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 |
|---|---|---|---|---|---|---|
Red velvety appearance of gastric mucosa is seen in poisoning with - | [
"Abrus precatorius",
"Lead",
"Arsenic",
"Copper"
] | C | Red velvety appearance of gastric mucosa is characteristic of arsenic poisoning. | train | med_mcqa | null |
Plateau phase of ventricular muscle is d/f opening of | [
"Na+ channel",
"K+ channel",
"Ca++ - Na+ channel",
"Closure of K+ channel"
] | C | C i.e. Ca++-Nat Channel In cardiac (e.g. ventricular) muscle, rapid depolarization phase (0) is d/t Nat influx through rapidly opening fast Nat channels (Nat current, INa); initial rapid repolarization phase (1) is d/t inactivation of Nat channel; platue phase (2) is d/t Cattinflux (Ca+tcurrent, Ica) through more slowly opening (slow) Ca++channels (also called calcium-sodium channels) and a slow repolarization phase (3) due to net Kt efflux through multiple types of K+ channels, allows the cell to return to resting membrane potential. Myocardial fibers (cells) have RMP of approximately -90mv. Action Potential in Cardiac Ventricular Muscles volts in ventricular muscle fibers instead of -55 milivolts in the nodal fibers. - Action potential in cardiac muscle fibers averages about 105 mili volts i.e. the intracellular potential rises form a very negative -90 mV between beats to slightly positive +20 mV during each beat. 3 type of membrane ion channels in cardiac muscles responsible for causing the voltage changes include Channel Effect Fast Na' Rapidly opening of fast sodium channels for Channel 10,000 the of a second) causes rapid influx of positive sodium ion (Na+) to the interior of cardiac muscle fiber (Necurrent, IN.). It is responsible for rapid upstroke spike of action potential or rapid depolarization phase 0. Initial rapid repolarization phase lis caused by inactivation of Na+ channels. Slow Ca++ Slower opening of slow calcium (or sodium? (Na+ - Ca++) calcium) channels for about 0.3 second (i.e Channels longer duration) causes large influx of both Ca*+ and Na+ positive ions to interior of cardiac muscle fibre. This (Ca++ current/influx, Ica mainly) is responsible for maintenance of prolonged period of depolarization or platue phase (2) of ventricular AP. Potassium Rapid diffusion of large amounts of positive K+ (K+) Channels ions in outward direction (efflux) from the cardiac muscle fibre (Ek+, K+ current) immediately returns the membrane potential to its resting levels, thus ending the AP Difference b/w AP of Cardiac of Skeletal Muscles Cardiac muscles have prolonged AP (Action potential) and a platue phase, whereas skeletal muscles do not because AP of skeletal muscle is caused and almost entirely by sudden opening of fast Na+ channels for a very sho period. At the end of this abrupt closure, repolarization occurs and AP is over in another thousandth of a second. Whereas AP in cardiac muscle is caused by same fast Na+ channels as well as slow Ca+ (Na+ - channels which are slower to open and more impoantly remain open for several tenths of a second (i.e prolonged duration) thereby maintaining prolonged period of depolarization, causing the platue phase. In skeletal muscles, Ca++ ions for contraction is derived from intracellular sacroplasmic reticulum. Whereas, in cardiac muscles the Ca** that enters during plate phase activate the muscle contractile process. Immediately after the onset of AP, the permeability of cardiac muscle fiber for K+ decreases about 5 folds as a result of excess Ca++ influx through Ca++ channels. Therefore, greatly decreased outflux of positively charged K+ ions during AP platue in cardiac muscles prevents early return of AP voltage to its resting levels. This greatly decreased K+ permeability is not seen in skeletal muscles. Difference b/w AP of Cardiac Muscle & Sinus Nodal Fibers - AT the less negative (- 55 mV) RMP of nodal fibers the fast Na* channels mainly have already become inactivated (or blocked). Therefore only the slow Na+ channels can become activated (open) and cause AP. - So AP is slower to develop in nodal fibers than ventricular fibers. Similarly return of potential to its negative resting state occurs slowly as well rather than the abrupt return that occurs in ventricular muscles. | train | med_mcqa | null |
Which is true regarding exhumation? | [
"Should be within a time period of two years",
"By written order from coroner",
"Under bright illumination preferably at night",
"All are true"
] | B | Exhumation is the digging out of an already buried dead body from the grave. There is no time limit for exhumation in India. It is done only on the order of a First Class Magistrate (Executive) or Coroner. It is preferably done under natural day light. Ref:Krishnan vij Textbook of Forensic Medicine and Toxicology; 5th ed; Page no: 27 | train | med_mcqa | null |
In muscle contraction all of the following occurs except | [
"Z-lines become closer",
"H zone diappears",
"A band shortens",
"M line becomes more prominent"
] | C | In muscle contraction
Z-line become closer
Sarcomere shorten
A-band remains unchanged
H-zone disappears
I-band shortens
M line becomes more prominent | train | med_mcqa | null |
Trophozoite of Entamoeba histolytica ? | [
"Has eccentric Karyosome",
"Shows erythrocyte in cytosol",
"Central nucleus",
"Non motile"
] | B | Ans. is 'b' i.e., Shows erythrocyte in cytosol | train | med_mcqa | null |
Direction of water jet while doing syringing of ear should be: | [
"Anteroinferior",
"Posterosuperior",
"Anterosuperior",
"Posteroinferior"
] | B | In syringing (done to remove impacted wax) pinna is pulled upwards and backwards and a stream of water from the ear syringe is directed along the posterosuperior wall of the meatus. | train | med_mcqa | null |
. Renal damage due to amphotericin B are all, except- | [
"Azotemia",
"Renal tubular acidosis",
"Glomerulonephritis",
"Hypokalemia"
] | C | Impaired renal function is a relatively common complication of amphotericin B, as are other renal manifestations, including urinary potassium wasting and hypokalemia, urinary magnesium ,renal cell acidosis, azotemia,wasting and hypomagnesemia, metabolic acidosis due to type 1 (or distal) renal tubular acidosis, and polyuria due to nephrogenic Ref Harrison20th edition pg 267 | train | med_mcqa | null |
Regarding adhesive intestinal obstruction, TRUE is ? | [
"Avoid surgery for initial 48-72 hours",
"Never operate",
"Operate after minimum 10 days of conservative treatment",
"Immediate operation"
] | A | Ans. is 'a' i.e., Avoid surgery for initial 48-72 hours There are three main measures in the tit of acute intestinal obstruction. These are 1) Gastro intestinal drainage (Nasogastric suction) 2) Fluid and electrolyte replacement 3) Surgery for relief of obstruction The first two steps are always necessary prior to the surgical relief of obstruction. Surgical treatment is necessary for most cases of intestinal obstruction, but it should always be delayed until resuscitation is complete. The timing of surgical intervention is dependent on clinical picture. The classical clinical advice on a case of unrelieved intestinal obstruction is that "Sun should not both rise and set" i.e., the operative procedure should not be delayed beyond 24 hrs. But, there are ceain exceptions to this rule. In some cases operation is delayed in the hope of spontaneous resolution. In adhesive intestinal obstruction, usually occuring after surgery the upto 72 hours in the hope of spontaneous resolution. In these cases continued radiological evidence of obstruction. Also know the four types of obstruction, where operation should be done a) Stangualtion b) Closed loop obstuction c) Colon obstruction d) Early simple mechanical obstruction More about adhesive intestinal obstruction - Commonest cause of intestinal obstruction, usually follows pelvic operations Obstruction due to postoperative adhesions commonly involve the lower small bowel. | train | med_mcqa | null |
Embroyo develops from ? | [
"Inner cell mass",
"Troploblasts",
"Outer cell mass",
"None of the above"
] | A | Ans. is'a'i.e., Inner cell mass[Ref Textbook of embryology p. 24)As the morula enters the uterine cavity, uterine fluid diffuses through zona pellucida and fills small intercellular gaps between blastomeres, and morula is conveed to blastocyst.Embryoblast :A group of centrally located cells of inner cell mass and later give rise to tissues of the embryo proper. | train | med_mcqa | null |
75% respiration is due to: | [
"Diaphragm",
"Internal intercostals",
"Intercostals",
"Serratus anterior"
] | A | Ans. A DiaphragmRef: Snell Anatomy, 7h ed. pg 499; BDC 6th ed. vol. I pg. 212-13* Diaphragm is major respiratory muscle* Inspiration is an active process and requires contraction of inspiratory muscles.* During quiet breathing expiration is a passive process.* During inspiration all the 3 dimensions of the thoracic cavity expand# Vertical-75% (by diaphragm)# AP 25% (external intercostals and internal intercostals)# Transverse# Increase in vertical diameter is brought about by downward movement of diaphragm--which account for 70% of the thoracic expansion. | train | med_mcqa | null |
