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A 70-year-old male presents with Neck nodes. Examination reveals a Dull Tympanic Membrance, deafness and tinnitus and on evaluation Audiometry gives Curve B. The most probable diagnosis is: | [
"Nasopharyngeal carcinoma",
"Fluid in middle ear",
"Tumor in interior ear",
"Sensorineuronal hearing loss"
] | A | null | train | med_mcqa | null |
The "Malpighian Layer" of epidermis includes: | [
"Stratum corneum, Stratum granulosum",
"Stratum granulosum, Stratum spinosum",
"Stratum granulosum, Stratum lucidum",
"Stratum spinosum, Stratum basale"
] | D | Ans. d. Stratum spinosum, Stratum basaleNamed after Marcello Malpighi.The malpighian layer of the epidermis is generally defined as both stratum basale and stratum spinosum as a unit. | train | med_mcqa | null |
Which of the following is the largest intestinal protozoa? | [
"Entamoeba coli",
"Balantidium coli",
"Giardia lamblia",
"Toxoplasma gondii"
] | B | Balantidium coli is the largest of the human intestinal protozoa. It can produce a spectrum of large-intestinal disease called as balantidiasis. Infective cysts can be transmitted from person to person and through water, but many cases are due to the ingestion of cysts derived from porcine feces. Many patients remain asymptomatic. In symptomatic individuals, the pathology in the bowel--both gross and microscopic--is similar to that seen in amebiasis. Balantidiasis, unlike amebiasis, does not spread hematogenously to other organs. The diagnosis is made by detection of the trophozoite stage in stool or sampled colonic tissue. Tetracycline (500 mg four times daily for 10 days) is an effective therapeutic agent. Ref: Weller P.F. (2012). Chapter 215. Protozoal Intestinal Infections and Trichomoniasis. 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 |
Drug which can act as antagonis of Haloperidole ? | [
"Ropinirole",
"Clozapine",
"Imipramine",
"Pimozide"
] | A | Ans. is'a'i.e., Ropinirole Haloperidol is an antipsychotic, acts by > D2 receptor blockage.Ropinirole is an antiparkinsonian drug, acts by > D2 receptor agonist. | train | med_mcqa | null |
Young females come in with primary amenorrhea with normal breast, normal pubic hair. USG reveals absent uterus and cervix with short vaginal pouch and normal ovaries. Diagnosis: | [
"Klinefelter syndrome",
"Mullerian agenesis",
"Gonadal agenesis",
"XYY"
] | B | Ans. B. Mullerian agenesisMULLERIAN AGENESIS* Congenital absence of both uterus and vagina is referred as mullerian aplasia, mullerian agenesis, or Mayer- Rokitansky- Kuster-Hauser syndrome.* In classic mullerian agenesis, patients have a shallow vaginal pouch, only measuring up to 1.5 inches deep. In addition, the uterus, cervix, and upper part of the vagina are absent.* Typically, a portion of the distal fallopian tubes are present. In addition, normal ovaries are present, given their separate embryonic origin.* Most patients with mullerian agenesis have only small rudimentary mullerian bulbs without endometrial activity.* Surgical excision of symptomatic rudimentary bulbs is required. With mullerian agenesis, traditional conception is impossible, but pregnancy may be achieved using sophisticated technology involving oocyte retrieval, fertilization, and implantation into a surrogate. | train | med_mcqa | null |
Neutral substance which have size of 6 nm are | [
"Freely filtered",
"Permeability is inversely proportional to diameter",
"Not filtered",
"None of the above"
] | B | Neutral substances
< 4nm ⇒ freely filtered
> 8mm ⇒ not filtered
4nm - 8nm ⇒ Permeability is inversely proportional to diameter | train | med_mcqa | null |
A 45-year-old man comes to the physician because of a small mass in his oral cavity. Physical examination shows left facial nerve palsy and a firm, mobile, painless mass in the left parapharyngeal space Biopsy from the mass in the oral cavity shows chondromyxoid stroma and epithelium.
Which of the following best explains this mass? | [
"Once it is excised, no recurrence occurs",
"The mass represents a benign cystic tumor with germinal centers",
"The mass represents the most common malignant tumor in the salivary glands",
"The mass represents the most common salivary gland tumor"
] | D | null | train | med_mcqa | null |
Microorganisms that enter freshly laid eggs are | [
"Salmonella",
"Brucella",
"Shigella",
"Vibrio cholerae"
] | A | Ans. is 'a' i.e., Salmonella . Salmonella can enter through the shell if eggs are left on contaminated chicken feed or feces and grow inside. | train | med_mcqa | null |
A physician decides to discontinue or not to use extraordinary life sustaining measures to prolong his patients life. It is known as? | [
"Active euthanasia",
"Passive euthanasia",
"Positive euthanasia",
"Assisted Suicide"
] | B | Active euthanasia or positive euthanasia is a positive merciful act, to end useless suffering or a meaningless existence. It is an act of commission. Example: By giving large doses of drugs to hasten death. Passive euthanasia means discontinuing or not using extraordinary life sustaining measures to prolong life. This includes acts of omission. Example: Failure to resuscitate a terminally ill or hopelessly incapacitated patient. Assisted suicide: A person providing information to another with information, guidance and means to take his own life with the intention that it will be used for this purpose is assisted suicide. Ref: The Essentials of Forensic Medicine and Toxicology 29th Ed Page 42. | train | med_mcqa | null |
Maximum number of Na+ channels per square micrometer is present in | [
"Cell body",
"Axon terminal",
"Surface of myelin",
"Nodes of Ranvier"
] | D | "Saltatory" Conduction in Myelinated Fibers from Node to Node: Even though almost no ions can flow through the thick myelin sheaths of myelinated nerves, they can flow with ease through the nodes of Ranvier.Therefore, action potentials occur only at the nodes. Yet the action potentials are conducted from node to node, this is called saltatory conduction.That is, electrical current flows through the surrounding extracellular fluid outside the myelin sheath, as well as through the axoplasm inside the axon from node to node, exciting successive nodes one after another. Thus, the nerve impulse jumps along the fiber, which is the origin of the term "saltatory."Ref: Guyton; 13th edition; Chapter 5; Membrane Potentials and Action Potentials | train | med_mcqa | null |
Aspirin should be used with caution in the following groups of patients because of which of the following reason : | [
"In diabetics because it can cause hyperglycemia",
"In children with viral disease, because of the risk of acute renal failure",
"In gout, because it can increase serum uric acid",
"In pregnancy, because of high risk of teratogenicity"
] | C | At therapeutic doses, Aspirin can cause hyperuricemia by decreasing the excretion of uric acid. It, therefore, should not be used in patients with gout. It also decreases the uricosuric action of probenecid. At high doses (>5 g/ d), it increases the excretion of uric acid, but such high doses are not tolerated.
Aspirin is contraindicated in children (<12 yrs old) due to increased risk of Reye's syndrome, which is a type of hepatic encephalopathy.
