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External Cephalic Version (ECV) is contraindicated in all of the following , EXCEPT? | [
"Twins",
"Flexed breech",
"Premature Rupture of membranes",
"Previous abruption"
] | B | ECV -Absolute contraindications : Placenta pre Multifetal gestation Severe contracted pelvis - Relative contraindications Early labor oligohydramnios or rupture of membranes structural uterine abnormalities fetal growth restriction prior abruption | train | med_mcqa | null |
A patient with spine, chest and abdominal injury in road traffic accident developed hypotension and bradycardia. Most likely reason is: | [
"Hypovolemic shock",
"Distributive",
"Hypovolemic + septicemic shock",
"Neurogenic shock"
] | D | Trauma+ Hypotension+ Bradycardia= Neurogenic shock NEUROGENIC SHOCK - Results from loss or suppression of sympathetic tone-Massive vasodilation in venous Vasculature -| Venous return -| Cardiac output - Impaired tissue perfusion & Cellular metabolism. Clinical features - Paralysis below the level of lesion; Hypotension - Bradycardia due to loss of sympathetic tone - Aerial & venous vasodilation - Warm & dry skin - Hypothermia | train | med_mcqa | null |
A pole vaulter had a fall during pole vaulting and had paralysis of the arm. Which of the following investigations gives the best recovery prognosis. | [
"Electromyography",
"Muscle biopsy",
"Strength duration curve",
"Creatine phosphokinase levels"
] | A | EMG (electromyography) is by far the most reliable and effective test to predict about nerve recovery. Diagnostic Tests for Nerve Injuries: EMG: Denervation fibrillation potentials. Appears at 2-3 weeks then spontaneous fibrillation. EMG is the earliest indicator of nerve recovery. Nerve conduction study: reduced in axonotmesis and neurotmesis but cannot differentiate between the 2. Normal nerve conduction velocity on day 10 goes toward neuropraxia. No conduction will indicate neurotmesis. Sweat Test: In autonomous area, presence of sweat rules out complete injury as sweat fibers are most resistant to compression. MRI: Value only in nerve root lesions (e.g. Brachial plexus injuries). | train | med_mcqa | null |
Which of the folloiwng is not a labile cell ? | [
"Bone marrow",
"Epidermal cells",
"Small intesting mucosa",
"Hepatocytes"
] | D | Ans is 'd' i.e., Hepatocytes | train | med_mcqa | null |
Branches from the Anterior division of the Mandibular nerve supplies all of the following muscles, EXCEPT: | [
"Lateral Pterygoid",
"Medial Pterygoid",
"Masseter",
"Temporalis"
] | B | Branches from the anterior division of the mandibular nerve are the buccal nerve, the nerve to masseter, the deep temporal nerves to the temporalis muscle and the nerve to the lateral pterygoid. The nerve to the medial pterygoid is a branch from the main trunk of the mandibular nerve.Ref: Clinical Anatomy (A Problem Solving Approach), By Neeta V Kulkarni, 2nd edition, Page 388, 389, 602, 603; Human Anatomy Regional and Applied, Volume Three, By B.D.Chaurasia, 3rd edition, Page 124-126. | train | med_mcqa | null |
Vitamin E is | [
"Anticoagulant",
"Coagulant",
"Antioxidant",
"Antiinflammatory"
] | C | The E vitamins consist of eight naturally occurring tocopherols, of which a-tocopherol is the most active (Figure 28.28).The primary function of vitamin E is as an antioxidant in prevention of the nonenzymic oxidation of cell components, for example, polyunsaturated fatty acids, by molecular oxygen and free radicalsRef: Lippincott, 5th edition, page no: 391 | train | med_mcqa | null |
Stage of 16 cells is | [
"Embryo",
"Morula",
"Zygote",
"Blastocyst"
] | B | A morula is distinct from a blastocyst in that a morula (3-4 days post feilization) is a 16-cell mass in a spherical shape whereas a blastocyst (4-5 days post feilization) has a cavity inside the zona pellucida along with an inner cell mass | train | med_mcqa | null |
All the following are true about Diphtheria except | [
"Faucial diphtheria is more dangerous than laryngeal diphtheria",
"Laryngeal diphtheria mandates tracheotomy",
"Child is more toxic with faucial diphtheria",
"Myocarditis may be a complication"
] | A | Laryngeal diphtheria is more dangerous than faucial diphtheria. Asphyxia due to mechanical obstruction of the respiratory passage by the pseudomembrane, for which an emergency tracheostomy may become necessary. Ref: Textbook of microbiology; Ananthanarayan and paniker's; 10th Edition; Pg: 241 | train | med_mcqa | null |
Which of the following increases the risk of salivary gland tumors? | [
"Radiotherapy to head and neck",
"Exposure to silica dust",
"Early menarche and nulliparity",
"All of the above"
] | D | ETIOLOGY OF SALIVERY GLAND TUMORS - Radiotherapy to head and neck (for mucoepidermoid carcinoma) - EBV infection (for lymphoepithelial carcinoma) - Exposure to silica, dust, nitrosamines - Increased risk in females with early menarche and nulliparity - Trisomy 5 in primary mucoepidermoid carcinoma of minor salivary glands. - Polysomy of 3 and 17 especially in adenoid cystic carcinoma. | train | med_mcqa | null |
Which of the following drug increases gastro -intestinal motility | [
"Glycopyrrolate",
"Atropine",
"Neostigmine",
"Fentanyl"
] | C | ref;KD Tripathi 7the edition pharmacology (page no;471,114,103) Constipation is a prominent feature of Fentanyl action. Acts on intestines and in CNS-increases tone and segmentation but decreases propulsive movements. Atropine and Glycopyrrolate are anticholinergics. All visceral smooth muscles that receive parasympathetic motor innervation are relaxed by anticholinergics (M3 blockade). Tone and amplitude of contractions of stomach and intestine are reduced; the passage of chyme is slowed-constipation may occur, Neostigmine is an anticholinesterase. Smooth muscle in most organs is contracted (mainly through M3 receptors). Tone and peristalsis in the gastrointestinal tract are increased and sphincters relax=abdominal cramps and evacuation of bowel. | train | med_mcqa | null |
All the following statements are true regarding Parkinsonism disease developing in people > 70 years of age, except - | [
"The long-term side effects of levodopa such as dyskinesia are less",
"They are more likely to develop autonomic disturbances",
"Cognitive changes and dementia are more common",
"Prognosis is worse"
] | D | null | train | med_mcqa | null |
Vasomotor centre of medulla is associated with? | [
"Acts with the cardiovagal centre to maintain B.P.",
"Independent of coicohypothalamic inputs",
"Influenced by baroreceptors not chemoreceptors",
"Essetially silent in sleep"
] | A | Acts with the cardiovagal centre to maintain B.P. (Ref Ganong 23/e p556]Neural regulation of the blood pressure is brought about by 2 different centres located in medulla - Vasomotor centre which control the sympathetic outflow, and Cardiovagal centre which controls the parasympathetic outflow.TheVasomotor centre and the Cardiovagal centre act together to maintain the B.P. (Note that many books do not make the distinction between the vasomotor and cardiovagal centre and collectively use the term vasomotor centre for all the neurons in medulla that control the B.P.Vasomotor centreCardio vagal centreVasomotor centre is group of neurons located in RostralCardiovagal centre lies in the nucleus ambiguous.Ventrolateral Medulla (RVLM) associated with sympatheticIt sends parasympathetic impulses to the hea thedischarge controlling the cardiovascular system.vagus(note that blood vessels receive onlyThe sympathetic discharge from vasomotor centre goes tosympathetic impulses whereas hea receives bothhea and blood vessels resulting in:sympathetic and parasympathetic supply).- Increased hea rate (Chronotropic effect)This results in:- Increased force of cardiac contraction (Inotropic effect)- Decreased hea rate- Increased rate of transmission in the cardiac conductive- Decrease cardiac outputtissue (Dromotropic effect)- Decreased B.P.