Urea cycle components are all except | [
"Urease",
"Arginase",
"Transcarbamoylase",
"Arginosuccinase"
] | A | l-Ornithine transcarbamoylase (EC 2.1.3.3) catalyzes transfer of the carbamoyl group of carbamoyl phosphate to ornithine, forming citrulline and ohophosphate. Argininosuccinate synthase (EC 6.3.4.5) links aspaate and citrulline the amino group of aspaate (reaction 3, Figure 28-16) and provides the second nitrogen of urea Hydrolytic cleavage of the guanidino group of arginine, catalyzed by liver arginase (EC 3.5.3.1), releases urea. Urease is not involved in the urea cycleRef: Harpers Illustrated Biochemistry, 30th edition, page no: 294 | train | med_mcqa | null |
In one and half syndrome w hich movement is classically spared? | [
"Limitation of horizontal eye movement to abduction in one eye",
"No horizontal movement of the other eye",
"Presence of nystagmus when the eye on the opposite side of the lesion is abducted",
"Convergence"
] | D | (D) Convergence# ONE AND A HALF SYNDROME is a rare ophthalmoparetic syndrome characterized by Ma conjugate horizontal gaze palsy in one direction and an internuclear ophthalmoplegia in the other".> Most common manifestation of this unusual syndrome is limitation of horizontal eye movement to abduction (moving away from the midline) of one eye (e.g. right eye in the diagram on the right) with no horizontal movement of the other eye (e.g. left eye in the diagram on the right).> Nystagmus is also present when the eye on the opposite side of the lesion is abducted. Convergence is classically spared as Cranial Nerve III (oculomotor nerve) and its nucleus is spared bilaterally. | train | med_mcqa | null |
Which vaccine is contraindicated in child with history of convulsions | [
"DPT",
"Measles",
"Typhoid",
"BCG"
] | A | After DPT vaccination , due to the peussis component, rarely convulsions may occur either due to the fever or due to an encephalopathy syndrome. An infant who develops convulsions following a dose of DPT should not be given any fuher peussis vaccine; fuher doses should be DT vaccine or tetanus toxoid alone.Febrile convulsions is not a contraindication. Reference: Ghai essential pediatrics 6th edition Page 193Page 193 | train | med_mcqa | null |
Shortest acting mydriatic is? | [
"Tropicamide",
"Atropine",
"Phenylephrine",
"Hyoscine"
] | A | ANSWER: (A) TropicamideREF: khurana 4th ed p. 68shortest acting mydriatic - TropicamideOnly mydriatic and not cycloplegic - phenylephrineUsed in children - Atropine | train | med_mcqa | null |
Non-specific esterase is positive in all the categories of Acute Myeloid Leukemia, EXCEPT: | [
"M3",
"M4",
"M5",
"M6"
] | A | Non specific esterase is negative in M3 type of Acute myeloid leukemia (AML). Alpha naphthyl acetate esterase (ANAE), Alpha naphthyl butyrate esterase (ANBE) and Alpha naphthyl AS esterase (NASA) are the non specific esterase reactions that are positive in M4 (acute myelomonocytic leukemia) and M5 (acute monocytic/monoblastic leukemia) type of AML. Their presence is variable in M6 (acute erythroid leukemia). Ref: Wintrobe's Clinical Hematology, 10th Ed, Page 2221; Textbook of pathology, B N Datta, 2nd Edition, Page 1118 & 1119. | train | med_mcqa | null |
Gluconeogenesis in Fasting state is indicated by | [
"Citrate activation by acetyl co-a carboxylase",
"Pyruvate Carboxylase activation by Acetyl CoA",
"Fructose 1,6 bisphosphate activates Pyruvate Kinase",
"Fructose 2,6 bisphosphate activates PFK-1"
] | B | Ans is 'b' i.e. Pyruvate Carboxylase activation by Acetyl CoA "Allosteric activation of hepatic pyruvate carboxylase by acetyl CoA occurs during fasting. As a result of excessive lipolysis in adipose tissue, the liver is flooded with fatty acids. The rate of formation of acetyl CoA by f-oxidation of these fatty acids exceeds the capacity of the liver to oxidize it to CO2 and H2O. As a result, acetyl CoA accumulates and leads to activation of pyruvate carboxylase. Acetyl CoA also inhibits pyruvate dehydrogenase. Thus, this single compound can divert pyruvate toward gluconeogenesis and away from the TCA cycle. Lippincott BiochemistryGluconeogenesis is not simple reversal of glycolysis. There are 10 reactions in glycolysis. Seven of these glycolytic reactions are reversible and are used in the synthesis of glucose from lactate or pyruvate. However, three of the reactions are irreversible. These 3 reactions are circumvented by four alternate reactions.The 3 irreversible reactions of Glycolysis are:Phosphorylation of Glucose to Glucose -6-phosphate by HexokinasePhosphorylation of Fructose-6-phosphate to Fructose 1, 6 -bisphosphate by Phosphofructokinase-1.Conversion of Phosphoenolpyruvate to Pyruvate by Pyruvate kinaseThe reactions unique to gluconeogenesis which circumvent these 3 irreversible reactions are:Pyruvate to Phosphoenolpyruvate by 2 reactions:Pyruvate is carboxylated to Oxaloacetate by Pyruvate carboxylase.Oxaloacetate is converted to Phosphoenolpyruvate by enzyme Phosphoenolpyruvate carboxykinase (PEP carboxykinase).Conversion of Fructose 1, 6-Bisphosphate to Fructose 6-phosphate catalyzed by Fructose 1, 6-bisphosphataseConversion of Glucose 6-phosphate to glucose catalyzed by glucose 6-phosphatase.Since Glycolysis and Gluconeogenesis share the same pathway but in opposite directions, they are regulated reciprocally.Allosteric regulation:Allosteric regulation by acetyl CoAPyruvate carboxylase is allosterically activated by acetyl CoA. .During fasting large amounts of acetyl CoA derived from oxidation of fatty acids, inhibits pyruvate dehydrogenase and activates Pyruvate carboxylase. Thus, acetyl CoA diverts pyruvate toward gluconeogenesis and away from the TCA cycle.Allosteric regulation by AMPFructose 1, 6-bisphosphatase is inhibited by AMP--a compound that activates phosphofructokinase. Elevated AMP thus stimulates glycolytic pathway that oxidize nutrients to provide energy for the cell. (AMP signals "energy-poor" state in the cell.) Conversely, low concentrations of AMP and high levels of ATP stimulate gluconeogenesis.Allosteric regulation by Fructose 2, 6-bisphosphate:Fructose 2, 6-bisphosphate is allosteric inhibitor of fructose 1, 6-bisphosphatase and activator of phosphofructokinase-1.The concentration of fructose 2, 6-bisphosphate is influenced by the levels of circulating glucagon.When there is abundant supply of glucose, the concentration of fructose 2, 6-bisphosphate increases, stimulating glycolysis by activating phosphofructokinase-1 and inhibiting fructose 1, 6-bisphosphatase.The gluconeogenesis pathway. The numbered reactions are unique to gluconeogenesis.In the fasting state Glucagon levels increase. Glucagon lowers the level of fructose 2, 6-bisphosphate, resulting in activation of fructose 1, 6-bisphosphatase and inhibition of phosphofructokinase, thus favoring gluconeogenesis over glycolysis. | train | med_mcqa | null |
All of the following statements about extramedullary tumours are true except | [
"These can lead to brown sequard syndrome",
"Radicular pain is often prominent",
"Early sacral sensory loss occurs",
"Spastic weakness in the legs is early feature"
] | A | Extramedullary intradural spinal tumors are rare. Less than 15% of all central nervous system (CNS) tumors are spinal. Ninety percent of these patients are older than 20 years. Most of spinal tumors are extradural (50-55%) whereas 40-45% are intradural. Fuhermore, 5% are intramedullary and 40% are extramedullary. Most common are Schwannomas (29%), followed by meningiomas (25%) and gliomas (22%). These tumors produce pain syndroms, a variety of neurological symptoms-motor, sensory, sphincter or a combination of thereof. All spinal levels may be involved. The diagnostics includes magnetic resonance imaging (MRI) including contrast enhancement, computerizing tomography (CT) scanning (bone windows with reconstruction) and possibly CT myelograms Presenting signs and symptoms Median time to diagnosis is 12 months and cauda equina location is not presenting earlier than other spinal locations. The symptoms are lesion nonspecific and do not differ between intramedullary and extramedullary locations. Most common initial symptom is pain, which may be local and nocturnal or radiating to arm and/or leg. Sphincter dysfunction, paraparesis and erectile dysfunction occur in 20%, 12% and 2% of patients respectively Ref Harrison20th edition pg 2766 | train | med_mcqa | null |
A 65-year-old man undergoes a technically difficult abdominal-perineal resection for a rectal cancer during which he receives 3 units of packed red blood cells. Four hours later, in the intensive care unit (ICU), he is bleeding heavily from his perineal wound. Emergency coagulation studies reveal normal prothrombin, paial thromboplastin, and bleeding times. The fibrin degradation products are not elevated, but the serum fibrinogen content is depressed and the platelet count is 70,000/mL. Which of the following is the most likely cause of his bleeding? | [