It should be avoided in diabetics because of risk of hypoglycemia
It should be avoided in pregnancy because it may be responsible for low birth weight babies, however, it does not cause congenital malformations. | train | med_mcqa | null |
Autonomic disturbances are seen in? | [
"Hypehyroidism",
"Diabetes",
"Hyperaldosteronism",
"Hyperparathyroidism"
] | B | Diabetes REF: Harrison's Internal Medicine 17'h edition chapter 370 I. Autonomic disorders with brain involvement A. Associated with multisystem degeneration 1. Multisystem degeneration: autonomic failure clinically prominent Multiple system atrophy (MSA) Parkinson's disease with autonomic failure Diffuse Lewy body disease (some cases) 2. Multisystem degeneration: autonomic failure clinically not usually prominent Parkinson's disease Other extrapyramidal disorders (inherited spinocerebellar atrophies, progressive supranuclear palsy, coicobasal degeneration, Machado-Joseph disease) B. Unassociated with multisystem degeneration 1. Disorders mainly due to cerebral coex involvement Frontal coex lesions causing urinary/bowel incontinence Paial complex seizures 2. Disorders of the limbic and paralimbic circuits Shapiro's syndrome (agenesis of corpus callosum, hyperhidrosis, hypothermia) Autonomic seizures 3. Disorders of the hypothalamus Wernicke-Korsakoff syndrome Diencephalic syndrome Neuroleptic malignant syndrome Serotonin syndrome Fatal familial insomnia Antidiuretic hormone (ADH) syndromes (diabetes insipidus, inappropriate ADH) Disturbances of temperature regulation (hypehermia, hypothermia) Disturbances of sexual function Disturbances of appetite Disturbances of BP/HR and gastric function Horner's syndrome 4. Disorders of the brainstem and cerebellum Posterior fossa tumors Syringobulbia and Arnold-Chiari malformation Disorders of BP control (hypeension, hypotension) Cardiac arrhythmias Central sleep apnea Baroreflex failure Horner's syndrome H. Autonomic disorders with spinal cord involvement Traumatic quadriplegia Syringomyelia Subacute combined degeneration Multiple sclerosis Amyotrophic lateral sclerosis Tetanus Stiff-man syndrome Spinal cord tumors III. Autonomic neuropathies A. Acute/subacute autonomic neuropathies 1. Subacute autoimmune autonomic neuropathy (panautonomic neuropathy, pandysautonomia) Subacute paraneoplastic autonomic neuropathy Guillain-Barre syndrome Botulism Porphyria Drug induced autonomic neuropathies Toxic autonomic neuropathies B. Chronic peripheral autonomic neuropathies 1. Distal small fiber neuropathy 2. Combined sympathetic and parasympathetic failure Amyloid Diabetic autonomic neuropathy Autoimmune autonomic neuropathy (paraneoplastic and idiopathic) Sensory neuronopathy with autonomic failure Familial dysautonomia (Riley-Day syndrome) | train | med_mcqa | null |
In retinal detachment | [
"Effusion of fluid into the suprachoroidal space",
"Retinoschisis",
"Separation of sensory retina from pigment epithelium",
"None of the above"
] | C | Ans. (c) Separation of sensory retina from pigment epitheliumRef: Kanski 7/e, p. 689, 701* Retinal detachment: Separation of NSR from RPE, leading to accumulation of fluid in sub retinal spaceRetinoschisis (splitting of retina)Typical/degenerative split in OPLReticular/congential split at NFL | train | med_mcqa | null |
In full term neonates, the ductus arteriosus closure is mainly due to | [
"Cardiac output",
"Prostaglandins",
"Low pressure CO2",
"Low pressure O2"
] | D | (Low pressure O2): Ref 45-Dutta 6th (394-Ghai 7th) Changes of the fetal circulation at birth 1. Closure of the umbilical arteries: Functional closure is almost instaneous preventing even slight amount of the fetal blood to drain out. Actual obliteration takes about 2-3 months. The distal parts from the lateral umbilical ligaments and the proximal parts remain open as superior vesical arteries. 2. Closure of umbilical vein: - The obliteration occurs a little latter than the arteries, After obliteration, the umbilical vein forms the ligamentum teres and the ductus venosus becomes ligamentum venosum 3. Closure of the ductus arteriosus - Within few hours of respiration, the muscle wall of the ductus arteriosus contracts probably in response to rising oxygen tension of the blood flowing through the duct. The effects of the variation of the O2 tension on the ductus arteriosus are thought to be mediated through the action of prostaglandins. Prostaglandin antagonists given to the mother may lead to the premature closure of the ductus arteriosus. Whereas functional closure of the ductus may occur soon after the establishment of pulmonary circulation, the anatomical obliteration takes about 1-3 months and becomes ligamentum arteriosum 4. Closure of the foramen ovale: - This is caused by an increased pressure of the left atrium combined with a decreased pressure on the right atrium. Functional closure occurs soon after birth but anatomical closure occurs in about 1 year time. Within one or two hours following birth ,the cardiac output is estimated to be a bout 500 ml per minute, and the heart rate varies from 120 -140 per minute * During foetal life, patency of the ductus arteriosus appears to be maintained by the combined relaxant effects of low oxygen tension and endogenously produced prostaglandins (PGE2), In full term neonates the oxygen is the most important factor controlling ductual closure (1480- Nelson 17th) Ref 2 - PATHOPHYSIOLOGY The DA is derived from the distal dorsal sixth aortic arch and is completely formed by the eighth week of gestation.6 Its role is to shunt the blood from the nonfunctional fetal lung through its connection between the main pulmonary artery and the proximal descending aorta. This right-to-left shunt allows the blood with a relatively low oxygen concentration to be carried from the right ventricle through the descending aorta and eventually to the placenta, where gas exchange will occur. Before birth, approximately 90% of right ventricular output flows through the DA. Figure 1 illustrates the role of the DA in redirecting fetal circulation in comparison to neonatal circulation.15 Premature closure in the fetus is associated with significant morbidities, including right-sided heart failure, which may result in fetal hydrops.6 Normally, the DA closes within 24-72 hours after a full-term birth; if after 72 hours the ductus fails to close, a diagnosis of persistent PDA may be made.1,16 Figure 1. Left-The ductus arteriosus is an essential component of fetal circulation. It functions by shunting blood away from the nonfunctional fetal lung and into the systemic circulation through the aorta. Right-After birth, decreases in PGE2 and oxygen tension contribute to the closure of the ductus Arteriosus, allowing gas exchange to occur in the newly functioning lungs rather than the now absent placenta. Blue = oxygen-poor blood; Red = oxygen-rich blood; LA = left atrium; LV = left ventricle; RA = right atrium; RV = right ventricle. The paradoxical patent ductus arteriosus. J Clin Invest 166:2863-2866 by Ivey KN, and Srivastava D. Copyright 2006 by J Clin Invest. Reproduced with permission of J Clin Invest via Copyright Clearance Center. The patency of the DA is primarily controlled by low fetal oxygen tension and the circulation of prostanoids produced from the metabolism of arachidonic acid by COX, with PGE2 producing the most profound ductal relaxation among the prostanoids.16,17 Smooth muscle relaxation of the DA results from the activation of the G-coupled prostaglandin receptor EP4 by PGE2. Following the activation of prostaglandin receptor EP4, a cascade of events ensues, which includes the accumulation of cyclic adenosine monophosphate, increased protein kinase A, and finally, decreased myosin light chain kinase, leading to vasodilation and ultimately DA patency.15 The preterm ductus is especially sensitive to the vasodilatory effects of prostaglandins, contributing to the failure of ductal closure.18 In term infants, as birth approaches, decreased sensitivity of the DA to prostaglandins and decreased circulating levels of PGE2 contribute to DA closure.19 Within 24-72 hours after a full-term birth, the DA closes as a result of increased oxygen tension and decreased circulating PGE2 and prostacyclins (PGI2). As oxygen tension increases, smooth muscle voltage-dependent potassium channels are inhibited. Through this inhibition, an influx of calcium contributes to ductal constriction. This oxygen-induced constriction fails in preterm infants potentially due to immaturity of oxygen-sensing receptors.20 Levels of circulating PGE2 and PGI2 are decreased as a result of increased metabolism in the newly functioning lung, as well as the removal of the placental source. The decreased circulating levels of these potent vasodilators allow the DA to constrict. These factors collectively contribute to smooth muscle constriction, leading to ischemic hypoxia of the inner muscle wall of the DA. As the ductus constricts, the luminal area is diminished, resulting in a thickened vessel wall and obstructed flow through the vasa vasorum, the essential capillary network nourishing the outer cells of the vessel. This causes an increased distance of diffusion for oxygen and nutrients, including glucose, glycogen, and adenosine triphosphate (ATP), which results in nutritional deficit and oxygen starvation, leading to cell death.21 Ductal constriction in preterm infants is not sufficiently profound. Consequently, preterm infants are resistant to smooth muscle hypoxia, which is paramount in triggering the cell death and remodeling required for permanent closure of the DA.22 Inhibition of prostaglandin and nitric oxide resulting from tissue hypoxia is not as extensive in the preterm neonate in comparison to the term infant, further contributing to resistance to DA closure in the preterm infant.23 The main provider of nutrients to the DA is the lumen; however, the vasa vasorum is also a substantial provider to the outer wall of the ductus. The vasa vasorum grows toward the lumen and extends 400-500 mm from the outer wall of the ductus. The distance between the lumen and the vasa vasorum (40-500 mm) is referred to as the avascular zone and represents the maximum distance allowable for effective nutrient diffusion. In full-term infants, this avascular zone is expanded beyond the effective diffusion distance, therefore contributing to cell death. In preterm infants, the avascular zone does not sufficiently expand, resulting in cell survival and maintenance of ductal patency.24 If the levels of circulating PGE2 and other prostaglandins are decreased through COX inhibition, closure is facilitated. The abovementioned differences between ductal vessel wall thickness of the fetus, term neonate, and preterm neonate are illustrated in Figure 2.16 In response to the nutritional deficit and ischemic hypoxia, vascular endothelial growth factor and transforming growth factor beta (both of which contribute to endothelial proliferation), in combination with other inflammatory mediators, contribute to the remodeling of the DA into the non-contractile ligament commonly referred to as the ligamentum arteriosum.16,24 Figure 2. Comparison of fetal and both the premature and full-term newborn ductus arteriosus. The avascular zone in the preterm ductus (bottom row) does not sufficiently expand beyond the effective diffusion distance after birth (bottom right). Hermes-deSantis et al.16 Reprinted by permission from Macmillan Publishers Ltd: J Perinatol 26: s14-s18, copyright 2006. | train | med_mcqa | null |
True about critical illness myoneuropathy? (Asked twice in the exam) | [
"Neurological recovery is complete",
"Sequential nerve demyelination followed by inflammatory myopathy during course of disease",
"Cranial nerves are involved more commonly than peripherl nerve",
"Diaphrogmatic atony dure to prolonged intubation may cause it."
