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 |
|---|---|---|---|---|---|---|
Micro-vesicular fatty liver in Reye's syndrome is? | [
"Due to defect in beta oxidation of fatty acids",
"Due to defect in oxidative phosphorylation",
"Due to defect in fatty acid synthesis",
"Defective synthesis of acyl COA synthesis"
] | A | The most common secondary mitochondrial hepatopathy is Reye syndrome Recurrent Reye-like syndrome is encountered in children with genetic defects of fatty acid oxidation, such as 1. Deficiencies of the plasmalemmal carnitine transpoer 2. Carnitine palmitoyltransferase I and II 3. Carnitine acylcarnitine translocase 4. Medium and long-chain acyl-CoA dehydrogenase, multiple acyl-CoA dehydrogenase, and long-chain L-3 hydroxyacyl-CoA dehydrogenase | train | med_mcqa | null |
Drugs which cause ototoxicity and circumoral paraesthesia are: | [
"Antileprotic drugs",
"Antitubercular drugs",
"Streptomycin",
"Chloramphenicol"
] | C | null | train | med_mcqa | null |
Which of the following enzymes require Vitamin C for their activity? | [
"Procollagen proline hydroxylase",
"Procollagen amino peptidase",
"Procollagen carboxyl peptidase",
"Lysyl oxidase"
] | A | Vitamin C plays the role of a coenzyme in hydroxylation of proline and lysine while protocollagen is converted to collagen (i.e. post-translational modification). The hydroxylation reaction is catalysed by lysyl hydroxylase (for lysine) and prolyl hydroxylase (for proline). | train | med_mcqa | null |
Rotten egg odour is not characteristic with which substance | [
"Disulfiram",
"Hydrogen sulphide",
"N - Acetyl cysteine",
"Nitrobenzene"
] | D | Rotten egg odour can be felt in - Disulfiram, Mercaptans, N acetyl cysteine, Hydrogen sulphide. | train | med_mcqa | null |
All are true about hepatoblastoma except:- | [
"Associated with FAP .",
"Most cases <18 months .",
"Prognosis is very poor with pulmonary metastases .",
"Treatment is chemotherapy followed by surgical resection"
] | C | Hepatoblastoma M/C 1deg Malignancy of Liver in children Associated with - FAP - Familial Adenomatous Polyposis - BWS - Beckwith Wiedemann Syndrome Most patient are <18 months and all patient are <3yrs of Age. IOC for diagnosis - Biopsy Management *Neo Adjuvant Chemotherapy (NACT) + Surgery is done | train | med_mcqa | null |
Which of the following complications is not seen with peritonitis - | [
"Renal failure",
"Residual abscess",
"Endoxic shock",
"None"
] | D | Ans. is 'None' Systemic complications of peritonitis Bacteraemic/endotoxic shock Bronchopneumonia/respiratory failure Renal failure Bone marrow suppression Multisystem failure Abdominal complications of peritonitis - Adhesional small bowel obstruction Paralytic ileus Residual or recurrent abscess Poal pyaemiafiiver abscess | train | med_mcqa | null |
Which among the following secretions has the highest HC03 content? | [
"Saliva",
"Bile",
"Succus entericus",
"Pancreatic secretions"
] | D | The pancreatic juice is alkaline and has a high HCO3- content (approximately 113 mEq/L vs 24 mEq/L in plasma). Composition of Normal Human Pancreatic Juice: Cations: Na+, K+, Ca2+, Mg2+ (pH approximately 8.0) Anions: HCO3-, Cl-, SO42-, HPO42- Digestive enzymes Other proteins Ref: Barrett K.E., Barman S.M., Boitano S., Brooks H.L. (2012). Chapter 25. Overview of Gastrointestinal Function & Regulation. In K.E. Barrett, S.M. Barman, S. Boitano, H.L. Brooks (Eds), Ganong's Review of Medical Physiology, 24e. | train | med_mcqa | null |
Chalazion all are true EXCEPT: | [
"Vertical incision given to squeeze out contents",
"Horizontal incision to be made to squeeze out contents",
"Incision and curettage done",
"It s a granulomatous condition"
] | B | ANSWER: (B) Horizontal incision to be made to squeeze out contentsREF: Khurana 4th ed p. 347'Vertical incision is given on the conjunctiva to prevent injury to meibomian ducts and on the skin side horizontal incision is given" | train | med_mcqa | null |
During rape on a virgin, rupture of hymen occurs at the following degree: | [
"4",
"6",
"11",
"12"
] | A | Tearing of hymen in a virgin during rape usually occurs posteriorly at the sides, in the 4 or 8 O'clock position, or in the middle line of the hymen. More than two tears are unusual. Tears usually occur in the posterior midline of the hymen because the hymen lies suspended across a potential space, whereas anteriorly the periurethral tissues buttress the hymen. Ref: The Essentials of Forensic Medicine and Toxicology by K S Narayan Reddy, 27th edition, Page 356. | train | med_mcqa | null |
Sign of thyroid ophthalmopathy ? | [
"Van Graefe's sign",
"Dalrymple's sign",
"Joffroy's sing",
"All of the above"
] | D | Ans. is 'd' i.e., All of the above Signs of thyroid ophthalmopathy are - Bilateral exophthalmos with associated exposure keratitis. Dalrymple's sign - There is peculiar stare due to retraction of the upper lid Von Graefe's sign - Upper lid lags on downward movments of the eyeball Stellwags sign - There is infrequent and incomplete blinking Mobius c sign - There is weakness of convergence Jellinek's sign - There is increased pigmentation of lids. Joffroy's sign - There is poor forehead wrinking on looking up Enroth's sign - Fullness of eyelids (Puffy edematous) Griffbrd's sign - Difficulty in eversion of upper lid. | train | med_mcqa | null |
All are seen in Behchets syndrome except | [
"Genital Ulcers",
"Uveitis",
"Oral Ulcers",
"Pyoderma gangrenosum"
] | D | In Behcets disease there is mucocutaneous manifestation including genital and oral ulcers. Extra cutaneous manifestation includes ocular manifestation, ahritis, neurological manifestation,pulmonary and cardiac involvement and intestinal ulcers. From illustrated synopsis of dermatology and sexually transmitted diseases neena khanna 5th edition page no 202,203 | train | med_mcqa | null |
Neonatal fat necrosis (subcutaneous fat necrosis of newborn) resembles: | [
"Erythema induratum",
"Post-steroidal panniculitis",
"Lupus panniculitis",
"Lipodermatosclerosis"
] | B | B i.e. Post-steroidal panniculitis Histology of poststeroid panniculitis is very similar to that of sub-cutaneous fat necrosis of newborn, in that needle shaped crystals may be found within lipocytes & histiocytes. Subcutaneous fat necrosis of newborn occurs in infants treated acutely with high doses of systemic steroids during withdrawl. It is inflammatory process involving areas of abundant sub cutaneous fat (discrete nodules) with good prognosis. The steroid reinstituted & tapered slowly. Scleroma neonatorum is non inflammatory, rapidly progressive, diffuse, non tender hardening of subcutaneous tissue seen in sick infants with recurrent or persistent hypothermia. It has poor prognosis. | train | med_mcqa | null |
Which of the following is not true about dengue shock syndrome? | [
"Susceptibility to dengue shock syndrome drops considerably after 12 years of age",
