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 |
|---|---|---|---|---|---|---|
Prokaryotes are characterized by? | [
"Absence of nuclear membrane",
"Presence of microvilli on its surface",
"Presence of smooth Endoplasmic Reticulum",
"All of the above"
] | A | Based on differences in cellular organization and biochemistry this kingdom has been divided into two groups: prokaryotes and eukaryotes. Bacteria and blue-green algae are prokaryotes while fungi other algae, slime molds, and protozoa are eukaryotes. Bacteria are prokaryotic microorganisms that do not contain chlorophyll. They are unicellular and do not show true branching except in the so-called higher bacteria. Ref: Textbook of Microbiology; Ananthanarayan and Paniker; 9th edition; Pg no: 9 | train | med_mcqa | null |
Regarding drug conversion which of the following is considered as useless | [
"Inactive drug to inactive metabolite",
"Active drug to active metabolite",
"Inactive drug to active metabolite",
"all the above"
] | A | Ans) a ( Inactive drug ...) Ref Goodman and gilman ll'h ed, KDT 7"1 ed, general pharmacologyDirect pick from KDTBiotrasformation means chemical alteration of drug in the body.lt is needed to render nonpolar compounds polar, so that they are not reabsorbed in the renal tubules and are excreated. The primary site for drug metabolism is liver; other are kidney,intestine,lungs and plasma.Biotransformation of drugs may lead to the following and are considered useful1. Inactivation of active drug metabolite2. Active metabolite from an active drug3. Activation of an inactive drugSo coversion of inactive drug to inactive metabolite is useless in biotransformation.Most metabolic biotransformations occur at some point between absorption of the drug into the general circulation and its renal elimination.A few transformations occur in the intestinal lumen or intestinal wall. In general, all of these reactions can be assigned to one of two major categories called phase I and phase II reactionsPhase I reactions usually convert the parent drug to a more polar metabolite by introducing or unmasking a functional group (-OH, -NH2, -SH).Often these metabolites are inactive, although in some instances activity is only modified or even enhanced.Some times phase I undergo a subsequent reaction in which an endogenous substrate such as glucuronic acid, sulfuric acid, acetic acid, or an amino acid combines with the newly incorporated functional group to form a highly polar conjugate.Such conjugation or synthetic reactions are the hallmarks of phase II metabolism.For example, the hydrazide moiety of isoniazid is known to form an /V-acetyl conjugate in a phase II reaction. This conjugate is then a substrate for a phase I type reaction, namely, hydrolysis to isonicotinic acid. Thus, phase II reactions may actually precede phase I reactions. | train | med_mcqa | null |
Which of the following are situated away from the coding region | [
"Promoter",
"Enhancer",
"Operator",
"All of these"
] | D | Structural genes are present in coding region. Rest all genes, like promoter gene, operator gene, regulatory gene (enhancer/repressor), are present away from coding region. | train | med_mcqa | null |
A normal healthy child has a height of 100 cm and weighs 16 kg. What is his most likely age ? | [
"3 years",
"4 years",
"5 years",
"6 years"
] | B | null | train | med_mcqa | null |
How many weeks are required approximately for complete uterine involution during puerperium? | [
"4",
"6",
"12",
"20"
] | B | Uterine involution is nearly complete by 6 weeks, at which time the organ weighs less than 100 g. Myometrial contractions, or afterpains, assist in involution. These contractions occur during the first 2-3 days of the puerperium and produce more discomfo in multiparas than in primiparas. Such pains are accentuated during nursing as a result of oxytocin release from the posterior pituitary. During the first 12 hours postpaum, uterine contractions are regular, strong, and coordinated. In case of abnormal uterine involution, infection and retained products of conception should be ruled out. Ref: Pessel C., Tsai M.C. (2013). Chapter 10. The Normal Puerperium. In A.H. DeCherney, L. Nathan, N. Laufer, A.S. Roman (Eds), CURRENT Diagnosis & Treatment: Obstetrics & Gynecology, 11e. | train | med_mcqa | null |
Which of the following statements about Von-Hippel Lindau syndrome is true - | [
"Multiple tumors are rarely seen",
"Craniospinal hemangioblastomas are common",
"Superatentorial lesions are common",
"Tumors of Schwann cells are common"
] | B | null | train | med_mcqa | null |
Calcification is best detected by | [
"X-ray",
"USG",
"CT Scen",
"MRI"
] | C | C i.e. CT Scan | train | med_mcqa | null |
Gallow's traction is used for fracture: | [
"Shaft femur",
"Neck femur",
"Shaft tibia",
"Tibial tuberosity"
] | A | Ans is 'a' i.e. Shaft femur Gallows traction is used for treatment of fracture shaft femur, in infants and children < 2 yrs of age.Weight must not be more than 12 kgs.Both the fractured and the normal femur are placed in skin traction and the infant is suspended by these from a special frame. The buttocks should be lifted just off the bed so that the weight of the body provides counter traction and the fracture is reduced.Russel's traction or Thomas splint is used for fracture shaft femur in older children. | train | med_mcqa | null |
Best index of platelet function is: | [
"Bleeding time",
"Clotting time",
"Clot retraction time",
"Prothrombin time"
] | C | Bleeding time (N = 1-3 min) is an index of platelet number. Bleeding time is prolonged when platelet number falls below 50,000/mm3. Clot retraction is a function of platelets. The contractile filaments of platelets, in the platelet plug, are responsible for retraction of the clot that has formed on the surface of the platelet plug. Clot retraction occurs by 30-60 minutes after the formation of clot. | train | med_mcqa | null |
A 88 years male patients presented with end stage renal disease with coronary aery block and metastasis in the lungs. Now presents with acute cholecystitis, patient's relatives need treatment to do something - | [
"Open cholecystectomy",
"Tube cholecystostomy",
"Laparoscopic cholecystectomy",
"Antibiotics then elective cholecystectomy"
] | B | Ans. is 'b' i.e., Tube cholecystostomy | train | med_mcqa | null |
Chalcosis is deposition of:September 2010, March 2013 | [
"Iron",
"Calcium",
"Copper",
"Lead"
] | C | Ans. C: CopperA deposit of fine paicles of copper in the lungs or other tissues is known as chalcosis. | train | med_mcqa | null |
Left lobe is responsible for | [
"Appreciation of Music",
"Spatial orientation",
"Visual Stimuli Processing",
"Written and Spoken Language"
] | D | D i.e. Written and Spoken Language | train | med_mcqa | null |
Functional basic of ionising radiation depends on – | [
"Pyramidine base pairing",
"Removal of orbital electron",
"Linear energy transfer",
"Adding orbital electron"
] | B | Ionizing radiation gives energy to an electron which results in excitation of electron and if radiation carries enough energy there is ejection of an electron from the atom, leaving its parent atom positively charged.
Excitation:- Elevation of an electron to a higher energy level without actual ejection of the electron. It occurs when radiation excites an electron from an occupied orbit into a higher energy orbit.
Ionization:- There is an actual ejection of electrons from atom. an It occurs when radiation carries enough energy to completely remove an electron from an atom. | train | med_mcqa | null |
A calcium channel sensitizer approved for use in treatment of Congestive Hea failure is- | [
"Levosimendan",
"Nesitritide",
"Vasopressin",
"Nitroprusside"
] | A | levosimendan is a calcium channel channel sensitiser used in CHF Levosimendan is a calcium sensitiser that can be administered intravenously (IV) to patients with acute decompensated congestive hea failure (CHF). At therapeutic dosages levosimendan enhances myocardial contractility without increasing oxygen requirements, and causes coronary and systemic vasodilation. Ref Davidson edition23rd pg 463 | train | med_mcqa | null |
ST elevation is seen in all of the following conditions except - | [
"Myocardial infarction",
"Coronary aery spasm",
"Constrictive pericarditis",
"Ventricular aneurysm"
] | C | Constrictive pericarditis is a medical condition characterized by a thickened, fibrotic pericardium, limiting the hea's ability to function normally.In many cases, the condition continues to be difficult to diagnose and therefore benefits from a good understanding of the underlying cause Signs and symptoms of constrictive pericarditis are consistent with the following: fatigue, swollen abdomen, difficulty breathing (dyspnea), swelling of legs and general weakness. Related conditions are bacterial pericarditis, pericarditis and pericarditis after a hea attack The pathophysiological characteristics of constrictive pericarditis are due to a thickened, fibrotic pericardium that forms a non-compliant shell around the hea. This shell prevents the hea from expanding when blood enters it. This results in significant respiratory variation in blood flow in the chambers of the hea. During inspiration, pressure in the thoracic cavity decreases but is not relayed to the left atrium, subsequently a reduction in flow to the left atrium and ventricle happens. During diastole, less blood flow in left ventricle allows for more room for filling in right ventricle and therefore a septal shift occurs During expiration, the amount of blood entering the right ventricle will decrease, allowing the interventricular septum to bulge towards the right ventricle, and increased filling of the [[left ventricle and subsequent increased pressure generated by the left ventricle during systole.This is known as ventricular interdependence, since the amount of blood flow into one ventricle is dependent on the amount of blood flow into the other ventricle. Ref Harrison 20th edition pg 1445 | train | med_mcqa | null |
Integrin connects actin to which macromolecule in ECM? | [
"Vitronectin",
"Laminin",
"Fibronectin",
"Collagen"
] | C | Ans. C. Fibronectin > LamininIntegrins localized in the plasma membrane are the major adhesion receptor connecting cells with components of the extracellular matrix. Integrins interact directly with laminin and mainly fibronectin present in the basal lamina and intracellularly contact actin through intermediate proteins, such as alpha-actinin, vinculin, and talin. Integrins are calcium-independent adhesion molecules. | train | med_mcqa | null |
Which amino acids are absorbed in enterocytes through Meister cycle? | [
"Dibasic amino acids",
"Basic amino acids",
"Dicarboxylic amino acids",
"Neutral amino acids."