] | D | Critical illness polyneuropathy (CIP) and critical illness myopathy (CIM) are overlapping syndromes of diffuse, symmetric, flaccid muscle weakness occurring in critically ill patients and involving all extremities and the diaphragm with relative sparing of the cranial nerves. Ref Harrison20th edition pg 2477 | train | med_mcqa | null |
Which of the following species of clostridium species does not break carbohydrate and protein - | [
"Sporogenes",
"Septicum",
"Cochlearium",
"Novyi"
] | C | Cl. cochlearium does not break carbohydrate and protein. Neither proteolytic nor Saccharolytic - Cl. cochlearium. Proteolytic Clostridium turn the meat black and produce foul odor - Cl. tetani, Cl botulinum A, B, and F. Saccharolytic Clostridium turn the meat pink -Cl. perfringens, Cl. difficle and , Cl botulinum C, D, E. Robeson's cooked meat (RCM) broth: (refer to the image below) Anaerobic Medium for the growth of Clostridium. Contains unsaturated fatty acids, digested meat, and sulfhydryl compounds. Renders the broth turbid. Saccharolytic Clostridium turn the meat pink, while proteolytic species turn the meat black and produce foul smell. Most of the Clostridium produce gas. Left side tube- Uninoculated Robeson cooked meat . Ride side tube - RCM broth turns into black colour. | train | med_mcqa | null |
Glands of Zeis are: | [
"Modified sebaceous glands",
"Modified sweat glands",
"Modified lacrimal glands",
"Modified meibomian glands"
] | A | Ans. Modified sebaceous glands | train | med_mcqa | null |
The capsule of the crystalline lens is thinnest at | [
"Anterior pole",
"Posterior pole",
"Equator",
"None"
] | B | (Posterior pole) (167- Khurana 4th)Lens Capsule - is a thin, transparent, hyaline membrane surrounding the lens* Capsule is thickest at pre-equator regions (14 p) and thinnest at the posterior pole Op) | train | med_mcqa | null |
Starvation and diabetes mellitus can lead on to ketoacidosis. Which of the following features is in favour of ketoacidosis due to diabetes mellitus - | [
"Increase in glucagon/insulin ratio, increased cAMP and increased blood glucose",
"Decreased insulin, increased free fatty acid which is equivalent to blood glucose",
"Decreased insulin, increased free fatty acid which is not equivalent to blood glucose",
"Elevated insulin and free fatty acid, equivalent to b... | A | Increase in glucagon/insulin ratio, increased c-AMP & increased blood sugar
In diabetes little glucose is oxidized as fuel, except by the brain. The rest of tissues bum a large amount of fat, particularly the liver where the amount of acetyl CoA formed from fatty acids exceeds the capacity of the tricarboxylic acid cycle to oxidize it. The excess acetyl CoA is converted to ketone bodies leads to ketonemia, ketonuria and ketoacidosis.
Diabetics not only have a defect in the tissue utilization of glucose but also appears to be metabolically poised to produce maximum amount of glucose from amino acids (gluconeogenesis) and to prevent glucose from being utilized to form fat. (fat synthesis).
Insulin is decreased and glucagon is increased leads to ↑glucagon / insulin ratio. Glucagon acts via elevation in c-AMP. | train | med_mcqa | null |
Who said: "Skin is the best dressing"? | [
"Joseph Lister",
"John Hunter",
"James Paget",
"McNeill Love"
] | A | Ans. is 'a' i.e., Joseph Lister | train | med_mcqa | null |
True about Toxaplasma gondii is, it is carried by - | [
"Cats",
"Dogs",
"Rats",
"Cow"
] | A | Cat and felines-definite host Only the asexual forms,trophozoites and tissue cysts are found in other animals including humans and birds which act as intermediate host(refer pgno:64 baveja 3 rd edition) | train | med_mcqa | null |
Ligamentum teres hepatis is derivative of: | [
"Ductus aeriosus",
"Ductus venosus",
"Umbilical vein",
"None of the above"
] | C | After bih, the left umbilical vein and ductus venosus are obliterated and form the ligamentum teres hepatis and ligamentum venosum, respectively. Ref: Langman's embryology 11th edition Chapter 12. | train | med_mcqa | null |
Which of the following ECG changes in an Asymptomatic Athlete's Hea should be considered pathological? | [
"Increased amplitude of QRS",
"Second Degree (Mobitz 1) hea block",
"Prolonged QTc Interval",
"T Wave inversion"
] | C | Answer is C (Prolonged QTc Interval) A Prolonged QT Interval that is corrected for hea rate (Prolonged QTc) in an athlete should be considered pathological and evaluated fuher. Prolonged QT interval is a normal finding in professional athletes and is often seen due to the presence of bradycardia. The presence of prolonged QT interval corrected for hea rate (QTc) is however unusual. The presence of prolonged QTc Interval should be considered pathological and evaluated .fuher Athlete's hea is usually associated with a prolonged QT interval because of bradycardia. Professional athletes should be evaluated fuher for Identification of a prolonged QT Interval corrected for hea rate (QTc). QTc interval at upper limit is a common finding in athletes, however the presence of a significantly prolonged QTc interval in athletes should be considered a pathological finding and evaluated fuher to exclude Congenital Long QT Syndrome (LQTS). Congenital Long QT Syndromes (LOTS) are a recognized cause of adrenergic mediated polymorphic ventricular tachycardia and has been implicated in exercise related sudden cardiac death in young athletes. The identification of a prolonged QT interval corrected for hea rate (QTc) should be considered pathological and evaluated fuher. | train | med_mcqa | null |
Which of the following is nd seen in a case of borderline personality disorder? | [
"Identity crisis",
"Dissociative events",
"Risk taking behavior",
"Strong and stable interpersonal relationships"
] | D | Borderline personality disorder patients does not maintain strong & stable interpersonal relationships. | train | med_mcqa | null |
Hypercalciuria is seen in - | [
"Hyperparathyroidism",
"VitD intoxication",
"Sarcoidosis",
"All"
] | D | <p>Primary hyperparathyroidism is a generalized disorder of calcium, phosphate, and bone metabolism due to an increased secretion of PTH. The elevation of circulating hormone usually leads to hypercalcemia and hypophosphatemia. There is great variation in the manifestations. Patients may present with multiple signs and symptoms, including recurrent nephrolithiasis, peptic ulcers, mental changes, and, less frequently, extensive bone resorptionHypercalcemia in vitamin D intoxication is due to an excessive biologic action of the vitamin, perhaps the consequence of increased levels of 25(OH)D rather than merely increased levels of the active metabolite 1,25(OH) 2 D (the latter may not be elevated in vitamin D intoxication). 25(OH)D has definite, if low, biologic activity in the intestine and bone. The production of 25(OH)D is less tightly regulated than is the production of 1,25(OH) 2 D. Hence concentrations of 25(OH)D are elevated severalfold in patients with excess vitamin D intakeIn patients with sarcoidosis and other granulomatous diseases, such as tuberculosis and fungal infections, excess 1,25(OH) 2 D is synthesized in macrophages or other cells in the granulomas.Indeed, increased 1,25(OH) 2 D levels have been repoed in anephric patients with sarcoidosis and hypercalcemia. Macrophages obtained from granulomatous tissue conve 25(OH)D to 1,25(OH) 2 D at an increased rate. There is a positive correlation in patients with sarcoidosis between 25(OH)D levels (reflecting vitamin D intake) and the circulating concentrations of 1,25(OH) 2 D, whereas normally there is no increase in 1,25(OH) 2 D with increasing 25(OH) D levels due to multiple feedback controls on renal 1a-hydroxylase(harrison 18 pg 3108)</p> | train | med_mcqa | null |
Medial meniscus of knee joint is injured more often than the lateral meniscus because the medial meniscus is relatively - | [
"More mobile",
"Less mobile",
"Thinner",
"Attached lightly to femur"
] | B | *Medial meniscus is more frequently injured than lateral meniscus because: 1) The medial meniscus is securely attached around the entire periphery of the joint capsule, which makes it less mobile. 2) Where as the lateral meniscus is more mobile and has no weak point between a movable and relatively fixed point. 3) Popliteus muscle sends few fibers into the posterior margin of lateral meniscus. Thus muscle contraction withdraw & protects the lateral meniscus by drawing it posterilaterally during flexion of the knee and medial rotation of the tibia. Function of the Meniscus * Distributes stress across the joint surface by providing a lar * Deepens the stabilization * Acts as a sho forces result&; movement * Provide lubr synol cavi er area of contact tibial plateau for greater of the knee * The lateral meniscus is loosely attached anteriorly and posteriorly to the joint capsule * Due to the great lateral meniscu injury * Lateral menisca than medial medial meniscus * The medial meniscus is firmly attached to anteriorly and posteriorly to the joint capsule * Medial meniscal tears are more common than lateral meniscal injuries -- Occur 2-5 times more often Ref: Campbell's operative ohopaedics 13th/e p.2143 | train | med_mcqa | null |
A 8 yr old boy presents with upper GI bleeding. On examination, he is found to have splenomegaly; there are no signs of ascites, or hepatomegaly; esophageal varices are found on upper GI endoscopy. Most likely diagnosis is: | [
"Budd chiari syndrome",
"Cirrhosis",
"Veno-occlusive disease",
"Non cirrhotic poal fibrosis"
] | D | The diagnostic criteria of NCPF includes splenomegaly, normal liver function test, esophageal varices (90-95% cases), patent hepatic and poal veins and no evidence of cirrhosis on biopsy. Based on this criteria, the most probable diagnosis in this patient is Non cirrhotic poal fibrosis. Ref: Arun J. Sanyal, Vijay H. Shah (2005), Chapter 25, "Noncirrhotic Poal Hypeension and Poal Vein Thrombosis", In the book, "Poal Hypeension: Pathobiology, Evaluation and Treatment", USA, Pages 411-12 ; Harrison's Internal Medicine, 15th Edition, Page 1759 | train | med_mcqa | null |
Management of typical febrile seizures include all the following except | [
"Tepid sponging",
"Paracetamol and ibuprofen",
"Intermittent diazepam",
"Prophylactic phenobarbitone."