"Delayed blood transfusion reaction",
"Autoimmune fibrinolysis",
"A bleeding blood vessel in the surgical field",
"Factor VIII deficiency"
] | C | Whenever significant bleeding is noted in the early postoperative period, the presumption should always be that it is due to an error in surgical control of blood vessels in the operative field. Hematologic disorders that are not apparent during the long operation are most unlikely to surface as problems postoperatively. Blood transfusion reactions can cause diffuse loss of clot integrity; the sudden appearance of diffuse bleeding during an operation may be the only evidence of an intraoperative transfusion reaction. In the postoperative period, transfusion reactions usually present as unexplained fever, apprehension, and headache--all symptoms difficult to interpret in the early postoperative period. Factor VIII deficiency (hemophilia) would almost ceainly be known by history in a 65-year-old man, but, if not, intraoperative bleeding would have been a problem earlier in this long operation. Moreover, factor VIII deficiency causes prolongation of the paial thromboplastin time (PTT), which is normal in this patient. Severely hypothermic patients will not be able to form clots effectively, but clot dissolution does not occur. Care should be taken to prevent the development of hypothermia during long operations through the use of warmed intravenous fluid, gas humidifiers, and insulated skin barriers. | train | med_mcqa | null |
Intrauterine pressure is raised during labour to: | [
"First stage -- 40-50 mm Hg",
"Second stage -- 100-120 mm Hg",
"Third stage -- 100-120 mm Hg",
"All of the above"
] | D | Ans. is d, i.e. All of the aboveIntrauterine pressure during labor:StagePressure* 1st* 40-50 mm Hg* 2nd* 100-120 mm Hg* 3rd* 100-120 mm Hg | train | med_mcqa | null |
In 'Down's syndrome' the shape of the head is - | [
"Oxycephalic",
"Scaphocephalic",
"Brachicephalic",
"Plagiocephalic"
] | C | Ans. is 'c' i.e., Brachicephalic | train | med_mcqa | null |
Estimated mean Hemoglobin (Hb) of 100 women is 10g%. Standard detion is 1 gm%. Standard error of estimated will be - | [
"0.001",
"1",
"10",
"0.1"
] | D | <p>standrad error of mean= standard detion/[?]n =1/[?]100 =1/10 =0.1 Parks textbook of preventive and social medicine.K Park. Edition 23.Pg no: 850 </p> | train | med_mcqa | null |
Percentage of offspring affected by colour blindness when a healthy male and heterozygous female marry | [
"0",
"25%",
"50%",
"100%"
] | B | null | train | med_mcqa | null |
Late deceleration indicates: | [
"Head compression",
"Cord compression",
"Foetal hypoxia",
"Breech presentation"
] | C | Ans. C. Foetal hypoxiaDeceleration pattern - Three typea. Early deceleration - due to head compressionb. Late deceleration - chronic placental insufficiencyc. Variable deceleration - cord compressiond. Sinusoidal pattern - It is stable baseline FHR with fixed base line variability without any acceleration. If is often associated with fetal anaemia, feto-maternal hemorrhage, fetal hypoxia, and when narcotics are given to motherse. In situations of uteroplacental insufficiency, the uterine contractions may decrease the placental perfusion sufficiently to cause fetal hypoxia which outlasts the duration of the contraction.f. The FHR tracing shows decelerations which begin with the peak of the uterine contractions and persists even after the conclusion of the contraction (late deceleration), late decelerations are indicative of fetal compromise | train | med_mcqa | null |
A 54-year-old man comes to the emergency room with severe pain in his right toe. He has had less severe episodes in the past, which he always treated with pain medications. The toe is red, inflamed, and exquisitely sensitive to movement. Needle aspiration of the toe confirms uric acid crystals, and he is treated with oral indomethacin (NSAID). One month later, he remains symptom free, and allopurinol is recommended for prevention of this condition. Which of the following is the most likely mechanism of action of allopurinol? | [
"inhibition of xanthine oxidase",
"solubilization of uric acid",
"reactivity with hypoxanthine",
"anti-inflammatory effect on joint tissue"
] | A | Allopurinol inhibits the enzyme xanthine oxidase, resulting in decreased uric acid production. Allopurinol is particularly useful in the treatment of uric acid nephrolithiasis in gouty individuals. Even if the gouty individual has calcium oxalate stones, allopurinol may be helpful. | train | med_mcqa | null |
Which of the following drug causes Pseudotumour cerebri - | [
"Sparfloxacin",
"Tetracycline",
"Gentamicin",
"Clofazimine"
] | B | Ans. is 'b' i.e., Tetracycline Drugs causing Pseudotumour cerebri o A miodarone o Mineralocoicoids (withdrawl) o Oral contraceptives o Glucocoicoids (withdrawl) o Hypervitaminosis A o Tetracyclines o Quinolones | train | med_mcqa | null |
There is a breakout of MRSA in your hospital. What will you do next to prevent the spread of infection? | [
"Close the hospital for a month",
"Asking the staff to wash hands thoroughly and frequently",
"Collect nasal swabs to identify MRSA carriers and isolate the patient",
"Clean the floor with chlorhexidine"
] | B | All the mentioned steps have to be done but washing the hands is the next immediate step to prevent the spread of MRSA Ref: Textbook of Microbiology Baveja 5th ed Pg 638 | train | med_mcqa | null |
Which of the following is not an X-linked condition | [
"Duchne muscular dystrophy",
"B. Emery dreifuss muscular dystrophy",
"C. Fascioscapululohumeral muscular dystrophy",
"Becker muscular dystrophy"
] | C | Fasioscapulohumeral muscular dystrophy is an autosomal dominant disorder characterized by facial weakness and scapular winging Slowly progressive weakness of face, shoulder girdle and foot dorsiflexion | train | med_mcqa | null |
Palpable purpura could occur in the following conditions, except: | [
"Thrombocytopenia",
"Small-vessel vasculitis",
"Disseminated gonococcal infection",
"Acute meningococcemia"
] | A | Answer is A (Thrombocytopenia) Thrombocytopenia is associated with non palpable purpura'. Causes of Non palpable pupura: Primary cutaneous disorders Systemic diseases Clotting disturbance Vascular fragility Thrombosis 1 Emboli Possible immune complex Trauma Thrombocytopenia Amyloidosis Disseminated Cholesterol Gardner-Diamond syndrome Solar purpura (including ITP) Ehlers-Danlos intravascular Fat Waldenstrom's Steroid purpura Abnormal platelet syndome coagulation hypergammaglobulinemic Capillaritis Livedoid vasculitis function Clotting factor defects . Scurvy Monoclonal cryoglobulinemia Thrombotic thrombocytopenic purpura purpura Warfarin reaction | train | med_mcqa | null |
'Shepherd's crook' deformity of the proximal femur seen in | [
"Fibrous dysplasia",
"Chondroblastoma",
"Osteochondroma",
"Aneurysmal bonecyst"
] | A | (Fibrous dysplasia) (227-M) (174-75-Abley 8th)FIBROUS DYSPLASIA is a developmental disorder in which areas of trabecular bone are replaced by cellular Fibrous tissue containing flecks of osteoid and woven bone* ** Occasionally the bone disorders is associated with "cafe-au-lait " patches on the skin and (in girls) precocious sexual development (Albright's syndrome)* * Malignant transformation to fibrosarcoma occurs in 5-10% of patients with polystotic lesions, but only rarely in monostotic lesionsX ray shows radiolucent 'cystic ' areas in the metaphysis or shaft because they contain fibrous tissue with diffuse spots of immature bone, the lucent patches typically have a slightly hazy or 'ground glass' appearanceThe weight bearing bones may be bent and one of the classic features is the 'shepherd's crook' deformity of the proximal femur | train | med_mcqa | null |
Non contraceptive benefits of oral contraceptive agent are against development of all of the following except: March 2012 | [
"Ectopic pregnancy",
"Endometrial carcinoma",
"Ovarian carcinoma",
"Cervical carcinoma"
] | D | Ans: D i.e. Cervical carcinoma Oral contraceptive pills The contraceptive effect of OCPs prevents ectopic pregnancy. The protection rate is 90% in current OCP users Users of OCP have a 50% reduction in endometrial cancer compared with those who have never used OCPs OCPs suppress ovarian activity and inhibit ovulation; the interruption of a significant number of ovulatory cycles in oral contraceptives users may lead to a decreased incidence of ovarian cancer There may be a small increased risk of cancer of the cervix paicularly in women with more than 5 years of use and in women who test positive for human papilloma virus. | train | med_mcqa | null |
Which of the following is true about single donor platelet transfusion? | [
"Equal to 6-8 random donor platelets",
"Stored in 2-6 degree",
"10 days shelf life",
"Bedside leukodepletion done"