"Well-nourished child is protected from the manifestation",
"Serotype 1 infection followed by serotype 2 seems to be more dangerous than serotype 4 followed by serotype 2",
"Serotype 2 infection has more chances of developing ... | B | Ans. is 'b' i.e., Well-nourished child is protected from the manifestation * The induction of vascular permeability and shock in dengue patients i. e. development of dengue shock syndrome depends on multiple factors, including the following:i) Presence of enhancing and nonneutralizing antibodies-- Transplacental maternal antibody may be present in infants <9 months old, or antibody elicited by previous heterologous dengue infection may be present in older individuals. T cell reactivity is also intimately involved.ii) Age--Susceptibility to DHF/DSS drops considerably after 12 years of age.iii) Sex--Females are more often affected than males.iv) Race--Whites are more often affected than blacks.v) Nutritional status--Malnutrition is protective.vi) Sequence of infection--F or example, serotype 1 followed by serotype 2 seems to be more dangerous than serotype 4 followed by serotype 2.vii) Infecting serotype--Type 2 is apparently more dangerous than other serotypes.Note: There is considerable variation among strains of a given serotype, with Southeast Asian serotype 2 strains having more potential to cause DHF/DSS than others. | train | med_mcqa | null |
IgE is secreted by - | [
"Mast cell",
"Basophils",
"Eosinophils",
"Plasma cells"
] | D | IgE is synthesised by plasma cells. Monomers of IgE consist of two heavy chains (e chain) and two light chains, with the e chain containing 4 Ig-like constant domains Reff: Ananthanarayanan & Panikers textbook of microbiology 9th edition pg:136 | train | med_mcqa | null |
A male newborn infant is brought to the clinic by his mother and diagnosed with a congenital malformation. MRI studies reveal that the cerebellum and medulla oblongata are protruding inferiorly through the foramen magnum into the vertebral canal. What is this clinical condition called? | [
"Meningocele",
"Klippel-Feil syndrome",
"Arnold-Chiari malformation",
"Hydrocephalus"
] | C | Arnold-Chiari malformation results from herniation of the medulla and cerebellum into the foramen magnum. Meningocele is a small defect in the cranium in which only the meninges herniate. Klippel-Feil syndrome results from an abnormal number of cervical vertebral bodies. Hydrocephalus results from an overproduction of cerebrospinal fluid, obstruction of its flow, or interference with CSF absorption. Tethered cord syndrome is a congenital anomaly caused by a defective closure of the neural tube. This syndrome is characterized by a low conus medullaris and a thick filum terminale. | train | med_mcqa | null |
Folic acid : | [
"Is also called as pteroyl glutamic acid",
"Is useful in carriage of one carbon atom moiety",
"Tetrahydrofolate is the active form",
"All of the above"
] | D | null | train | med_mcqa | null |
Culex tritaenorrhyncus transmits | [
"Dengue fever",
"Yellow fever",
"KFD",
"Japanese encephalitis"
] | D | Ans. is 'd' i.e., Japanese encephalitis Dengue transmitted by - Aedes*Yellow fever transmitted by - Aedes*KFD transmitted by - Hard tick* | train | med_mcqa | null |
One year old male child with cat\'s eye reflex and raised IOT – | [
"Toxplasma gondii infection",
"Toxcara canis",
"Retinoblastoma",
"Retinopathy of prematurity"
] | C | Leukocoria with raised IOT is characteristic of retinoblastoma. | train | med_mcqa | null |
All are causes of night blindness except: | [
"Vitamin A deficiency",
"Oguchi disease",
"Myopia",
"Devics disease"
] | D | Devics disease | train | med_mcqa | null |
Most common site of splenic implant in abdomen - | [
"Stomach",
"Tail of pancreas",
"Peritoneal cavity",
"Suprarenal gland"
] | C | Answer- C. Peritoneal cavityHeteopic splenic implant (splenosis) may occur in the peritoneal cavity, after splenic trauma or splenectomy.Splenosis is autotransplantation of splenic tissue after disruption of splenic capsule by trauma or surgery.Most common areas of implantalion are peritoneum, omentum and mesentry. | train | med_mcqa | null |
Intolerance to loud sound, nerve affected is | [
"5th nerve",
"7th nerve",
"10th nerve",
"None"
] | B | Clinical features of the 7th nerve palsy: Eyeball turns up and out Saliva dribbles Tears flow down Pain in the ear Noise intolerance Loss of taste Ref: Dhingra 7e pg 104. | train | med_mcqa | null |
Which one of the following is not a target disease under &;Vision 2020: The Right to Sight&;- | [
"Refractive error",
"Trachoma",
"Corneal blindness",
"Diabetic retinopathy"
] | B | Vision 2020 The Right to Sight Target diseases are cataract, refractive errors, childhood blindness, corneal blindness, glaucoma, diabetic retinopathy. Ref: PARK&;S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE 23rd edition pg 440 | train | med_mcqa | null |
A child was brought to the emergency depament with recurrent epistaxis. A detailed history revealed that he had a fall two days before, but he neglected because it didn't hu him. Examination shows septal hematoma. Management of septal hematoma is: | [
"Incision and drainage",
"Wait and watch",
"Only pressure bandage",
"All of the above"
] | A | Septal hematoma is a complication of direct nasal trauma, often associated with fracture of the nasal septum with or without concomitant nasal bone fracture. Bleeding from submucosal blood vessels leads to an accumulation of blood between the mucoperichondrium and the septal cailage, which may lead to ischemic avascular necrosis of the underlying cailage, destruction of the cailage and saddle deformity of the distal nose. Prompt incision of the hematoma and drainage through the mucosal surface is necessary. | train | med_mcqa | null |
True about Ca vulva associated/predisposed by: | [
"Paget's disease",
"Vulval intraepithelial neoplasia",
"Bowen's disease",
"All of the above"
] | D | null | train | med_mcqa | null |
Which of the following is an irreversible inhibitor of COX enzyme | [
"Aspirin",
"Phenylbutazone",
"Indomethacin",
"Piroxicam"
] | A | null | train | med_mcqa | null |
Which is false regarding Ureteric stones -a) Urine is always infectedb) Should be removed immediatelyc) Source is always the kidneysd) Pain is referred to tip of penis in intramural stones | [
"ac",
"a",
"ab",
"bc"
] | C | null | train | med_mcqa | null |
Desmoplastic response is commonly seen in? | [
"Ovarian cancer",
"Hodgkins Lymphoma",
"Renal cell carcinoma",
"Pancreatic carcinoma"
] | D | Pancreatic adenocarcinoma and cholangio carcinoma produce demsoplastic response | train | med_mcqa | null |
A child is brought by mother with HO massive hematemesis with HO drug intake previously with NSAIDS and on Rx. Associated with moderate splenomegaly diagnosis is – | [
"Oesophageal varices",
"Duodenal ulcer",
"Drug induced gastritis",