] | D | Absorption of neutral amino acids requires Meister cycle Glutathione is essential here 3 ATPs are used in this cycle to transpo one amino acid Not a common transpo system for amino acids | train | med_mcqa | null |
A patient with microcytic hypochromic anemia, Hb-9%, serum iron is 20 p./d1, ferritin level 800 mg/ml, transferrin percentage saturation is 64. What is possible diagnosis aEUR' | [
"Atransferrinemia",
"Iron deficiency anemia",
"DMT 1 mutation",
"Hemochromatosis"
] | A | Atransferinemia Derangment in serum iron indices mentioned in the question : ? Microcytic hypochromic anemia Low serum iron - Normal (50-170 ,ug/dI) High serum. ferritin Normal (30-400 ng/ml) High serum transferrin Normal (30-50%) Let's look at the options first Iron deficiency anemia Can be easily ruled out as serum ferritin is low in Iron deficiency anemia. Hemochromatosis Hemochromato.sis is characterized by increased serum iron level. So, we are left with two options - Atransferinemia and DMT1 mutation These are classified in genetic forms of iron deficiency anemia. - Here is a brief discussion on genetic, forms of iron deficiency anemia. Genetic forms of Iron deficiency anemia -Iron deficiency anemia is an acquired disease. It is generally associated with low cost diet and bleeding. - Recent advances in iron metabolism led to the recognition of new entices of iron deficiency anemia in nonbleeding and "high cost diet" nourished individuals. These are known as genetic ,fonns of iron deficiency anemia. - Apparently rare these genetic .forms of iron deficiency anemia should be recognized by hematologists as they are refractory to classical oral or intravenous iron administration. These includes - Mutations in gene encoding DMT1 - Mutations in gene encoding glutaredoxin 5. - Hypotransferrinemia or Atransferriemia - Deficiency of ceruloplasmin - IRIDA (Iron Recractory, Iron Deficiency Anemia) Genetic forms of Iron deficiency anemia DMT1 Mutation Atransferrinemia Glutaredoxin 5 Aceruloplasminemia Age at diagnosis At bih Late onset Midlife Laic onset Anemia Microcytic hypochromic Microcytic hypochromic Microcytic hypochromic Microctic hypochromic Serum iron High Low High Low Transferrin saturation High High or non measurable High Low Serum ferritin Low or normal fen-itin High High High ,o Ringed sideroblasts No No Yes No Liver iron overload Yes Yes Yes Yes Brain damage No No No Yes Hepcidin levels Low et Not y measured Not yet measured Not yet measured Coming back to the question The serum iron indices of the patient match those of Atransferrinemia i.e., low serum iron increased serum ferritn, increased transferring saturation. DMT1 can be ruled out as it has low ferritin level and high iron level. Atransferrinemia Transferrin is an iron carrying protein that transmits iron to the erythroblasts. Atransferrinemia or hypotransferrinemia results in reduced delivery of iron to erythroblasts and development of iron deficient anemia. This leads to massive but .futile iron absorption. The increased iron that is absorbed is not carried to the erythroid cell, instead. it is deposited elsewhere outside of erythroblasts. Iron is deposited in the visceral organs rather than in the bone marrow. DMT Lmutation DMT1 is a tran.smembrane protein involved in dietary nonheme iron uptake at the brush border of duodenal enterocytes and also plays crucial role in iron utilization at the endosomal membrane of the erythroid precursors. In DMT1 mutation the iron absorption in the duodenum continues because the absorption of heme iron is not affected. The mutation primarily affects iron utilization and not absorption. Iron utilization in erythroid precursors is disturbed leading to severe iron deficiency anemia. | train | med_mcqa | null |
Drug not used in SIADH is : | [
"Demeclocycline",
"Desmopressin",
"Restriction of free water intake",
"3% NaCl"
] | B | null | train | med_mcqa | null |
Which of the following does not pass through cavernous sinus? | [
"Occulomotor (III) nerve",
"Trochlear nerve",
"Medial cerebral artery",
"Trigeminal nerve"
] | C | null | train | med_mcqa | null |
Term vaccine was coined by: September 2004 | [
"Robe Koch",
"Louis Pasteur",
"Needham",
"Goodpasture"
] | B | Ans. B i.e. Louis Pasteur | train | med_mcqa | null |
50 year tobacco chewer comes with chief complaints of a mass in the oral cavity of 1.5 cm with a single lymph node size <3 cm on ipsilateral neck. TNM stage is....... | [
"T1 N3",
"T3 N1",
"T2 N2",
"T1 N1"
] | D | Ans. (d) T1 N1Ref: Bailey and Love Page 709Staging of Oral cavity Cancer:* T1 - <2cm* T2- 2-4cm* T3 - 4-6cm* T4 - adjacent structure involvement* N1-Ipsilateral single node <3cm* N2 a- Ipsilateral single node 3-6cm* N2 b- Ipsilateral multiple nodes all <6cm* N2 c- Contralateral nodes<6cm* N3- any node >6cm size* M1-metastasis | train | med_mcqa | null |
Pus formation in lacerated wound occurs in: | [
"12-24 hours",
"24-48 hours",
"48-72 hours",
"1 week"
] | B | Normally, pus formation occurs in about 48 hours, but in a lacerated wound it occurs slightly earlier. | train | med_mcqa | null |
Cellular suppo is provided by: | [
"Mitochondria",
"Cytoskeleton",
"Golgi apparatus",
"All"
] | B | Cytoskeleton froms framework of the cell It has microtubules, microfilaments,intermediate filaments | train | med_mcqa | null |
In which of the following conditions the level of creatinine kinase 1 increases? | [
"Myocardial ischemia",
"Brain Ischemia",
"Kidney damage",
"Electrical cardioversion"
] | B | Ans. B. Brain IschemiaLocalization of CPK isoenzymesa. CPK 1 (CPK BB) - Brainb. CPK 2 (CPK MB) - Myocardiumc. CPK 3 (CPK MM) - Skeletal muscle | train | med_mcqa | null |
Bilaterally symmmetrical contracted scarred kidney is seen in- | [
"Nephrosclerosis",
"Chronic glomerulonephriris",
"End stage renal disease",
"Chronic pyelonephritis"
] | B | Ans. is 'b' i.e., Chronic glomerulonephritis | train | med_mcqa | null |
Addison's disease is characterized by all except - | [
"Hyperglycemia",
"Hypotension",
"Hyperkalemia",
"hyponatremia"
] | A | null | train | med_mcqa | null |
High energy phosphate compounds are: | [
"ATP",
"Creatinine phosphate",
"Acetyl CoA",
"All of the above"
] | D | A, B, C i.e. ATP, Creatinine phosphate, Acetyl CoA | train | med_mcqa | null |
Hyaluronic acid is present in | [
"Lens",
"Vitreous humour",
"Blood vessels",
"cornea"
] | B | Vitreous is composed of water, collagen and hyaluronic acid. Vitreous Humour. Vitreous humor is the fluid-like gel, composed of approximately 98-99% water with trace amounts of hyaluronic acid, glucose, anions, cations, ions, and collagen, located in the posterior chambers of the eyes Reference: khurana 6th edition pg 567 | train | med_mcqa | null |
A newborn baby presents with shock, hyperkalemia and hypoglycemia. What is the most likely diagnosis | [
"Septicemia",
"Inborn error of metabolism",
"Diabetes mellitus",
"Congenital adrenal hyperplasia"
] | D | These features of congenital adrenal hyperplasia may due to deficiency of 21-hydroxylase and present with ambiguous genetalia,polyuria,shock,recurrent vomiting and features of sepsis with negative septic screen. Reference : OP Ghai,essential paediatrics,8th edition page no 526 | train | med_mcqa | null |
Foreign body from trachea most common goes to right bronchus due to ? | [
"Right bronchus shallow",
"Wider & in continuous line with trachea",
"Right bronchus is longer",
"Right bronchus is horizontal"
] | B | Trachea bifurcates at Carina (at lower border of T4 veebra at T4-T5 disc space) into right and left principal (primary) bronchi. Right principal bronchus is wider, shoer (2.5 cm long), and more veical in the line of trachea (25deg with median plane). Therefore a foreign body is most likely to lodge in the right bronchus. | train | med_mcqa | null |
The most common cause of embolic stroke | [
"Non rheumatic atrial fibrillation",
"Carotid aery atherosclerosis",
"Paradoxical embolism",
"LV aneurysm"
] | A | Ans. is 'a' i.e., Non rheumatic atrial fibrillation No rheumatic atrial fibrillation leads to clot formation in left atrial appendage that can embolize to the brain leading to neurological dificits | train | med_mcqa | null |
To check power of IOL, which formula is commonly used: March 2010 | [
"Hoffer formula",
"Holladay formula",
"SRK formula",
"None of the above"
] | C | Ans. C: SRK formula Sander's-Retzlaff-Kraff (SRK) formula is the widely used formula for calculating the power of the intraocular lens to be implanted. It is based on a statistical correlation between calculated and observed refractive error after intraocular implantation. | train | med_mcqa | null |
Millard Gubler syndrome includes the following, except: | [
"5th nerve palsy",
"6th nerve palsy",
"7th nerve palsy",
"Contralateral hemiparesis"
] | A | Millard Gubler syndrome is not associated with 5th nerve palsy. Lateral rectus weakness (6th nerve involvement), ipsilateral facial palsy (7th nerve involvement) and contralateral hemiparesis (coicospinal tract involvement) are features of Millard Gubler syndrome. Ref: Harrison's Principles of Internal Medicine, 16th Edition, Page 175; Anatomic Basis of Neurologic Diagnosis, Cary D. Alberstone, Chapter 7, Page 272. | train | med_mcqa | null |
Regarding HIV which of the following statement is not TRUE? | [
