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 |
|---|---|---|---|---|---|---|
Drug of choice for hypeensive emergency in pregnancy is: | [
"Methyldopa",
"Nitroprusside",
"Labetalol",
"Nicardipine"
] | C | Labetalol is DOC for hypeension in pregnancy whether it is routine or emergency HTN. DOC for hypeensive emergency in non pregnant patients is Nicardipine. | train | med_mcqa | null |
Carcinoma ovary marker is- | [
"CA 19-9",
"CD 99",
"CD 34",
"CA 125"
] | D | Ans is 'd' i.e.; CA125 Tumor MarkersCancerHormones o Human chorionic gonadotropino Gestational trophoblastic disease, gonadal germ cell tumoro Calcitonino Medullary cancer of the thyroido Catecholamineso Pheochromocytomao Gastrino Gastrinoma (pancreatic neuroendocrine tumor)Oncofetal Antigens o Alphafetoproteino Hepatocellular carcinoma, gonadal germ cell tumoro Carcinoembryonic antigeno Adenocarcinomas of the colon, pancreas, lung, breast, ovaryEnzymes o Prostatic acid phosphataseo Prostate cancero Neuron-specific enolase & chromogranin Ao Small cell cancer of the lung, neuroblastomao Lactate dehydrogenaseo Lymphoma, Ewing's sarcomaTumor Associated Proteins o Prostatic-specific antigenProstate cancero Monoclonal immunoglobulinMyelomao CA- 125Ovarian cancero CA 19-9Colon, pancreatic, breast cancero CA - 15-3Breast cancero CA 72-4Ovarian, pancreatic & gastric Ca.o CA 27.29 &CA 15-3Breast cancero CD 30Hodgkin's disease, anaplastic large cell lymphomao CD 25Hairy cell leukemia, adult T cell leukemia / lymphomao CD-34Alveolar soft part sarcomao b 2 - MicroglobulinMultiple myelomao S-100, HMB-45, TA-90Malignant melanomao NMP-22Urinary bladder Cao CD-99Ewing \s sarcoma | train | med_mcqa | null |
A 42-year-old man presents to his doctor with complaints of left-sided flank pain radiating into his groin. The pain began suddenly and has increased in intensity. He had a similar problem several years ago, but he did not seek medical attention, and his symptoms resolved spontaneously. He denies fever, chills, nausea, or vomiting. He has had no diarrhea or difficulty urinating. Physical examination is remarkable for tenderness along the left flank and into the groin, but is otherwise normal. There are no inguinal hernias detected on examination. A urinalysis reveals microscopic hematuria without casts. Serum chemistry reveals: Sodium: 143 mEq/L Potassium: 2.4 mEq/L Bicarbonate: 17 mEq/L Chloride: 115 mEq/L Blood urea nitrogen: 12 mg/dL Creatinine: 1.0 mg/dL Glucose: 85 mg/dL Which of the following is MOST likely present in this patient? | [
"Normal acid-base status",
"Metabolic acidosis",
"Metabolic alkalosis",
"Respiratory acidosis"
] | B | This patient's bicarbonate is lower than the normal range of 22-28 mEq/L. This means that there is less bicarbonate in his blood than usual. If his breathing is normal, then his CO2 level should be about normal. Bicarbonate is produced when CO2 binds to an H2O molecule, which then splits into a H+ ion and a HCO3- (bicarbonate) ion. This reaction is governed by an equilibrium constant propoional to the concentrations of the products multiplied together over the concentrations of the reactants multiplied together. By convention, the "water" concentration is ignored because it is "constant." So, in order for the equilibrium constant to not change value, the H+ concentration must increase if the bicarbonate decreases and the CO2 remains the same. This means that an acidosis is produced. In this case, it is a metabolic acidosis, since there is no indication of respiratory disease in this patient. Neither a normal acid-base status nor a metabolic alkalosis would have a low bicarbonate. Note: The hallmark of metabolic acidosis is decreased HCO3-. Metabolic acidosis are classified by the anion gap, either normal or increased. The anion gap is the difference between readily measured anions and cations. Ref: Cho K.C. (2013). Chapter 21. Electrolyte & Acid-Base Disorders. In M.A. Papadakis, S.J. McPhee, M.W. Rabow (Eds), CURRENT Medical Diagnosis & Treatment 2013. | train | med_mcqa | null |
Following are feature of catatonic schizophrenia, except: | [
"Mutism",
"Echolalia",
"Waxy flexibility",
"Deep tendon reflexes are increased"
] | D | D. i.e. Deep tendon reflexes are increased | train | med_mcqa | null |
True about Adenocarcinoma lung is all except | [
"Most common Lung cancer in Females",
"Most common Lung cancer in Smokers",
"Most common Lung cancer in Young patients",
"Most common presents as a peripheral lesion"
] | B | Adenocarcinoma is Most common lung cancer in non - smokers. | train | med_mcqa | null |
Millard's 'Rule of Ten' includes all except - | [
"10 lbs",
"10 weeks",
"10 gm % Hemoglobin",
"10 months"
] | D | Ans- D Rule often is the criteria used to judge the "readiness" of an infant for surgical repair of a cleft lip. The infant must weigh 10 Ib; be 10 weeks old; have a hemoglobin value of 10gm/dl and have a WBC count < 10,000. | train | med_mcqa | null |
Cephalic index is used for - | [
"Race",
"Age",
"Sex",
"Caste"
] | A | Ans. is 'a' i.e. Race o Cephalic index, height index & nasal index are used for determination of race,o Cephalic index = maximum breadth of skull' maximum length of skull x 100Type of skullCephalic indexRace1) Dolico-cephalic70-75Pure Aryans, aborigines & negros2) Maesati-cephalic75-80Europeans & Chinese3) Brachy-cephaiic80-85Mongolian | train | med_mcqa | null |
All of the following poison's are dialyzable except- | [
"Ethylene glycol",
"Methanol",
"Barbiturates",
"Copper sulphate"
] | D | Hemodialysis is not useful in copper sulfate poisoning. It is useful in poisoning with other three given options. | train | med_mcqa | null |
Which of the following periodontal disease is associated with haematological disorder? | [
"AIDS",
"Hypophosphatemia",
"Wegeners Granulomatosis",
"Histiocytoses - X"
] | A | null | train | med_mcqa | null |
Chediak - Higashi syndrome, true is: | [
"Defect in phagocytosis",
"Neutropenia",
"Agammaglobulinemia",
"IgA deficiency"
] | A | Ans. is 'a' i.e., Defect in phagocytosis (Ref: CP Baveja, 5th/e, p. 150)* Chediak - Higashi syndrome is a rare autosomal recessive disorder that arises from a mutation of LYST gene codes for lysosomal trafficking regulator protein, which leads to a decrease in phagocytosis. Failure of phagolysosome fusion, defective chemotaxis. The decrease in phagocytosis results in recurrent pyogenic infections, partial albinism and peripheral neuropathy. | train | med_mcqa | null |
The splenic aery usually follows a touous course along which of the following structure? | [
"Left kidney",
"Greater curvature of the stomach",
"Pancreas",
"Transverse colon"
] | C | The splenic aery, the largest branch of the celiac trunk, follows a touous course posterior to the omental bursa, anterior to the left kidney, and along the superior border of the pancreas. | train | med_mcqa | null |
Phagocytosis enhanced by coating the surface of antigen is called - | [
"Opsonisation",
"Chemotaxis",
"Decoding",
"CFT"
] | A | The opsonin is the heat liable substance present in fresh normal sera, which facilitated phagocytosis. This process is called opsonization Reference:nathanarayan & paniker's 9th edition, pg no: 112 <\p> | train | med_mcqa | null |
The following are true of PKDL except - | [
