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Without breast feeding the first menstrual usually begins - weeks after delivery : | [
"2-4 weeks",
"4-6 weeks",
"6-8 weeks",
"8-10 weeks"
] | C | 6-8 weeks | train | med_mcqa | null |
All of the following are the markers for malignant germ cell tumors of ovary except : | [
"CA - 125",
"Alpha feto protein",
"p HCG",
"LDH"
] | A | Ans. is a i.e. CA - 125 | train | med_mcqa | null |
Loss of lamina dura and ground glass appearance indicates: | [
"Paget's disease",
"Fibrous dysplasia",
"Caffey's disease",
"Osteomalacia"
] | B | The periphery of fibrous dysplasia lesions most commonly is ill defined, with a gradual blending of normal trabecular bone into an abnormal trabecular pattern. Occasionally, the boundary between normal bone and the lesion can appear sharp and even corticated, especially in young lesions. The abnormal trabeculae usually are shorter, thinner, irregularly shaped, and more numerous than normal trabeculae. This creates a radiopaque pattern that can vary; it may have a granular appearance (or ground-glass appearance, resembling the small fragments of a shattered windshield), a pattern resembling the surface of an orange (peau d’orange), a wispy arrangement (cotton wool), or an amorphous, dense pattern. A distinctive characteristic is the organization of the abnormal trabeculae into a swirling pattern similar to a fingerprint. Occasionally, radiolucent regions resembling cysts may occur in mature lesions of fibrous dysplasia. These are bone cavities that are analogous to simple bone cysts and occur more commonly in mandibular lesions. If the fibrous dysplasia increases the bone density, the periodontal ligament space may appear to be very narrow. Fibrous dysplasia can displace teeth or interfere with normal eruption, complicating orthodontic therapy. In rare cases, some root resorption may occur. Involved teeth may have hypercementosis. Fibrous dysplasia appears to be unique in its ability to displace the inferior alveolar nerve canal in a superior direction.
Reference: White and Pharoah's Oral Radiology Principles and Interpretation 7th edition page no 407 | train | med_mcqa | null |
True about diaphragmatic injury | [
"Advice diagnostic laproscopy",
"Chest X ray is useful",
"Conservative management is done in most cases",
"Late complication is herniation of abdominal content"
] | A | Contrast studies of the upper or lower gastrointestinal tract, CT scan and diagnostic peritoneal lavage all lack positive or negative predictive value. The most accurate evaluation is by video-assisted thoracoscopy (VATS) or laparoscopy, the latter offering the advantage of allowing the surgeon to proceed to a repair and additional evaluation of the abdominal organs Operative repair is recommended in all cases. All penetrating diaphragmatic injury must be repaired the abdomen and not the chest, to rule out penetrating hollow viscus injury. Ref : Bailey and love 26thE pg826 | train | med_mcqa | null |
All are growth promoting oncogenes except - | [
"FGF",
"TGF-a",
"TGF-b",
"PDGF"
] | C | Robbins basic pathology 9th edition page no 187 TGF b can function to prevent or promote tumor growth, depending on the state of other genes in the cell. | train | med_mcqa | null |
Which virus given below is not a teratogenic virus ? | [
"Rubella",
"Cytomegalovirus",
"Herpes simplex",
"Measles"
] | D | Ans. is 'd' i.e., Measles Many viruses can be transmitted to the fetus and cause infection and tissure damage. Five viruses are known to be teratogenic in humans: cytomegalovirus, rubella, herpes simplex, Venezuelan equine encephalitis, and varicella viruses. | train | med_mcqa | null |
A 9 1/2 -year-old girl presents to your office with an approximately 1 1/4 -cm nodule in her neck, just to the left of the midline and below her cricoid cartilage. It is nontender and moves when she swallows. It has been enlarging over the last several months and was not seen by the pediatrician at her 9-year-old check-up. There is no family history of endocrine disorders. The most likely diagnosis is | [
"Reactive viral lymphadenopathy",
"Papillary thyroid cancer",
"A brachial cleft cyst",
"A follicular adenoma of the thyroid"
] | B | While reactive lymphadenopathy is by far the most common cause of neck masses in children; a lymph node should not move with deglutition and is more likely to be tender. A branchial cleft syst should be more lateral and the thyroglossal duct cyst should be higher and in the midline (although they can sometimes present off the midline). One might also have expected some prior evidence of both of these congenital cysts, although that is not always the case. The location and characteristics strongly suggest a thyroid nodule. While follicular adenomas are much more common in adults than cancers they are rarer in children and a rapidly growing solitary nodule is likely to be a papillary carcinoma, the most common thyroid cancer in children. | train | med_mcqa | null |
Which of the following can be viewed on a conventional radiograph? | [
"Buccal curvature of roots",
"Gingival fibers",
"Calcification of canals",
"Periodontal ligament"
] | C | Calcification of canals. Buccal curvature cannot be seen from the conventional radiographs. Gingival fibers and the periodontal ligament, being connective tissues, are radiolucent radiographically. | train | med_mcqa | null |
Gene transmitted but not translated: | [
"Glycosyl transferase",
"t-RNA",
"Keratin",
"Histone"
] | B | B i.e. t RNAAll RNA molecules (eg r RNA, tRNA, mRNA etc) are produced from transcription of DNAQ. Whereas, as a new strand of DNA is formed by DNA polymerase III enzyme in process of DNA synthesis/ replication. And complementary (c) DNA is prepared by using mRNA as a template by enzyme reverse transcriptase (= RNA dependent DNA polymrase)Q in process of reverse transcription. | train | med_mcqa | null |
Conley's Pointer is used to | [
"Identify the Lingual Nerve",
"Identify the Hypoglossal Nerve",
"Identify the Facial Nerve",
"All the above"
] | C | Ans. (c) Identify the facial nerveRef: Bailey and Love 27th Edition Page 790Location of Facial Nerve Trunk: Antegrade techniques:* Conley's pointer - Inferior portion of cartilaginous canal, Facial nerve lies 1cm deep and inferior to its tip.* Upper border of posterior belly of digastric muscle* Squamo tympanic fissure.* Styloid process (nerve is superficial to it)* Mastoid process can be drilled and nerve identified more proximally. | train | med_mcqa | null |
True about veebral aery ? | [
"A branch of thyrocervical trunk",
"Enters skull through foramen magnum",
"Unite to form posterior cerebral aery",
"A small aery"
] | B | Ans. is 'b' i.e., Enters skull through foramen magnum Veebral aery It is the largest branch of subclan aery. Veebral aery traverses through veebral triangle, foramina transversaria of upper six cervical veebrae, suboccipital triangle, posterior atlanto-occipital membrane, veebral canal, pierce duramater and arachnoid (Subarachnoid) and passes through foramen magnum to enter posterior cranial fossa. It gives following branches:- Cervical branches :- Spinal branches, muscular branches (to suboccipital muscle). Cranial branches :- Posterior inferior cerebellar aery, medullary aery, meningeal branches, anterior spinal aery, posterior spinal aery and both veebral aeries unite to form basilar aery. | train | med_mcqa | null |
Leeway space of Nance is utilized in | [
"Early mesial shift of first permanent molars",
"Incisal liability",
"Late mesial shift of first permanent molars",
"Secondary spacing of first permanent molars"
] | C | null | train | med_mcqa | null |
On abdominal ultrasound gall bladder shows at neck and comet tail aifacts. The most likely diagnosis will be: | [
"Adenomyomatosis",
"Adenocarcinoma of gall bladder",
"Xanthogranulomatous cholecystitis",
"Chelesterol crystals"
] | A | Adenomyomatosis Repeat from May 11 Adenomyomatosis is a benign condition characterized by hyperplastic changes of unknown etiology involving the gallbladder wall. It causes overgrowth of the mucosa, thickening of the muscular wall, and formation of intramural diveicula or sinus tracts termed as Reokitansky-Aschoff sinuses. These sinuses may contain cholesterol crystals. The presence of cholesterol crystals in theses sinuses can result in "ring down", "V-shaped",or "comet-tail" aifacts. The disease can be focal or diffuse. It has no malignant potential. | train | med_mcqa | null |
All the following are important in the development of Type I diabetes mellitus except: | [
"High sugar",
"Gluten",
"Smoked & red meat",
"Cow milk"