"It is a DNA retrovirus",
"Contains Reverse Transcriptase",
"May infect host CD4 cells other than T-lymphocytes",
"Causes a reduction in host CD4 cells at late stage of disease"
] | A | The genome of HIV is diploid, composed of 2 identical single stranded positive sense RNA copies. In association with viral RNA is the reverse transcriptase enzyme which is the characteristic feature of retroviruses. Pathogenesis: When virus infects a cell RNA, viral RNA is transcribed by the enzyme, first to single stranded DNA and then to double stranded DNA which is integrated into the host cell chromosome. The provirus initiate viral replication by directing synthesis of viral RNA and other components. When naked virus buds outs through host cell surface membrane, it acquires a lipoprotein envelope which consist of lipid derived from the host cell membrane and glycoprotein which are virus coded. The spikes which constitute the major surface component of the virus, binds to CD4 receptors on susceptible host cells. The transmembrane pedicle cause cell fusion. Ref: Ananthanarayan and Panicker's Textbook of Microbiology, 8th Edition, Page 395 | train | med_mcqa | null |
Acalculous cholecystitis can be seen in all the following conditions except - | [
"Enteric fever",
"Dengue haemorrhagic fever",
"Leptospirosis .",
"Malaria"
] | D | Ans. is 'd' i.e., Malaria Both Dengue and malaria are uncommon causes of acalculous cholecystitis.But Malaria seems to be more uncommon between the two.Only two cases have so far been reported which establishes the association between malaria and acalculous cholecystitis.One has been reported from some, Spanish Hospital and the other one was reported from Mahatma Gandhi institute, in Wardha.There are some reports linking coinfection of Plasmodium vivax and Plasmodium falciparum with acalculous cholecystitisDengue and acalculous cholecystitisDengue is definitely associated with acalculous cholecystitis.Several cases of acalculous cholecystitis have been reported all over the word in patients with DengueA report published from a Taiwan Hospital has shown that there is definite association between Dengue and acalculous cholecystitisMore about Acalculus cholecystitisIn acalculous cholecystitis, there is acute inflammation of gallbladder without gallstones.In over 50% of cases of acalculous cholecystitis an underlying explanation is not found.Acalculous cholecystitis typically develop in critically ill patients in the ICU. Patients on parenteral hyperalimentation with extensive bums, sepsis, major operations, multiple trauma or prolonged illness with multiple organ system failure are at risk for developing acalculous cholecystitis.Harrison writes * "An increased risk for the development of acalculous cholecystitis is especially associated with serious trauma or bums, with the postpartum period following prolonged labor, and with orthopedic and other nonbiliary major surgical operations in the post operative period. It may possibly complicate periods of prolonged parenteral hyperalimentation. For some of these cases, biliary sludge in the cystic duct may be responsible. Other precipitating factors includevasculitis obstructing adenocarcinoma of the gall bladder diabetes mellitus torsion of the gall bladderunusual bacterial infections of the gall bladder (eg. Leptospira, Streptococcus, Salmonella, or Vibrio cholera), and parasitic infestation of gallbladder.* Acalculous cholecystitis may also be seen with a variety of other systemic disease processes sarcoidosis - syphilis cardiovascular disease - actinomycosistuberculosisClinical manifestation is indistinguishable from those of calculous cholecystitis, however, the setting of cholecystitis in severe underlying illness is characteristic of acalculous cholecystitis.U/S & CT examinations show a large, tense, static gallbladder without stones and with evidence of poor emptying over a prolonged period. Ultrasonography is usually the diagnostic test of choice, as it can be done bedside in the intensive care unit.ManagementThe complication rate of acalculous cholecystitis is more than calculous cholecystitis.Acalculous cholecystitis requires urgent intervention.Percutaneous ultrasound or CT guided cholecystostomy is the treatment of choice for these patients, as they are unfit for surgery.If the diagnosis is uncertain, percutaneous cholecystostomy is both diagnostic and therapeutic. About 90% of patients will improve with the percutaneous cholecystostomy. However, if they do not improve, other steps, such as open cholecystostomy or cholecystectomy, may be required.If needed cholecystectomy can be done after the patient has recovered from the underlying disease. | train | med_mcqa | null |
For isolating a gene of long DNA molecules (50-100 KB) following is used: | [
"Chromosome walking",
"Sanger's sequencing",
"RFLP",
"SSLP"
] | A | Ans. A. Chromosome walking(Ref: Harper 30/e page463)Chromosome WalkingMethod to isolate and clone target DNA from a long segment of DNAIn Chromosome walking, a fragment representing one end of a long piece of DNA is used to isolate another fragment, that overlaps the first but extends the first. This process continued till the target DNA is isolated.Cystic fibrosis (CF) gene was the first to be isolated solely by chromosome walking. | train | med_mcqa | null |
Not a feature of bronchial asthma: | [
"Thickening of bronchial wall",
"Increase in number of goblet glands",
"Hypertrophy of smooth muscle",
"Increased Ig E"
] | A | Ref: Robbin E-book, P 502-504* Increased numbers of goblet cells (goblet cell hyperplasia) is part of airway remodelling in asthma.* The remodelling also includes epithelial proliferation, thickening of the reticular basement membrane, increased bronchial vascularity and hypertrophy of smooth muscle and submucosal glands.* Thickening of bronchial wall is seen in bronchiectasis. | train | med_mcqa | null |
Most common presenting symptom of thread worm infection amongst the following is - | [
"Abdominal pain",
"Irritation and pruritus of perianal area",
"Uicaria",
"Vaginitis"
] | B | Threadworm causes enterobiasis The worm produces intense irritation and pruritus of the perianal and perineal area when it crawls out of anus to lay eggs.This leads to scratching and excoriation of skin around anus. Ref:panikers textbook of Medical parasitology 8th edition page 196 | train | med_mcqa | null |
The Millennium Development Goals (MDG) is to be achieved by the year- | [
"2010",
"2015",
"2020",
"2030"
] | B | Governments have set a date of 2015 by which they would meet the MDGs I.e, eradicate extreme povey and hunger;achieve universal primary education;promotes gender equality;improve maternal health,ensure environmental sustainability and develop a global panership for development (refer pgno:893 park 23rd edition) | train | med_mcqa | null |
Burst Fracture of spine is a - | [
"Compression Fracture",
"Extension injury",
"Direct injury",
"Flexion - rotation"
] | A | Burst fracture (crushed communited fracture) is caused by axial (vertical) compression injury. | train | med_mcqa | null |
7-methyl guanosine is added as a cap on mRNA. This methyl group is donated by: | [
"S-Adenosyl methionine (SAM)",
"Methenyl THF",
"Tetra hydro Folate (THF)",
"Vit B12"
] | A | Capping is a post transcriptional modification. 7-methyl guanosine cap is added at the 5'end of mRNA by Guanylyl Transferase. Methyl group is donated by SAM (S-Adenosyl Methionine) by enzyme Guanine-7-Methyl Transferase, which occurs in cytoplasm (rest all post transcriptional modifications occur in nucleus). This cap facilitate initiation of translation and stabilize mRNA by preventing it from attack by 5' exonucleases. Cap is attached to 5' end of mRNA by an unusual 5' 5' triphosphate linkage. | train | med_mcqa | null |
Commonest cause of female pseudo hermaphroditism is : | [
"Virlizing ovarian tumor",
"Ovarian dysgenesis",
"Exogenous androgen",
"Congenital adrenal hyperplasia"
] | D | Congenital adrenal hyperplasia The early development of the genital system is similar in both the sexes. Congenital defects in sexual development. usually arising from a variety of chromosomal abnormalities tend to present clinically with ambiguous external genitalia. These conditions are known as intersex or hermaphroditism. True hermaphroditismdeg : Individuals with this disorder have both ovarian and testicular tissue, most commonly as composite ovotestes but occasionally with an ovary on one side and testis on the other. Pseudo hermaphroditismdeg : The genetic sex indicates one sex whereas the external genitalia has characteristics of the other. Pseudo hermaphroditism is caused by either abnormal levels of sex hormones or abnormalities in sex hormone receptor. Female pseudohermaphroditism Genetic females (gonads ovaries) with masculinized external genitalia manifesting as - clitoral hyperophydeg and some degrees of fusion of urogenital or labioscrotal folds. Male pseudohermaphroditism Genetic males (Gonads testis) with feminized external genitalia manifesting as hypospadiasis, or incomplete fusion of the urogenital or labioscrotal folds of female pseudohermaphroditism Congenital adrenal hyperplasia (M/C cause)deg : 21 - hydroxylase (P450c21) deficiencydeg 113 - hydroxylase (P450c11) deficiencydeg 3 [3 - hydroxysteroid dehydrogenase deficiencydeg Elevated androgens in maternal circulation due drug intakedeg - testosterone, danazol norethindrone Maternal virilising ovarian tumourdeg Aromatase (P450arom) deficiencydeg Causes of male pseudohermaphroditism Androgen insensitivity syndrome (Androgendeg receptor abnormalities : 5tx - reductase deficiencydeg Testosterone biosynthesis defects 3 3 - hydroxysteroid dehydrogenase deficiencydeg 173 - hydroxylase (P450c17) deficiency deg 173 - hydroxysteroid dehydrogenase deficiencydeg Congenital lipoid adrenal hyperplasia (STAR deficiency)deg Gonadotropin - resistant testes Anti - mullerian hormone deficiency | train | med_mcqa | null |