"Persistent hypergammaglobulinemia",
"Seen in 2-10 year after succesfull treatment of VL",
"Cancrum oris can occur",
"Full treatment prevents PKDL"
] | D | Recccurence doesnt depend on full tratment , reccurence is even seen after full treatment. Persistent hypergammaglobulinemia is seen in Kala azar which is detected by antimony test which is done for Kala azar. Cancrum oris can occur in Kala azar. Option 1, 2, 3, 4 PKDL (Post Kala-azar Dermal Leishmaniasis): Seen in 2-10 year after succesfull treatment of VL (< 6 months in Sudan). Incidence among patients with VL: 50%(Sudan), 2-20% (Indian). Nonulcerative hypopigmented macular lesions, becomes nodular later. Persists for 20 years (few months for Sudan cases). Treatment: Longer courses of antimonials, resolve slowly. | train | med_mcqa | null |
All are true regarding Tumor lysis syndrome except: | [
"Hypercalcemia",
"Hypocalcemia",
"hyperphosphatemia",
"Hyperkalemia"
] | A | Ref: Harrisons Principles of Internal Medicine, 18,th edition, pg 2274Explanation:Tumor lysis syndrome (TLS)Characteristic biochemical changes in Tumor lysis SyndromeHyperuricemia,Hyperkalemia,Hypocalcemia,Hyperphosphatemia.AcidosisAcute renal failure.Caused by destruction of large number of rapidly multiplying neoplastic cells: During Burkin's lymohoma. ALL. CLL on chemotherapyChemotherapy commonly associated are-Fludarabine.Letrozole,Tamoxifen.Glucocorticoids,RituximabGemtuzumabAcute hyperurecemic nephropathy- urinary uric acid ! urine creatinine > 1High calcium:phosphate ratio - renal failureTumor burden, hyperuricemia & high LDH - high risk for TLS.TreatmentAllopurinolRasburicase (recombinant urate oxidase): contraind in G6PD deficiency, can cause bronchospasm, hypotension & hypoxiaAggressive hydration with Vi NSUrinary alkalinization with pH > 7 with IV sodium bicarbonateHemodialysis/hemofUtration:If S.potassium > 6;S. Uric acid > 10.S.Phosphate >10.S.Creat > 10 with severe hypocalcemiaCauses of hypercalcemia: VITAMINS TRAPVitamin D, A intoxication. VIPomaImmobilisationThiazide. TPNAddison'sMilk-alkali syndromeInfection: TuberculosisNeoplasm- Myeloma, secondary depositsSarcoidosisTuberculosis, ThyrotoxicosisRadiationAIDSParathyroid excess- primary /tertiary; Paget's | train | med_mcqa | null |
Which of the following is not done in high altitude sickness? | [
"Acetazolamide",
"Digoxin",
"Rapid descent",
"Oxygen"
] | B | Acute Mountain Sickness (AMS) Treatment of High-altitude sickness: Gradual ascent, with adequate time for acclimatization, is thebest methodfor the prevention of altitude illness. Proper hydration(but not overhydration) in high-altitude trekking and climbing, aimed at countering fluid loss due to hyperventilation and sweating, may play a role in avoiding AMS. Acetazolamideis thedrug of choicefor AMS prevention. It inhibits renal carbonic anhydrase, causing prompt bicarbonate diuresis. Dexamethasone(8 mg/d in divided doses) is also effective Spironolactone,Digoxin, Medroxyprogesterone, Magnesium, Calcium channel blockers, and Antacids, conferno benefitin the prevention of AMS. | train | med_mcqa | null |
Which of the following is not a sign of pulmonary hydatidosis | [
"Waterlily sign",
"Rising sun sign",
"Meniscus sign",
"Drooping lilly sign"
] | D | Drooping lilly sign is seen in neuroblastoma and duplication of ureter Duplication of ureter: Drooping lilly sign on IVP(Nonvisualized upper pole of a duplex system displaces the lower pole down, looking like a drooped down lilly flower on IVP Chracteristic signs of pulmonary hydatidosis Meniscus sign Double arc sign Moon sign Waterlily sign Crescent sign Ref: Wolfgang 2nd edition Pg no : 309 | train | med_mcqa | null |
The most common side effects of cancer chemotherapy is nausea with or without vomiting .The anticancer drugs vary in their ability to cause nauesa and vomiting .which of the 6 anticancer drugs is least6 likely to cause6 nausea and vomiting | [
"Chlorambucil",
"Cisplatin",
"Doxorubucin",
"Danurubicin"
] | A | Cisplantin and cycloohosphamide have very high emetogenic potential wherrsas6 chlorambucil and busulfan have the least Refer KDT 7th/859 Refer Harrison 18th/708 | train | med_mcqa | null |
Lymphocytic colitis | [
"Bloody diarrhea",
"Intra epithelial lymphocytes",
"Lymphocytes is stools",
"Through Ileoscopy look for payer's patches"
] | B | The characteristic feature of LC is an infiltration by lymphocytes into the colonic epithelium. Collagenous colitis (CC) shares this feature but additionally shows a distinctive thickening of the subepithelial collagen table. LC and CC have been suggested to represent different phases of a single pathophysiologic process, with LC possibly being a precursor or earlier phase of CC; however, this has not been proven. REFERANCE. MEDSCAP.COM IMAGE REF: | train | med_mcqa | null |
The drug of choice in digitalis induced ventricular arrhythmias is: | [
"I.V. Lignocaine",
"Phenytoin",
"Quinidine",
"Procainamide"
] | A | (IV Lignocaine): Ref: 463-KDT (514-KDT 6th)Treatment of digitalis induced ventricular arrhythmias* Lignocaine IV repeated as required is the drug of choice. It suppresses the excessive automaticity but does not accentuate A V block* Phenytoin is also useful but not preffered now (sudden death occurs)* Quinidine and procainamide are contraindicated. | train | med_mcqa | null |
In Refeeding syndrome - lab values to be monitored are all except | [
"Calcium levels",
"Magnesium levels",
"Phosphate levels",
"Ammonia"
] | D | This is characterised by severe fluid and electrolyte shifts in malnourished patients undergoing refeeding. It can occur either with enteral or parenteral nutrition, but more common with latter It results in hypophosphataemia, hypocalcaemia, hypomagnesaemia. These electrolyte disorders can result in altered myocardial function, liver dysfunction, seizures, confusion, coma, tetany and death. Patients at risk are those with alcohol dependency, those suffering severe malnutrition, anorexic and those who have undergone prolonged periods of fasting. Treatment involves matching intakes with requirements and assiduously avoiding overfeeding. Calorie delivery should be increased slowly and vitamins administered regularly. Hypophosphataemia and hypomagnesaemia require treatment. Ref: Bailey and love 27th edition Pg no :288 | train | med_mcqa | null |
PQLI lies between: | [
"0 and 1",
"0 and 10",
"0 and 100",
"1 and 10"
] | C | Ans. (c) 0 and 100Ref: K. Park 23rd ed. /17PQLI (Physical Quality of Life IndexHDI (Human Development Index)Literacy rateLiteracy rateInfant mortality rateIncomeLife expectancy (at 1 year)Life expectancy () birth)Range: 0 and 100Range: 0 and +1Value in India: 650.547Also Know* Range of correlation coefficient; 1 to +1 | train | med_mcqa | null |
The most common cause of the congenital heart defect is: | [
"A viral infection in mother during first trimester",
"A bacterial infection in mother during first trimester",
"Consumption of NSAIDs by mother during first trimester",
"None of the above"
] | A | Congenital heart disease is not uncommon, occurring in about 8 of every 1000 live births.
One of the most common causes of congenital heart defects is a viral infection in the mother during the first trimester of pregnancy, when the fetal heart is being formed.