"Peptic ulcer"
] | A | Clues in this question are -
1) H/0 massive hematemasis
2) Splenomegaly
Amongst the given options, splenomegaly will be seen only in esophageal varices due to portal hypertension. | train | med_mcqa | null |
Proliferation independent agents include all the following except | [
"Vincristine",
"Carmustine",
"Melphalan",
"Cyclophosphamide"
] | A | Ref: KDT 6/e p821,882 Proliferation independent means cell cycle nonspecific agents | train | med_mcqa | null |
Following are the post moem findings in carbon monoxide poisoning except - | [
"Froth at mouth and nose",
"Blue skin discoloration",
"Basal ganglia cavitation",
"Congested lungs"
] | B | Autopsy findings cherry red discoloration of skin,mucous membrane,nail bed blood is fluid fine froth in mouth and nose congestion of lungs,pulmonary edema hemorrhages in meninges and cox Features of asphyxia REF;THE SYNOPSIS OF FORENSIC MEDICINE:KS NARAYANA REDDY;28th EDITION;PAGE NO 360 | train | med_mcqa | null |
Nasolacrimal duct opens into:- | [
"Inferior meatus",
"Superior meatus",
"Middle meatus",
"Spheno-ethmoidal recess"
] | A | Nasolacrimal duct opens into the inferior meatus. Structures opening into nasal cavity | train | med_mcqa | null |
Which of the following drugs causes extra pyramidal symptoms: | [
"Antibiotics",
"Salicylates",
"Barbiturates",
"Phenothiazines"
] | D | null | train | med_mcqa | null |
The most effective antiemetic for controlling cisplatin induced vomiting is: | [
"Prochlorperazine",
"Ondansetron",
"Metoclopramide",
"Aprepitant"
] | B | (Ref: KDT 6/e p646) 5HT3 antagonists like ondansetron, granisetron and topisetron are the agents of choice for chemotherapy induced vomiting. | train | med_mcqa | null |
Which of the following is a multipennate muscle:March 2012 | [
"Rectus femoris",
"Deltoid",
"Flexor pollicis longus",
"Temporalis"
] | B | Ans: B i.e. DeltoidMusclesRectus femoris is a bipennate muscleMultipennate muscle examples include subcapsularis, deltoid (acromial fibres)Flexor pollicis longus is an unipennate muscleTemporalis is a triangular muscle | train | med_mcqa | null |
True about hemiazygos vein are all EXCEPT: | [
"Formed by right lumbar azygos and right ascending lumbar veins",
"Pierces left crus of diaphragm",
"Drains esophageal vein",
"At T8 level drains into azygos vein"
] | A | Hemiazygos vein is formed by the confluence of the left ascending lumbar and left subcostal vein. It pierces left crus of diaphragm. Some pa of abdominal pa of abdominal esophagus drain into hemiazygous vein. At T8 level drain into azygous vein. | train | med_mcqa | null |
Prions are killed by | [
"Autoclave and NaOH",
"Ethylene dioxide",
"Gamma radiation",
"Autoclave"
] | A | prions are killed by autoclave. | train | med_mcqa | null |
Which of the following is least likely to cause interstitial nephritis on chronic use- | [
"Methicillin",
"Cephalothin",
"Heparin",
"Ampicillin"
] | C | Ans. is 'c' i.e., Heparin Drug causing interstitial nephritis o Cephalosporine o Allopurinol o Phenindione o Thiazides o Rifampcin o Penicillins (esp. methicillin) o Ciprofloxacin o Sulphonamides o NSAIDS o Furosemide | train | med_mcqa | null |
True about sipple syndrome is? | [
"MCT, Pheochromocytoma, Mucocutaneous neuromas",
"MCT, Pheochromocytoma, Parathyroid adenomas",
"MCT, Pheochromocytoma, Pancreatic tumours",
"MCT, Pheochromocytoma, Diabetes"
] | B | MEN 2 (also known as MEN 2a or Sipple's syndrome) Ref - davidsons 23e p689 | train | med_mcqa | null |
Deep nucleus of cerebellum | [
"Lentiform",
"Caudate",
"Putamen",
"Fastigial"
] | D | Nucleus of cerebellum (Lateral to medial ):Dentate, emboliform, globose &fastigial Cerebellar nuclei function Dentate working with lateral pa Co-ordinate movement of joint Fastigial working with central vermis Saccadic eye movement. Interposed nuclei (emboliform & globose) working with para vermal area Feedback mechanism from joints to have proper co- ordination of joint. Caudate nucleus and Lentiform nucleus (inner Globus pallidus + outer putamen) are Basal ganglia nuclei. | train | med_mcqa | null |
Most impoant inflammatory mediator - | [
"TNF",
"IL2",
"Interferon",
"PAF"
] | A | Ans. is 'a' i.e., TNF Note : Amongst the cytokins, TNF, IL-1 & IL-6 are most impoent. | train | med_mcqa | null |
All are true about apoptosis except: | [
"Inflammation is seen",
"Nuclear condensation",
"Chromatin cleavage",
"Cell shrinkage"
] | A | Features of Necrosis and Apoptosis Feature Necrosis Apoptosis Nucleus Pyknosis - Karyorrhexis - Karyolysis Fragmentation into nucleosome size fragments Cell size Enlarged (swelling) Reduced (Shrinkage) Cellular contents Enzymatic digestion; may leak out of cell Intact; may be released in apoptotic bodies Plasma membrane Disruoted Intact; altered structure, especially orientation of lipids Adjacent inflammation Frequent No Physiologic or pathologic role Invariably pathologic (culmination of irreversible cell injury) Often physiologic, means of eliminating unwan ted cells; may be pathologic after some forms of cell injury, especially DNA damage | train | med_mcqa | null |
TRUE statement regarding use of adrenaline in anaphylactic shock is: | [
"The usual dose is 0.5-1 mg by IM route",
"Cerebral hemorrhage never occurs as an adverse effect to epinephrine when used in treatment of anaphylactic shock",
"It is repeated after every 2-4 hours",
"Same solution can be given for SC as well as IV route"
] | A | Ans. (A) The usual dose is 0.5-1 mg by IM route(Ref: KDT 8th/e p150)Adrenaline 0.5 ml of 1 :1000 solution (i.e., 0.5 mg) by i.m. route is drug of choice for anaphylactic shock. It can also be used by s.c. routeIf not responding, it can be repeated after 5 minutes (not 2-4 hours). In desperate circumstances i.v. route can be used but it must be diluted 10 times (i.e., 1 : 10000 concentration is used), therefore same solution cannot be utilized, However, in rare circumstances, i.v. adrenaline can result in cerebral hemorrhage due to uncontrolled rise in blood pressure. | train | med_mcqa | null |
A 70 year old man comes to clinical attention with progressive memory loss, urinary incontinence, and gait instability. MRI of the brain shows dilatation of the ventricular cavities, while the cerebral coex appears normal. No infarcts are seen. Repeated lumbar punctures reveal occasional increases in cerebrospinal fluid (CSF) pressure. A biopsy of the frontal coex demonstrates the absence of neurofibrillary tangles and senile plaques. Which of the following is the most appropriate treatment? | [
"Acetylcholinesterase inhibitors such as tacrine",
"Aspirin",
"L-DOPA",
"Ventricular shunt"
