question stringlengths 1 6.54k | choices listlengths 4 4 | answer stringclasses 4 values | rationale stringlengths 0 22.5k ⌀ | split stringclasses 1 value | dataset stringclasses 6 values | subject stringclasses 1 value |
|---|---|---|---|---|---|---|
Which is the most common contaminant in a positive blood culture | [
"Staphylococcus epidermidis",
"Bacteriodes",
"Candida",
"Aceinobacter"
] | A | Staphylococcus epidermidis is the most common contaminant in positive blood culture among the given bacteria. Ref ananthnarayana and panikers microbiology textbook 8/e | train | med_mcqa | null |
A female with primary amenorrhoea with negative progesterone challenge test but positive combined progesterone & estrogen test. Diagnosis may be: | [
"Mullerian agenesis",
"PCOD",
"Asherman syndrome",
"Prolactinoma"
] | D | Ans. D Female is having amenorrhoea d/t hypothalamic or pituitary cause, so prolactinoma is only answer among optionsProgesterone Challenge Test# Indications ; Amenorrhea evaluation# Procedure : Administer Progesterone* Assess for Menstrual Bleeding after Progesterone* Anticipate within 7 days of Progesterone completion# Interpretation* Withdrawal bleeding within Progesterone deficiency> See Normogonadotropic Hyprogonadism for causes> Enddometrial Caner risk with unopposed Estrogen- Requires Progesterone replacement* No withdrawal bleeding* Perform Estrogen-Progesterone Challenge Test- No withdrawal bleed suggests outflow obstruction* Obtain Serum FHS and Serum LH> FSH> 20 and LH 40: Hypergonadotropic hypogonadism> FSH and LH< 5: Hypogonadotropic HypogonadismEstrogen-Progesterone Challenge Test# Indications* Secondary Amenorrhea evaluation* No withdrawal bleeding with Progesterone Challenge test# Procedure* Administer Estrogen-Progesterone* Assess for Menstrual Bleeding after stopping medication> Anticipate within 7 days of medication completion# Interpretation* No withdrawal bleeding occurs> Suggests uterine bleeding outflow obstruction* Withdrawal bleeding {but not after Progesterone alone)> Obtain Serum FSH and Serum LH- FSH > 20 and LH 40: Hypergonadotropic hypogonadism- FHS and LH < 5: Hypogonadotropic hypogonadism | train | med_mcqa | null |
Javelle’s water is | [
"NaOCl",
"Chlorhexidine",
"EDTA+ NaOCl",
"EDTA"
] | A | null | train | med_mcqa | null |
Behcet's disease is characterized by all of the following Except | [
"Iritis associated with oral and genital mucocutaneous ulcerations",
"Aoic aneurysm is the most common vascular disorder",
"Venous thrombosis is managed with lifelong oral anticoagulation",
"Immunosuppressive therapy is used in Mucocutaneous and eye lesions"
] | B | Behcet's disease is a clinicopathologic entity characterized by recurrent episodes of oral and genital ulcers, iritis, and cutaneous lesions. The underlying pathologic process is a leukocytoclastic venulitis, although vessels of any size and in any organ can be involved.The recurrent aphthous ulcerations are a sine qua non for the diagnosis.Skin involvement is observed in 80% of patients and includes folliculitis, erythema nodosum, an acne-like exanthem, and, infrequently, vasculitis, Sweet syndrome, and pyoderma gangrenosum. Nonspecific skin inflammatory reactivity to any scratches or intradermal saline injection (pathergy test) is a common and specific manifestation.Eye involvement with scarring and bilateral panuveitis is the most dreaded complication since it occasionally progresses rapidly to blindness. In addition to iritis, posterior uveitis, retinal vessel occlusions, and optic neuritis can be seen in some patients with the syndrome.Nondeforming ahritis or ahralgias are seen in 50% of patients and affect the knees and ankles.Superficial or deep peripheral vein thrombosis is seen in 30% of patients. Aerial involvement occurs in less than 5% of patients and presents with aoitis or peripheral aerial aneurysm and aerial thrombosis.Mucous membrane involvement may respond to topical glucocoicoids in the form of mouthwash or paste. In more serious cases, thalidomide (100 mg/d) is effective.Colchicine can be beneficial for the mucocutaneous manifestations and ahritis. Uveitis and CNS-Behcet's syndrome require systemic glucocoicoid therapy (prednisone, 1mg/kg per day) and azathioprine (2-3 mg/kg per day). Cyclosporine (5 mg/kg) has been used for sight-threatening uveitis, alone or in combination with azathioprine.Ref: Harrison; 19th edition; Page no: 2194 | train | med_mcqa | null |
T-cell are identified by - | [
"Rosette formation with sheep RBC",
"Immunoglobulins on their surface",
"EAC Rosette with sheep erytnrocytes",
"Have filamentous projections on their surface"
] | A | Erythrocyte rosetting or E-rosetting is a phenomenon seen through a microscope where red blood cells (erythrocytes) are arranged around a central cell to form a cluster that looks like a flower. The red blood cells surrounding the cell form the petal, while the central cell forms the stigma of the flower shape. This formation occurs due to an immunological reaction between an epitope on the central cells surface and a receptor or antibody on a red blood cell. The presence of E-rosetting can be used as a test for T cells although more modern tests such as immunohistochemistry are available. May be caused by Plasmodium in malaria. Reff: www.mayoclinic.com | train | med_mcqa | null |
An 8 yr. old child with large front teeth having jagged margins seeks consultation. What is the treatment plan: | [
"Smoothen the jagged margins and apply fluoride varnish",
"Extraction",
"Assure and send him back",
"Build up other teeth to large size"
] | C | null | train | med_mcqa | null |
After two doses of vaccination against plague, the immunity will last for - | [
"Six months",
"One year",
"Eighteen months",
"Twenty-four months"
] | A | - the plaque vaccine is killed vaccine. - two doses of 0.5 &1 ml given subcutaneously at interval of 7-14 days. - immunity sta 5-7 days after inoculation and lasts for 6 months. Reference : Park's textbook of preventive and social medicine, 23rd edition, pg no:296 <\p> | train | med_mcqa | null |
Investigation of choice in the early phase of renal transplant | [
"IVP",
"Retrograde cystourethrogram",
"Ultrasonogram",
"CT scan"
] | C | • Vascular complications after renal transplantation are low, presents during the first week after transplantation with sudden pain and swelling at the site of the graft.
• Diagnosis is confirmed by Doppler ultrasonography.
• Urgent surgical exploration is indicated and, in most cases, transplant nephrectomy is required. | train | med_mcqa | null |
True about 1° teeth: | [
"Calcification of 1° teeth is almost complete at birth.",
"Calcification of all 1° teeth and permanent incisors is complete at birth.",
"Calcification of all permanent teeth starts at birth.",
"Calcification of all permanent and primary teeth except 3rd M is completed at birth."
