question stringlengths 1 6.54k | choices listlengths 4 4 | answer stringclasses 4 values | rationale stringlengths 0 22.5k ⌀ | split stringclasses 1 value | dataset stringclasses 6 values | subject stringclasses 1 value |
|---|---|---|---|---|---|---|
Which of the following conditions cannot be detected by bone scintigraphy? | [
"Avascular necrosis",
"Fractures",
"Osteomyelitis",
"None"
] | D | null | train | med_mcqa | null |
Differential growth means: | [
"Difference between growth and development",
"Difference between individual growth",
"Acceleration in growth",
"Different tissues grow at different times rate and amount"
] | D | null | train | med_mcqa | null |
Asteroid bodies are seen in histological examination in tissues infected with which of the following causative agent? | [
"Histoplasmosis",
"Aspergillosis",
"Sporotrichosis",
"Nocardiosis"
] | D | Asteroid bodies are seen in association with Sporotrichosis. Sporotrichosis is an infection caused by Sporothrix schenckii a thermally dimorphic fungus. In H&E stained tissue, the asteroid body consists of a central basophilic yeast cell surrounded by radiating extensions of eosinophilic material, which are depositions of antigen antibody complexes and complement. Sporotrichosis occurs following traumatic inseion of S schenckii into the skin. The initial lesion is usually located on an extremity which later develops into a granulomatous nodule that may progress to form a necrotic or ulcerative lesion. The draining lymphatics becomes thickened and cor like. It can be seen when stained with Gomori methenamine silver or periodic acid-Schiff stain. It can be cultured on Sabouraud's agar containing antibacterial antibiotics and incubated at 25-30degC. Ref:Brooks G.F., Carroll K.C., Butel J.S., Morse S.A., Mietzner T.A. (2013). Chapter 45. Medical Mycology. In G.F. Brooks, K.C. Carroll, J.S. Butel, S.A. Morse, T.A. Mietzner (Eds), Jawetz, Melnick, & Adelberg's Medical Microbiology, 26e | train | med_mcqa | null |
True about acanthosis Nigricans is all except | [
"Cutaneous marker of insulin resistance.",
"More common in woman with PCOD and normal weight.",
"Affects flexure area like axillae, waist, groin.",
"Can be seen in gastrointestinal malignancy."
] | B | Acanthosis develops more frequently in obese women with PCOD than in those with PCOD and Normal weight. | train | med_mcqa | null |
ck 7 negative and ck 20 negative tumor is | [
"Prostate carcinoma",
"Carcinoma colon",
"Urothelial carcinoma",
"Mesothelioma"
] | A | Answer- A. Prostate carcinomaCK7- 1 CK20 - carcinoma of adrenal coex, prostate | train | med_mcqa | null |
In which stage of filariasis are microfilaria seen in peripheral blood: | [
"Late adenolymphangitis stage",
"Tropical eosinophilia",
"Early adenolymphangitis stage",
"Elephantiasis"
] | C | Ans. (c) Early adenolymphangitis stage* Filariasis is a parasitic disease that is caused by thread- like nematodes (roundworms) belonging to the family known as "filariae".* These are transmitted from host to host by blood-feeding arthropods, mainly black flies and mosquitoes.* The adult worms, which usually stay in one tissue, release early larval forms known as microfilariae into the hosts bloodstream. Person is infective once microfilaria presents in the peripheral blood.* The inflammatory phase is characterised by Lymphangitis, lymphadenitis and adenolymphangitis.* It lasts for a few days, then subsides spontaneously & recurs at irregular intervals for a period of weeks to months.* These circulating microfilariae can be taken up with a blood meal by the arthropod vector; in the vector, they develop into infective larvae that can be transmitted to a new host.* Filariasis is diagnosed in microfilaraemic cases primarily through direct observation of microfilariae in the peripheral blood.* Remember: W. bancrofti is nocturnally periodic i.e. micro filariae are scarce in peripheral blood by day and increase at night. | train | med_mcqa | null |
A 60 year old female is suffering from renal failure and is on hemodialysis since last 8 years. She developed carpel tunnel syndrome. Which of the following finding will be associated? | [
"AL",
"AA",
"ATTR",
"B2 microglobulin"
] | D | . | train | med_mcqa | null |
A patient has hepatic encephalopathy, the drug used for gut sterilization in this patient is - | [
"Neomycin",
"Netilmycin",
"Bleomycin",
"None of the above"
] | A | Ans. is 'a' i.e., Neomycin o Normally NH, is produced by colonic bacteria. This is absorbed and conveed to urea by liver. In severe hepatic failure, detoxication of NH3 does not occur, blood NH3 level rise and produce encephalopathy. Neomycin, by suppressing intestinal flora, diminishes NH3 production and lowers its blood level; clinical improvement is seen within 2-3 days. o Because of toxic potential of neomycin, lactulose is preferred. | train | med_mcqa | null |
A 45 yrs old male came to the psychiatric OPD complaining of continuous, dull, non-progressive headache for the last 8 years. The patient has seen numerous neurologists in the belief that he has a brain tumor even though all his investigations have been normal. The patient insisted that he had a brain tumor and requested yet another workup. Psychiatric evaluation reveals disease conviction in the background of normal investigations. The most probable diagnosis is: | [
"Hypochondriasis",
"Conversion disorder",
"Somatization disorder",
"Somatoform pain disorder"
] | A | Patient in the question suffering from headache since 8 years believes that he has brain tumor despite of all the investigations being normal. His symptoms are suggestive of hypochondriasis. Essential feature of hypochondriasis, is a belief of serious medical illness that persists despite reassurance and appropriate medical evaluation. These patients have a history of poor relationships with physicians because of the feeling that they have been evaluated and treated inappropriately or in adequately. This disorder is disabling in intensity and is persistent, with waxing and waning symptomatology. Although somatization and somatoform disorders are similar, the major difference is that in somatization patient is not concerned about any paicular diagnosis e.g. cancer. They however are worried about symptoms e.g. aches and pains. Ref: Harrison's Principles of Internal Medicine, 18th Edition, Chapter 391 | train | med_mcqa | null |
An 18-year-old girl is brought to hospital because of weakness. She feels well, but is under a lot of stress at school. Most of her time is spent studying, dieting, and exercising. On physical examination she is 5'8" weighs 85lbs, and appears unwell. The blood pressure is 85/70 mm Hg, heart rate is 50/min, and there is prominent muscle wasting. Which of the following is this patient most likely at risk for? | [
"renal failure",
"ventricular tachyarrhythmias",
"DM",
"hyperthermia"
] | B | Patients with severe eating disorders are at risk of ventricular tachyarrhythmias. Risk of death in anorexia nervosa is also associated with hypothermia, suicide, or pneumonia with emaciation. Because of the danger of ventricular tachyarrhythmias, patients should be followed with ECGs. A prolonged QT interval is a sign of danger. In addition, severe weight loss can lead to both systolic and diastolic dysfunction of the ventricles. Diabetes is not a feature of eating disorders and acute kidney injury can sometimes develop in severe volume depletion states, but not typically seen. | train | med_mcqa | null |
Raised calcium and phosphorus are seen in - | [
"CRF",
"Vitamin D intoxication",
"Hyperparathyroidism",
"pseudohypoparathyroidism"
] | B | <p>Primary hyperparathyroidism is a generalized disorder of calcium, phosphate, and bone metabolism due to an increased secretion of PTH. The elevation of circulating hormone usually leads to hypercalcemia and hypophosphatemia.Hypercalcemia in vitamin D intoxication is due to an excessive biologic action of the vitamin, perhaps the consequence of increased levels of 25(OH)D rather than merely increased levels of the active metabolite 1,25(OH) 2 D (the latter may not be elevated in vitamin D intoxication). 25(OH)D has definite, if low, biologic activity in the intestine and bone. The production of 25(OH)D is less tightly regulated than is the production of 1,25(OH) 2 D. Hence concentrations of 25(OH)D are elevated severalfold in patients with excess vitamin D intake. The diagnosis is substantiated by documenting elevated levels of 25(OH)D >100 mg/mL. Hypercalcemia is usually controlled by restriction of dietary calcium intake and appropriate attention to hydration. These measures, plus discontinuation of vitamin D, usually lead to resolution of hypercalcemia. However, vitamin D stores in fat may be substantial, and vitamin D intoxication may persist for weeks after vitamin D ingestion is terminated. Such patients are responsive to glucocoicoids, which in doses of 100 mg/d of hydrocoisone or its equivalent usually return serum calcium levels to normal over several days; severe intoxication may require intensive therapy(harrison 18 pg 3108)</p> | train | med_mcqa | null |