] | D | This is an "interdisciplinary" question, which begins with a clinical scenario and ends by testing your knowledge of pathophysiology and pharmacology. The clinical presentation has the classic triad of memory loss, urinary incontinence, and gait abnormalities characteristic of normal pressure hydrocephalus (recently renamed intermittently raised pressure hydrocephalus). This condition results from intermittent increases in CSF pressure, leading to progressive damage to cerebral white matter and dilatation of the ventricles. No significant coical atrophy is present. The lack of Alzheimer-related changes in the biopsy and the measurements of CSF pressure suppo the diagnosis. Relief of CSF pressure can be obtained by placing a ventricular shunt, which usually improves clinical symptomatology. Tacrine and other inhibitors of acetylcholinesterase are used in the symptomatic therapy of Alzheimer disease. The pathology of this disease includes degeneration of cerebral cholinergic systems, such as the basal nucleus of Meyne, which project to the neocoex and are involved in memory and learning. Acetylcholinesterase degrades acetylcholine after release from presynaptic boutons. Acetylcholinesterase inhibitors therefore enhance the concentration of acetylcholine and amplify cholinergic neurotransmission. Aspirin is used to prevent aggregation and adhesion of platelets in patients with risk factors for cerebrovascular disease. Prophylactic aspirin treatment lowers the incidence of transient ischemic attacks and brain infarcts. L-DOPA is a precursor of dopamine, the neurotransmitter of the nigrostriatal neurons that degenerate in Parkinson disease. L-DOPA, especially in combination with a peripheral decarboxylase inhibitor, is therefore used in the treatment of this disorder. Ref: Ropper A.E., Ropper A.H. (2012). Chapter 209. Intracranial Hemorrhage and Related Conditions. In G.V. Lawry, J. Matloff, D.D. Dressler, D.J. Brotman, J.S. Ginsberg (Eds), Principles and Practice of Hospital Medicine. | train | med_mcqa | null |
Rate limiting enzyme in bile acid synthesis - | [
"Desmolase",
"21a-hydroxylase",
"7a-hydroxylase",
"12a-hydroxylase"
] | C | Ans. is 'c' i.e., 7a-hydroxylase o About half of the cholesterol in the body is ultimately metabolized to bile acids.o The primary bile acids are synthesized from cholesterol in liver. These are cholic acid and chenodeoxycholic acid.o Rate limiting enzyme in primary bile acids synthesis is 7a- hydroxylase (cholesterol 7a - hydroxylase).o This enzyme is inhibited by bile acids and induced by cholesterol.o Thyroid hormones induce transcription of 7a-hvdroxylase, thus in patients with hypothyroidism plasma cholesterol tends to rise (because of inhibition of 7a-hydroxyiase which in turn inhibits conversion of cholesterol to bile acids). | train | med_mcqa | null |
Which of the following step of osseous surgery removes the widow pick: | [
"Vertical grooving",
"Radicular Blanding",
"Flattening of interproximal bone.",
"Gradualizing marginal bone"
] | D | null | train | med_mcqa | null |
Group of viruses that inhabit the alimentary tract of children below 2 years age: | [
"Coxsackie virus",
"Paramyxovirus",
"Varicella zoster virus",
"Herpes simplex virus"
] | A | null | train | med_mcqa | null |
Schistocytes are - | [
"Malarial parasite",
"WBC",
"Broken RBC",
"Schizont"
] | C | null | train | med_mcqa | null |
Arterial O2 content is reduced in one of the following | [
"Stagnant hypoxia",
"Anemic hypoxia",
"Histotoxic hypoxia",
"Ischemic hypoxia"
] | B | Arterial PO2/ Dissolved oxygen is normal in anemic hypoxia, but the arterial oxygen content is low. Whereas, in Hypoxic hypoxia, both are low. In case of stagnant hypoxia/ischemic hypoxia and histotoxic hypoxia, both are normal. | train | med_mcqa | null |
AB group has following agglutinins: | [
"Anti - A & anti - B",
"Neither anti-A nor anti-B",
"Anti-A",
"Anti-B"
] | B | Blood Types with Their Genotypes and Their Constituent Agglutinogens and Agglutinins: | train | med_mcqa | null |
All muscles of pharynx are supplied by pharyngeal plexus except - | [
"Palatopharyngngeus",
"Stylopharyngeus",
"Salpingopharyngeus",
"Superior constrictor"
] | B | All muscles of pharynx are supplied by cranial accessory through branches of vagus pharyngeal plexus except stylopharyngeus which is supplied by glossopharyngeal. The inferior constrictor receives an additional supply from the external and recurrent laryngeal nerves. | train | med_mcqa | null |
VITAMIN WHICH IS NOT SYNTHESIZED BY THE BACTERIAL FLORA IN THE INESTINE IS? | [
"vitamin k",
"Biotin",
"Niacin",
"Pantothenic acid"
] | C | Endogenously synthesized Vitamins are 1. Synthesized by the body- Niacin: synthesized from an amino acid Tryptophan Vitamin D: synthesized from 7 Dehydrocholesterol by exposure to UVB rays(290-315nm)in the skin. 2. Synthesized in the body(by Bacterial flora in the intestine) Vitamin K Biotin Pantothenic Acid Reference: Harpers illustrated biochemistry 30th edition | train | med_mcqa | null |
Which is the best way to differentiate between stable angina and NSTEMI? | [
"ECG",
"Cardiac-biomarkers",
"Trans-thoracic Echocardiography",
"Multi uptake gated Acquisition scan"
] | B | Cardiac markers are used in the diagnosis and risk stratification of patients with chest pain and suspected acute coronary syndrome (ACS). The cardiac troponins, in paicular, have become the cardiac markers of choice in acute coronary syndrome which includes NSTEMI. However, in chronic Stable angina, the symptoms arise on exeion/emotion or post-prandially and have characteristic ST-segment depression on exercise testing. Cardiac biomarkers are normal as no cell death occurs in this case. | train | med_mcqa | null |
Thyroid hormones in blood is transpoed by: | [
"Albumin",
"Globulin",
"Prealbumin",
"All"
] | D | A i.e. Albumin; B i.e. Globuin; C i.e. Prealbumin Thyroid hormones in blood is transpoed combined with plasma proteins. Normally 99.9% of T4 (&T3) in plasma is protein bound. Plasma protein which bind T4 & T3 are: i) AlbuminQ ii) Thyroxine binding prealbuminQ (TBPA) (new called transthyretin) iii) Thyroxine binding globulinQ (TBG): affinity to bind T4 is maximum. Protein Plasma Concentration (mg/ dl) Amount of Circulating Hormone bound ( %) T4 T3 TBGQ 2 67Q 46 TransthyretinQ (TBPA) 15 20 1 AlbuminQ 3500 13 53 - TransferrinQ : transpo iron to plasmaQ. - CeruloplasminQ transpo Cu to plasma. | train | med_mcqa | null |
Pleomorphic adenomas (mixed tumors) of the salivary glands are characterized by which of the following? | [
"They occur most commonly on the lips, tongue, and palate",
"They grow rapidly",
"They rarely recur if simply enucleated",
"They present as rock-hard masses"
] | A | There are approximately 400-700 minor salivary glands in the oral cavity. Pleomorphic adenomas (mixed tumors) can occur in any of them. These round tumors have a rubbery consistency and are slow-growing; all are potentially malignant. Unless adequately excised, they tend to recur locally in a high percentage of cases. The sites most commonly affected by pleomorphic adenomas of the salivary glands are the lips, tongue, and palate. | train | med_mcqa | null |