] | A | Ans: a (High sugar) Ref: Davidson, 19th ed,p. 653Type IA diabetes results from autoimmune beta cell destruction, which results in insulin deficiency.Individuals with Type IB diabetes lack immunologic markers indicative of autoimmune destructive process of beta cells. However they develop insulin deficiency and are ketosis prone.Type I diabetes develops as a result of synergestic effects of genetic, environmental and immunological factors that ultimately destroy pancreatic beta cells.The important dietary factors responsible are, bovine serum albumin (BSA) a major constituent of cow milk. It has been implicated in triggering type I diabetes. Various nitrosamines (found in smoked and cured meats) and coffee have been proposed as potentially diabetogenic factors. In susceptible animals such as diabetes prone BB rat, various dietary protein (e.g., gluten) may be essential for expression of clinical type I diabetes.Other environmental triggers for Type I DM include viruses, coxsackie and rubella most prominently.Notes: The major susceptibility gene for Type IA DM is located in HLA region in chromosome 6.Most individuals with type IA diabetes have HLA DR3 and /or HLA DR4 haplotype. | train | med_mcqa | null |
Relative afferent pupillary defect is characteristically seen In damage to - | [
"Optic nerve",
"Optic tract",
"Lateral geniculate body",
"Occulomotor nerve"
] | A | For testing relative afferent pupillary defect (RAPD), a strong, steady light is used. The light is shined into one eye, and then quickly switched to the other. This is repeated back and foh, until one of four conclusions is reached (listed below). Since light in one pupil causes both pupils to constrict, quickly switching from one eye to the other will give a "relative" indication of the functioning of each eye and optic nerve. If both eyes are equally dysfunctional, no "relative" defect would be found. | train | med_mcqa | null |
All of the following are Indications for CSF examination in adults with all stages of Syphilis Except | [
"RPR titer >= 1:32",
"VDRL titer < 1:32",
"Active teiary syphilis",
"Suspected treatment failure"
] | B | Indications for Cerebrospinal Fluid Examination in Adults with All Stages of SyphilisAll PatientsAdditional Indications in HIV-Infected Persons1. Signs or symptoms of nervous system involvement (e.g., meningitis, hearing loss, cranial nerve dysfunction, altered mental status, ophthalmic disease , ataxia, loss of vibration sense), or2. RPR or VDRL titer >=1:32, or3. Active teiary syphilis, or4. Suspected treatment failure11. CD4+ T cell count <=350/mL, or2. All HIV-infected persons (recommended by some expes)Reference: Harrison&;s Principles of Internal Medicine; 19th edition; Chapter 206; Syphilis | train | med_mcqa | null |
Which is not a alkylating agent? | [
"Cyclophosphamide",
"Chlorambucil",
"5-FU",
"Melphalan"
] | C | 5-FU is an metabolite | train | med_mcqa | null |
Down's syndrome is due to: | [
"5/12 translocation",
"18 trisomy",
"21trisomy",
"14/21 trisomy"
] | C | Ans: c (21 trisomy)Ref: Nelson Pediatrics, 19th ed., Pg. 384Trisomy 21, Down's syndrome seen in 1/600-800 births. Please note the clinical features which are often asked Hypotonia Dysplasia of the pelvis Flat face, cardiac malformations Speckled irises Simian crease (Brushfield spots) Varying degrees of mental Short, broad hands and growth retardation Hypoplasia of middle Upward slanted palpebral phalanx of 5th finger fissures and epicanthic folds Intestinal atresia, and high arched palate | train | med_mcqa | null |
Best indicator for nutritional status for a child is – | [
"Mid arm circumference",
"Head circumference",
"Rate of increase of height and weight",
"Chest circumference"
] | C | Health and development are intimately interconnected.
Proper nutrition of children is fundamental to the achievement of sustainable development.
Anthropometric measurements are the most widely used indicators of nutritional status in a community.
The commonly used anthropometric measurements are -
Weight
Length / height
Arm circumference
Chest circumference
Skinfold thickness
Measurement of weight and rate in gain in weight are the best single parameters for assessing physical growth.
The comparison of a child's height and weight with the standard growth chart helps to determine if the particular child is within the expected normal range for his age, sex and socioeconomic status.
It does not indicate if the rate of growth of child was normal in the recent past.
The point to stress here is that it is very difficult to recognize a recent disturbance in growth by comparing weight or height with the reference standards because a clearly abnormal percentile position on the growth chart becomes evident only when the factors retarding growth are profound or if they have persisted for a considerable time.
Measurement of the velocity of growth or increment in unit time is a better tool for early identification of factors affecting growth and also for assessment of the usefulness of social and remedial measures. | train | med_mcqa | null |
A patient presented with painful ophthalmoplegia. On CT scan, there was enlargement of the cavernous sinus on one side. The most likely diagnosis is: | [
"Cavernous sinus thrombosis",
"Gradeniego's syndrome",
"Tolosa- Hunt syndrome",
"Orbital Pseudotumor"
] | C | C i.e. Tolosa Hunt Syndrome Painful opthalmoplegia can be seen in cavernous sinus thrombosis, Tolosa Hunt syndrome & orbital pseudotumor. These are differentiated by? Orbital pseudotumor There is enlargement of extraocular muscles (not cavernous sinus)Q Gradeniego's syndrome CT scan show - enhancement of cavernous sinusQ (not enlargement) - petrous apicitis of temporal bone including opacification of mastoid air cells - bony erosion with in petrous apex Idiopathic orbital inflammatory disease (Pseudo tumor) It is non neoplastic, non infectious, non specific space occupying orbital lesion (a diagnosis of exclusion). Unilateral disease is the rule in adults, although may be bilateral in children. It usually presents in 30-60 years male with acute unilateral periorbital (lid) redness, swelling and pain with proptosis. Rarely opthalmoplegia and optic nerve dysfunction may occur in severe cases. It may 1/t intermittent episodes with spontaneous recovery without sequelae or prolonged course resulting in frozen orbit characterized by opthalmoplegia, ptosis & visual impairment. USG shows diffuse infiltration of hetrogenous consistency CT scan shows ill defined orbital opacification & loss of definition of contents, diffuse thickening of the extraocular muscles including their tendinous inseion, which differentiates it from thyroid eye disease where the muscle enlargement is confined to the muscle belly and spares the terminal tendinous poionQ. Steroids, radiotherapy (in unresponsive cases) and cyclophosphamide are used to treat. Tolosa-Hunt Syndrome It is a rare diagnosis of excision, caused by non specific granulomatous inflammation of the cavernous sinus, superior orbital fissure and /or orbital apexQ. The clinical course is characterized by remissions and recurrences. It is characterized by acute, painful, opthalmoplegia, with or without involvement of optic nerve and ophthalmic division of trigeminal nerve and it responds promptly to steroid treatment (in 24-48 hrs). It presents with diplopia a/w ipsilateral periorbital or hemicranial pain, mild proptosis, ocular motor nerve palsies often with involvement of pupil and sensory loss along the distribution of 1st & division of trigeminal nerve. Original cases had granulation around carotid aery in cavernous sinus. Full investigation to exclude diagnosis of carotid- cavernous fistula, infraclinoid aneurysm, pituitary tumor, meningioma & orbital tumor. Other lesions may be responsive to steroids but neither is the remission complete nor it occurs so rapidlyQ. THS should not be diagnosed with out aeriography and venography or when there are atypical features (clinical /radiological/in resonse to treatment). Thin slice high magnetic field MRI of cavernous sinus including coronal sections with & without contrast and fat suppressed cuts of orbital regions is modality of choice Inflammatory changes in cavernous sinus, superior orbital fissure & /or orbital apex are observed on high resolution contrast enhanced imaging. Enlargement of optic nerve &/or extra ocular muscles. | train | med_mcqa | null |
Large PDA leads to - | [
"Endocardial valvulitis",
"Eisenmenger syndrome",
"CHF",
"All of above"
] | D | Ans. is 'd' i.e., AH of above Patent ductus arteriosus (PDA)o Small PDA may not cause any complication but targe defect if untread may leads to :Pulmonary hypertension Left to Right shunt leads to too much circulation of blood in lung which leads to pulmonary hypertension.Eisenmenger's syndrome - Large standing pulmonary hypertension leads to permanent lung damage and causes Right to Left shunt.Endocarditis.Arrhythmia Enlargement of heart due to PDA increase risk of arrhythmias. | train | med_mcqa | null |
All of the following may occur in Noonan's syndrome except: | [
"Hyperophic cardiomyopathy",
"Cryptoorchidism",
"Infeility in females",
"Autosomal dominant transmission"
] | C | Answer is C (Infeility in females) : Females usually show normal sexual maturation but it is delayed 2 years on an average. Males frequently have cryptorchidism and small testes. They may be hypogonadal or normal. Pubey is delayed 2 yr on average Term 'Noonan Syndrome' has been applied to males and. females who have some phenotypic features that resamble females with turner's syndrome (45 X, 0), but themselves have apparently normal sex chromosomes (46XX or 45 XY). These boys and girls have normal Karyotopee Inheritance is autosomal dominants (gene on chromosome 12q) Clinical features Q: Sho stature, webbed neck, pectus carinatum / excavatum Hypeelorism, epicanthus, dominant slanted palpebral fissures, ptosis, micrognathia and ear abnormalities. Clinodactyly, hernias, veebral anomalies are less common Mental retardation occurs in 25% of patients High frequency sensorineural hearing loss is common Cardiac Defects : Pulmonary stenosis, Hyperophic Cardiomyopathy, ASD Hepatosplenomegaly and hematological diseases including Leukemia occur | train | med_mcqa | null |
