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in the aboove show triangle posteror border is formed by ? | [
"bony labrynth",
"sigmoid sinus",
"superior petrosal sinus",
"CAVERNOUS SINUS"
] | B | THIS IS THE IMAGE OF TRAUGHTMANNS TRIAGNLE REF : GRAYS ANATOMY | train | med_mcqa | null |
A patient presented with subcutaneous nodules over the Iliac Crest, snow flake oplacity in eye. Skin Scraping contains microfilaria and adult worms of | [
"Onchocerca volvulus",
"Loa loa",
"Brugia Timori",
"Mansonella Ozzardi"
] | A | Subcutaneous nodules, snow flake opacities is a feature of Onchocerciasis. | train | med_mcqa | null |
Dermatophytes are – | [
"Sporothrix",
"Tinea versicularis",
"Microsporidium",
"Trichophyton rubrum"
] | D | Microsporidium (not microsporum). Microsporidium is a protozoal parasite. | train | med_mcqa | null |
On mammogram all of the following are the features of a malignant tumor except | [
"Spiculation",
"Microcalcification",
"Macrocalcification",
"Irregular mass"
] | C | Mammographic features suggestive of breast cancer A solid mass with or without stellate features Asymmetric thickening of breast tissues Clustered microcalcification Presence of fine, stippled calcium in and around a suspicious lesion is suggestive of breast cancer and occurs in as many as 50% of nonpalpable cancers These microcalcifications are especially impoant sign of cancer in younger women, in whom it may be the only mammographic abnormality Ref:Sabiston 20th edition Pgno : 828 | train | med_mcqa | null |
Drug of choice for restless leg syndrome ? | [
"Ropinirole",
"Chlorpromezine",
"Haloperidol",
"Bupripione"
] | A | Ans. is'a'i.e., Ropinirole Drugs of choice for Restless leg syndrome are dopamine agonists like ropinirole or promipole or rotigotine.Levodopa can also be used. | train | med_mcqa | null |
At what age baby with congenital hypertrophic pyloric stenosis show symptoms | [
"At the time of birth",
"First week",
"3rd to 4th week",
"Second month"
] | C | Baby show the symptoms of projectile vomiting, olive shaped mass and visible peristalsis | train | med_mcqa | null |
All of the following are morphological neurological complication of measels except | [
"Transverse myelitis",
"Encephalitis",
"Optic neuritis",
"SSPE"
] | C | Answer- C. Optic neuritisComplications of measles are :-Respiratory: Otitis media (most common complication) , pneumonia (Giant cell or Hecht,s pneumonia), bronchitis, laryngitis, croup.CNS : These are most serious and include encephalitis, transverse myelitis and a rare complication SSPE (Subacute sclerosingpanencephalitis).Gastrointestinal- Gastroentritis, hepatitis, appendicitis, diarrhea, ileocolitis, mesenteric adenitis. | train | med_mcqa | null |
Which one of the following muscles of thumb is not supplied by median nerve | [
"Adductor pollicis brevis",
"Flexor pollicis brevis",
"Opponens pollicis",
"Abductor pollicis brevis"
] | A | -in the palm, the median nerve flattens at the distal border of the flexor retinaculum and divides into lateral and medial divisions. The lateral division gives a recurrent branch that curls upwards to supply the thenar muscles except for the deep head of flexor pollicis brevis. Thenar muscles are abductor pollicis brevis, flexor pollicis brevis and opponents policies Mnemonic Median nerve innervates hand muscles like The LOAF muscles Lumbricals 1 & 2 Opponens pollicis Abductor pollicis brevis Flexor pollicis brevis -Reference: Textbook of anatomy, Upper limb and thorax, Vishram Singh, 2nd edition, page no.144,177 Figure: 9.41,page no: 126- BD chaurasia , 6th edition | train | med_mcqa | null |
Patient of Rectovaginal fistula should be initially treated with | [
"Colostomy",
"Primary repair",
"Colporrhaphy",
"Anterior resection"
] | A | Recto-Vaginal Fistula Management Preliminary colostomy is done Local repair after 3 weeks Closure of colostomy after 3weeks Ref: D.C.DUTTA&;S TEXTBOOK OF GYNAECOLOGY; 6th edition; Pg no:428 | train | med_mcqa | null |
In old age for rectal prolapse palliative surgery in a patient unfit for surgery is | [
"Orr-Loygue procedure",
"Well's procedure",
"Thiersch's operation",
"Low anterior resection"
] | C | Rectal prolapse Procedures Abdominal Procedures Perineal procedures Considered the surgical procedures of choice for young & fit individuals Not suitable for elderly and inform patients Are most likely to improve continence Have least recurrence rates Postoperative constipation is the MC side effect Abdominal procedures Abdominal rectopexy Suture rectopexy Mesh rectopexy - posterior (Well's Ivalon's), Anterior (Ripstein's), Lateral (Orr-Loygue), ventral Resection rectopexy (Frykmann and Goldberg) Anterior resection Relatively minor procedures that may be performed under local or regional anaesthesia Well tolerated by elderly, frail & unfit patients Less likely to improve continence Recurrence rates varrying from 5-35% higher than following abdominal rectopexy Postoperative constipation is infrequent Perineal procedure Delorme's muscosectomy Theirsch and encirclement Altemeier rectosigmoidectomy Ref: Bailey and love 27th edition Pgno : 1323 | train | med_mcqa | null |
Which of the following is the rate-limiting enzyme of bile acid synthesis? | [
"microsomal 7-a hydroxylase",
"mitochondrial 7-a hydroxylase",
"microsomal 17-a hydroxylase",
"mitochondrial 17-a hydroxylase"
] | A | microsomal 7-a hydroxylaseis rate-limiting enzyme of bile acid synthesis The first intermediate in the synthesis of bile acids is 7a-hydroxycholesterol It is catalyzed by the enzyme 7a-hydroxylase, a microsomal CYP450 enzyme, which requires NADPH, oxygen, and vitamin C as co-factors. | train | med_mcqa | null |
Spontaneous pneumothorax exceeding .....% of chest cavity should have a chest tube inseed - | [
"10",
"25",
"45",
"60"
] | B | Ans. is 'b' i.e., 25 Exact answer according to Schwaz in 30%. | train | med_mcqa | null |
Reasons for preference of internal jugular vein over external jugular vein for measurement of JVP include all except | [
"IJV is in direct continuation with right atrium",
"Increased sympathetic activity in IJV",
"EJV passes through more facial planes",
"Prominent valves at proximal portion of EJV"
] | B | Increased sympathetic activity in EJV causes vasoconstriction of EJV , so pulsations become barely visible. | train | med_mcqa | null |
Outcome indicator for ASHA - | [
"IMR",
"TB/leprosy cases detected",
"Child malnutrition rate",
"% of institutional deliveries"
] | D | Ans. is 'd' i.e., % of institutional deliveries Monitoring and Evaluation of ASHA's workGovernment of India has set up following indicators for monitoring ASHA (41).1. Process IndicatorsNumber of ASHAs selected by due processNumber of ASHAs trained; and% of ASH As attending review meeting after one year2.Outcome Indicators% of newborn who were weighed and families counseled.% of children with diarrhoea who received ORS.% of deliveries with skilled assistance.% of institutional deliveries.% of JSY claims made to ASHA% of completely immunized in 12 to 23 months age group.% of unmet need for spacing contraception among BPL.% of fever cases who received chloroquine with in first week in a malaria endemic area.3.Impact IndicatorsIMRChild malnutrition ratesNumber of cases of TB/leprosy detected as compared to previous year. | train | med_mcqa | null |
Consider the following statements about Jacuzzi syndrome and mark the true statement . | [
"It is caused by Pneumococcus .",
"It is also known as hot tub folliculitis .",
"It is progressive illness .",
"It is always a painless condition ."