- Vasoconstriction(this leads to increased stroke volume and increased BP) The vasomotor centre receive inputs from Coicohypothalmic fibres Coicohypothalmic .fibres are descending tracts to the vasomotor area from the cerebral coex (paicularly the limbic coex) that relay in the hypothalamus. These fibers are responsible .for the blood pressure rise and tachycardia produced by emotions such as sexual excitement and anger.The vasomotor centre is not silent during sleep The vasomotor centre neurons arc tonically active and discharge rhythmically.The vasomotor centre receives inputs from baroreceptors and also from chemoreceptors.The baroreceptors are stretch receptors in the walls of carotid sinus and aoic arch. The baroreceptors are stimulated by distention of the structures in which they are located, and so they discharge at an increased rate when the pressure in these structures rises. Increased baroreceptor discharge inhibits the tonic discharge of sympathetic nerves and excites the vagal innervation of the hea. These neural changes produce vasodilation, venodilation, a drop in blood pressure. bradycardia, and a decrease in cardiac output.Chemoreceptors are located in carotid and aoic bodies. These receptors are primarily activated by a reduction in paial pressure of oxygen (Pa02), but they also respond to an increase in the paial pressure of carbon dioxide (PaCO2) and pH. Chemoreceptors exe their main effects on respiration; however, their activation also leads to vasoconstriction. Hea rate changes are variable and depend on various factors, including changes in respiration.Factors Affecting the Vasomotor centre (RVLM)Direct stimulationCO2HypoxiaExcitatory inputsCoex hypothalamusMesencephalic periaqueductal grayBrain stein reticular formationPain pathwaysSomatic afferents (somatosympathetic reflex)Carotid and aoic chemoreceptorsInhibitory inputsCoex hypothalamusCaudal ventrolateral medullaCaudal medullary raphe nucleiLung inflation afferentsCarotid, aoic, and cardiopulmonary baroreceptorsThus we see that the cardiovascular system is under neural influences of medulla, which in turn receive feedback from sensory receptors in the vasculature (eg, baroreceptors). An increase in neural output from the brain stem to sympathetic nerves leads to a decrease in blood vessel diameter (aeriolar constriction) and increases in stroke volume and hea rate, which contribute to a rise in blood pressure. This in turn causes an increase in baroreceptor activity, which signals the vasomotor centre to reduce the neural output to sympathetic nerves.Also know:The neurons of vasomotor centre secrete excitatory transmitter- glutamate (and not epinephrine)Inflation of the lungs causes vasodilation and a decrease in blood pressure. This response is mediated vagal afferents from the lungs that inhibit vasomotor discharge.In general, stimuli that increase the hea rate also increase blood pressure, whereas those that decrease the hea rate lower blood pressure. However, there are exceptions, such as the production of hypotension and tachycardia by stimulation of atrial stretch receptors and the production of hypeension and bradycardia by increased intracranial pressure (Cushing reflex).Cushing reflex: Increase in intracranial pressure compromises the blood supply to the vasomotor neurons, and the resulting local hypoxia and hypercapnia increase discharge from the vasomotor centre. This results in rise in systemic aerial pressure (Cushing reflex) which tends to restore the blood flow to the medulla. Over a considerable range, the blood pressure rise is propoional to the increase in intracranial pressure. The rise in blood pressure causes a reflex decrease in hea rate the aerial baroreceptors. This is why bradycardia rather than tachycardia is characteristically seen in patients with increased intracranial pressure. | train | med_mcqa | null |
Liver transplantation is done in -a) Hemochromatosisb) Primary billiary cirrhosisc) Sclerosing cholangitis without uncerative colitisd) Sclerosing cholangitis with uncerative colitis | [
"abc",
"bcd",
"ac",
"bd"
] | B | null | train | med_mcqa | null |
Stye is suppurative inflammation of glands of ? | [
"Zeis",
"Meibonian",
"Wolfring",
"All the above"
] | A | Ans. is 'a' i.e., Zeis | train | med_mcqa | null |
Vulval carcinoma metastasizes to which lymph group : | [
"Para aoic nodes",
"Superficial inguinal nodes",
"Internal iliac nodes",
"External iliac nodes"
] | B | Ans. is b i.e. Superficial inguinal lymph nodes Vulvar cancer spreads by the following routes : Direct extension, to involve adjacent structures such as the vagina, urethra, and anus Hematogenous spread to distant sites, including the lungs, liver, and bone Lymphatic embolization : At first the superficial inguinal nodes are involved through lymphatic emboli, but later lymphatic channel permeation is seen. The malignancy spreads to deep nodes. and gland of Cloquet to the external iliac glands, obturator and common iliac nodes, in the late stages. Thus inguinal, femoral and pelvic lymph nodes are involved in vulvar cancer. But most impoant amongst these are inguinal-femoral nodes. "The overall incidence of inguinal-femoral lymph node metastasis is repoed to be about 30%. Metastasis to pelvic nodes occur in about 12% of cases. Pelvic nodal metastasis are rare (0.6%) in the absence of groin node involvement." | train | med_mcqa | null |
Brinzolamide is | [
"Competitive and reversible carbonic anhydrase inhibitor",
"Non-competitive and reversible carbonic anhydrase inhibitor",
"Competitive and irreversible carbonic anhydrase inhibitor",
"Non-competitive and irreversible carbonic anhydrase inhibitor"
] | B | Carbonic anhydrase (CAse) is an enzyme which catalyses the reversible reaction H2O + CO2 - H2C03 Hence, Carbonic anhydrase functions in CO2 and HC03 transpo and in H+ ion secretion. Carbonic anhydrase inhibitors act by non-competitive but reversible inhibition of the enzyme -Decreases the production of aqueous humor from ciliary body epithelium. Ex: Acetazolamide, dorzolamide and Brinzolamide. | train | med_mcqa | null |
Absence seizures are characterized on EEG by- | [
"3 Hz spike & wave",
"1-2 Hz spike & wave",
"Generalized polyspikes",
"Hypsarrythmia"
] | A | null | train | med_mcqa | null |
Wavelength of light produced by wood's Lamp is ? | [
"320nm",
"360 nm",
"400 nm",
"760-800 nm"
] | B | B i.e. 360 nm | train | med_mcqa | null |
Among the many molecules of high-energy phosphate compounds formed as a result of the functioning of the citric acid cycle, one molecule is synthesized at the substrate level. In which of the following reactions does this occur? | [
"Citrate - a-ketoglutarate",
"a-ketoglutarate - succinate",
"Succinate - fumarate",
"Fumarate - malate"
] | B | 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 alpha-ketoglutarate to succinate is catalyzed by the a -ketoglutarate dehydrogenase complex and succinyl-CoA synthetase, respectively. | train | med_mcqa | null |
Aminopeptidase is elevated in obstruction of: | [
"Ureter",
"Urethra",
"CBD",
"Bladder"
] | C | Leucine Aminopeptidase: Increased Leucine aminopeptidase (LAP) activity is seen in: Carcinoma of the pancreas, choledocholithiasis, acute pancreatitis Viral hepatitis. Cirrhosis, carcinoma with liver metastasis In common bile duct obstruction,whether due to carcinoma pancreas or choledocholithiasis, the elevated serum LAP levels returned to normal following relief of the obstruction. This is in agreement with the hypothesis that the increased serum LAP activity in these conditions is the result of bile duct obstrcution Ref: American journal of Gastroenterology Dec1963 Vol. 41 Issue 6, pgno: 620 | train | med_mcqa | null |
Pain insensitive structure in brain is : | [
"Flex cerebri",
"Dural sheath surrounding vascular sinuses",
"Middle meningeal aery",
"Choroid plexus"
] | D | Choroid plexus Choroid plexus is pain insensitive structure. Harrison writes:-"relatively few cranial structures are pain- producing; these include the slap' middle meaningeal aery, dural sinuses, falx cereberi, and proximal segments of the large pail aeries. The ventricular ependyma, choroid plexus, pail veins, and much of the brain parenchyma are not pain-producing." | train | med_mcqa | null |
Which enzyme is deficient in c/c alcoholics? | [
"Aconitase",
"Citrate synthase",
"Isocitrate dehydrogenase",
"Alpha ketoglutarate dehydrogenase"
] | D | Ans. D. Alpha ketoglutarate dehydrogenaseBecause in alcoholics there is thiamine deficiency, so a thiamine dependent enzyme will be deficient.So answer is Alpha Ketoglutarate Dehydrogenase. | train | med_mcqa | null |
Fear of darkness is called | [
"Agarophobia",
"Claustrophobia",
"Mysophohbia",
"Nyctophobia"
] | D | Phobias:- * Acrophobia is morbid fear of high places. * Agarophobia is fear of being in a large open space. * Nyctophobia is morbid fear of darkness. * Claustrophobia is fear of staying in a closed or confined space. * Mysophobia is morbid fear of filth or contamination. * Xenophobia is fear of strangers. Ref:- Essentials of Forensic medicine Dr KS narayana Reddy 33th Edition; Pg num:- 482 | train | med_mcqa | null |
A 6-year-old boy experienced life threatening shock ,his CT scan showed large amount of ascites, bowel wall thickening and poor or absent enhancement of the strangulated bowel segment, showing gangrenous bowel on surgical exploration.True about anastomosis is- | [
"Should be done by continuous layers as it takes less time",
"Should be Done with catgut",
"Should be Done by single layer seromuscular lembe sutures",
"Should be Done by Single layer taking submucosa"
] | C | * Diagnosis is of congenital IH with strangulated small bowel with gangrenous small bowel * Transmesenteric hernia was the most common type in older children as well as in neonates . * IH results from incomplete closure of surgically created mesenteric defects, and usually acquired resulting from previous abdominal surgery especially Roux-en-Y anastomosis * Anastomosis should be done by single layer seromuscular lembe sutures * The Lambe suture generally is used in abdominal surgery. It is an inveing suture, that can be either continuous or interrupted, used to join two segments of an intestine without entering the lumen (the inner channel through which stomach contents flow). REF : BAILEY AND LOVE 27TH ED | train | med_mcqa | null |
Function of myoepithelial cell: | [
"Accelerate the initial outflow of saliva from the acini.",
"Reduce the luminal volume.",
"Contribute to secretory pressure in the acini or duct.",
"All of the above."