Defects are particularly prone to develop when the expectant mother contracts German measles; thus, obstetricians may advise termination of pregnancy, if German measles occurs in the first trimester. | train | med_mcqa | null |
A patient gives a H/0 twisting strain and locking of the knee joint, the most likely diagnosis is: | [
"Avulsion of tibial tubercle",
"Meniscal tear",
"Tearing of lateral collateral ligament",
"Tear of anterior cruciate ligament"
] | B | B i.e. Meniscal tear | train | med_mcqa | null |
Custodial rape is punished under | [
"377 IPC",
"354 C IPC",
"376 D IPC",
"376 C IPC"
] | D | Refer the byte "Legal sections". | train | med_mcqa | null |
Ventouse is contraindicated in all except : | [
"Fetal distress",
"Face presentation",
"Transverse lie",
"Anemia"
] | D | Anemia | train | med_mcqa | null |
The ureteric bud develops from ? | [
"mesonephric duct",
"metanephric duct",
"pronephric duct",
"genital sinus"
] | A | Development of kidneys - The definative human kidney arises from two distinct sources, 1). The secretory pa , I.e., excretory tubules or (nephrons) are derived from the lowest pa of the nephrogenic cord this pa is the metanephros, the cells of which form the metanephric blastema 2). The collecting pa of the kidney is derived from a diveiculum called the ureteric bud which arise from the lower pa of the mesonephric duct. Ref : Inderbir singh's Human Embryology, eleventh edition , pg. no., 265. | train | med_mcqa | null |
The laboratory diagnosis of thiamine deficiency is by: | [
"Transaldolase assay measured before and after the addition of thiamine pyrophosphate",
"Transketolase assay measured before and after the addition of thiamine pyrophosphate",
"Thiamine pyrophosphate assay in RBC after adding sugar",
"Serum LDH levels"
] | B | The laboratory diagnosis of thiamine deficiency usually is made by a functional enzymatic assay of transketolase activity measured before and after the addition of thiamine pyrophosphate. >25% stimulation by the addition of thiamine pyrophosphate is interpreted as abnormal. Thiamine or the phosphorylated esters of thiamine in serum or blood also can be measured by high-performance liquid chromatography to detect deficiency. | train | med_mcqa | null |
Disease which does not present as shock is: | [
"Meningococcemia",
"Erythema infectiosum",
"TSS",
"SSSS"
] | B | Ans: b (Erythema infectiosum)Ref Harrison, 17 ed. pg. 128, 877, 878; Davidson, 21ed. Pg. 3261. Erythema infectiosum - by parvovirus B19, affecting children (3-12 yrs)C/F - slapped cheek > trunkal rash > lacy reticular pattern that wax and wane over 3 weeks Adults - arthritis Pregnancy - fetal hydrops2. Streptococcal toxic shock syndrome - usually Group A (occasionally Group C/G)Pyrogenic exotoxin A - acts like a superantigen Erythematous rash over chest - circulatory shockStaphylococcal toxic shock syndrome:Due to toxic shock syndrome toxin (TSST1) Seen in women using vaginal tampons C/F: Fever, systemic symptoms, generalized erythematous blnching rash, hypotension Rx iv antistaphylococcal antibiotics (flucloxacillin/vancomycin + protein synthesis inhibitors like clindamycin)3. Meningococcal sepsis: Usually presents with rapid onset of obtundation due to cerebral oedema resulting from (a) endotoxin (b) cytokine release (c) circulatory collapse.Adverse prognostic features include hypotensic shock, rapidly developing rash, haemorrhagic diasthesis, and multisystem failure. Age >60 years.4. Staphylooccal scalded skin syndrome: In children especially neonates. Child usually presents with fever, irritability, skin tenderness, erythema, blister, superficial erosions that can rapidly involve large areas of skin, significant amount of fluid lost in most extensive cases. | train | med_mcqa | null |
Approximate time interval between HIV infection and development of AIDS is | [
"7.5 years",
"10 years",
"12 years",
"15 years"
] | B | HIV 1 (India)- 10 years HIV 2 (Africa)- 15 years | train | med_mcqa | null |
III Nerve palsy associated with contralateral hemiplegia is together known as | [
"Weber's syndrome",
"Benedict's syndrome",
"Claude's syndrome",
"Avellis syndrome"
] | A | (A) Weber's syndrome > Injury to structures surrounding fascicles of the oculomotor nerve descending through the midbrain has given rise to a number of classic eponymic designations.> In Nothnagel's syndrome, injury to the superior cerebellar peduncle causes ipsilateral oculomotor palsy and contralateral cerebellar ataxia.> In Benedikt's syndrome, injury to the red nucleus results in ipsilateral oculomotor palsy and contralateral tremor, chorea, and athetosis.> Claude's syndrome incorporates features of both the aforementioned syndromes, by injury to both the red nucleus and the superior cerebellar peduncle.> Finally, in Weber's syndrome, injury to the cerebral peduncle causes ipsilateral oculomotor palsy with contralateral hemiparesi: | train | med_mcqa | null |
Microsatellite sequence is | [
"Small satellite",
"Extra chromosomal DNA",
"Sho sequence (2-5) repeat DNA",
"Looped-DNA"
] | C | Microsatellite is a tract of repetitive DNA in which ceain DNA motifs(ranging in length from 2-5 base pairs) are repeated, typically 5-50 times. Microsatellites are a powerful tool in population genetics as a whole in pa due to their cost efficiency. They are widely used for DNA profiling Ref-Harpers illustrated biochemistry 30/e 673 | train | med_mcqa | null |
Tonometer with variation in application surface | [
"Mackey Marg tonometer",
"Rebound tonometer",
"Dreger's tonometer",
"Maklakov tonometer"
] | D | Ans. d. Maklakov tonometer Indentation tonometry Indentation tonometry was devised by SchiotzQ. Because of its simplicity, reliability, low price and relative accuracy, it is the most widely used tonometer in the world. For repeated use in multiple patients it can be sterilized by dipping the footplate in ether, absolute alcohol, acetone or by heating the footplate in the flame of spirit. The greatest accuracy is attained if the deflection of lever is between 3-4. Its main disadvantage is that it gives a false reading when used in eyes with abnormal scleral rigidity') False low level of 10P are obtained in eyes with low scleral rigidityQ seen in high myopes and following ocular surgery Applanation tonometry The concept of Applanation tonometry was introduced by GoldmannQ is 1954. It is best on lmbe-Fick lawQ. Currently, it is the most popular and accurate tonometerQ | train | med_mcqa | null |
Nucleus tractus solitarius is associated with which cranial nerve: | [
"5",
"9",
"8",
"4"
] | B | Ans. B. 9Nucleus tractus solitarius (NTS) is a series of purely sensory nuclei forming a vertical column of grey matter embedded in the medulla oblongata. It is best known for carrying afferent taste (special visceral afferent) information, but it is also a major processing station for ascending visceral information from throughout the body, and it plays an important role in neuro-immune loops and autonomic reflexes. Major functions include taste and cardiac control.The nucleus tractus solitarius and associated tract receives special and general visceral afferents via the facial (CN VII), glossopharyngeal (CN IX) and vagus (CN X) nerves. | train | med_mcqa | null |
Multinucleated giant cells are seen in smear from the lesions of: March 2013 | [
"Poliovirus",
"Herpes simplex virus",
"Rabiesvirus",
"HIV"
] | B | Ans. B i.e. Herpes simplex virus Herpes simplex and herpes zoster viruses cause abnormal cell division in epidermal cells, and this creates multinucleated giant cells. These are epidermal cells that are much larger than the normal epidermal cells, and they contain multiple nuclei. | train | med_mcqa | null |
A pt. was treated with amitryptiline for depression developed urinary retention, constipation and blurring of vision, most likely cause is : | [
"Anticholinergic side effects",
"Expressed symptoms of depression",
"Superadded prostatic enlargement",
"Any of the above"
] | A | Ans. is 'a' Anticholinergic side effects Tricyclic Antidepressants have prominent Anticholinergic side effects. Symptoms are -Dry mouthBad TasteBlurred vision (mydriasis)ConstipationUrinary retentionEpigastric distress | train | med_mcqa | null |
The following are true about acanthosis nigrans except | [
"It is an important cutaneous marker of benign conditions",
"It is autosomal recessive",
"It is an important cutaneous marker of malignant conditions",
"Most commonly appears in the flexural areas of the body"