] | D | In cases of developing epilepsy-intermittent prophylaxis with diazepam (oral or rectal) staed at the onset of fever is recommended. Chronic prophylaxis with phenobarbitone advocated earlier has been abandoned, because of poor efficacy and behavioral side effects. REF: KD TRIPATHIH 8TH ED | train | med_mcqa | null |
Half-life of factor VIII | [
"2-4 hours",
"8-12 hours",
"6 minutest",
"60 days"
] | B | Factor VIII (8) Dosage Calculated on the basis that 1 unit/kg of factor VIII leads to a rise in plasma factor VIII of approximately 2%. EXAMPLE: 50 units/kg will increase factor VIII level by ~100%. Doses are rounded UP to the nearest l size. The half-life of factor VIII is 8-12 hours. Refer also to RCH Clinical Practice Guideline Haemophilia. | train | med_mcqa | null |
A patient with pCO2 80 mm Hg and plasma bicarbonate 33 mEq/L is having- | [
"Metabolic acidosis",
"Respiratory acidosis",
"Respiratory alkalosis",
"Excessive renal bicarbonate loss"
] | B | Respiratory acidosis is an acid-base balance disturbance due to alveolar hypoventilation. ... Lung diseases that cause abnormalities in alveolar gas exchange do not typically result in alveolar hypoventilation. Often these diseases stimulate ventilation and hypocapnia due to reflex receptors and hypoxia Ref Davidson 23rd edition pg 367 | train | med_mcqa | null |
Most common congenital tumour of conjunctiva is | [
"Papilloma",
"Squamous cell carcinoma",
"Epibulbar dermoid",
"Melanoma"
] | C | Commonest congenital tumour of the conjunctiva - Epibulbar dermoid | train | med_mcqa | null |
A 5–year old child is assessed to have a developmental age of one year. His developmental quotient would be – | [
"100",
"80",
"60",
"20"
] | D | null | train | med_mcqa | null |
Tachycardia due to nitrates in a patient with angina pectoris is blocked by- | [
"Digoxin",
"Dobutamine",
"Beta blocker",
"Calcium channel blocker"
] | C | Ans. is 'c' i.e., Beta blocker o Use of beta blocker and long acting nitrate combination is rational in classical angina because:Tachycardia due to nitrate is blocked by beta blockerThe tendency of beta blocker to cause ventricular dilatation is countered by nitrateThe tendency of beta blocker to reduce the total coronary flow is opposed by nitrate | train | med_mcqa | null |
True about free water clearance is | [
"Regulated by ADH",
"Regulated by aldosterone",
"Increased by furosemide",
"None of the above"
] | A | ADH or Vasopressin - hormone secreted by the posterior pituitary gland and also by nerve endings in the hypothalamus; affects blood pressure by stimulating capillary muscles and reduces urine flow by affecting reabsorption of water by kidney tubules Ref: Ganong's review of medical physiology; 24th edition; page no: 690 | train | med_mcqa | null |
Gower sign is classical of one of the following condition – | [
"Congenital myopathy",
"Werdig–Hoffman disease",
"Duchenne muscular dystrophy",
"Guillain–Barre syndrome"
] | C | null | train | med_mcqa | null |
Antiseptic technique in surgery was first introduced by: | [
"Joseph Lister",
"Louis Pasteur",
"Robert Koch",
"Antony Van Leeuwenhoek"
] | A | null | train | med_mcqa | null |
A 2 years old child is brought to the emergency with history of fever and vomiting. On examination he has neck rigidity. CSF examination shows polymorphs more than 200 /ml; protein 100 mg/dl and glucose 10 mg/dl. the Gram's stain shows the presence of Gram-negative coccobacilli. The culture shows of bacteria only on chocolate. Agar and not on blood agar. The causative agent is: | [
"Neisseria meningitidis",
"Haemophilus influenzae",
"Branhatnella catarrhalis",
"Legionella pneuntophila"
] | B | Ans. (b) H. influenzae See the morphology of asked bacteria, you will know the answer. H. influenzae - Gram-negative coccobacilli N. meningitidis - Gram-negative cocci Legionella - Gram-negative coccobacilli B. catarrhalis - Gram-negative cocci | train | med_mcqa | null |
Hypocalcemia is characterized by all of the following features except - | [
"Numbness and tingling of circumoral region",
"Hyperactivity tendon reflexes",
"Shortening of Q-T interval in ECG",
"Carpopedal spasm"
] | C | null | train | med_mcqa | null |
A 50-year-old man had drinks followed by a heavy dinner. He had severe vomiting and chest pain and collapsed. X-ray of chest showed hydropneumothorax. The likely diagnosis is: | [
"Mallory-Weiss syndrome",
"Boerhaave syndrome",
"Ruptured duodenal ulcer",
"Myocardial infarction"
] | B | Severe vomiting can cause tear of oesophageal mucosa only (Mallory-Weiss syndrome) or tear of all the layers of oesophageal wall (Boerhaave syndrome) above the diaphragm due to sudden increase in oesophageal pressure. Since there is hydropneumothorax, all the layers of oesophagus are torn. Oesophagogram with water-soluble die will show tear located just above the diaphragm. Small tears may be missed unless barium is used.Treatment of Boerhaave syndrome is thoracotomy, repair of the tear and mediastinal drainage. Systemic antibiotics should be used to control infection. | train | med_mcqa | null |
Subdural hematoma is due to rupture of - | [
"Middle meningeal artery",
"Saccular berry Anuerysm",
"Communicating veins to superior sagittal sinus",
"Retromandibuar vein"
] | C | Ans. is 'c'i.e., Communicating veins to superior sagittal sinus Chronic Subdural hematomao Accumalation of blood in the subdural spaceo It occurs mainly in elderly patients with some degree of cerebral atrophy.o The amount of trauma required is minimal.o Bleeding is the result of rupture of communicating veins passing from the cerebral cortex to the superior saggital sinus. Rupture occurs when there is movement of the brain relative to the fixed superior saggital sinus and is most likely when cerebral atrophy is presento Clinical course is slow (over days to month).# Pt. presents with slowly increasing intracranial pressure, causing headache, vomitting, papilledema and fluctuating levels of consciousness.# Compression of the underlying brain may cause focal epileptic convulsions and neurological symptoms, most commonly contralateral spastic paralysis with prolonged but less severe compression, atrophy of the brain occurs and cause dementia.o Treatment is by surgical evacuation of the subdural collection. | train | med_mcqa | null |
Which of the following ATT has maximum CSF penetration ? | [
"Streptomycin",
"INH",
"Rifampicin",
"Ethambutol"
] | B | null | train | med_mcqa | null |
A 30-year-old lady C/O sudden onset of breathlessness, anxiety, palpitation, and feeling of impending doom. Physical examination is normal. Diagnosis is: | [
"Panic attack",
"Anxiety disorder",
"Conversion disorder",
"Acute psychosis"
] | A | Ans. A i.e. Panic attack-A panic attack is the abrupt onset of intense fear or discomfo that reaches a peak within minutes.-The symptoms include Palpitation, Sweating, Trembling or shaking, Shoness of breath or smothering sensation, Choking sensation, Chest pain or discomfo Nausea or Abdominal distress, Dizziness, Light-headedness, Chills or heat sensation, Paraesthesia's, Derealisation or depersonalization, Fear of losing control or "going crazy", Fear of death. | train | med_mcqa | null |
In which of the following procedures sperms are aspirated from the testes? | [
"ZIFT",
"GIFT",
"TESA",
"MESA"
] | C | Aspiration of sperms from testes is done in Testicular sperm aspiration(TESA). In this technique, an aspiration needle is inseed percutaneously to the testis parenchyma to aspirate fluid or small pieces of seminiferous tubules to obtain sperm. Ref: Feility Cryopreservation By Ri-Cheng Chian, Page 52-3; Feility Preservation: Emerging Technologies and Clinical Applications By Emre Seli, page 305. | train | med_mcqa | null |
Pregnant lady's hanging in postponed by high cou, it comes under which CrPC - | [
"416",
"417",
"300",
"312"
] | A | S.312 causing miscarriage, if woman is quick with child. S.300 defines d offense of murder & also states the 5 xceptions when culpable homicide is not murder. Ref:Textbook of forensic medicine & Toxicology, (V.V.Pillai) pg no-14,16th edition. | train | med_mcqa | null |
Newer insulins are - | [
"Acidic",
"Alkaline",
"Neutral",
"Monomers"
] | C | Ans. is 'c' i.e., Neutral o Initially there were neutral and acidic preparations of insulin. Now only neutral insulin preprations are available, also known as regular insulin, except glargine (supplied at acidic pH-4) | train | med_mcqa | null |