All of the following are true about the Herd immunity for infectious diseases except - | [
"It refers to group protection beyond what is aforded by the protection of immunized individuals",
"It is likely to be more for infections that do not have a sub-clinical phase",
"It is affected by the presence and distribution of alternative animal hosts",
"In the case of tetanus it does not protect the indi... | B | Ans. is 'b' i.e., It is likely to be more for infections that donot have a sub-clinical phase o Herd immunity is more for infections that have a subclinical phase, because by subclinical infection the individual develops immunity against that paicular infection and buildup herd immunity. o Herd immunity implies group protection beyond that afforded by the protection of immunized individuals. Significance of herd immunity Herd immunity predicts occurance of epidemics. o If herd immunity is sufficiently high the occurance of epidemics is highly unlikely. o Herd immunity may lead to elimination of the diseae : - i) Diphtheria and poliomyelitis may be eliminated by stepping up herd immunity. ii) Small pox was eliminated by elimination of source of infection and not by herd immunity. | train | med_mcqa | null |
Unconjugated hyperbilirubinemia is seen in - | [
"Rotor syndrome",
"Dubin-Johnson syndrome",
"Gilbert syndrome",
"Bile duct obstruction"
] | C | Ans. is 'c' i.e., Gilbert syndrome {Ref: Harrison 18th/e p. 325 fig (42.1), 326 table (42.1); 17th/ep. 263 t. (43.1)]Causes of isolated hyperbilirubinemiaIsolated Indirect hyperbilirubinemiaIsolated Direct hyperbilirubinemiaA) Inherited conditionsInherited conditionso Cirgler Najjar type I and IIo Dubin Jhonson syndromeo Gilbert's syndromeo Rotors syndromeB) Ineffective ervthropoiesis Cobalamine folate, thalassemia, and severe iron deficiencies C) Drugs Rifampicin, Probenecid, Ribavarin D) Hemolytic disorder 1) Inherited o Spherocytosis, Elliptocytosis Glucose 6 phosphate dehydrogenase Pyruvate kinase deficiency o Sickle cell anemia 2) Acquired o Microangiopathic hemolytic anemia o Paroxysmal nocturnal hemoglobinuria o Immune hemolysis Unconiugated Bilirubin (Indirect bilirubin)o Isolated elevation o f unconjugated Bilirubin is rarely due to liver disease.o An isloated elevation of unconjugated Bilirubin is seen primarily in hemolytic disorders and in number of genetic conditions such as Crigter Najar and Gilbert's syndrome.Conjugated Bilirubin (Direct bilirubin)o In contrast to unconjugated bilinibinemia, conjugated bilirubinemia almost always implies liver or biliary tract disease.o Elevation of conjugated bilirubin may be seen in any type of liver disease. In most of the liver diseases both conjugated and unconjugated fraction of the bilirubin may be elevated. | train | med_mcqa | null |
Which of the following is nephrotoxic - | [
"Halothane",
"Methoxyflurane",
"Ether",
"Cyclopropane"
] | B | Ans. is 'b' i.e., Methoxyflurane o Intrarenal metabolism of methoxyflurane and subseuent intrarenal production offlouride ion is the significant cause of methoxyflurane renal toxicity.o It can cause high output renal failure.o It was the most potent inhalation agent (least MAC), but not used now (now Halothane is most potent).o It should not be used in closed circuit (reacts with rubber tubing of the closed circuit). | train | med_mcqa | null |
Hereditary angioneurotic edema is due to ? | [
"Deficiency of C1 inhibitor",
"Deficiency of NADPH oxidase",
"Deficiency of MPO",
"Deficiency of properdin"
] | A | Ans. is 'a' i.e., Deficiency of C1 inhibitor Hereditary angioneurotic edema is due to C1inhibitor (Ci esterase inhibitor) deficiency. | train | med_mcqa | null |
Wich one of the following drugs does not produce central anticholinergic syndrome | [
"Atropine sulphate",
"Glycopyrrolate",
"Antihistaminics",
"Tricyclic antidepressants"
] | B | Ref: KD Tripathi pharmacology 7th edition (page.no: 111) Glycopyrrolate is a potent and rapidly acting antimuscarinic, lacking central effects. It is having a quaternary structure. so it doesn't cause the central anticholinergic syndrome. Atropine has both central and peripheral action. Tricyclic antidepressants, Antihistaminics have central anticholinergic effects | train | med_mcqa | null |
An example of chronic myeloproliferative disorder is | [
"Neutrophilic leukemoid reaction",
"Essential thrombocythemia",
"Plasmacytosis",
"Hairy cell leukemia"
] | B | <p>According to WHO classification of myeloid neoplasms,the diseases under myeloproliferative group are chronic myeloid leukemia ,chronic neutrophilic leukemia ,chronic eosinophilic leukemia ,polycythemia vera & essential thrombocytopenia.</p><p>Reference :Harsh mohan textbook of pathology sixth edition pg no 357.</p> | train | med_mcqa | null |
A 26 year old lady has been on Olanzapine for the treatment of Schizophrenia. All of the following are the ATP III (Adult Treatment Panel) criteria for metabolic syndrome, except: | [
"Abdominal obesity",
"Triglyceride > 150 mg/dl",
"Blood pressure > 130/85",
"LDL > 150 mg/dl"
] | D | LDL is not included in metabolic syndrome criteria. All others are indicated. The new generation anti-psychotics like Olanzapine and Risperidone increases the risk of metabolic syndrome and increase the risks of cardiovascular disease. ATP III (Adult Treatment Panel) Criteria for Metabolic Syndrome is as follows: Abdominal obesity, given as waist circumference Men>102 cm (>40 in) Women>88 cm (>35 in) Triglycerides>=150 mg/dL HDL cholesterol Men<40 mg/dL Women<50 mg/dL Blood pressure>=130/>=85 mm Hg Fasting glucose>=110 mg/dL | train | med_mcqa | null |
Genital elephantiasis is caused by- | [
"Herpes genitalis",
"LGV",
"Gonorrhea",
"Syphilis"
] | B | Ans. is 'b' i.e., LGV o LGV is caused by chlamydia trachomatis, serotypes L1, L2, L3. Serotype L2 is the most common cause. The clinical course of LGV consist of following three stages:-1) First stage (Primary LGV):- Self limited, Single, asymptomatic, painless, nonbleeding genital ulcer.2) Secondary stage:- Painful inguinal lymphadenopathy (Remember - Ulcer is pain less but lymphodenopathy is tender & painful). Swollen lymph nodes coalesce to form bubos, i.e., matted lymph nodes. Buboes may rupture to form discharging sinus. Groove's sign - Enlarge lymph nodes both above and below inguinal ligament.3) Tertiary LGV (genitorectal syndrome):- Characterized by proctocolitis.o Complications of LGV1) Esthiomene -Enlargement, thickening and fibrosis of labia.2) Elephantiasis of the genitals3) Rectal stricture4) Systemic - Arthritis, pneumonitis, Perihepatitiso Frei's test was used for diagnosis (not used now)o Treatment - Doxycycline/tetracycline is DOC. Erythromycin is an alternative. | train | med_mcqa | null |
Most common Cytochrome P450 involved in drug metabolism is | [
"CYP 3A4",
"CYP 1AI",
"CYP 2E1",
"CYP 2D6"
] | A | Cytochrome P-450 (CYP) isoenzymes are grouped into families designated by numerals (1, 2, 3....; each having several sub-families designated by capita: letters (A, B, C. .... ), while individual isoenzymes are again allocated numerals (1, 2, 3 .... ). In human beings, only a few, members of three isoenzyme families (CYP 1, 2 and 3 carry out the metabolism of most of the drugs, The CYP isoenzyme: CYP3A4/5 Carryout biotransformation of largest number: (nearly 50%) of drugs. 20-30% of metabolism is done by the next common cyp2d6 In addition to liver, these isoforms are expressed in the intestine (responsible for the first-pass metabolism at this site) and kidney as well. Ref: KD Tripathi pharmacology 7th edition (page.no: 24) | train | med_mcqa | null |
Cytokeratin 8 and 18 and ubiquitin present in all except? | [
"Alcoholic hepatitis",
"Non alcoholic steatohepatitis",
"Primary biliary cirrhosis",
"Acute viral hepatitis"
] | D | Option D - Cytokeratin 8,18 and ubiquitin presence is found in MALLORY-DENK BODIES. MALLORY-DENK BODIES. -Eosinophilic inclusion bodies seen in Hepatocyte swelling. -Tangled skeins of intermediate filaments -Commonly seen in Alcoholic hepatitis Non-alcoholic steatohepatitis Metabolic disorders like Wilson's diseaseChronic cholestatic disease HCC Primary biliary cirrhosis | train | med_mcqa | null |
Which activity will be difficult to perform for a patient with an anterior cruciate deficient knee joint? | [
"Walk downhill",
"Walk uphill",
"Sit cross leg",
"Getting up from sitting"