] | A | Option A is the most appropriate among all the options. | train | med_mcqa | null |
Referred pain from all of the following conditions may be felt along the inner side of right thigh, except | [
"Inflamed pelvic appendix",
"Inflamed ovaries",
"Stone in pelvic ureter",
"Pelvic abscess"
] | D | .Clinical Features of pelvic abscess includes * Diarrhoea. * Mucus discharge per rectum. * High temperature with chills and rigors. * Lower abdominal pain and distension. * Frequency and burning micturition. * P/R shows a soft, boggy, and tender swelling in the anterior wall of the rectum. ref:SRB&;s manual of surgery,ed 3,pg no 507 | train | med_mcqa | null |
Schick test is for - | [
"Susceptibility to diphteria",
"Susceptibility to tetanus",
"Susceptibility to scarlet fever",
"Susceptibility to RF"
] | A | null | train | med_mcqa | null |
Corynebacterium diphtheria produce black or grey colonies on the following agar | [
"Mac-conkey agar",
"Potassium tellurite agar",
"Thayer main medium",
"Tinsdale agar"
] | B | Corynebacterium produce black or grey colonies on potassium tellurite blood agar It acts as a selective medium for its growth Ref: Textbook of Microbiology Baveja 5th ed Pg 211 | train | med_mcqa | null |
Two year old child presented with multiple bone defects and seborrheic dermatitis. Diagnosis ? | [
"Eosinophilic granuloma",
"Hand schuller Christian disease",
"Letterer siwe disease",
"Hashimoto pritzker disease"
] | C | Letterer Siwe disease - - child- <2yrs - generalised systemic involvement - Bone>skin>hepatosplenomgaly with lymphadenopathy -Skin- mc manifestation is seborrheic dermatitis. Current Classification Single-system Disease - either Localized (single site) or Multiple siteMultisystem Disease - Low-risk group (Disseminated disease with involvement of low-risk organs (skin, bone, lymphnode, pituitary) or High-risk group (Disseminated disease with involvement of one or more of the high-risk organs(hematopoietic system, lungs, liver, and spleen) | train | med_mcqa | null |
Type I MEN involves all, except - | [
"Pancreas",
"Adrenal",
"Pituitary-'",
"Parathyroid"
] | B | Ans. is 'b' i.e., Adrenal Characteristic triad of MEN IParathyroid tumors (Most common)Pancreatic endocrine tumors (Second most common)Pituitary tumors (Third most common)Hyperparathyroidism is the mostCommon manifestation of MEN I.-- HarrisonNeoplasia of the pancreatic islet is the second most common manifestation of MEN1.Pituitary tumors are third most common tumors of MEN / and occur in more than half of patients with MEN I.Relative frequency of tumors causing hyperparathyrodism :Relative frequency of endocrine tumors of pancreatic islets:Relative frequency ofpituitary tumors:o Parathyroid hyperplasia is the most common cause of hyperparathyroidism in MEN Io Pancreatic polypeptide (75-82%)o Prolactinomas are the most common pituitary tumors in MEN Io Gastrin (60%) (Gastrinomas/ZES)o Insulin (25-30%) (Insulinomas)o Acromegaly due to excessive growth hormone (GH) production is the second most common pituitary tumor in MEN Io Parathyroid adenomas are less common than parathyroid hyperplasia and tend to occur in older patient or those with long standing disease.o Glucagon (5-10%) (Glucagonoma)o VIP (3-5%) (VIPomas)o Somatostatin (1-5%) (Somatostatinoma)o Cushing s syndrome Other tumors in MEN Io Pheochromocytomaso Carcinoid tumours (foregut type : derived from lung; thymus, stomach or duodenum).o Subcutaneous and visceral lipomas.o Cutaneous leiomyomas.o Skin angiofibromas or collagenomas. | train | med_mcqa | null |
All of the following are seen in antemoem burns, EXCEPT: | [
"Vesicle",
"Pus formation",
"Inflammatory red line",
"Blister with hypermedia base"
] | A | Antemoem burns are characterised by the presence of large blisters, with a red inflammatory base and with fluid consisting of albumin, chlorides and white blood cells. Difference between antemoem and postmoem burns: Features Ante moem burns Post moem burns Line of redness Present around burnt area Absent Vesication Blister contain serous fluids with protein and chlorides Blister contain fluid and air, proteins and chlorides are not seen Reparative process Present Absent Blood May be cherry red due to carbon monoxide Not seen Soot paicles in upper respiratory passages Present Absent Curling's ulcer May be seen Absent Enzyme activity Present Absent Ref: Concise Textbook Of Forensic Medicine & Toxicology By Sharma page 72. | train | med_mcqa | null |
The following statement is true regarding chrono-pharmacology(REPEAT) | [
"Study of time related effects of drugs",
"Study of dose related effects of drugs",
"Study of adverse effects of drugs",
"Study of naturally obtained drugs"
] | A | Chrono-pharmacology is the science dealing with effects of drugs in relation to biological clock. | train | med_mcqa | null |
Venous return to hea during quiet standing is facilitated by all of the following factors, except | [
"Calfmuscle contraction during standing",
"Valves in perforators",
"Sleeve of deep fascia",
"Gravitational ihcrease in aerial pressure"
] | D | During quiet standing gravity act against venous return to the heaGravity induces peripheral pooling of blood in leg instead.Calf muscle contraction pushes the blood towards heavalves prevents backflowRef: Medical Physiology Indu Khurana 2015 edition pAge No:220 | train | med_mcqa | null |
A schizophrenic patient on antipsychotic drugs may develop the following side effect | [
"Decreased prolactin",
"Increased prolactin",
"Hypeension",
"Wakefullness"
] | B | NAME OF THE TRACT LOCATION FUNCTION PROBLEMS WHEN BLOCKED Meso coical To prefrontal coex Controls attention, drive In patients with schizophrenia decreased dopamine in meso coical tract causes lack of drive, decreased attention Decreased attention, drive Worsens negative symptoms in schizophrenia Meso limbic To limbic system Control thoughts, emotions In patients with schizophrenia increased dopamine in mesolimbic tract causes delusions and hallucinations Decreases thoughts and emotions Improves positive symptoms in schizophrenia Nigro striatal To basal ganglia Smoothens and co-ordinates movements Extra pyramidal symptoms Tubero infundibular To hypothalamus Regulates prolactin Dopamine decreases prolactin Galactorrhea Amenorrhea Sexual dysfunctions Reference: Kaplon and sadock, 11 th edition, synopsis of psychiatry, 11 th edition, pg no. 537 | train | med_mcqa | null |
Which set of aerial blood values describes a patient with paially compensated respiratory alkalosis after 1 month on a mechanical ventilator? pH ,HCO3- (mEq/L), Pco2 (mm Hg) (A) 7.65, 48, 45 (B) 7.50, 15, 20 (C) 7.40, 24, 40 (D) 7.32, 30, 60 (E) 7.31, 16, 33 | [
"A",
"B",
"C",
"D"
] | B | The blood values in respiratory alkalosis show decreased Pco2 (the cause) and decreased and by mass action. The is fuher decreased by renal compensation for chronic respiratory alkalosis (decreased HCO3- reabsorption). | train | med_mcqa | null |
Termination is caused by all EXCEPT: | [
"48 S complex",
"UAA",
"RF-1",
"Peptidyl transferase"
] | A | 48 s ribosome complex is involved in initiation of translation, not termination. Termination of translation, Stop codons are UAA, UAG & UGA, which do not code for any amino acid. Peptidyl transferase is responsible for the release of polypeptide chain from the P-site of ribosome. | train | med_mcqa | null |
Earliest visual field change in open angle glaucoma is – | [
"Paracentral scotoma",
"Ring scotoma",
"Siedel's scotoma",
"Arcuate scotoma"
] | A | Earliest clinically significant field defect is small wing-shaped paracentral scotoma. | train | med_mcqa | null |
Trans-placental spread is least associated with ? | [
"HBV",
"Rubella",
"HSV",
"HIV"
] | C | HSV infection may be acquired in utero, during the bih process,or during the neonatal period. Intrauterine and postpaum infections occur infrequently. Most cases of neonatal herpes result from maternal infection and transmission usually during passage through a contaminated infected bih canal of a mother with asymptomatic genital herpes. TRANSPLACENTAL spread is associated with the following - Toxoplasmosis,syphilis, parvovirus,rubella, cytomegalovirus (TORCH)infections. some other bacterial infections also occur transplacentally like TREPONEMA pallidum, LISTERIA monocytogenes. Reference: Nelson textbook of pediatrics 19th edition Page 1101 | train | med_mcqa | null |
Dried semen stain in clothes is identified by | [
"UV light",
"Spectroscopy",
"Magnifying lens",
"Infra red"
] | A | UV light 3) Microscopic examination - Involves identification of spermatozoa under the microscope. Fluorescence microscopy is based on the principle that the Y-chromosome is fluorescent to quinacrine. 4) Electrophoretic methods Acid phosphatase isoenzyme test - Polyacrylamide gel electrophoresis followed by staining with methyl umbelliferyl phosphate reagent makes the seminal acid phosphatase to be distinguished from the acid phosphatase present in other substances & in vaginal secretion. This is superior to LDH isoenzyme method since semen can be identified in the absence of sperms as in azoospermic or vasectomised persons. Lactate dehydrogenase (LDH) isoenzyme Test - Sperm specific LDH isoenzyme can be separated from other LDH isoenzymes of semen by polyacrylamide gel electrophoresis. Proof of semen: The only absolute proof of semen is the finding of at least one unbroken spermatozoan, or electrophoretic LHD isoenzyme detection of sperms. In case of azoospermia, vasectomy or very old persons a stain will be seminal if it gives - characteristic fluorescence in UV light - positive 1-taarate acid-phosphatase and - High levels of acid phosphatase & creatine phosphokinase or electrophoretic seminal acid phosphatase or PSA (P30) positive Species (Human or animal) is confirmed by precipitin test as in blood stains. Source (from which person) is identified by DNA & different grouping systems such as ABO, GM, PGM & GLO-I. New test Commercial ELISA, the SEMA(r)assay, for a seminal vesicle-specific antigen (SVSA) provides highly sensitive detection of semen but are costly . | train | med_mcqa | null |