] | A | Platelets has two impoant source- RDP - -old blood (slow )- PRP -(high) Platelets 20- 24deg C (agitation) 3-5 days 1 unit/10kg BW DISADVANTAGES - Platelets of multiple donors - recipient sensitized SDP - -donor only given platelets 6-8 RDP | Alloimmunization Leucodepletion not required stored at room temp | train | med_mcqa | null |
Glucagon acts on muscle to cause | [
"Gluconeogenesis",
"Gycogenolysis",
"Glycolysis",
"Kreb's cycle"
] | A | Glucagon - a polypeptide hormone secreted by the alpha cells of the islets of Langerhans in response to hypoglycemia or to stimulation by growth hormone. It increases blood glucose concentration by stimulating glycogenolysis in the liver and can be administered parenterally to relieve severe hypoglycemia from any cause, especially hyperinsulinism.Ref: Ganong&;s review of medical physiology; 24th edition page no: 432 | train | med_mcqa | null |
Samter's triad is related to - | [
"Ethmoid polyp",
"Nasopharyngial",
"Angiofibroma",
"Nasal glioma"
] | A | Ans, is 'a' i.e., Ethmoid polypSamter-s triado Samtef s triad is a medical condition consisting of asthma, aspirin sensitivity-, and nasal/ethmoidal polyposis. It occurs in middle age (twenties and thirties are the most common onset times) and may not include any allergies,o Most commonly the first symptom is rhinitis.o The disorder typically progeses to asthma, then polyposis, with aspirin sensitivity coming last,o The aspirin reaction can be severe, including an asthma attack, anaphylaxis, and urticaria in some cases. Patients typically react to other NSAIDS such as ibuprofen, although paracetamol is generally considered safe,o Anosmia (lack of smell) is also typical, as the inflammation reaches the olfactory- receptors in the nose. | train | med_mcqa | null |
Drugs of choice for corneal herpes is: | [
"Idoxuridine",
"Acyclovir",
"Vidarabine",
"Amantadine"
] | B | Acyclovir | train | med_mcqa | null |
Culture media for Legionella: | [
"BCYE agar",
"Baird Parker medium",
"Macconkey agar",
"PLET medium"
] | A | Buffered charcoal, yeast extract (BCYE) agar- Legionellae are highly fastidious and grow on complex media, such as BCYE agar (pH 6.8- 6.9) Plates are incubated al 37 degree Celsius in 5% CO2 for 3-5 days. Colonies are round with an entire edge, glistening, convex, green or pink iridescent and have granular or speckled opalescence resembling ground glass. | train | med_mcqa | null |
A patient presented with unilateral proptosis which was compressible and increases on bending forward. No thrill or bruit was present. MRI shows a retroorbital mass with enhancement. The likely diagnosis is- | [
"AV malformations",
"Orbital encephalocoecle",
"Orbital varix",
"Neurofibromatosis"
] | C | *Proptosis on bending forward is typical of intermittent proptosis. Orbital varices constitute about 90% of cases of intermittent proptosis). So, it is seen in venous malformation, i.e orbital varixes. *AV malformation and encephalocele cause pulsatile exophthalmos. Ref: Henderson's orbital tumors 2nd/e p.404 | train | med_mcqa | null |
All of the following are disorders of phagocyte function, except: | [
"Chronic granulomatous disease",
"X-linked SCID",
"Chediak-Higashi syndrome",
"Myeloperoxidase deficiency"
] | B | X-linked Severe Combined Immunodeficiency (SCID): most common form of SCID, mutation in the common g-chain (gc) subunit of cytokine receptors, defect in T-cell development, T-cell numbers are greatly reduced, B cells may be normal in number, antibody synthesis is impaired. Chronic granulomatous disease: Decreased oxidative burst due to defect in phagocyte oxidase, can be X-linked (majority) or autosomal recessive, macrophage-rich chronic inflammatory reaction seen due to inadequate neutrophil response. Chediak-Higashi syndrome: autosomal recessive, defect lies in fusion between phagosome and lysosome (impaired bacteriolysis), occurs due to mutation in LYST gene (defective transpo of materials into lysosomes), neutropenia, defective degranulation, and delayed microbial killing. Myeloperoxidase deficiency: Decreased microbial killing because of defective MPO-H2O2 system after phagocytosis of microbes. | train | med_mcqa | null |
Eye lash infestation by pediculosis is caused by: | [
"Pediculosis Capitis",
"Pediculosis corporis",
"Phthiriasis pubis",
"Hymenoptera"
] | C | Lice: Head lice Body lice Pubic lice Pediculosis capitis Pediculosis corporis Phthiriasis pubis Phthriasis palpebrarum - -rare eyelid infestation -cause: Phthiriasis pubis | train | med_mcqa | null |
All of the following types of interactions cooperate in stabilizing the teiary structures of globular proteins except | [
"Disulphide bonds",
"Hydrogen bonds",
"Ionic interactions",
"Peptide bonds"
] | D | Peptide bonds are not involved in stabilizing teiary structure of proteins.It forms the primary structure of proteins. Interactions stabilizing teiary structure of proteins are as follows: Disulfide bonds Hydrophobic interactions Hydrogen bonds Ionic interactions NOTE: Hydrogen bond and Van der waal interactions are involved in the formation of alpha helix(secondary structure) Reference: Harpers illustrated Biochemistry 31st Edition pg 39 | train | med_mcqa | null |
A patient presents with LVH and pulmonary complications. ECG, shows left axis detion. Most likely diagnosis is: | [
"TOF",
"Tricuspid atresia",
"TAPVC",
"VSD"
] | B | Congenital absence of tricuspid valve is tricuspid atresia. Right ventricle is hypoplastic. Systemic venous blood from Rt Atrium -> ASD/patent foramen ovale -> Lt atrium -> Lt ventricle -> Aoa and through muscular VSD blood also enters Rt ventricle and pulmonary aery. Ref: Kliegman, Behrman, Jenson, Stanton (2008), Chapter 430.4, "Tricuspid Atresia", In the book, "NELSON TEXTBOOK OF PEDIATRICS", Volume 2, 18th Edition, New Delhi, Pages 1913-14 ; O P Ghai Essential Peadiatrics, 6th Edition, Page 410 | train | med_mcqa | null |
Which anti-cancer drug affects DNA as well as RNA? | [
"5-FU",
"Methotrexate",
"Actinomycin-D",
"Etoposide"
] | C | Actinomycin-D is one of the anti-tumor antibiotic. It has two mechanisms of action: - It blocks RNA transcription by interfering with template function of DNA. - It causes single strand breaks in the DNA. It is used in the treatment of Wilm's tumor and rhabdomyosarcoma. | train | med_mcqa | null |
One of the following drug causes least gain in weight | [
"Quetiapine",
"Ziprasidone",
"Olanzapine",
"Risperidone"
] | B | (B) Ziprasidone # Risperidone, a benzisoxazole derivative, is more potent at 5HT2 than D2 receptor sites, like clozapine, but it also exerts significant a2 antagonism, a property that may contribute to its perceived ability to improve mood and increase motor activity.> Risperidone is not as effective as clozapine in treatment resistant cases but does not carry a risk of blood dyscrasias.> Olanzapine is similar neurochemically to clozapine but has a significant risk of inducing weight gain.> Quetiapine is distinct in having a weak D2 effect but potent a1 and histamine blockade.> Ziprasidone causes minimal weight gain and is unlikely to increase prolactin, but may increase QT prolongation.> Aripiprazole also has little risk of weight gain or prolactin increase but may increase anxiety, nausea, and insomnia as a result of its partial agonist properties.ANTIPSYCHOTIC AGENTSNameUsualPOSide Effects Daily Dose, mgSedationCommentsClozapine(Clozaril)2 0 0 - 600Agranulocytosis (1%); weight gain; seizures; drooling; hyperthermia+ +Requires weekly WBCRisperidone (Risperdal) observed with doses >6 mg qd2-6Orthostasis+Requires slow titration; EPSEsOlanzapine(Zyprexa)10-20Weight gain+ +Mild prolactin elevationQuetiapine(Seroquel)3 5 0 - 700Sedation; weight gain; anxiety+ + +Bid dosingZiprasidone(Geodon)40-60Orthostatic hypotension+/+ +Minimal weight gain; increases QT intervalAripiprazole (Ability)10-30Nausea, anxiety, insomnia0/+Mixed agonist /antagonist | train | med_mcqa | null |
Increased levels of which of the following in amniotic fluid is an indicator of neural tube defect in the fetus : | [
"Acetylcholinesterase",
"Butyrylcholinesterase",
"Pseudocholinesterase",
"Phosphatidyl esterase"
] | A | Acetylcholine esterase: (AChE) Amniotic fluid AChE level is elevated in most cases of open neural tube defects. It has got better diagnostic value than AFP. Reference: D C Dutta's Textbook of Obstetrics 7th edition page no 113 | train | med_mcqa | null |
A 26-year old primigravida at 32 weeks of gestation experienced faintness and nausea in lying down and recovers after turning on her side or getting up. These symptoms can be attributed to which of the following? | [
"Reduced placental flow",
"Increased intragastric pressure",
"Increased intracranial pressure",
"Interior vena caval compression"