What is differentiating feature between irritable bowel syndrome and inflammatory bowel disease is? | [
"pain in abdomen",
"Stool calprotectin",
"Mucus in stools",
"Diarrhoea"
] | B | FECAL CALPROTECTIN, is a biomarker of bowel inflammation and help in differentiating from irritable bowel syndrome. Faecal lactoferrinis a highly sensitive and specific marker for detecting intestinal inflammation. Faecal calprotectinlevels correlate well with histologic inflammation, predict relapses, and detect pouchitis. | train | med_mcqa | null |
Moron is the one with an IQ of: | [
"0-24",
"25-49",
"50-69",
"70-79"
] | C | Levels of intelligence based on IQ levels: Levels of intelligence IQ range Idiot 0-24 Imbecile 25-49 Moron 50-69 Borderline 70-79 Low normal 80-89 Normal 90-109 Superior 110-119 Very superior 120-139 Near Genius 140 and over Calories of mental retardation based on IQ levels: Mental status IQ range Normal IQ 70 and over Mild mental retardation 50-69 Moderate mental retardation 35-49 Severe mental retardation 21-34 Profound mental retardation 20 or below Ref: Park 25th edition Pgno: 716 | train | med_mcqa | null |
STEPS is for - | [
"Communicable disease",
"Non-communicabie disease",
"Both",
"None"
] | B | Ans. is 'b' i.e., Non-communicable disease STEPS risk factorso The WHO STEPwise approach to surveillance of non-communicable diseases risk factors (STEPS) was developed by WHO as a part of a global surveillance strategy in response to the growing need for country-level trends in non-communicable diseases.o By using same standardized questions and protocols, all countries can use STEPS information not only for monitoring within countries trend, but also for making between country comparisons,o The approach encourages the collection of small amounts of useful data information on a regular and continuing basis.o It focuses on a minimum numbers of risk factors that predict the major non-communicable diseases,o This information can, in turn, be used to plan for disease prevention through population level risk factor reduction,o There are currently two primary STEPS surveillance systems, the STEPwise approach to chronic disease risk factor surveillance and the STEPwise approach to Stroke surveillance.STEPwise approach to chronic disease risk factor surv eillance (STEPS)The STEPS approach focuses on obtaining core data on the established risk factors that determine the major disease burden.The STEPS Instrument covers three different levels of "steps'* of risk factor assessment. These steps are:i) Questionnaireii) Physical measurementsiii) Biochemical measurements | train | med_mcqa | null |
A 25-year-old man presents to the outpatient clinic complaining of feeling sleepy all the time, even during the daytime. The symptoms have persisted for years and are now brought to medical attention after falling asleep at work on multiple occasions. He is concerned that he might lose his job. He has no past medical history and is not taking any sedative medications. On physical examination, he is slender and the heart and lung exams are normal. Neurologic assessment reveals normal orientation, memory, concentration, and no focal deficits. Which of the following symptoms might he also complain about? | [
"excessive snoring (wife's report)",
"automatic behavior (wife's report)",
"restless sleep (wife's report)",
"paresthesia"
] | B | The early age of onset and otherwise good health suggest a diagnosis of narcolepsy, which is usually accompanied by other symptomatology. Hypnagogic hallucinations are almost always visual. They occur most frequently at the onset of sleep, either during the day or at night. They are generally very vivid. Cataplexy is a brief loss of muscle power without loss of consciousness. The patient is fully aware of what is going on. The paralysis may be complete or partial. Automatic behavior with amnesia is a common manifestation of the narcolepsy cataplexy syndromes, occurring in 50% of cases. Automatic behavior can be confused with complex partial seizures. Paresthesia are not part of narcolepsy syndrome. Snoring, restless sleep, and morning headache suggest sleep apnea. | train | med_mcqa | null |
A newly married couple, the woman is having irregular menstruation. What is the contraceptive of choice? | [
"Barrier method",
"OCP",
"Calendar method",
"Progesterone only pills"
] | B | - Contraceptive of choice in above case is OCP Non contraceptive benefits of use of oral contraceptives Help in treating Menstrual disturbances: irregularity, dysmenorrhea, menorrhagia, ovulation pain Cancers: protective for endometrial and ovarian cancers and choriocarcinoma Reduction in Benign tumors: benign breast disease, ovarian cysts Treat Endometriosis Acne improvement Inhibition of hirsutism progression Decrease incidence of Rheumatoid ahritis Reduce Anemia and malnutrition: by preventing pregnancy and decreasing menorrhagia Increase bone density | train | med_mcqa | null |
'Cafeteria approach' is related with: March 2012 | [
"Diet programme",
"Child and maternal health",
"National vector borne disease control programme",
"Contraception"
] | D | Ans: D i.e. Contraception A "Cafeteria Approach" meaning choose whatever method of contraception you like was introduced by the Health and Family welfare minister Prof. Chandrasekhar. | train | med_mcqa | null |
A 34-year-old woman is admitted to the hospital after a car collision. Physical examination reveals a mallet finger. Which of the following conditions is expected to be present during radiographic examination? | [
"A lesion of the ulnar nerve at the distal flexor crease of the wrist",
"A separation of the extension expansion over the middle interphalangeal joint",
"Compression of the deep ulnar nerve by dislocation of the lunate bone",
"Avulsion fracture of the dorsum of the distal phalanx"
] | D | Mallet finger, also known as baseball finger, is a deformity in which the finger will be permanently flexed at the distal interphalangeal joint, due to avulsion of the insertion of the extensor tendon at the distal phalanx. | train | med_mcqa | null |
The common function of Golgi apparatus and endoplasmic reticulum - | [
"Protein synthesis",
"Protein degradation",
"Post-transcriptional modification",
"Glycosylation"
] | D | Ans. is 'd > c' i.e., Glycosylation > Post-translational modification Note: Glycosylation is a critical function of the biosynthetic-secretory pathway in the endoplasmic reticulum (ER) and Golgi apparatus o Golgi apparatus and ER are involved in glycosylation process o Glycosylation is a type of post-translational modification. | train | med_mcqa | null |
Anti LKM-2 autoantibody is seen in drug induced liver injury. It is directed against: | [
"Cytochrome P 450",
"Cytoplasm",
"BIliary tract",
"Poal tract"