Elemental iron and folic acid in adult IFA table is - | [
"100 mg iron & 200 mg FA",
"200 mg iron & 100 mg FA",
"20 mg iron & 100 mg FA",
"100 mg iron & 500 mg FA"
] | D | Ans. is 'd' i.e., 100 pg iron & 500 jag FA o Iron and Folic Acid content per I FA tablet# Adult tablet: 100 mg elemental iron and 500 meg folic acid.# Pediatric tablet: 20 mg elemental iron and 100 meg folic acid. | train | med_mcqa | null |
Allopurinol is used in treatment of: | [
"Rheumatoid arthritis",
"Psoriatic arthritis",
"Gouty arthritis",
"Poly sero arthritis"
] | C | Ans. is 'c' i.e., Gouty arthritis* Allopurinol is a hypoxanthine analogue which was synthesized as a purine anti metabolite.* Allopurinol is xanthine oxidase inhibitor.* Uses:# Allopurinol is the first choice drug for chronic gout. It can be used for both over producers as well as under excretors of uric acid.# With long term allopurinol therapy, tophi gradually disappear and nephropathy is halted and even reversed.* Allopurinol is contraindicated in acute gout because a sudden decrease in urate levels may precipitate re - crystallization in the joints.* Other uses# Allopurinol may be used in some cases of kala azar or leishmaniasis but efficacy is doubtful. | train | med_mcqa | null |
A 55-year-old male has a complaint of left-sided maxillary tooth pain. A dental examination reveals no abnormalities of his teeth. During physical examination tapping on his right maxilla elicits sharp pain on the right side of his face. The patient reports that he has no allergies. Which of the following conditions will be the most likely diagnosis? | [
"Sphenoid sinusitis",
"Anterior ethmoidal sinusitis",
"Posterior ethmoidal sinusitis",
"Maxillary sinusitis"
] | D | Maxillary sinusitis is an infection of the maxillary sinus, which is located in the body of the maxillary bone. Sharp pain can be a major symptom of maxillary sinusitis. The difference between the remaining answer choices is the location of the sinus. The sphenoid sinus is located in the posterior nasopharynx. The ethmoid sinuses are located laterosuperiorly to the nasal septum. The frontal sinus is located in the frontal bone in the anterior part of the face. | train | med_mcqa | null |
Stain used for staining fungal elements - | [
"Acid fast stain",
"Mucicarmine",
"Methenamine silver",
"Gram stain"
] | C | Routinely used stains for the demonstration for fungal elements in tissue sections are : -
Methenamine silver
Periodic acid Schiff (PAS) | train | med_mcqa | null |
Perinatal mortality is expressed in terms of – | [
"Deaths/1000 total births",
"Deaths/1000 live births",
"Deaths/10000 total births",
"Deaths/10000 live births"
] | B | null | train | med_mcqa | null |
Paramyxoviruses are most commonly associated with which of the following diseases? | [
"Fifth disease",
"Rubella",
"Croup",
"Tonsillitis"
] | C | Both mumps and measles are well-recognized paramyxovirus infections. This group also includes parainfluenza virus, which causes laryngotracheobronchitis (croup) in children, and respiratory syncytial virus, which can cause bronchiolitis in infants. Paramyxoviruses have glycoprotein spikes that extend their lipid membrane and are responsible for hemagglutination activities. | train | med_mcqa | null |
Which of the following groups of proteins assist in the folding of other proteins? | [
"Proteases",
"Proteosomes",
"Templates",
"Chaperones"
] | D | Chaperones are proteins that assist the covalent folding or unfolding and the assembly or disassembly of other macromolecular structures. Chaperones are present when the macromolecules perform their normal biological functions and have correctly completed the processes of folding and/or assembly. The chaperones are concerned primarily with protein folding | train | med_mcqa | null |
Liver abscess ruptures most commonly in | [
"Pleural cavity",
"Peritoneal cavity",
"Pericardial cavity",
"Bronchus"
] | B | . | train | med_mcqa | null |
Diabetic patient with mass and blackish discharge from nose is most likely to have: | [
"Aspergillus",
"Mucormycosis",
"Rhinosporidium",
"Candida"
] | B | Ans: b (Mucormycosis) Ref: Dhingra, 4th ed, p. 151MucormycosisSeen in uncontrolled diabetics and immunosuppressive drug usageClinical features include black necrotic mass filling nasal cavity eroding the septumComplicationsIt can break through cribriform plate entering meninges and brainTreatment:Amphotericin B and surgical debridement | train | med_mcqa | null |
A 15cm hyperpigmented macule on an adolosent male undergoes changes such as coarceness, growth of hair & acne. Diagnosis is ? | [
"Melanocytic nevus",
"Becker nevus",
"Sebaceous nevus",
"Sebaceous nevus"
] | B | Ans. is 'b' i.e., Becker nevus Becker Nevus Usually stas in adolescence as an irregular smooth hyperpigmented macule. Usually involves shoulder, anterior chest and scapular region, although any pa of the may be involved. Slowly grows in size of a palm wile acquiring thick dark hair. Often lesion resembling acne vulgaris in different stages may appear on surface. No treatment is required. | train | med_mcqa | null |
Which of the following viral families is known to be causally associated with tumor formation in healthy appearing human adults? | [
"Flaviviruses",
"Papovaviruses",
"Paramyxoviruses",
"Polyoma viruses"
] | B | A Papovavirus is any member of the former virus family of Papovaviridae. They are mainly associated with various neoplasms in mammals. The family of Papovaviridae is no longer used in recent taxonomy, but is split into the Papillomaviridae and the Polyomaviridae. HPV is a member of the Papillomaviridae family and is causally associated with cervical cancer in otherwise healthy individuals Hepatitis C virus is a member of the flaviviruses family and causes chronic hepatitis and in severe cases is a factor in liver cancer development Paramyxoviruses include agents such as respiratory syncytial virus and measles virus and are not associated with carcinomas Human polyoma viruses include BK and JC viruses, which have been associated with immunocompromised patients, and their role in formation of human tumors is still under investigation. Ref: Ray C.G., Ryan K.J. (2010). Chapter 19. Papilloma and Polyoma Viruses. In C.G. Ray, K.J. Ryan (Eds), Sherris Medical Microbiology, 5e. | train | med_mcqa | null |
Earliest presentation of Friedrich's ataxia is - | [
"Ataxia",
"Seizures",
"Optic atrophy",
"Stuttering"
] | A | null | train | med_mcqa | null |
If pre-surgical movement of maxillary segments is indicated in a cleft infant, it is done beginning at: | [
"3 to 6 weeks of age",
"10 to 12 weeks of age",
"3 to 6 months of age",
"10 to 12 months of age"
] | A | null | train | med_mcqa | null |
Subarachnoid hemorrhage blood is collected mostly in which pa of the skull - | [
"Basal cistern",
"Around Fah carebri",
"Near cerebellum",
"Tentorium"
] | A | Answer- A. Basal cisterncausative factor-Exclude underlying aneurysmal ruptureTypical location-Basal cisternsClinical profileHeadache,meningismusdelayed manifestations,vasospasm | train | med_mcqa | null |
Which of the following binds to viral envelope glycoprotein preventing the conformational changes required for the fusion of viral and Cellular membranes | [
"Avacavir",
"Indunavir",
"Enfuviide",
"Osltamivir"
] | C | Ref-KDT 6/e p774 It is a fusion inhibitor useful in the treatment of HIV infection | train | med_mcqa | null |
Development of diaphragmbegins at 4 weeks of gestation. Diaphragm has contributions from different structures. Central tendon of diaphragm develops from? | [
"Dorsal mesooesophagus",
"Septum transversum",
"Pleuro peritoneal membrane",
"Cervical myotomes"
] | B | Development of Diaphragm
Diaphragm develops from
Septum transversum: it is a mass of mesodermal tissue arising from coelomic wall at the 4rd week of gestation. It forms the central tendon of diaphragm.
Dorsal mesooesophagus forms the median portion of diaphragm & the crurae.
Cervical myotomes (from C3-C5 somites) of lateral body wall form the peripheral parts of diaphragm.
Pleuro-peritoneal membranes.
Chromosome 15q plays a major role in diaphragm development
- During the initial period of development, it lies at a higher level (cervical) and then migrates caudally and hence the nerve supply is from C3, C4, C5 (Phrenic nerve). | train | med_mcqa | null |
Acellular peusis vaccine contains-( | [
"Peactin, flagillary hemagglutinin, cytotoxin, endotoxin",
"Peactin, flagillary hemagglutinin, fimbriae, endotoxin",
"Peactin, cytotoxin, fimbriae, peusis toxin",
"Flagillary hemagglutinin, peusis toxin, fimbriae"
] | D | Ans. is 'd' i.e., Flagillary hemagglutinin, peussis toxin, fimbrial . Acellular peussis vaccines currently available from different manufactures should be considered as different and unique products because of the presence of one or more different components which are: - Chemically or genetically detoxified peussis toxin (PT toxoid). - Filamentous hemagglutinin - 69k Da outer membrane protein ( also known as peactin). - Fimbrial-2 and fimbrial-3 antigens. | train | med_mcqa | null |
Colonization of a new smooth surface of a tooth will occur by S. mutans when its level in the oral cavity reaches: | [
">105/ml",
"4.5 x 104/ml",
"3.5 x 103/ml",
"5.5 x 102/ml"
] | B | Levels of S.mutans greater than 105 are indicative of an acceptable cariogenic challenge because colonization does not occur until the level of S. mutans reaches 4.5×104/ml for smooth surface and 103/ml of occlusal fissures.