] | D | Ans. d. Inferior vena caval compression (Ref: Dutta 6/e p53)Symptoms of faintness and nausea in lying down position and recovery after turning on the side or getting up in a 26-year old primigravida at 32 weeks of gestation can be attributed to inferior vena caval compression."Supine hypotensive syndrome is caused when the inferior vena cava is compressed by the weight of a pregnant female uterus, fetus, placenta and amniotic fluid while lying in the supine position. The condition can develop as early as the second trimester but is maximum during the third trimester. The patient experiences reduced blood pressure signs of shock such as cool, moist and clammy skin, tachycardia (early sign), bradycardia (very late sign), dizziness, syncope or near syncope, pedal edema, nausea, decreased femoral pulse and signs of fetal distress. Supine hypotensive syndrome is easily managed by placing the patient in left lateral position."Supine Hypotension Syndrome (Postural Hypotension)During late pregnancy, the gravid uterus produces a compression effect on the inferior vena cava when the patient is in supine position.This, however, results in opening up of collateral circulation by means of paravertebral and azygous veins. In some cases (10%) when collateral circulation fails to open up, the venous return to heart is seriously curtailed.This results in production of hypotension, tachycardia and syncope.Turning patient to lateral position quickly restores the normal blood pressureQ.Can cause severe fetal distressThe augmentation of venous return during uterine contraction prevents the manifestation from developing during labourQ. | train | med_mcqa | null |
All of the following are seen in oliguric phase of Acute Tubular necrosis, Except: | [
"Hypernatremia",
"Hypermagnesemia",
"Hyper uricemia",
"Hyper phosphatemia"
] | A | Answer is A (Aminoglycoside toxicity): Non-Oliguric Renal Failure is typically associated with Aminoglycoside toxicity. 'Aminoglycoside nephrotoxicity typically is associated with non-oliguric renal failure' - Management of Acute Kidney Problems 'Non-Oliguric renal failure is a common expression of aminoglycoside nephrotoxity and may reflect a direct inhibitory effect on solute transpo along the thick ascending loop of Hence or possibly tubulointerstitial cell injury. - Diseases of Kidney and Urinary Tract 81h/1035 'Non-Oliguric Acute Kidney Injury accompanies 10-30% of courses of aminoglvcosides even when plasm levels are in therapeutic range'- Harrison 18th/2298 'The Acute Kidney Injury of Aminoglycoside toxicity is characteristically non-oliguric and reversible with a low moality' - 'Renal and Electrolyte Disorders' by Sh -icy (Lippincott Williams) 2010/357-358 Non-Oliguric renal failure may also be associated with contrast induced nephropathy, however it is most typical /characteristic of Aminoglycoside toxity. | train | med_mcqa | null |
Which of the following is not a branch of internal iliac artery? | [
"Superior rectal artery",
"Middle rectal artery",
"Superior gluteal artery",
"Inferior vesicle artery"
] | A | Ans. A Superior rectal arteryRef: Gray's, 41st ed. pg. 1224-25* Common iliac artery bifurcates into internal and external iliac artery at the level of sacroiliac joint.* Length of internal iliac artery: ~ 4 cm.Mnemonic for Remember the Branches of the Internal Iliac Artery* I Love Going Places In My Very Own Underwear!Mnemonic* I: iliolumbar artery* L: lateral sacral artery* G: gluteal (superior and inferior) arteries* P: (internal) pudendal artery* I: inferior vesicle (uterine in females) artery* M: middle rectal artery* V: vaginal artery* O: obturator artery* U: umbilical artery* Also, the first three arteries (iliolumbar, lateral sacral and superior gluteal arteries) are all branches of the posterior trunk of the internal iliac artery, whilst the remainder are branches of the anterior trunk.* Superior rectal artery is a branch of inferior mesenteric artery.* Inferior epigastric artery is a branch of external iliac artery. | train | med_mcqa | null |
Healthy volunteers are recruited in which phase of clinical trials? | [
"Phase 1",
"Phase 2",
"Phase 3",
"Phase 4"
] | A | Phase 1- Done on healthy people. Maximum tolerable dose of drug is tested Phase 2- Done on fewer patients (20-200) . Efficacy and safety of drug is tested here Phase 3-Done on more patients ( upto 5000).Efficacy is confirmed in this phase Phase 4- Post marketing surveillance. Long term and rare side effects are monitored in this phase | train | med_mcqa | null |
Culex mosquito transmits: | [
"Yellow fever",
"Dengue fever",
"Tularemia",
"Japanese encephalitis"
] | D | Ans: D (Japanese encephalitis) Ref: 21st edition Park.Explanation:The diseases transmitted by various insects are* Anopheles mosquito- MalariaFilaria (not in India)Culex mosquitoBancroftian FilariasisJapanese EncephalitisWest Nile feverViral Arthritis (epidemic / polyarthritis)Aedes mosquitoYellow fever (not in India)DengueDengue Haemorrhagic feverChikungunya feverChikungunya haemorrhagic feverRift Valley feverFilaria (not in India)Mansonoides mosquitoMalayan (Brugian) filariasisChikungunya feverHouseflyTyphoid and paratyphoid feverDiarrhoeaDysentryCholeraGastroenteritisAmoebiasisHelminthic infestationsPoliomyelitisConjucntivitisTrachomaAnthraxYawsSandflyKala-azarOriental SoreSandfly feverOraya FeverTsetse FlySleeping SicknessLouseEpidemic TyphusRelapsing FeverTrench FeverPediculosisRat FleaBubonic PlagueEndemic TyphusChiggerosisHymenolepis diminutaBlack FlyOnchocerciasisReduvid BugChagas DiseaseHard TickTick TyphusViral EncephalitisViral FeversViral Hemorrhagic fevers (eg KFD)TularemiaTick ParalysisHuman BabesiosisSoft TickQ FeverRelapsing FeverTrombiculid MiteScrub TyphusRickettsial PoxItch-miteScabiesCyclopsGuinea WormFish Tape wormCockroachesEnteric Pathogens | train | med_mcqa | null |
The Poal vein is formed? | [
"By the superior mesenteric vein",
"By the splenic vein",
"At the level of 2nd lumbar veebra",
"All of the above"
] | D | All of the above | train | med_mcqa | null |
Tetanus toxin acts on which of the following synaptic protein | [
"R-SNARE",
"Q-SNARE",
"SNAP25",
"Rab and Munc 18"
] | A | Tetanus toxin cleaves synaptobrevin-2 . Synaptobrevin is a R-SNARE protein also known as Vesicle Associated Membrane Protein(VAMP) Q-SNARE proteins are syntaxin (Qa), SNAP25(Qb & Qc)and SM protein (Munc18) Botulinum toxin (BT) serotype A, B and E are toxic to humans. BT-A, BT-E cleaves SNAP25, BT-C cleaves both SNAP25 and syntaxin. BT-B, BT-D, BT-F, BT-G cleaves synaptobrevin- 2 (VAMP-2) | train | med_mcqa | null |
Frozen DPT vaccine should be - | [
"Shaken thoroughly before use",
"Allowed to melt before use",
"Discarded",
"Brought to room temperature before use"
] | C | null | train | med_mcqa | null |
Disease which can be transmitted by milk | [
"Q fever",
"Poliomyelitis",
"Whooping cough",
"Diphtheria"
] | A | Q fever caused by C.burnetii. In milk, it may survive even after pasteurization by the holder method. It can remain infectious for months in milk, water, soil and wool. The organism is shed in the milk of infected cat. Ref: Baveja textbook of microbiology; 4th edition | train | med_mcqa | null |
False about Popliteal entrapment syndrome | [
"Mainly due to atherosclerosis",
"Exercise induced calf claudication",
"Decreased ankle pulse on ankle flexion",
"Abnormal relation between medial head of gastrocnemius and popliteal artery"
] | A | Popliteal entrapment syndrome
Due to congenital adnormality between popliteal artery and medial head gastrocnemius.
Treated with release of muscular origin of medial head of gastrocnemius. | train | med_mcqa | null |
Painless effusion in joints in congenital syphilis is known as: | [
"Stiffer joints",
"Cluttons joints",
"Emphymic joint",
"None"
] | B | Painless effusion in joints is known as Cluttons joints.
Clutton's joints is a term describing the finding of symmetrical joint swelling seen in patients with congenital syphilis. It most commonly affects the knees, presenting with synovitis and joint effusions (collections of fluid within the joint capsules) lasting up to a year. It has also been reported affecting the ankles, elbows, wrists and fingers. | train | med_mcqa | null |
Ramesh , 30 yrs old male,diagnosed case of CO poisoning presented with syncope or coma with intermittent convulsions, rapid respirations, tachycardia with a weak pulse and pink or red discolouration of the skin; estimated percentage of COHb : - | [
"30 to 40 %",
"40 to 50 %",
"50 to 60 %",
"60 to 70 %"
] | C | null | train | med_mcqa | null |
A systematic observation and recording of activities of one or more individuals at random interval is done in – | [
"Systems analysis",
"Network analysis",
"Work sampling",
"Input–Output analysis"
] | C | Work sampling
It is systematic observation and recording of activities of one or more individuals, carried out at predetermined or random intervals.
It provides quantitative measurement of various activities.
It helps in standardizing the methods of performing jobs and determining the manpower needs in any organization.
Input-out analysis
Input → All health service activities which consume resources (manpower, money, material and time).
Output → Useful outcomes (cases treated, lives saved).
Input-output analysis shows how much of each "input" is needed to produce a unit amount of each "output".