] | A | Ans. is 'a' i.e. Walk downhill I could not get a satisfactory answer to this question in any of the book, not even from residents and consultants of orthopedics. The only clue is derived from these lines of Turek- "The type of injury that most frequently damage the anterior cruciate ligament are those that cause excessive external rotation and valgus of the flexed knee or forcible hyper extension of the knee while the tibia is in internal rotation. The knee may immediately collapse and become extremely painful; at the other extreme, it may not give way and the initial discomfort may be so trivial that person is misled into continuing his activity. Later, the knee may give way to sudden change of direction, squatting, walking on uneven ground, or descending stairs." | train | med_mcqa | null |
Tear drop sign: (Repeat) | [
"floor of orbit",
"Retinoblastoma",
"Dry eyes",
"Congenital nasolacrimal duct obstruction"
] | A | Ans: A ( floor of the orbit) Ref: Basok Essentials of ophthalmology 5th edition, pg no 421: kanski 7th edition clinical ophthalmology, pg no 873- 874Explanation:Blow out fracture of orbit:Caused by a sudden increase in the orbital pressure by an impacting object of size > 5cm like tennis ball or fist.The fracture usually involves the floor of the orbit, along the thin bone covering the infra orbital canal.Two types:Pure Blow Out fracture does not involve the orbital rim or the other bonesImpure Form involves other bonesSymptoms:Diplopia - due to the entrapment of muscle into the fracture , intraorbital hemorrhage or injury to the muscle itselfDouble Diplopia - Diplopia in both upgaze & downgaze due to entrapment of both Inferior rectus (Depression) & inferior oblique (Elevation)Periocular ecchymosis & edemaEnophthalmosInfraorbital nerve anaesthesia Investigations: X-ray (WATER'S view) - kTear Drop Sign ' because of the protruding orbital tissue from the floor if the orbit into the maxillary antrum.Management:Conserv ative management with antibiotics & anti inflammatory drugsOrbital floor repair with bone graft, silicone plate within 2 weeksIndications:Fracture involving > one third of the floorPersisting diplopiaEnophthalmos > 2mmBlow-In Fracture:Sudden rise of pressure in the maxillary antrum due to trauma to the face with subsequent elevation of bone fragments into the orbit. | train | med_mcqa | null |
A 28-year-old man presents to the emergency room (ER) with a large amount of blood and protein in his urine. He has had a sensorineural hearing loss since his teen years and has misshaped lenses (anterior lenticonus). The physician is suspicious of a genetic disorder that may lead to eventual kidney failure. If this is the case, the patient most likely has a mutation in which one of the following proteins? | [
"Spectrin",
"a1-Antitrypsin",
"Collagen",
"Fibrillin"
] | C | The patient has Alport syndrome, a mutation in type IV collagen that alters the basement membrane composition of kidney glomeruli. In the absence of a functional basement membrane, the kidneys have difficulty in properly filtering waste products from blood into the urine, and both blood and proteins can enter the urine. Type IV collagen is also important for hearing (it is found in the inner ear) and for the eye. Type IV collagen forms a mesh-like structure, which is different from the rod-like structures found in type I collagen and is found in almost all basement membrane structures. Given sufficient time, the alteration in the basement membrane in the glomeruli will lead to their destruction and loss of kidney function. A mutation in a1-antitrypsin will lead to emphysema, mutations in spectrin can lead to hereditary spherocytosis, mutations in fibrillin lead to Marfan syndrome, and mutations in b-myosin heavy chain can lead to FHC. | train | med_mcqa | null |
Anticentromere antibodies are most commonly associated with- | [
"Diffuse cutaneous systemic sclerosis",
"Mixed connective tissue disease",
"CREST syndrome",
"Polymyositis"
] | C | CREST syndrome, also known as the limited cutaneous form of systemic sclerosis (lcSSc) is a multisystem connective tissue disorder. The acronym "CREST" refers to the five main features: calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia. It is associated with detectable antibodies against centromeres (a component of the cell nucleus), and usually spares the kidneys (a feature more common in the related condition systemic scleroderma). If the lungs are involved, it is usually in the form of pulmonary aerial hypeension. | train | med_mcqa | null |
Mifepristone is used in - | [
"Medical terminations of pregnancy",
"Breast carcinoma",
"Prostatic carcinoma",
"Dysfunctional uterine bleeding"
] | A | Ans. is 'a' i.e., Medical termination of pregnancy Mifepristone Mifepristone is a 19-norsteroid with potent competitive antiprogestational, antiglucocoicod and antiandrogenic action. Mifepriston is a paial agonist and competitive antagonist at both A and B isoforms of progesterone receptors. Uses Termination ofpregnancy 3. Postcoital contraceptive 5. Induction of labour Cervical ripening 4. Once-a-month contraceptive 6. Cushing's syndrome o Uses under evaluation are-in endometriosis, uterine fibroid, ceain breast cancers and meningioma. | train | med_mcqa | null |
A neurological examination of a 47 year old woman reveals a normal corneal reflex in her right eye, but no consensual corneal reflex in her left eye. Which of the following additional findings might be expected? | [
"Absence of pupillary light reflex of the left eye",
"Hyperacusis of the left ear",
"Inability to abduct the right eye",
"Loss of pain and temperature of the left face"
] | B | The first trick to this question is to determine where the lesion is. The corneal reflex is tested by touching a cotton wisp to the eye. A normal response would be blinking of the ipsilateral eye as well as the contralateral eye (consensual reflex). The afferent limb of the corneal reflex is contained within the ophthalmic division of the ipsilateral ophthalmic nerve (V1), the efferent limb is by both (right and left) facial nerves (VII). This woman had a normal corneal reflex in her right eye, indicating a normal right V1 and right VII. However, she lacked a consensual reflex, indicating an abnormal left VIIth nerve. The next trick to this question is to determine what other signs a lesion in the left VIIth nerve could produce. A lesion in the left VIIth would also produce hyperacusis (increased sensitivity to sound) in the left ear because of paralysis of the stapedius muscle, which ordinarily dampens sound transmission through the middle ear. The absence of a pupillary light reflex of the left eye could be caused either by a lesion of the left optic nerve (CN II; afferent limb) or by a lesion of the left oculomotor nerve (CN III; efferent limb). The inability to abduct the right eye could be caused by a lesion of the right abducens nerve (CN VI), which innervates the lateral rectus muscle. Loss of pain and temperature of the left face could be caused by a lesion of the spinal nucleus of V. This nucleus is located in the medulla, and receives pain and temperature information from the face the trigeminal nerve (CN V). Ref: Rosenga A.J., Novakovic R.L., Frank J.I. (2005). Chapter 67. Coma, Persistent Vegetative State, and Brain Death. In J.B. Hall, G.A. Schmidt, L.D. Wood (Eds),Principles of Critical Care, 3e. | train | med_mcqa | null |
. A patient has loss of sensation at angle of mandible (jaw) and parotid area. Which of the following nerve is most likely to be injured. | [
"Mandibular nerve",
"Auriculotemporal nerve",
"Lesser occipital nerve",
"Greater auricular nerve"
] | D | D i.e. Great auricular nerve Angle of mandible is supplied by great auricular nerve (C2,3)Q Tip of nose is supplied by ophthalmic division of trigeminalQ; and side and alae of nose is supplied by maxillary division of trigeminal nerveQThe skin of face is supplied by three divisions of trigeminal nerve, except for the small area over the angle of mandible and parotid gland which is supplied by great auricular nerveQ (C2, C3)Spatial representation of face in spinal nucleus of trigeminal nerve (paicularly for pain) is more akin to an onion skin pattern with fibers from central area of face reaching the highest (cranial) pa of nucleus & fibers from more posterior pa passing to progressively lower (caudal) levels of nucleus. | train | med_mcqa | null |
An 8-month-old child presents with a silver sheen to her hair, seizures, hepatosplenomegaly, lymphadenopathy, pancytopenia, recurrent Staph aureus skin infections, and enlarged granules noted within neutrophils on peripheral smear. Which of the following gene defects is most likely to be identified? | [
"c-kit",
"LYST",
"PAX3",
"HPS1"
] | B | Chediak-Higashi Syndrome Autosomal recessive Lysosomal transpo protein (LYST/CHS1) gene defect, vesicular trafficking defect Incomplete oculocutaneous albinism Decreased chemotaxis of neutrophils, decreased antibody dependent cellular cytotoxicity, presence of giant peroxidase-positive lysosomal granules in peripheral blood granulocytes; results in severe infections Clinical findings;- Childhood CHS: accelerated phase: early onset with fever, anemia, and neutropenia . Adolescent CHS: severe infections in early childhood, no accelerated phase Adult CHS: mild form, develop progressive and fatal neurologic dysfunction in middle age Eyes: ocular hypopigmentation causes photophobia, nystagmus, and strabismus Hair: silvery sheen Skin: pale, deep ulcerations, petechiae, bruising, and gingival bleeding Neurologic: weakness, ataxia, sensory deficits, and progressive neurodegeneration Lymphoma: "accelerated phase" precipitated by viruses (e.g., Epstein-Barr virus); widespread infiltration of viscera Other: hepatosplenomegaly, lymphadenopathy, pancytopenia, pseudomembrane, and sloughing of the buccal mucosa . Laboratory findings:- Giant intracellular granules in circulating neutrophils, melanocytes, neurons, and renal tubular cells * Granules form secondary to delayed disorder of lysosomal enzymes from cells. Treatment:- Bone marrow (or stem cell) transplant, acyclovir, interleukin, gamma globulin, vincristine, prednisone, and prophylactic antibiotics. Ref:- Dermatology pictorial review by ASRA ALI; pg num:-170 | train | med_mcqa | null |