Several clinical studies have corroborated the finding that the percentage of S.mutans in saliva increases significantly as a function of the DMFS score.
There is thus substantial evidence for associating high S.mutans counts with caries activity.
Shafers textbook of Oral Pathology – page 468 | train | med_mcqa | null |
Muscle rigidity by fentanyl is due to which receptor: | [
"Meu (m)",
"Kappa (k)",
"Delta (d)",
"Sigma (s)"
] | A | Ans. (a) Meu (m)Ref.: Millers Anaesthesia 7th ed. / 914Opioid receptors are of four variety - mu (m), Kappa (k), delta (d) & sigma (s)ReceptorClinical effectAgonist (m2)Muscle rigidityPhysical dependenceSupraspinal analgesiaRespiratory depressionFentanylMorphineb- EndorphinMu (m) (m2)Kappa (k)SedationSpinal analgesiaMorphineNalbuphineDynorphin (endogenous opioid)Butorphanol oxycodoneDelta (d)AnalgesiaBehavioralEpileptogenicLeu - Enkephalinb- EndorphinSigma (s)DysphoriaHallucinationRespiratory stimulationPentazocineNalorphineKetamine | train | med_mcqa | null |
Which cranial nerve is involved in the clinical presentation shown below? | [
"Occulomotor",
"Trochlear",
"Abducent",
"Facial"
] | C | First picture is showing the neutral position of eye, when pt is looking straight. 2nd picture - pt is asked to look towards right side. Right Lateral rectus & left medial rectus is used and its normal. 3rd picture - pt is asked to look towards left side. Right medial rectus is used, but left eye remained in neutral position which is indicative of paralysis of lateral rectus of left eye supplied by 6thC.N - ABDUCENT NERVE . Threfore, Pt has squint. | train | med_mcqa | null |
All the drugs are used in the treatment of Giardiasis except: | [
"Nitazoxanide",
"Metronidazole",
"Tinidazole",
"Diloxanide furoate"
] | D | Treatment options for Giardiasis:metronidazole (250 mg tds for 5 days)tinidazole (2 g once by mouth)nitazoxanide (500 mg bd for 3 days)paromomycin, an oral aminoglycosideDiloxanide furoate is a lumenal amebicide(ref:Harrison's 18/e p1731, 17/e p1313) | train | med_mcqa | null |
A 3-year-old child presented to the OPD for the first time with complaints of abdominal mass, polyuria and polydipsia. The child was born at 39 weeks gestation spontaneous vaginal delivery outside the hospital. IVP reveals streaky appearance of the kidneys. USG and CT abdomen were done. The gene involved in the above condition is present on which chromosome: - | [
"6p",
"6q",
"14p",
"14q"
] | A | This is a case of autosomal recessive polycystic kidney disease. Both the USG and CT reveal multiple cysts in the kidney. CT scan also shows caroli's disease in liver. Results from a mutation in the PKHD1 (polycystic kidney and hepatic disease) gene location on chromosome 6p.T The age of presentation is variable and is divided into perinatal, neonatal, infantile and juvenile forms. On imaging, it usually presents on ultrasound with enlarged echogenic kidneys with multiple small cysts. Liver involvement with coarse echotexture, biliary tract cystic changes, and poal hypeension may be evident, depending on the age and stage of hepatic fibrosis. | train | med_mcqa | null |
Case finding in RNTCP is based on - | [
"Sputum culture",
"Sputum microscopy",
"X -ray chest",
"Mantoux test / PCR"
] | B | Ans. is 'b' i.e., Sputum microscopy Following information has been added in 22nd/e of Park o Liquid culture method is now gold standard for TB diagnosis. Confirmation is done from biological characteristics of culture growth and selected molecular & biochemical tests. Rapid immunochromatographic assay (strip speciation tests) provides a definitive identification of M. tuberculosis and is recommended. J Caridge based nucleic acid amplification test : -A second generation NAAT - based TB diagnostic test has sensitivity almost similar to liquid culture. o In microscopy, following methods helps in early diagnosis of large number of cases : - (i) Fluorescence microscopy by auramine stain, (ii) Light - emitting diode fluorescence microscopy (LEDs). o Drug susceptibility testing provide a definitive diagnosis of drug -resistant TB. A number of techniques are used : i) Phenotype method (detect drug resistance) : - Three methods are used : propoion, absolute concentration and resistance ratio. ii) Genotype methods (detect molecular mutations responsible for resistance) : - e.g., Molecular testing for rifampic in resistance. | train | med_mcqa | null |
Which of the following is the vascular arrangement inside the young red bone marrow? | [
"Nutrient aery-central longitudinal aerioles-radial capillaries-sinuses-central longitudinal veins-nutrients vein",
"Nutrient Aery-central longitudinal aerioles-radial capillaries-sinuses- nutrient nutrient vein",
"Radial Capillaries-sinuses-nutrients in",
"Nutrient aery-radial aeries-sinusoids-nutrient vein"... | B | Nutrient aery-central longitudinal aerioles-radial capillaries- sinuses-nutrient vein, is the correct vascular arrangement inside the young red bone marrow. A nutrient aery enters the cavity through a large nutrient foramen in the shaft of the bone. Other aeries typically enter the cavity near the ends of the bone. These are designated as metaphysical aeries. At least one large nutrient vein leaves the marrow cavity through the nutrient foramen with the nutrient aery. Blood vessels also pass from the narrow cavity into the compact bone of the shaft. The vessels leaving the compact bone of the shaft exit as periosteal vessels. Ref: Kaushansky K. (2010). Chapter 16. Hematopoietic Stem Cells, Progenitors, and Cytokines. In J.T. Prchal, K. Kaushansky, M.A. Lichtman, T.J. Kipps, U. Seligsohn (Eds), Williams Hematology, 8e. | train | med_mcqa | null |
Cocket and Dodd's operation is for: | [
"Saphenofemoral flush ligation",
"Subfascial ligation",
"Deep vein thrombosis",
"Diabetic foot"
] | B | Cockett and Dodd Operation:- Perforators are ligated deep to the deep fascia through incisions in the antero-medial side of the leg . | train | med_mcqa | null |
All of the following are the disadvantages of anesthetic ether, except | [
"Induction is slow",
"Irritant nature of ether increases salivary and bronchial secretions",
"Cautery cannot be used",
"Affects blood pressure and is liable to produce arrhythmias"
] | D | Ether has high blood solubility (high blood : gas partition coefficient) → induction is slow.
It is irritant in nature and increases salivary & respiratory secretions.
Blood pressure is maintained because of reflex stimulation and high sympathetic tone. It does not sensitizes the heart to arrhythmogenic action of adrenaline
It is highly inflammable, cautery should not be used. | train | med_mcqa | null |
Which of the following drugs is contraindicated in a patient with history of sulfa allergy presenting with an acute attack of angle closure glaucoma – | [
"Glycerol",
"Acetazolamide",
"Mannitol",
"Latanoprost"
] | B | Carbonic anhydrase inhibitors are contraindicated in patients hypersensitive to sulfonamide (sulfa drugs). | train | med_mcqa | null |
You are in the eye OPD and wish to use a topical beta blocker in a patient. The chosen drug by you should have all the following properties EXCEPT: | [
"Strong local anaesthetic activity",
"High lipophilicity",
"High ocular capture",
"Low systemic activity"
] | A | Drugs having local anesthetic property will increase the risk of corneal ulcers. | train | med_mcqa | null |
The percentage of body water is greater in | [
"Males than in females",
"Children than in adults",
"Obese than in lean individuals",
"Old than in young objects"
] | A | In a 70 kilogram adult man, the total body water is about 60 percent of the body weight, or about 42 liters. This percentage depends on age, gender, and degree of obesity. As a person grows older, the percentage of total body weight that is fluid gradually decreases. This decrease is due in part to the fact that aging is usually associated with an increased percentage of the body weight being fat, which decreases the percentage of water in the body.
Because women normally have a greater percentage of body fat compared with men, their total body water averages about 50 percent of the body weight. In premature and newborn babies, the total body water ranges from 70 to 75 percent of body weight. Therefore, when discussing “average” body fluid compartments, we should realize that variations exist, depending on age, gender, and percentage of body fat.