] | B | Jacuzzi syndrome :- It is caused by Pseudomonas aeruginosa This condition arises due to inflammation of hair follicles (haiub folliculitis). It is usually self limiting condition . It can be extremely painful or itchy condition . | train | med_mcqa | null |
Coho study is associated with: March 2010 | [
"Prevalence",
"Odd's ratio",
"Relative risk",
"Exposure rates"
] | C | Ans. C: Relative riskOdd's ratio can be derived from a case control study, which is a measure of the strength of the association between risk factor and outcome. | train | med_mcqa | null |
A 25-year-old woman complains of weakness and easy fatigability, which is most pronounced in the late afternoon. She describes difficulty reading and tiredness while watching television. She has problems chewing and swallowing and loses her voice while talking. Physical examination reveals ptosis and diplopia. Laboratory studies would most likely demonstrate serum autoantibodies directed against which of the following proteins? | [
"Acetylcholine receptor",
"Phosphodiesterase",
"Desmin",
"Dystrophin"
] | A | Acetylcholine receptor. Myasthenia gravis is an acquired autoimmune disease characterized by abnormal muscular fatigability. It is caused by circulating antibodies to the acetylcholine receptor at the myoneural junction (motor endplate). Antibodies to the acetylcholine receptor can be demonstrated in the serum of most patients with myasthenia gravis and localized in muscle biopsies by immunohistochemistry. The clinical severity of the condition is variable, and symptoms tend to wax and wane. The other choices are not related to myasthenia gravis.Diagnosis: Myasthenia gravis | train | med_mcqa | null |
In Orthodontic treatment, placing the tooth into its normal position results in | [
"Esthetics",
"Esthetics, Function and Tooth placement",
"Esthetics and Occlusion",
"Esthetics, Occlusion and Stability"
] | D | null | train | med_mcqa | null |
The phosphor crystals often contain rare earth elements, the most common being: | [
"Lanthanum and gadolinium",
"Thulium",
"Niobium",
"Terbium"
] | A | The phosphor layer is composed of phosphorescent crystals suspended in a polymeric binder. When the crystals absorb X-ray photons, they fluoresce. The phosphor crystals often contain rare earth elements, most commonly lanthanum and gadolinium. Their fluorescence can be increased by the addition of small amounts of elements, such as thulium, niobium, or terbium. Rare earth screens convert each absorbed X-ray photon into approximately 4000 lower-energy, visible light (green or blue) photons. These visible photons expose the film. | train | med_mcqa | null |
Best view for right pleural effusion in X-Ray chest | [
"Supine",
"Right lateral decubitus",
"Left lateral decubitus",
"All"
] | C | C i.e. Right lateral decubitus | train | med_mcqa | null |
GCS max score is - | [
"3",
"15",
"6",
"18"
] | B | Ans. is 'b' i.e., 15 | train | med_mcqa | null |
The genes involved in CA stomach are all except | [
"Supression of p53 gene",
"C-kit mutation",
"APC gene",
"k-ras mutation"
] | B | Ans. is B C-kit mutationRisk factors for gastric carcinomaA) Environmental factors : H. Pylori infection, dietary factors (nitrites/nitrate, smoked and salted foods, lack of fresh fruits/vegetables, deficiency of vitamin C & E), cigarette smoking, and low socioeconomic status.B) Host factors : Chronic gastritis (causing hypochlorhydria or intestinal metaplasia), partial gastrectomy, gastric adenoma, Barrett's esophagus, and Menetrier disease.Intestinal metaplasia is the most significant precursor lesion for Gastric cancer.C) Genetic factors : Blood group A, Hereditary nonpolyposis colon cancer syndrome (HNPCC) and Familial gastric cancer syndrome (E-cadherin mutation). Genes and genetic alterations involved in gastric carcinoma arei) Intestinal type gastric cancer: K-ras mutation, APC mutation, pS2 methylation, HMLH1 methylation, p16lNK4a methylation, p 73 deletion and C-erb B-2 amplification.ii) Diffuse type gastric caner: CDH1 gene (E-Cadherin) mutation, K-sam amplification.iii) For both type: Telomerase reduction (telomerase shortening), hTERT expression, genetic instability, overexpressionof the cyclin E & CDC25B & E2F1 genes,p53 mutations, reduced expression, CD44 aberrabont transcripts, and amplification of the C-met & Cyclin E genes.Decreased risk of stomch cancer is seen witho Vitamine C & Eo Aspirino Diet high in green leafy vegetables and citrus fruitso Beta - Carotene | train | med_mcqa | null |
An adult female patient presents with asthma symptoms for at least 4 days a week and wakes up at night due to breathlessness approximately 2 -3 days in a month. she is classified to be having. | [
"Severe persistent Asthma",
"Mild persistent Asthma",
"Intermittent Asthma",
"Moderate persistent Asthma"
] | B | null | train | med_mcqa | null |
With MAO inhibitors, food not given is: | [
"Cheese",
"Beer",
"Fish",
"All of the above"
] | D | Ref: KDT 6/e p440 Cheese, beer, wine, pickled meat, fish and yeast extract are rich in sympathomimetic amines. In MAO inhibited patients, these indirectly acting sympathomimetic amines are not degraded in the intestinal wall and liver and reach into systemic circulation where they cause release of large amount of norepinephrine from adrenergic nerve endings, thus precipitating hypeensive crises. It is known as cheese reaction. | train | med_mcqa | null |
Which of the following features is NOT seen in papillary carcinoma thyroid? | [
"Papillary structure usually complex with a fibrovascular core",
"Optically clear nuclei with nuclear overlapping",
"Nuclear pseudoinclusions and nuclear grooves",
"Tumor cell immunopositivity for calcitonin"
] | D | Tumor cell immunopositivity for calcitonin | train | med_mcqa | null |
Which structure connects Broca's area and Wernicke area? | [
"Arcus fasciculus",
"Anterior commissure",
"Corpus callosum",
"Fornix"
] | A | Wernicke's area- for comprehension Broca's area- for expression/fluency Arcus fasciculus- connection between broca's and Wernicke's area. - for repetition Corpus callosum- connects both cerebral hemispheres. Fornix- area bet 2 lateral ventricles. | train | med_mcqa | null |
A 40-year-old woman has been complaining of a 3-year history of increasing dyspnea and fatigue. She has no other medical illness. Physical examination reveals increased jugular venous pressure (JVP) with prominent c-v wave, and a reduced carotid pulse. Precordial examination reveals a left parasternal lift, loud P2, and right-sided S3 and S4. There are no audible murmurs. CXR reveals clear lung fields and an ECG shows evidence of right ventricular hypertrophy. Pulmonary function tests show a slight restrictive pattern. Primary pulmonary hypertension is suspected. Which of the following is the most appropriate test to confirm the diagnosis? | [
"open lung biopsy",
"pulmonary angiography",
"cardiac catheterization",
"noninvasive exercise testing"
] | C | Open lung biopsy is not required. Pulmonary angiography is usually performed only if a lung scan suggests thromboembolic disease. Cardiac catheterization is useful to exclude an underlying cardiac shunt as the cause of the pulmonary hypertension. The pulmonary capillary wedge pressure is normal but can be difficult to obtain. | train | med_mcqa | null |
Regarding Good pasture's syndrome all are true except | [
"Auto immune disease",
"Anty body against collagen type IV alpha3 chain of GBM and pulmonary capillaries",
"Diffuse bilateral pulmonary infiltrates",
"Slowly progressive Renal failure"
] | D | Good pasture's syndrome causes glomerulonephritis that results in rapidly progressive renal failure. | train | med_mcqa | null |
In which of the following conditions postmortem caloricity may be seen in death due to - | [
"Massive haemorrhage",
"Cyanide poisoning",
"Corrosive poisoning",
"Septicemia"
] | D | null | train | med_mcqa | null |
Following are the examples of apoptosis except:September 2008 | [
"Graft versus host disease",
"Menstrual cycle",
"Pathological atrophy following duct obstruction",
"Tumour necrosis"
] | D | Ans. D: Tumour necrosis | train | med_mcqa | null |
A 57 year old female presented with sho distance claudication. Peripheral aneurysm was suspected. Which of the following is the MOST common site of peripheral aneurysm? | [
"Femoral aery",
"Radial aery",
"Popliteal aery",
"Brachial aery"
] | C | Popliteal aery aneurysms account for 70% of peripheral aerial aneurysms. Popliteal aneurysms may embolize repetitively over time and occlude distal aeries. They are often undetected. The symptoms range from sudden onset pain and paralysis to sho distance claudication that slowly lessens as collateral circulation develops. Ref: Rapp J.H., Owens C.D., Johnson M.D. (2013). Chapter 12. Blood Vessel & Lymphatic Disorders. In M.A. Papadakis, S.J. McPhee, M.W. Rabow (Eds), CURRENT Medical Diagnosis & Treatment 2013. | train | med_mcqa | null |