Hypothermia in elderly male | [
"Decrease heart rate",
"Decrease in cardiac out put",
"May cause MI",
"All of the above"
] | D | (AH of the above): Ref: 122-H,304-Sabiston 17th (135-H17th)HYPOTHERMIA:Body response include* Decrease in cardiac output* Reduction in heart rate* Cardiac arrhythmias* < 35degC - Coagulation is significantly affected as well as platelet functions (Bleeding become more serious problems)Hypothermia associated with sepsis is a poor prognostic sign. Hepatic failure causes decreased glycogen stores and gluconeogenesis, as well as a diminished shivering response. In acute MI associated with low cardiac out, hypothermia may be reversed after adequate resuscitation. | train | med_mcqa | null |
Which of the following statements is true regarding vocal cords? | [
"Two muscles adduct (close) the vocal cords",
"One muscle abducts (opens) the vocal cords",
"One muscle adjusts the length of the vocal cords",
"One muscle adjusts the tension of the vocal cords"
] | B | (b) One muscle abducts (opens) the vocal cords(Ref. Scott Brown, 8th ed., Vol 3; 889)All muscles of VC are adductorsThe tensors alter the length, hence tension of vocal cords. There are two tensors of VC. | train | med_mcqa | null |
Which of the following is not a feature of primary tuberculosis: September 2010 | [
"Apical lung cavity",
"Ghon's focus",
"Paratracheal lymphadenopathy",
"Heal spontaneously by fibrosis"
] | A | Ans. A: Apical lung cavityThe primary complex generally exists singly and only occasionally in multiple units.In overwhelming majority of cases primary complex occurs in the lungs and only in about 5% cases they are distributed among the intestines, Oropharynx, the skin and other rarer sites. The primary focus in the lungs is called as Ghon focus. It generally occurs in the subpleural region of midline and lower lung zones. Mostly hilar and inter-pleural lymph nodes are involved to form the primary complex.Secondary TB is usually localized to apical and posterior segment of upper lobes. | train | med_mcqa | null |
"Blow-out" fracture of orbit involves: | [
"Floor",
"Medial wall",
"All of the above",
"None of the above"
] | C | Ans. All of the above | train | med_mcqa | null |
In colposcopy following are visualised except: | [
"Upper 2/3rdendocervix",
"Cervical carinoma in situ",
"Cervical polyp",
"Cervical dysplasia"
] | A | null | train | med_mcqa | null |
The trabeculated pa of the right ventricle is derived from which of the following? | [
"Truncus aeriosus",
"Bulbus cordis",
"Primitive ventricle",
"Primitive atrium"
] | C | C. The trabeculated pa / rough pa /anterior pa of the right ventricle is derived from the primitive ventricle. | train | med_mcqa | null |
Angiomatosis is | [
"Sturge Weber syndrome",
"Rendu Osler Weber syndrome",
"Parry Romberg syndrome",
"Peutz Jeghers syndrome"
] | A | null | train | med_mcqa | null |
Test used to differentiate maternal from fetal blood? | [
"Osmotic fragility test",
"Water bulb test",
"Apt test",
"Kleihauer Betke test"
] | C | Apt test or Singer's alkali denaturation test is used to differentiate between fetal and maternal blood. It is based on the principle that fetal Hb is more resistant to alkali denaturation. Thus, when eater and the blood are mixed with sodium hydroxide, it remains pink for longer if foetal in origin. If it is maternal blood, it turns yellow brown in 2 min, as adult Hb is denatured easily.Kleihaur Betke test is performed on maternal blood to assess the amount of fetomaternal bleed.The osmotic fragility test (OFT) is used to measure erythrocyte resistance to hemolysis while being exposed to varying levels of dilution of a saline solution.Conditions associated with increased osmotic fragility include Hereditary spherocytosis, Autoimmune spherocytosis, Poisoning, Severe burns. Conditions associated with decreased fragility: Thalassemias, Iron deficiency anemia, Sickle cell anemia. Reference : page 138 and 311 Textbook of Obstetrics Sheila Balakrishnan 2nd edition | train | med_mcqa | null |
Which of the following is true regarding Fluorescence? | [
"Spontaneous illumination in dark",
"Release of longer wavelength light on absorbing light of shorter wavelength",
"Release of shorter wavelength light on absorbing light of longer wavelength",
"Continuous emission of lights of different wavelength"
] | B | Ans. b. Release of longer wavelength light on absorbing light of shorter wavelength (Ref: Tietz' Fundamentals of Clinical Chemistry 5/e p75; Lehninger 4/447; Harper 29/e p311)In Fluorescence, there is release of longer wavelength of light on absorbing light of shorter wavelength is seen.FluorescenceIt is the emission of light by a substance that has absorbed light or other electromagnetic radiationQ.It is a form of luminescenceQIn most cases, the emitted lights have a longer wavelength and lower energy than the absorbed radiationQ. | train | med_mcqa | null |
After how many days of ovulation embryo implantation occurs? | [
"3-5 days",
"7-9 days",
"10-12 days",
"13-15 days"
] | B | Ans-B i.e. 7-9 days Shaws states "Implantations occurs about 6th day after fertilization or approximately 20th day of a regular menstrual cycle " Guyton states (10th/e, p 945)"After reaching the uterus, the developing blastocyst usually remains in the uterine cavity for an additional 1-3 days before it implants in the endometrium, thus implantation ordinarily occurs on about 5th to 7th day after ovulation" 10th/ep. 945.But on page (936-937) of the same edition, Guyton clearly state "From the time a fertilized ovum enters the uterine cavity from the fallopian tube (which occurs 3-4 days after ovulation) until the time ovum implants (7-9 days after ovulation) the uterine secretions called uterine milk provides nutrition for the early dividing ovum." | train | med_mcqa | null |
Positive moality indicator is ? | [
"IMR",
"Child moality rate",
"MMR",
"Life expectancy"
] | D | Ans. is 'd' i.e., Life expectancy Moality indicators These are :? Crude death rate Maternal moality rate Expectation of life (life expectancy) Disease specific moality rate Infant moality rate Age specific death rate Child moality rate Adult moality rate Under-5 propoional moality rate Years of potential life lost Among these only life expectancy is a positive moality indicator, i.e. increase life expectancy means improvement in health. All other are 'negative' health indicators, i.e. increase value of these indicators implies poor health of community. | train | med_mcqa | null |
Neurotransmitter which is released at the end organ of the parasympathetic division of ANS: | [
"Acetylcholine.",
"Adrenaline.",
"Non adrenaline.",
"All of the above."
] | A | Non-adrenaline is secreted at the end organ of the sympathetic system except in sweat glands and hair follicle while acetylcholine is released at parasympathetic system. | train | med_mcqa | null |
Class III amalgam restoration is not indicated in which of the following cases? | [
"Extensive preparation with only minimal facial involvement",
"Mesial surface of canines",
"The gingival margin involves primarily cementum",
"Moisture control is difficult"
] | B | There are few indications for a Class III amalgam restoration. It is generally reserved for the distal surface of maxillary and mandibular canines if:
The preparation is extensive with only minimal facial involvement.
The gingival margin involves primarily cementum.
Moisture control is difficult.
For esthetic reasons, amalgam is rarely indicated for the proximal surfaces of incisors and the mesial surface of canines.
However, amalgam may be used for any Class III restoration that does not involve the facial surface or undermine the incisal corner.