] | B | Acanthosis nigricans is a condition marked by thickened, hyperpigmented skin with a “velvet-like” texture that most commonly appears in the flexural areas (axillae, skin folds of the neck, groin, and anogenital regions). It can be an important cutaneous marker of benign and malignant conditions and, accordingly, is divided into two types. The benign type, which constitutes about 80% of all cases, develops gradually and usually occurs in childhood or during puberty. It may occur (1) as an autosomal dominant trait with variable penetrance, (2) in association with obesity or endocrine abnormalities (particularly with pituitary or pineal tumors and diabetes), and (3) as part of several rare congenital syndromes. As with seborrheic keratoses, acanthosis nigricans sometimes occurs as a paraneoplastic process resulting from the production of growth factors by a variety of tumors. The malignant type refers to lesions arising in middle-aged and older individuals in association with underlying cancers, most commonly gastrointestinal adenocarcinomas. The epidermis and underlying enlarged dermal papillae undulate sharply to form numerous repeating peaks and valleys. Variable hyperplasia may be seen, along with hyperkeratosis and slight basal cell layer hyperpigmentation (but no melanocytic hyperplasia). The familial form is associated with germline activating mutations in FGFR3; depending on the mutation, acanthosis may be an isolated finding or be seen together with skeletal deformities, including achondroplasia and thanatophoric dysplasia. | train | med_mcqa | null |
Pterygium of nail is characteristically seen in | [
"Lichen planus",
"Psoriasis",
"Tinea unguium",
"Alopecia areata"
] | A | A i.e. Lichen planus | train | med_mcqa | null |
Which of the following is not a hyaline cailage | [
"Aicular cailage",
"Thyroid cailage",
"Meniscus",
"Nasal septum"
] | C | Inderbir Singh's Human Histology Pg 83 Hyaline cailage seen in thyroid and cricoid cailage and also in nasal septum region | train | med_mcqa | null |
Autosomal recessive polycystic kidney disease features include: | [
"Can be diagnosed intrauterine",
"Proceeds to renal failure till children reaches school going age",
"Can be palpated abdominally",
"Hypertension doesn't develop until late stages of the disease"
] | A | Ans. A. Can be diagnosed intrauterineExplanationClinical features of ARPKD (Autosomal recessive polycystic kidney disease) are:Classic ARPKD is generally diagnosed in utero or within the neonatal period and characterized by greatly enlarged echogenic kidneys in diseased fetuses. (Option a)Reduced fetal urine production may contribute to oligohydramnios and pulmonary hypoplasia.About 30% of affected neonates die shortly after birth due to respiratory insufficiency. Close to 60% of mortality occurs within the first month of life.In the classic group, most patients are bom with renal insufficiency and ESRD (End stage renal disease). (Option b)However, infants often have a transient improvement in their GFR; death from renal insufficiency at this stage is rare.Some patients are diagnosed after the neonatal stage and form the older group. Morbidity and mortality in this group often involve systemic hypertension, progressive renal insufficiency, and liver manifestations.The hallmarks of ARPKD liver disease are biliary dysgenesis due to a primary ductal plate malformation with associated periportal fibrosis, namely congenital hepatic fibrosis (CHF) and dilatation of intrahepatic bile ducts (Caroli's disease). CHF and Caroli's disease can then lead to portal hypertension exhibiting hepatosplenomegaly, variceal bleeding, and cholangitis.Some patients with the diagnosis of ARPKD at 1 year of age with nephromegaly exhibit slowly declining renal function over 20 years with only minimally enlarged kidneys at ESRD (Option c and e) and markedly atrophic kidneys following renal transplantation.The slow progression of renal disease is likely due to increasing fibrosis rather than the development of cysts.Systemic hypertension is common in all ARPKD patients, even those with normal renal function. (option d) | train | med_mcqa | null |
In primary pulmonary hypeension basic abnormality in gene lies in | [
">Bone morphogenetic protein receptor II",
">Endothelin",
">Homeobox gene",
">PAX-11"
] | A | Bone morphogenetic protein receptor II Mutation in the bone morphogenetic protein receptor-2 (BMPR-II) cause pulmonary aerial hypeension. The BMPR-II gene plays a role in regulating the number of cells in ceain tissues. Researchers suggest that a mutation in this gene promotes cell division or prevents cell death, resulting in an overgrowth of cells in small aeries throughout the lungs. As a result, these aeries narrow in diameter which increases the resistance to blood flow. The blood pressure in the pulmonary aery and the right ventricle of the hea increases to overcome the increased resistance to blood flow resulting in pulmonary hypeension. | train | med_mcqa | null |
In a child, CSF examination is not used in diagnosis of: | [
"ALL",
"Hodgkin's lymphoma",
"Non- Hodgkin's lymphoma",
"AML"
] | B | Ans. b. Hodgkin's lymphoma Acute Lymphoblastic Leukemia (ALL), Non-Hodgkin's lymphoma and Acute Myeloid Leukemia disseminate CSF. So, CSF examination can be used in the diagnosis. Prophylactic craniospinal irradiation is used in the treatment In Hodgkin s lymphoma, there is no CSF spread, so CSF examination is not used in the diagnosis Prophylactic Craniospinal Irradiation Prophylactic craniospinal irradiation is useful in CNS malignancy which disseminate CSF or any malignancy with high risk of CNS spreadQ Indications of Prophylactic Craniospinal Irradiation MedulloblastomaQ GlioblastomaQ GerminomaQ Small cell Ca of lung ALLQ Non-Hodgkin's lymphomaQ Leptomeningeal RhabdomyosarcomaQ | train | med_mcqa | null |
Which of the following diagnostic techniques is most specific for pulmonary embolism | [
"Pulmonary angiography",
"Ventilation lung scanning",
"Perfusion lung scanning",
"Aerial blood gas analysis"
] | A | CT pulmonary angiography is the first-line diagnostic test for pulmonary thromboembolism.It has the advantages of visualising the distribution and extent of the emboli,or highlighting an alternative diagnosis,such as consolidation,pneumothorax or aoic dissection.A definitive diagnosis of Pulmonary embolism depends on visualisation of an intraluminal filling defect in more than one projection.Secondary signs of PE include abrupt occlusion("cut off")of vessels,segmental oligemia or avascularity, a prolonged aerial phase with slow filling,and touous,tapering peripheral vessels. Reference:Harrison's Medicine-18th edition,page no:2174;Davidson's Medicine-22nd edition,page no:722. | train | med_mcqa | null |
Ovulation is seen after how many hours of the 'Peak' of the 'Up stroke' in this diagram here : | [
"0-6 hours",
"10-12 hours",
"12-24 hours",
"24-36 hours"
] | B | From the onset of the LH surge, it takes 34-36 hours and from the peak it takes 10-12 hours to ovulate. The midcycle LH surge is responsible for a dramatic increase in local concentrations of prostaglandins and proteolytic enzymes in the follicle. These substances progressively weaken the follicular wall and ultimately allow a perforation to form. | train | med_mcqa | null |
A 60-yrs-old diabetic man undergoes resection of an infected boil on his back. The wound is left open for packing and cleansing. Week by week, the wound grows smaller. Which of the following is true concerning wound contracture? | [
"It is the primary process affecting closure of a sutured or stapled surgical wound",
"Bacterial colonization significantly slows the process of contraction",
"It may account for a maximum of 50% decrease in the size of a wound",
"It is based on specialized fibroblasts that contain actin myofilaments"
] | D | While epithelialization is responsible tor the healing of a closed incision, wound contraction is the primary method of closure in open wounds. During this process, the skin surrounding the wound is pulled over the wound surface and may account for up to a 90% reduction in the size of an open wound. In areas of greater adherence of skin to underlying tissue, the ability of contraction to close the wound is hindered due to the decreased mobility of the skin, Therefore, in areas of tight skin adherence such as the leg, contraction may only account for- 30 to 40% reduction in wound size. Fibroblasts in the open wound, which predominate during the proliferative phase, contain increasing numbers of actin microfilaments, thereby becoming myofibroblasts, These specialized fibroblasts are thought to be responsible tor wound contraction either through intrinsic cellular contraction or attachment to collagen strands. | train | med_mcqa | null |
Duration of latent phase of labour is affected by :a) Early use of conduction anaesthesia and sedation b) Unripe cervixc) Hypertonic uterine contractiond) Pre-eclampsia | [