] | D | Accelerate the initial outflow of saliva from the acini.
Reduce luminal volume. The intercalated ducts may shorten and widen the ducts helping to maintain their patency.
Contribute to secretory pressure in the acini or duct.
Support the underlying parenchyma and reduce the back permeation of fluid.
Help salivary flow to overcome increase in peripheral resistance of the ducts | train | med_mcqa | null |
ACE inhibitor when used for long time in hypeension patient cause | [
"Rightward shift in Renal pressure natriuresis curve",
"Reduction in filtration fraction",
"Significant increase in hea rate",
"No change in the compliance of large aeries"
] | B | Refer Goodman and Gilman 10e p804 Angiotensin 2 shifts the renal pressure natriuresis curve to the right side and helps to adjust the sodium levels in the body according to dietary intake of the sodium( more excretion from more intake and less excretion from less excretion from less intake ACE inhibitors block the action of angiotensin 11 and cause leftward shift of renal pressure natriuresis curve show that if the sodium intake is decreased much more natriuresis occur ACE inhibitors can increase the renal blood flow without increasing GFR and thus result in reduction of filtration fraction | train | med_mcqa | null |
A diabetic patient presents with pus from eye. Colonies of isolated organisms are black with microscopic feature of non-septate hyphae and obtuse branching. Diagnosis is - | [
"Aspergillosis",
"Candidiasis",
"Mucormycosis",
"Histoplasmosis"
] | C | null | train | med_mcqa | null |
Asteroid Hyalosis bodies are composed of | [
"Iron",
"Calcium and phosphates",
"Cadmium and chloride",
"None"
] | B | Answer- B. Calcium and phosphatesAsteroid hyalosis is a degenerative condition of the eye involving small white opacities in the vitreous humor.The asteroid bodies are made up of hydroxyapatite, which in turn consists of calcium and phosphates. | train | med_mcqa | null |
A 17 years male presented with swelling in the cheek with recurrent epistaxis. Most likely diagnosis is | [
"Angiofibroma",
"Carcinoma nasopharynx",
"Rhabdomyosarcoma",
"Ethmyoid polyp"
] | A | A. i.e. (Angiofibroma) (230 - Dhingra 4th) (296 - maqbool 11th)NASOPHARYNGEAL ANGIOFIBROMA* Benign but locally invasive lesion of the nasophagrynx* Exclusively in males 10 and 25 years of age* Lesions arise from the ventral periosteum of the skull as a result of hormonal (imbalance or persistence of embryonic tissue* Gradually increasing nasal obstruction and recurrent attacks of epistaxis are the common presenting symptoms* Probing or palpation of the nasopharynx should not be done (Biopsy is contraindicated)*** ** CT scan of head with contrast enhancement is now the investigation of choice* **Surgical excision - Transpalatine + sublabial (Sardanas approach) is now the treatment of choice* Concomitant RT and cisplatin, followed by adjuvant chemotherapy is currently considered the best treatment of naso pharyngeal carcinoma. | train | med_mcqa | null |
Zero order kinetics is followed by all the drugs except | [
"Phenytoin",
"Barbiturates",
"Alcohol",
"Theoplylline"
] | B | A barbiturate is a drug that acts as a central nervous system depressant, and can therefore produce a wide range of effects, from mild sedation to death . The kinetics of barbiturate elimination are mixed: first order at low concentrations and zero order at high ones Ref-6/e p31 | train | med_mcqa | null |
At PHC level, a woman who complains of spotting following Intrauterine contraceptive device inseion should be advised | [
"Analgesics and observation",
"Antibiotics and observation",
"Iron supplements and observation",
"Removal of IUCD"
] | C | The commonest complaint of women fitted with an IUD is increased vaginal bleeding.Usually bleeding or spotting between periods settles within 1-2 months.The patient who is experiencing the bleeding episodes should receive iron tablets.Ref: Park 23rd edition pg: 498 | train | med_mcqa | null |
Cancers caused by asbestosis all except: | [
"Adenocarcinoma of lung",
"Mesothelioma",
"Gastric Ca",
"Pancreatic Ca"
] | D | Ans. D. Pancreatic CaExplanationAsbestos causes lung, esophageal, gastric, and colon carcinoma; mesothelioma. | train | med_mcqa | null |
The earliest manifestations of Chronic lead poisoning include - | [
"Colic and constipation",
"Encephalopathy",
"Punctate basophilia",
"Lower limb paralysis"
] | C | Facial pallor is the earliest and most consistent symptom. However, among the given options, punctate basophilia is the earliest manifestation. | train | med_mcqa | null |
EBV receptor mimics ? | [
"CD 20",
"CD 21",
"CD 22",
"CD 23"
] | B | Ans. is 'b' i.e., CD 21 | train | med_mcqa | null |
Most common site for mucoepidermoid carcinoma is | [
"Parotid gland",
"Submandibular gland",
"Sublingual gland",
"Minor salivary gland"
] | A | Mucoepidermoid carcinoma is the most frequently diagnosed malignancy of the salivary gland. Among the major salivary glands, the parotid gland is most commonly involved. | train | med_mcqa | null |
Medial calcification is seen in - | [
"Atherosclerosis",
"Arteriolosclerosis",
"Monckeberg's sclerosis",
"Dissecting aneurysm"
] | C | First, see types of arteries
Based on their size and structural features, arteries are divided into three types.
1. Large or Elastic arteries
Aorta
Its large branches, eg. - Innominate, Subclavian, common carotid, iliac.
Pulmonary arteries.
2. Medium sized or muscular arteries
Small branches of aorta → Coronary, Renal
3. Small arteries and arterioles
Within substance of the tissue
Now see their affection -
Arteriosclerosis
Don’t get confused with atherosclerosis.
Arteriosclerosis means hardening of arteries by thickening and loss of elasticity of arterial wall.
There are three patterns of arteriosclerosis.
1. Atherosclerosis
Characterized by intimal lesions, i.e. atheromas, which project into a vascular lumen and may obstruct it.
This is the most common pattern of arteriosclerosis.
It involves elastic arteries and large & medium size muscular arteries.
2. Arteriolosclerosis
Seen in arterioles of patients with hypertension and diabetes.
Two anatomic variants are common hyaline and hyperplastic arteriolosclerosis.
3. Monckeberg medial calcific sclerosis
It is seen in small and medium-sized muscular arteries.
It is a degenerative and apparently non-inflammatory disease.
Media of these arteries becomes calcified.
It occurs in patients older than 50 years. | train | med_mcqa | null |
Which one of these is NOT associated with decrease in Residual Volume? | [
"Emphysema",
"Bacterial pneumonia",
"Interstitial lung disease",
"Lung abscess"
] | A | (A) Emphysema# RESIDUAL VOLUME is the amount of gas remaining in the lungs at the end of a maximal exhalation.> Residual Volume is important because it prevents the lungs from collapsing.> Even after we have expelled as much air as possible (expiratory reserve volume) gaseous exchange is still occurring by residual volume in the lungs. It also prevents the inner surfaces of the lungs sticking together.# In Chronic Bronchitis and Emphysema:> Increase in Residual volume> Peak Expiratory flow rate usually reduced.> VA/Q i.e., ventilation perfusion ratio is a poor indicator of the severity of the disease.TypeExamplesDescriptionFEV1/FVCRestrictiveLungDiseases Pulmonary fibrosis, Infant Respiratory Distress syndrome, Weak respiratory muscles, PneumothoraxVolumes are decreasedOften in a normal range (0.8 to 1.0)ObstructiveLungDiseases Asthma or COPD or EmphysemaVolumes are essentially normal but flow rates are impededOften low (Asthma can reduce the ratio to 0.6, Emphysema can reduce the ratio to 0.78 to 0.45) | train | med_mcqa | null |
True statement about orbital aiculation is | [
"Medial wall of orbit and floor formed by sphenoid bone",
"Great wing of sphenoid contribute to floor",
"Body of sphenoid form the Lateral wall of orbit",
"Inferior orbital fissure is formed between the lateral wall and the floor of orbit."