Reference: Sturdevant operative dentistry. 4th edition: page no.744,743 | train | med_mcqa | null |
Metyrapone inhibits- | [
"11-B-hydroxylase",
"21-B-hydroxylase",
"Both",
"None"
] | A | mineral I coical is specificially achieved by local metabolism of coisol to inactive compound coisone by 11B hyroxylase which is inhibited by metyrapone ( Harrison 17 pg 2248) | train | med_mcqa | null |
Which of the following is a manifestation of Copper sulphate poisoning? | [
"Acute hemolysis",
"High anion gap acidosis",
"Peripheral neuropathy",
"Rhabdomyolysis"
] | A | Acute copper sulphate poisoning can manifest with acute hemolysis. The pathogenesis of this effect is not known but may be related to copper induced oxidation of intracellular glutathione, hemoglobin and NADPH as well as inhibition of Glucose 6 phosphate dehydrogenase by copper. Patients with acute copper poisoning presents with severe nausea, vomiting, thirst, metallic taste in mouth, burning pain and salivation. Oliguria, hematuria, uremia and albuminuria is also seen. Patients usually die of shock. Ref: Toxicology of Metals, Volume 1 edited by Louis W. Chang, page 941. Concise Textbook Of Forensic Medicine & Toxicology By Sharma page 267. | train | med_mcqa | null |
Ketosis is caused by - | [
"Excessine utilization of glucose",
"Over production of acetyl-CoA",
"Excessine secretion of insulin",
"Excessine intake of carbohydrates"
] | B | Ans. is 'b' i.e., Over production of acetyl-CoA o Ketogenesis occurs when there is high rate of fatty acid oxidation in liver which provides excessine acetyl-CoA.o Normally, rates of ketone body synthesis and their utilization (oxidation) are balanced so that their serum concentration is maintained to very low level (normal is < 0.2 mmol/L or< 1 mg/d1) and urinary excretion is negligible (< 1 mg/ 24 hours).o However, when rate of ketogenesis exceeds their utilization, their concentration in blood rises, and the condition is known as ketonemia (hyperketonemia).o Excess ketone bodies are eliminated in urine, this is known as kenonuria.o The overall condition is called Ketosis.o Ketogenesis is usually associated with excessive fatty acid oxidation^ which occurs most notably in starvation and diabetes (type 1 DM). | train | med_mcqa | null |
Lancefield classification is used for: | [
"Streptococci and based on protein",
"Streptococci and based on carbohydrate",
"Staphylococci and based on protein",
"Gonococci and based on protein"
] | B | Streptococci and based on carbohydrate | train | med_mcqa | null |
Forceps may be applied for delivery for all situations listed below, EXCEPT? | [
"Saggital suture of head is 15 degree sho of rotation in pelvis",
"Presenting pa is face (mento anterior)",
"Presenting pa is at zero station",
"Presence of caput succedaneum"
] | C | Following are the criteria for operative vaginal delivery Criteria for forceps delivery Outlet Fetal scalp visible without separating the labia Fetal skull has reached the pelvic floor Sagittal suture is in the anterio - posterior diameter or right or left occiput anterior or posterior position (rotation does not exceed 45o) Low Leading point of the skull (not caput) is at station plus 2 cm or more and not on the pelvic floor. Two Subdivisions: Rotation of 45o or less from the occipito - anterior position. Rotation of more than 45o including the occipito - posterior position Low and outlet procedures are acceptable now and mid and high are not done in modern obstetrics since they are associated with increased maternal and fetal morbidity. Forceps can be applied for mento-anterior face presentation and in the presence of caput. These both are contraindication for applying vacuum | train | med_mcqa | null |
All of the following are features of reversible cell injury, except: | [
"Endoplasmic reticulum swelling",
"Karyorrhexis",
"Plasma membrane blebbing",
"Detachment of ribosomes"
] | B | MECHANISM OF REVERSIBLE INJURY:- Karyorrhexis is seen in necrosis (irreversible cell injury) | train | med_mcqa | null |
Discolouration of silver alloy is due to: | [
"Tarnish",
"Tarnish and corrosion",
"Wet corrosion",
"Dry corrosion"
] | B | null | train | med_mcqa | null |
Best investigation for Traumatic paraplegia | [
"CT Scan",
"Routine Tomography (MRI)",
"X Ray spine",
"Myelography"
] | B | B i.e. MRI MRIQ is the investigation of choice for imaging traumatic spine (ex paraplegia). CT is second best investigation. | train | med_mcqa | null |
Veins not involved in spreading infection to cavernous sinus from danger area of face: | [
"Lingual vein",
"Pterygoid plexus",
"Facial vein",
"Cephalic vein"
] | D | A. Lingual vein and D.Cephalic vein Dangerous area of face includes upper lip and anteroinferior pa of nose including the vestibule.This area freely communicates with the cavernous sinus through a set of valveless veins,anterior facial vein and superior ophthalmic vein. Any infection of this area can this travel intracranially leading to meningitis and cavernous sinus thrombosis. Ref.Maqbool 11/e,p 172. | train | med_mcqa | null |
Cystic fibrosis affects all system except - | [
"Respiratory",
"Endocrine",
"Hepatobiliary",
"Genitoutinaty"
] | B | CF causes thick mucus that clogs ceain organs, such as the lungs, pancreas, and intestines. This may cause malnutrition, poor growth, frequent respiratory infections, breathing problems, and chronic lung disease.doesnt effect endocrine system Ref Robbins 9/e pg 178 | train | med_mcqa | null |
A 47 year old man presents to the emergency room with sudden onset of severe upper abdominal pain with vomiting. The pain is focused in the epigastrium with radiation to the back. Serum amylase levels are 2000 U/L. Which of the following are the most commonly encountered predisposing factors for this patient's condition? | [
"Alcohol use and gallstones",
"Helicobacter pylori infection and excess gastric acid secretion",
"Hepatitis B infection and iron overload",
"Obesity and high serum cholesterol"
] | A | The clinical scenario is typical of acute pancreatitis. The overwhelmingly most impoant contributing factors for development of acute pancreatitis are gallstones (paicularly small ones) and alcohol abuse. Helicobacter pylori infection and excess gastric acid secretion are predisposing factors for peptic ulcer disease of the stomach and duodenum, respectively. Hepatitis B infection and iron overload predispose for cirrhosis. Predisposing factors for myocardial infarction include obesity, high serum cholesterol, stress, and cigarette smoking. Ref: Wyatt C., Kemp W.L., Moos P.J., Burns D.K., Brown T.G. (2008). Chapter 15. Pathology of the Liver, Gallbladder, and Pancreas. In C. Wyatt, W.L. Kemp, P.J. Moos, D.K. Burns, T.G. Brown (Eds), Pathology: The Big Picture. | train | med_mcqa | null |
Breast feeding should be initiated with in: September 2009 | [
"Half an hour",
"One hour",
"One and a half hour",
"Two hour"
] | A | Ans. A: Half an Hour | train | med_mcqa | null |
A 25-year-old is admitted with loss of consciousness after cocaine over-dosage. On examination BP= 200/100 with GCS of 7/15. The right-sided pupil is dilated and shows a sluggish reaction to light. Which is not recommended for this patient? | [
"Administer mannitol at 1g/kg body weight",
"Administer hypeonic fluids to maintain sodium of 145mEq/dl",
"Initiate sodium nitroprusside to achieve MAP below 130 mmHg",
"Neuromuscular paralysis"
] | C | CNS bleed due to a cocaine overdose. The dilated right side pupil indicates evidence of uncal herniation. Sodium nitroprusside is not recommended to manage a hypeensive crisis in CNS event. The metabolism of sodium nitroprusside, which occurs in the red blood cell, liberates cyanide that can accumulate in those receiving high doses or prolonged infusions. The current guidelines recommend the use of nicardipine or labetalol. Mannitol or 3% saline can be used to lower raised ICP. Neuromuscular paralysis is useful to reduce ICP.Airway compromise is always present in GCS less than 8. Hence NM paralysis and intubation is to be done. | train | med_mcqa | null |
Spur cell anemia is seen in - | [
"Drug induced anemia",
"Hepatocellular disease",
"Renal disease",
"Alcoholism"
] | B | null | train | med_mcqa | null |
True about maximum isolation period of enteric fever: | [
"Till three consecutive negative urine/stool culture samples are obtained from patient",
"After chloramphenicol treatment for 72 hours",
"Disappearance of fever",
"Widal test negative"