A patient presented with thunder clap headache. Followed by unconsciousness with progressive 3rd cranial nerve palsy - | [
"Extradual hemorrhage",
"Aneurysmal subarachnoid hemorrhage",
"Basilar migraine",
"Cluster Headache"
] | B | null | train | med_mcqa | null |
Glucuronidation takes place in ? | [
"Liver",
"RBC",
"Pancreas",
"Thyroid"
] | A | Ans. is 'a' i.e., Liver GLUCURONIDATION This is the most impoant synthetic reaction carried out by a group of UDP-glucuronosyl transferases (UGTs). Glucuronidation occurs mainly in the liver, although the enzyme responsible for its catalysis, UDP?glucuronyltransferase, has been found in all major body organs (e.g., intestine, kidneys, brain, adrenal gland, spleen, and thymus). Compounds with a hydroxyl or carboxylic acid group are easily conjugated with glucuronic acid which is derived from glucose. Examples are- chloramphenicol, aspirin, paracetamol, lorazepam, morphine, metronidazole. Not only drugs but endogenous substrates like bilirubin, steroidal hormones and thyroxine utilize this pathway. Glucuronidation increases the molecular weight of the drug which ours its excretion in bile. Drug glucuronides excreted in bile can be hydrolysed bybacteria in the gut-the liberated drug is reabsorbed and undergoes the same fate. This enterohepatic cycling of the drug prolongs its action, e.g. phenolphthalein, oral contraceptives. | train | med_mcqa | null |
The period of normalsy is seen between two psychosis. The diagnosis is: | [
"Schizophrenia",
"Manic Depressive Psyhosis (MDP)",
"Alcoholism",
"Depression"
] | B | B i.e. Manic depressive psychosis | train | med_mcqa | null |
An 8 year old boy presented with fever and bilateral cervical lymphadenopathy with prior history of sore throat. There was no hepatomegaly. The peripheral blood smear shows >20% lympho plasmacytoid cells. The most likely diagnosis is: | [
"Tuberculosis",
"Infectious Mononucleosis",
"Acute lymphoblastic leukemia",
"Influenza"
] | B | Ans. B. Infectious MononucleosisThe given clinical situation suggests Infectious MononucleosisFeatures of Infectious Mononucleosis:* Cervical Lymphadenopathy* Fever* History of sore throat* >20% atypical lymphocytesHepatomegaly may be absent (Occurs only in 30% of cases) | train | med_mcqa | null |
Flat vegetations in pockets of valves are due to : | [
"Rheumatic hea disease",
"Libman sacks Endocarditis",
"NBTE",
"Infective endocarditis"
] | B | Answer is B (Libman sach's Endocarditis) Flat vegetation in pockets of valves are charachteristic of Libman sach's endocarditis | train | med_mcqa | null |
Low bih weight statistics of a hospital is best shown by- | [
"Bar chas",
"Histogram",
"Pictogram",
"Frequency polygon"
] | A | . | train | med_mcqa | null |
Normally which tooth remains in mouth lastly? | [
"Maxillary canine",
"Mandibular canine",
"Mandibular central & lateral incisor",
"Maxillary 1st premolar"
] | B | Mandibular canine has the maximum chances of last remaining tooth in mouth. | train | med_mcqa | null |
A mother is HBsAg positive at 32 weeks of pregnancy. What should be given to the new born to prevent neonatal infection - | [
"Hepatitis B vaccine + immunoglobulins",
"Immunoglobulins",
"Hepatitis B vaccine only",
"Immunoglobulin followed by vaccine 1 month later"
] | A | Ans. is 'a' i.e., Hepatitis B vaccine + immunoglobulin Immunization of infants born to HbsAg positive women.o These infants should receive both active and passive immunization soon after birth.The first dose of active immunization should be accompanied by administration of.5 ml of HBIG as soon after delivery is possible, because the effectiveness decreases rapidly with increased time after birth.o Subsequent doses of active immunization should be given at l-2mo. and 6 mo of age.Indication and dosing schedule for Hepatitis B vaccine and hepatitis B immune globulin.GroupActive im m unization (Recombivax, or Engeris)Passive immunization (HBIG)Neonates Schedule ScheduleInfants of Hbs o Birth, Ag positiveo 1 mo.within 12 hr of birthwomen o 6 mo. Infants of o Birth HbsAgo 1-2 mo,None-Negative o 6-18 mo women | train | med_mcqa | null |
Best vein for total parenteral nutrition is | [
"Subclavian vein",
"Femoral vein",
"Brachial vein",
"Saphenous vein"
] | A | Ans. a (Subclavian vein). (Ref. Baily and Love surgery 25th/pg. 231)TOTAL PARENTERAL NUTRITIONDefined as the intravenous provision of all nutritional requirements, without the use of GIT.Indications:# Proximal intestinal fistula# Inflammatory bowel disease# Massive intestinal resection (especially if <100 cm of small bowel remains)# Ileus# Pancreatitis (severe)Preferred vein:# Peripheral line (for short period < 2 weeks)# Central line (for long period)Central venous route is chosen more commonly, and the catheter should be inserted via either subclavian, internal/ external jugular vein should be avoided as it is associated with high incidence of infection and thrombosis. The catheter tip should be in distal SVC to minimize risk of central venous or cardiac thrombosis.Complications of TPN:Catheter relatedFeeding Regimen related# Arterial, venous injuries and cardiac perforation and thrombosis# Hyperglycemia# Hypoglycemia# Brachial plexus and stellate ganglion injury# Hypertriglyceridemia# Pneumothorax# Hyperchloremic acidosis# Thoracic duct injury# Electrolyte imbalance# Air embolism# Trace element and vitamin deficiency# Catheter related infections # Catheter migration/embolus # Thrombotic catheter occlusion # SABE | train | med_mcqa | null |
A 24-year-old man with a history of depression is brought to the emergency room because of a drug overdose. He is experiencing some nausea and vomiting, but no other symptoms. Physical examination and vital signs are normal. Six hours prior to presentation, he intentionally took 40 tablets of acetaminophen (500 mg/tablet). Baseline acetaminophen level, liver enzymes and function are drawn, and he is admitted to the hospital. Which of the following is the most appropriate next step in management? | [
"give ethanol to compete with the parent drug for metabolism, therefore preventing formation of toxic metabolites",
"give Narcan to block its actions directly",
"give intravenous prostacyclin to maintain cellular integrity",
"give N-acetyl cysteine to allow binding of the toxic metabolite"
] | D | TV-acetylcysteine probably acts by providing a reservoir of sulfhydryl groups to bind the toxic metabolite of acetaminophen. Narcan is effective for narcotic overdose, and ethanol is the antidote for methanol intoxication. | train | med_mcqa | null |
Small size placenta is seen in ? | [
"Peripheral vascular disease in mother",
"Pre eclampsia",
"Maternal weight < 50 Kg",
"Multiple pregnancy"
] | B | Ans. is 'B' i.e., Pre eclampsiaSmall placenta on antenatal ultrasound USG may be due to :-Variation in placental morphology :Only post of placenta is seen.Bibbed placenta :Only one lobe is seen.Succenturiate lobe.Hypeensive states (pre-eclampsia, eclampsia)Chromosomal disorders :Trisomy 18, Dysgenic triploidy, IUGR or intrauterine infection | train | med_mcqa | null |
True regarding isozymes is: | [
"Forms of the same enzymes that catalyze different reaction",
"Forms of the same enzymes that catalyze same reaction",
"Forms of the different enzymes that catalyze different reaction",
"Forms of the different enzymes that catalyze same reaction"
] | B | Isozymes/Isoenzymes are different forms of same enzyme,catalyzing same reaction in same species, Example:- There are five isozymes of Lactate Dehydrogenase (LDH-1 to LDH-5), All conve Pyruvate to Lactate. Same for Isoenzymes Reaction Species Different for Isoenzymes Structure (subunits) Km, Vmax Electrophoretic mobility Genes (but closely relate) Heat stability Susceptibility to inhibitor If species different, then it is known as Alloenzyme Isoenzymes may be present in same/different tissues | train | med_mcqa | null |
Exclusive breast feeding is recommended by WHO upto age of:- | [
"1 month",
"2 months",
"4 months",
"6 months"
] | D | WHO recommendations on breast feeding in developing countries: Exclusive breast feeding: Upto age of 6 months. Breast feeding: Upto age of 2 years. Vaccines , Medications , Vitamin supplementation are permitted in exclusive breast feeding. | train | med_mcqa | null |
Vitamin used for treating toxic ambylopia: March 2012 | [
"Hydroxycobalamine",
"Vitamin B1",
"Vitamin B6",
"Vitamin B3"