What is the recommended daily energy requirement in a 15 kg child | [
"1500 KCal",
"1000 KCal",
"1250 KCal",
"1400 KCal"
] | C | Body weight
Recommended daily energy requirement
< 10 Kg
100 KCal / kg
10 - 20 kg
1000 KCal + 50 Kcal / Kg for each kg above 10 Kg
> 20 Kg
1500 KCal + 20 KCal / Kg for each kg above 20 kg
∴ 15 kg child
= 1000 KCal + 50 X 5
= 1250 KCal. | train | med_mcqa | null |
Scaling and root planning is performed | [
"As initial treatment",
"Post surgically",
"In only gingival enlargements",
"after only antibiotics"
] | A | null | train | med_mcqa | null |
As viewed from the right atrium, the floor of the fossa ovalis is formed by | [
"Septum primum",
"Septum secundum",
"Endocardial cushions",
"Tricuspid valve orifice"
] | A | Fossa oavlis represents the site of embryonic spectum primum hence from right atrium its seems to be developed from septum primum. BD CHAURASIA'S HUMAN ANATOMY.VOLUME 1. 6TH EDITION.PAGE NO 255 | train | med_mcqa | null |
Trisomy 13 is identified as: | [
"Edward's syndrome",
"Patau's syndrome",
"Down's syndrome",
"Klinefelter's syndrome"
] | B | Trisomy 13 = Patau's syndrome Trisomy 18 = Edward's syndrome Trisomy 21 = Down's syndrome Extra X chromosome = Klinefelter syndrome( 47 XXY) | train | med_mcqa | null |
Which of the following is a controlled delivery device which is used to deliver a fixed concentration of oxygen? | [
"Venturi mask",
"Nasal cannula",
"Nasal mask",
"Non breathing mask"
] | A | Venturi mask is a type of HAFOEmask (High Air Flow Oxygen Enrichment Devices). It is used to deliver a controlled oxygen concentration to a patient. The patient breathes a fixed concentration of oxygen enriched air because the gas flow is greater than the peak inspiratory flow rate of the patient. Thus there is minimal dilution from atmospheric air. The high gas flow flushes expired gas from the mask preventing rebreathing. Nasal cannula isused when a low-flow of oxygen is indicated. These do not increase dead space. Inspiratory oxygen concentration depends on the flow rate. No rebreathing occurs. Non-rebreathing mask has a one way valve prevents the exhaled air from entering the reservoir bag. It provides the patient with enriched oxygen during inhalations. Nasal masks are effective interfaces for non invasive positive pressure ventilation (NIPPV) in most pediatric patients. It allows better removal of CO2. | train | med_mcqa | null |
White infarcts are seen in all of the following organs, EXCEPT: | [
"Hea",
"Kidney",
"Lungs",
"Spleen"
] | C | White infarcts occur with aerial occlusions in solid organs with end-aerial circulation (e.g., hea, spleen, and kidney), and where tissue density limits the seepage of blood from adjoining capillary beds into the necrotic area. Ref: Robbins, 8th edition, Chapter 4. | train | med_mcqa | null |
TOC used in nocturnal enuresis is: | [
"Bed alarms",
"Imipramine",
"Fluoxetine",
"Trazodone"
] | A | Treatment of Sleep related enuresis: Bed alarms (behavioural therapy)- TOC Desmopressin (DOC) Imipramine (TCA Antidepressant) | train | med_mcqa | null |
Which of the following statements regarding the schilling test for vitamin B12 malabsorption is most accurate? | [
"The schilling test results are abnormal in patients with dietary vitamin B12 deficiency.",
"In patients with pernicious anemia, the results of the schilling test normalize after oral administration of intrinsic factor,",
"In patients with ileal disease, the results of the schilling test normalize after oral ad... | B | Answer is B (In patients with pernicious anemia, the results of the Schilling test normalize after oral administration of intrinsic factor): An abnormal Schilling's test that corrects or normalizes after administration of intrinsic factor suggests a diagnosis of Pernicious Anemia (Intrinsic Factor Deficiency). Shilling's test is done to determine the cause of cyanocobalamine deficiency (Vitamin B12).Schilling test is abnormal in conditions that affect cobalamine absorption including Pernicious anemia, Chronic Pancreatitis, Bacterial overgrowth syndrome and Ileal dysfunction. An Abnormal Schilling's test that corrects after administration of Intrinsic Factor indicates Pernicious Anemia An Abnormal Schilling's test that corrects after administration of Pancreatic Enzymes suggests Exocrine Pancreatic Insufficiency (from Chronic Pancreatitis) An Abnormal Schilling's test that corrects after administration of five days of antibiotics suggests Bacterial Overgrowth Syndrome An Abnormal Schilling's test that does not correct after administration of intrinsic factor, pancreatic enzymes and/or antibiotics suggests Ileal mucosal dysfunction | train | med_mcqa | null |
Lipoprotein with seavenging action is: | [
"HDL",
"LDL",
"VLDL",
"None"
] | A | A i.e. HDLHDL scavanges body cholesterol and blood vessel wall cholesterol by 'reverse cholesterol transpo'-[Shinde P- 3861 The transpo of cholesterol from the tissue to liver is known as 'reverse cholesterol transpo'.* Class B scavenger receptor Bl (SR -B1) and ATP binding cassette transpoer Al (ABCA 1) are involved in reverse cholesterol transpoQ.* Reverse cholesterol transpo involves efflux of cholesterol from peripheral cells to HDL, esterification of cholesterol by PCAT (phosphatidyl choline: cholesterol acyl transferase), binding of cholesterol ester rich HDL (HDL-2) to liver and steroidogenic cells, the selective transfer of the cholesteryl esters into these cells and the release of lipid depleted HDL (HDL-3).The efflux of cholesterol from peripheral cells is mediated by ABCA-1 and the uptake of cholesteryl ester by liver is mediated by SRBI. Hepatic lipase degrade both triacyl glycerol and phospholipid, & paicipate in conversion of HDL2 to HDL3, (HDL cycle). HDL2 concentrations are inversely related to incidence of coronary atherosclerosis. HDLc (HDLG) is found in diet induced hyper cholesterolemic animals. It is rich in cholesterol & has only apo E apoprotein. | train | med_mcqa | null |
Riga fede disease is the ulceration seen on | [
"Attached gingiva",
"Buccal mucosa",
"Lower Lip",
"Tongue"
] | D | null | train | med_mcqa | null |
Nerve roots involved in Klumpke's paralysis - | [
"C4-5",
"C5-6",
"C6.7",
"C8T1"
] | D | Ans. is 'd' i.e., C8T1 Klumpke's paralysiso Site of injury : Lower trunk of the brachial plexus.o Cause of injury : Undue abduction of the arm. as in clutching something with the hands after a fall from a height, or sometimes in birth injury,o Nerve roots involved : - Mainly T1 and partly C8.o Muscles paralysedIntrinsic muscles of the hand (T1).Ulnar flexors of the wrist and fingers (C8).Deformity (position of the hand). Claw hand due to the unopposed action of the long flexors and extensors of the fingers. In a claw hand there is hyperextension at the metacarpophalangeal joints and flexion at the interphalangeal joints.o DisabilityClaw handCutaneous anaesthesia and analgesia in a narrow zone along the ulnar border of the forearm and hand.Homer's syndrome if T1 is injured proximal to white ramus communicans to first thoracic sympathetic ganglion. There is ptosis, miosis, anhydrosis, enophthalmos, and loss of ciliospinal reflex-may be associated. (This is because of injury to sympathetic fibres to the head and neck that leave the spinal cord through nerveT1)Vasomotor changes : The skin area with sensory loss is warmer due to arteriolar dilation. It is also drier due to the absence of sweating as there is loss of sympathetic activity.Trophic changes : Long standing case of paralysis leads to dry and scaly skin. The nails crack easily with atrophy of the pulp of fingers. | train | med_mcqa | null |
Drug therapy used in treatment of Wernicke's encephalopathy | [
"Diazepam",
"Disulfiram",
"Thiamine",
"Cyanocobalamin"
] | C | (C) Thiamine # Thiamin deficiency can result in three distinct syndromes:> A chronic peripheral neuritis, beriberi, which may or may not be associated with heart failure and edema; acute pernicious (fulminating) beriberi (shoshin beriberi), in which heart failure and metabolic abnormalities predominate, without peripheral neuritis; and Wernicke's encephalopathy with Korsakoff's psychosis, which is associated especially with alcohol and drug abuse.> Therapeutic uses of Thiamine: most neurological symptoms in chronic alcoholics are due to thiamine deficiency -peripheral neuritis Wernick's encephalopathy, Korskoffs psychosis: give 100 mg/day paranterally. | train | med_mcqa | null |
Which of the following is not a cause of oropharyngeal carcinoma | [