] | A | Ans. (a) Till three consecutive negative urine/stool culture samples are obtained from patient Control of Typhoid Fever Lontrol of reservoir: Reservoir may be case or carrier: A. Cases: Early diagnosis and treatment: With early diagnosis and treatment, carrier stage can be prevented. Isolation: Owing to the infectious nature of typhoid fever, cases should be isolated till three bacteriologically negative stools and urine repos are obtained on three separate days. Disinfection: Stools and urine are sole source of infection. They should be received in closed containers and disinfected with 5% cresol for at least 2 hours. All solid clothes and linen should be soaked in a solution of 2% chlorine and steam sterilized. All the medical and paramedical person should disinfect their hands. Follow-up: Follow up examination of stool and urine should be done 3-4 months after discharge of patient and again after 12 months to prevent the development of carrier stage. B. Carriers Identification: Culture of duodenal drainage establishes the presence of Salmonella in the biliary tract in carriers. The Vi antibody is seen in up to 80% of carriers. Treatment: Ampicillin or amoxycillin (4-6 g a day) together with probenecid can achieve eradication of carrier stage in about 70%. Cholecystectomy with concomitant ampicillin therapy is the most successful approach for treatment of carriers. Surveillance: The carriers should be kept under surveillance and are prevented from handling food, milk for others. Control of Sanitation: The weakest link in the chain of transmission is sanitation which can be achieved easily Protection and purification of drinking water supplies, improvement of basic sanitation and promotion of food hygiene are essential measures of controlling typhoid. Immunization: Immunization does not give 100% protection, but it definitely lowers both the incidence and seriousness of infection. | train | med_mcqa | null |
Boezomib is used for treatment of which cancer? | [
"Multiple myeloma",
"Breast cancer",
"Tyrosine kinase inhibitor",
"Janus kinase inhibitor"
] | A | Proteasome inhibitors - Boezomib - Ixazomib - Carfilzomib Boezomib - primary indication is Multiple Myeloma, both for first line combined therapy as well as for relapsed disease. It is also used for refractory mantle cell lymphoma. | train | med_mcqa | null |
Functional analysis of kidney is best done by – | [
"Radionuclide scanning",
"IVP",
"Ultrasound",
"MRI"
] | A | Functional imaging or dynamic renal scintigraphy is done by Tc - 99m - DTPA or Tc - 99m - MAG3 | train | med_mcqa | null |
Transvaginal USG can detect fetal cardiac activity in: | [
"6 weeks",
"7 weeks",
"8 weeks",
"10 weeks"
] | A | Ans. is a i.e. 6 weeks Embryonic investigations suggest that cardiac contractions begin in fetus at 36 days gestational age.deg This is evident on : Transvaginal USG At 6 weeks of gestational age corresponding to 13 - 18mm of MSD Transabdominal USG At 8 weeks of gestational age corresponding to 25 mm of MSD. Note : MSD is mean Sac diameter According to Williams Obs 23/e p 200 Using real time sunography with a vaginal transducer fetal cardiac activity '-'?0 hs seen as early as 5th menstrual week | train | med_mcqa | null |
Mid-day meal contains proteins and calories in what propoion? | [
"1/2 proteins and 1/2 calories",
"1/2 proteins and 1/3 calories",
"1/3 proteins and 1/3 calories",
"1/3 proteins and 2/3 calories"
] | B | The mid-day meal programme is also known as school lunch programme. Following broad principles should be kept in mind:The meal should be a supplement and not a substitute to the home dietThe meal should supply at least one-third of the total energy requirement and half of the protein needThe cost of the meal should be reasonably lowThe meal should be such that it can be prepared easily in schools; no complicated cooking process should be involvedAs far as possible locally available foods should be used; this will reduce the cost of the meal andThe menu should be frequently changed to avoid monotonyRef: Park; 23rd ed; Pg 661 | train | med_mcqa | null |
Trisomy 13 is seen in – | [
"Edward Syndrome",
"Patau Syndrome",
"Down Syndrome",
"Turner Syndrome"
] | B | Trisomy 13 - Patau Syndrome
Trisomy 18 - Edward Syndrome
Trisomy 21 - Down Syndrome
XO - Turner Syndrome
XXY - Klinefelter's syndrome | train | med_mcqa | null |
Which of the following is called the Mercier's bar in bladder? | [
"Mucosa between two ureteric orifices",
"Mucosa between uvula vesicae and ureteric orifice",
"Mucosa between verumontanum and ureteric orifice",
"Mucosa between internal and external urethral orifice"
] | A | The Mercier's bar (interureteric bar/ interureteric ridge) is a curved fold of mucous membrane between the two ureteric orifices inside the bladder. This fold of mucous membrane is formed by the thicknening of the superior border of the trigone muscle. In cystoscopy, the intraureteric ridge appears as a pale band and acts as a guide to the ureteric orifices. The mucosal fold running from the uvula vesicae to the ureteric orifice office is called the Bell's Bar This fold forms the lateral borders of the trigone and contains a band of muscle fibers called the Bell's Muscle. Ref: Gray's Anatomy 41st edition Pgno: 87 | train | med_mcqa | null |
Hu includes all except - | [
"Physical pain",
"Mental pain",
"Infirmity",
"Disease"
] | B | the synopsis of forensic medicine & toxicology;Dr k.s narayan reddy; 28th edition; pg.no. 154 . Hu means bodily pain,disease or infirmity caused to any person . | train | med_mcqa | null |
A 10 year old male child presents with pallor and h/o blood transfusion 2 months back. On investigation, Hb-4.5 gms, Total count-60,000,Platelet count-2 lakhs and CD 10+ve, CD 19+ve, CD 117 +ve, MPO +ve and CD 33 -ve. What is the most probable diagnosis? | [
"ALL",
"AML",
"Undifferentiated leukemia",
"Mixed phenotypic a/c leukemia"
] | D | . Mixed phenotypic a/c leukemia | train | med_mcqa | null |
Psammoma bodes are seen in ? | [
"Necrosis",
"Apoptosis",
"Metastatic calcification",
"Dystrophic calcification"
] | D | Psammoma bodies
Concentrically laminated calcified concretions (dystrophic calcification)
Found in-Papillary Carcinoma of Thyroid and kidney, Ovary and Salivary Glands, Calcified bodies in Meningioma, Mesothelioma | train | med_mcqa | null |
The only reliable method for determining the mode of respiratory function is: | [
"Butterfly test",
"Water test",
"Induction rhinomanometry",
"Halometer"
] | C | Induction rhinomanometry or plethysmography is considered as gold standard for determining the mode of respiration in any given individual. | train | med_mcqa | null |
Precursor for the synthesis of testosterone is: | [
"Aldosterone",
"Cholesterol",
"Pregnenolone",
"Cortisol"
] | C | Pregnenolone or Progesterone are the precursors for the synthesis of testosterone, aldosterone, estradiol and cortisol. | train | med_mcqa | null |
Colour of Oxygen cylinder is: | [
"Blue",
"Grey",
"Orange",
"Black and White"
] | D | Black and White | train | med_mcqa | null |
One of the following drugs can slow the loss of alveolar bone in periodontitis: | [
"Dexamethasone",
"Ibuprofen",
"Penicillin",
"Calcium channel Mockers"
] | B | null | train | med_mcqa | null |
Gray equals | [
"100 rad",
"1000 rad",
"10000 rad",
"All"
] | A | A i.e., 100 rads Rad (radiation absorbed dose) is energy deposited within living matter & is equal to 100 ergs/gm of tissue. Whereas, I gray is absorption of 1 joule energy by 1 kg living matter. | train | med_mcqa | null |
All of the following diseases are having a strong asscoiation with peptic ulcer disease, EXCEPT: | [
"COPD",
"Coronary aery disease",
"Chronic renal failure",
"Nephrolithiasis"
] | B | Diseases with strong association with peptic ulcer disease (1) systemic mastocytosis, (2) chronic pulmonary disease, (3) chronic renal failure, (4) cirrhosis, (5) nephrolithiasis, and (6) alpha 1-antitrypsin deficiency. Diseases with a possible association are (1) hyperparathyroidism, (2) coronary aery disease, (3) polycythemia vera, and (4) chronic pancreatitis. Ref: Harrisons principles of internal medicine, 18th edition, Page: 2444 | train | med_mcqa | null |
DNA enzyme for aging: | [
"Telosomerase",
"Topoisomerase",
"Telomerase",
"DNA polymerase"
] | C | Ans. (c) TelomeraseRef: Harper's Biochemistry, 30th ed. pg. 374, 732, 26th ed. Pg- 318* The ends of each chromosome contain structures called telomeres.* Telomeres consist of short, repeat TG-rich sequences. Human telomeres have a variable number of repeats of the sequence 5'-TTAGGG-3', which can extend for several kilobases.* Telomerase, is related to viral RNA-dependent DNA polymerases (reverse transcriptases) and is the enzyme responsible for telomere synthesis and thus for maintaining the length of the telomere.* Telomere shortening has been associated with both aging and malignant transformation. Because of this reason, telomerase has become an attractive target for cancer chemotherapy and drug development. | train | med_mcqa | null |
Inversion and eversion occurs at which joint | [
"Subtalar and midtarsal",
"Calcaneo navicular",
"Midtarsal",
"Calcaneocuboid only"
] | A | A. i.e. Subtalar & mid tarsal joint | train | med_mcqa | null |
What can mother benefit from breastfeeding ? | [
"Breastfeeding mothers would lose weight rapidly.",
"Breastfeeding is a 100% effective contraceptive method because of lactational amenorrhea method",
"Breastfeeding mothers can teach the fathers how to breastfeed so they can enjoy feeding time.",
"Breastfeeding prevents cancer"
] | D | D: Woman who breastfeeds reduces her chance of acquiring breast cancer. A: This is not true; women still need a balanced diet during breastfeeding and therefore should eat more. B: Some breastfeeding women are already ovulating four weeks after giving bih, some even during breastfeeding. C: The father can find other ways to bond with the infant aside from feeding. Ref - Bailey and love 27e p870-75 | train | med_mcqa | null |
A 8 yr old boy presents with petechie, azotemic oligurea altered sensorium in casualty. There is history of diarrhoea for the past 5 days. The clinical diagnosis is - | [
"Acute prophyria",
"Idiopathic thrombocytopenic purpura",
"H.S. purpura",
"H.U.S."