Which of the following factor is related to diabetic retinopathy? | [
"Duration of disease",
"Severity of disease",
"Family history",
"Control of diabetes"
] | A | Duration of DM and degree of glycemic control are the best predictors of the development of retinopathy; hypeension is also a risk factor. Nonproliferative retinopathy is found in many individuals who have had DM for >20 years (25% incidence with 5 years, and 80% incidence with 15 years of type 1 DM). Although there is genetic susceptibility for retinopathy, it confers less influence than either the duration of DM or the degree of glycemic control. Ref: Powers A.C. (2012). Chapter 344. Diabetes Mellitus. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e. | train | med_mcqa | null |
Submandibular gland is divided into superficial and deep parts by - | [
"Digastric",
"Geniohyoid",
"Mylohyoid",
"Stylohyoid"
] | C | Ans. is 'c' i.e., Mylohyoid Submandibular glando This walnut sized gland lies belowr the mandible in the anterior part of digastric triangle. It is J-shaped and consists of a large superficial and a small deep parts, separated by mylohyoid muscle and continuous with each other around the posterior border of mylohyoid muscle.Superficial parto It is situated in the anterior part of digastric triangle. The gland is partially closed in a capsule formed by two layers of deep cervical fascia. It has three surfaces: (i) inferior, (ii) lateral, and (iii) medial.Inferior surface is covered by skin, platysma, cervical branch of facial nerve, deep fascia, facial vein and submandibular lymph nodes.Lateral surface is related to submandibular fossa (on mandible), medial pterygoid (insertion) and facial artery.Medial surface is related to mylohyoid, hyoglossus and styloglossus muscles.Deep parto It lies on the hyoglossus muscle deep to mylohoid. It is related above to lingual nerve and submandibular ganglion; and below to hypoglossal nerve. | train | med_mcqa | null |
Maximal reduction in gastric acidity is achieved by - | [
"Truncal vagotomy and pyloroplasty",
"Truncal vagotomy and antrectomy",
"Partial gastrectomy",
"Highly selective vagotomy"
] | B | null | train | med_mcqa | null |
A 40 year old male with diabetes presents with vitreous hemorrhage. What is the cause? | [
"Posterior retinal detachment",
"Neovascularization at disc",
"Central retinal vein occlusion",
"Trauma to central retinal aery"
] | B | Neovascularization, defined as abnormal formation of blood vessels in the retina, is a sight-threatening condition indicative of late-stage diabetic retinopathy (DR). ...Neovascularization on the disc (NVD) is diagnosed when new vessels are located within one disc-diameter of the optic disc. Ref AK khurana 6/e p 278 | train | med_mcqa | null |
A mentally ill person smells unpleasant odor when none is present. This is an example of: COMEDK 07; KCET 13 | [
"Illusion",
"Delusion",
"Obsession",
"Hallucination"
] | D | Ans. Hallucination | train | med_mcqa | null |
In the management of severe acute malnutrition (SAM) child, iron should be started | [
"Immediately",
"On day 2 start of stabilization phase",
"In Rehabilitation Phase, after fever subside",
"Iron should never be given"
] | C | Do not given Iron is Stabilization Phase. If given Iron releases free radical, causing injury to GIT.
Iron should be started in Rehabilitation Phase (after day 7) | train | med_mcqa | null |
An alternate to lead in the walls of radiology room is: | [
"Walls made up of 3 inch concrete",
"Walls made up of barium plaster or barium concrete",
"Walls made up of 3 inch steel",
"All of the above"
] | D | Walls made of 3" concrete, 3" x 16" of steel or 1 mm of lead, barium plaster or barium concrete will suffice to protect adjacent rooms from radiation. | train | med_mcqa | null |
The shortest diameter of fetal head is: | [
"Biparietal diameter",
"Suboccipitofrontal diameter",
"Occipitofrontal diameter",
"Bitemporal diameter"
] | D | Ans. is d, i.e. Bitemporal diameterRef. Dutta Obs. 9/e. p 11MnemonicRemember Friends: always transverse diameters of the fetal skull are smaller than Anteroposterior diameters.Amongst the given options: Biparietal and bitemporal diameters are transverse diameters, whereas suboccipitofrontal and occipitofrontal are anteroposterior diameters.Now, the choice is between bitemporal and biparietal diameters.For memorizing this: learn a mnemonic, where transverse diameter are arranged in ascending order of their size.Miss = Bimastoid diameter = 7.5 cmTina = Bitemporal diameter = 8 cmS = Super subparietal diameter = 8.5 cmPretty = Biparietal diameter = 9.5 cmSo, our answer is bitemporal diameter (8 cm)Remember:In AP diameters:The longest AP diameter of fetal skull is mentovertical diameter = 14 cmThe second longest AP diameter is submentovertical = Occipitofrontal = 11.5 cm. | train | med_mcqa | null |
Michalis Gutmann bodies are seen in | [
"Xanthogranulomatous pyelonephritis",
"Malakoplakia",
"Nail patella syndrome",
"Chronic pyelonephritis"
] | B | Malakoplakia *Etiology : Inflammation due to chronic bacterial infection, mostly by E.coli and proteus.*Common in immunosuppressed individuals*Pathogenesis : Disturbed phagocytic activity due to overloaded bacteria within macrophages*Sites : Urinary bladder, Colon, Lungs,Bones, Kidneys, prostate and epididymis *Microscopic findings : Sheets of macrophages, giant cells and michaelis-gutmann bodies *Michaelis gutmann bodies - Laminated mineralized concretions resulting from deposition of calcium In enlarged lysosomes of macrophages (Ref: Robbins 8/e p975) | train | med_mcqa | null |
Isovolumetric relaxation is defined as | [
"Relaxation of both atria",
"Relaxation of both atria with all valves open",
"Relaxation of LV with mitral & aortic valve closed",
"All of the above"
] | C | ‘Isovolumetric’ means the volume remains same. That occurs only when both the valves are closed. | train | med_mcqa | null |
Most common pulmonary manifestation in AIDS: | [
"TB",
"Pneumonia",
"Bronchiectasis",
"Mycobacterial avium intercellular"
] | B | Pulmonary disease is one of the most frequent complications of HIV infection. The M/C manifestation of pulmonary disease is Pneumonia. Most common AIDS- defining illnesses are :- Recurrent bacterial pneumonia, Tuberculosis, and Pneumonia due to the unicellular fungus P.jiroveci. | train | med_mcqa | null |
Test based on counting the direction of each within paired sample is- | [
".'t' test",
"Z test",
"F test",
"Sign test"
] | D | * The 'Sign test' is non parametric / distribution free test which can be utilized to analyze paired sample * It is based on counting the direction (or Sign) of each 'within-pair difference | train | med_mcqa | null |
The best investigation for colorectal carcinoma - | [
"Exfoliative cytology",
"Air contrast barium enema",
"Ultrasound",
"Colonoscopy and biopsy"
] | D | null | train | med_mcqa | null |
A 19 year old football player was hit in the lateral pa of the knee just as he put his leg on the ground. Unable to walk without assistance, taken to the hospital. An MRI reveals a torn medial collateral ligament. Which structure is most likely to be injured due to its attachment at this ligament ? | [
"Medial meniscus",
"Lateral meniscus",
"Anterior cruciate ligament",
"Posterior cruciate ligament"
] | A | The medial meniscus is firmly attached to the medial collateral ligament.Damage to the medial collateral ligament causes concomitant damage to the medial meniscus. Anterior collateral ligament is torn in hyperextension. Ref: Gray's Anatomy The Anatomical Basics of Clinical Practice 41 e pg 1390. | train | med_mcqa | null |
Number of vertebrae in human vertebral column is | [
"30",
"31",
"32",
"33"
] | D | (D) 33# Human vertebral column usually consists of 33 vertebrae:> 24 Presacral vertebrae: 7 cervical, 12 thoracic, and 5 lumbar)> Sacral veretebrae (5 fused sacral vertebrae) and> Coccyx vertebrae (4 frequently fused coccygeal vertebrae). | train | med_mcqa | null |
In one of the following condition cavities filled with
fluid is seen in the centre of spinal cord: | [
"Multiple sclerois",
"Syringo myelia",
"Tabes Dorsalis",
"Meningovascular syphilis"
] | B | null | train | med_mcqa | null |
Which heart diseases are most commonly associated with rubella infection – | [
"PDA",
"VSD",
"ASD",
"Eisemenger's syndrome"
] | A | Patent ductus arteriosus is the most common congenital heart disease associated with rubella, followed by pulmonary artery stenosis.