"Occupational exposure to hydrochloric acid",
"Smoking",
"Human Papilloma Virus infection",
"Plummer-Vinson syndrome"
] | A | ETIOLOGY: Smoking: Incidence of oral cancer is six times more in smokers than in nonsmokers. Tobacco chewing: Carcinoma develops at the site of the quid. Alcohol: Cancer of upper aerodigestive tract occurs six times more in heavy drinkers as compared to nondrinkers. Dietary deficiencies: Riboflavin deficiency may be responsible for cancer in alcoholics. Paterson-Brown-Kelly syndrome also called Plummer-Vinson syndrome (iron deficiency anaemia) is responsible for cancer of the oral cavity and hypopharynx. Dental sepsis, jagged sharp teeth and ill-fitting dentures: All these cause chronic irritation and may lead to the development of cancer. Ref: Textbook of ENT, Dhingra; 6th edition; Pg no: 225 | train | med_mcqa | null |
Which of the following are true about ASD? | [
"Ostium primum is the most common defect",
"Children are always growth retarded",
"Surgery is electively done at 1-3 year age for large defects",
"Commonly affected by Infective endocarditis"
] | C | c. Surgery is electively done at 1-3 year age for large defects(Ref: Nelson's 20/e p 2190-2191)The timing for elective closure of ASD is usually after the 1st yr and before entry into school. | train | med_mcqa | null |
Most common organism involved in nosocomial infection - | [
"Staph aureus",
"E. coli",
"Legionella",
"Strep pneumonia"
] | A | UTI is the most common type of nosocomial infection. . Most common cause of UTI ---> E coli . Most common cause of UTI in ICU ----> Candida . Overall staph aureus is a leading cause of nosocomial infection. . Staph aureus is the most common cause of surgical wound infection - . Most common cause of primary bacteremia --> Coagulase negative staphylococcus. REF : ananthanarayana 10th ed | train | med_mcqa | null |
Which among the following is the most common mode of lead poisoning? | [
"Ingestion",
"Dermally",
"Inhalation",
"None of the above"
] | C | Lead poisoning (Plumbism) may occur in 3 ways: Inhalation - Most cases of industrial lead poisoning is due to inhalation of fumes and dust of lead or its compounds. Ingestion - Small quantities of lead trapped in the upper respiratory tract may be ingested. Contaminated hands may also lead to ingestion. Skin - Only organic lead (e.g., tetraethyl lead) is absorbed dermally. Ref: Park's Textbook of Preventive and Social Medicine, 19th edition, Page 662. | train | med_mcqa | null |
Sensations which are appreciated in thalamus | [
"Propioception",
"Pain and temperature",
"Tactile sensations",
"All"
] | D | Thalamus acts as the sensory relay station for all sensors Ref: guyton and hall textbook of medical physiology 12 edition page number:691,692,693 | train | med_mcqa | null |
Inferior rectal aery is a branch of | [
"Inferior mesenteric aery",
"Superior mesenteric aery",
"Celiac trunk",
"Internal pudendal aery"
] | D | The inferior rectal aery arises near the posterior end of the pudendal canal from internal pudendal aery, and accompanies the nerve of the same name.The aery supplies the skin and muscles of the anal region, and anastomoses with the superior and middle rectal aeries And the other branches are - The perineal aery ( arises near the anterior end of the pudendal canal ), The aery of the penis or theclitoris Ref : B D Chaurasia's Human Anatomy, seventh edition , volume 2 , pg. no. 397 | train | med_mcqa | null |
Cranial nerve emerging from dorsal surface of brain- | [
"Trigeminal",
"Trochlear",
"Abducent",
"Vague"
] | B | Ans. is 'b' i.e., Trochlear o "The nucleus (deep origin) is situated in the ventral wall of aqueduct of midbrain at the level of inferior colliculus and the nerve emerges from the dorsal surface of the midbrain below the inferior colliculus (superficial origin) after decussating with nerve of opposite side - Essentials of neuroanatomyo Unique features of trochlear nerve arei) Most selender cranial nerve.ii) Only cranial nerve to emerge on the dorsal aspect of brain.iii) Only cranial nerve to undergo complete internal decussation before emerging i.e. right trochlear nerve arises from left trochlear nucleus and vice versa.iv) Has longest intracranial course (Vagus nerve has overall longest course).v) Thinnest cranial nerve (smallest nerve in terms of the number of axons it contains). | train | med_mcqa | null |
All true except ? | [
"Cotrimoxazole is effective against P carinii",
"Clarithromycin effective against mycobacterium avium complex",
"Doxycycline is effective against legionella",
"Ceftriaxone is effective against gonorrhea"
] | C | Ans. is 'c' i.e., Doxycycline is effective against legionella | train | med_mcqa | null |
Recent biomarker for early detection of surface epithelial tumours of ovary - | [
"Ca 125",
"Cal9-9",
"Ca 15-5",
"Ostopontin"
] | A | Ans. is 'a' i.e., Ca 125 "Fertility preservation in early stage ovarian cancer the uterus and the contralateral ovary- can be preserved in women with stage la, grade l& 2 who desire to preserve fertility. The condition of the women should be monitored carefully with routine periodic pelvic examinations and determinations of serum CA 125 levels. "CA 125 is raised inBenign gynaecological conditionsMalignant conditionso Pregnancyo Endometrial Cao PIDo Pancreas Cao Endometrioseso Colon Cao Uterine fibroido Fallopian tubes Cao In 1% normal femaleso Breast Ca o Ovarian epithelia Ca (MC) o Lung Ca | train | med_mcqa | null |
Poorly differentiated carcinoma express- | [
"Cytokeratin",
"Vimentin",
"ILA",
"desmin"
] | A | Cytokeratins are proteins of keratin-containing intermediate filaments found in the intracytoplasmic cytoskeleton of epithelial tissue. The term "cytokeratin" began to be used in the late 1970s (for example, see "Intermediate-sized filaments of human endothelial cells" by Franke, Schmid, Osborn and Weber) when the protein subunits of keratin intermediate filaments inside cells were first being identified and characterizedThe subsets of cytokeratins which an epithelial cell expresses depends mainly on the type of epithelium, the moment in the course of terminal differentiation and the stage of development. Thus this specific cytokeratin fingerprint allows the classification of all epithelia upon their cytokeratin expression profile. Fuhermore, this applies also to the malignant counterpas of the epithelia (carcinomas), as the cytokeratin profile tends to remain constant when an epithelium undergoes malignant transformation. The main clinical implication is that the study of the cytokeratin profile by immunohistochemistry techniques is a tool of immense value widely used for tumor diagnosis and characterization in surgical pathology. | train | med_mcqa | null |
Zileuton, a 5-lipooxigenase inhibitor, acts by which of the following mechanisms? | [
"LT C4 synthesis inhibitor",
"D4 synthesis inhibitor",
"LT B4 synthesis inhibitor",
"All of the above"
] | D | Ans. d (All of the above) (Ref. KDT, Pharmacology, 6th ed. 175, 223)ZILEUTON# 5-Lipoxygenase inhibitor and blocks LTC4, LTD4 as well as LTB4 Synthesis# Duration of action - Short 3-4 hrs# Adverse effect - Hepatotoxicity.MONTELEUKAST, ZAFIRLUKAST# Cys LT1 receptor antagonist used in asthma prophylaxis# Side effects:- Eosinophilia, Neuropathy, Churg-Strauss disease | train | med_mcqa | null |
Cell fusion of HIV with target cell is done by - | [
"gp 120",
"gp41",
"p24",
"p 18"
] | B | Ans. is 'b' i.e., gp 41 o Target cells for HIV infection are CD4 Help T-cells (major target), monocyte-macrophages, dendritic cells, Langerhans cells, few B lymphocytes and glial cells/microglia in CNS.o The receptor for the virus is CD4 antigen, and therefore the virus may infect any cell bearing the CD4 antigen on the surface this is primarily the CD4 + (Helper) T Lymphocyte. Specific binding of virus to CD4 receptor is by the envelopc glycoprotein gp-120. However, for infection to take place, cell fusion is essential, which is brought about by the transmembrane gp41. Entry of virus into the cells also requires coreceptor moleculei) Tcells (Helper Tcells) have coreceptor CXCR4 and are infected by T-tropic isolates or syncitia-inducing (SI) strains of HIV (X4 virus).ii) Macrophages have coreceptor CCR5 and are infected by M-tropic isolates or non-syncitia-inducing (NSI) strains of HIV (R5 virus).o Virus using both coreceptors (CXCR4 and CCR5) are called R5X4 viruses.o Follicular dendritic cells from tonsil can be infected by HIV without the involvement of CD4.o When HIV infects a cell, the viral RNA is transcribed by reverse transcriptase, first into single stranded DNA and then to double stranded DNA (Provirus). Provirus is integrated into host cell chromosome. This provirus initiates viral replication by directing synthesis of viral RNA, in response to viral promoters. Thus, the sequence in replication is RNA - DNA - RNA & proteins.HIV infection of a cell | Viral RNA inside the cell |Reverse transcriptaseSingle stranded DNA |Reverse transcriptaseDouble stranded DNA (Provirus) | Integrated into host chromosomes |.- Viral promotorsSynthesis of viral RNA and other components | train | med_mcqa | null |