Reference: GUYTON AND HALL TEXTBOOK OF MEDICAL PHYSIOLOGY, THIRTEENTH EDITION(INTERNATIONAL EDITION ) page no 306 | train | med_mcqa | null |
Best gas used for creating pneumoperitonium at laparoscopy is: | [
"N2",
"O2",
"CO2",
"N20"
] | C | null | train | med_mcqa | null |
Which of the following is true regarding intravenous administration of chemotherapy? | [
"Subcutaneous extravasation of carmustine (BCNU) or 5-fluorouracil (5-FU) usually causes ulceration",
"Extravasation of doxorubicin rarely causes serious ulceration because the agent binds quickly to tissue nucleic acid",
"Serious and progressive ulceration can be expected following extravasation of vincristine... | D | Since chemotherapy is generally most effective in killing rapidly dividing cells, the rapidly dividing cells of a fresh surgical wound should be in jeopardy when chemotherapy is given in the early postoperative period. Each of the phases of normal wound healing is theoretically at risk from one or another class of chemotherapeutic agents. Immediately following wounding, inflammation and vascular permeability lead to fibrin deposition and polymorphonuclear neutrophil (PMN), monocyte, and platelet influx. Macrophages are attracted by the activated complement system. By the fourth day the proliferative phase begins, and for the next 20 days fibroblasts produce mucopolysaccharides and collagen. Cross-linking of the collagen fibers then continues for several months in the maturation phase. It seems logical to delay antineoplastic agents for 10-14 days unless there are compelling clinical indications (e.g., superior vena cava syndrome) for more urgent treatment. Administration of folinic acid simultaneously with methotrexate normalizes wound healing. Extravasation of chemotherapeutic agents during intravenous administration may result in severe ulceration and sloughing. The nature of the injury is largely related to the nucleic-acid binding characteristics of the agent. Those agents that do not bind to tissue nucleic acid (vincristine, vinblastine, nitrogen mustard, BCNU, 5-FU) generally cause only local damage from the immediate injury. These substances are quickly metabolized or inactivated, and usual patterns of wound healing can be expected. On the other hand, agents that bind the nucleic acid (doxorubicin, dactinomycin, mitomycin C, mithramycin, and daunorubicin) cause not only immediate toxic reaction in the tissues but, unless excised, continuing and progressive tissue damage. Though some authors have reported success with elevation and ice packs, most recommend surgical excision if there is severe pain, any sign of early necrosis, or significant blistering. | train | med_mcqa | null |
The diagnosis of a child with small abrasion over face developing fever with chills,induration and fiery red swelling over the face to extending to the ear? | [
"Erysipalas",
"Carbuncle",
"Cellulitis",
"Anthrax"
] | A | - Erysipelas is a bacterial infection of skin involving upper subcutaneous tissue with marked dermal lymphatic vessel involvement. - Causative organisms are group A streptococcus and staphylococcus aureus. - Characterised by an erythematous, edematous and painful indurated plaque with sharply demarcated borders. - Face, ear and lower limbs are involved. - Patient May present with history of minor trauma and is associated fever and malaise. FIGURE : Butterfly rash of erysipelas. The sharp demarcation between the salmon-red erythema and the normal surrounding skin is evident. Reference : IADVL&;s concise textbook of dermatology, first edition, pg no:43 | train | med_mcqa | null |
False statement about diffuse carcinoma of the stomach is: | [
"It is seen mostly in older individuals",
"Leather Bottle appearance",
"Loss of expression of E-cadherin",
"Poorer prognosis"
] | A | Gastric adenocarcinomas divided into two categories: Diffuse type It Infiltrate and thicken the stomach wall without forming a discrete mass In younger patients Linitis plastica, or "leather bottle" appearance Loss of expression of E-cadherin Carry a poorer prognosis Intestinal type Frequently ulcerative Commonly appear in the antrum and lesser curvature Precancerous process, often initiated by Helicobacter pylori infection Ref: Harrison,E-18,P-765 | train | med_mcqa | null |
Use of FAST? | [
"To detect fluid in pericardial and peritoneal sacs",
"Pyoperitoneum",
"Intestinal obstruction",
"Pancreatitis"
] | A | Ans. is 'a' i.e., To detect fluid in pericardial and peritoneal sacs o FASTFocused Assessment of Sonographic examination of Trauma patient is a rapid diagnostic examination to assess patients with potential thoraco abdominal injuries.It sequentially survavs for pressence of blood in pericardial sac and dependent abdominal regions.It is exquistely sensitive for detecting fluid of > 250 ml. After application of vs transmission gel, a 3.5 MHZ convex transducer is used to assess, in sequence-pericardial area, RUQ, LUQ and Pelvis.It is very accurate in assessing Hypotensive patients with blunt trauma abdomen; if FAST positive, immediate surgery is justified. | train | med_mcqa | null |
Which one of the following combination is wrong? | [
"Phenylalanine - Niacin",
"Trytophon - Serotonin",
"Phenylalanine - Melanin",
"Tyrosine - Epinephrine"
] | A | Niacin is formed by metabolism of tryptophan. Other options are correct amino acids and their metabolic productsRef: Textbook of biochemistry for medical students, seventh edition, page no: 239 | train | med_mcqa | null |
Energy released by oxidation of 1 mole of acetyl CoA is: | [
"6 ATP",
"8 ATP",
"10 ATP",
"15 ATP"
] | C | Transpo in the respiratory chain of electrons from FADH2 and NADH leads to the synthesis of four high-energy phosphates for each of the seven cycles needed for the breakdown of palmitate to acetyl-CoA (7 x 4 = 28). A total of 8 mol of acetyl-CoA is formed, and each gives rise to 10 mol of ATP on oxidation in the citric acid cycle, making 8 x 10 = 80 mol. Two must be subtracted for the initial activation of the fatty acid, yielding a net gain of 106 mol of ATP per mole of palmitate, or 106 x 51.6 = 5470 kJ. This represents 68% of the free energy of combustion of palmitic acid. Ref: Harper 28th edition, chapter 22. | train | med_mcqa | null |
The systematic study of human disease and social conditions/factors is known as: | [
"Social physiology",
"Social pathology",
"Socialised medicine",
"Social medicine"
] | B | SOCIAL PATHOLOGY: Study of social problems which undermine the social, psychological or economical health of the populations. Used to describe relationship between disease and social conditions. Social pathology is uncovered by 'Social Surveys'. Social medicine: Investigate social, environmental & genetic factors affecting disease patterns & disability. Promote methods to prevent diseases &health measures which are protective. Socialized medicine: Medical service & education provided by State, but regulated by professional groups . EXTRA EDGE: - SOCIAL CONSTRAINS: Povey, Migration, Industrialization. - SOCIAL EVILS: Smoking, alcoholism ; Castism, gender bias , Child labour, prostitution. - SOCIAL DETION: Drug abuse, Delinquency, Suicide. | train | med_mcqa | null |
Commonest cause of Eustachian tube diseases - | [
"Adenoids",
"Sinusitis",
"Otitis media",
"Pharyngitis"
] | A | null | train | med_mcqa | null |
An 8-year-old girl with asthma presents with respiratory distress. She has a history of allergies and upper respiratory tract infections. She also has history of wheezes associated with exercise. Which of the following preformed substances is released from mast cells and platelets, resulting in increased vascular permeability in the lungs of the patient? | [
"Bradykinin",
"Hageman factor",
"Histamine",
"Leukotrienes (SRS-A)"
] | C | Histamine. When IgE-sensitized mast cells are stimulated by antigen, preformed mediators of inflammation are secreted into the extracellular tissues. Histamine binds to specific H1 receptors in the vascular wall, inducing endothelial cell contraction, gap formation, and edema. Massive release of histamine may cause circulatory collapse (anaphylactic shock). Bradykinin (choice A) and Hageman factor (choice B) are plasma-derived mediators. The other choices are not preformed molecules but are synthesized de novo following cell activation.Diagnosis: Asthma | train | med_mcqa | null |
A patient on antipsychotics was admitted with complaints of muscle rigidity, fever and tachycardia. Investigations showed increase in WBC counts and increase in creatinine phosphokinase levels. Drug of choice for this patient is : | [
"Paracetamol + IV Fluids",