Heart disease in congenital Rubella → PDA > PS > VSD > ASD. | train | med_mcqa | null |
Therapeutic aboion was accepted by | [
"Declaration of Genava (1948)",
"Declaration of Oslo (1970)",
"Declaration of Helsinki",
"Declaration of Tokyo"
] | B | Ans. is 'b' i.e., Declaration of Oslo (1970) | train | med_mcqa | null |
CAMP test is positive for- | [
"Group A streptococcus",
"Group B streptococcus",
"Group C streptococcus",
"Group D streptococcus"
] | B | Ans. is 'b' i.e., Group B streptococcus Medically important streptococci and their characteristicsSpecies or common nameLancefield groupHemolysisHabitat in human hostsLaboratory testCommon diseases causedStr. PyogenesAbetaThroat,skinBacitracin sensitive;PYR test positive;Ribose not fermentedUpper respiratory tract infection; pyoderma; rheumatic fever; glomerulonephritisStr. agalactiaeBbetaFemalegenitaltract,rectumCAMP test, hippuratehydrolysisNeonatal menigitis, septicemiaStr. equisimilisCbetaThroatRibose and trehalose fermentationPharyngitis, endocarditisStr. anginosusA,C,F,G untvpablebeta (alpha, gamma)Throat colon female genital tractGroup A strains bacitracin resistantPYR negative;Minute colony variants of other groupsPyogenic infectionsEnterococcus sp.(Str. faecalis and other enterococci)DGamma(alpha,beta)ColonGrowth in 6.5% NaCl; PYR positiveUrinary tract infections, endocarditis,Suppurative infectionsNonenterococcalGroup D species(Str. bovis)DGammaColonNo growth in 6.5% NaClEndocarditisViridans steptococci (many species)No typedalpha (gamma)Mouth colon, female genital tractOptochin resistantSpecies classification on biochemical propertiesEndocarditis (Str. sanguis): dental caries (Str. mutans) | train | med_mcqa | null |
Lipid in tissue is detected by - | [
"Oil Red O",
"Muciramine",
"PAS",
"Myeloperoxidase"
] | A | null | train | med_mcqa | null |
Apo B48 & Apo B100 are synthesised from same mRNA due to difference in: | [
"Splicing & chemical modification",
"Splicing",
"Differential RNA processing",
"All"
] | C | Apo B48 & Apo B100 are synthesized from same mRNA due to difference in RNA Editing/Chemical modification of RNA/ Differential RNA Processing In theliver, apo B mRNA is 100% translated to produceapoB100protein. In theintestine,the same apo B mRNA is acted upon by the cytosine deaminase enzyme which conve one of the cytosine bases (in the mRNA) to uracil conveing the codon CAA to UAA (stop codon). Later during translation of this mRNA protein synthesis gets prematurely terminated with final protein missing some of the amino acid of apoB100 protein. This sho version of protein is apoB48. which lacks the hepatic receptor-binding domain (missing amino acids). It has different propeies than apoB100. | train | med_mcqa | null |
Heparin does not cause | [
"Osteoporasis",
"Factor V inhibition",
"Thrombocytopenia",
"Prolongation of a PTT"
] | B | Heparin doesnot cause factor V inhibition whereas it causes all the other three. From medical pharmacology padmaja 4th edition Page no 335 | train | med_mcqa | null |
All are true about popliteus except | [
"Flexes the knee",
"Unlocks the knee",
"Intracapsular",
"Inseed to medial meniscus"
] | D | POPLITEUS:- Origin:-intracapsular origin.lateral condyle of femur.lateral meniscus of knee.Inseion:-posterior surface of shaft of tibia above soleal line. Nerve supply:- tibial nerve.Action:-Unlocks knee by lateral rotation of femur on tibia prior to flexion. <img src=" /> {Reference: BDC 6E pg no. 108} | train | med_mcqa | null |
TOF not associated with - | [
"ASD",
"VSD",
"RVH",
"PS"
] | A | Ans. is 'a' i.e., ASD Tetralogy of falloto Cyanotic heart disease (MC)o Defect in infundibular septum leads to :o Pulmonary stenosiso VSD (Not ASD)o Dextroposition and overriding of aorta.o Right ventticular hypertrophy (NOT LVH).o Pink TOF (Acyanotic TGF) when PS is mild to moderate balanced shunt tnt across the VSD, pt not have cyanosis. | train | med_mcqa | null |
Lifespan of neutrophils is | [
"6 hours",
"1 day",
"7 days",
"120 days"
] | A | The average half-life of a neutrophil in the circulation is 6 hoursRef: Ganong's Review of Medical Physiology Twenty-Third Edition Page No: 64 | train | med_mcqa | null |
Most serious adverse effect of ketoconazole is : | [
"Adrenal insufficiency",
"Pellagra like skin lesion",
"Liver injury",
"Prostate cancer"
] | A | null | train | med_mcqa | null |
A 29-years-old male taking oral hypoglycemic drug never had ketonuria in his life. His BMI is 20.5. His grandfather had diabetes and his father who is only son of his grandfather too had the disease. Which type of DM this person will be most likely - | [
"Pancreatic",
"MODY",
"Type I",
"Type II"
] | B | A number of unusual genetic diseases are associated with diabetes. In rare families, diabetes is caused by single gene defects with autosomal dominant inheritance. These subtypes constitute less than 5% of all cases of diabetes and typically present as 'maturity-onset diabetes of the young' (MODY), i.e. non-insulin-requiring diabetes presenting before the age of 25 years (Box 21.6). Very rarely, diabetes can develop at or soon after bih. This neonatal diabetes is usually genetic in origin, with 50% due to mutations in the KATP channel of the pancreatic b cell causing insulin deficiency and diabetic ketoacidosis. However, sulphonylurea drugs overcome the defect in potassium channel signalling, so that insulin therapy is not necessary in these cases. DAVIDSONS PRINCIPLES AND PRACTICE OF MEDICINE 22ND EDITION PAGE NO-806,807 | train | med_mcqa | null |
A child can withhold and postpone his/her bowel movements at _______ | [
"1 year",
"2 years",
"3 years",
"4 years"
] | C | Encopresis is defined as passage of stools in clothes beyond an age when bowel control should have been achieved (usually 4 years). It may be retentive (associated with constipation) or non-retentive, primary (never achieved bowel control) or secondary (loss of control after an initial phase of control for at least 6 months). Primary encopresis is usually associated with constipation, while secondary is associated with significant psychological stressors. Behavioral therapy with positive reinforcement and treatment of constipation are necessary. Ref : Nelson paediatrics chapter : Groth and de | train | med_mcqa | null |
Antimalarial month is – | [
"April",
"May",
"September",
"June"
] | D | Antimalarial month is observed every year in month of June throughout the country, prior to the onset of mansoon and transmission season, to enhance the level of awareness and encourage community participation. | train | med_mcqa | null |
Translatary movements of the condyle and the disk are controlled by | [
"Capsular Ligament and suprahead of medial pterygoid",
"Capsular ligament and suprahead of Lateral pterygoid",
"Suprahead of medial and Lateral pterygoid",
"Capsular ligament and the infrahead of Lateral pterygoid"
] | B | null | train | med_mcqa | null |
Which of the following is not a pa of glomerular filtration barrier ? | [
"Mesangial cell",
"Endothelial cell",
"Podocyte",
"Basement membrane"
] | A | Ans. is 'a' i.e., Mesangial cellThe glomerular membrane (or the filtration barrier) is the filtration surface through which the fluid is filtered out from the blood into the uriniferous tubules. The glomerular membrane (filtration barrier) comprises :i) The glomerular capillary endothelium,ii) The basement membrane (basal lamina) andiii) The Bowman's visceral epithelium (podocytes). | train | med_mcqa | null |
A 35-year-old woman with a history of cholecystectomy arrives in the emergency room with intractable hiccups most likely caused by an abdominal abscess secondary to surgical infection. Which of the following nerves carries pain sensation caused by irritation of the peritoneum on the central poion of the inferior surface of the diaphragm? | [
"Vagus nerve",
"Lower intercostal nerve",
"Phrenic nerve",
"Greater splanchnic nerve"