] | A | Ans. is 'a' i.e., Hemolytic uremic syndrome The boys is suffering from hemolytic uremic syndrome. Hemolytic uremic syndrome HUS is characterized by the triad of - 1) Anemia (microangiopathic hemolytic anemia) 2) Renal failure (microangiopathy of kidney involving glomerular capillaries and aerioles). 3) Thrombocytopenia (due to platelet destruction) o HUS is common in children under 2 years of age. (But may also occur in older children). o It usually follows an episode of acute gastroenteritis. o The prodrome is usually of abdominal pain, diarrhoea and vomiting. Sholy thereafter, signs and symptoms of acute hemolytic anemia, thrombocytopenia and acute renal failure ensue. o Sometimes neurological findings also occur (But usually absent and differentiates HUS from TTP). | train | med_mcqa | null |
All drugs are used in Treatment of Mania except - | [
"Haloperidol",
"Trihexylphenidyl",
"Lithium",
"Carbamazepine"
] | B | Drugs used for mania are Lithium, Valproate, Carbamazepine / Oxcarbazepine, Typical & atypical antipsychotics (olanzapine, risperidone, quetiapine, ziprasidone, aripiprazole, haloperidol), benzodiazepines.
Trihexylphenidyl is a central anticholinergic drug used in Drug induced Parkinsonism. | train | med_mcqa | null |
The highest concentrations of Vitamin A is seen in - | [
"Polar bear liver",
"Cod liver oil",
"Shark liver oil",
"Papaya"
] | B | Ans. is 'b' i.e., Codliver oil Amongst the given options, cod liver oil has highest concentration. | train | med_mcqa | null |
A 65-year-old smoker presents with hoarseness, hemoptysis and a hard painless lump in the left supraclavicular fossa. Which of the following is the most appropriate diagnostic step - | [
"Undeake an open biopsy of the neck lump",
"Undeake a radical neck dissection",
"Do fine needle aspiration cytology",
"Give a trial of Anti tuberculous therapy"
] | A | Ans. is 'a' i.e., Undeake an open biopsy of the neck lump | train | med_mcqa | null |
Second primary malignancy of head and neck is commonly associated with which of the following | [
"Oral cavity",
"Hypopharynx",
"Larynx",
"Paranasal sinuses"
] | A | Ans. a. Oral cavity Second primary malignancy of head and neck is commonly associated with oral cavity. "The site of index cancer influences the most likely site of a second primary malignancy, as an example, in a series of 1257 patients with SCC of the head and neck, patients with an index malignancy arising in the larynx were more like to develop a second primary cancer in the lung, while those arising in the oral cavity were more likely to develop a second primary in the head and neck or esophagus. This relationship has been observed in other studies as well."- Second primary malignancies in patients with head and neck cancers by Sandeep Samant, Head and Neck 2005; 27; 1042 Patients with head and neck SCC are at increased risk for the development of second primary malignancies compared with general populationQ. These second primary malignancies typically develop in the aerodigestive tract (lung, head and neck, esophagus)Q. MC second primary malignancy: Lung cancerQ Highest relative increase in risk is for a second head and neck cancerQ | train | med_mcqa | null |
Louse transmits ? | [
"Epidemic typhus",
"Endemic typhus",
"Murine typhus",
"Rickettsial pox"
] | A | Ans. is 'a' i.e., Epidemic typhus | train | med_mcqa | null |
Which of the following types of bias can be reduced by allowing equal interview time - | [
"Berkesonian bias",
"Recall bias",
"Selection bias",
"Interviewer bias"
] | D | Ans. is 'd' i.e., Interviewer bias Interviewer's bias o This type of bias may occurs when the interviewer knows the hypothesis and also knows who the cases are. o This prior information may lead him to question the cases more throughly than the controls regarding a postive history of the suspected causal factor. o This bias can therefore be reduced by allowing equal time to interview both cases and controls. o This bias can be eleminated by double blinding. Slection bias o This type of bias may occur when the cases and controls selected for the study group are not representative of the cases and controls in the general population. o This type of bias can be best controlled by its prevention i.e., by proper selection of a representative study group. Recall bias (Memory bias) : o This type of bias may occur when cases and controls are asked to recall ceain events, and subjects in one group are more likely to remember the event than those in the other group. o For example people take aspirin commonly and for many reasons, but patients diagnosed as having peptic ulcer disease may recall the ingestion of aspirin in greater accuracy than those without G I problems. Also patients who have had an MI are more likely to recall and remember ceain habits (like eating habit) with greater accuracy than those who have not had an MI. | train | med_mcqa | null |
A sporangium contains | [
"Spherules",
"Sporangiospores",
"Chlamydospores",
"Conidia"
] | B | Sexual spores are of 4 types - oospore, ascospore, zygospore and basidiospore. Ascospore produced by ascomycetes. Asexual spores are of 2 type - vegetative and aerial spores. Vegetative - blastospores, ahrospores and chlamydospores. Aerial - conidiospores, microconidia, macroconidia , sporangiospores. Reference: Textbook of Microbiology; Baveja; 4th edition | train | med_mcqa | null |
Which of the following oral hypoglycemic agent is preferred in obese patients? | [
"Tolbutamide",
"Glipizide",
"Gliclazide",
"Metformin"
] | D | Metformin doesn't cause weight gain. It may rather cause weight loss. So, it is preferred in obese patients. | train | med_mcqa | null |
A patient presenting with H/0 diarrhea for several years with recent onset pruritus & ↑ Alkaline Phosphatase, normal SGOT/PT& USG shows no gall stones & biliary tract abnormality, the diagnosis is - | [
"Hodgkins Lymphoma",
"Sclerosing cholangitis",
"Chronic Hepatitis",
"Autoimmune Hepatitis"
] | B | null | train | med_mcqa | null |
RNA primer in eukaryote is formed by ? | [
"Ligase",
"RNA polymerase",
"Topoisomerase",
"Helicase"
] | B | DNA synthesis cannot commence with deoxyribonucleotides because DNA polymerase cannot add a mononucleotide to another mononucleotide.Thus, DNA polymerase cannot initiate synthesis of complementary DNA synthesis strand of DNA on a totally single stranded template.For this, they require RNA primer, which is a sho piece of RNA formed by enzyme primase (RNA polymerase) using DNA as a template.RNA primer is then extended by addition of deoxyribonucleotides.Later on, the ribonucleotides of the primer are replaced by deoxyribonucleotides. Primase is actually a DNA primase which has RNA polymerase activity. This DNA primase is also called DNA polymerase. | train | med_mcqa | null |
The most common complication after thoracic injury is: | [
"Chylothorax",
"Pulmonary contusion",
"Empyema",
"Oesophageal rupture"