Postural ohostatic tachycardia syndrome is characterised by all except? | [
"Women affected more commonly than men",
"Hea rate > 120/minute",
"Increase in hea rate > 30/minute when standing",
"Usually presents with ohostatic hypotension"
] | D | Postural ohostatic tachycardia syndrome (POTS) is characterised by symptomatic ohostatic intolerance without ohostatic hypotension that is associated with either hea rate of more than 120/minute or increase of >30/minute when standing that subside on sitting / lying down. The symptoms of ohostatic intolerance include lightheadedness, blurred vision, palpitation and nausea. Usually affects women more than men. This syndrome develops between 15 and 50 years of age. Reference: Harrison's Principles of Internal Medicine, 20th edition, p3164 | train | med_mcqa | null |
Emesis is not contraindicated in | [
"Kerosene poisoning",
"Nux vomica poisoning",
"Oxalic acid poisoning",
"arsenic poisoning"
] | D | Emesis should be used only if there is difficulty in obtaining gastric lavage. Vomiting can be produced if the medullary centers are still responsive. Due to danger of aspiration of gastric contents, vomiting should only be induced in a conscious patient. Contraindications: Severe hea and lung diseases. Advanced pregnancy. Kerosene poisoning In cases of CNS depression, seizures or rapidly acting CNS poisons (camphor, cyanide, tricyclicantidepressants, propoxyphene and strychnine). | train | med_mcqa | null |
In haemolytic glaucoma the mechanisms are all except: | [
"Siderosis of trabeculae",
"Deposition of haemosiderin",
"RBC clogging the trabeculae",
"Inflammation"
] | D | Ans. Inflammation | train | med_mcqa | null |
Cephalosporin that does not require dose reductionin patient with any degree of renal impairment is aEUR' | [
"Cefuroxime",
"Cefoperazone",
"Ceftazidime",
"Cefotaxime"
] | B | Cefoperazone [Ref: Goodman Gilman 17thie 1147, 1148; Katzung 10 p. 7371 Remember: ? Most cephalosporins are excreted mainly by tubular secretion. But ceftriaxone and cefoperazone are excreted mainly in bile and no dose adjustment is required in renal insufficiecy. The other unique feature of cefriaxone is its long half life. Thus it can be injected O.D. or B.D. in serious infections. According to Goodman and Gilman "All cephalosporins are excreted through kidney except celPiramide and cefoperazone which are excreted predominantly in the bile". About ceftriaxone Goodman Gilman mentions. "50% of this drug is excreted through urine while 50% of it is excreted through bile". But Katzung differs from Goodman Gilman "All cephalosporins are excreted through kidney except .for cefoperazone and ceftriaxone which are excreted mainly through the bilian' tract". Antimicrobial Drugs that do not require dosage adjustment in Renal Failure Cephalosporins Antitubercular * Cefoperaczone * Rifampicin * Ceftriaxone Other (miscellaneous) * Cefopiramide * Clindamycin * Chloramphenicol * Metronidazole Macrolides * Amphoterecin B * Erythomycin * Linezolid * Clarithomycin * Quinupristin / Dalfopristin * Azithromycin * Nafcillin / Oxacillin Fluoroquinolones Tetracycline * Trovafloxacin * Doxycycline * Grepafloxacin * Minocycline Use of Antimicrobial Agents in the Presence of Renal Dysfunction (Anesthesiology by Longnecker, Newman, Zapol'(2007J/285 Containdicated in the presence of dosage Require Require dosage adjustment only with severe adj adjustment with renal failures: renal failure: moderate renal failure: * Tetracyclines (except doxycycline), * Carbenicillin, ticarcillin, * Ampicillin, * Isoniazid, * Nitrofurantoin, * Cefazolin, * Mezlacillin. * Ethambutol, * Cephaloridine, * Aminoglycosides, * Piperacillin * Meropenem, * Long-acting sulfonamides, * Vancomycin, * Cefoxitin, * Nalidixic acid, * Methenamine, * Irnipenem, * Cefotaxime, * Ciprofloxacin, * Paraaminosalicylic acid * Flucytosine, * Penicillin G, * 5- fluorocytosine, * Fluconazole * Ceftizoxime, * Ofloxacin, * Ceftazidime, * Levofloxacin, * Cefuroxime, * Norfloxacin, * Cefotetan, * Itraconazole * Trimethoprim? * Sulfamethoxazole, | train | med_mcqa | null |
Following delivery, uterus becomes a pelvic organ after: September 2012 | [
"2 weeks",
"4 weeks",
"6 weeks",
"8 weeks"
] | A | Ans. A i.e. 2 weeks | train | med_mcqa | null |
Aplastic anemia in hereditary spherocytosis precipitated by- | [
"Parvo virus",
"HIV",
"Adenovirus",
"Influenza virus"
] | A | Answer is A (Parvovirus) Aplastic crisis is usually triggered by an acute parvovirus infection. | train | med_mcqa | null |
True statements about DNA structure: | [
"All nucleotides are involved in linkage",
"Antiparallel",
"Bases are perpendicular to DNA",
"All"
] | D | A i.e. All nucleotides are involved in linkage; B i.e. Antiparallel; C i.e. Bases perpendicular to DNA | train | med_mcqa | null |
Which one of the following statement is false about Pituitary gland? | [
"Somatotropic hormone secretion",
"Blood supply is by circle of Willis",
"It is derived completely from ectoderm",
"It is connected to thalamus by infundibulum"
] | D | The pituitary gland is suspended from the floor of the 3 rd ventricle by a stalk called the infundibulum.It secretes somatotropic hormonesAerial supply is by superior and inferior hypophyseal aeries, branches of internal carotid aeryDevelopment from ectoderm.Reference: Textbook of anatomy, Head Neck, and Brain, Vishram Singh, 2nd edition, page no.330-331 | train | med_mcqa | null |
Bacteria with tuft of flagellae at one end are called - | [
"Monotrichate",
"Peritrichate",
"Bipolar",
"Lophotrichate"
] | D | Ans. is 'd' i.e., Lophotrichate Two projections from the cells are impoant in relation to bacteria? i) Flagella ii) Fimbriae Flagella Flagella are the organs of locomotion. All motile bacteria except for spirochetes possess flagella. Flagella are made up of protein antigen flagellin Though flagella of different genera of bacteria have the same chemical composition, they are antigenically different Flagellar antigen induce specific antibodies in high titres. Flagellar antibodies are not protective but are helpful in serodiagnosis. On the basis of arrangement of flagella, bacteria may be divided into - | train | med_mcqa | null |
CD marker of Angiosarcoma is? | [
"CD 10",
"CD 19",
"CD 25",
"CD 31"
] | D | Robbins basic pathology 9th edition page no 362 Table:morphology The endothelial origin can be demonstrated in the poorly diffrentiated tumors by staining for the endothelial cell markers CD31 and von Wilebrand factor | train | med_mcqa | null |
Main role of Basal ganglia - | [
"Temperature regulation",
"Planning & programming of movement",
"Gross motor activity",
"Equilibrium"
] | B | Ans. is 'b' i.e., Planning & programming of movement o The basal ganglia are involved in planning and programming of movement or more broadly, in the process by which on abstract thought is converted into a voluntary action. Like, lateral cerebellum, neurons in the basal ganglia discharge before the movements begin. They influence the motor cortex via the thalamus, and corticospinal tract is the final common pathway to motor neuron. Putamen circuit is involved in complex pattern motor activity and skilled movement,o Basal gangl ia is part of extrapyramidal system and therefore is involved in regulation of tone and posture.o The basal ganglia, particularly the caudate nuclei, also play a role in some cognitive proces - So, caudate nucleus plays a major role in cognitive control of motor activity. | train | med_mcqa | null |
A patient of chronic liver failure presented with acute variceal bleeding. The BP was 80/60 mm Hg. Which of the following is not done? | [
"Octreotide infusion",
"Endoscopy banding",
"TIPS",
"Platelet transfusion"