"Dantrolene",
"Neostigmine",
"Paracetamol + Penicillin"
] | B | The above symptoms suggests of "Neuroleptic malignant syndrome", a fatal side effect of antipsychotics. It is treated using Dantrolene which is a directly acting muscle relaxant that inhibits Ryanoudine receptors and prevent release of calcium from sarcoplasmic reticulum. | train | med_mcqa | null |
Stain used for glycogen - | [
"PAS",
"Cango red",
"Prussian blue",
"Alician blue"
] | A | Ans. is 'a' i.e., PASo PAS reaction is a technique for demonstration of glycogen in tissue sections, o PAS strands for Periodic acid schiff.o The purpose of the periodic acid is to oxidize some of the tissue carbohydrates. This produces aldehyde group which can then condense with schiffs reagent forming a megenta colouration, o The t/t with periodic acid oxidize only those carbohydrates which have 1-2 glycols in their structure.o Since all carbohydrates do not include this structure, the PAS is not a method for carbohydrates in general but only for those which contain 1-2 glycols or closely related structure.The following criteria must be presnt in tissue substance to give a PAS postive reaction -i) It must contain the 1-2 glycol grouping, an equivalent amino or alkylamino grouping, or the oxidation product CHOH-CO.ii) It must not diffuse away during fixationiii) It must given an oxidation product which does not diffuse away.iv) It must be present in sufficient concentration to produce a detectable final colour.Carbohydrates which usually stain with this method include -o Polysaccharideso Mucopolysaccharideso Glycoproteinso GlycolipidsP.A.S. staining is useful in all of the following -o Glycogeno Neutral mucosubstanceso Some epithelial sulfomucins and sialomucinso Basement membraneo Cerebrosideso Gangliosideso Cartilageo Kerasin (Gaucher's disease) | train | med_mcqa | null |
"Bullneck" appearance is a characteristic feature seen in | [
"Epidermolysis bullosa",
"Severe Diphtheria",
"Epidemic Parotiditis",
"Acute Epiglottitis"
] | B | Regional lymphadenopathy in diphtheria causes a brawny thickening /swelling all around the neck, giving a 'bull neck" appearance Ref : Park 23rd edition Pgno : 161 | train | med_mcqa | null |
A 1 yr old boy presents with history of recurrent pneumonia. He also has eczema and a history of prolonged bleeding after circumcision. Peripheral smear shows thrombocytopenia with small platelets. Which of the following is most likely to be deficient? | [
"IgA",
"IgE",
"IgM",
"IgG"
] | C | The history here is highly suggestive of Wiskott-Aldreich syndrome. IgM levels are decreased in this condition. Wiskott-Aldrich syndrome It is an X-linked disease characterised by a traid of clinical manifestations: R - Recurrent infections E - Eczema T - Thrombocytopenia with small platelets. Serum IgM levels are low but IgE and IgA levels are normal or elevated. IgG is usually normal Reference: Ananthanarayan and Paniker&;s Textbook of Microbiology Tenth edition | train | med_mcqa | null |
All of the following are features of temporal lobe lesions Except: | [
"Wernicke's Aphasia",
"Contralateral homonymous superior quadrantanopia",
"Auditory hallucinations",
"Hemineglect"
] | D | Answer is D (Hemi neglect): Hemineglect or neglect of contralateral side is a feature of Parietal lobe lesion (Non dominant hemisphere) and is not a feature of temporal lobe lesion. Wernicke's Aphasia contralateral superior homonymous quadrantopia and auditory hollucinations are all features of temporal lobe lesions. | train | med_mcqa | null |
Higher kVp is | [
"Disadvantageous to film",
"Disadvantageous to patient",
"Advantageous to film",
"All of the above"
] | A | null | train | med_mcqa | null |
Best method to determine age upto 14 years is - | [
"Ossification centres",
"Dentition",
"Anthropometry",
"Head circumference"
] | B | Among the given options, dentition is the best method for age determination. | train | med_mcqa | null |
Aspirin inhibits which of the following enzymes ? | [
"Lipoprotein lipase",
"Lipoxygenase",
"Cyclooxygenase",
"Phospholipase D"
] | C | null | train | med_mcqa | null |
24 hour pH manometery is gold standard investigation for? | [
"Hiatal hernia",
"Barrett's esophagus",
"Reflux esophagitis",
"Esophageal ulcers"
] | C | ANSWER: (C) Reflux esophagitisREF: Sabiston 18th ed p. 1112The gold standard for diagnosing and quantifying acid reflux is 24 hour pH test, and 24 hours pH score is DeMeester score | train | med_mcqa | null |
Phenylketonuria is due to deficiency of: | [
"Phenylalanine",
"Phenylalanine hydroxylase (PAH)",
"Galactokinase",
"Tyrosinase"
] | B | Ref. Textbook of Biochemistry for Medical Students. Page.300
Phenylketonuria
Defect in Phenyl alanine Hydroxylase
A variant, nonclassic PKU, is a result of a defective enzyme in tetrahydrobiopterin synthesis.
Mental retardation
Musty odor
Microcephaly
Diet low in phe
nyl-alanine
Avoid aspartame
Diet important during pregnancy to prevent complication in the kid | train | med_mcqa | null |
A new tooth is erupting in the mouth of a one and a half year old child. This tooth is most likely to be a deciduous: | [
"Maxillary central incisor",
"Mandibular lateral incisor",
"Maxillary lateral incisor",
"Maxillary canine"
] | D | null | train | med_mcqa | null |
Scan used to estimate collecting system dilatation is | [
"99m Tc- DTPA scan",
"MAG 3 scan",
"DMSA scan",
"Hippuran scan"
] | A | (Ref: Grainger&;s diagnostic radiology, 6th ed; page 134) | train | med_mcqa | null |
What is the absolute neutrophil count in a patient with severe neutrophill depletion? | [
"100",
"250",
"500",
"1000"
] | C | Absolute neutrophil count in severe neutropenia is less than 500 cells/ microL. Also know: In mild neutropenia, absolute neutrophil count is between 1000 to 1500 cells/microL. In moderate neutropenia, absolute neutrophil count is between 500 to 1000 cells/microL. In chronic neutropenia, absolute neutrophil count is less than 500 for more than 6 months. Neutropenic children are at greatest danger of developing infection with Staphylococci or with gram negative enteric organism. Ref: Oski's Pediatrics: Principles And Practice By Julia A. McMillan, 4th edn, page 1713 | train | med_mcqa | null |
Unilateral breast involvement with scaly skin around the nipple and intermittent bleeding is suggestive of: September 2005 | [
"Galactocoele",
"Pagets disease",
"Eczema",
"Sebaceous cysts"
] | B | Ans. B: Pagets disease Paget's disease of the breast is an eczema-like change in the skin of the nipple, and is a superficial manifestation of an underlying breast cancer. The underlying breast cancer may be an invasive breast cancer or ductal carcinoma in situ (DCIS). In DCIS, the cancer cells are completely contained within the milk ducts. Paget's disease affects about 1-2 out of every 100 women with breast cancer. It is most common in women in their 50s, but can occur at a younger or older age. It can affect men, but this is extremely rare | train | med_mcqa | null |
All endothelial cells produce thrombomodulin except those found in- | [
"Hepatic circulation",
"Cutaneous circulation",
"Cerebral microcirculation",
"Renal circulation"
] | C | Thrombomodulin (TM), CD141 or BDCA-3 is an integral membrane protein expressed on the surface of endothelial cells and serves as a cofactor for thrombin. It reduces blood coagulation by conveing thrombin to an anticoagulant enzyme from a procoagulant enzyme. Thrombomodulin is also expressed on human mesothelial cell, monocyte and a dendritic cell subset.Thrombomodulin functions as a cofactor in the thrombin-induced activation of protein C in the anticoagulant pathway by forming a 1:1 stoichiometric complex with thrombin. This raises the speed of protein C activation thousandfold. Thrombomodulin-bound thrombin has procoagulant effect at the same time by inhibiting fibrinolysis by cleaving thrombin-activatable fibrinolysis inhibitor (TAFI,aka carboxypeptidase B2) into its active form. Thrombomodulin is a glycoprotein on the surface of endothelial cells that, in addition to binding thrombin, regulates C3b inactivation by factor I. Mutations in the thrombomodulin gene (THBD) have also been repoed to be associated with atypical hemolytic-uremic syndrome (aHUS). The antigen described as BDCA-3 has turned out to be identical to thrombomodulin. Thus, it was revealed that this molecule on a very rare (0.02%) subset of human dendritic cells called MDC2. Its function on these cells is unknown. | train | med_mcqa | null |
According to Universal system the primary right central incisor is coded as: | [
"A",
"F",
"E",
"O"
] | C | null | train | med_mcqa | null |
'CURB-65' Includes- | [