] | D | Inferior orbital fissure is formed between lateral wall and floor of orbit. Floor Orbital surface of body of Maxilla, Zygomatic bone and Palantine bone (MAX-ZIP) Medial wall Body of Sphenoid, Ethmoid, Lacrimal bone, Maxilla Lateral wall Greater wing of Sphenoid and Zygomatic bone Roof Frontal bone, lesser wing of Sphenoid | train | med_mcqa | null |
Commonest cause of postpaum hemorrhage In multipara is: | [
"Fibroid",
"Retained placenta",
"Uterine atony",
"Uterine perforation"
] | C | Uterine atony | train | med_mcqa | null |
Best treatment for kawasaki's disease is | [
"Aspirin",
"I.V. immunoglobulins",
"Coicosteroids",
"Methotrexate"
] | B | Kawasaki disease: IVIG is given within the first 10 days of illness. Concomitant aspirin should be staed until the patient is afebrile If fever persist beyond 36 hours after the initial IVIG infusion, a new dose of IVIG should be given if no other source of fever is found. Methylprednisolone should follow if the disease persists after the second IVIG administration. Fuher options for refractory cases include TNF blockers (infliximab), cyclophosphamide, methotrexate, and plasmapheresis. | train | med_mcqa | null |
A young girl presents with repeated episodes of throbbing occipital headache associated with ataxia and vertigo. The family history is positive for similar headaches in her mother. Most likely diagnosis is - | [
"Vestibular Neuronitis",
"Basilar migraine",
"Cluster headache",
"Tension headache"
] | B | null | train | med_mcqa | null |
A 20 year old girl presents with abdominal pain, ahralgia and a palpable purpuric rash all over the body. The most likely diagnosis is: | [
"Henoch Schonlein Purpura (HSP)",
"Kowasaki Disease",
"Hemolytic Uremic Syndrome (HUS)",
"Idiopathic Thrombocytopenic Purpura (ITP)"
] | A | Answer is A (Henoch Schonlein Purpura): Palpable Purpura (most commonly distributed over the buttocks and lower extremities), ahralgias, and abdominal pain are all charachteristic features of Henoch-Schonlein purpura. Although H.S purpura is usually seen in children and most patients range in age from 4-7 years, Harrisons text clearly mentions that this condition may also be seen in infants and adults. The charachteristic clinical manifestation of palpable purpura, ahralgia and abdominal pain in this young adult suggest the diagnosis of H-S purpura. | train | med_mcqa | null |
Major functions of Vitamin E in the body | [
"Regulation of energy metabolism",
"Carboxylation reaction",
"Blood clotting",
"Protection of biological membrane from free radical damage"
] | D | The primary function of vitamin E is as an antioxidant in prevention of the nonenzymic oxidation of cell components, for example, polyunsaturated fatty acids, by molecular oxygen and free radicals. Vitamin E deficiency is almost entirely restricted to premature infants. When observed in adults, it is usually associated with defective lipid absorption or transpo. The signs of human vitamin E deficiency include sensitivity of erythrocytes to peroxide and the appearance of abnormal cellular membranes. Reference: Lippincott Textbook of Biochemistry pg no. 391 | train | med_mcqa | null |
Which is the muscle relaxant of choice in renal failure? | [
"Rocuronium",
"Vecuronium",
"Rapacuronium",
"Atracurium"
] | D | Atracurium and cis-atracurium are inactivated by Hoffman's elimination. It is the spontaneous molecular re- arrangement of these drugs leading to their inactivation without the requirement of liver or kidney. Therefore they are the muscle relaxants of choice for renal and hepatic failure patients. Also know Elimination of muscle relaxants: Renal Hepatic Both None Doxacurium Rapacuronium Pipecuronium Atracurium Tubocurarine Vecuronium Cis-atracurium Pancuronium Rocuronium Mivacurium Succinyl choline Ref: Katzung 9th/pg. 432; KDT 6th/pg. 345. | train | med_mcqa | null |
Enzyme specificity is given by - | [
"Km",
"Vmax",
"Both",
"None"
] | A | Ans. is "a' i.e., Km "The of an enzyme is the concentration of the substrate that enables the enzyme to function at half maximum activity and is therefore a measure of the specificity of a substrate for the enzyme"___________Clinical biochemistryo Actually enzyme specificity is not measured by Km alone.o It is measured by the ratio Kcat/Km which is a second order rate constant for the reaction between substrate and free enzyme.o This ratio is important, for it provides a direct measure of enzyme efficiency and specificity,o Note : Kcat is turnover number and measures the rate of the catalytic process. | train | med_mcqa | null |
True about carriers ? | [
"Infection with clinical symptoms",
"Serves as source of infection",
"More infectious than cases",
"Less dangerous than cases"
] | B | Ans. is 'b' i.e., Serves as source of infection A carrier is defined as "an infected person or animal that harbours a specific infectious agent in the absence of clinical disease and serves as a potential source of infection". As a rule carriers are less infectious than cases, but epidemiologically they are more dangerous than cases because they escape recognition, and continuing as they do to live a normal life among the population or comunity, they readily infect the susceptible individuals over a wider area and longer period of time. | train | med_mcqa | null |
NOT a feature of hypothyroidism is ? | [
"Sho metacarpals in hands",
"Delayed pubey",
"Delayed bone age",
"Altered upper and lower segment ratio"
] | A | Ans. is 'a' i.e., Sho metacarpal in hands Hypothyroidism o Hypothyroidism results from deficient production of thyroid hormone or a defect in thyroid hormone receptor activity. o Hypothyroidism may be : - i) Congenital --> Present since bih ii) Acquired --> Symptoms appear after a period of apparently normal thyroid function. Hypothyroidism causes - i) Delayed bone growth (Bone age markedly delayed) ii) Delayed pubey & Alteration in upper and lower segment ratio (upper segment > lower segment) Hypothyroidism o Hypothyroidism results from deficient production of thyroid hormone or a defect in thyroid hormone receptor activity. o Hypothyroidism may be : - i) Congenital --> Present since bih ii) Acquired --> Symptoms appear after a period of apparently normal thyroid function. Hypothyroidism causes - i) Delayed bone growth (Bone age markedly delayed) ii) Delayed pubey & Alteration in upper and lower segment ratio (upper segment > lower segment) | train | med_mcqa | null |
Which of the following is true about octeride ? | [
"It stimulates growth hormone secretion",
"It is useful in controlling secretery diarrhoea",
"It is active orally",
"Its used is contraindicated in acromegaly"
] | B | Ans is b i.e. It is useful in controlling secretery diarrhoea As octeride is somatostatin analogue, it inhibits the secretion of GH, TSH, prolactin and almost all GI secretions. It is used in acromegaly, bleeding esophalgeal varicies, insulinoma and secretory diarrhoea associated with carcinoid, WDHA syndrome, gastrinoma and glucagnoma. | train | med_mcqa | null |
Thomas test is used for testing? | [
"Hip flexion",
"Knee flexion",
"Hip abduction",
"Hip rotation"
] | A | Hip flexion REF: Lange book of Ohopedics and Spos Medicine Thomas Test: With the patient lying supine, maximally flex both hips. Allow the femur on the ipsilateral side to fall into as much extension as possible, while holding the other hip up. The angle between the femur and examining table is the residual flexion and represents the flexion contracture. REF : Maheshwari book of ohopedics 6th Ed | train | med_mcqa | null |
Indicator used in Horrock's apparatus produces which color in the presence of residual chlaine | [
"Blue",
"Yellow",
"Green",
"Red"
] | A | null | train | med_mcqa | null |
Which of the following is a contraindication for medical management of Gall stones - | [
"Radioopaque stones",
"Radioluscent stones",
"Normal functioning gall bladder",
"Small stones"
] | A | <p >Davidson&;s principles and practice of medicine 22nd edition. *radio opaque gallstones -symptomatic gall stones are best treated surgically by laprolaparoscopic cholecysectomy.</p> | train | med_mcqa | null |
In classic Barret's, the length of columnar epithelium in distal oesophagus is | [
">1cm",
">2cm",
">3cm",
">4cm"
] | C | Classic Barrett's (>= 3cm columnar epithelium);Sho-segment Barrett's (<3 cm of columnar epithelium);Cardia metaplasia (intestinal metaplasia at the oesophagogastric junction without any macroscopic change at endoscopy).The relative risk of cancer rises with increasing length of abnormal mucosa. | train | med_mcqa | null |
Pathological is seen in following except: | [
"Radiation",
"Anaemia",
"Osteoporosis",
"Osteomalacia"