] | D | Ans. (D) Platelet transfusion(Ref: Bailey & Loves Short Practice of Surgery 27th Ed; Page No-1164)Bleeding Esophageal VaricesLower esophagus being the most common site for variceal bleeding.Diagnosis may be confirmed; if the patient is known to have liver cirrhosis.Esophageal varices will not bleed until the pressure exceeds 12 mm Hg.Variceal haemorrhage is a medical emergency. Patients with massive haemorrhage should be admitted to the intensive treatment unit (ITU).ManagementBlood transfusion: Blood volume should be replaced with colloids, plasma expanders and blood transfusions.Correct coagulopathy: Vitamin K is administered (10 mg intravenously), but correction of a coagulopathy will require the administration of fresh-frozen plasma (FFP).Esophageal balloon tamponade (Sengstaken-Blakemore tube)#Modified Sengstaken-Blakemore contains four lumens (old Sengstaken-Blakemore tube contains 3 tubes). One for aspiration rom stomach one from esophagus, one for esophageal balloon dilation and last one for gastric balloon dilation.#The gastric balloon inflated to 250 mL of air and esophageal balloon to a pressure of 40 mm Hg using Air.#The potentially lethal complication is accidentally inflating gastric balloon inside the esophagus resulting in perforation of esophagus.#Balloons should be temporarily deflated after 12 hours to prevent esophageal necrosis.#Pharmacotherapy:#Octreotide (Long acting analogue of somatostatin) and somatostatin are effective like endoscopy.#Vasopressin previously used id also effective but nitroglycerine must be given along with it to prevent coronary vessels constriction.#Recently Terlipressin is commonly used to arrest bleeding.Endoscopic sclerotherapy or banding#Endoscopic banding is advantageous over sclerotherapy because it doesn't lead to necrosis or ulceration of esophagus but both are equally effective in controlling bleeding.#Sclerosants used- Ethanolamine oleate, Cyanoacrylate, and sodium morrhuate or sodium tetradecyl sulphate.Assess portal vein patency (Doppler ultrasound or CT)Transjugular intrahepatic portosystemic stent shunts (TIPSS)#Short-term bridge to liver transplant.#Inserted via IJV by interventional radiologist.#Access the portal vein inside the liver via a branch of hepatic vein and dilate the tract to 10 m through which expandable metallic stent is inserted.#It is not used as initial therapy but can used if endoscopy and pharmacotherapy fails.#It is a type of non-selective shunt between PV and HV.#It is an intrahepatic shunt.Surgery#Portosystemic shunts#Esophageal transection#Splenectomy and gastric devascularization | train | med_mcqa | null |
Cushing reflex, there is | [
"Increased BP and Increased hea rate",
"Increased BP and Decreased hea rate",
"Decreased BP and Decreased hea rate",
"Decreased BP and Increased hea rate"
] | B | Cushing reflex 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. Ref: Ganong&;s Review of medical physiology 25th edition. Page: 593 | train | med_mcqa | null |
Autonomous zone of sensory supply by radial nerve | [
"1st dorsal web space",
"Tip of index finger",
"Tip of thumb",
"Tip of little finger"
] | A | Autonomous zone for radial nerve is 1st dorsal web space Refer Campbell 12th/e p 3100 | train | med_mcqa | null |
'Gold standard' in diagnosis of GERD is | [
"24 Hr oesophageal pH",
"Oesophageal manometry",
"Upper GI endoscopy",
"CT chest"
] | A | 24-hour pH recording is the 'gold standard' for diagnosis of GORDNormally endoscopy with biopsy is done. If the typical appearance of reflux oesophagitis, peptic stricture or Barrett's oesophagus is seen, the diagnosis is clinched,In patients with atypical or persistent symptoms despite therapy, oesophageal manometry and 24-hour oesophageal pH recording (ideally with impedance measurement) is done.Manometry and pH recording are essential in patients being considered for antireflux surgery.A CT scan gives the best appreciation of gastro-oesophageal anatomy. This may be impoant in the context of surgery for rolling or mixed hiatus hernias,Ref: Bailey and Love 27e pg: 1078 | train | med_mcqa | null |
Which of the following instrument is NOT used in intracapsular extraction of lens | [
"Cryo",
"Elschning's forceps",
"Phaco-emulsifire",
"Van-graefe's cataract knife"
] | C | C i.e. Phaco-emulsifier Phacoemulsifier which emulsifies lens nucleus & coical matter by ultrasonic vibration (1 mm titanium needle vibrating 40,000 times/second) is used in phacoemulsification method of ECCE not in ICCE. | train | med_mcqa | null |
True labour pain includes all except: | [
"Painful uterine contraction",
"Short vagina",
"Formation of the bag of waters",
"Progressive descent of presenting part"
] | B | Ans. is b, i.e. Short vaginaRef. Dutta Obs. 7/e, p 117Differences between true and false labour pains.FeaturesTrue labour painsFalse labour painsCervical changes (dilatation & effacement)PresentAbsentFrequency and duration of contractionsRegular and gradually increaseIrregularPainLower abdomen and back, radiating to thighsLower abdomen onlyBag of waterFormedNot formedShowPresentAbsentRelief with enema/sedationNoNo | train | med_mcqa | null |
Selenocysteine is a pa of | [
"NADP re ductase",
"NADPH dehydrogenase",
"Thioredoxin reductase",
"Pyruvate dehydeogenase"
] | C | Selenocysteine is abbreted as SeCys. It is seen at the active site of the following enzymes: a) Thioredoxin reductase; b) Glutathione peroxidase, which scavenges peroxides; c) 5&;- De-iodinase that removes iodine from thyroxine to make triiodothyronine and d) Selenoprotein P, a glycoprotein seen in mammalian blood. Replacement of SeCys by Cys will lead to decreased activity of these enzymes. Deficiency of some of these enzymes with the anti-oxidant function may be related with atherosclerosis. Concentration falls in selenium deficiency. Its structure is COOH-CHNH2-CH2-SeH. It is directly incorporated into proteins during the translation process. Biosynthesis of selenocysteine is by replacing the oxygen of serine by selenium; this is done by two steps: Se + ATP - Se-P + AMP + Pi Serine + Se-P - SeCys + PiRef: DM Vasudevan, Page no: 187 | train | med_mcqa | null |
In a five year old child, which of the following foramen is located in posterior cranial fossa? | [
"Jugular Foramen",
"Foramen Rotundum",
"Foramen Spinosum",
"Foramen Lacerum"
] | A | Except Option 1 - jugular foramen, all the other options/foramina are found in middle cranial fossa.
Jugular foramen is found in posterior cranial fossa. It lies at posterior end of petro-occipital fissure. | train | med_mcqa | null |
Sentinel lymph node biopsy is used for | [
"Breast carcinoma",
"Penile cacinoma",
"Retroperitoneal sarcoma",
"Hepatic carcinoma"
] | A | Sentinel Lymph Node Mapping and Biopsy
For breast cancer, sentinel lymph node is the largest lymph node in the axilla and is the first to receive the lymph and potential metastases drained from the breast.
Intraoperative lymphatic mapping and biopsy of the sentinel lymph node initially introduced for the staging of melanoma has been similarly used for the detection of axillary metastases in breast cancer, where it has also become the accepted standard of care.
In both the cases the method provides for minimally invasive surgery, and its success is now stimulating attempts to introduce it in the staging of the thyroid, gastric, colonic, lung and endometrial cancers.
In breast cancer surgery this technique avoids significant morbidity of axillary dissection and inexperienced hands has proven to provide acceptable rates of metastatic identification | train | med_mcqa | null |
Bone marrow plasmacytosis in multiple myeloma is characteristically more than: September 2011 | [
"10%",
"20%",
"30%",
"40%"
] | C | Ans. C: 30% Manifestations of multiple myeloma includes bone marrow plasmacytosis of more than 30% Multiple myeloma: MC symptomatic monoclonal gammopathy Histology: Russel bodies, flame cells, Mott cells, Dutcher bodies Presents as pathological fractures with hypercalcemia, M-spike and Bence-Jones proteins (light chains) TL-6 is associated with poor prognosis Raised calcium and raised uric acid WHO criteria (major): Bone marrow plasmacytosis more than 30% Plasmacytoma on biopsy Presence of monoclonal M protein (M component) in urine/serum Serum IgG more than 3.5 g/ dl, or Serum IgA more than 2 g/ dl, or Urine Bence-Jones protein more than 1 gm/day WHO criteria (minor): Bone marrow plasmacytosis of 10 - 30% Presence of monoclonal M protein (M component) in urine/ serum, but less than the above concentration Presence of lytic bone lesions Reduced normal immunoglobulins to less than 50% of normal IgG less than 600 mg/ dl, or IgA less than 100 m/ dl, or IgM less than 50 mg/ dl Diagnostic requirement: Minimum of 1 major criterion and 1 minor criterion, or 3 minor criterion which must include bone marrow plasmacytosis of 10 - 30% and the presence of a monoclonal rotein These criteria must be manifested in a symptomatic patient with progressive disease | train | med_mcqa | null |
Non-Frame shift Mutation of Dystrophin gene causes: | [
"Duchenne Muscular dystrophy",
"Becker's Muscular Dystrophy",
"Myotonic Dystrophy",
"Limb Girdle Dystrophy"
] | B | Duchenne&;s and Becker&;s Muscular Dystrophies are both caused by a mutation on the dystrophin gene located on the X Chromosome (Xp21). An out-of-Frame mutation typically results in complete disruption of dystrophin production and causes Duchenne&;s Dystrophy. An in-Frame mutation results in a shoened but semi-functional dystrophin and causes Becker&;s Dystrophy. X-Linked recessive mutation of the dystrophin gene on the Sacrolemmal membrane Mutations are located in the Dystrophin gene on XP21 Since these are X-Linked Recessive disorders, they occur primarily in boys. (Females are usually Asymptomatic carriers with a normal gene on one X Chromosome and a mutant gene on the other X-Chromosome. Frame-shift-mutation (Out-of-Frame) - Results in complete loss of dystrophin - Duchenne muscular dystrophy Non-Frame shift mutation (In-Frame) - Results in paial function of dystrophin - Becker muscular dystrophy Clincal severity more dependent on in-frame versus out-of-frame mutation ("reading-frame-rule"), rather than the location of the mutation along the gene. Mutations disrupting the translational reading frame of the gene (Frameshift mutation) result in near total loss of dystrophin and usually lead to DMD, while in-frame mutation result in the translation of semi-functional dsytrophin of abnormal size and/or amount, typically resulting in outlier of BMD clinical phenotypes. Although there are exceptions to the "reading-frame rule", 92% of phenotypic differences are explained by in-frame and out-of-frame mutations. Ref: Robbins and cotran 9th edition Vol 2 | train | med_mcqa | null |