A young girl presented with swelling of right thigh, with history of trauma 2 months back. Now she presents with swelling at mid-shaft of femur & low grade fever. ESR is mildly raised. X-ray shows a laminated periosteal reaction. Next line of investigation would be: | [
"MRI",
"Biopsy",
"Bone scan",
"Blood count & CRP"
] | A | MR1 Age group, swelling at mid-shaft of .femur, low grade .fever, mildly raised ESR & laminated periosteal reaction; all point towards the diagnosis of Ewing's sarcoma. But Osteomyelitis can also be put in d/d. Only point which goes against osteomyelitis is the location i.e. the mid-shaft of femur. Osteomyelitis is commonly seen at metaphysis, although diaphysis can be rarely involved. Grainger writes-"The differential diagnosis of Ewing's sarcoma includes osteomyelitis, other lyric bone lesions, osteosarcorna and metastases from another primary tumour. The routine imaging algorithm of these patients includes plain radiography and MRI of the primary lesion, bone scintigraphy of the skeleton looking for metastatic bone spread and plain radiography and CT for chest evaluation of metastases." "When a large soft-tissue mass is present it can still be difficult to differentiate between tumour and infection, even with Gadolinium enhancement. The diagnosis is made by biopsy." In this case X ray has already been done. Next investigation should be MRI (or CT; MR is better). MRI is ideally suited for evaluating the soft tissues, the intramedullary extent of disease, and adjacent soft-tissue involvement of the primary lesion and is an essential pa of the evaluation of a patient with Ewing's sarcoma. Biopsy is done to confirm the diagnosis and rule out osteomyelitis and other bone tumors.Bone scintigraphy is done to look for bone metastases.CT chest is done to look for any lung metastasis. Ewing's sarcoma: Ewing's sarcoma of bone is a highly anaplastic, small, round cell tumor of neuroectodermal origin. It is an aggressive malignancy with a high local recurrence and metastatic rate. Ewing sarcoma is the second most common primary malignancy of bone (after osteosarcoma) in patients younger than 30 years of age and the most common in patients younger than 10 years of age. The most common locations include the metaphyses of long bones (often with extension into the diaphysis) and the flat bones of the shoulder and pelvic girdles. Ewing sarcoma is exceedingly rare in individuals of African descent. Clinical findings: Pain is an almost universal complaint of patients with Ewing sarcoma. Usually the onset is insidious, and the pain may be of long duration before the patient seeks medical attention, The pain may be only mild and intermittent initially and may respond to initial conservative treatment. In addition to pain, patients also may have fever, erythema, and swelling suggesting osteomyelitis. Diagnosis: Laboratory studies may reveal an increased white blood cell count, an elevated erythrocyte sedimentation rate, and an elevated C-reactive protein. Ewing sarcoma appears radiographically as a central lytic tumor of the diaphyseal-metaphyseal bone. It creates extensive permeative destruction of coical bone, and as it breaks through under the periosteum, it takes on a typical onionskin, multilaminated appearance; however, this is not pathognomonic for Ewing's sarcoma. Radiating spicules of new bone in a sunburst pattern (sun-ray appearance) can also occur, making radiographic differentiation from osteosarcoma difficult. Saucer-shaped destruction of the exterior coex is a fairly characteristic feature. Regardless of the location, MRI of the entire bone should be ordered to evaluate the full extent of the lesion, which typically extends beyond the abnormality apparent on plain films. MRI also is useful to evaluate the extent of the soft-tissue mass, which often is very large. All patients should have a baseline radiograph and a CT scan of the chest because the lung is the most common site of metastases. A bone scan should be performed because bone is the second most common site of metastases. Histologically, Ewing sarcoma consists of small blue cells with very little intercellular matrix. Cytogenetic or immunohistochemical studies often are required to differentiate Ewing sarcoma from other small blue cell tumors. The t(11;22)(q24;q12) is the most common translocation diagnostic of Ewing sarcoma and is present in greater than 90% of cases. Immunohistochemical staining for the MIC2 gene product has been repoed to be specific for Ewing sarcoma. In addition, Ewing sarcomas usually are periodic acid-Schiff positive (owing to intracellular glycogen) and reticulin negative. This is in contrast to lymphomas, which are periodic acid-Schiff negative and reticulin positive. Treatment The prognosis is always poor and surgery alone does little to improve it. Radiotherapy has a dramatic effect on the tumor but overall survival is not much enhanced. Chemotherapy is much more effective. The best results are obtained by a combination of all three methods: a course of preoperative neoadjuvant chemotherapy; then wide excision if the tumor is in a ourable site, or radiotherapy. .followed by local excision if it is less accessible,. and then a. fuher course of chemotherapy.for 1 year. Postoperative radiotherapy may be added if the resected specimen is found not to have a sufficiently wide margin of normal tissue. | train | med_mcqa | null |
The process increasing the ability for phagocytosis of foreign bodies by body is called ? | [
"Cross reactivity",
"Opsonisation",
"Immune Tolerance",
"Immune Surveillance"
] | B | Ans. is 'b' i.e., Opsonisation Opsonization . The coating of an antigen or paicle (eg. infectious agent) by substances such as antibodies, complement components and fibronectin facilitate phagocytosis. . Opsonization can occur by three mechanisms : Antibody alone acts as opsonin Antibody plus antigen can activate complement classical pathway to yield opsonin. Opsonin may be produced by a heat labile system in which immunoglobulin or other factors activate C3 alternative pathway. Opsonin . A substance capable of enhancing phagocytosis. . Antibodies and complement are the two main opsonins. About other options: . Cross reactivity Some times single antigen stimulates production of variety of antibodies that more or less resemble the correct fit for the antigen. Each of these antibodies may attack different antigens that more or less resemble one another. This is known as antigen cross reactivity. . Immunological tolerance Immunological tolerance is the condition in which contact with an antigen specifically abolishes the capacity to mount an immune response against that paicular antigen when it is administered subsequently. . Immunological surveillance It is the process by which cell mediated immunity destroys malignant cells that arise by somatic mutation. | train | med_mcqa | null |
Number of pericytes in diabetic retinopathy | [
"Increases",
"Decreases",
"No change",
"Decreases followed by increases"
] | B | In diabetic retinopathy loss of pericytes in capillaries cause leakage of vessels. The onset of diabetic retinopathy is characterized by morphologic alterations of the microvessels, with thickening of the basement membrane, loss of inter-endothelial tight junctions and early and selective loss of pericytes, together with increased vascular permeability, capillary occlusions, microaneurysms Reference: Aravind FAQS in Ophthalmology; First Edition; Page no: 335 | train | med_mcqa | null |
All of the following are the components of the score used to assess respiratory distress in a term neonate EXCEPT? | [
"Respiratory rate",
"Grunt",
"Central cyanosis",
"Wheeze"
] | D | Downe score is used to assess respiratory distress in a term neonate. 5 criterion, based on which Downe score is done: Respiratory Rate, Retractions, Cyanosis, Air entry, Grunting. Wheeze is not a component of the Downe's score used to assess respiratory distress in a term neonate | train | med_mcqa | null |
The most impoant use of transrectal ultarsonography (TRUS) is for - | [
"Screening for Ca prostate",
"Distinguishing prostate cancer from BPH",
"Systematic prostate biopsy in suspected prostate cancer",
"Guiding transurethral resection of prostate cancer"
] | C | Ans. is 'c' i.e., Systematic prostate biopsy in suspected prostate | train | med_mcqa | null |
Infants of diabetic mother manifests all of the following EXCEPT? | [
"Hyperglycemia",
"Hypoglycemia",
"Hypocalcemia",
"Hyperbilirubinemia"
] | A | Metabolic problems seen in infant of diabetic mothers: hypoglycemia hypocalcemia hypomagnesemia hyperbilirubinemia. | train | med_mcqa | null |
Capgras syndrome is - | [
"Sharing of delusion",
"Delusion of double",
"Erotomania",
"Hypochondriacal delusions"
] | B | Ans. is 'b' i.e., Delusion of double o Capgras syndrome is delusion of double.The delusional misidentification syndrome LDSM)o DSM is characterized by misidentification delusions of other or self. Four main syndromes are differentiated : -Capgras syndrome (Delusion of double) Patient falsely sees a familiar person as a complete stranger who is imposting on him as a familiar person.Fregoli syndrome (illusion de fregoli) : - The patient falsely identifies stranger as familiar person.Syndrome of subjective double : - The patients own self is perceived as being replaced by a double.Syndrome of intermetamorphosis : - A false belief that a person can transform into another person.o These syndrome most commonly appear in schizophrenia. Other causes axe Alzheimer syndrome, head injuries, and delusional disorders, | train | med_mcqa | null |