] | C | The most common complication after thoracic injury is development of an empyema. Management is based on CT diagnostic criteria. Percutaneous drainage is indicated for single loculations without appreciable rind. Early decoication video-assisted thoracic surgery is pursued in patients with multiple loculations or a pleural rind of >1 cm. Antibiotic treatment is based on definitive culture results. Ref: Cothren C., Biffl W.L., Moore E.E. (2010). Chapter 7. Trauma. In F.C. Brunicardi, D.K. Andersen, T.R. Billiar, D.L. Dunn, J.G. Hunter, J.B. Matthews, R.E. Pollock (Eds), Schwaz's Principles of Surgery, 9e. | train | med_mcqa | null |
Which of the following nerve innervates the anterior belly of the digastric muscle? | [
"Facial nerve",
"Trigeminal nerve",
"Vagus nerve",
"Abducens nerve"
] | B | The anterior belly of the digastric muscle is innervated by the mandibular division of the trigeminal nerve. The inferior alveolar nerve which give rise to the mylohyoid nerve innervates the mylohyoid muscle. Ref: Mastery of surgery, Volume 1 edited by Josef E. Fischer, K. I. Bland, Mark P. Callery | train | med_mcqa | null |
Ali of the following are true about Zenker's diveiculum except: | [
"It is an acquired condition",
"It is a false diveiculum",
"Barium swallow, lateral view is the investigation of choice",
"Out pouching of anterior pharyngeal wall above cricopharyngeus muscles"
] | D | Zenker's diveiculum is an acquired posterior pharyngeal pulsion diveiculum in which only the mucosa and submucosa herniate through the Killian's dehiscence. It is a false diveiculum. IOC is barium study. | train | med_mcqa | null |
65-year-old lady underwent mastectomy for carcinoma breast. Later she developed frontai headache, pain in temple region and around eye. Her ESR is 55 mm/hour. What is the most probable diagnosis? | [
"Cavernous sinus thrombosis",
"Meningeal metastasis",
"Frontal sinusitis",
"Giant cell arteritis"
] | D | Ans: D (Giant cell arteritis) Ref: Harrison's Principles of Internal Medicine, 18th ednExplanation:Giant Cell Arteritis taka Temporal Arteritis)Inflammation of large sized arteries.Commonly involves extracranial branches of external carotid artery.Most common involved artery - Temporal artery.Associated with polymyalgia rheum ail ca (seen in 40-50% cases of GCA).Common in elderly patients { > 55 years).More common in women.Clinical Featureso Localized scalp tenderness over the temporal artery.o Thick and nodular on palpation,o Jaw claudication - Most specific symptom.o Visual symptoms: Diplopia or amaurosis fugax (Anterior ischemic optic neuropathy),o Fever, Malaise, Fatigue,o Anorexia, Less of weight, Sweats,o Arthralgia.Investigationso Elevated ESR.o Anemia.o Temporal artery biopsy - showing giant cells - Investigation of choice.Treatment - Oral Prednisolone. | train | med_mcqa | null |
Homer wright rossette are seen in-a) Neuroblastomab) Astrocytomac) Meningiomad) Pinealoma | [
"ad",
"c",
"ac",
"ab"
] | A | Rosettes
Rosettes are pathological findings characterized by a halo or spoke wheel arrangement of cells surrounding a central core or hub.
Type of Rosette
1. Flexner - Wintersteiner Rosettes
A halo of cells surrounds a largely empty central hub but small cytoplasmic extension from cells project into the lumen.
It is characteristic of retinoblastoma.
May also be seen in → Medulloblastoma, Primitive neuroectodermal tumor, Pineoblastoma.
2. Homer Wright rosettes
A halo of cells surrounds a central hub that contains a meshwork of fibres (neutrophil rich centre).
Homer-Wright rosettes are characteristic of neuroblastomas and medulloblastomas.
May also be seen in → Primitive neuroectodermal tumors (PNET), Pineoblastomas, Retinoblastomas.
3. True ependymal Rosette
A halo of cells surrounds an empty lumen.
It is characteristic of ependymomas.
4. Perivascular pseudorosettes
A halo of cells surrounds a blood vessel.
The term pseudo is used because the central structure is not formed from the tumor itself, and represents a nonneoplastic element.
May be seen in
Ependymonas
Glioblastomas
Medulloblastomas
Retinoblastoma
Primitive neuroectodermal tumors
Monimorphous pilimyxoid astrocytoma
Central neurocytoma | train | med_mcqa | null |
'Bulla spread sign' is seen in which of the following condition? | [
"Herpes gestationalis",
"Bullous pemphigoid",
"Pemphigus vulgaris",
"Herpes simplex"
] | C | Pemphigus vulgaris is associated with positive Nikolsky sign and Asboe- Hansen sign or Bullae spread sign. In positive bullae spread sign, pressing the top of existing bullae will lead to spread of bullae to adjacent normal appearing skin. Positive Nikolsky sign refers to shearing of the epidermis by exeing lateral pressure on the normal skin adjacent to an active blister. Pemphigus vulgaris is an acquired chronic disease in which blisters develop on normal appearing skin and mucous membrane. In this condition the pemphigus antibodies attach to extracellular domain of desmoglein and interfere with its attachment to similar domains on other cells reducing cell cell adherence. It is characterised by the development of flaccid clear blister which rupture and evolve into an inflamed erosion. Ref: Blistering Skin Diseases By Lawrence S. Chan page 26. | train | med_mcqa | null |
Which of the following statements is not true cases of infective enfective endocarditis caused by HACEK organisms? | [
"The clinicaI course of HACEK endocarditis tends be acute and fulminate",
"Cultures of blood from patients HACEK endocarditis may require up to be positive",
"Embolization is common and occures in around 50 /o cases of HACEK endocarditis",
"Valvular vegetation are seen in up to 85% of patients"
] | A | Gram negative bacilli account for approximately 5% of IE diagnoses. These can be divided into HACEK and non-HACEK IE. The acronym HACEK stands for Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, and Kingella. IE due to HACEK organisms is rarely acute . Ref Harrison20th edition pg 1077 | train | med_mcqa | null |
Radiation Dose Monitoring in Occupational Workers is done by | [
"TLD Badge",
"Linear Accelerator",
"Collimators",
"Grid"
] | A | TLD Batch (Thermoluminescent Dosimeter) It is used to evaluate occupational radiation exposure It is made up of lithium flouride (LiF) or Calcium suphate Dysprosium It is worn under lead apron | train | med_mcqa | null |
Clasp assemblies that accommodate functional prosthesis movement are designed to address the concern of: | [
"Class I lever",
"Class II lever",
"Class III lever",
"Class IV lever"
] | A | Clasps Designed to Accommodate Functional Movement
Clasp assemblies that accommodate functional prosthesis movement are designed to address the concern of a Class I lever.
The concern is that the distal extension acts as a long “effort arm” across the distal rest “fulcrum” to cause the clasp tip “resistance arm” to engage the tooth undercut. This results in harmful tipping or torquing of the tooth, which is greater with stiff clasps and increased denture base movement.
Two strategies may be adopted to change the fulcrum location and subsequently the “resistance arm” engaging effect (mesial rest concept clasp assemblies), or to minimize the effect of the lever through the use of a flexible arm (wrought-wire retentive arm).
Key Concept:
Clasp assemblies that accommodate functional prosthesis movement are designed to address the concern of a Class I lever.