] | B | B i.e. Anaemia Pathological Fracture A fracture in an abnormal bone is referred to as pathological fracture. Abnormal bone means a bone rendered weak by a disease localized to a paicular hone, or by a generalised bone disorder. Bone that fractures spontaneously, or after tril trauma must be regarded as abnormal until proven otherwise. Veebral bodies (thoracic & lumbar) are the most often affected bones f/b neckfemur & lower end radius (colle's ). Most common cause is osteoporosisQ. Other causes of pathological fractures are: Localized Diseases* Chronic infection eg. tubercular & pyogenicosteomyelitis.* Eosinophilic granuloma* Benign neoplastic lesions- Solitary bone cystQ- Aneurysmal bone cystQ- Fibrous coical defect- Monostotic fibrous dysplasia- Chondromyxoid fibroma- Chondroma (Enchondroma)Q- Osteoclastoma (giant cell tumor)* Malignant bone tumor- Osteosarcoma- Ewing's tumor- Chondrosarcoma* Atrophic bone due to- Polio- Radiation (Radiotherapy)Q Generalised Diseases Congenital/ Developmental- Osteogenesis imperfecta- Osteopetrosis- 011iers disease (multiple enchondromatosis /dyschondroplasia).- Polyostotic fibrous dysplasia- Histiocytosis X- Gaucher's disease* Acquired Disorders producing osteopenia- Osteoporosis (most common cause)Q- OsteomalaciaQ- Hyperparathyroidism- Renal osteodystrophy- Paget's disease- Myeloma * Other metabolic bone diseasesQ- Rickets- Scurvy* Disseminated malignancyin bones- Multiple myeloma- Myelomatosis- Metastatic carcinomaQ (2^d m.c) | train | med_mcqa | null |
The operation of plication of inferior lid retractors is indicated in: | [
"Senile ectropion",
"Senile entropion",
"Cicatricial entropion",
"Paralytic entropion"
] | B | Ans. Senile entropion | train | med_mcqa | null |
Medical treatment of acute pancreatitis includes | [
"Calcium",
"Glucagon",
"Aprotinin",
"Cholestyramine"
] | A | Treatment Cornerstone of the treatment : Aggressive fluid resuscitation using isotonic crystalloid solution with supplementary oxygen Narcotics are usually preferred, especially Buprenophine >Morphine as analgesics In acute pancreatitis medical treatment Analgesics (Buprenophine, meperidine) IV fluids and colloids No oral alimentation Treatment of hypocalcaemia, if symptomatic Antibiotics Ref: Sabiston 20th edition Pgno :1524-1528 | train | med_mcqa | null |
Cystinuria all of the following amino acids are excreted, except: | [
"Cystine",
"Ornithine",
"Leucine",
"Arginine"
] | C | Ref. Textbook of Biochemistry for Medical Students. Page. 283
Cystinuria is an inherited metabolic disorder characterized by the abnormal movement (transport) in the intestines and kidneys, of certain organic chemical compounds (amino acids).
These include cystine, lysine, arginine, and ornithine.
Excessive amounts of undissolved cystine in the urine (cystinuria) cause the formation of stones (calculi) in the kidney
Subtypes of cystinuria
Type I cystinuria, there is a defect in the active transport of cystine and the amino acids (dibasic) lysine, arginine, and ornithine in the kidneys and small intestine.
Type II cystinuria, cystine and lysine transport is severely impaired in the kidneys and only somewhat impaired in the intestines
Type III cystinuria, kidney transport of cystine and lysine is defective; intestinal transport is normal | train | med_mcqa | null |
A patient with microcytic hypochromic anemia, Hb-9%, serum iron is 20 ?/dl, ferritin level 800 mg/ ml, transferrin percentage saturation is 64. What is possible diagnosis - | [
"Atransferrinemia",
"Iron deficiency anemia",
"DMT 1 mutation",
"Hemochromatosis"
] | A | null | train | med_mcqa | null |
Dilution of epinephrine in anaphylactic shock is | [
"1: 100 inhalational route",
"1: 1000 IM",
"1:10000 IV",
"All the above"
] | D | . | train | med_mcqa | null |
Missing cases are detected by ? | [
"Active surveillance",
"Passive surveillance",
"Sentinel surveillance",
"Prevalence rate"
] | C | Ans. is 'c' i.e., Sentinel surveillance Surveillance Surveillance is defined as "the continous scrutiny of the factors that determine the occurrence and distribution of disease and other conditions of ill health". Surveillance may be of following types :? 1) Passive surveillance Data is repoed itself to health system, e.g. a patient (clinical case) is coming to a doctor. Most of the national health programmes in India rely on passive surveillance for data collection. 2) Active surveillance Data is collected actively by health system, e.g. collection of blood slides every fonight from house to house to control malaria. Active surveillance in India is done in :- National leprosy elimination programme (modified leprosy elimination campaigns). National vector Borne disease control programme (VVBDCP) e.g. malaria. 3) Sentinel surveillance Sentinel surveillance helps in identifying missing cases and supplementing notified cases. Sentinel surveillance in India is done in national AIDS control programme. | train | med_mcqa | null |
Von Hippel Landau Syndrome is associated with which type of renal neoplasm? | [
"Renal clear cell carcinoma",
"Angiomvolipoma",
"Papillary renal cell carcinoma",
"Renal medullary carcinoma"
] | A | Ans: A (Renal clear cell carcinoma) Ref: Campbell Walsh Urology, 10th edition. 2011, Page 1426Explanation: (See table below)Site of origin:Proximal tubule-Conventional (clear cell) RCC and papillary RCCDistal tubule - OncocytomasCollecting duct - Chromophobic and collecting duct RCCCalyceal epithelium near renal papillae - Renal medullary carcinomaConventional (clear cell) RCC:70-80% of RCCsWorse prognosisAggressiveRenal tumorSyndromeChromosomeGeneOther featuresConventional/Von Hippel3p25-26VHLClear cell RCCHemangioblastomas of thecentral nervous systemRetinal angiomas Pheochromocytomaclear cell RCCLindau genePapillary RCC type 1Hereditary papillary RCC7q31c-MET proto- oncogeneType 1 PRCCPapillary RCC type 2FamilialLeiomyomatosis and RCC1q42FumaratehydrataseType 2 PRCCCutaneous and uterineleiomyomasChromophobeRCCBirt-Hogg-Dube17p12q11BHD1geneChromophobe RCCOncocytomaTransitional (hybrid oncocytic) tumorsOccasional clear cell RCCCutaneous fibrofolliculomasLung cystsSpontaneous pneumothoraxOncocytoma 1p-Loss ofY, 14q Rearrang-ements of 11ql3 Spoke-wh eel pattern on angiographyStellate scar on cross-sectional imagingAbundance of mitochondriaAngiomyolipomaWunderlich Tuberous Sclerosis (TSc)TSc - 9 and 16TSc1TSc 2Massive retroperitoneal haemcrrhage(10%)Positive for HMB45Fat (plain CT: <-20 HU within a renal lesion) - diagnostic hallmarkHypervascular3p deletion. VHL gene mutation. Loss of 8p. 9p. 14q and Gain of 5qRespond to immunotherapyChromophilic (papillary) RCC:10-15% of RCCsHvpovascularSeen in End-Stage Renal Disease (ESRD) and Acquired Renal Cystic Disease (ARCD)Multicentricity is an important feature {40%)Trisomy 7.17. Loss of Y chromosomeType 1: BasophilicType 2: Eosinophilic - aggressiveChromophobic RCC:3-5% of RCCsPrognosis better than conventional RCCHypo vascularMircovesides on electron microscopy - defining featurePlant cell appearancePerinuclear haloPositive for Hale's colloidal iron (indicates presence of mucopolysaccharide) - unique to RCCPositive for cytokeratin; Negative for vimentinLoss of 1.6.8.11,18.21 .Y; VHL mutations and chromosome 3 abnormalitiesCollecting duct (Bellini duct) RCC:1% of RCCsPoor prognosisInfiltrativeAffinity for UlexeuropaceouslectmRenal medullary' carcinoma:Exclusively associated with sickle cell traitInfiltrativeRelatively hypoxic environment plays a role in fumori gene sisOncocytoma:Histology and mean size (4-6 cm) similar to Chromophobe RCCIncreased uptake on Technetium Sestamibi scan - uniqueNumerous large mitochondriaCentral scarLow gradeAngiomyolipoma (AML):Mature adipose tissue, smooth muscle and thick walled vessels seenHMB 45 positiveHyperechoic on ultrasonogramSeen in tuberous sclerosis: 30 years. F:M -- 2:1; multicentric5-6th decade; F>>M (if not associated with TS)Fat on CT (< -20HU) diagnostic of AML and excludes RCCPregnancy increases risk of haemorrhage from AML | train | med_mcqa | null |
In which of the following diseases decrease in levels of single neurotransmitter was first identified? | [
"Alzheimer's disease",
"Parkinson's disease",
"Huntington disease",
"Schizophrenia"
] | B | Neurons of the substantia nigra communicate with neurons of the basal ganglia by liberating the neurotransmitter dopamine (DA). In Parkinson's disease, neurons of the substantia nigra progressively degeneration; as a result, the amount of DA available for neurotransmission in the corpus striatum is lowered. Ref Harrison20th edition pg 2456 | train | med_mcqa | null |
A neonate born to infected hepatitis- B mother, should be treated with - | [
"Isolation",
"Immunoglobulins",
"Hepatitis-B-Vaccine",
"Immunoglobulins & hepatitis-B-vaccine"
] | D | Ans. is 'd' i.e., Immunoglobulins & Hepatitis B Vaccine "Infants born to Hbs Ag positive mothers should receive both HBIG and HB vaccine intramuscularly at seperate sites within 12 hours of bih, followed by 2nd and 3rd dose of vaccine at 1 and 6 months respectively." | train | med_mcqa | null |