Cholesterol gallstones are made up of:- | [
"Crystalline cholesterol monohydrate",
"Crystalline cholesterol dihydrate",
"Amorphous cholesterol monohydrate",
"Amorphous cholesterol dihydrate"
] | A | 1. Cholesterol stones: Contains >50% of crystalline cholesterol monohydrate 2. Pigment stones: Composed of bilirubin & calcium salts predominantly Risk Factors for Gallstones Cholesterol Stones Demography: nohern Europeans, Noh and South Americans, Native Americans, Mexican Americans Advancing age Female sex hormones Female gender Oral contraceptives Pregnancy Obesity and metabolic syndrome Rapid weight reduction Gallbladder stasis Inborn disorders of bile acid metabolism Hyperlipidemia syndromes Pigment Stones Demography: Asians more than Westerners, rural more than urban Chronic hemolytic syndromes Biliary infection Gastrointestinal disorders: ileal disease (e.g., Crohn disease), ileal resection Or bypass, cystic fibrosis with pancreatic insufficiency. | train | med_mcqa | null |
The Earliest sign of male puberty is : | [
"Pubic hair",
"Axillary hair",
"Hoarseness of voice",
"Testicular enlargement"
] | D | In boys, first visible sign of puberty and hallmark of SMR2 is testicular enlargement, beginning as early as 9½ years. This is followed by penile growth during SMR3. Peak growth occurs when testis volumes reach approximately 9-10 cm3 during SMR4. Under the influence of LH and testosterone, and prostate enlarge. The left testis normally is lower than the right. Some degree of breast hypertrophy, typically bilateral, occurs in 40-65% of boys during SMR2-3 due to a relative excess of estrogenic stimulation
In girls, the first visible sign of puberty and the hallmark of SMR2 is the appearance of breast buds, between 8 and 12 years of age. Menses typically begins 2-2½ years later, during SMR3-4 (median age, 12 years; normal range, 9-16 years), around the peak height velocity. Less obvious changes include enlargement of the ovaries, uterus, labia, and clitoris, and thickening of the endometrium and vaginal mucosa | train | med_mcqa | null |
Pseudo obstruction of intestine is also known as? | [
"Hamann's syndrome",
"Ozili's syndrome",
"Ogilive's syndrome",
"Merizzi syndrome"
] | C | This condition describes an obstruction, usually of the colon, that occurs in the absence of a mechanical cause or acute intraabdominal disease. It is associated with a variety of syndromes in which there is an underlying neuropathy and/or myopathy and a range of other factors Ref: Bailey & Love&;s Sho Practice of Surgery,E25,Page-1202 | train | med_mcqa | null |
Which of the following is not a tributary of azygos vein? | [
"Right posterior intercostal",
"Right superior intercostal",
"Left superior intercostal",
"Accessory hemiazygos"
] | C | Tributaries of Azygos vein
Right superior intercostal vein
Right posterior intercostal veins (5 to 11)
Hemiazygos vein
Accessory hemiazygos vein
Right bronchial vein
Esophageal, mediastinal and pericardial veins. | train | med_mcqa | null |
What is present in the pa of the bone which received radiotherapy- | [
"Response to radiotherapy is good",
"Fast healing",
"More destruction of bone",
"Tumour regression is not affected"
] | C | Ans. is 'c' i.e., More destruction of bone o Infection and radiation, both cause bone destruction and predispose to pathological fracture. | train | med_mcqa | null |
Electrically shockable rhythm is | [
"Ventricular Fibrillation",
"Asystole",
"Pulseless electrical activity",
"Bradycardia"
] | A | Shockable Rhythms Fibrillation V.Tachycardia TDP. PSV. Asystole= DC shock is C/I Pulseless electrical activity= Tension pneumothorax , Cardiac tamponade. Bradycardia=Rx- Atropine, Trans Cutaneous pacing, TVP (Trans Venous Pacer) Non shockable rhythms 1. Asystole 2. Electromechanical Dissociation | train | med_mcqa | null |
Which disease comes under international surveillance - | [
"Typhoid fever",
"Salmonellosis",
"Chikungunya fever",
"Hepatitis B"
] | B | Ans. is 'b' i.e., Salmonellosis | train | med_mcqa | null |
Earliest ophthalmic finding in Diabetes mellitus retinopathy | [
"Cotton wool spots",
"Micro-aneurysm",
"Flame shaped haemorrhage",
"Hard exudate"
] | B | (Microaneurysm) (260- Khurana 4th) (295-P)Microaneurysms in the macular area (The earliest detectable lesions)Ophthalmic features of Non proliferative diabetic retinopathy* Micro aneurysm (Earliest detactable lesions)* Retinal haemorrhages both deep {dot and blot haemorrhages) and superficial haemorrhages {flame-shaped)* Hard exudates - yellowish- white waxy looking patches* Retinal oedema* Cotton - wool spots (If >8, there is high risk of developing PDR)* Venous abnormalities - beading, looping and dilatation* Intraretinal microvascular abnormalities (IRMA)**Hall mark of proliferative diabetic retinopathy (PDR) is the occurrence of neovascularization** Moderate loss of vision in DM is due - Macular oedema* Earliest changes of background DR-characteristically effect the small blood vessels. Small dot and blot haemorrhages are common and degeneration of the vessel walls leads to the development of micro aneurysm | train | med_mcqa | null |
Cajal cells are involved in- | [
"Mesangial cell contraction in Kidney",
"Pacemaker activity in Heart",
"Pacemaker activity in GIT",
"Respiratory rhythm generation"
] | C | Ans. is 'c' i.e., Pacemaker activity in GIT * Pacemaker cells are called interstitial cells ofCajal.* Pacemaker cells (interstitial cells of Cajal) are stellate mesenchymal cells with smooth muscle like features. Pacemaker cells are absent in the esophagus and proximal stomach. In the distal stomach and small intestine they are located in outer circular muscle layer near myentric plexus. In the colon they are at the submucosal border of circular muscle layer. In stomach and small intestine, pacemaker frequency is in descending gradient and the pacemaker with highest frequency usually dominates (like heart). | train | med_mcqa | null |
Regarding urogenital diaphragm all are true except | [
"Is also called triangular ligament",
"Is not so well developed in female as in male",
"Consists of two layers of fascia through which pass the vagina and urethra",
"Deep transverse perineal muscle lies external to fascia"
] | D | Deep transverse perineal muscle lies between 2 layers of fascia of urogenital diaphragm. | train | med_mcqa | null |
The most common site for amoebiasis is: | [
"Sigmoid colon",
"Transverse colon",
"Caecum",
"Liver"
] | C | Amoebiasis: - MC site involved is caecum & ascending colon. - Caused by Entamoeba histolytica. - Dysentery develops when amoeba attach to colonic epithelium, induce apoptosis, invade crypts & burrow laterally into lamina propria. - This recruits neutrophils, causes tissue damage, & create a flask-shaped ulcer with narrow neck & broad base. | train | med_mcqa | null |
Scheibe's syndrome is characterized by? | [
"Middle ear anomaly",
"Dysplasia of cochlea",
"Semicircular canal fistula",
"Bony labyrinth defect"
] | B | Ans. is 'b' i.e., Dysplasia of cochlea style="font-size: 1.04761904761905em; font-family: Times New Roman, Times, serif">Scheibers Aplasia (cochleosaccular dysplasia)oScheibe's aplasia is the most common form seen in inherited congenital hearing losses, especially those having autosomal recessive inheritance. In this type of aplasia, the bony labyrinth is fully formed, as are the membranous utricle and semicircular canals. The parts inferior (saccule and cochlear duct) is represented by mounds of undifferentiated cells. The tectorial membrane is reduced in size. The scala media is collapsed and Reissner's membrane may lie directly on the mound of undifferentiated cells and the stria. The stria vascularis and organ of Corti show abortive strands of connective tissue. The wall of the saccule is flattened and lies on the aplastic sensory epithelium and otolithic membrane.Also knowOther important causes of congenital Genetic Hearing LossoMichel's aplasia is characterized by total lack of development of the inner ear. In some cases even the petrous portion of the temporal bone is not developed, whereas in others it is present but is underdeveloped at the usual site of the labyrinth.oMondini's aplasia has been described as a flattened cochlea with development only of the basal coil. Instead of two and one-half turns in the bony cochlea, there may be only one and one-half turns, with the middle and apical turns occupying a common space or cloaca. The vestibular structures and their associated neural elements may be similarly underdeveloped.oAlexander's aplasia is characterized by aplasia of the cochlear duct. The organ of Corti and adjacent ganglion cells of the basal coil of the cochlea are most affected, resulting in a high frequency hearing loss. | train | med_mcqa | null |
All of the following are true about Herpes group virus except: | [
"Ether-sensitive",
"May cause malignancy",
"HSV II involves below diaphragm",
"Burkitt’s lymphoma involves T-cells"
] | D | Burkitt’s lymphoma = ALL L3.