Systemic analysis
Systemic analysis is essentially finding the cost-effectiveness of the available alternatives. | train | med_mcqa | null |
A 43-year-old man is admitted to the emergency department with a fracture of the base of his skull. A thorough physical examination reveals that a number of structures have been injured, possibly including the right greater petrosal nerve. Which of the following conditions needs to be identified during physical examination to confirm the diagnosis of greater petrosal nerve injury? | [
"Partial dryness of the mouth due to lack of salivary secretions from the submandibular and sublingual glands",
"Partial dryness of the mouth due to lack of salivary secretions from the parotid gland",
"Dryness of the right cornea due to lack of lacrimal secretion",
"Loss of taste sensation from the right ant... | C | The greater petrosal nerve carries parasympathetic fibers that are involved in the innervation of the lacrimal gland, as well as the mucosal glands of the nose, palate, and pharynx. As a result, an injury to the right greater petrosal nerve would be expected to result in decreased lacrimal secretions for the right eye. The sublingual and submandibular glands receive their parasympathetic fibers from the facial nerve via the chorda tympani and the lingual nerve. They would be unaffected by this lesion. The parotid gland receives its parasympathetic secretory innervation from the glossopharyngeal nerve via the lesser petrosal and auriculotemporal nerves and would be unaffected. Taste to the anterior tongue is provided by the facial nerve via the chorda tympani, and general sensation to the anterior tongue is provided by the mandibular division of the trigeminal nerve via the lingual nerve. | train | med_mcqa | null |
Insal-Salvati index is used for ? | [
"Olecranon",
"Patella",
"Talus",
"Scaphoid"
] | B | Ans. is 'b' i.e., Patella Two radiological indices are commonly used for determining the position of patella - Insall-Salvati index It is the ratio of patellar tendon length to patella length. Normally it is 1-0. An index of 1.2 or more is seen in patella alta (high riding patella). An index of 0.8 or less is seen in patella baja (low lying patella). Blackbume-Peel lindex It is the ratio of (i) the distance of tibial plateau to inferior aicular surface of patella (numerator), to (ii) length of aicular surface of patella (denominator). Normally it is 0.8. An index of 1 or more is seen in patella alta. | train | med_mcqa | null |
The following is not seen in undescended testis: | [
"Hydrocele",
"Hernia",
"Teratoma",
"Seminoma"
] | A | Ans. (a) HydroceleRef: Bailey 26th Edition, Page 1378* Around 90 % of boys with an undescended testis have a patent processus vaginalis (Hernia)* Malignancy associated with undescended testis are Seminoma and Teratoma Seminoma is the most common cancer associated. | train | med_mcqa | null |
Drug of choice for pain relief in diabetic neuropathy is- | [
"Gabapentin",
"Lamotrigene",
"Pregabalin",
"Mexiletene"
] | C | Chronic, painful diabetic neuropathy is difficult to treat but may respond to duloxetine, amitriptyline, gabapentin, valproate, pre- gabalin, or opioids. Two agents, duloxetine and pregabalin, have been approved by the U.S. Food and Drug Administration (FDA) for pain associated with diabetic neuropathy, but no treatments are satisfactory. Reference : page 2427 Harrison's Principles of Internal Medicine 19th edition | train | med_mcqa | null |
A 37 yr old man was reffered to NIMHANS Neurology opd with history of 2 episodes of GTCS, Headache, weakness on right side of body,behavior and personality changes. NCCT was given below what is the most probable diagnosis can be made? | [
"Meningioma",
"Oligodendroglioma",
"Glioblastoma",
"Craniopharyngioma"
] | B | Oligodendroglioma has chicken wire calcifications. Above given NCCT image shows ill-defined hypodense lesion in left frontal lobe with dense foci of calcification in the centre. * Both low- and high-grade oligodendroglial tumors express proangiogenic mitogens and may contain regions of increased vascular density with finely branching capillaries that have a 'chicken wire' appearance. Up to 90% of oligodendrogliomas contain visible calcification on CT, which can be central, peripheral or ribbon-like. Meningioma is dural based and appear hyperdense on NCCT. Craniopharyngioma is supra-stellar in location. GBM usually doesn't show calcification. | train | med_mcqa | null |
CT Scan of head showing a 'Tram track5 appearance in | [
"Neurofibroma",
"Tuberous sclerosis",
"Von Hippel Lindau disease",
"Sturge weber syndrome"
] | D | Ans. is 'd' i.e.,. Sturge Weber Syndrome. Sturge-Weber syndrome is characterized by -A large unilateral cutaneous angioma* (.Port wine stain*) of the faceA cerebral angioma involving the ipsilateral* cerebral hemisphere and meninges.Adrenal pheochromocytoma*.Cerebral angioma leads to cortical atrophy and epilepsy*.Characteristic tram track calcification* is seen on x-ray and CT head. | train | med_mcqa | null |
Which one of the following is not a cause of secondary postpaum hemorrhage? | [
"Placenta pre",
"Retained bits of placenta",
"von Willebrand disease",
"Placental polyp"
] | A | - Placenta pre causes APH Secondary postpaum hemorrhage is bleeding after 24 hours to 12 weeks after delivery. Causes of PPH : Uterine atonicity ( most common cause of primary PPH) Injury to any pa of genital tract Coagulopathy (von Willebrand's disease) Retained tissues - (most common cause of secondary PPH ) Usually, retained products undergo necrosis with fibrin deposition and may eventually form a so-called placental polyp. | train | med_mcqa | null |
A 45-year-old Nobel Prize-winner in chemistry has recently been the recipient of a heart transplant. Patient education has included both verbal and written descriptions of the potential cardiovascular effects of pharmacologic agents. Which one of the following drugs is least likely to cause tachycardia in this patient? | [
"Amphetamine",
"Dobutamine",
"Epinephrine",
"Isoproterenol"
] | A | This question is to remind you that indirect-acting sympathomimetics require innervation of the effector organ to exert effects. In this case, amphetamine would not be effective because the transplanted heart lacks sympathetic innervation; thus, there is no "mobile pool" of NE capable of being released by a drug. However, transplanted hearts retain receptors, including those (b1 ) responsive to direct-acting sympathomimetics. Heart transplants are not responsive to AChE inhibitors because they, too, are indirect acting and require vagal innervation to exert effects on the heart. | train | med_mcqa | null |
Best contraceptive for newly married healthy couple- | [
"Barrier method",
"IUCD",
"Oral contraceptive pill",
"Natural methods"
] | C | For newly married couples oral contraceptive pill is the method of choice.
It has many noncontraceptive benefits along with effective contraception. | train | med_mcqa | null |
Gold poisoning leading to exfoliative dermatitis is Rx by: | [
"Chloroquine",
"Steroid",
"Antibiotics",
"Antihistaminics"
] | B | Rx of exfoliative dermatitis: Topical: Emollients Systemic: Systemic steroids Cyclosporine Antimetabolites Antibiotics only for secondary infection. | train | med_mcqa | null |
Grey colour & yellow fluorescence in infant teeth is caused by: | [
"Phenvtoin",
"Porphyria",
"Tetracycline",
"Barbiturate"
] | C | Ans: C (Tetracyclines) Ref: The Pharmacological basis of therapeutics by Goodman & Gilman - 12th edition, page no. 1526Explanation:TetracyclinesTetracyclines cause grey colour & yellow fluorescence in infant teeth.The discoloration is dependent on the total drug dose more than the number of days of exposure to drug therapy.The drug gets deposited in the teeth and bones as tetracyclines can bind with calcium to form chelation complexes in these tissues.Children of mothers exposed to tetracyclines during pregnancy are at high risk.The greatest time at which the risk is maximal is between 20 weeks gestation to 6 months post natal period. | train | med_mcqa | null |
All electrolyte abnormalities are seen in immediate postoperative period, EXCEPT | [
"Negative nitrogen balance",
"Hypokalemia",
"Glucose intolerance",
"Hyponatremia"
] | D | Following surgery there is variable period of reduced excretion of sodium due to increased adrenocoical activity. This leads to hypernatremia therefore it is advisable not to administer large quantities of isotonic (a) saline solution. Sometimes postoperative hyponatremia too develops, as a result of too prolonged administration of sodium free solution. | train | med_mcqa | null |
A 40 years old man presents with a recurrent hemoptysis and purulent cough. X-ray was found to be normal. The next investigation done to aid in diagnosis is – | [
"MRI",
"Bronchoscopy",
"HRCT",
"CT guided biopsy"
] | B | If chest X-ray is normal in a patient with recurrent hemoptysis, next investigation of choice is Bronchoscopy. | train | med_mcqa | null |
Drug of choice for central diabetes insipidus is : | [
"Desmopressin",
"Leuprolide",
"Thiazide diuretics",
"Insulin"
] | A | null | train | med_mcqa | null |
A 58-year-old man with a 700-pack-peryear smoking history presents to the emergency depament with shoness of breath and hemoptysis. Poable chest radiography demonstrates a large mass centrally located within the left lung field. The serum calcium is 13.0 mg/dL (normal 8.5 to 10.2). The metabolic abnormality described here is likely due to elaboration of which substance | [
"Adrenocoicotropic hormone-like substance",
"Antidiuretic hormone",
"Carcinoembryonic antigen",
"Parathyroid-related hormone"
] | D | The man is likely to have a lung tumor, given his clinical presentation and the radiographic results. The patient's hypercalcemia is likely due to a paraneoplastic syndrome, such as that due to the elaboration of parathyroid-related hormone (PTrH). PTrH is produced by squamous cell carcinoma Adrenocoicotropic-like substance and antidiuretic hormone are produced by yet another form of lung cancer--small cell carcinoma of the lung. Carcinoembryonic antigen is an onco-fetal antigen produced by colon cancer cells. Erythropoietin causes secondary polycythemia and is related to renal cell carcinoma | train | med_mcqa | null |
Sampling method used in assessing immunization status of children under immunization programme is | [
"Systemic sampleing",
"Stratified sampling",
"Group sampling",
"Cluster sampling"
] | D | Ans. is 'd' i.e., Cluster sampling o In the Expanded programme on Immunization (EPI) cluster technique, a simplified cluster sampling method is used. It is based on ranodm selection of 210 children who are 12-23 months of age. These patients are selected in 30 clusters of 7 children each to estimate immunization coverage levels. | train | med_mcqa | null |
A middle aged woman on oral contraceptives for many years, developed neurological symptoms such as depression, irritability, nervousness and mental confusion. Her hemoglobin level was 8g/cll. Biochemical investigations revealed that she was excreting highly elevated concentrations of xanthurenic acid in urine. She also showed high levels of triglycerides and cholesterol in serum. All of the above findings are most probably related to vitamin B6 deficiency caused by prolonged oral contraceptive use except : | [
"Increased urinary xanthurenic acid excretion",
"Neurological symptoms by decreased synthesis of biogenic amines",
"Decreased hemoglobin level",
"Increased triglyceride and cholesterol level"
] | D | D i.e. Increased triglyceride & cholesterol level in serum | train | med_mcqa | null |
A 68-year-old man who was a diagnosed case of HIV infection for last 12 years was brought to outpatient depament for evaluation. His wife repos that for last 6 months she has been noticing changes in his behaviour. She fuher added that 'He appears uninterested and doesn't seem to care about anything. I haven't seen him crying or saying something negative, but may be he is getting depressed. He is also having difficulty remembering things ' The patient has been irregular with his HIV medications. His last CD4+ cell count, measured 5 months ago, was 210/mm3. While walking , patient was observed to have subtle jerking movements. Which of the following is the likely diagnosis? | [
"Alzheimer's disease",
"Delirium",
"HIV-associated dementia",
"Major depressive disorder"
] | C | It is a neurocognitive disorder, which is usually seen in untreated HIV patients with a CD4+ cell count of <200/mm3 and in patients with long-standing HIV disease. The onset is usually subacute and manifests with apathy and impairment of attention. Subcoical (e.g, basal ganglia, nigrostriatal) symptoms manifest early with symptoms such as slowed movement and difficulty with smooth limb movement. This is followed by coical symptoms such as memory decline. Regular antiretroviral therapy decreases the possibility of development of HIV associated dementia, and may be helpful even if the symptoms have already staed. | train | med_mcqa | null |
The following symbol indicates: | [
"Radioactive caution",
"Recycle",
"Biohazard",
"Cytotoxic"
] | A | null | train | med_mcqa | null |
Inspiratory stridor is found in what kind of lesions: | [
"Supraglottic",
"Subglottic",
"Tracheal",
"Bronchus"
] | A | Answer A. SupraglotticGenerally, an inspiratory stridor suggests airway obstruction above the glottis.While an expiratory stridor is indicative of obstruction in the lower trachea.A biphasic stridor suggests a glottic or subglottic lesion. | train | med_mcqa | null |
A 28-year-old boy met with on accident and sustained severe crush injury. He is most likely to develop: | [
"Acute Renal Failure",
"Hypophosphatemia",
"Hypercalcemia",
"Acute Myocardial Infarction"
] | A | Acute Renal failure is an established complication of crush syndrome with myoglobin causing blockage of kidney tubules. | train | med_mcqa | null |
With oral iron therapy, rise in Hb% can be seen after: | [
"1 week",
"3 weeks",
"4 weeks",
"6 weeks"
] | B | Rise in hemoglobin with oral iron – 0.7 gm-1 gm per week, which is seen after 3 weeks of initiation of oral therapy.