Ref: McCracken's REMOVABLE PARTIAL PROSTHODONTICS, THIRTEENTH EDITION page no 72 | train | med_mcqa | null |
Gene therapy methods are: | [
"Electroporation",
"Intranuclear injection",
"Site directed mutagenesis",
"All"
] | D | A i.e. Electroporation, B i.e. Intranuclear infection, C i.e. Site directed mutagenesis | train | med_mcqa | null |
Oropharynx manifestation of HIV infection is - | [
"Oral hairy leukoplakia",
"Caries tooth",
"Cheilitis",
"Paharyngitis"
] | A | repeat | train | med_mcqa | null |
A56 years old patient presents after three days of cataract surgery with a history of increasing pain and decrease of vision after an initial improvement the most likely cause would be | [
"Endophthalmitis",
"After cataract",
"Central retinal vein occlusion",
"Retinal detachment"
] | A | Pain which is increasing along with decrease in vision paicularly after only three days of cataract surgery strongly suggest endophthalmitis | train | med_mcqa | null |
Total number of refractive surfaces in the Eye is | [
"2",
"4",
"5",
"3"
] | B | There are 4 refractive surfaces in the Eye
Anterior surface of Cornea
Posterior surface of Cornea
Anterior surface of Lens
Posterior surface of Lens | train | med_mcqa | null |
Total number of genes in a human being is? | [
"800,000",
"50,000",
"100,000",
"30,000"
] | D | D i.e. 30,000 | train | med_mcqa | null |
The following is true about bronchial carcinoids- | [
"Highly radiosensitive",
"Metastasis common",
"Carcinoid syndrome does not manifest",
"Commonly arise from terminal bronchioles"
] | B | Ref:Textbook of pathology (Harsh mohan) 6th edition,page no.503 BRONCHIAL CARCINOID AND OTHER NEUROENDOCRINE TUMOURS Neuroendocrine tumours of the lung represent a continuum spectrum of lung tumours with progressively increasing aggressiveness which include: typical carcinoid (least aggressive), atypical carcinoid, and large cell endocrine carcinoma, and also small cell carcinoma (most aggressive). All these tumours arise from neuroendocrine (Kulchitsky) cells of bronchial mucosa. Formerly, bronchial carcinoids used to be classified as 'bronchial adenomas' but now it is known that they are locally invasive and have the capacity to metastasise. Bronchial carcinoids tend to occur at a younger age than bronchogenic carcinoma, often appearing below the age of 40 years, and are not related to cigarette smoking. CLINICAL FEATURES. Bronchial carcinoids occur at a relatively early age and have equal sex incidence. Most of the symptoms in bronchial carcinoids occur as a result of bronchial obstruction such as cough, haemoptysis, atelectasis and secondary infection. About 5-10% of bronchial carcinoids metastasise to the liver and these cases are capable of producing carcinoid syndrome. | train | med_mcqa | null |
Which is the direct branch of celiac trunk: | [
"Rt. Gastric",
"Lt. Gastric",
"Gastroduodenal",
"Rt gastro epiploic aery"
] | B | B. i.e. Left gastric aery | train | med_mcqa | null |
All are absolute indications of tonsillectomy except | [
"Suspicious malignancy",
"Peritonsillar abscess",
"Chronic tonsillits",
"Tonsils causing obstructive sleep apnea"
] | C | Ans. is 'c' i.e., Chronic tonsillits Tonsillectomy Tonsillectomy, as the name suggests, is the surgical procedure to remove the tonsils. Often, tonsillectomy is done at the same time as adenoidectomy. Indications Indications are divided into :? A. Absolute 1. Recurrent infections of throat. This is the most common indication.Recurrent infections are fuher defined as : Seven or more episodes in one year, or Five episodes per year for 2 years, or Three episodes per year for 3 years, or Two weeks or more of lost school or work in one year. 2. Peritonsillar abscess. In children. tonsillectomy is done 4-6 weeks after abscess has been treated. In adults, second attack of peritonsillar abscess forms the absolute indication. 3. Tonsillitis causing febrile seizures. 4. Hyperophy of tonsils causing Airway obstruction (sleep apnoea) Difficulty in deglutition Interference with speech. 5. Suspicion of malignancy. A unilaterally enlarged tonsil may be a lymphoma in children and an epidermoid carcinoma in adults. An excisional biopsy is done. B. Relative Diphtheria carriers, who do not respond to antibiotics Streptococcal carriers, who may be the source of infection to others. Chronic tonsillitis with bad taste or halitosis which is unresponsive to medical treatment. Recurrent streptococcal tonsillitis in a patient with valvular hea disease. C. As a pa of Another Operation Palatopharyngoplaty which is done for sleep apnoea syndrome. Glossopharyngeal neurectomy. Tonsil is removed first and then IX nerve is severed in the bed of tonsil. Removal of styloid process. | train | med_mcqa | null |
Biological value is used for assessment of – | [
"Fat quality",
"Protein quality",
"Carbohydrate quality",
"None of the above"
] | B | Biological value (BV)
It is the percentage of absorbed nitrogen retained by the organism.
BV = Retained nitrogen / Absorbed nitrogen x 100 | train | med_mcqa | null |
A 63-year-old woman presents with a 6-month history of recurrent epigastric pain and nausea. Abdominal ultrasound reveals a 13-mm hypoechoic lesion in the tail of the pancreas. Physical examination shows flushing of the face, periorbital edema, and hypotension (blood pressure =90/50 mm Hg). Laboratory studies disclose normal serum levels of gastrin, amylase, insulin, and vasoactive intestinal polypeptide. Urinalysis demonstrates elevated levels of metanephrines (10 mg per 24 hours). Which of the following is the most likely diagnosis? | [
"Adenocarcinoma of pancreas",
"Glucagonoma",
"Insulinoma",
"Pancreatic carcinoid"
] | D | Carcinoid tumors of the pancreas are rare malignant neoplasms that closely resemble intestinal carcinoids. When confined to the pancreas, they may induce the so-called atypical carcinoid syndrome, which is associated with severe facial flushing, hypotension, periorbital edema, and tearing. Hepatic metastases cause the full-blown carcinoid syndrome. Adenocarcinoma of the pancreas (choice A) does not produce hormones. The other choices lead to other endocrine syndromes.Diagnosis: Carcinoid tumor | train | med_mcqa | null |
Which of the following present as acute abdomen | [
"Acute intermittent porphyria",
"Tabes",
"Pneumonitis of lower lobe",
"All"
] | D | null | train | med_mcqa | null |
Which is the commonest complication of Mumps in adults ? | [
"Encephalitis",
"Orchitis",
"Pancreatitis",
"Carditis"
] | B | Meningoencephalitis is common in children. Unilateral deafness and thyroiditis are also known complication. | train | med_mcqa | null |
All of the following features may be used to distinguish PAN from microscopic Polyangitis, Except: | [
"ANCA positivity",
"RBC cast in urine",
"Necritizing vasculitis",
"HBV infection"
] | C | Answer is C (Necrotizing vasulitis): Both polyaeritis nodosa and microscopic polyangitis are characterized by histologicaly by necrotizing vasculitis. Clinical Features PAN MPA Kidney Involvement * Renal vasculitis with infarcts and microaneurysms Yes No * Rapidly progressive glomerulonephritis with crescents No Yes Lung involvement * Alveolar hemorrhage No Yes Laboratory data Yes (10%) No * HBV-infection * ANCA Negative Positive (p-ANCA) Abnormal angiogram with microaneurysms Yes No * Histology Necrotizing vasculitis Necrotizing vasculitis (no granulomas) * Relapses Rare Common | train | med_mcqa | null |
Most commonly used cholinesterase regenerator at NM junction is - | [
"Pralidoxime",
"Obidxime",
"Diacetyl monoxime",
"Edrophonium"
] | A | Ans. is 'a' i.e., Pralidoxime o Pralidoxime is most commonly used cholinesterase reactivater.OXIMESo Oximes 1 Pralidoxime 2-PAM, obidoxime and diacetyl-monoxime (DAM)J are used in organophosphatepoisoning.o Oximes acts by reactivating cholinesterase enzyme.o Mechanism of actionIn organophosphate poisoning esteratic site of cholinesterase is phosphorylated and anionic site is free.Phosphorylated cholinesterase reacts very slowly with water.However, if more reactive OH groups in the form of oximes are provided, reactivation occurs more than a million time faster.Oximes attach to anionic site and provide more reactive OH groups.Oximes are ineffective in Carbamates poisoning.Pralidoxime is contraindicated in carbamates poisoning, because not only it does not reactivate carbamylated enzyme, it has weak anti-chE activity of its own.Remembero Obidoxime is more potent than pralidoxime.o Pralidoxime and obidoxime are lipid insoluble, while diacetyl-monoxime (DAM) is lipid soluble so it can cross EBB and regenerate AChE in brain.o Atropine is used in both organophosphate and carbamate anticholinesterase poisoning. | train | med_mcqa | null |
A farmer presenting with fever off and on for the past 4 years was diagnosed to be suffering from chronic Brucellosis. All of the following serological tests would be helpful in the diagnosis at this state except: | [
"Standard agglutination test",
"2-mercapto-ethanol test",
"Complement fixation test",
"Coomb's test"
] | A | Option 1, 2, 4 - Acute infection: Standard agglutination test (SAT) - This test detects mainly IgM antibodies which are absent in chronic brucellosis. - SAT performed with 2-mercaptoethanol treated with serum will detects only IgG - Blocking antibodies--IgA antibodies that interfere with agglutination by IgG and IgM. They appear during the subacute stage of infection, tend to persist for many years- detected by the Coombs test Option 3 - CFT and ELISA: Are preferred in chronic brucellosis for Ab detection. Other Tests: PCR using primers for rrs-rrl gene, Omp2 gene Brucellin skin test Diagnosis of Brucellosis in Animals: Antibody detection in milk by (i) Milk ring test,(ii) Rose Bengal card test and (iii) Whey agglutination test | train | med_mcqa | null |
The maxillary nerve arises from the trigeminal ganglion in the middle cranial fossa. It passes forward in the lateral wall of the cavernous sinus and leaves the skull through which of the following foramen to enter the pterygopalatine fossa | [
"Foramen ovale",
"Foramen spinosum",
"Foramen rotundum",
"Formen lacerum"
] | C | (Foramen rotundum) (236 - BDC - 3)STRUCTURE PASSING THROUGH.Foramen spinosumForamen ovaleForamen lacerum1. Middle meningeal artery2. Meningeal branch of the mandibular nerve or nervus spinosus3. Posterior trunk of the middle meningeal vein1. Mandibular nerve 2. Acessory meningeal artery 3. Lesser petrosal nerve 4. Emissary vein Internal carotid artery Foramen rotundumSuperior orbital fissureJugular foramenMaxillary division of the trigeminal nerveLacrimal, frontal, trochlear occulomotor, nasociliary and abducent nerve, superior ophthalmic vein* Glossopharyngeal* Vagus* Acessory nerve* Sigmoid sinus becomes internal jugular vein | train | med_mcqa | null |
Foot drop due to injury of which nerve | [
"Tibial nerve",
"Deep peroneal nerve",
"Superficial peroneal nerve",
"Sural nerve"
] | B | FOOT DROP:- Paralysis of muscles of anterior compament of the leg due to injury to deep peroneal nerve results in loss of power of dorsiflexion of foot and eversion. As a result foot us plantar flexed. Ankle reflex is intact.This is usually caused by injury or disease of the common peroneal nerve due to trauma, leprosy or peripheral neuritis.Sensory loss- first interdigital cleft. {Reference: BDC 6E pg no.97} | train | med_mcqa | null |
Which of the following is false regarding conventional immediate dentures (CID) | [
"It is intended as definitive or long term prosthesis",
"Generally indicated when only anterior teeth are present",
"Esthetics of CID can be altered during fabrication of second denture",
"It is indicated when two extraction visits are feasible."