A competitive antagonist is a substance that | [
"Interacts with receptors and produces submaximal effect",
"Binds to the same receptor site and progressively inhibits the agonist response",
"Binds to the nonspecific sites of tissue",
"Binds to one receptor subtype as an agonist and to another as an antagonist"
] | B | In the presence of a fixed concentration of agonist, increasing concentrations of a competitive antagonist progressively inhibit the agonist responseBasic and clinical pharmacology Katzung 13th edition pg 23 | train | med_mcqa | null |
Battle's sign is associated with: | [
"Orbital cellulitis",
"Head injury",
"Conjunctivitis",
"Liver failure"
] | B | Extravasation of blood results in ecchymosis behind the ear, known as Battle's sign. A fracture of the anterior skull base can result in anosmia (loss of smell from damage to the olfactory nerve), CSF drainage from the nose (rhinorrhea), or periorbital ecchymoses, known as raccoon eyes. Ref: Schwaz's principle of surgery 9th edition, chapter 42. | train | med_mcqa | null |
Most common tumour of eyelid is | [
"Basal cell carcinoma",
"Adenocarcinoma",
"Squamous cell carcinoma",
"Sebaceous cell carcinoma"
] | A | (A) (Basal cell carcinoma) (430-Nema 5th) (457- Parson 21st)* Basal cell carcinoma is the most common maligment tumour of the eyelids and constitutes 85%-90% of the all malignant epithelial eyelid tumours.* Squamous papilloma is the most common benign tumour of the eyelid.Common malignant tumours of the eyelidTypeCommon locationClinical featuresSpreadTherapyBasal cell carcinomaMedial canthus, lower lidNodule, central ulceration with pearly surface telangiectasiaLocalResection RadiationSquamous cell carcinomaLower lid. From previous actinic keratosisUlcer with thickened margins, keratosis papillomatousLocal, lymph nodesResection,RadiationCryotherapySebacious cell carcinomaUpper lidNodular resembling, chalazion multifocal F > M recurrence commonLocal intraepith elial lymph nodesResectionCryotheropyExenterationMalignant melanomaPrevious nevi> 6mm size pigmented lesion. Vascularization inflammationLocal vascular lymph nodesResectionExenterationThe moct common benign orbital tumour is adults Cavernous HemangiomaMost common malignant orbital tumour in adults is LymphomaMost common benign orbital tumour in children is Dermoid cystMost common malignant orbital tumour in children is RhabdomyosarcomaBASAL CELL CARCINOMA* Also k/a "Rodent ulcer"* It is more common in Caucasians (99%)* Age is 40-79 years* Ultravoilet light exposure is one of the most important risk factors* It is locally malignant* It involves most commonly lower eyelid (50-60) >medial canthus (25-30%) >upper eyelid (15-20%) > lateral canthus* Basal cell nevus syndrome (Gorlin- Goltz syndrome) is a rare syndrome occurring in <l%of patients with basal cell carcinoma* Surgery is the treatment of choice - there are two- techniques(i) Moh's micrographic surgery(ii) Excisional biopsy with frozen section control | train | med_mcqa | null |
Dukes classification is used for | [
"Pancreas carcinoma",
"Gastric carcinoma",
"Urinary bladder carcinoma",
"Colo-rectal carcinoma"
] | D | Dukes' classification was originally described for rectal tumours but has been adopted for histopathological repoing of colon cancer as well. Dukes' classification for colon cancer is as follows: A: confined to the bowel wall; B: through the bowel wall but not involving the free peritoneal serosal surface; C: lymph nodes involved.Dukes himself never described a D stage, but this is often used to describe either advanced local disease or metastases to the liver.Dukes classified carcinoma of the rectum into three stages: A: The growth is limited to the rectal wall (15%); prognosis excellent. B: The growth is extended to the extrarectal tissues, but no metastasis to the regional lymph nodes (35%): prognosis reasonable. C: Secondary deposits in the regional lymph nodes (50%); prognosis is poor. These are subdivided into C1, in which the local pararectal lymph nodes alone are involved, and C2, in which the nodes accompanying the supplying blood vessels are implicated up to the point of division.A stage D is often included, which was not described by Dukes which signifies the presence of widespread metastases, usually hepatic.Reference : page 1180 and 1230 Bailey and Love's sho practice of surgery 25th edition | train | med_mcqa | null |
Which is the characteristic lesion of pregnancy? | [
"Vitiligo",
"Pemphigus",
"Tinea",
"Chloasma"
] | D | Chloasma | train | med_mcqa | null |
In the treatment of hydatid cyst, PAIR is contraindicated in | [
"Lung cyst",
"Size >5 cm",
"Not amenable to treatment with albendazole",
"Multiple"
] | A | Contraindication to PAIR Inaccessible location Pulmonary hydatid cyst Complicated cyst( communicating with biliary tract) | train | med_mcqa | null |
Investigation of choice to detect Hydatiform mole is : | [
"X-ray abdomen",
"USG",
"Serum HCG level",
"Gravindex"
] | B | USG | train | med_mcqa | null |
Membrane attack complex is formed by all except? | [
"C3",
"C5",
"C7",
"C9"
] | A | Ans. (a) C3 | train | med_mcqa | null |
Which one of the following radioisotope is not used as permanent implant: | [
"Iodine-125.",
"Palladium-103",
"Gold-198.",
"Caesium-137"
] | D | D i.e. Cesium - 137 | train | med_mcqa | null |
Vossius ring is seen in: | [
"Cornea",
"Lens",
"Vitreous",
"Retina"
] | B | Ans. Lens | train | med_mcqa | null |
Which one of the following statement is FALSE with regard to pyuria in children: | [
"Presence of more than 5 WBC/hpf for girls and more than 3 WBC/hpf for boys",
"Infection can occur without pyuria",
"Pyuria maybe present without UTI",
"Isolated pyuria is neither confirmatory nor diagnostic for urinary tract infection"
] | A | a. Presence of more than 5WBC/hpf for girls and more than 3WBC/hpf for boys(Ref: Nelson's 20/e p 2557)High Yield Points:Pyuria suggests infection, but infection can occur in the absence of pyuria; Conversely, pyuria can be present without UTI;Sterile pyuria (positive leukocytes, negative cultures) occurs in partially treated bacterial UTI, viral infections, renal tuberculosis, renal abscess, interstitial nephritis, inflammation near ureter or bladderIn an uncentrifuged urine specimen >5WBCs/hpf is abnormal and is called pyuria. | train | med_mcqa | null |
Little old lady's hernia is also know as | [
"Femoral hernia",
"Incisional hernia",
"Obturator hernia",
"Inguinal hernia"
] | C | null | train | med_mcqa | null |
During incision and drainage of ischiorectal abscess, which nerve is affected | [
"Superior rectal nerve",
"Inferior rectal nerve",
"Inferior gluteal nerve",
"Ilioinguinal nerve"
] | B | Contents of ischiorectal fossa
Fat
Pudendal canal and its contents
Inferior rectal nerve and vessels. | train | med_mcqa | null |
In psoritic ahropathy TOC is | [
"Mtx",
"5FU",
"PUVA",
"Steroid"
] | A | A i.e. Mtx | train | med_mcqa | null |
Painful ulcer on glans penis is seen in: | [
"Syphilis",
"Lymphogranuloma venerum",
"Chancroid",
"Chancre"
] | C | Ans: (c) ChancroidRef: Harrison 19th ed. / 881, 1134* Chancroid is a bacterial STD caused by H.Ducreyi. It is characterized by painful sores on the genitalia. Chancroid is known to spread from one individual to another solely throueh sexual contact.* A chancre on the other hand is a painless ulceration/ sore most commonly formed during the primary stage of syphilis. | train | med_mcqa | null |
Man is the intermediate host of: | [
"Malaria",
"Filaria",
"Dengue",
"Plague"
] | A | Sexual cycle takes place in the mosquitoes, while asexual Cycle takes place in human beings. Therefore, mosquito acts as the definitive host, while man-the intermediate host. Asexual cycle is responsible for producing clinical malaria in man, while sexual cycle is responsible for reproduction. Human cycle acts as a reservoir, while mosquito cycle a transmitter of the disease. | train | med_mcqa | null |
A 60 yr old male had a sudden fall in toilet. His BP was 90/50 mm Hg and pulse was 100/min. His relatives reported that his stool was black/dark in colour. Further careful history revealed that he is a known case of hypertension and coronary artery disease and was regularly taking aspirin, atenolol and sorbitrate. The most likely diagnosis is | [
"Gastric ulcer with bleeding",
"Acute myocardial infarction with cardiogenic shock",
"Acute cerebrovascular accident",
"Pulmonary embolism"
] | A | null | train | med_mcqa | null |
All of the following predispose to gastric carcinoma except | [
"Achlorhydria",
"'O'blood group",
"Pernicious anaemia",
"Post gastrectomy"
] | B | null | train | med_mcqa | null |
Acute hemorrhagic conjunctivitis occurs due to - | [
"Poliovirus",
"Hepadnavirus",
"Enterovirus 70",
"Coxackie B virus."