(According to COGDT, 10/ed, p 407 — Hemoglobin levels should increase by atleast 0.3g/dl/week if the patient is responding to therapy)
If there is no significant clinical or hematological improvement within 3 weeks, diagnostic re-evaluation is needed. | train | med_mcqa | null |
Psedomonas is which type of bacteria - | [
"Anaerobic",
"Microaerophilic",
"Strict aerobe",
"Obligate anaerobe"
] | C | Ans. is 'c' i.e., Strict aerobe o Pseudomonas is an obligate aerobe (strict aerobe).Oxygen requirement of bacteriao Different bacteria have different oxygen requirment.o Why is it so ? Lets seeMolecular oxygen is very reactive .When it accepts an electron in electron transport chain, it can form H2O2, superoxide radicals (O2-) and a hydroxyl radical (OH-).All of these are toxin unless broken down.There are three enzymes : catalase, peroxidase and superoxide dismutase which can break down these oxygen radicals and can prevent bacteria from oxidative damage, i.e. these three enzymes defend bacteria from oxidative damage.The bacteria which possess all three enzymes are most oxygen tolerant, the bacteria which have one or two enzyme are less oxygen tolerant, while the bacteria which have no enzyme can not tolerat oxygen.Based on oxygen requirement the bacteria are classified into -Obligate aerobeso They grow only in aerobic conditions.o These bacteria have all the three enzymes and they have electron transport chain as the final electron acceptor,o Obligate aerobes are -1 Nocardia3. Mycobacteria 5. Pseudomonas7. Legionella2. Bacillus cereus4. Meningococci6. Bordetella 8. Brucella Facultative anaerobeso They prefer aerobic conditions, but can also grow in anaerobic conditions.o They are similar to obligate aerobes, i.e. they have all the enzymes.o The only difference is that they can grow in the absence of oxygen by using fermentation of energy,o Facultative anaerobes are1. Staphylococcus4. Corynebacterium7. Mycoplasma10. Salmonella2. Bacillus anthracis5. Listeria8. E. coli 3. Listeria6.Actinomyces9. Shigella Microaerophilic (aerotolerant anaerobes)o They prefer anaerobic conditions, but can tolerate low amounts of oxygen because they have superoxide dismutase (but they have no catalase),o Microaerophilic bacteria are -StreptococcusSpirochetes - Treponema, Borrelia, LeptospiraCampylobacterObligate anaerobeso They have no enzymes to defend against oxygen.o They grow only in anaerobic environment and can not tolerate aerobic conditions.o Obligate anaerobes are -1. Clostridium 2. Bacteroides | train | med_mcqa | null |
62-year-old female has kidney stone and treated with PCNL. After 2 days she again comes to OPD with chills and fever. What is the complication? | [
"Bacterial sepsis",
"Acute pancreatitis",
"Splenic injury",
"Ureteric stricture"
] | A | Bacterial sepsis Complications relating to PCNL include: Injury to the spleen, pleura and colon. Haemorrhage (MC) Sepsis. Extravasation due to rupture of the collecting system. Retained stone fragments. Open surgery to the kidney is sometimes more complicated after PCNL. | train | med_mcqa | null |
All are developed from muscles of 1 arch except | [
"Tensor tympani and tensor veli palatini",
"Posterior belly of digastric",
"Masticatory muscles",
"Mylohyoid"
] | B | null | train | med_mcqa | null |
Primary sinusoidal dilatation of liver is also known as | [
"Hepar lobatum",
"Peliosis hepatic",
"Von-Meyerburg complex",
"Caroli's disease"
] | B | Peliosis hepatis is an uncommon vascular condition characterised by multiple, randomly distributed, blood-filled cavities throughout the liver. The size of the cavities usually ranges between a few millimetres and 3 cm in diameter. In the past, it was a mere histological curiosity occasionally found at autopsies, but has been increasingly recognised with wide-ranging conditions from AIDS to the use of anabolic steroids. It also occasionally affects spleen, lymph nodes, lungs, kidneys, adrenal glands, bone marrow, and other pas of gastrointestinal tract. | train | med_mcqa | null |
Morphine is contraindicated in all of the following
except | [
"Pulmonary oedema",
"Emphysema",
"Bronchial asthma",
"Head injury"
] | A | null | train | med_mcqa | null |
Which one is not true regarding pyloric stenosis. | [
"Hypokalemia",
"Alkaline urine",
"Metalbolic alkalosis",
"Hypochloremia"
] | B | Ans. is 'b' ie. Alkaline urine (Ref. Schwartz, 9/e p1426 (8/e p1486, 7/e, p 1728))Because of persistant vomitting, there will be, loss of potassium and chloride ion and the infant will develop metabolic alkalosis & hypokalemia & hypochloremia."The serum pH level is high where as the urine pH level is high initially but eventually drops as the severe potassium deficit leaves only hydrogen ion to exchange with sodium ions in the distal tubule of the kidney. "This will lead to paradoxical aciduria. | train | med_mcqa | null |
'Second gas effect' is exerted by which of the following gas when co-administered with halothane: | [
"Nitrous oxide",
"Cyclopropane",
"Nitrogen",
"Helium"
] | A | Concentration-effect, second gas effect and diffusion hypoxia are seen with inhalational agents used in high concentrations (like N2O). | train | med_mcqa | null |
During 3rd day to 2nd week of starvation, brain depends on which of the following substance as fuel: | [
"Ketone bodies",
"Glucose",
"Fatty acid",
"Amino Acid"
] | A | For brain, Glucose is the main/preferred fuel during Fed as well Fasting state whereas during Starvation, Brain depends upon Ketone Bodies as the fuel. So, answer is A - Ketone bodies. ADDITIONAL EDGE: Fed state: When we eat food (Within 2 hours of food intake is called Fed state) Fasting state: In between meals, when we are not eating food (From 12-18 hours after food upto 48 hours is Fasting) Starvation: Severe or complete lack of nutrients (since last 1-3 days) In between meals and night time is called Fasting time. That's why Breakfast is named -->BREAK THE NIGHT FAST. | train | med_mcqa | null |
CT scan was invented by- | [
"Hounsfield",
"Roentgen",
"Cormack",
"Tesla"
] | A | Ans. is 'a' i.e., Hounsfield * A new method of forming images from X-rays (i.e. CT/CAT) was developed and introduced into clinical use by a British physicist Godfrey Hounsfield in 1972.* Godfrey Hounsfield is considered as the inventor of CT/CAT. | train | med_mcqa | null |
Which of the following test is likely to helpful in diagnosing a patient presenting with an itchy annular plaque on the face? | [
"Gram's stain",
"Tissue smear",
"Wood's lamp examination",
"Potassium hydroxide mount"
] | D | Patient in the question is most likely a case of fungal infection of the skin of the face. So the best method to diagnose the condition would be a KOH mount, in which the keratin of the skin will be lysed and the fungal hyphae and other elements are clearly visualised. KOH mount in a case of Tinea corporis will show "Spaghetti and meatballs" appearance. Ref: Laboratory Diagnosis of Infectious Diseases: Essentials of Diagnostic Microbiology By Paul G. Engelkirk, Page 491; Combating Fungal Infections: Problems and Remedy By Iqbal Ahmad, Pages 179-80. | train | med_mcqa | null |
Test used for Posterior dislocation of glenohumeral joint | [
"Jerk test",
"Fulcrum test",
"Cranks test",
"McMurray's test"
] | A | Test for posterior glenohumeral instability is jerk testMaheswari 5th edition PG 95 | train | med_mcqa | null |
Which are seen in endodermal sinus tumor? | [
"Schiller-duval bodies",
"Reed-Sternberg cells",
"Reinke's crystals",
"Russell bodies"
] | A | Ans. is a, i.e. Schiller-Duval bodiesRef: CGDT 9th/ed, p938; Shaw 13rd/ed, p362Call exner bodies are small cyst like spaces found in cases of granulosa cell tumor.FeatureAssociated tumorCall exner bodies & coffee bean nucleiGranulosa cell tumorSchiller duval bodiesEndodermal sinus tumorReinke's crystalHilus cell tumorPsammoma bodiesSerous epithelial tumorsWalthard cell nestBrenner tumorSignet ring cellKrukenberg tumorHobnail cellClear cell tumorLarge polygonal cell with lymphocyticInfiltration and fibrous septaDysgerminomaSkin, teeth, cartilageTeratoma | train | med_mcqa | null |
