOXETINE==============PME ESCITALOPRAM===========HEA SAFE, PATHOLOGICAL EMOTIONS PAROXETINE=========SEDATING, PANIC DISORDER IMPULSE CONTROL DISORDERS PME PARAPHILIA SIDE EFFECTS Paradoxical SUICIDE, this is a type of suicide where an antidepressant used to treat depression and decrease suicide increase the chance of suicidal attempt ( IT'S A PARADOX). The explanation that is given is SSRI initially activates the patient and decreases fatigue, thus patients with low mood and suicidal ideas will have more energy to act on the ideas. GIT- thus it should not be given in an empty stomach SD- delays ejaculation. This mechanism is used for its prescription in patients with premature ejaculation ANXIETY INSOMNIA Ref, kaplon and sadock, synopsis of psychiatry, 11 th edition, 955 | train | med_mcqa | null |
In a rape indence occurred in child of 5yrs the hymen is | [
"Ruptured because it is thin",
"Ruptured because it is situated superficially",
"Don't rupture because it is thick and elastic",
"Dont rupture because it is situated deeply"
] | D | ref : narayana reddy | train | med_mcqa | null |
All are causes of granular contracted kidneys,except- | [
"Benign nephrosclerosis",
"Diabetes mellitus",
"Chronic PN",
"Chronic GN"
] | B | null | train | med_mcqa | null |
All of the following may precipitate digitalis toxicity except : | [
"Hypocalcemia",
"Hypokalemia",
"Hypomagnecemia",
"Hypothyroidism"
] | A | Answer is A (Hypocalcemia) Calcium synergizes with digitalis and precipitates its toxicity. Thus digitalis toxicity is associated with hypercalcemia and not hypocalcemia Also Remember: Digitalis does not cause Hypokalemia Q but Hypokalemia enhances digitalis toxicity e - Digitalis toxicity causes Hyperkalemia e-Harrison - Hypokalemia enhances digitalis toxicity (by increasing its binding to Na+/K+ ATPase Q Both Hypehyroidism and Hypothyroidism enhance digitalis toxicity - Thyrotoxicosis : patients are more prone to develop digitalis arrhythmia. Q - Myxoedema : enhances responsiveness. These patients eliminate digoxin more slowly. e - Magnesium depletion (hypomagnesimia) may reduce tolerance to digitalis Q | train | med_mcqa | null |
Major portion of auricle is supplied by: | [
"Greater auricular nerve",
"Lesser occipital nerve",
"Facial nerve",
"Auriculotemporal nerve"
] | A | Ans. (a) Greater auricular nerveRef: Dhingra's ENT 6th ed/4* Greater auricular nerve has major contribution of auricle. It supplies major portion on lateral aspect as well as on the medial aspect. | train | med_mcqa | null |
The ratio of fat cells and blood cells in bone marrow is- | [
"1:04",
"1:02",
"1:01",
"2:01"
] | C | Fat to Cell ratio - in bone marrow should be 1:1 so 1/2 hemopoietic cells and 1/2 are fat cells myeloid: erythroid ratio -in bone marrow -should be 3:1 -an increased ratio is found in infections, chronic myelogenous leukemia, or erythroid hypoplasia. | train | med_mcqa | null |
A 44 year old man goes to his physician for an employment physical examination. The clinician notices that the patient's fingers are clubbed. He also demonstrates tenderness over the distal ends of the radius, ulna, and fibula. This patient should be explicitly evaluated to exclude which of the following? | [
"Gastrointestinal cancer",
"Liver cancer",
"Lung cancer",
"Renal cancer"
] | C | This patient has the finger clubbing and hyperophic pulmonary osteoahropathy that can be associated with bronchogenic carcinoma (other than squamous cell carcinoma), benign mesothelioma, and diaphragmatic neurilemmoma. X-ray of the bones generally shows formation of new periosteal bone; ahritis may be present. The etiology of these changes remains a mystery. An ale clinician may identify a cancer at an earlier, potentially curable stage by investigating a possible paraneoplastic syndrome. Ref: Imboden J.B. (2013). Chapter 56. Rheumatic Manifestations of Malignancy. In J.B. Imboden, D.B. Hellmann, J.H. Stone (Eds), CURRENT Diagnosis & Treatment: Rheumatology, 3e. | train | med_mcqa | null |
The lymphatic drainage of the vulva is to the...: | [
"Inguinal lymphnodes",
"Iliac lymphnodes",
"Para aoic lymphnodes",
"Mediastinal nodes"
] | A | Inguinal lymphnodes | train | med_mcqa | null |
Which of the following is a procoagulation protein | [
"Thrombomodulin",