] | A | Autoantibody seen in drug induced liver inuury is Anti LKM2 antibody. It is directed against cytochrome P 450. Ref: Harrison, Edition-18, Page-2560 | train | med_mcqa | null |
What change will be seen in vertebral column in ochronosis- | [
"Calcification of disc",
"Bamboo spine",
"Increased disc space",
"None"
] | A | Ans. is 'a' i.e., Calcification of discAlkaptonuria# It is due to deficiency of homogentisate oxidase. As a result homogentisic acid (homogentisate) is excreted execessively in urine, There are three important characteristic features in alkaptonuria-Urine becomes dark after being exposed to air. It is due spontaneous oxidation of homogentisate into benzoquinone acetate, which polvmerse to form black-brown pigment alkapton which imparts a characteristic black-brown colour to urine.Alkapton deposition occurs in sclera, ear, nose, cheeks and intervertebral disc space. A condition called ochronosis. There may be calcification of intervertebral discs.Onchronosis arthritis affecting shoulder, hips, knee.# Benedict's test is strongly positive in urine and so is the ferric chloride (FeClyl test. Benedict's reagent gives a greenish brown precipitate with brownish black supematent. Feh ling's reagent (FeClj gives blue green colour. | train | med_mcqa | null |
All are features of drowning except | [
"Washer woman's hands",
"Cutis anserina",
"Pugilistic attitude",
"Cadaveric spasm"
] | C | Appearance in fresh water drowning: Body and clothes found to be wet Washer woman's hands Postmoem hypostasis Cutis answering Grasping of mud, grass, etc (cadaveric spasm) Foam in nostrils and mouth Paltauf's hemorrhage Ref: TEXTBOOK OF FORENSIC MEDICINE AND TOXICOLOGY KRISHNAN VIJ FIFTH EDITION PAGE 140 | train | med_mcqa | null |
Relaxation of mesangial cells of the kidney is brought about by | [
"cAMP",
"Endothelin",
"PGF2",
"Vasopressin"
] | A | Substances causing relaxation of mesangial cells
- ANP
- Dopamine
- PGE2
- cAMP
Substances causing contraction of mesangial cells
- Endothelin
- Vasopressin
- PGF2
- Angiotensin II
- Norepinephrine
- PAF
- PDGF
- Thromboxane A2
- Leukotrienes C4, D4
- Histamine | train | med_mcqa | null |
True about fibronectin nephropathy are all exceptaEUR' | [
"Autosomal recessive inheritance",
"Gomerular enlargement and PAS+ trichrome mesangial deposit",
"Glomerulus do not consistently stain for Ig and complement",
"Ultrastructural feature is presence of large electron mesangial or subendothelial deposit"
] | A | Autosomal recessive inheritance Fibronectin nephropathy It is one of the fibrillary glomerulonephritis. Fibronectin nephropathy is an atypical form of lobular glomerulonephritis with massive mesangial expansion by intensely PAS positive deposits that were silver and congo red negative. These deposits are made up of "Fibronectin". Fibronectin is a multifocal extracellular matrix glycoprotein that is active in cellular adhesion and migration. Fibronectin is produced locally in the glomerulus by mesangial cells. Some of it is also produced in the liver which constitues the plasma fibronectin. Increased production of fibronectin protein may lead to glotnerular disease. Fibronectin nephropathy is an atypical fonn of lobular glomerulonephritis with massive subendothelialQ and mesangialf2 focal .fibrillary electron dense deposits. Clinical features :- It is an autosomal dominante glomerulonephritis Commonly presents with nephritic range proteinuria Can sometimes present with microscopic hematuria and mild hypeension. Pathology of Fibronectin nephropathy * Glomerular enlargement and lobulation due Light microscopic - PAS and Trichome positive features - Congo red negative * Massive mesangial proliferationdeg * The capillaries remain patent although reduced in size at periphery lmmunoflorescence * Glomendi do not stain with immunoglobulin or complement2 * Immutwhistological stains fore fibronectin strongly positive Electron microscopy / * Massive mesangialdeg and subendothelice electron dense Ultrastructural findings deposits that reflects the location of PAS positive fibronectin deposits Fibronectin nephropathy is considered to be one of the fibrillaty nephropathy | train | med_mcqa | null |
Contraceptive method of choice in lactating mothers is: | [
"Barrier method",
"Progesterone only pill",
"Oral contraceptive pills",
"Lactational amenorrhea"
] | B | Ans. is b, i.e. Progesterone only pillRef: Williams Obs, 23/e, p 694, Dutta Obs, 7/e, p 558"According to the American college of obstetries and gynecologist (2000), progestin only contraceptives are the preferred choice in most of the cases. In addition IUD's may be recommended for the lactating sexually active woman after uterine involution." --Williams, Obs 24/e, p 715Lactational amenorrhea"For mothers who are nursing exclusively, ovulation occurring during the first 10 weeks after delivery is unlikely. But it is not a reliable method if mother is nursing only in day time. Waiting for first menses involves a risk of pregnancy because ovulation usually antedates menstruation." -- Wiliams 24/e, p 715Safe period method - In this method the fertile period is calculated and the female should refrain from having sex during that periodThe basic prerequisite of this method is that cycles should be regular which is usually not the case with lactating mothers - safe period method is not applicable in them.IUCD's - According to Williams 23/e p 644 IUCD's can be used as an alternative to progesterone only pills by lactating mothers but only following complete uterine involution in woman who are sexually active.Remember in Nutshell1st contraceptive of choice in lactating mother - Progesterone only pill or progesterone implant or DMPA injection. IUCD can also be used. | train | med_mcqa | null |
Which is true regarding IL-1? | [
"Mainly derived from neutrophils",
"Produces necrosis of tumor cells",
"Increases expression of MHC coded proteins",
"Upregulates adhesion molecules"
] | D | Produced by tissue macrophages, monocytes, fibroblasts and dendritic cells and also expressed by B cells, lymphocytes, NK cells and epithelial cells Increases the expression of adhesion factors on endothelial cells to enable transmigration Causes fever, hyperalgesia, vasodilation and hypotension | train | med_mcqa | null |
Which of the following antiglaucoma drugs can cause heterochromia iridis | [
"Timolol",
"Lantanoprost",
"Apraclonidine",
"Acetazolamide"
] | B | Refer katzung 12e p 328 PGF2 alpha agonists like lantanoprost can cause iris pigmentation (heterochromia iridis) and growth of eye lashes(hyperichosis) as adverse effect | train | med_mcqa | null |
Uses of PUVA – a) Pigmented purpuric lesionb) Herpes zosterc) Mycosis fungoidesd) Lupus panniculitise) Lichenoid dermatitis of Gougerot & Blum | [
"acd",
"bde",
"cde",
"ace"
] | D | Indications for PUVA and UVB
Established major indications :- Psoriasis, atopic dermatitis, vitiligo, mycosis fungoides, Polymorphic light eruption, pompholyx.