"ac",
"a",
"ad",
"ab"
] | D | null | train | med_mcqa | null |
Paraxial mesoderm develops into | [
"Somites",
"Mesonephric duct",
"Notochord",
"All of the above"
] | A | Human embryology Tenth edition Inderbier Singh Page no 62At first, the cells of paraxial mesoderm are homogeneously arranged later the mesoderm get segmented The segment are two categories somitomeres and somites | train | med_mcqa | null |
Lymphangitis is caused by | [
"Staphylococcus",
"Streptococcus",
"Pneumococcus",
"Neisseria"
] | B | S. pyogenes causes a variety of suppurative infections of the skin, including infections of wounds and burns, with a predilection to produce lymphangitis and cellulitis. Ref: Textbook of microbiology; Ananthanarayan and paniker's; 10th Edition; Pg:215 | train | med_mcqa | null |
Amacrine cells secrete all except | [
"Acetylcholine",
"GABA",
"Adrenaline",
"Glycine"
] | A | Amacrine cells are interneurons in the retina. Amacrine cells are inhibitory neurons and project their dendritic arbours to the inner plexiform layer (IPL), there interacting with retinal ganglion cells and/or bipolar cells. The amacrine cells transmit signals in two directions, either directly from bipolar cells to ganglion cells or horizontally within the inner plexiform layer from axons of the bipolar cells to dendrites of the ganglion cells or to other amacrine cells.Histological and pharmacological studies have proven the existence of many types of amacrine cells that secrete at least eight types of transmitter substances, including gamma-aminobutyric acid (GABA), glycine, dopamine, acetylcholine, and indolamine, all of which normally function as inhibitory transmitters.Ref: Guyton 13e pg: 656 | train | med_mcqa | null |
Which of the following is true regarding superfecundation? | [
"Feilization of a second ovum in a woman who is already pregnant in different cycle",
"Occurs only in bipaite uterus",
"Both ova do not always develop to maturity",
"The second foetus is born later as a mature child"
] | C | Both ova do not always develop to maturity Superfecundation : Is feilization of 2 ova discharged from the ovary at the same period by 2 separate acts of coitus committed at sho intervals. Both ova do not always develop to maturity. One fetus may get aboed early or die and get retained until labour. Superfetation : Feilization of a second ovum in a woman who is already pregnant is superfoetation. It can occurs in a bipaite uterus. Superfoetation Superfecundation A long interval intervenes between feilization. Requires ovulation and feilization during the course of an established pregnancy. Unproven to occur in humans. Feilization of 2 ova within the same menstrual cycle but not at the same coitus,nor necessarily by sperm from the same male. | train | med_mcqa | null |
Most common ocular movement affected in thyroid ophthalmopathy- | [
"Adduction",
"Abduction",
"Elevation",
"Depression"
] | B | Unilateral elevator palsy caused by an involvement of the inferior rectus muscle followed by failure of abduction due to involvement of medial rectus muscle. Ref .ak khurana 6th edition pg no 414 | train | med_mcqa | null |
True about acute ITP: | [
"More common in adults.",
"Detection of specific anti platelet antibodies is a must for diagnosis",
"Viral infection predisposes to ITP",
"80% cases transform to chronic"
] | C | Discussing options one by one a. False ; The peak age is 1-4 yr, although the age ranges from early in infancy to the elderly b. False; Platelet antibody testing is seldom useful in acute ITP. c. True; A recent history of viral illness is described in 50-65% of cases of childhood ITP d. False; 20% of children (and 50% of adolescents) who present with acute ITP transform to chronic ITP. Idiopathic thrombocytopenic purpura -quantitative disorder of platelets caused by antibodies directed against platelet or megakaryocytic antigens -related to antibody-mediated immune destruction of platelets or their precursors. -The peripheral blood smear in ITP exhibits numerous large platelets, and the bone marrow shows acompensatory increase in megakaryocytes. Acute ITP exhibits: Non-palpable petechiae, which mostly occur in dependent regions Hemorrhagic bullae on mucous membranes Non papable purpura Gingival bleeding Signs of GI bleeding Menometrorrhagia, menorrhagia Retinal hemorrhages Evidence of intracranial hemorrhage Non-palpable spleen | train | med_mcqa | null |
Duffy antigen is associated with | [
"Plasmodium falciparum",
"Plasmodium ovale",
"Plasmodium vivax",
"Plasmodium malariae"
] | C | The Duffy glycoprotein is a receptor for chemicals that are secreted by blood cells during inflammation. It also happens to be a receptor for Plasmodium vivax, a parasite that invades red blood cells (RBCs) and causes malaria. Ref ananthnarayana and panikers microbiology textbook 8/e | train | med_mcqa | null |
Distribution of blood flow is mainly regulated by the: | [
"Arteries",
"Arterioles",
"Capillaries",
"Venules"
] | B | null | train | med_mcqa | null |
ERCP is indicated for the following except | [
"Distal CBD tumor",
"Hepatic poa tumor",
"Proximal cholangiocarcinoma",
"Gallstone pancreatitis"
] | C | . | train | med_mcqa | null |
Which of the following factor is mainly responsible for virulence in Streptococcus - | [
"Carbohydrate",
"Streptokinase",
"Streptodornase",
"M protein"
] | D | null | train | med_mcqa | null |
A young asymptomatic female is observed to have a Mid-systollic click on routine examination. Valves are likely to show | [
"Myxomatous degeneration",
"Aschoff bodies",
"Calcified degeneration",
"Rupture chordae tendinae"
] | A | Ref Harrison 19 th ed pg 1546 MVP, also variously termed the systolic click-murmur syndrome, Barlow's syndrome, floppy-valve syndrome, and billowing mitral leaflet syndrome, is a relatively common but highly variable clinical syndrome resulting from diverse pathologic mechanisms of the mitral valve apparatus. Among these are excessive or redundant mitral leaflet tissue, which is commonly associated with myxomatous degeneration and greatly increased concentrations of ceain glycosaminoglycans. | train | med_mcqa | null |
Retentive grooves of a proximal box in a class II cavity prepared for amalgam should be: | [
"Sharp and elongated at the dentino enamel junction of the buccal and lingual walls",
"Sharp and well defined extending from the gingival to the occlusal cavosurface angle along the buccal and lingual line angles",
"Elongated and rounded in dentine at the buccoaxial and linguoaxial Line angles extending from th... | C | null | train | med_mcqa | null |
Best marker for cardiac events- | [
"hsCRP",
"Homocysteine levels",
"Interleukin-6",
"P. selection"
] | A | hs-CRP is a very promising novel biochemical marker for the prediction of future first or recurrent coronary events. American and European prospective studies have been highly consistent regarding the ability of hs-CRP to predict future CHD risk in both men and women. Ref Davidson 23rd edition pg 434 | train | med_mcqa | null |
Pain by massaging & liniments is relieved due to - | [
"Gate control",
"Endogenous opioids",
"Inhibition of pain receptors",
"All of the above"
] | A | Ans. is 'a' i.e., Gate control Dorsal horn gating (Gate control theory):o Substantia gelatinosa (SG) in dorsal horn of spinal cord contains enkephalinergic inhibitory interneurons that inhibit, presynaptically as well postsynaptically, the nociceptive spinothalamic neurons. The tactile (touch- pressure) large myelinated Ab fibers of dorsal root stimulate these interneurons through collaterals and thereby inhibit the conduction of pain by spinothalamic tract. The nociceptor Ad and C fibers themselves inhibit these SG inhibitory intemeurons by collaterals and thereby able to transmitt the pain. However, this is only possible if Ab fibers are not stimulated simultaneously.o In other words, SG inhibitor intemeurons serve as a gate in the pain pathway. The gate remains open when only Ad and C fibers are stimulated but tends to close down when Ab fibers are stimulated simultaneouslyo The gate control theory provides the basis for reducing pain by other tactile stimuli. For example, application of counterirritant balm or liniments; massage; transcutaneous electric stimulation (TENS), stimulation of skin e.g. applying hot water bag over an area of visceral stimulation; or acupuncture etc. | train | med_mcqa | null |
Peak growth velocity in adolescent girl is indicated by – | [
"Breast enlargment",
"Axillary hair",
"Public hair",
"Just before commensement of menarche"
] | D | Mensus typically appears around the peak in height velocity -Nelson
Menarche usually occurs after peak velocity has been attained and as the growth rate begins to decline.