] | A | Ans: A i.e. Hydroxycobalamine Improvement in toxic amblyopias/ tobacco induced optic neuropathy may be hastened by intramuscular injections of 1000 microgram hydroxycobalamine | train | med_mcqa | null |
Which among the following is a MAO inhibitor? | [
"Phenelzine",
"Amitriptyline",
"Benztropine",
"Clonazepam"
] | A | Both phenelzine and amitriptyline are used in the treatment of major depression. Phenelzine, an MAO inhibitor, augments available catecholamine neurotransmitters for release into the synaptic cleft by inhibiting the intraneuronal breakdown of norepinephrine, serotonin, and dopamine. The degree of enzyme inhibition appears to be directly related to the antidepressant effect. Amitriptyline, a tricyclic antidepressant, exes its therapeutic effect by means of inhibition of serotonin reuptake into the presynaptic neuron, thus enhancing the availability of neurotransmitter for action on the postsynaptic neuron. There is controversy surrounding the use of these medications for obsessive-compulsive disorder, phobic disorder, and panic attack, in which derangements in catecholamine neurotransmitters are also implicated. Clonazepam is a benzodiazepine used primarily as an anticonvulsant in the treatment of akinetic and myoclonic seizures. Haloperidol is a high potency antipsychotic agent with minimal anticholinergic propeies and maximal dopamine-blocking propeies; it is used in the treatment of schizophrenia, manic-depressive disorder, and other psychotic states. Benztropine is an anticholinergic used to manage the pseudoparkinsonian and extrapyramidal side effects of the higher potency antipsychotic agents like haloperidol. Ref: Olson K.R. (2013). Chapter 38. Poisoning. In M.A. Papadakis, S.J. McPhee, M.W. Rabow (Eds), CURRENT Medical Diagnosis & Treatment 2013. | train | med_mcqa | null |
An evidence that splenectomy might benefit a patient with idiopathic thrombocytopenic purpura includes which of the following | [
"A signifificant enlargement of the spleen",
"A high reticulocyte count",
"Patients age less than five years",
"An increase in platelet count on coicosteroid therapy"
] | D | Splenectomy is not indicated in non-bleeding ITP for 6 months with platelet count above 50,000 /cu.mm.reaponse rate 80%.relapse of ITP after splenectomy is 10%.it is probably due to hepatic sequestration of platelets in such patients or presence of accessory spleens Ref: SRB&;s manual of surgery,ed5, pg no 675 | train | med_mcqa | null |
A diabetic female at 40 wks of gestation delivered a baby by elective cesarean section. Soon after birth, the baby developed respiratory distress. The diagnosis is - | [
"Transient tachypnea of the new bom",
"Congenital diaphragmatic hernia",
"Tracheo oesophageal fistula",
"Hyaline membrane disease"
] | A | Ans. is 'a' Transient tachypnea of the newborn (Ref. Nelson, 16th/e, p. 505; Ghai O.P., 5th/e, p. 145).lam going against the majority in this question. Most of the students believe that the answer is a Hyaline membrane.Now read carefully what Nelson has to say about HMD." Hyaline membrane disease occurs primarily in premature infants, the incidence is inversely proportional to the gestational age and birth weight. It occurs in 60-80% of infants less than 28 wks of gestational age, in 15-30% of those between 32 and 36 wks in about 5% beyond 37 wk and rarely at term*".So it must be clear to you that hyaline membrane disease is rare in a term infant and the infant in question is a term infant (40 wks).About transient tachy apnea, It's written that "it usually follows uneventful normal preterm or term vaginal delivery or Cesarian delivery. "SOHyaline membrane disease is an important cause of respiratory distress in preterm infants and rarely in term infants whereas transient tachy apnea of the newborn causes respiratory distress in term infants.Now the only confusion left us about diabetes (it increases the incidence of hyaline membrane disease in infants.1 thinks the history of diabetes is given to confuse us.Remember that prematurity is the most important factor for HMD.Well, It's just my way of interpretation of the facts, I may be wrong on this one. | train | med_mcqa | null |
An outbreak of streptococcal pharyngitis has occured in a remote village. In order to carry out the epidemiological investigations of the outbreak it is necessary to perform the culture of the throat swab of the patients suffering from the disease. The transpo media of choice would be - | [
"Salt mannitol media",
"Pike's media",
"Stua's media",
"Cary Blair media"
] | B | Ans. is 'b' i.e., Pike's media "For cultures, swabs should be collected under vision from the affected site and either plated immediately or sent to the laboratory in Pike's medium (blood agar containing crystal violet and sodium azide)". | train | med_mcqa | null |
The current treatment of choice for a large antrochoanal polyp in a 30 year old man is - | [
"Intranasal polypectomy",
"Caldwell luc operation",
"F.E.S.S. (Endoscopic Sinus Surgery)",
"Lateral Rhinotomy and excision"
] | C | FESS is the treatment of choice for all polyps, whenever available and has superceded other methods of polyp removal. | train | med_mcqa | null |
Sympathetic ganglion develops from ? | [
"Surface ectoderm",
"Mesoderm",
"Neural crest",
"Mesenchymal neuroectoderm"
] | C | Ans. is 'c' i.e., Neural crest | train | med_mcqa | null |
The process in which a material melts to form a crystalline phase and a liquid phase known as: | [
"Incongruent melting",
"Congruent melting",
"Sintering",
"Ceramming"
] | A | When feldspar is heated at temperatures between 1150°C and 1530°C, it undergoes incongruent melting to form crystals of leucite in a liquid glass. Incongruent melting is the process by which one material melts to form a liquid plus a different crystalline material.
This tendency of feldspar to form leucite during incongruent melting controls thermal expansion during the use of porcelains for metal bonding.
Reference: PHILLIPS’ SCIENCE OF DENTAL MATERIALS, 12th ed page no 430 | train | med_mcqa | null |
Bull's eye lesion seen with: | [
"Chloroquine",
"Dapsone",
"Rifampicin",
"Ethambutol"
] | A | Ans. Chloroquine | train | med_mcqa | null |
All of the following structures lie in the renal medulla, Except | [
"Juxtaglomerular apparatus",
"Loop of Henle",
"Collecting duct",
"Vasa Recta"
] | A | Ans. (a) Juxtaglomerular apparatus(Ref: Ganong, 25th ed/p.672)Structures that lie in renal medulla are,#Loop of Henle#Medullary collecting duct#Vasa recta | train | med_mcqa | null |
The term infantile polyaeritis nodosa was formerly used for | [
"Goodpasteurs syndrome",
"Henoch schenon purpura",
"Kawasaki disease",
"Takaysaus aeritis"
] | C | Refer Robbins page no 510 Clinically infantile polyaeritis nodosa often ilia pa of the spectrum of Kawasaki disease | train | med_mcqa | null |
Method used to examine periphery of retina: | [
"Direct ophthalmoscopy",
"Retinoscopy",
"Indirect ophthalmoscopy",
"None"
] | C | - With Indirect ophthalmoscope Field of view is much larger & Examination of peripheral retina up to ora serratais possible. - Used along with scleral indentation to obtain ora serrata and pars plana visualization in difficult situations - Image formed is real & inveed - Feild of vision = 8DD (1DD= 1.5mm) - Convex lens of +20 D is used, commonly USES- in periphral Retinal breaks , Retinal detachement ROP evaliation | train | med_mcqa | null |
Post translational modification in the form of sulfation of tyrosine residue happen in which GIT hormone: | [
"Gastrin",
"Somatostatin",
"CCK",
"VIP"
] | C | Post translational modification is responsible for ceain changes in the peptide structure of GIT hormones, eg: 1. Peptide cleavage to smaller forms occurs in case of somatostatin 2. Amidation of the carboxyterminus occurs in the case of Gastrin 3. Sulfation of the tyrosine residue in the case of CCK (Cholecystokinin). Sulfated CCK is 100 times more potent than normal CCK. Ref: Sleisenger and Fordtrans, Edition-9, Page -6. | train | med_mcqa | null |
All age groups are included in numerator of dependency ratio except - | [
"0-5 years",
"5-10 years",
"20-60 years",
"> 65 years"
] | C | Numerator in dependency ratio includes:-
i) 0-14 years (option a & b)
ii) > 65 years (option d) | train | med_mcqa | null |
Transplacental crossing is not seen in – | [
"Iso immune haemolytic anemia",
"Rh–haemolytic anemia",
"Toxoplasmosis",
"Toxic erythema"
] | D | Toxic erythma is a normal finding in newborn.