Less frequently treated (less evidence of effectiveness) :- Pityriasis rosea, morphea, chronic urticaria, Pityriasis lichenoid chronica, Alopecia totalis & Universalis, Lichen plaints, Pityriasis rubra pilaris, Granuloma annulare, Generalized pruritis, Nacrobiosis lipoidics.
"Pignzented pruritic lichenoid dermatosis of Gougerot & Blum can be treated by PUVA". | train | med_mcqa | null |
Not seen in pellagra - | [
"Diarrhea",
"Dyspepsia",
"Dementia",
"Dermatitis"
] | B | - niacin deficiency results in pellagra. The disease is characterized by diarrhea, dermatitis and dementia. - niacin deficiency is common in maize eating population due to aminoacid imbalance cause by an excess of leucine. - excess of leucine appears to interfere in the conversion of tryptophan to niacin. Reference: Park's textbook of preventive and social medicine, 23rd edition, pg no:619 <\p> | train | med_mcqa | null |
In COPD w hich is true - | [
"FEV1/FVC<0.7",
"FEVl/FVC|",
"RV|",
"TLV |"
] | A | Ans. is 'a' i.e., FEV1 / FVC < 0.7 The lung function tests in obstructive lung disease can be summarized as -o Forced expiratory vital capacity (FEVc)- Normal to slightly decreasedo Forced expiratory volume in 1 secQ (FEV )-Decrease out of proportion to FVCo FEV1/FEV1Q-Decrease can be as low as 20% - 30%o Peak expiratory flow rate-Decreasedo Total lung capacity-Increaseo Residual volume-Increaseso Functional residual capacity-Higher | train | med_mcqa | null |
Not seen in pre capillary pulm. hypertension | [
"↑ pressure in pulm circulation",
"↑ capillary pressure",
"Rt-vent. hypertrophy",
"↑ Pulm. wedge pressure"
] | D | null | train | med_mcqa | null |
The Cubital Fossa is bounded laterally by the? | [
"Biceps",
"Triceps",
"Brachioradialis",
"Coracobrachialis"
] | C | Brachioradialis | train | med_mcqa | null |
All of the following conditions are indications of Radioactive iodine use, EXCEPT: | [
"Age > 40 years",
"Elderly",
"Hypehyroid children",
"Presence of comorbidities"
] | C | Radioiodine (I 131) may be given safely after patient has been treated with antithyroid drugs and becomes euthyroid. Radioiodine is indicated for patients who are over 40 or are poor risk for surgery and patients with recurrent hypothyroidism. It is less expensive than the operative treatment and is effective. To date, radioiodine treatment at doses necessary to treat hypehyroidism has not been associated with an increase in leukemia or the induction of congenital anomalies. However, an increased incidence of benign thyroid tumors and rare cases of malignant thyroid tumors has been noted to follow treatment of hypehyroidism with radioiodine. In young patients, radiation hazard is ceainly increased, and the chance of developing hypothyroidism is viually 100%. The incidence of hypothyroidism increases about 3% per year after treatment with radioiodine. Steroids should be given to patients with grave's ophthalmopathy, whenever radioiodine is used. Hypehyroid children and pregnant women should not be treated with radioiodine. Ref: L & B 25/e, Page 787-88 ; CSDT 11/e, Page 301-02 | train | med_mcqa | null |
REM sleep is associated with all except ? | [
"Dreams",
"Delta waves",
"Loss of muscle tone",
"Increased BP"
] | B | Ans. is 'b' i.e., Delta wave Stages of Sleep Sleep is basically divided into two phases : ? Non-REM (NREM) or slow-wave sleep : - It is called Non-REM sleep because no rapid eye movement (REM) is there on eletrooculogram, rather there is slow or quiscent eye movement. It is also referred as S-sleep (synchronized sleep) or quiet sleep or ohodox sleep because there diminished physiological functions and a low level of overall activity. It is fuher divided into : ? Stage 1 : - It is a transition from wakefulness to sleep and is characterized by disappearance of alpha activity and appearance of theta activity. There is slow eye movements. Stage 2 : - It is characterized by typical EEG activity i.e., Sleep spindles and IC-complex'. No eye movement occurs. Stage 3 & 4 : - Stage 3 & 4 are stages of deep sleep. These are also called slow wave sleep as these stages are characterized by slow delta waves. Delta wave appearance stas in stage 3 and dominated in stage 4. REM sleep : - The REM sleep is so named as there is rapid roving movements of eye, i.e., rapid eye movement (REM)on electro-oculogram. It is also called paradoxical sleep because there is a paradoxical elevation of brain activity & metabolism and physiological activity. The high-amplitude slow waves seen in stage 3,4 of REM sleep is replaced by rapid low voltage activity (beta wave). Features of REM sleep are : - EEG Beta wave, Reappearance of alpha wave, Saw-tooth wave (low voltage fast activity), Pontogenital-occipital spikes. Dreaming Other features : - Generalized muscular atony, Penile erection, autonomic hyperactivity (Increased pulse rate & BP) and intermittent movement of small muscle groups. | train | med_mcqa | null |
In a person with ventricular tachycardia, extra systoles appear in | [
"P wave",
"QRS complex",
"T wave",
"R wave"
] | A | Extrasystoles are essentially extra beats, or contractions, which occur when there is electrical discharge from somewhere in the hea other than the SA node. Atrial extrasystoles may also be of little consequence but are exacerbated by alcohol and caffeine The P wave indicates atrial depolarizationp. Multiple abnormalities of the P wave are discussed in detail in ECG Reviews and Criteria. Atrial enlargements can widen the P wave or increase the P wave amplitude. Ectopic atrial rhythms( ventricular tachycardia) dampens of the normal morphology of P waves Ref Harrison 20th edition pg 1456 | train | med_mcqa | null |
Secretin is produced by which of the following duodenal cells? | [
"I cells",
"T cells",
"M cells",
"S cells"