] | C | The diaphragm receives somatic motor fibers only from the phrenic nerves. However, the peritoneum on the central pa of the diaphragm receives sensory fibers from the phrenic nerve, and the peripheral pa of the diaphragm receives such fibers from the lower intercostal nerves. The subcostal nerve supplies the peritoneum inferior to the diaphragm. The vagus and greater splanchnic nerves do not carry pain fibers from the peritoneum. | train | med_mcqa | null |
Terminal axillary draining lymph nodes - | [
"Anterior",
"Posterior",
"Scapular",
"Apical"
] | D | Ans. is 'd' i.e., Apical o The apical group of axillary lymph node receives lymph from anterior (pectoral), posterior (subscapular), central and lateral (humeral) group of axillary lymph nodes. Hence apical group of lymph node is the terminal group of axillary lymph node.Axillary lymph nodeRelated vesselsAnterior (pectoral)Along lateral thoracic vesselsPosterior (scapular)Along subscapular vesselsLateralMedial to axillary veinApical (terminal or infraclavicular)Along axillary vessels | train | med_mcqa | null |
A patient at 34 weeks pregnancy presents with acute liver failure with coagulopathy and IUFD. BP is normal , viral markers are negative. Most probable diagnosis is? | [
"IHCP",
"Viral hepatitis",
"Acute fatty liver of pregnancy",
"Obstructive jaundice"
] | C | Acute fatty liver of pregnancy Presents late in pregnancy Presentation: persistent nausea/ vomiting, malaise, progressive jaundice, liver failure, may be associated with pre eclampsia Complications: coagulopathy, renal failure, death, fetal distress, IUD Management: resuscitation, blood and blood products( coagulopathy), Termination of pregnancy to be done irrespective of gestation | train | med_mcqa | null |
Class II elastics are used by stretching an elastic between which of the two following points? | [
"From the posterior to the anterior within the maxillary arch",
"From the posterior to the anterior within the mandibular arch",
"From the posterior of the maxillary arch to the anterior of the mandibular arch",
"From the posterior of the mandibular arch to the anterior of the maxillary arch"
] | D | Class II elastics work in the direction that would be used to correct a Class II malocclusion, to pull the mandibular teeth forward and the maxillary teeth distally. | train | med_mcqa | null |
Radiological signs of coarctation of aoa are all EXCEPT: | [
"Rib notching",
"'E' sign",
"Normal shaped hea",
"'Egg on side' appearance"
] | D | Coarctation of the aoa is the most common congenital cardiovascular cause of hypeension. The diagnosis may be confirmed by Chest x-ray and Transesophageal echocardiography. Rib notching is the most specific sign and it occurs mainly in the fouh to the tenth ribs and appears by the age of 10. The left border of the hea shows the 3 sign. Therapeutic options include Surgical repair and balloon angioplasty, with or without placement of an Intravascular stent. TRANSPOSITION OF GREAT AERIES (TGA) : The vascular pedicle is characteristically narrow in the frontal plane because the pulmonary aery lies behind the aoa and not by its side. The Hea is enlarged and takes the shape of an "egg on the side" | train | med_mcqa | null |
Primitive streak is initiated and maintained by? | [
"Nodal gene",
"BMP4",
"FGF",
"Brachyury gene"
] | A | The primitive streak itself is initiated and maintained by expression of Nodal, a member of the transforming growth factor-b (TGF-b) family. Once the streak is formed, Nodal upregulates a number of genes responsible for formation of dorsal and ventral mesoderm and head and tail structures. Another member of the TGF-b family, bone morphogenetic protein 4 (BMP4), is secreted throughout the embryonic disc. Ref: Langman's Medical embryology 10/e, p 52-53. | train | med_mcqa | null |
Drinking water is best made free of cyclops by - | [
"Filtration",
"Boiling",
"Chlorination",
"None of the above"
] | C | Chlorine destroys Cyclops and larvae of guinea worms in a strength of 5 ppm. This high concentration of Chlorine gives an objectionable smell and taste to drinking water REFERENCE: PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE, 25TH EDITION, PG NO. 842 | train | med_mcqa | null |
Which toxin of streptococcus cause hemolysis | [
"Streptolysin O",
"Streptolysin S",
"Streptodornanse",
"Hyaluronidase"
] | B | Streptococci produces two hemolysins - streptolysin O and S. Streptolysin S is an oxygen stable hemolysin and is responsible for the hemolysis seen around streptococcal colonies on the surface of blood agar plates. It is called streptolysin S as it is soluble in serum. It is a protein but is not antigenic. Reference: Textbook of Microbiology; Anathanarayan and paniker's; 10th edition; Page no: 213 | train | med_mcqa | null |
Which one of the following conditions is associated with Kawasaki's syndrome ? | [
"Acute rheumatic fever",
"Pulmonary embolus",
"Coronary aery aneurysm",
"Systemic lupus erythematosus"
] | C | Kawasaki disease is a vasculitis that mostly involves the coronary vessels. It presents as an acute systemic disorder, usually affecting children under 5 years. It occurs mainly in Japan and other Asian countries, such as China and Korea, but other ethnic groups may also be affected. Presentation is with fever, generalised rash, including palms and soles, inflamed oral mucosa and conjunctival injection resembling a viral exanthema. Cardiovascular complications include coronary aeritis, leading to myocardial infarction, transient coronary dilatation, myocarditis, pericarditis, peripheral vascular insufficiency and gangrene. Ref - Davidson 23e pg 1041-1042 | train | med_mcqa | null |
Incidence of infeility isin reproductive age couples ? | [
"0-5 %",
"5-10%",
"10-20 %",
"25-30%"
] | C | Ans: C. 10-20 %Infeility is defined as the failure to conceive after one year of regular unprotected intercourse.Incidence10-20% of reproductive ages couples. | train | med_mcqa | null |
Inhibitors of DNA synthesis - | [
"Penicillin",
"Polymyxin",
"Chloramphenicol",
"Actinomycin"
] | D | D i.e. Actinomycin | train | med_mcqa | null |
Following are the brachytherapy techniques for carcinoma cervix except- | [
"Paris technique",
"New York technique",
"Manchester technique",
"Stockholm technique"
] | B | Ans. B. New York techniqueThe Manchester system of cervical brachytherapy was one of the most commonly used methods of cervical brachytherapy, till the arrival of computer-based dosimetry.Before a look into the reason why this system was so popular we must look into the history of cervical brachytherapy and dosimetric systems as a wholeIn the Paris system of cervical brachytherapy, a single application of radium was specified.the system incorporated two cork colpostats in the form of a cylinder and an intrauterine tube.The Stockholm system of cervical brachytherapy was the predecessor of modern-day cervical brachytherapy dosimetric systems. In this system of fractionated course of radiotherapy was delivered and the total course of radiation therapy was delivered over a period of one month. Usually 2-3 applications were used, with each application lasting for a period of 20 to 30 hours. | train | med_mcqa | null |
In Gradenigo's triad there is ____ palsy- | [
"Oculomotor nerve",
"Trigeminal nerve",
"Abducent nerve",
"Facial nerve"
] | C | retroorbital pain due to pain in the area supplied by the ophthalmic branch of the trigeminal nerve (fifth cranial nerve), abducens nerve palsy (sixth cranial nerve)and otitis media. | train | med_mcqa | null |
Treatment with anti-hypeensive drug spironolactone leads to formation of spironolactone bodies in: | [
"Adrenal coex",
"Adrenal medulla",
"Renal coex",
"Renal medulla"