"PaO2 less than 65 mm",
"Severe Azotemia",
"Coagulopathy",
"Base deficit (acidosis)"
] | B | The CURB-65 criteria for pneumonia include five variables(a) Confusion (b)Urea>7 mmol/L,Respiratory rate>/= 30/min (d) Blood pressure,systolic <90 mmHg or diastolic<60 mmHg,(e) age >/= 65 years.CURB-65 score of 1 or 2 are likely to be suitable for home treatment.With a score of 2, patients should be admitted to hospital.Among patients with scores >/= 3,moality rates are very high and require admission to an ICU. Reference:Harrison' s Medicine-18th edition,page no:2135. | train | med_mcqa | null |
Regarding retinoblastoma all of the following are true, EXCEPT: | [
"13q14p mutation",
"Autosomal dominant",
"25% Bilateral",
"40% Heritable forms"
] | C | Hereditary retinoblastoma accounts for 40% of cases. All bilateral and cases and about 15% of the unilateral cases are hereditary. Retinoblastoma gene has been identified as 14 band on the long-arm of chromosome 13 (13q14). Deletion or inactivation of this protective gene by two mutations results in occurrence of retinoblastoma. Inheritance is autosomal dominant and the risk of transmitting the gene mutation is 50%. Because of high penetrance 40% of offspring of a surviver of hereditary retinoblastoma will develop the tumor. 33% are bilateral (1/3rd cases). Ref: Ophthalmology by A K Khurana 4th edition, Page 280 | train | med_mcqa | null |
Lymph from glans penis drains into ? | [
"Superficial inguinal nodes",
"Deep inguinal lymph nodes",
"Obturator nodes",
"Internal iliac nodes"
] | B | Vessels from the glans penis drain into the deep inguinal lymph nodes (gland of Cloquet)From rest of the penis, lymph drains into the superficial inguinal lymph nodes. | train | med_mcqa | null |
Treatment of choice for laryngeal carcinoma of glottis extending to supraglottic region with vocal cord fixation with papable solitary ipsilateral lymph node is ? | [
"Conservative laryngectomy",
"Total laryngectomy",
"Total laryngectomy with radical neck dissection",
"Palliative therapy"
] | C | Patient with with glottis carcinoma extending to the supra glottis region along with vocal cord fixation (bad prognostic sign; involvement of thyroarytenoid muscle) belongs to T3 stage og glottis carcinoma Single ipsilateral lymph node of 2 cm size signifies N1 nodal status And there is no evidence of distal metastases so MO This patient belongs to T3N1 MO. Treatment of choice in such patient is total laryngectomy with radical neck dissection. STAGING OF LARYNX CANCER Treatment of larynx cancer depends upon the stage of the tumor. Therefore, one should know the TNM staging (TNM classification) of large cancer. | train | med_mcqa | null |
Primary amenorrhoea is seen in all except: (Repeat) | [
"Kali man syndrome",
"Rokitansky syndrome",
"Ashermann syndrome",
"Turner's syndrome"
] | C | Ans: C (Ashermann syndrome) Ref: Dutta's Gynecology pg 433Explanation:(See Table 17 and Figure Below)Asherman's syndrome or Fritsch syndromeIt is characterized by adhesions and fibrosis of the endometrium.Most often associated with dilation and curettage of the intrauterine cavity.Patients present with secondary amenorrhea. Table 17 : Causes of Primary AmenorrheaOutflow tractAnomalies/obstructionGonadal/end-organ disordersPituitary and hypothalamicUterine* Mullerian agenesis (2nd MC cause)* Gonadal dysgenesis, including Turner syndrome, is the most common cause* Androgen insensitivity syndrome {Testicular feminization syndrome)* Receptor abnormalities for hormones FSH and LH* Specific forms of congenital adrenal hyperplasiaHypothalamic: Kallmann syndromeVaginal:* Vaginal atresia,* Cryptomenontioea* Imperforate hymen.* Swyer syndrome* Galactosaemia* Aromatase deficiency* Prader-Willi syndrome* Male pseudo-hermaphroditism Approach to Primary Amenorrhea History and Physical Exam | Uterus Present Uterus absent or uncertain || |FSH -20 IU/L and' LH >40 IU/LFSH -20 IU/L and' LH >40 IU/L || KaryotypePatient Hypogonadotropic HypogonadismEating disordersBrain injury or irradiationKallman SyndromePituitary defectHyperprolactinemiaHemochromatosisHypergonadotropicHypogonadism | |KaryotypePatient 46. XX46. XY||||45. XO46. XXMullenanAgenesis/MayerRokitansktKusterHauserSyndromeAndrogenInsensitivitySyndrome.Vanishing TestesSyndrome.5 alpha reductase deficiency|| TurnerSyndromePremature OvarianFailureConsider MRI | train | med_mcqa | null |
Which of these cases of ca vulva has the poorest prognosis? | [
"Large tumour size",
"positive inguino-femoral lymph nodes",
"positive pelvic lymph nodes",
"involvement of lower 1/3rd of vagina"
] | C | The single most impoant prognostic factor is lymph node status:5-year survival without groin node metastases is greater than 90%; with groin node metastases, 5-year survival is 50%. Inguino-femoral lymph nodes are involved in stage iii whereas pelvic and other lymph nodes are involved in stage iv A and hence pelvic lymph nodes will have poorer prognosis | train | med_mcqa | null |
Bilateral past-pointing is due to defect in | [
"Brainstem",
"Cerebellum",
"Vestibular system",
"Basal ganglia"
] | C | Bilateral past pointing is due to defect in vestibular system Past pointing, falling and the slow component of nystagmus are all in the same direction. if there is acute vestibular failure say on the right side, nystagmus is to the left side but past pointing and falling towards right Ref: PL Dhingra 6th edition of Ear, Nose and Throat; Pg no 42 | train | med_mcqa | null |
Function of peroxisomes is: | [
"Generate hydrogen peroxide",
"Degrade hydrogen peroxide",
"Both",
"None"
] | C | Peroxisomes are associated with: Production of peroxides and degradation of peroxides | train | med_mcqa | null |
Triad of glomerulonephritis, pulmonary hemorrhages,and antibody to basement membrane is called? | [
"Goodpasture syndrome",
"Systemic Necrotising Vasculitis",
"Mixed connective tissue disease",
"Diabetic nephropathy"
] | A | * Goodpasture syndrome- autoimmune disease in which antibodies attack the lungs and kidneys, leading to bleeding from the lungs and to kidney failure. * It may quickly result in permanent lung and kidney damage, often leading to death. * It is treated with immunosuppressant drugs such as coicosteroids and cyclophosphamide, and with plasmapheresis, in which the antibodies are removed from the blood. | train | med_mcqa | null |
Acute hyponatremia becomes symptomatic at | [
"<135 mEq",
"<125 mEq",
"<120 mEq",
"<115 mEq"
] | B | Severe symptoms (e.g., coma, seizures) typically occur when the sodium level falls below 120 mEq per L, but can occur at less than 125 mEq per L. Severe symptomatic hyponatremia must be corrected promptly because it can lead to cerebral edema, irreversible neurologic damage, respiratory arrest, brainstem herniation, Ref Davidson 23rd edition pg 350 | train | med_mcqa | null |
Acquired mutations in PIGA gene gives rise to : | [
"Paroxysmal Nocturnal Hemoglobinuria",
"Hereditary Spherocytosis",
"Isoimmune hemolytic anemia",
"Fanconi’s anemia"
] | A | Paroxysmal nocturnal hemoglobinuria (PNH) is a hemolytic anemia that stems from acquired mutations in PIGA, a gene required for the synthesis of phosphatidylinositol glycan (PIG), which serves as a membrane anchor for many proteins. Because PIGA is X-linked, normal cells have only one active PIGA gene, a mutation of which is sufficient to cause PIGA deficiency. | train | med_mcqa | null |
Which of the following eicosanoids cause vasoconstriction as well as increase vascular permeability? | [
"Prostacyclin",
"Thromboxane A2",
"PGE1",
"Leukotriene C4"
] | D | Principal Inflammatory Actions of Arachidonic Acid Metabolites (Eicosanoids) ACTION EICOSANOIDS Vasodilation PGI2 (prostacyclin), PGE1, PGE2, PGD2 Vasoconstriction Thromboxane A2, leukotrienes C4, D4, E4 Increased vascular permeability Leukotrienes C4, D4, E4 Ref: Robbins 8th edition Chapter 2. | train | med_mcqa | null |
Which one of the following modalities is maximum dangerous to 10 weeks pregnant lady? | [
"CT CHEST",
"SPECT",
"CT Abdomen",
"Bone-scan"
] | C | CT scan Typical effective dose (mSv) for various investigations: Chest X-ray: 0.02CT Head: 2.3CT Chest: 8CT Abdomen / Pelvis: 10Bone scan (Tc-99m): 4 | train | med_mcqa | null |
False statement about treatment of Ca cervix | [
"Radiotherapy is helpful in all stages",
"Prognosis of surgery good if done in early stages",
"When Radiotherapy is given, para aoic LN's should be included",
"From stage lb onwards same prognosis with surgery and"