Which of the following statements on lymphoma is not Trne - | [
"A single classification system for Hodgkin's disease (HD) is almost universally accepted",
"HD more often tends to remain localized to a single group of lymph nodes and spreads by contiguity",
"Several types of non Hodgkin's lymphoma (NHL) may have a leukemic phase",
"In general follicular (nodular) NHL has ... | D | <p>Diffuse NHL is high grade NHL & is very aggresive, fatal if untreated & poor prognosis.Follicular NHL is low grade NHL & it has low proliferation rate with 5 yr survival in about 50-70%.</p><p>Reference :Davidson&;s principles & practice of medicine 22nd edition pg 1043.</p> | train | med_mcqa | null |
ADEK deficiency is seen in: September 2007 | [
"Malabsorption syndrome",
"Obstructive jaundice",
"Deficiency of pancreatic lipase",
"All of the above"
] | D | Ans. D: All of the aboveFat soluble vitamins (A,D,E,K) are poorly absorbed in the absence of bile/pancreatic lipase.Malabsorption syndrome includes deficient absorption of amino acids, with marked body wasting and, eventually, hypoproteinemia and edema. Carbohydrate and fat absorption are also depressed. Because of the defective fat absorption, the fat-soluble vitamins (vitamins A, D, E, and K) are not absorbed in adequate amounts. The amount of fat and protein in the stools is increased, and the stools become bulky, pale, foul-smelling, and greasy (steatorrhea). | train | med_mcqa | null |
Neostigmine antagonizes nondepolarizing blockade by all of the following mechanisms, except ? | [
"Decreasing the breakdown of Acetylcholine at the motor end plate",
"Preventing K+ efflux from the cell",
"Increasing the release of Acetylcholine at the motor end plate",
"Depolarization of the motor end plate"
] | C | Ans. is 'c' i.e., Increasing the release of Acetylcholine at the motor end palate o Anticholinestrases act by inhibiting the action of acetylcholinesterase (an enzyme that degrades acetylcholine by causing its hydrolysis). o Anticholinesterases thus increase the level of acetylcholine at the neuromuscular junction. o Neostigmine also has some additional direct action on cholinergic receptors i.e., it depolarizes motor end plate. o It does not increase the release of ACH. Accumulated ACH acts on prejunctional muscarinic autoreceptors and inhibits the release of ACH. | train | med_mcqa | null |
An ultrasound performed on a women, shows twin pregnancy. Which of the following is a feature of dizygotic twins? | [
"Separate amnion and same chorion",
"Separate chorion and amnion",
"Always different sex",
"None of the above"
] | B | In Dizygotic twins, each twin has separate amnion and chorion and the intervening membrane consists of 4 layers amnion, chorion, chorion and amnion. They have two placentae either completely separated or more commonly fused at the margin appearing to be one. There is no anastomosis between two fetal vessels. In monozygotic twins: There is only a single placenta, there is varying degree of anastomosis between two foetal vessels. Each fetus is surrounded by a separate amniotic sac with the chorion layer common to both (diamniotic monochorionic). Intervening membrane consist of two layers of amnion only. Ref: Textbook of Obstetrics By DC Dutta, 6th edn, page 203 | train | med_mcqa | null |
Ankylosis of TMJ can be best viewed in: | [
"Lateral oblique view",
"Lateral view",
"Transcranial",
"PA view"
] | C | null | train | med_mcqa | null |
Patient says, "I ate rice in the morning, fish lives in water". This is suggestive of : | [
"Loosening of association",
"Flight of ideas",
"Thought insertion",
"Tangentiality"
] | A | There is loss of connection between individual thought components and speech is not meaningful, which is suggestive of a Formal thought disorder - Loosening of association. | train | med_mcqa | null |
Which of the following is not true regarding infrabulge clasp | [
"It is esthetic",
"Increased retention without tipping",
"More chances of accidental distortion",
"Approaches abutment from gingival side"
] | C | Some of the advantages attributed to the infrabulge clasp are,
Its interproximal location, which may be used to esthetic advantage.
Increased retention without tipping action on the abutment.
Less chance of accidental distortion, resulting from its proximity to the denture border. | train | med_mcqa | null |
Horner's syndrome can be caused by following except | [
"Medial medullary syndrome",
"Carotid aneurysm",
"Postoperative Raynaud's disease",
"Multiple sclerosis"
] | A | Horner's syndrome, also known as oculosympathetic paresis, is a combination of symptoms that arises when a group of nerves known as the sympathetic trunk is damaged. The signs and symptoms occur on the same side (ipsilateral) as it is a lesion of the sympathetic trunk. It is characterized by miosis (a constricted pupil), paial ptosis (a weak, droopy eyelid), apparent anhydrosis (decreased sweating), with apparent enophthalmos (inset eyeball). Causes can be divided according to the presence and location of anhidrosis: Central (anhidrosis of face, arm and trunk) Syringomyelia Multiple sclerosis Encephalitis Brain tumors Lateral medullary syndrome Preganglionic (anhidrosis of face) Cervical rib traction on stellate ganglion Thyroid carcinoma Thyroidectomy Goiter Bronchogenic carcinoma of the superior fissure (Pancoast tumor) on apex of lung Klumpke paralysis Trauma - base of neck, usually blunt trauma, sometimes surgery. As a complication of tube thoracostomy Thoracic aoic aneurysm Postganglionic (no anhidrosis) Cluster headache - combination termed Hoon's headache An episode of Horner's syndrome may occur during a migraine attack and be relieved afterwards Carotid aery dissection/carotid aery aneurysm Cavernous sinus thrombosis Middle ear infection Sympathectomy Nerve blocks, such as cervical plexus block, stellate ganglion or interscalene block Ref : https://en.m.wikipedia.org/wiki/Horner%27s_syndrome | train | med_mcqa | null |
A 10 year old child develops hematuria after 2 days of diarrhoea. Blood film shows fragmented RBCs & thrombocytopenia. Ultasound shows marked enlargement of both kidnews. The likely diagnosis is - | [
"Acute pyelonephritis",
"Disseminated intravascular coagulopathy",
"Haemolytic uremic syndrome",
"Renal vein thrombosis"
] | D | In this case, stasis is the cause of renal vein thrombosis -stasis is due to DEHYDRATION(most conmon cause of statis in pediatric population) caused by diarrhoea . Renal thrombosis can present with falnk pain ,tenderness ,hematuria, proteinuria, rapid decline in renal function. Ref:Harrison 20 th edition pg no. 2167 | train | med_mcqa | null |
Regarding ACE inhibitor which of the following is trueaEUR' | [
"Inhibits conversion of angiotensinogen to arigiotensin I",
"T 1/2 of enalapril is more than lisinoproil",
"Omission of prior diuretic dose decreases the risk of postural hypotension",
"It is effective only with left ventricular systolic dysfunction"
] | C | Omission of prior diuretic dose decreases the risk of postural hypotension Angiotensin conveing enzyme inhibitors Renin is an enzyme produced by the kidney in response to sodium depletion and increased adrenergic activity. Renin conves a circulating glycoprotein (angiotensinogen) into the biologically ine angiotensin I, which is then conveed by angiotensin conveing enzyme (ACE or kininase II) into the highly potent vasoconstrictor Angiotensin II. Angiotensin conveing enzyme or (ACE) is located on the luminal surface of capillary endothelial cells, paicularly in the lungs. Angiotensin II exes its effect by acting on two receptors i.e. ATi and AT2. Main actions of Angiotensin II a)Vasoconstriction Angiotensin II is the most potent vasoconstrictor in the body. It increases total peripheral resistance by constricting precapillary aerioles and to a lesser extent postcapillary venules by activating ATi receptors. Angiotensin II also produces peripheral vasoconstriction by enhancement of peripheral noradrenergic neurotransmission. b) Release of Aldosterone from adrenal coex Angiotensin II stimulates the zona glomerulosa of the adrenal coex to increase the synthesis and secretion of aldosterone. c) Altered renal hemodynamics Angiotensin II variably influences glomerular filtration rate several mechanisms - i) Constriction of the afferent aerioles which reduces intraglomerular pressure and tends to reduce GFR. ii) Contraction