] | A | Aldosterone-producing adenomas Solitary, small (<2 cm in diameter), well-circumscribed lesions Bright yellow on cut section and, surprisingly, are composed of lipid-laden coical cells that more closely resemble fasciculata cells than glomerulosa cells (the normal source of aldosterone). Hallmark feature is presence of eosinophilic, laminated cytoplasmic inclusions, known as spironolactone bodies, found after treatment with the antihypeensive drug spironolactone. Do not suppress ACTH secretion. Adjacent adrenal coex and that of the contralateral gland are not atrophic. | train | med_mcqa | null |
A charachteristic infection of Nocardia Asteroides is - | [
"Diarrhea",
"Secondary Dissemination to liver",
"Brain Abscess",
"Colonic Diveiculosis"
] | C | Ans. is 'c' i.e., Brain Abscess Brain Abscess is the most charachteristic infection of Nocardia Asterodies amongst the options provided. The most common site of dissemination of nocardiosis is the brain, The typical manifestation is a subacute brain abscess'. The most charachteristic infection of Nocardia Asterodies is Respiratory Tract Disease in the form of subacute pneumonia (Not provided amongst options). | train | med_mcqa | null |
Vitamin which prevents autoxidation: | [
"Tocopherol",
"Biotin",
"Pyridoxine",
"Vitamin-A"
] | A | Vitamin E acts as a lipid-soluble antioxidant in cell membranes, where many of its functions can be provided by synthetic antioxidants, and is impoant in maintaining the fluidity of cell membranes. It also has a (relatively poorly defined) role in cell signaling. Vitamin E is the generic descriptor for two families of compounds, the tocopherols and the tocotrienols. Ref : Bender D.A. (2011). Chapter 44. Micronutrients: Vitamins & Minerals. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K. Murray, V.W. Rodwell (Eds),Harper's Illustrated Biochemistry, 29e. | train | med_mcqa | null |
Delayed prolonged vascular leakage can result from: | [
"Burns",
"X-Rays",
"Exposure to the sun",
"All of the above"
] | D | In some forms of mild injury (e.g., after burns, irradiation or ultraviolet radiation, and exposure to ceain bacterial toxins), vascular leakage begins after a delay of 2 to 12 hours and lasts for several hours or even days. Delayed prolonged leakage may be caused by contraction of endothelial cells or mild endothelial damage. Sunburn is a classic example of damage that results in late-appearing vascular leakage. | train | med_mcqa | null |
Which of the following anti glaucoma medication is unsafe in infants | [
"Timolol",
"Brimonidine",
"Latanoprost",
"Dorzolamide"
] | B | IOP-lowering drugs are currently the only medical treatment approved for glaucoma management. ... Brimonidine, the only selective alpha-adrenergic receptor agonist approved for chronic treatment in glaucoma, is indicated for reducing IOP in patients with open-angle glaucoma or OHT. Ref-KDT 6/e p146-147 | train | med_mcqa | null |
Catalase positive, beta-hemolytic Staphylococcus is | [
"Staphylococcus aureus",
"Staphylococcus epidermidis",
"Staphylococcus saprophyticus",
"None"
] | A | Staphylococcus aureus is beta hemolytic, produce a sharply defined clear colorless zone of hemolysis on blood agar within which red cells are completely absent. Staphylococcus aureus is catalase positive. Catalase test: place a loopful of hydrogen peroxide on colonies on the nutrient agar. Prompt effervescence indicates catalase production. Ref: Textbook of Microbiology; Ananthanarayanan and Panicker; 10th Edition; Page no: 207 | train | med_mcqa | null |
Oxalate stones are found in | [
"Ethylene glycol",
"Ethanol",
"Diethyl glycol",
"Methyl alcohol"
] | A | The severity of ethylene glycol toxicity is related to the metabolic acidosis resulting from the biotransformation of ethylene glycol into toxic metabolites. Ethylene glycol is metabolized by the enzyme alcohol dehydrogenase to glycoaldehyde. Through interaction with aldehyde dehydrogenase, ethylene glycol is then metabolized to glycolic acid (GA).Glycolic acid causes severe acidosis. This glycolate is then transformed into glyoxylic acid which may be transformed into the highly toxic oxalate or the safer glutamate or a-ketoadipic acid metabolites. Thus, calcium oxalate crystals may form and accumulate in blood and deposit in kidneys and other tissues. | train | med_mcqa | null |
Hirsutism is caused by which drug: | [
"Minoxidil",
"Dactinomycin",
"Cycloserine",
"Valsartan"
] | A | Ans. (A) Minoxidil(Ref: KDT 6th/e p548)Minoxidil is a potassium channel opener, useful as antihypertensive drug. It can cause hirsutism in females and is used for the treatment of alopecia in males. | train | med_mcqa | null |
Major thyroxine binding protein ? | [
"Albumin",
"Prealbumin",
"Globulin",
"Transferrin"
] | C | Ans. is 'c' i.e., GlobulinMost of the circulating thyroid, hormones are protein bound, leaving only 0.02% T4 and about 0.2% T3 unbound or free.There are three hormone binding plasma proteins, i.e., thyroxine binding globulin (major thyroid hormone binding protein), thyroxine binding albumin and thyroxine binding prealbumin.Thyroid binding globulin level is raised in pregnancy and by drugs estrogens, methadone, heroin, tranquilizers, clofibrate.TBG decreases by glucocoicoid, androgen, danazol, asparginase (cancer chemotherapy) and nephrotic syndrome. | train | med_mcqa | null |
A 5 year old boy has multiple asymptomatic oral and circular faintly hypopigmented macules with fine scaling on his face. The most probable clinical diagnosis is: | [
"Pityriasis versicolor.",
"Indeterminate leprosy",
"Pityriasis alba",
"Acrofacial vitiligo"
] | C | . | train | med_mcqa | null |
Double density sign in Mitral stenosis is a sign of enlargement of- | [
"Right Atrium",
"Left Atrium",
"Left Auricle",
"Right Auricle"
] | B | Ans. is 'b' i.e., Left Atrium o Double Density sien in Mitral Stenosis is a sign of enfargementof Left Atrium.Double density sign is seen on frontal chest radiograph in the presence of left atrial enlargement and occurs when the right side of the left atrium pushes behind the right cardiac shadows indenting the lung and forming its own district sihhouette.If large enough it can actually reach beyond the border of the right atrium. | train | med_mcqa | null |
ECV is absolutely contraindicated in all except. | [
"Previous LSCS scar",
"Severe preeclampsia",
"Placenta pre",
"Septate uterus"
] | A | Contraindications multiple pregnancy Antepaum haemorrhage Uteroplacental insufficiency as in intrauterine growth restrictions or preeclampsia Ruptured membranes Previous Caesarean section Contracted pelvis and uterine anomalies Need for Caesarean due to other indications like medical disorders (refer pgno:451 Sheila textbook of obstetrics 2 nd edition) | train | med_mcqa | null |
Drugs that can be used safely in porphyria are: a) Phenobarbitone b) Ketamine c) Sodium valproate d) Midazolam e) Pethidine | [
"de",
"ae",
"ad",
"bc"
] | A | null | train | med_mcqa | null |
What is Neurapraxia: September 2010 | [
"Complete division of nerve",
"Loss of conduction due to axonal interruption",
"Irreversible injury",
"Reversible physiological nerve conduction block"
] | D | Ans. D: Reversible physiological nerve conduction block Neurapraxia is pa of Seddon's classification scheme used to classify nerve damage. It is a transient episode of motor paralysis with little or no sensory or autonomic dysfunction. Neurapraxia describes nerve damage in which there is no disruption of the nerve or its sheath. In this case there is an interruption in conduction of the impulse down the nerve fiber, and recovery takes place without true regeneration, as Wallerian degeneration does not occur. This is the mildest form of nerve injury. This is probably a biochemical lesion caused by concussion or shock-like injuries to the fiber. | train | med_mcqa | null |
Anti-D gamma globulin following first trimester abortion is - | [
"50mg",
"100mg",
"200mg",
"300mg"
] | A | Ans-A | train | med_mcqa | null |
Shoest action local anaesthetic: | [
"Procaine",
"Cocaine",
"Dibucaine",
"Chloroprocaine"
] | D | Shoest Acting LA Chlorprocaine Longest acting LA Dibucaine | train | med_mcqa | null |
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