] | C | As conventional immediate denture is intended as definitive prosthesis, esthetics once achieved cannot be altered. There is no second set where changes can be made. | train | med_mcqa | null |
A child presented with weakness of limbs, cannot sit properly and swaying both sides while walking. The lesion is in | [
"Cerebellar vermis",
"Cerebellar hemisphere",
"Cerebellopontine area",
"Neocerebellum"
] | A | (A) Cerebellar vermis # Cerebellum has 3 parts:> Archicerebellum (Vestibulocerebellum): It includes Flocculonodular lobe, which is located in the medial zone. Archicerebellum helps maintain equilibrium and coordinate eye, head, and neck movements; it is closely interconnected with the vestibular nuclei.> Midline vermis (Paleocerebellum): It helps coordinate trunk and leg movements. Vermis lesions result in abnormalities of stance and gait> Lateral hemispheres (Neocerebellum): They control quick and finely coordinated limb movements, predominantly of the arms.> Localization and regional distribution of pathology within the cerebellum dictates the clinical findings: Lesions of the midline cerebellar vermis produce truncal tremor and gait ataxia (splayed stance and swaying of the body while walking). Lesions of the cerebellar lateral hemispheres produces a limb ataxia & result in loss of muscular coordination and jerky puppet-like movements of the limbs on the ipsilateral side (same side as lesion).> Interruption of afferent and efferent connections within the neocerebellar system: Results in an ataxic gait (i.e., swaying in the standing posture, staggering while walking with a tendency to fall, and the adoption of a compensatory wide base), scanning dysarthria, explosive speech, hypotonia, intention tremor (i.e., oscillation of limbs that is pronounced at the end of a planned movement), dysdiadochokinesia (i.e., impaired alternating movements), dysmetria (i.e., impaired judgment of distance), decomposition of movement, and abnormalities of eye movements (i.e., nystagmus). Small lesions produce no signs or only transient symptoms; small deficits are compensated for by other parts of the brain.CEREBELLAR DYSFUNCTION: ANATOMYCerebellar LesionSigns* Posterior (Flocculo-nodular lobe Archicerebellum)Eye movement disorders: Nystagmus; Vestibulo-ocular Reflex (VOR)* Midline (Vermis; Paleocerebellum)Truncal & Gait Ataxia* Hemisphere (Neocerebellum)Limb ataxia: Dysmetria, Dysdiadochokinesis, 'intention' tremorDysarthriaHypotonia | train | med_mcqa | null |
Urinary bladder calcification radiologicaly which resemble fetal head in pelvis is | [
"Adenocarcinoma of bladder",
"Bladder stone",
"Schistosomiasis",
"Marion’s disease"
] | C | Schistosomiasis is associated bladder carcinoma ( SCC > TCC). | train | med_mcqa | null |
Drug of choice for ventricular premature beats(VPB) with digitalis toxicity is | [
"Diphenylhydantoin",
"Quinidine",
"Amiodarone",
"Verapamil"
] | A | Digoxin remains a very useful agent for chronic atrial fibrillation or for the ectopic beats associated with hea failure. But when rapid control of the ventricular rate is required to arrhythmias such as atrial fibrillation, atrial flutter, or paroxysmal atrial tachycardia, a slow infusion of verapamil is the agent of choice. In general, verapamil may be added to digoxin or given intravenously while a digoxin effect is awaited, unless there is digitalis toxicity. In digitalis toxicity, lignocaine remains the agent of choice for ventricular arrhythmias, and is given in the same doses as for acute myocardial infarction; phenytoin is used for digitalis-arrhythmias with A-V block. Verapamil may be infused very cautiously for digitalis-induced supraventricular tachyarrhythmias. The use of oral agents such as quinidine, disopyramide and mexilitene for chronic prophylaxis of ventricular ectopic beats is of doubtful effectiveness, unless the ectopic activity is symptomatic. Serious ventricular arrhythmias may be induced by quinidine and disopyramide. Beta-blockade is especially useful for ectopic beats associated with anxiety, or when arrhythmias are associated with angina of effo or hypeension. As always, major contraindications to the use of beta-blockade include cardiomegaly, hea failure or asthma | train | med_mcqa | null |
Manifestations of endemic cretinism include- | [
"Deafness and facial nerve involvement",
"Blindness and hypothyroidism",
"Strabismus and spastic diplegias",
"Multinodular goitre and mental retardation"
] | C | Ans. is 'c' i.e., Strabismus & Spastic deplegia Cretinism o Cretinism is a condition of severely stunted physical and mental growth due to untreated congenital hypothyroidism or from prolonged nutritional deficiency of iodine. o When cretinism is due to nutritional deficiency of iodine it is referred to as endemic cretinism. o When critinism is due to congenital hypothyroidism it is called sporadic cretinism. Endemic cretinism The term endemic cretinism includes two different overlapping syndromes. Neurologic syndrome Myxedematous syndrome Neurological Myxedematous Thyroid gland Enlarged (goitre) Normal in size Hormonal status Euthyroid Hypothyroid (I T4, T TSH) Mental R. Present, severe Present but less severe Deaf Mutism Usually present Absent Cerebral Diplegia Often present Absent Squint Present Stature Usually Normal Severe growth retardation General features No physical sign Physical signs present of hypothyroidism eg. Coarse dry skin, husky voice Reflexes Brisk Delayed relaxation ECG Normal Small voltage QRS X - ray Normal Epiphyseal dysgenesis Effects of Thyroid No effect Improvement Hormone substitution Note : Dearness occurs hut facial N. involvement is not seen usually. | train | med_mcqa | null |
True about DNA polymeare in eukaryotes | [
"Components are a, b, TS, D, E",
"b associated with repair",
"TS associated with repair",
"D associated with synthesis of mitochondrial DNA"
] | A | Alpha polymerise which synthesizes okazaki fragaments DNAP mainly responsible for the leading strnd synthesis DNAP beta is proofreading and repair enzymeDNAP gamma concerend with mitochondrial DNA replicationRef: DM Vasudevan, 7th edition, page no: 580 | train | med_mcqa | null |
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