] | C | Ans. is 'c' i.e., Enterovirus 70 o Enterovirus 70 causeso Coxsackie A-24 causeso Adenovirus causes---Acute hemorrhagic conjunctivitisAcute hemorhagic conjunctivitisEpidemic keratoconjunctivitisAcute Follicular conjunctivitisPharyngoconjunctival fever | train | med_mcqa | null |
A 6 years old boy presented with Complex seizures per day in spite of adequate 4 drug antiepileptic regime. He had history of repeated high-grade fever in childhood. MRI for epilepsy protocol revealed normal brain scan. Which of the following will not be helpful for functional imaging of brain? | [
"MDCT",
"SPECT imaging",
"Interictal 18F-FDG PET",
"Video EEG with Ictal 99mTc- HMPAO study of brain"
] | A | Brain perfusion study using perfusion agents like Tc-99m HMPAO, i.e., Tc-9W6HMPAO brain SPECT is indicated in acute cerebral infarct imaging before evidence of CT/MRI pathology, when positive findings are seen with 1 hour of event. Brain metabolic rate and functional activity study by using 18F –FDG PET is indicated in focal epilepsy prior to seizure.
MDCT is not useful for functional studies of brain. | train | med_mcqa | null |
Infliximab is contraindicated in | [
"Crohn's disease",
"Intestinal tuberculosis",
"Ankylosing spondylitis",
"Rheumatoid arthritis"
] | B | (B) Intestinal tuberculosis # Infliximab is a drug used to treat autoimmune disorders.> Infliximab is known as a "chimeric monoclonal antibody" (the term "chimeric" refers to the use of both mouse (murine) and human components of the drug i.e. murine binding Fab domains and human constant Fc domains).> Case studies have been done into other uses of infliximab, such as to treat skin diseases.> Infliximab has been approved for treating ankylosing spondylitis, Crohn's disease, fistulizing Crohn's disease, pediatric Crohn's disease, psoriatic arthritis, psoriasis, rheumatoid arthritis, and ulcerative colitis.> Infliximab is also prescribed (out of indication) for the treatment of Behcet's disease and infusions of infliximab have been used successfully in the treatment of sciatica due to slipped discs | train | med_mcqa | null |
Bimolar technique is name given to which of the following views of the jaws? | [
"Two molar TOPA of the right and Left sides",
"Modified panoramic radiograph",
"Oblique lateral views of the right and left sides",
"Bregma-menton view"
] | C | null | train | med_mcqa | null |
Number of doses of HDCV vaccine required for preexposure prophylaxis ? | [
"7",
"5",
"3",
"1"
] | C | Ans. is 'c' i.e., 3 Pre-exposure prophylaxis . Persons who run a high risk of repeated exposure such as laboratory staff working with rabies virus, veterinarian, animal handlers and wild -life officers should be protected by pre-exposure immunization. . Cell-culture vaccine given on days 0, 7 and 28 (Total 3 doses) . Fuher booster should be given at intervals of 2 years. | train | med_mcqa | null |
Most common tumor in children is - | [
"Leukemia",
"Lymphoma",
"Wilm's tumor",
"Neuroblastoma"
] | A | Ans. is `a' i.e., Leukemias o Most common childhood tumor --> Leumemia o Most common childhood leukemia --> ALL o Most common solid tumor of childhood --> Brain tumor o Most common tumor in infancy -----> Neuroblastoma o Most common abdominal tumor in child ----> Neuroblastoma | train | med_mcqa | null |
Most of the drugs are excreted in | [
"Faeces",
"Urine",
"Saliva",
"None"
] | B | Ans. is 'b' i.e., Urine o Most impoant channel of excretion for most drugs is through kidney (in urine). | train | med_mcqa | null |
On complete hydrolysis of DNA, we will get all following except: | [
"Adenosine",
"Purine base",
"Phosphoric acid",
"Dexose pentose sugar"
] | A | A i.e. Adenosine- Nitrogen base + sugar = Nucleoside - Adenosine is a nucleoside composed of ?- Nucleoside + phosphate = Nucleotide - Adenine (Nitrogen base)- Nucleotides linked together by. 3' 5' - Ribose (Pentose sugar)phosphodiester bond = Nucleic acid. - On complete hydrolysis, Adenosine should yield the above two component individually. | train | med_mcqa | null |
Which of the following colonic polyps has no risk for malignancy - | [
"Juvenile polyps",
"Hamartomatous polyps associated with Peutz- Jegher's syndrome",
"Juvenile polyposis syndrome",
"Famillial adenomatous polyposis syndrome"
] | A | Ans. is 'a' i.e. Juvenile Polyps Repeat from Nov 09Hamartomatous polyps (juvenile polyp is also a hamartomatous polyp) by definition do not have malignant potential. They are characterized by overgrowth of normal components of colon, such as epithelium and connective tissue.These hamartomatous polyps are seen in following syndromes - Familial juvenile polyposis, Cronkhite - Canada and Peutz-Jeghers syndromes.Unlike solitary juvenile (hamartomatous) polyps, polyps associated with Familial juvenile polyposis and Peutz Jeghers syndrome may degenerate into adenomas and eventually into carcinomas. There is increased risk of gastrointestinal as well as extra gastrointestinal malignancies in the syndromes. | train | med_mcqa | null |
Intra aerial thrombolysis is indicated in | [
"Suspected occlusion of larger aery",
"History of subarachnoid hemorrhage",
"History of dementia",
"Stroke of > 6 hours duration"
] | A | Answer- A. Suspected occlusion of larger aeryAcute ischemic stroke < 6 hours in durationStroke is significant, (i.e., disabling or life threatening)Suspected occlusion of a large aery (i.e., non-lacunar stroke syndrome)No hemorrhage on screening computed tomography scan | train | med_mcqa | null |
Levonorgestrel IUS used in treatment of AUB, has all benefits except | [
"Provides contraceptive cover",
"Effective for associated dysmenorrhea",
"No break-through bleeding",
"Women become amenorrheic within one year after insertion"
] | C | Irregular menses and break through bleeding occurs for first 3 → 9 months after insertion. | train | med_mcqa | null |
All of the following predispose to IHD except | [
"Smoking",
"Alcoholism",
"Sedentary habits",
"Diabetes"
] | B | null | train | med_mcqa | null |
Characteristic of Gerstmann syndrome include all EXCEPT | [
"Aphonia/Dysphonia",
"Left-right disorientation",
"Dysgraphia/Agraphia",
"Dyscalculia/Acalculia"
] | A | (A) Aphonia/Dysphonia > Gerstmann syndrome is characterized by four primary symptoms:1. Dysgraphia/agraphia2. Dyscalculia/acalculia3. Finger agnosia4. Left-right disorientation> Causes: This disorder is often associated with brain lesions in the dominant (usually left) hemisphere including the angular and supramarginal gyri near the temporal and parietal lobe junction. There is significant debate in the scientific literature as to whether Gerstmann Syndrome truly represents a unified, theoretically motivated syndrome. Thus its diagnostic utility has been questioned by neurologists and neuropsychologists alike. The angular gyrus is generally involved in translating visual patterns of letter and words into meaningful information, such as is done while reading.> In adults: the syndrome may occur after a stroke or in association with damage to the parietal lobe.> In addition to exhibiting the above symptoms, many adults also experience aphasia, which is a difficulty in expressing oneself when speaking, in understanding speech, or in reading and writing.> In children: There are few reports of the syndrome, sometimes called developmental Gerstmann syndrome, in children. The cause is not known. Most cases are identified when children reach school age, a time when they are challenged with writing and math exercises. Generally, children with the disorder exhibit poor handwriting and spelling skills, and difficulty with math functions, including adding, subtracting, multiplying, and dividing. An inability to differentiate right from left and to discriminate among individual fingers may also be apparent. In addition to the four primary symptoms, many children also suffer from constructional apraxia, an inability to copy simple drawings. Frequently, there is also an impairment in reading. Children with a high level of intellectual functioning as well as those with brain damage may be affected with the disorder.> Treatment: There is no cure for Gerstmann syndrome. Treatment is symptomatic and supportive. Occupational and speech therapies may help diminish the dysgraphia and apraxia. In addition, calculators and word processors may help school children cope with the symptoms of the disorder.> Prognosis: In adults, many of the symptoms diminish over time. Although it has been suggested that in children symptoms may diminish over time, it appears likely that most children probably do not overcome their deficits, but learn to adjust to them. | train | med_mcqa | null |