of measangial cells which decreases the capillary surface area which reduces GFR. iii) Constriction of efferent aerioles which increases intraglomerular pressure and tends to increase GFR. - The outcome of these opposing effects on GFR depends upon the physiological state :- Normally G.F.R is slighthy reduced by angiotensin II. d) Effect of Angiotensin II on cardiac structure :- i) Increased wall to lumen ratio in blood vessels ii) Concentric cardiac hyperophy iii) Eccentric cardiac hyperophy iv) Thickening of intimal surface of blood vessels ACE inhibitors ACE inhibitors are drugs which exe their action by inhibiting the conversion of Angiotensin Ito Angiotensin R. They inhibit the angiotensin conveing enzyme. Example of ACE inhibitors:? Captopril Enalapril Lisinopril Ramipril Trandolapril Perindropil Therapeutic uses of ACE inhibitors:? ACE inhibitors in hypeension Inhibition of ACE lowers systemic vascular resistance. ACE inhibitors lower mean, diastolic and systolic blood pressure in various hypeensive states. The initial change in blood pressure is directly related to plasma renin activity. Elevated plasma renin activity renders patients hyperre.sponsive to ACE inhibitor induced hypotension and initial dosages of all ACE inhibitors should he reduced in patients with high plasma level of renin (e.g. patients with hea failure and salt depleted patients). ACE inhibitors in left ventricular systolic dysfunction ACE inhibitors should be given to all patients with impaired left ventricular systolic .function. Although the mechanism by which ACE inhibitors improve outcome in patients with systolic dysfunction are not completely understood, the induction of a more ourable hemodynamic state most likely plays an impoant role. Inhibition of ACE commonly reduces afterload and systolic wall stress, and both cardiac output and cardiac index increases as do indices of stroke work and stroke volume. There is over whelming evidence that ACE inhibitors should be used in symptomatic and asymptomatic patients with a depressed Ejection fraction (< 40%). Although the role of ACE inhibitors in left ventricular systolic dysfunction is firmly established whether these drugs improve diastolic dysfunction is an impoant open question. Infusion of enalaprilat into the left coronary aeries of patients with left ventricular hyperophy significantly improves diastolic function. Remember, This impoant point about the use of ACE in hea failure. Severe hypotension may result in patient taking diuretics or who are hypovolemic, hyponatremic, elderly, have renal impainnent or with systolic blood pressure < 100 minHg. A test dose of captopril 6.25 mg by mouth may be given because its effect lasts only 4-61t. If tolerated, the preferred long acting ACE inhibitor may then be initiated in low dose. ACE inhibitors in myocardial infarction Several large prospective, randomized clinical studies involving thousands of patients provide convincing evidence that ACE inhibitors reduce overall moality when treatment is begun during peri-infarction period. ACE inhibitors in chronic renal failure Diabetes mellitus is the leading cause of renal disease. In patients with type I diabetes mellitus and diabetic nephropathy captopril prevents or delays the progression of renal disease. Specific renoprotection by ACE inhibitors is more di'. ficult to demonstrate in type 2 diabetics. Several mechanisms paicipate in renal protection afforded by ACE inhibitors. Increased glomerular capillary pressure induces glomerular injury and ACE inhibitors reduce this parameter both by decreasing aerial blood pressure and by dilating renal efferent aerioles. Adverse effect of ACE inhibitors Hypotension A steep fall in blood pressure may occur following the first dose of an ACE inhibitor in patients with elevated PRA (plasma renin activity). In this regard, care should he exercised in patients who are - Salt depleted - In patients being treated with multiple antihypeensive drugs, - In patients who have congestive hea. failure - In patients who are on diuretics. The doses of ACE inhibitors should be initiated in low doses followed by gradual increment if the lower doses have been well tolerated. Pharmacokinetics All ACE inhibitors except captopril and lisinopril are prodrugs and are conveed to the active agents by hydrolysis primarily in the liver. Enalapril is an oral prodrug that is conveed by hydrolysis in liver to an active form Enalaprilat. Enalaprilat itself is available only for intravenous use primarily for hypeensive emergencies. Enalapril has a half life of only 1.3 hours but enalaprilat because of tight binding to ACE has a plasma half life of about 11 hours. Lisinopril is the lysine analogue of enalapril. Unlike enalapril, Lisinopril itself is active and its half life in plasma is about 12 hours. All ACE inhibitors are cleared as the intact compound by the kidney (except fosinopril and moexipril). | train | med_mcqa | null |
Increased BP & decreased heart rate is seen in | [
"Hemorrhage",
"High altitude",
"Raised intracranial pressure",
"Anemia"
] | C | Raised intracranial pressure initiates Cushing’s reflex. Cushing’s reflex leads to a rise in arterial pressure, which restores the blood supply to the brain. At the same time, the raised BP causes reflex Bradycardia through the baroreceptors. | train | med_mcqa | null |
Which of the following is not a boundary of the Koch's triangle | [
"Tendon of Todaro",
"Limbus fossa ovalis",
"Coronary sinus",
"Tricuspid valve ring"
] | B | o The atrioventricular node (AVN) is within the subendocardial layer of the hea wall of the interatrial septum. In relation to the right atrium, its position is within the triangle of Koch o Triangle of Koch: a roughly triangular area on the septal wall of the right atrium, bounded by the base of the septal leaflet of the tricuspid valve, the anteromedial margin of the orifice of the coronary sinus, and the tendon of Todaro; it marks the site of the atrioventricular node. | train | med_mcqa | null |
The screening test for gestational diabetes mellitus that has highest sensitivity is : | [
"Glycosylated Hb",
"Blood fructosamine",
"50gms glucose challenge test",
"Random blood sugar"
] | C | 50gms glucose challenge test | train | med_mcqa | null |
False about biliary cystadenoma | [
"CT scan is used for diagnosis",
"CA 19-9 is elevated",
"Intra hepatic location",
"Common in males"
] | D | Biliary cystic adenocarcinoma Incidence : Female : Male is 2:1. It is more common in females Ref: Sabiston 20th edition Pgno :1469 | train | med_mcqa | null |
Battle's sign is seen ina) Fracture middle cranial fossab) Fracture base of skullc) Fracture anterior cranial fossad) All of the above | [
"ac",
"a",
"ab",
"bc"
] | C | null | train | med_mcqa | null |
Virulence of a disease is indicated by: | [
"Proportional mortality rate",
"Specific mortality rate",
"Case fatality rate",
"Amount of GDP spent on control of disease"
] | C | Ans. (c) Case fatality rateCASE FATALITY RATE (CFR):* CFR represents 'killing power of a disease'- It is 'closely related to virulence of organism'CFR=Totalno.ofcasesduetoadiseaseTotalno.ofdeathsduetoadisease x100* CFR is a Proportion: Always expressed in percentage* CFR is the 'complement of Survival Rate', thus CFR =1 - Survival Rate* Limitations of CFR:- Time interval is not specified- Usefulness is limited for chronic diseases - CFR for the same disease may vary in different epidemics | train | med_mcqa | null |
Factors that have been associated with an increased incidence of head and neck carcinomas include all of the following except | [
"Syphilis",
"Hepatitis B virus",
"Exposure to nickel",
"Alcohol consumption"
] | B | . | train | med_mcqa | null |
The period of embryo extends | [
"From the first week till the eighth week",
"From the period of ovum till the tenth week",
"From oogenesis till the eight week",
"From fertilization till the eighth week"
] | D | null | train | med_mcqa | null |
Most cardiotoxic local anesthetic ? | [
"Procaine",
"Bupivacaine",
"Cocaine",
"Lidocaine"
] | B | Ans. is 'b' i.e., Bupivacaine | train | med_mcqa | null |
Which gas is most commonly used in laparoscopy: | [
"O2",
"CO2",
"N2O",
"N2"
] | B | Ans. is 'b' CO2 | train | med_mcqa | null |
Squamous cell carcinoma marker is - | [
"Vimentin",
"Cytokeratin",
"Desmin",
"Myogenin"
] | B | Ans. is 'b' i.e., Cytokeratin {Ref: Sternberg Diggnostic surgical pathology 4th/e Volume 1, p. 148-150]o Cytokeratin is a intermediate filament found is carcinoma.lmiminohistochemistryo Immunohistochemistry is a method of analyzing and identifying cell types based on binding of antibodies to specific components of the cell.o Antibody, which is specific for an antigen of a particular tissue, is labled with a probe (coloured marker) and is run on the tissue specimen obtained from a biopsy.o If the tissue has that particular antigen, then antibody will get attached to the tissue and the labled antibody can be seen under a microscope.o Intermediate filaments of eytoskeleton are the major antigens used in immunohistochemistry.o There are five major types of intermediate filaments -CytokeratinCarcinoma, mesothelioma. Non-seminoma GCTVimentinSarcoma (Tumor of mesenchymal), melanoma, seminomas, lymphomaNeurofilamentNeural tumorsGlial fibrillary acid proteins (GFAP)Non-neural brain tissue (astroglial origin - Astrocytoma, ependymomas, medul loblastoma, oligodendroglioma)DcsminLeiomyoma (smooth muscle) & Rhabdomyoma (skeletal ms). | train | med_mcqa | null |