In Rh incompatibility and ABO incompatibility antibodies can cross placenta and cause erythroblastosis fetalis.
Toxoplasmosis can cross placenta. | train | med_mcqa | null |
Most common soft tissue tumor in a child: | [
"Rhabdomyosarcoma",
"Histiocytoma",
"Fibrosarcoma",
"Liposarcoma"
] | A | (a) Rhabdomyosarcoma- Rhabdomyosarcoma, the most common childhood soft-tissue sarcoma, is often located in the head and neck (40%) and in the trunk and extremities (25%). | train | med_mcqa | null |
Burns involving the eyelid leads to formation of - | [
"Spastic ectropion",
"Mechanical ectropion",
"Cicatricialectropion",
"None of the above"
] | C | Ans. is 'c' i.e., Cicatricial ectropion ECTROPIONo Out rolling or outward turning of the lid margin is called ectropion.Typeso Senile ectropion. It is the commonest variety and involves only the lower lids. It occurs due to senile laxity of the tissues of the lids and loss of tone of the orbicularis muscle,o Cicatricial ectropion. It occurs due to scarring of the skin and can involve both the lids. Common causes of skin scarring are: thermal burns, chemical bums, lacerating injuries and skin ulcers,o Paralytic ectropion. It results due to paralysis of the seventh nerve. It mainly occurs in the lower lids. Common causes of facial nerve patsy are: Bell's palsy, head injury and infections of the middle ear.o Mechanical ectropion. It occurs in conditions where either the lower lid is pulled down (as in tumours) or pushed out and down (as in proptosis and marked chemosis of the conjunctiva),o Spastic ectropion. It is a rare entity, seen in children and young adults following spasm of the orbicularis, where lids are well supported by the globe. | train | med_mcqa | null |
The extraocular muscles are derived from which of the following structures? | [
"Branchial arches",
"Optic cup ectoderm",
"Somites",
"Somitomeres"
] | D | The somitomeres are specialized masses of mesoderm found in the head region that give rise to the muscles of the head. The extraocular muscles are derived from somitomeres 1, 2, 3, and 5. | train | med_mcqa | null |
Telephone scotologia is | [
"Exhibitionism",
"Voyeurism",
"Frotteurism",
"Fetishism"
] | A | Ans. is 'a' i.e., Exhibitionism * Making obscene telephone calls for sexual pleasure is known as telephone scatologia and is considered a form of exhibitionism.* Exhibitionism (Sec 294 IPC): It is a willful and intentional exposure of the genitalia in a public place while in the presence of others to obtain sexual pleasure. May or may not be associated with masturbation (punishment = 3 months + fine).* Voyeurism = Scoptophilia = Peeping tom: Sexual gratification is obtained by looking at the sexual organs of other persons, watching the act of sexual intercourse, or witnessing undressing by a woman.* Frotteurism : Sexual satisfaction is obtained by rubbing against persons in crowd. If they attempt intercourse, they have a premature ejaculation or they are impotent. It is an uncommon perversion and rarely occurs alone.* Fetishism : A fetish is an abnormal stimulus or object of sexual desire. Fetishism means the use of such objects of sexual gratification leading to orgasm. For example underclothing, brassiere, petticoat, stocking, shoes, etc. | train | med_mcqa | null |
Iron is present in all of the following except | [
"Myoglobin",
"Cytochrome",
"Catalase",
"Pyruvate Kinase"
] | D | null | train | med_mcqa | null |
All are true of standardized mortality ratio except - | [
"Expressed as rate per year",
"Can be adjusted for age",
"Can be used for events other than death",
"Ratio of observed deaths to expected deaths"
] | A | Standardization is most commonly used for age.
Standardization can be used not only for age, but also sex, race, parity, etc.
SMR is the ratio of observed death to expected death and it is usually expressed as a percentage.
SMR is commonly used in occupational studies for comparison of morality in an industry and general population.
SMR can be used for occurrence of disease (rather than death). | train | med_mcqa | null |
Xantheurenic acid is produced in - | [
"Tyrosine metabolism",
"Tryptophan metabolism",
"Cysteine metabolism",
"Valine metabolism"
] | B | Ans. is 'b' i.e., Tryptophan metabolism o Serotonin secretion is increased in carcinoid syndrome which causes flushingQ. VasoconstrictionQ, diarrheaQ and bronchospasm (respiratory distress),Metabolism of tryptophano Tryptophan is an essential amino acidQ, containing indol ringQ. Tryptophan is oxidized to produce alanine (which is glucogenic) and acetyl-CoA (which is ketogenic). Therefore, tryptophan is both glucogenic and ketogenic. Tryptophan is precursor for the biosynthess of niacinQ (a vitaminQ), serotonin (a neurotransmitter) and melatoninQ (a hormone).o Tryptophan metabolism occurs by two pathways: (i) kinurenine pathwayQ and (ii) serotonine pathway.1) Kynurenine pathway :- Tryptophan is oxidized to kynurenine, which is then converted to either niacin (nicotinic acid) or acetyl-CoA. In the reaction alanine is also produced. o Deficiency of tryptophan can cause deficiency of niacin (if also deficient in diet). This can leads to Pallegra: dermatitis, diarrhea and dementia.o For every 60 mg of tryptophan, 1 mg. equivalent of niacin can be generatedQ.o In vitamin B6 deficiency the metabolism is shuted to xanthurenic acid. Therefore, xantheurenic acid excretion is increased in urine.2) Serotonin pathway:- Tryptophan is first oxidized to serotonine which is further converted to melatonin. | train | med_mcqa | null |
Which of the following is associated with obsessive compulsive dissorder? | [
"Mania",
"Depression",
"Delusion",
"Schizophrenia"
] | B | At least 1/2 of the people with OCD later develop sever depressive episode. They are considered as a seperate condition. | train | med_mcqa | null |
Ulcer that may develop in burn tissue is: | [
"Marjolin's",
"Rodent",
"Melanoma",
"Curlings"
] | A | When a squamous cell carcinoma (SCC) appears in scar it is known as Marjolins's ulcer. Ref: Bailey and Love's Sho Practice of Surgery, 22nd Edition, Page 133, 25th Edition, Page 611 and 23rd Edition, Page 148; Clinical Surgery By S. Das, Page 108. | train | med_mcqa | null |
Which of the following cause Teratogenecity - | [
"Vit. C",
"Vit. E",
"Vit. A",
"Vit. D"
] | C | Vit A is teratogenic and can cause craniofacial CVS and CNS defects. | train | med_mcqa | null |
Which dietary vitamin is required for transaminase reactions? | [
"Thiamine",
"Folic acid",
"Pyridoxine",
"Cyanocobalamin"
] | C | Pyridoxal phosphate paicipates in transamination by cycling between the pyridoxal and pyridoxamine forms. Thiamine is a cofactor for transketolase and the -ketoacid dehydrogenases. Folate functions in single carbon transfer reactions. Vitamin B12 functions in methionine synthase and methylmalonyl CoA mutase. | train | med_mcqa | null |
Isotope which is replacing radium is: | [
"Cesium",
"Iridium",
"Gold",
"Californium"
] | B | Ans. Iridium | train | med_mcqa | null |
A 36-year-old man developed neck and left arm pain. He noted paresthesias in the left index and long fingers. He was found to have weakness of the left triceps muscle and a diminished left triceps jerk. His left-sided disc herniation is most likely to be at:- | [
"C3-C4",
"C4-C5",
"C5-C6",
"C6-C7"
] | D | DISCUSSION: This patient has all of the neurologic components of the most common cervical disc syndrome, that caused by a herniation at the C6-C7 level with compression of the C7 nerve root. | train | med_mcqa | null |
Isomer different in position for -H and -OH at 2nd, 3rd and 4th carbon atom of glucose are called as- | [
"a) Optical isomers",
"b) Epimers",
"c) Anomers",
"d) D,L isomers"
] | B | Epimerism (Diastereoisomerism) - When sugars are different from one another, only in configuration with regard to a single carbon atom, other than the reference carbon atom, they are called epimers. Epimers of glucose-a) 2nd Epimer of Glucose - Mannoseb) 3rd Epimer of Glucose - Allosec) 4th Epimer of Glucose - Galactose | train | med_mcqa | null |
High copper amalgam can be produced | [
"From smooth atomized particles",
"From irregular and spherical particles",
"From lathe cut particles",
"From traditional alloy particles"
] | B | null | train | med_mcqa | null |
Diet given to pregnant lady under ICDS is | [
"3000Kcal with 60grams of protein",
"800Kcal with 25grams of protein",
"500Kcal with 12grams of protein",
"600Kcal with 18grams of protein"
] | D | In ICDS supplementary nutrition is given to children below 6 years, nursing and expectant mothers from low-income group.Each child 6-72 months of age get 500 Cal and 12-15Gm of proteinSeverely malnourished child 6-72 months of age get 800 Cal and 20-25Gm of proteinEach pregnant and nursing women to get 600 Cal and 18-20Gm of proteinPark 23e pg: 591 | train | med_mcqa | null |
the above marked structures are seen in a condition where most common cause of death is ? | [
"heafailure",
"aspirational pneumonia",
"renal failure",
"neuroparalytic coma"
] | B | Alzheimer&;s Disease * The most common cause of Dementia -- Progressive Memory Loss Plus loss in one other area of cognition: * Perception * Attention * Language/Symbols * Judgment * Reasoning * Problem Solving * Interferes with Activities of Daily Living * Other causes (stroke) and mimics (depression) ruled out . PATHOPHYSIOLOGY * Alzheimer&;s disease attacks nerves and brain cells as well as neurotransmitters. * The destruction of these pas causes clumps of protein to form around the brain&;s cells. These clumps are known as &;plaques&; and &;bundles&;. The presence of the &;plaques&; and &;bundles&; sta to destroy more connections between the brain cells, which makes the condition worse. neurofibrillary tangles are seen in brain parenchyma which due to neuronal damage leading to extracellular deposition which is stained with BIELISCHOWSKY STAINING . REF: ROBBINS 10TH ED | train | med_mcqa | null |
EMLA for newborns is: | [
"Contraindicated",
"Safe",
"Does not cause methemoglobinemia",
"Should be given in reduced doses"
] | B | Standard dosing of the topical local anesthetic EMLA (a mixture of lidocaine and prilocaine) in term newborns produced minimal amounts of methemoglobin, and EMLA should be regarded as very safe in the great majority of newborns Ref: Miller's anesthesia-7th ed , Chapter 30. | train | med_mcqa | null |
One of the following will always present with Bilious vomiting - | [
"Pyloric stenosis",
"Esophageal atresia",
"Atresia of the 3rd part of the duodenum",
"Malrotation of the gut"
] | C | The CBD opens into the 2nd part of duodenum. So obstructions which are proximal to it like pyloric stenosis & esophageal atresia would not have bile in their associated vomits.