Remember:
Growth acceleration begins in early adolescence, but peak growth velocities are not reached until middle adolescence. | train | med_mcqa | null |
Most common cause of epidural abscess - | [
"Staphylococcus",
"Streptococcus",
"Gram negative bacilli",
"Microaerophilic anaerobic streptococci"
] | A | Ans. is 'a' i.e., Staphylococcuso Therefore spinal epidural abscess is much more common than the intracranial epidural abscess.# Spinal epidural abscess is more common by a factor of nine to one.Causes of epidural abscess | train | med_mcqa | null |
During heterosexual intercourse, seminal fluid containing HIV contacts vaginal squamous mucosa. Cells capture virions and transport the virus via lymphatics to regional lymph nodes. Within the germinal centers of these lymph nodes, the virions infect CD4+ lymphocytes and proliferate, causing CD4+ cell lysis with release of more virions, which are taken up on the surface of cells having Fc receptors, allowing continued infection by HIV of more CD4+ cells passing through the nodes. Which of the following types of cells is most likely to capture HIV on its surface via Fc receptors? | [
"B lymphocyte",
"CD8+ cytotoxic lymphocyte",
"Follicular dendritic cell",
"Natural Killer cell"
] | C | Dendritic cells are a form of antigen-presenting cell. Dendritic cells in epithelia are known as Langerhans cells, and those within germinal centers are called follicular dendritic cells (FDCs). The FDCs may become infected but not killed by HIV. They have cell surface Fc receptors that capture antibody-coated HIV virions through the Fc portion of the antibody. These virions attached to the FDCs can infect passing CD4+ lymphocytes. Dendritic cells elaborate type I interferons that up-regulate antiviral proteins in neighboring cells. B cells are a component of humoral immunity, and antibody to HIV does not serve a protective function, but allows serologic detection of infection. CD8+ cells are cytotoxic lymphocytes that lack the receptor necessary for infection by HIV. Because they survive selectively, the CD4+:CD8+ ratio is reversed so that it is typically less than 1 with advanced HIV infection. Innate lymphoid cells resemble NK cells, but shape further lymphoid reactions. Langhans giant cells are "committees" of activated macrophages that are part of a granulomatous response. Macrophages are a type of antigen- presenting cell that can become infected by HIV without destruction. Mast cells have surface-bound IgE, which can be cross-linked by antigens (allergens) to cause degranulation and release of vasoactive amines, such as histamine, as part of anaphylaxis with type I hypersensitivity. | train | med_mcqa | null |
Commonest location of diaphragmatic (bochdalek) hernia in childrens is: | [
"Retrosternal",
"Posterior and left",
"Posterior and right",
"Central"
] | B | Bochdalek hernia (involves an opening on the left side of the diaphragm) occur posteriorly and are due to a defect in the posterior attachment of the diaphragm when there is a failure of pleuroperitoneal membrane closure in utero. Retroperitoneal structures may prolapse through the defect, e.g. retroperitoneal fat, spleen or left kidney. Bochdalek hernias occur more commonly on the posterior left side (85%, versus right side 15%).Complications are usually due to pulmonary hypoplasia.In adults, incidentally-discovered posterior diaphragmatic hernias are rare. Of these, right-sided hernias are more common (68%), and more frequently in females.The great majority are small, with only 27% containing abdominal organs such as bowel, spleen or liver.Morgagni hernia - A Morgagni hernia involves an opening on the right side of the diaphragm. The liver and intestines usually move up into the chest cavity. | train | med_mcqa | null |
An emergency thoracotomy shown here is known as | [
"Right thoracotomy",
"Clam shell thoracotomy",
"Median sternotomy",
"Left thoracotomy"
] | B | Ans. (b) Clam shell thoracotomy* In emergency the chest cage is opened fully at diaphragm level to look for major vessel injury and repair- this is known as Clam shell thoracotomy | train | med_mcqa | null |
Earliest response to iron in iron deficiency anemia is denoted by | [
"Restoration of enzymes",
"Reticulocytosis",
"Increase in iron birding capacity",
"Increase in heamoglobin"
] | B | Response to iron therapy:
Rapid subjective improvement, with disappearance (or) marked dimination of fatigue, lassitude, and other nonspecific symptoms before any improvement in anemia is observed.
Earliest heamotologic evidence of response to treatement is an increase in reticulocytes % G and Hb content.
Maximal reticulocytes % is on 5th to 10th day after institution of therapy and thereafter returns to normal.
Maximum value usually ranges from 5 to 10 % and is inversly related to the level of heamoglobin.
Heamoglobin level is the most accurate measure of the degree of anemia in iron deficiency. | train | med_mcqa | null |
Characteristic of protective epithelium is ? | [
"Regeneration of membrane",
"Microvilli",
"Thinness",
"Pinocytic vesicle"
] | A | Ans. is 'a' i.e., Regeneration of membraneThe regeneration of epithelium is one of the protective mechnaism of epithelial cells. There are three mechanism for healing.Resolution It is an ideal outcome of healing and occurs in acute infalmmatory responses to minor injuries.Regeneration Replacement of lost parenchymal cells by division of adjacent surviving parenchymal cells (Regeneration) can also restore injured tissue to normal. Whether regeneration occurs depends uponi) Regenerative capacity of the involved cell (i.e., their ability to divide)ii) The no. of surviving ble cellsiii) Presence of connective tissue framework that will provide the base for restoration of normal tissue structure. C.Repair by scar formation A scar is a mass of collagen that is the end result of repair by organization and fibrosis. Repair by scar formation occurs when.i) Resolution fails to occurs in an acute inflammatory responseii) When there is ongoing tissue necrosis in chronic inflammation.When parenchymal cells necrosis cannot be repaired by regeneration. | train | med_mcqa | null |
Low risk type of HPV - | [
"Type -16",
"Type - 6",
"Type-18",
"Type-31"
] | B | Ans. is 'b' i.e., type 6 o High risk HPV: HPV-16,18,31,33 & 45 - associated with cervical cancero Low risk HPV: HPV- 6 & 11 - associated with precursor lesions CINo HPV-5 & 8 - associated with squamous cell cancer in patients with epidermodysplasia verruciformis. | train | med_mcqa | null |
DOC for rapid cycling MDP - | [
"Lithium",
"Valproate",
"Calcium channel blocker",
"Carbamazepine"
] | B | DOC for rapid cyclers is Valproate.
Alternatives are Lithium, Carbamazepine and Lamotrigine. | train | med_mcqa | null |
Bile acids are synthesized from | [
"Cholesterol",
"Amino acids",
"Bilirubin",
"Protein"
] | A | Bile is a digestive juice formed continuously in liver. Bile contains organic substances like bile salts which are formed when conjugated bile acids combine with Na/K. Bile acids are of two types: Primary bile acids are choilc acid & chenodeoxycholic acid.These are synthesized by hepatocytes from cholesterol. Secondary bile acids are deoxycholic acid & lithocholic acid. These are formed from the primary bile acids in the colon by the action of intestinal bacteria.Ref: Medical Physiology, Indu Khurana | train | med_mcqa | null |
Recurrent epistaxis in a 15-year-old female the probable cause is: | [
"Juvenile nasopharyngeal fibroma",
"Rhinosporidiosis",
"Foreign body",
"Haematological disorder"
] | D | (d) Haematological disorder(Ref. Cummings, 6th ed., 680)Juvenile nasopharyngeal fibroma is seen typically in adolescent males.In Rhinosporidiosis there is nasal obstruction along with epistaxis and a history of taking bath in ponds frequented by animals is present.Foreign body is not seen at this age.So the probable cause here is haematological disorder. In this regard the patient should be asked regarding bleeding from any other site also.Characteristically haematological disorders present with bleeding from multiple sites. | train | med_mcqa | null |
Ventricular ectopic beats represented by - | [
"Irregular RR interval",
"Incomplete compensatory pause",
"A.V. dissociation",
"Presence of fusion beat"
] | A | Ventricular ectopic beats (VEBs) are commonly seen in daily clinical practice. They are largely asymptomatic but can cause upsetting symptoms in some patients. In normal heas, their occurrence is usually associated with no clinical significance RR intervals are irregular but there are normal PQRST complexes. Hea rate is usually normal, but slow in telemetered minipigs to 70 beats per minute. The irregularity in RR intervals is due to changes in vagal tone secondary to respiration, although not as great as in other species such as the dogs Ref Harrison 20th edition pg 1443 | train | med_mcqa | null |
Germ tube test is done for | [
"Candida albicans",
"Candida tropicalis",
"Candida glabrata",
"Candida kefyr"
] | A | Germ tube test / Reynold braude phenomenon - specific test for Candida albicans Colonies are mixed with human or sheep serum & incubated for 2 hours . Wet mount preparation is examined under microscope. Germ tubes are formed , describe as long tube like projections extending from yeast cells. | train | med_mcqa | null |
Which of the following bacteria act by increasing cAMP | [
"Staphylococcus aureus",
"E. coli heat stable toxin",
"Vibrio cholera",
"Salmonella"
] | C | Cholera produces a potent enterotoxin known as cholera toxin.