Cognitive model of depression was given by: | [
"Beck",
"Skinner",
"Cerletti",
"Freud"
] | A | The cognitive model of depression evolved from systematic clinical observation and experimental testing by Beck. The cognitive model postulates three specific concepts to explain the psychological substrate of depression The cognitive triad Schemas Cognitive errors Ref: Cognitive Therapy of Depression edited by Aaron T. Beck. | train | med_mcqa | null |
A 7-year-old child presents to the paediatric clinic with amiguous genitalia increasing with age. On examination her height, weight and blood pressure were recorded within normal limits. Labia appeared bifid with 2 separate perineal openings, phallic length was 2.5 cm and no palpable gonads were noted in the inguinal region. USG shows presence of mullerian structures. The most probable diagnosis is- | [
"Classic Salt-Wasting 21 Hydroxylase deficiency",
"Simple virilizing congenital adrenal hyperplasia",
"Complete Androgen Insensitivity Syndrome",
"5-Alpha Reductase Deficiency"
] | B | Ans. is 'b' i.e., Simple virilizing congenital adrenal hyperplasia Among the given options only 21 hydroxylase is the common cause of ambiguous genitalia. Now the confusion arises, because 21-hydroxylase deficiency typically presents with salt wasting and hypotension, whereas the child in question is having normal BP. Actually, some forms (simple virilizing form) of 21-hydroxylase deficiency have normal BP and no salt loss. Type of 2 I -hydroxylase deficiency (A) Classic salt wasting form o This is a severe form of deficiency characterized by features of both glucocoicoid (coisol)/mineralocoicoid deficiency (salt wasting) and androgen excess. (Ambiguous genitalia in females). Males may be normal at bih. o This form typically manifests early, between 7-21 days of life and is a potentially life threatening condition. Classic simple virilizing form o Patients with classic simple virilizing form have impaired coisol biosynthesis but do not develop salt loss. o Clinical features are caused solely by overproduction of androgens. o The only manifestation is ambiguous genitalia in a female child with varying degrees of clitoral enlargement and labial fusion. o Depending on severity of clitoral enlargement and labial fusion, the diagnosis may be established at bih. However such patients may present in early childhood. (C) Non-classic (aquired/late) from o Patients with non-classical form or late onset form produce normal amount of coisol and/or aldosterone, but at the expense of producing excess androgens. o These usually present in childhood or early adulthood with premature pubarche & symptoms/signs of PCOD. Hirsuitism, Acne and Oligomenorrhea are the most common presenting features. | train | med_mcqa | null |
If the annual growth rate of population is 1.5-2% then growth of population is rated as :- | [
"Moderate growth",
"Rapid growth",
"Very rapid growth",
"Explosive growth"
] | C | Relation between growth rate and population Rating Annual Rate of Growth % Number of years required for population to double in size Stationarypopulation Slow growth Moderate growth Rapid growth Very rapid growth "Explosive" growth -------"-------- -------"-------- -------"-------- No growth Less than 0.5 0.5 to 1.0 1.0 to 1.5 1.5 to 2.0 2.0 to 2.5 2.5 to 3.0 3.0 to 3.5 3.5 to 4.0 Nil More than 139 139-70 70-47 47-35 35-28 28-23 23-20 20-18 | train | med_mcqa | null |
A 13-year-old boy presents with swelling in the cheek with recurrent epistaxis. Most likely cause is | [
"Angiofibroma",
"Carcinoma of Nasopharynx",
"Rhabdomyosarcoma",
"None"
] | A | CLINICAL FEATURES 1. Age and sex. Tumour is seen almost exclusively in males in the age group of 10-20 years. Rarely, it may be seen in older people and females. 2. Profuse, recurrent and spontaneous epistaxis. This is the most common presentation. The patient may be markedly anaemic due to repeated blood loss. 3. Progressive nasal obstruction and denasal speech. It is due to the mass in the postnasal space. 4. Conductive hearing loss and otitis media with effusion. It occurs due to obstruction of the eustachian tube. 5. Mass in the nasopharynx. Tumour is sessile, lobulated or smooth and obstructs one or both choanae. It is pink or purplish in colour. Consistency is firm but digital palpation should never be done until at the time of operation. 6. Other clinical features like broadening of the nasal bridge, proptosis, swelling of the cheek, infratemporal fossa or involvement of IInd, IIIrd, IVth and VIth cranial nerves will depend on the extent of the tumour. (Ref: Diseases of Ear, Nose and Throat, PL Dhingra, 7th edition, page 279) | train | med_mcqa | null |
Which of the following drug is corticosteroid synthesis inhibitor? | [
"Metyrapone",
"Finasteride",
"Flutamide",
"Mifepristone"
] | A | Metyrapone inhibits 11 - β - hydroxylase enzyme and prevents synthesis of corticosteroids. | train | med_mcqa | null |
Eczema herpeticum is caused by | [
"Herpes simplex virus",
"Varicella",
"CMV",
"HPV"
] | A | Eczema herpeticum/ kaposis varicelliform eruption cutaneous eruption caused by herpes simplex infection or other viruses in patients with preexiting dermatosis most commonly associated with atopic dermatitis eruption is disseminated and predilection over the areas with rash. onset is abrupt with Ulster's of umbilicated lesions in preexisting dermatosis diagnosis: thank smear- multinucleated gaint cells,pcr treatment : acyclovir other viruses causing eczema herpeticum: vaccinia, coxasackie virus a 16 associated skin diseases that trigger eczema herpeticum: mycosis fungoides, pityriasis rubra Polaris,irritant contact dermatitis, ichthyosaurs vulgaris, pemphigus foliaceous, Hayley Hayley disease, seborrhoea dermatitisburns iadvl textbook of dermatology.page 245 | train | med_mcqa | null |
The therapeutic efficiency of antihypeensive drugs is blunted by NSAIDs because they | [
"Cause of sodium excretion",
"Increase the clearance of anti Hypeensive drugs",
"Decrease the absorption of antihypeensive drugs",
"Decrease the synthesis of Vascular prostacyclin"
] | D | PG E2 and PGI2 cause renal vasodilatation, natriuresis and increased water clearance due to inhibition of the action of ADH. Loop diuretics act paly by increasing the stimulation of cox. therefore NSAIDs attenuate the diabetic action of these drugs. Refer kDT 6/e p708 | train | med_mcqa | null |
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