] | D | Ans. is e i.e. From stage lb onwards same prognosis with Surgery and Radiotherapy Surgery Radiotherapy Chemo-Radiation Limited to patients with stage * Can be used to treat all stages.deg * Reserved for late stagesdeg I & IIdeg & in case of recurrencedeg. In early stages in young women * Combination of external surgery is better than Radiotherapy Teletherapy (to treat the as it helps to preserve their feility regional L.N & shrink the & does not produce sexual tumour size) + Intracavitary dysfunction (In contrast to ) brachytherapy (to decrease Para Aoic lymphnodes should be tumour from centre) is used evaluated when the disease extends * Sequence -- In early stages ? beyond the cervix or vaginal fornix intracavitary first followed by (stage lb or 11a). Teleterapydeg In late stages - external Radiotherapy first followed by intra cavitary radiotherapy. Radiotherapy causes fibrosis, stenosis of vagina, decrease in sexual function & destruction of ovary. | train | med_mcqa | null |
The most common manifestation of congenital toxoplasmosis - | [
"Hydrocephalus",
"Chorioretinitis",
"Hepatospienomegaly",
"Thrombocytopenia"
] | B | Ans. is 'b' i.e., Chorioretinitis | train | med_mcqa | null |
Screen used for X-ray exposure prevention, is made of- | [
"Lead",
"Tungsten",
"Manganese",
"Titanium"
] | A | Ans. is 'a' i.e., Lead * In x-ray facilities, walls surrounding the room with the x-ray generator may contain lead sheets, or the plaster may contain barium sulfate. Operators view the target through a leaded glass screen, or if they must remain in the same room as the target, wear lead aprons.* Lead is the most common agent used in modern constructions (Room design) to offer radiation shielding.Other Important facts about x-ray radiography* Filament (cathode) and Target (anode) are made of Tungsten. However, In mammography the target (anode) is made of Molybdenum or rhodium.* Most of the modern x-ray tubes have rotating anode because rotating anode have better heat dissipiation. The x-ray tube uses all three forms of cooling i.e., radiation, conduction and convection. However, radiation is most important.* X-ray grid is the part of x-ray machine that ensures the clarity of image on x-ray film, absorbs scattered x-rays and filters out radiations.* Filter is the device which absorbs low energy photons and there by decreases the radiation exposure to the patient. Filter is usually made of aluminium or aluminium copper combination.* Window is the part of x-ray machine through which the x-ray beam is emitted towards the patient.* Collimators are used to restrict the size of the x-ray beam, i.e., restriction of field size and decreases scatter radiation.* Film focus distance (the distance from x-ray tube target, i.e., anode to the x-ray film) is 100 cms (40 inches) for routine radiography. While for chest x-ray it is 180 cm (72 inches or 6 feet) to reduce magnification as short distance increases the magnification of body part. | train | med_mcqa | null |
A child presents with raised ICT, on CT scan a lesion is seen around foramen of Monroe and multiple periventricular calcific foci. What is the most probable diagnosis? | [
"Central neurocytoma",
"Ependymoma",
"Subependymal giant cell astrocytoma",
"Ganglioglioma"
] | C | Ans. c. Subependymal giant cell astrocytoma (Ref: Osborn 3/e p 583-571, 562, 432: Wolfgang 7/e p 334)Most probable diagnosis in a child with raised ICT, lesion around foramen of Monroe and multiple periventricular calcific foci on CT scan is subependymal giant cell astrocytoma."Foramen of Monro (FM) is a Y-shaped structure that connects the two lateral ventricles with the third ventricle. FM masses are uncommon in young children. Subependymal giant cell astrocytoma (SGCA) occurs in older children and young adults with tuberous sclerosis. Pilocytic astrocytoma also occurs in this age group. Subependymoma and central neurocytoma occurs in adults. All FM masses can cause obstructive hydrocephalous and lead to raised intracranial tension."Well Delinated Intraventricular-Mass around Foramen of Monro with Calcification and Obstructive HydrocephalusSubependymal Giant Cell AstrocytomaCentral NeurocytomaEpendymomaSubependymoma* Occurs in older children and young adults (<20years)Q* Lateral wall of lateral ventricle overlying head of caudate nucleus near foramen of Monro.* Features of tuberous sclerosis like cortical tubers and sub ependymal hamartomatous nodules* Large, multinucleated giant cells with GFAP reactivity and/or neuron specific enolase and swollen astrocytes with abundant glossy eosinophilic cytoplasm* Heterogenous (cystic and heavilly calcified) vascular mass showing strong/intense but heterogenous contrast enhancementQ.* Occurs in young adults, rare in children and older adults.* Exclusively in lateral ventricle near septum pellucidum and FM.* Indistinguishable from oligodendroglioma on light microscopy but demonstrate neuronal origin on electron microscopy (synapse, process, granules and microtubules) and immunohistochemistry (enolase and synaptophysin).* Heterogenous (multiple small cyst and heavy calcification) mass with mild to moderate inhomogenous contrast enhancement.* More common (60%) infratentoral/ posterior fossa tumors (in 4th ventricle mostly) are plastic ependymomas which occur predominantly in 1-6 years children.* Less common infratentoral (40%) tumors arise near atrium of left ventricle or foramen Monro, which occur predominantly in 2nd through 4th decade.* Perivascular pseudorosette, peritumoral edema and CSF seeding (mainly in infratentorial).* Heterogenous (mixed density/ intensity; due to heavy calcification and cyst) mass with peritumoral edema (hypodense halo on CT) and mild to moderate but heterogenous contrast enhancement.* In middle and elderly adultsQ* 4th ventricle (lower medulla) > frontal horn of lateral ventricle near septum pellucidum and FM* Avascular, homogenous, grade I tumor; although large tumors may contain calcification and microcystic changes (less common).* Homogenous, avascular/ hypovascular mass with variable no or minimal contrast enhancementQ.Subependymal Giant Cell Astrocytoma (SGCA)SGCA is a low grade (WHO grade I) tumor that occurs almost exclusively in patients with tuberous sclerosisQ; 10- 15% patients of TS develop SGCA.Arise from subependymal nodules located on the lateral walls of lateral ventricles overlying the head of caudate nucleus.The tumor does not invade the underlying caudate head but rather grows exophytically into the ventricular lumen near the foramen of MonroQSGCA is sharply delineated lobulated heterogenous tumor.Intratumor heavy calcification is commonQ and tumors are often vascular.SGCA almost always occur at foramen of MonroQ, and most patients become symptomatic before age 20 due to obstruction of foramen of MonroQ leading to raised ICT or obstructive hydrocephalus.Diagnosis:Imaging features of SGCA include: heterogenous (partially cystic, partially heavily calcified) mass at foramen of Monro which shows strong but heterogenous contrast enhancement. | train | med_mcqa | null |
Insulin causes all of the following except | [
"Glycogenesis",
"Glycolysiis",
"Lipogenesis",
"Ketogenesis"
] | D | Refer Katzung 11/e p 731 Insulin inhibits the formation of ketone bodies, therefore it's deficiency can result in diabetic ketoacidosis | train | med_mcqa | null |
All are Fibrous joint all except | [
"Gomphosis",
"tibiofibular joint",
"Suture",
"Symphysis pubis"
] | D | null | train | med_mcqa | null |
Choledochotomy is indicated in all of the following except | [
"Palpable CBD stones",
"History of jaundice or cholangitis",
"Abnormal alkaline phosphatase",
"Abnormal gamma glutamyl transferase"
] | D | Choledochotomy Absolute indications(High Suspicion of CBD calculi) Palpable CBD stones Jaundice with cholangitis Demonstration of stone on intra operative cholangiography CBD diameter >12 mm Relative indications (Low Suspicion of CBD calculi) Jaundice without cholangitis History of pancreatitis Dilated CBD White bile on aspiration Dilated cystic duct Ref: Shackelford 7th edition Pgno : 1326-1331 | train | med_mcqa | null |
C.S.F. cell count in tubercular meningitis varies between-a) 0 to 99b) 100 to 499c) 500 to 999d) 1000 to 5000 | [
"abc",
"bc",
"c",
"d"
] | B | In Bacterial meningitis → 1000-100000/μl mainly neutrophils
In viral meningitis → 10-100/μl mainly lymphocytes
In TB meningitis → 100-1000/μl mainly lymphocytes. | train | med_mcqa | null |
Stimulation for gastric emptyinga) Secretinb) CCKc) Gastrind) Distension | [
"ab",
"bc",
"cd",
"ac"
] | C | Distension of stomach by food leads to peristaltic wave to empty the gastric content. Gastrin also increases gastric emptying. | train | med_mcqa | null |
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