Post operative radiotherapy in breast is given for- | [
"To prevent metastasis",
"Ablation of remnant of cancer tissue",
"To prevent recurrence",
"Prevents distal metastasis"
] | C | null | train | med_mcqa | null |
Pleural fluid having low glucose is seen in all, except? | [
"Tuberculosis",
"Empyema",
"Mesothelioma",
"Rheumatoid ahritis"
] | A | Answer is A (None>Tuberculosis): Parapneumonic effusions (bacterial infections), Rheumatoid effusions, Malignant effusions (Mesothelioma) and Tuberculous effusions are all established causes that may present with low glucose (<60 mg/dl) in pleural Although tuberculosis may present with low glucose levels and is included in the differential diagnosis for conditions with low glucose in pleural fluid, the glucose levels in Tuberculosis is more often equal to serum levels. Tuberculosis is therefore the single best answer of exclusion amongst the options provided. Glucose levels in TB are usually equal to serum levels but Tuberculosis may present occasionally with Glucose < 60mg/d1- CMDT 09/277 According to Fishman's textbook on pulmonary disease, the presence of pleural fluid glucose below 60 mg/dl narrows the diagnostic possibilities to seven conditions. Conditions associated with Decreased Glucose (<60mg/dl) in pleural fluid Malignant Effusion (Also mentioned in Harrisons) Rheumatoid EffitsionQ (Also mentioned in Harrisons) Parapneumonic Effusion (Bacterial Infections as mentioned in Harrisons) Tuberculous EffitsionQ (Also mentioned in CMDT) Hemothorax Paragonimiasis Churg-Strauss Syndrome | train | med_mcqa | null |
Which of the following diuretic causes impaired glucose tolerance? | [
"Spironolactone",
"Thiazides",
"Amiloride",
"Canrenone"
] | B | Ans. is 'b' i.e., Thiazides Drugs causing hyperglycemia* Asparaginase* Ethacrinic acid* HIV protease inhibitors* Pentamidine* Chlorthalidone* Frusemide* Niacin* Thiazides* Diazoxide* Glucocorticoids* OCP* b-adrenergic agonists* Encainide* Growth-hormone* Phenytoin* b-blockers (propranolol)* Thyroid hormones* Vacor* Clozapine* a-IFN* Glucagon* Cyclosporine* Tacrolimus* Protease inhibitors* L-Asparaginase | train | med_mcqa | null |
Not a cause of granular contracted kidney-. | [
"Diabetes mellitis",
"Chronic pyelonephritis",
"Benign nephrosclerosis",
"Chronic glomerulonephritis"
] | A | Answer is A (Diabetes mellitus): Diabetes Mellitus is not associated with contracted (small) kidneys. The kidneys are typically normal or increased in size in diabetic nephropathy - Harrisons Causes of Contracted Kidneys Chronic Glonterulonephritis (Bilateral) Nephrosclerosis because of systemic hypeension (Bilateral) Chronic pvelonephritis (Usually unilateral) Global renal infarction (Unilateral) Radiation nephritis (Unilateral) Renal aery stenosis (Unilateral) Post obstructive atrophy (Unilateral) Note that Acute Gloinerulonephritis, and acute pvelonephritis are associated with enlarged kidneys but chronic cases are associated with contracted kidneys | train | med_mcqa | null |
Which of the following is beneficial in NSAID induced gastric ulcer? | [
"PGE1 agonist",
"PGE2 agonist",
"PGD agonist",
"PGF2 agonist"
] | A | Prostaglandin analogues exe a cyto-protective effect on the gastric mucosa which prefers them to be employed in the treatment of NSAID induced gastric ulcer. Though both PGE1 analogues (Misoprostol and Risoprostol) and PGE2 analogues (Enoprostol) have shown proven effects on gastric ulcer, only misoprostol is a FDA approved orally active and stable analogue of PGE1 to be used in the treatment of NSAID induced gastric ulcer. Ref: K D Tripathi Textbook of Pharmacology, 5th Edition, Pages 88, 163-64, 593-94; Prostanoids: Pharmacological, Physiological, and Clinical Relevance By Philip Keith Moore, Pages 68, 220 | train | med_mcqa | null |
Concentrating ability of kidney is lost by damage to? | [
"Glomerulus",
"Loop of Henle & collecting duct",
"Macula densa",
"Renal Pelvis"
] | B | Ans. b (Loop of Henle & collecting duct). (Ref. Ganong, Physiology, 21st/pg.721)NEPHRONS# Proximal convoluted tubule-- reabsorbs all of the glucose, inorganic phosphate, Cl, lactate and amino acids and most of the bicarbonate, sodium, and water. Secretes ammonia, which acts as a buffer for secreted W+.QThin descending loop of Henle--passively reabsorbs water via medullary hypertonicity (impermeable to sodium). Thick ascending loop of Henle--actively reabsorbs Na+, Mg2+ and Ca2+, impermeable to H2O, H+: and K+ extrusion occurs.# Glomerulus does the fuction of filtering.# Macula densa secretes renin# Renal pelvis one of the part of PC system that collects urine. | train | med_mcqa | null |
Therapeutic uses of calcium salts include the following except: | [
"Osteoporosis",
"Disorder of coagulation.",
"Laryngospasm.",
"Extreme hyperkalemia."
] | B | Calcium is used in the treatment of calcium deficiency states like osteoporosis, tetany and laryngospasm. Calcium gluconate is used to reverse some of the cardiotoxic effects of hyperkalemia and it may be life saving. Though calcium is involved in blood coagulation, it is not used to treat coagulation disorders. | train | med_mcqa | null |
All of the following structures forms the border of Quadrangular space, EXCEPT? | [
"Teres major",
"Teres minor",
"Pectoralis minor",
"Long head of the triceps brachii muscle"
] | C | Structures forming the borders of Quadrangular space are teres major and teres minor muscles, long head of the triceps brachii muscle, and the humerus. Contents of this space are: axillary nerve and the posterior circumflex humeral aery. Structures forming the border of triangular space are:Teres major and teres minor muscles and the long head of the triceps brachii muscle.Its contents is Circumflex scapular aery. | train | med_mcqa | null |
A 68-year-old male is brought to the outpatient by his wife due to increasing forgetfulness. On taking history in details, wife repoed that for around 6 months patient is having trouble in organising the finances and paying bills, something he has done all his life. He has also become withdrawn and has decreased meeting people. The patient also behaved inappropriately with a female neighbour couple of says back, which is much against his usual nature. The patient denies having any problems and seems indifferent to his wife's concern. He has a medical history of hypeension and type 2 diabetes mellitus There is a family history of Alzheimer disease. On MMSE, score came out to be 23. Which of the following is the most likely diagnosis? | [
"Alzheimer disease",
"Creutzfeldt-Jakob disease",
"Dementia with Lewy bodies",
"Frontotemporal dementia"
] | D | The history is suggestive of executive dysfunction (trouble in organising the finances and paying bills), apathy and disinhibition (decreased socialisation and inappropriate behaviour with women), lack of insight (denies having any problem) and memory disturbances. This is suggestive of frontotemporal dementia, in which personality changes are prominent, memory disturbances appear later in frontotemporal dementia. In contrast, in alzheimers disease memory disturbances are prominent early in the disorder and personality changes later. Creutzfeldt-Jakob disease which is caused by a prion manifests with rapidly progressive dementia, myoclonus, and cerebellar dysfunction. | train | med_mcqa | null |
TRUE about ureter is: | [
"Gonadal vessels lie anterior to it",
"It lies in front of great vessels",
"About 50 cm. long",
"Nerve supply from T8-Tio"
] | A | A. i.e. Gonadal vessels lie anterior to it | train | med_mcqa | null |
In patients with cirrhosis of the liver the site of obstruction in the poal system is in the? | [
"Hepatic vein",
"Post sinusoidal",
"Extra hepatic poal vein",
"Sinusoids"
] | D | Ans is d i.e. Sinusoids | train | med_mcqa | null |
Jumping gene is: | [
"Transposon",
"Cosmid",
"Episome",
"Plasmid"
] | A | Ans. is 'a' i.e., Transposon(Ref: Ananthanarayan, 9th/e, p. 63 and 8th/e, p. 64)Transposons are also known as jumping genes.Transposons are also known as jumping genes. They move between chromosomal DNA and extra chromosomal DNA within cell. They take part in drug resistance mechanism. | train | med_mcqa | null |
Most common cause of mass in posterior mediastinum in children – | [
"Rhabdo sarcoma",
"Duplication cyst of oesphagus",
"Lymphoma",
"Neuroblastoma"
] | D | "Most common posterior mediastinal masses in children are neurogenic tumors".