This toxin consists of | train | med_mcqa | null |
A 69 year old woman is brought to the emergency room after falling off a step stool and fracturing her hip. Her past medical history is significant for several bouts of pneumonia during the past year. Laboratory results indicate a normal white blood cell count, but platelets are decreased, and the erythrocyte sedimentation rate (ESR) is elevated. X-rays reveal multiple lytic bone lesions. Serum electrophoresis demonstrates an M-protein spike. Which of the following is the most likely diagnosis? | [
"Chronic lymphocytic leukemia",
"Monoclonal gammopathy of unceain significance",
"Multiple myeloma",
"Plasmacytoma"
] | C | The patient is suffering from multiple myeloma, a neoplastic proliferation of plasma cells (or their precursors) found within the bone marrow. These malignant cells are responsible for the production of excessive amounts of immunoglobulin (usually IgG or IgA), producing an M- protein spike, and increasing the ESR. The decreased platelet count probably reflects infiltration of the bone marrow by myeloma cells. It is not unusual for patients with malignant myeloma to have recurring bacterial infections, paicularly pneumococcal pneumonia, because the overall production of normal immunoglobulins of all isotypes is decreased. Lytic bone lesions due to infiltration by myeloma cells may lead to pathological fractures. All of the other disorders listed can be associated with an M- protein spike, but this is a nonspecific finding. Chronic lymphocytic leukemia is ruled out by the normal white count, since this type of leukemia is generally associated with an absolute lymphocytosis. Patients with monoclonal gammopathy of undetermined significance (choice B) are generally asymptomatic, although they have a predisposition for subsequently developing myeloma, lymphoma, amyloidosis, or Waldenstrom's macroglobulinemia. Plasmacytoma (solitary myeloma) is a rare, isolated plasma cell neoplasm in bone or soft tissues. If the primary cancer is in bone, it is likely to disseminate; extra osseous tumors tend to remain localized. Since this patient had multiple lytic bone lesions, multiple myeloma is the correct diagnosis. Ref: van Rhee F., Anaissie E., Angtuaco E., Bael T., Epstein J., Nair B., Shaughnessy J., Yaccoby S., Barlogie B. (2010). Chapter 109. Myeloma. In J.T. Prchal, K. Kaushansky, M.A. Lichtman, T.J. Kipps, U. Seligsohn (Eds), Williams Hematology, 8e | train | med_mcqa | null |
Barrets esophagus is commonly associated with one of the following | [
"Adenocarcinoma",
"Squamous cell carcinoma",
"Sarcoma",
"Gastrointestinal stromal tumor"
] | A | Barrett's oesophagus is a metaplastic change in the lining mucosa of the oesophagus in response to chronic gastro-oesophageal reflux . Squamous epithelium of lower end of the oesophagus is replaced by diseased columnar epithelium. When intestinal metaplasia occurs, there is an increased risk of adenocarcinoma of the oesophagus, which is about 25 times that of the general population.Reference : page 1022-23 Bailey and Love's sho practice of surgery 25th edition | train | med_mcqa | null |
True about Rocuronium bromide is all except | [
"One of the most commonly used non depolarizing agent",
"Non depolarizing agent of choice for RSI",
"Sugammadex is the specific reversal agent",
"Most preferred in hepatic and renal failure"
] | D | It is metabolized by liver and kidney so to be avoided in preexisting hepatic and renal disorder. Hepatic and Renal failure , the neuromuscular blocker of choice is Atracurium and Cisatracurium Cis-atracurium undergoes Hofmann elimination - which is spontaneous non-enzymatic degradation. So renal failure doesn't affect the clearance of cis atracurium. Hence it is the agent of choice in renal failure patients. Atracurium also undergo Hofmann elimination and so is an alternative to cis atracurium in renal failure. Steroidal muscle relaxants are predominantly eliminated by ultrafiltration by the glomeruli before urinary excretion. Doxacurium, pancuronium, and pipecuronium are paially excreted by the kidneys, and so the neuromuscular block is prolonged in patients with renal failure. | train | med_mcqa | null |
Which of the following acts as an antagonist to NMDA receptor? | [
"Ketamine",
"Spermine",
"Muscimol",
"Baclofen"
] | A | Ketamine is a general anesthetic agent which acts by blocking excitatory NMDA type of glutamate receptors. | train | med_mcqa | null |
Treatment of diabetic retinopathy | [
"Phacoemulsification",
"Retina laser photocoagulation",
"LASIK",
"None"
] | B | B i.e. Retina laser photocoagulation | train | med_mcqa | null |
Which of the following agents enhances the bioavailability of levodopa in patients with Parkinson's disease: | [
"Amantadine",
"Ropinirole",
"Entacapone",
"Selegiline"
] | C | Entacapone & tolacapone which cones under COMT INHIBITORS enhance & prolong the therapeutic effect of levodopa-carbidopa in advanced & fluctuating PD . Ref: KD Tripathi 8th ed. | train | med_mcqa | null |
Frisch bacillus affects most commonly - | [
"Mouth",
"Nose",
"Eye",
"Ear"
] | B | Ans. is 'b' i.e., Noseo Frisch bacillus is Klebsiella rhinoscleromatis, which causes rhinoscleroma, a granulomatous disease of nose.Bacteria and their alternate nameso Bordetellao Clostridium tetanio Corynebacterium diphtheriaeo Corynebacterium pseudotuberculosiso Haemophilus aegypticuso Haemophilus influenzao Klebsiella pneumoniao Klebsiella ozaenaeo Klebsiella Rhinoscleromatiso Mycobacterium tuberculosiso Mycobacterium intracellulareo Mycobacterium paratuberculosiso Mycoplasmao Pseudomonas pseudomalleiBordet Gengou bacillusNicolaire s bacillusKlehs-Loeffler '.s bacillusPreisz-Nocard bacillusKoch-Weeks bacillusPfeiffer s bacillusFriedlander s bacillusAbel's bacillusFrisch's bacillusKoch's bacillusBatteys bacillusJohne's bacillusEaton agentWhitmore s bacillus | train | med_mcqa | null |
Treatment in days for meningitis for strept pneumonia in children ? | [
"5 days",
"7 days",
"10 days",
"21 days"
] | C | Ans. is 'c' i.e., 10 days Child with bacterial meningitis shows improvement in 10 days and rarely necessary beyond 14 days. Staph meningitis and gram negative infection require treatment for 21-28 days. N. meningitis - Penicillin for 5-7 days. H. Influenze - for 7-10 days | train | med_mcqa | null |
Floatation of a body in water is due to - | [
"Flesh being eaten by fishes",
"Presence of gases",
"Water logging of body",
"All of the above"
] | B | o Floatation of dead body occurs due to accumulation of sufficient putrefactive gases. | train | med_mcqa | null |
Hypersensitivity pneumanitis is classifically described as | [
"Type I hypersensitivity reaction",
"Type II hypersensitivity reaction",
"Type III (immune complex) hypersensitivity",
"Type IV (cell mediated) hypersensitivity"
] | D | null | train | med_mcqa | null |
The normal pH of the saliva is about | [
"5.5",
"9.5",
"7.5",
"8.5"
] | C | null | train | med_mcqa | null |
Periodontitis may best be described as | [
"A chronic inflammatory disease with periods of remission and exacerbation",
"A chronic inflammatory disease that usually does not manifest itself clinically before the age of 40",
"A degenerative disease of the periodontium",
"An acute inflammatory disease of long duration"
] | A | null | train | med_mcqa | null |
In which condition vanillylmandelic acid is excreted in urine | [
"Gaucher's disease",
"Phenylketonuria",
"Pheochromocytoma",
"Hartnup's disease"
] | C | In Pheochromocytoma, increased and uncontrolled synthesis of catecholamines takes place.