"Protein C",
"Protein S",
"Thrombin"
] | D | ref Robbins 7/e p127 , Harrison 17/e p346,9/e p120-121. Prothrombin time (PT) screens for the activity of the pro- teins in the extrinsic pathway (factors VII, X, II, V, and fibrinogen). The PT is performed by adding phospholip- ids and tissue factor to a patient's citrated plasma (sodium citrate chelates calcium and prevents spontane- ous clotting), followed by calcium, and the time to fibrin clot formation (usually 11 to 13 seconds) is recorded. Because factor VII is the vitamin K-dependent coagulation factor with the shoest half-life (roughly 7 hours), the PT is used to guide treatment of patients with vitamin K antagonists (e.g., coumadin). * Paial thromboplastin time (PTT) screens for the activity of the proteins in the intrinsic pathway (factors XII, XI, IX, VIII, X, V, II, and fibrinogen). The PTT is performed by adding a negatively charged activator of factor XII (e.g., ground glass) and phospholipids to a patient's citrated plasma, followed by calcium, and recording the time required for clot formation (usually 28 to 35 seconds). The PTT is sensitive to the anticoagulant effects of heparin and is therefore used to monitor its efficacy. Once thrombin is formed, it not only catalyzes the final steps in the coagulation cascade, but also exes a wide variety of effects on the local vasculature and inflammatory milieu; it even actively paicipates in limiting the extent of the hemostatic process | train | med_mcqa | null |
Hypokalemia is defined as a plasma potassium concentration of | [
"< 3.5 mmol/L",
"< 3.6 mmol/L",
"< 3.7 mmol/L",
"< 3.8 mmol/L"
] | A | Hypokalemia, defined as a plasma K+ concentration of <3.5 mM, Hyperkalemia is defined as a plasma potassium level of 5.5 mM Ref: Harrison 19e pg: 305 | train | med_mcqa | null |
29 yrs male was brought to OPD by his wife giving history of aggressive behaviour with decreased social interaction and lack of self care. O/E grasp reflex present, CT scan would be showing lesion of which lobe ? | [
"Frontal lobe",
"Occipital",
"Temporal",
"Parietal"
] | A | Frontal lobe lesion manifest as: (Anterior Cerebral Aery occlusion) Aggressive and antisocial behaviour Abulia Apathy Urge incontinence Magnetic gait/Gait apraxia O/E: Primitive reflexes like grasp and rooting reflex are present. | train | med_mcqa | null |
A 12 year old, Aswin, presents with a severely damaged nail on his index finger, after accidentally crushing the finger while closing a door. A decision is made to excise the injured nail. In preparation for the procedure, the physician would most likely anesthetize a branch of which of the following nerves? | [
"Anterior interosseous nerve",
"Median nerve",
"Musculocutaneous nerve",
"Radial nerve"
] | B | The median nerve supplies the surface of the lateral palm, the palmar surface of the first three digits and the distal dorsal surface of the index and middle fingers (including the nail beds). Therefore, prior to performing surgery in this area, it is essential to anesthetize a branch of this nerve (possibly a proper digital branch) to eliminate pain sensation around the nail bed of the index finger.Neither the anterior interosseous nor the musculocutaneous nerves supplies the hand. The anterior interosseous nerve supplies the flexor pollicis longus, the lateral half of flexor digitorum profundus, and pronator quadratus. The musculocutaneous nerve supplies the coracobrachialis, biceps, and most of the brachialis muscle, then becomes the lateral cutaneous nerve of the forearm. The radial nerve supplies skin on the radial side of the dorsal surface of the hand, but not the fingeips. | train | med_mcqa | null |
Midline cleft lip is due to failure of fusion of - | [
"Two medial nasal processes",
"Medial and lateral nasal processes",
"Two lateral nasal processes",
"Any of the above"
] | A | null | train | med_mcqa | null |
Which laser is used in the management of after cataracts: | [
"Argon",
"Krypton",
"Nd-YAG",
"Excimer"
] | C | Ans. Nd-YAG | train | med_mcqa | null |
Putrefaction is a : | [
"Perimoem sign of death",
"Immediate sign of death",
"Early sign of death",
"Late sign of death"
] | D | D i.e. Late sign of death | train | med_mcqa | null |
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