Posterior mediastinal mass in children
1) Neurogenic tumors (Most common)
2) Foregut cyst (Second most common)
3) Lymphoma (Third most common)
4) Germ cell tumors
5) Lymphangiomas and agiomas
Mediastinal neurogenic tumors are
❑ Mediastinal neuroblastoma
❑ Ganglioneuroma
❑ Ganglioneuroblastoma
❑ Schwannoma
❑ Mediastinal pheochromocytoma | train | med_mcqa | null |
Osteotomies | [
"of the Le Fort III type, like the Le Fort III fracture, are not associated with great blood loss and therefore the patient rarely needs more than 2 pints of blood transfused.",
"of the Le Fort III type, if done with the use of a bicoronal flap are not followed by nerve paraesthesias postoperatively",
"of the L... | C | null | train | med_mcqa | null |
All the following are essential criteria for perinatal asphyxia except | [
"Prolonged metabolic alkalosis",
"Persistence of Apgar score of 0-3 for >5 min",
"Hypoxic ischemic encephalopathy (HIE) in the immediate neonatal period",
"Evidence of multiorgan dysfunction in the immediate neonatal period"
] | A | Essential criteria for perinatal asphyxia Prolonged metabolic or mixed acidemia (pH <7.0) on an umbilical aerial blood sample Persistence of Apgar score of 0-3 for >5 min Neurological manifestations, e.g. seizures, coma, hypotonia or hypoxic-ischemic encephalopathy (HIE) in the immediate neonatal period Evidence of multiorgan dysfunction in the immediate neonatal period Ref: Paediatrics; O.P. Ghai; 8th edition; Page no: 166 | train | med_mcqa | null |
All of the following are autosomal dominant disorder except? | [
"Von hippel lindau disease",
"Achondroplasia",
"Duchenner muscular dystrophy",
"Multiple endocrine neoplasia"
] | C | Duchenne muscular dystrophy is x linked recesive disorder. | train | med_mcqa | null |
Renal damage due to Amphotericin B are all EXCEPT: March 2004 | [
"Azotemia",
"Renal tubular acidosis",
"Glomerulonephritis",
"Hypokalemia"
] | C | Ans. C i.e. Glomerulonephritis | train | med_mcqa | null |
Organism associated with fish consumption and also causes carcinoma gallbladder: | [
"Gnathostoma",
"Anglostrongyloidosis cantonensis",
"Clonorchis sinensis",
"H. dimunata"
] | C | • Clonorchis sinensis is a liver fluke, acquired by ingestion of raw or inadequately cooked freshwater fishes.
• In human body, it lives within bile ducts and causes inflammatory reaction leading to cholangiohepatitis and biliary obstruction.
• It is a well known risk factor for cholangiocarcinoma.
• It is a rare, but mentioned risk factor for carcinoma gallbladder. | train | med_mcqa | null |
Which of the following grading methods is used to evaluate the prognosis after subarachnoid hemorrhage: | [
"Glasgow Coma Scale",
"Glasgow Blatchford Bleeding Score",
"Intracerebral hemorrhage Score",
"Hess and Hunt Scale"
] | D | null | train | med_mcqa | null |
True regarding testicular feminization syndrome: | [
"Phenotype that of female",
"Phenotype and genotype of male",
"Genotype, phenotype and gonads of male",
"Gnods and genotype that of female"
] | A | Ans. is a, i.e. Phenotype that of femaleIn Testicular feminizing syndrome:Genotype = 46 (XY) = malePhenotype = Female (well developed breast)Gonads = Testes. | train | med_mcqa | null |
Figure of 8 configuration on chest x–ray is seen in – | [
"TOF",
"ASD",
"TAPVC",
"VSD"
] | C | X-ray findings of TAPVC
Cardiomegaly
Plethoric lung fields
Snowman or figure of 'V configuration ---> In supracardiac TAPVC.
Ground glass appearance of lung —> In obstructive TAPVC.
Clinical manifestations of TAPVC
Nonobstructive TAPVC -4 Patients presents with mild cyanosis and CHF at 6-8 weeks.
Obstructive TAPVC —> Paients presents with severe cyanosis and CHF within first week.
EOG
.Right axis deviation with right ventricular hypertrophy.
In obstructive TAPVC pulmonale. | train | med_mcqa | null |
mood stabilizer used in the tretament of rapid cycling | [
"vaproate",
"lithium",
"carbamezepine",
"lamotrigine"
] | A | Lamotrigine is a mood stabilizer which works best in BIPOLAR DEPRESSION Lithium is a mood stabilizer which works best in BIPOLAR MANIA valproate is a mood stabilizer which works best in RAPID CYCLING ref. kaplon and sadock, synopsis of psychiatry, 11 thedition, pg no.935 | train | med_mcqa | null |
All are true about antenatal umbilical aery Doppler except? | [
"Decreased diastolic flow of umbilical aery is suggestive of IUGR",
"S/D Ratio of umbilical aery is less than S/D ratio of Fetal MCA",
"S/D Ratio is decreased in smoking females",
"Reversal of diastolic flow in umbilical aery Doppler suggests impending Fetal demise"
] | C | S/D Ratio of umbilical aery Doppler is increased in smokers. Decreased, absent or reversal of diastolic flow on umbilical aery Doppler suggests fetal IUGR and impending Fetal death. Fetal MCA S/D ratio is normally more than S/D ratio of umbilical aery. Fetal MCA S/D ratio is less than S/D ratio of umbilical aery Doppler in IUGR. | train | med_mcqa | null |
The first step in alcohol metabolism by the liver is the formation of acetaldehyde from alcohol, a chemical reaction catalyzed by: | [
"Cytochrome P450",
"NADPH-cytochrome reductase P450",
"Alcohol oxygenase",
"Alcohol dehydrogenase"
] | D | Ans. D. Alcohol dehydrogenaseAlcohol dehydrogenase catalyzes the conversion of alcohol to acetaldehyde, which is then converted to acetate. Acetate is then metabolized by hepatocytes. Cytochrome P450 is a primary component of the oxidative enzyme system involved in the metabolism of drugs. NADPH-cytochrome P450 reductase is an enzyme involved in phase I reactions of drug metabolism. There is no such enzyme as alcohol oxygenase. Glycogen phosphorylase is an enzyme involved in glycogen breakdown, not alcohol metabolism. | train | med_mcqa | null |
True about duodenal adenocarcinoma -a) Commonest small intestinal tumorb) Arises from periampullary regionc) Jaundice & anaemia foundd) 5 yr survival is 5%e) Surgery is only curative | [
"ab",
"bc",
"acd",
"bce"
] | D | null | train | med_mcqa | null |
Acute malnutrition in a child is clinically assessed by: September 2005 | [
"Body mass index",
"Weight for age",
"Height for age",
"Weight for height"
] | D | Ans. D: Weight for height An indicator known as weight-for-height is used to determine whether a child is acutely malnourished or not. The child's weight is compared to the 'normal' weight for that height. Based on this information, the World Health Organisation (WHO) has developed chas known as international standards for expected growth. If a child's weight falls within the range considered normal for his/her height, the child is found to be well-nourished. If the weight is less than the international standards, the child is considered acutely malnourished or wasted. WHO has created cut-off points to indicate the severity of the malnutrition. If a child's weight-for-height is less than -2 z-scores (or standard detions) of normal children, s/he is considered to suffer from moderate acute malnutrition or wasting. If the child's weight-for-height is less than -3 z-scores (standard detions) of normal children s/he suffers from severe acute malnutrition and is considered to be severely wasted. Another measurement used to determine a child's nutritional status is the mid-upper arm circumference (MUAC) measurement. Because MUAC measurements require a simple, colour-coded measuring band rather than weighing scales and height boards, they are often used during crisis situations. Useful for children between six months and five years of age, a MUAC measurement of less than 12.5 cm indicates that a child is suffering from moderate acute malnutrition. If the MUAC measurement is under 11.0 cm, however, the under-five child's life may be in danger as he or she is suffering from severe acute malnutrition. Although no anthropometric measure is a perfect marker of acute malnutrition, in the past, there has been a tendency to view W/H measures as the gold-standard anthropometric measure to diagnose acute malnutrition in emergencies. Discrepancies between MUAC and W/H have therefore been explained by MUAC being a poor indicator of nutritional status. A third way of diagnosing acute malnutrition is by testing for the presence of oedema. Oedema affects a child's appearance, giving him or her a puffy, swollen look in either lower limbs and feet or face. It can be detected by small pits or indentations remaining in the child's lower ankles or feet, after pressing lightly with the thumbs. The presence of oedema in both feet and lower legs is always considered a sign of severe acute malnutrition. | train | med_mcqa | null |
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