The breakdown product of catecholamines is vanillymandelic acid, and thats get excreted in urine. | train | med_mcqa | null |
Underlying pathology of Nevus anemicus is: | [
"Autoimmune destruction of melanocytes",
"Arrest of migration of melanocytes",
"Abnormal vasoconstriction",
"Defect in tyrosinase enzyme"
] | C | Nevus anemicus presents as a localized area of skin blanching and hypopigmentation because of abnormal vasoconstriction due to increased sensitivity of blood vessels to catecholamines. | train | med_mcqa | null |
Which of the following is not pa of control measures for diphtheria- | [
"Treatment of cases with antitoxin and erythromycin",
"Treatment of carriers with antitoxin",
"Isolation of cases, suspected cases and carriers",
"Regular immunization under-fives"
] | B | The carriers should be treated with 10 days course of oral erythromycin, which is the most effective drug for the treatment of carriers . Ref:PARK&;S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE 23rd edition , Page :161 | train | med_mcqa | null |
According to WHO International Health organizations. What is the distance surrounding an Airpo or Seapo which should be free of mosquitoes? | [
"100 meter",
"200 meter",
"300 meter",
"400 meter"
] | D | Under the WHO International Health Regulations, all international airpos and seapos are kept free from all types of mosquitoes for a distance of 400 m around the perimeter of the pos. Park's textbook of preventive and social medicine 23rd edition. | train | med_mcqa | null |
Type of inheritance in Tuberous sclerosis | [
"Autosomal dominant",
"Autosomal recessive",
"X-linked dominant",
"X-linked recessive"
] | A | Tuberous sclerosis complex (TSC) is a rare multisystem genetic disease that causes benign tumors to grow in the brain and on other vital organs such as the kidneys, hea, liver, eyes, lungs, and skin. A combination of symptoms may include seizures, intellectual disability, developmental delay, behavioral problems, skin abnormalities, and lung and kidney disease. TSC is caused by a mutation of either of two genes, TSC1 and TSC2, which code for the proteins hamain and tuberin, respectively. These proteins act as tumor growth suppressors, agents that regulate cell proliferation and differentiationTSC is a genetic disorder with an autosomal dominant pattern of inheritance, variable expressivity, and complete penetrance. Two-thirds of TSC cases result from sporadic genetic mutations, not inheritance, but their offspring may inherit it from them. Current genetic tests have difficulty locating the mutation in roughly 20% of individuals diagnosed with the disease. So far, it has been mapped to two genetic loci, TSC1 and TSC2. | train | med_mcqa | null |
‘Smoking’ is not associated with the following respiratory lesion | [
"Sarcoidosis",
"Chronic bronchitis",
"Emphysema",
"Lung carcinoma"
] | A | null | train | med_mcqa | null |
RB gene is located on - | [
"13p",
"13q",
"15p",
"15q"
] | B | Ans. is 'b' i.e., 13q Location of Important Genes on ChromosomesGeneChromosomeGeneChromosomep73IPRET10Folate transporter21 qWT-IlipNeuroblastomaIPvWF12Rhodopsin3Retinoblastoma (RB)13qVHL3pBRCA-1I3qADPKD-24qBRCA-2I7qADC-PFibrillin-115MHC6pFibrillin-25ARPKD6NF-117qCystic fibrosis7qp5317qMET7NF-222q | train | med_mcqa | null |
A 45-year old chronic alcoholic patient developed ascites and decreased libido. Physical examination revealed mild enlargement of the breasts and atrophy of testes. A liver biopsy was done. All of the followings are probable findings seen in histopathologic examination, EXCEPT: | [
"Complete disruption of hepatic lobular architecture",
"Bands of fibrosis",
"Necrosis and infiltration of neutrophils within hepatic lobules",
"Regenerating lobules"
] | C | Chronic alcohol intake may give rise to cirrhosis of the liver in the long run. Cirrhosis of the liver is featured by destruction of hepatic lobules, regeneration of hepatic lobules, formation of fibrotic bands, and infiltration of lymphocytes within fibrous bands. Stasis of bile and proliferation of bile ductule are also seen. Necrosis and infiltration of neutrophils and lymphocytes of hepatic lobules are seen in chronic active hepatitis. Ref: Bacon B.R. (2012). Chapter 308. Cirrhosis and Its Complications. 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 |
Sleep waves in hippocampal area is(MP 2000, AI 1998, KARNATAKA 2002, ASSAM 2002) | [
"Delta",
"Theta",
"Beta",
"Alpha"
] | B | Ans. (b) Theta(Ref: Ganong, 25th ed/p.273)Theta wave#Frequency is 4-7Hz#Generated in hippocampus#Most commonly seen in children#Pathologically seen often in degenerative brain diseases | train | med_mcqa | null |
The factor/mechanism involved in glomerulotubular balance is: | [
"signalling by macula densa cells",
"Oncotic pressure in peritubular capillaries",
"Contraction of the mesangial cells",
"Sluggish blood flow in medullary interstitium"
] | B | G-T balance refers to the mechanism by which increase in GFR and filtration of Na+ propoionately increases the Na+ (and water) reabsorption. Thus, a constant fraction (67%) of the filtered Na+ and water is reabsorbed from PCT, despite fluctuations in GFR. Mechanism: ~ Increased GFR (and increased filtered load of Na+& water) a increased protein concentration in the glomerular capillary plasma (as the fluid has been filtered out of this plasma) Protein-rich plasma leaves the glomerular capillaries efferent aerioles and enters the peritubular capillaries Colloid Oncotic pressure will increase in peritubular capillaries a increased the solute and water reabsorption by the PCT. Options A & C are involved in tubuloglomerular feedback. Sluggish blood flow in medullary interstitium is the basis for countercurrent exchange by vasa recta. | train | med_mcqa | null |
Major source of collagen in cirrhosis- | [
"Kupfer cells",
"Ito cell (Hepatic stellate cell)",
"Hepatocvte",
"Canalicular cell"
] | B | Ans. is 'b' i.e., Ito cell (hepatic stellate cell) o Perisinusoidal stellate cells (Ito cells) play a role in the storage and metabolism of vitamin A and are transformed into collagen producing myofibroblasts when there is inflamation of the liver,o These cells are the major source of colieeen in cirrhosis. | train | med_mcqa | null |
Minimal change glomerulopathy may be seen in association with all of the following except - | [
"Hepatitis B",
"HIV",
"Drug-induced interstitial nephritis",
"Hodgkin's disease"
] | A | null | train | med_mcqa | null |
Which of the following viruses cause an acute febrile rash and produces disease in immunocompetent children but has been associated with transient aplastic crises in persons with sickle cell disease? | [
"Rubella",
"Varicella- zoster",
"Parvovirus",
"Rubella"
] | C | Parvovirus B 19 is the causative agent of erythema infectiosum (fifth disease). It is associated with transient aplastic crisis in persons with hereditary hemolytic anemia. In adults, it is also associated with polyahralgia. | train | med_mcqa | null |
Iris pearls are pathognomonic for | [
"Syphilis",
"Sarcoidosis",
"Herpes simplex virus",
"Leprosy"
] | D | Iris pearls are seen as glistening white beads at the pupillary margin. They are compared of bacilli within histiocytes and are pathognomonic for Lepromatous uveitis. | train | med_mcqa | null |
A Female patient comes for treatment of discoloured maxillary canine tooth. On examination there is yellowish discoloration of tooth which is not tender on palpation or percussion test. Radiograph reveals obliteration of root canal. History of trauma is elicited on questioning.
What is the condition? | [
"Fibrous degeneration of pulp",
"Calcific metamorphosis",
"Pulp calcification",
"Dental fluorosis"
] | B | null | train | med_mcqa | null |
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