Burkitt leukemia/lymphoma is now considered a mature B-cell neoplasm.
It was formerly classified as precursor B ALL(Acute lymphoblastic leukemia) with L3 morphology (FAB-L3).
The lymphoma cells are positive for B cell antigens, express surface immunoglobulins, and lack TdT expression with nearly 100% of cells being positive for ki-67.
Feature of Herpes Virus:
Enveloped Ds DNA virus, nucleocapsid is icosahedral.
Are enveloped, so are susceptible to fat solvent like ether, alcohol, bile salts.
Replicate in nucleus, forming cowdry type A intranuclear (lipschutz) inclusion bodies.
Some herpes virus have been implicated with malignancies.
EBV: Nasopharyngeal carcinoma
HSV - 2 - Carcinoma cervix
HHV-8 - Kaposi sarcoma, Multiple myeloma. | train | med_mcqa | null |
Patient repos sharp shooting retrosternal pain progressing downward initially between scapulae and later to epigastric region. On examination he has feeble lower limb pulse compared to upper limbs. This is highly suggestive of- | [
"Coarctation of aoa",
"Dissecting aneurysm of aoa",
"Peripheral vascular disease",
"Aooaeritis"
] | B | Aoic dissection (AD) occurs when an injury to the innermost layer of the aoa allows blood to flow between the layers of the aoic wall, forcing the layers apa.In most cases, this is associated with a sudden onset of severe chest or back pain, often described as "tearing" in character. Also, vomiting, sweating, and lightheadedness may occurOther symptoms may result from decreased blood supply to other organs, such as stroke or mesenteric ischemia Aoic dissection can quickly lead to death from not enough blood flow to the hea or complete rupture of the aoa AD is more common in those with a history of high blood pressure, a number of connective tissue diseases that affect blood vessel wall strength including Marfan syndrome and Ehlers Danlos syndrome, a bicuspid aoic valve, and previous hea surgery. Major trauma, smoking, cocaine use, pregnancy, a thoracic aoic aneurysm, inflammation of aeries, and abnormal lipid levels are also associated with an increased risk.The diagnosis is suspected based on symptoms with medical imaging, such as computed tomography, magnetic resonance imaging, or ultrasound used to confirm and fuher evaluate the dissection.The two main types are Stanford type A, which involves the first pa of the aoa, and type B, which does not. Ref Davidson 23rd edition pg 431 | train | med_mcqa | null |
Treatment of hydatiform mole is - | [
"Chemotherapy only",
"Hysterectomy & chemotherapy",
"Only hysterectomy",
"Suction & evacuation"
] | D | Ans. is 'd' i.e., Suction and Evacuation Managem_entof Hydatid.iform mole:o Suction evacuation (SE) is the prefered method of treatment. It is safe, rapid and effective in almost all cases. Suction evacuation can safely be done even when the uterus is of 28 weeks of gestation. | train | med_mcqa | null |
Which of the following is not a swelling in midline: | [
"Thyroglossal cyst.",
"Sublingual dermoid.",
"Branchial cyst.",
"Submental lymph nodes enlargement."
] | C | The common swellings in the midline are:
Submental lymph nodes
Thyroid gland enlargement
Thyroglossal cyst
Sublingual dermoid
Lipoma
Common lateral swellings in the neck are:
Lymph node swelling
Salivary gland enlargement
Thyroid enlargement
Branchial cyst
Lipoma | train | med_mcqa | null |
A young pregnant woman presents with fulminant hepatic failure. The most likely aetiological agent is - | [
"Hepatitis B virus",
"Hepatitis C virus",
"Hepatitis E virus",
"Hepatitis A virus"
] | C | Ans. is 'c' i.e., Hepatitis - E virus Characteristic feature of different Hepatitis viruses . HEV - Causes fulminant hepatitis in pregnant woman - Causes cholestasis . HAV - Cause spiky fever - Can cause cholestasis (less common than HEV) . HBV - Only hepatitis virus which is DNA virus. . HCV - Paucity of inflammation - Causes fatty change in liver. - Episodic pattern of aminotransferases activity. | train | med_mcqa | null |
Metastasis to liver is UNCOMMON with malignancy of: March2013 | [
"Colon",
"Lung",
"Breast",
"Prostate"
] | D | Ans. D i.e. ProstateAlthough the most common primary sources producing hepatic metastases are those of the colon, breast, lung, and pancreas, any cancer in any site of the body may spread to the liver, including leukemias, melanomas, and lymphomas | train | med_mcqa | null |
LATS is a ? | [
"IgM",
"IgG",
"Glycoprotein",
"IgA"
] | B | Reference :Robbins basic pathology 9th edition pg no 726:Thyroid stimulating immunoglobulin(LATS): Graves disease is characterized by a breakdown in self-tolerance to thyroid autoantigens, of which the most impoant is the TSH receptor. The result is the production of multiple autoantibodies, including: * Thyroid-stimulating immunoglobulin: An IgG anti- body that binds to the TSH receptor and mimics the action of TSH, stimulating adenyl cyclase, with resultant increased release of thyroid hormones. Almost all persons with Graves disease have detectable amounts of this auto- antibody, which is relatively speci c for Graves disease. | train | med_mcqa | null |
Dose of Reteplase for management of Acute MI is? | [
"5 IU",
"10 IU",
"15 IU",
"50 IU"
] | B | Answer- B. 10 IUThe recommended dose for Reteplase in Acute Myocardial infarction is l0 Unit bolus given over 2 minutes.It is recommended to repeat the second I0 unit dose after 30 minutes. | train | med_mcqa | null |
The tensile strength of the wound stas and increases after- | [
"Immediate suture of the wound",
"3 to 4 days",
"7-10 days",
"6 months"
] | B | Ans. is 'b' i.e., 3 to 4 days. | train | med_mcqa | null |
Azygous vein drains | [
"Into superior vena cava",
"Anterior to costochondral junction",
"Oesophagus",
"Directly into right atrium"
] | A | The azygous vein is formed by the confluence of the Lumbar azygous vein, Right ascending lumbar vein and right subcostal vein. It passes superiorly through the aoic apeure, posterior to the right diaphragmatic crus and anterior to the twelth veebral body. The azygos vein transpos deoxygenated blood from the posterior walls of the thorax and abdomen into the superior vena cava vein. | train | med_mcqa | null |
Commonest cause of epistaxis in children is | [
"Trauma",
"Foreign body",
"Nasal diphtheria",
"Enlarged adenosis"
] | A | Commonest cause of epistaxis in children is trauma in Little&;s area | train | med_mcqa | null |
Which of these is not true regarding guttapercha? | [
"60-70% Gutta Percha",
"It can't be heat sterilized",
"Can stain the crown",
"25 size cone is used for sinus tracing"
] | A | null | train | med_mcqa | null |
Most common autoimmune disease in young men? | [
"Reiter's disease",
"Ankylosing spondylosis",
"Inclusion body myositis",
"CIDP"
] | A | Reiter syndrome is a type of reactive ahritis that happens as a reaction to a bacterial infection in the body. The infection usually happens in the intestines, genitals, or urinary tract. Reiter syndrome includes redness, joint swelling and pain, often in knees, ankles, and feet, along with inflammation of the eyes and urinary tract. It is not contagious. But the bacteria that trigger it can be passed from one person to another. There is no cure for Reiter syndrome, but you can control the symptoms. For most people, symptoms go away in 2 to 6 months.Signs and Symptoms Ahritis. Includes pain, swelling, stiffness, and redness of joints, usually the hips, knees, ankles, spine, and feet. Conjunctivitis, inflammation of the eye. Usually brief and mild. Iritis, inflammation of the iris of the eye. Less common but needs immediate medical treatment to avoid eye damage. Uveitis, inflammation of the inner eye. Less common but needs immediate medical treatment to avoid eye damage. Urinary tract infection. Pain or burning during urination and frequent urge to urinate. May include inflammation of the prostate or cervix. Men may have pus drainage from penis. Painless, shallow ulcers on the penis. Pus-filled sores on soles, palms, and penis. May also include mouth sores. Rashes of small nodules on the soles of the feet, and, less often, on the palms of the hands or elsewhere. Hea problems, affecting about 10% of people who have Reiter syndrome. | train | med_mcqa | null |
A 50-year-old male patient having a history of chronic smoking presents with a single lymph node enlargement and hoarseness of voice. The next line of management is: | [
"FNAC",
"IDL with CXR",
"Percutaneous biopsy",
"Advise him very seriously to stop smoking"
] | C | Ans. Percutaneous biopsy | train | med_mcqa | null |
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