Bilious vomiting would only occur if the obstruction is distal to CBD opening.
Atresia of the 3rd part of duodenum would always produce bilious vomiting.
Malrotation of the gut is a broad entity and may manifest clinically in several different ways. The vomiting may be bilious or nonbilious. | train | med_mcqa | null |
Which structures are preserved in scanlon's modified radical mastectomy | [
"Lateral pectoral nerves",
"Level III nodes in axilla",
"Pectoral fascia",
"Nipple and the areola"
] | A | .* Scanlon's operation: Is a modified Patey's operation wherein instead of removing pectoralis minor, it is incised to approach the affected Level III lymph nodes.* Auchincloss modified radical mastectomy: Here pectoralis minor muscle is left intact and level III lymph nodes are not removed. ref:SRB's manual of surgery,ed 5,pg no 547 | train | med_mcqa | null |
A 36 years old multigravida at 34 weeks, with previous 2 LSCS now presented with unstable lie. The most likely diagnosis in this case is: | [
"Oligohydramnios",
"Placenta previa",
"Pelvic tumor",
"Uterine anomalies"
] | B | Ans. b. Placenta previa (Ref: Dutta 6/e p244, 251)Oligohydraminos does not present with unstable lie.History of previous cesarean section or any scar on uterus is a predisposing factor for Placenta previa.Placenta PreviaDefinition: When placenta is attached partly or completely in lower uterine segmentPrevia means in front ofPredisposing FactorsMultiparous womenQAge >35 yearsQHistory of previous cesarean section or any scar on uterusQLarge placenta sizeQ Types/Degree of Placenta Previa (PP) (Norman and White)I* Low lying (Lateral)QII* Marginal (Dangerous PP)QIII* Partial (Incomplete central)QIV* Total (Complete central)QClinical Features:Bleeding in PP is always maternalQ.Sudden ''painless" vaginal bleeding, causeless, recurrentQOn abdominal examination:Malpresentation is more commonQHead floating in contrast to period of gestationQUterus feel: Soft, relaxed, no tendernessQStall-Worthy's SignSlowing of heart rate on pressing the head down into the pelvis which soon recovers promptly as pressure is released, is suggestive of low lying placenta specially posterior typeQ.Diagnosis:USG: Most accurate method for localization of placentaQExpectant Management for Placenta Previa (Johnson's and Macafee Regimen):\Suitable cases for expectant management:Mother is in good condition, patient not in labour and should be hemodynamically stableQHb 10 gm% or morePregnancy <37 weeksQFHS: goodActive bleeding absentInitial bout of bleeding <600 mlExpectant treatment carried up to 37 weeks i,e. Baby becomes maturePremature termination of expectant treatment may be doneRecurrence of brisk hemorrhageQFetus is deadQFetus is found congenitally malformed on investigationsQExpectant Management for Placenta Previa (Johnson's and Macafee Regimen)Suitable cases for expectant management:Mother is in good condition, patient not in labour and should be hemodynamically stableQHb 10 gm% or morePregnancy <37 weeksQFHS: goodActive bleeding absentQInitial bout of bleeding <600 mlExpectant treatment carried upto 37 weeks i.e. Baby becomes mature Premature termination of expectant treatment may be done:Recurrence of brisk hemorrhageQFetus is deadQFetus is found congenitally malformed on investigationsQ | train | med_mcqa | null |
Endoscope wash with diy water is associated with ? | [
"M. tuberculosis",
"M. bovis",
"M. chelonea",
"M. ulcerans"
] | C | .endoscope wash with diy water is often associated with a wide spectrumof clinical manifestations which mainly includes infection by mycobacterium chelonae.it belongs to the non tuerculous bacteria and is grouped under rapidly growing bacteria. ref:SRB&;s manual of surgery,ed 3,pg no 499 | train | med_mcqa | null |
All of the following are disruptive & impulse control disorders, except : | [
"Munchausen syndrome",
"Conduct disorder",
"Intermittent explosive disorder",
"Oppositional defiant disorder"
] | A | Munchausen syndrome is a mental illness where the patient feigns symptoms deliberately without ant motive. | train | med_mcqa | null |
Classical sign of neovascular glaucoma is | [
"Retinal neovascularization",
"Disc neovascularization",
"Ciliary body neovascularization",
"Iris neovascularization"
] | D | Ans. (d) Iris neovascularizationRef.: A.K. Khurana 6th ed. /250-51* Neovascular glaucoma results from the formation of a neovacular membane involving the anterior chamber secondary to diffuse retinal hypoxia. There is release of factors like vascular endothelial growth factor (VEGF) from the vitreous which causes formation of abnormal new blood vessels over the iris. The fibrovascular membrane then progressively closes the angle of the anterior chamber.* It is usually associated with neovascularisation of the iris (rubeosis iridis). | train | med_mcqa | null |
The cement, which is least soluble in oral cavity: | [
"Glass ionomer",
"Resin cement",
"Polycarboxylate cement",
"Silico — phosphate cement"
] | B | null | train | med_mcqa | null |
Pelvis with only one ala is known as: March 2010 | [
"Rachitic pelvis",
"Naegele's pelvis",
"Scoliotic pelvis",
"Robe's pelvis"
] | B | Ans. B: Naegele's Pelvis If ala is absent on one side, it is Naegele's pelvis. If alae of both the sides are absent, it is known as Robe's pelvis Delivery in both the condition is done by caesarean section. | train | med_mcqa | null |
A 56-year-old man has painful weeping rashes over the upper eyelid and forehead for the last 2 days along with ipsilateral acute punctuate keratopathy. About a year back, he had chemotherapy for Non-Hodgkin's lymphoma. There is no other abnormality. Which of the following is the most likely diagnosis? | [
"Impetigo",
"Systemic Lupus Erythematosus",
"Herpes Zoster",
"Pyoderma gangrenosum"
] | C | It is a case of infection with Herpes Zoster.
The point which leaves no doubt about the diagnosis of Herpes zoster
Painful (unilateral) rashes over upper eyelid and forehead
H/O chemotherapy for Non-hodgkin's lymphoma
Ipsilateral acute punctate keratopathy
Herpes infections are characterized by pain and its occurrence in an immunocompromised patient.
Patients with Hodgkin's disease and Non-Hodgkins lymphoma are at great risk of developing progressive herpes zoster. | train | med_mcqa | null |
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