Most common site of metastasis in skeleton ? | [
"Femur",
"Tibia",
"Veebrae",
"Skull"
] | C | Ans. is 'c' i.e., Veebrae Metastasis Metastatic bone disease is the commonest malignancy of bones and is much more common than primary bone tumors. The commonest sites for bone metastases are veebrae (most common), pelvis, the proximal half of the femur and the humerus. Extremities distal to elbow and knee are least commonly involved sites. Spread is usually the blood stream; occasionally, visceral tumors spread directly into adjacent bones e.g., the pelvis and ribs. Ceain tumors are known to be common sources of bone metastasis. The following primary tumors are the most common to metastasize in the bone; breast, prostate, lung, thyroid, kidney, and gastrointestinal tract. The commonest source of metastatic bone disease is carcinoma of the breast. In males most common source is prostate carcinoma. Bladder and uterine carcinomas are less common sources. In children, skeletal metastases originate from neuroblastoma, Ewing's sarcoma, and osteosarcoma. | train | med_mcqa | null |
A elderly gravida (G6P5) became disoriented, lightheaded, breathless, and cyanotic 20 minutes after an uncomplicated spontaneous vaginal term delivery. Her blood pressure is 80/40 mm Hg, pulse is 110/min, and respiratory rate is 30/min. O2 saturation is 75% on face mask.A generalized purpuric rash and bleeding from the I.V line site are seen. Which of the following is the most appropriate next step in management of this patient? | [
"Abdominal ultrasound",
"Intramuscular magnesium sulfate",
"Intravenous heparin",
"Intubation and mechanical ventilation"
] | D | The above history is suggestive of Amniotic fluid Embolism - Treatment is mainly suppoive to correct the hypoxemia (eg, oxygen, intubation, mechanical ventilation) and hypotension (eg, vasopressors). Since this patient is in shock and is showing signs of hypoxia, immediate resuscitation in the form of intubation and mechanical ventilation is the next best step. | train | med_mcqa | null |
A 4–year–old child is admitted with fever, non–purulent conjunctivitis, rashes, cervical lymphadenopthy, hepatomegaly and desquamation of fingers and toes. Echocardiography shows coronary artery aneurysm. What is the most likely diagnosis ? | [
"Measles",
"German measles",
"Progeria",
"Kawasaki disease"
] | D | null | train | med_mcqa | null |
Meig's syndrome is associated with ovarian: September 2006 | [
"Teratoma",
"Brenner tumour",
"Fibroma",
"Theca cell tumour"
] | C | Ans. C: Fibroma Meigs' syndrome, is the triad of ascites, pleural effusiion and benign ovarian fibroma. It resolves after the resection of the tumour. For reasons unknown, the pleural effusion is classically on the right side | train | med_mcqa | null |
Which of the following drug is useful in prophylaxis of migraine? | [
"Propranalol",
"Sumatriptan",
"Aspirin",
"Ergotamine"
] | A | Migraine: Propranolol is the most effective drug for chronic prophylaxis or migraine.
Drug therapy of migraine | train | med_mcqa | null |
A term baby developed jaundice on 3rd day up to the thigh with normal stool and urine. Mother's blood group is 'O' –ve and that of babies 'A' +ve. The cause of jaundice is – | [
"Rh incompatibility",
"Physiological jaundice",
"Extrahepatic biliary atresia",
"Sepsis"
] | B | Physiological jaundice
Most neonates develop visible jaundice due to elevation of unconjugated bilirubin concentration during their first week.
This common condition is called physiological jaundice.
This pattern of hyperbilirubinemia has been classified into two functionally distinct periods -
1. Phase one
Last for 5 days in term infant with peak bilirubin levels to 12 mg/dl.
Last for 7 days in preterm infant with peak bilirubin levels to 15 mg/d1.
2. Phase two
a. There is decline to about 2 mg/dl, which lasts for 2 weeks after which adult values are attained. | train | med_mcqa | null |
Which of the following is the r,ichest source of Vitamin C? | [
"Orange",
"Guava",
"Cabbage",
"Amila"
] | D | Orange contains 30mg ,guava-212mg,cabbage-124mg and amla contains 600mg/100g.REF.PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE.Editon-21.Page no.-573. | train | med_mcqa | null |
A blood stained discharge from the nipple indicates | [
"Breast abscess",
"Fibroadenoma",
"Duct papilloma",
"Fat necrosis of breast"
] | C | (Duct papilloma) (831 - Baity & Love 25th, 281- CSDT 13th)Blood discharge from nipple caused by benign papilloma in the ductCauses of blood stained discharge from nippleBlood stained discharge from a single ductMore than one duct,* Intraductal carcinoma* Intraductal papilloma*** Duct ectasia* Carcinoma* Ectasia* Fibrocystic diseaseCauses of other tvpe of discharge from nippleSerous (any colour)Grumous/GramPurulentMilk* Fibrocystic disease* Duct ectasia* Carcinoma* Duct ectasiaInfections* Lactation* OCP users* Estrogen replacement therapyGreenish discharge is seen in fibroadenosis and mammary duct ectasia* Treatment of ductal papilloma (<40 years) - Michrodochectomy*** Lobular carcinoma are associated with bilaterality, A biopsy of the contralateral breast is therefore requiredCEA is a marker of Paget's disease of the mammary gland (Infiltratina ductal carcinoma)Post radical neck dissection syndrome - arising from denervation and atrophy of the trapezius muscle due to sacrifice of the spinal accessory nerve (SAN)- Inability to abduct the shoulder beyond 90deg cephalad- Long standing pain in the shoulder- Deformity of the shoulder girdle- Drooping of the shoulder, shoulder abduction and external rotationCauses of Fat necrosis1. After surgery / surgical trauma -* Wide local excision* Reduction mammoplsty*** Breat reconstruction* Breast biopsy2. Following radiotherapy* including iridium implant3. following trauma4. Autologous fat injection using the liposuction* technique to fill in irregular contours & small soft tissue defects in the breast may lead to fat necrosis secondary to poor blood supply in the injected fat5. Conservative treatment of breast cancer with lumpectomy & radiation therapy may also result in fat necrosis* Phenomena resulting from lymphatic obstruction in advanced breast cancer(i) Peaud's orange (due to cutaneous lymphatic oedema)(ii) Cancer-en-cuirasse(iii) Lymphangiosarcoma* Aromatase Inhibitors are used in Breast carcinoma are - Letrozole, Anastrozole, Exemestane, Aminoglutethimide | train | med_mcqa | null |
Which of the following drug is most efficacious against Pediculosis humanus as well as Sarcoptes Scabiei? | [
"Permethrin",
"Hexachlorocyclohexane",
"Monobenzone",
"Crotomiton"
] | A | Permethrin 1. Broad spectrum potent pyrethroid insecticide 2. Currently it is the most efficacious and the most convenient drug against both scabies and lice. 3. It acts on parasite's nerve cell membrane to disrupt the sodium channel current which causes delayed repolarisation,paralysis and death. 4. Toxicity in humans is very low. 5. Nearly 100% cure rates Permethrin 5% cream is the first-line topical therapy in the UK and the USA. Permethrin is adulticidal and ovicidal against the scabies mite and is therefore highly effective after a single application However, in practice the prescribed regimen often involves two applications. Ref Robbins 9/e pg 567 | train | med_mcqa | null |
Magnan syndrome is seen in which poisoning - | [
"Morphine",
"Alcohol",
"Cannabis",
"Cocaine"
] | D | Altered tactile sensation: the person feel that some small insects are crawling on his skin. This is known as Magnan's symptom or cocaine bugs (formication). REF;THE SYNOPSIS OF FORENSIC MEDICINE:KS NARAYANA REDDY;28th EDITION;PAGE NO 347 | train | med_mcqa | null |
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