] | D | Ans. D. S cells. (Ref. Guyton's Medical Physiology 11th/pg. 801; Ganong 23rd/ Chapter 36).GI secretory products1. Nitrous oxide: Causes smooth muscle relaxation (e.g., elower oesophageal sphincter (LES) relaxtion).2. Gastrin: Secreted in response to gastric distention, vagal stimulation, and amino acid entering the stomach; causes gastric H+ secretion.3. Secretin: Secreted in response to H+ and fatty acids entering the duodenum; causes pancreatid secretion of of HCO3 and inhibits gastrin H+ secretion. It is known as Nature's antacid as after being secreted by 'S' cells of duodenum it causes, secretion of bicarbonate from pancreas, which neutralises gastric acid.4. Cholecystokinin (CCK): Secreted in response to amino acids and fatty acids entering the duodenum; causes contraction of gallbladder and pancreatic secretion of enzymes and HC03 (AIIMS-99).5. Parasympathetic (ACh): Increases production of saliva; increased gastric H+ secretion; increases pancreatic enzyme and HCO3+ secretion; stimulates enteric nervous system to create intestinal peristalisis; relaxes sphincters.6. Vasoactive intestinal peptide (VIP): Secreted by smooth muscle and nerves of intestines. Relaxes intestinal smooth muscle causes pancreatic HC03 secretion and inhibits gastric H+ secretion.7. Sympathetic (NE): Increases production of saliva; deceases spalnchnic blood flow in fight-or-flight response: decreases motility; constricts sphincters.HormoneSourceActionRegulationNotesGastrinG cells, antrum of stomach| gastric H+ secretion, | growth of gastric mucosa, | gastric motility| by stomach distention, amino acids peptides, vagal stimulation; | by H+ secretion and stomach acid pH <1.5| | in Zollinger-Ellison syndrome; phenylalanine and tryptophan are potent stimulatorsCholecy- stokinin| cells, duodenum, jejunum| pancreatic secretion, | gallbladder contraction; |gasctic emptying, | growth of exocrine pancreas and gallbladder| by secretin and stomach pH < 1.5; | by fatty acids, amino acidsIncholelithiasis, pain woesens after fatty food ingestion due to| CCKSecretinS cells, duodenum| pancreatic HCO3' secretion, | gastric acid secretion| by acid, fatty acids in lumen of duodenum| HCO3 neutralizes gastric acid in duodenum, allowing pancrestic enzymes to functionSomatostainD cells, pancreatic islets; GI mucosa| gastric acid and pepsinogen secretion | pancreatic and small intestine fluid secretion | insulin and glucagon release| by acid; | by vagal stimulationInhibitory hormone; antigrowth hormone effects (digestion and absorption of substances needed for growth)Gastric inhibitory peptide (GIP)K cells, duodenum and jejunumExocrine: | gastric H+ secretionEndocrine: | insulin release| by fatty acids, amino acids, oral glucose (only GI hormone stimulated by all 3 nutrient classes)| GIP is why an oral glucose load is used more rapidly than the equivalent given by IVSecretin# Secretin is a polypeptide, containing 27 amino acids (molecular weight about 3400), present in an inactive form, prosecretin, in so-called S cells in the mucosa of the duodenum and jejunum. When acid chyme with pH less than 4.5 to 5.0 enters the duodenum from the stomach, it causes duodenal mucosal release and activation of secretin, which is then absorbed into the blood. The one truly potent constituent of chyme that causes this secretin release is the hydrochloric acid from the stomach.# Secretin in turn causes the pancreas to secrete large quantities of fluid containing a high concentration of bicarbonate ion (up to 145 mEq/L) but a low concentration of chloride ion. The secretin mechanism is especially important for two reasons: First, secretin begins to be released from the mucosa of the small intestine when the pH of the duodenal contents falls below 4.5 to 5.0, and its release increases greatly as the pH falls to 3.0. This immediately causes copious secretion of pancreatic juice containing abundant amounts of sodium bicarbonate.Cholecystokinin# The presence of food in the upper small intestine also causes a second hormone, cholecystokinin, a polypeptide containing 33 amino acids, to be released 'I cells', in the mucosa of the duodenum and upper jejunum. This release of cholecystokinin results especially from the presence of proteoses and peptones and long-chain fatty acids in the chyme coming from the stomach.# The differences between the pancreatic stimulatory effects of secretin and Cholecystokinin:- intense sodium bicarbonate secretion in response to acid in duodenum, stimulated by secretin,- a dual effect in response to soap (a fat), and- intense digestive enzyme secretion (when peptones enter duodenum) stimulated by CCK.Educational points:Basic Stimuli That Cause Pancreatic SecretionThree basic stimuli are important in causing pancreatic secretion:1. Acetylcholine, which is released from the parasympathetic vagus nerve endings and from other cholinergic nerves in the enteric nervous system2. Cholecystokinin, which is secreted by duodenal and upper jejunal mucosa when food enters small bowel3. Secretin, which is also secreted by duodenal and jejunal mucosa when highly acid food enters small bowel.The presence of acid, fat, protein breakdown products, hyperosmotic or hypo-osmotic fluids, or any irritating factor in the upper small intestine causes release of several intestinal hormones. One of these is secretin, which is especially important for control of pancreatic secretion. However, secretin opposes stomach secretion. Three other hormones--gastric inhibitory peptide, vasoactive intestinal polypeptide, and somatostatin--also have slight to moderate effects in inhibiting gastric secretion. | train | med_mcqa | null |
In which of the following condition is Tetanus most commonly noticed? | [
"Burn cases",
"Wounds contaminated with fecal matter",
"Open fracture",
"Gunshot wounds"
] | B | Wounds contaminated with fecal matter and soil are most prone for tetanus development, however tetanus may develop in chronic conditions, such as skin ulcers, abscesses, gangrene, burns, frost bite, and middle ear infection. It is also associated with surgery, aboion, childbih, body piercing, and drug abuse notably skin popping and open fracture etc. All of the conditions given are associated with tetanus but as wounds contaminated with fecal matter and soil are most prone so, it is the answer of choice here. Ref: Harrison 16/e, Page 840-43. | train | med_mcqa | null |
If both the parents are carriers of the beta-thalassemia gene, the chance of having a child with thalassemia major in each pregnancy is | [
"25%",
"50%",
"75%",
"100%"
] | A | Normally, the majority of adult hemoglobin (HbA) is composed of four protein chains, two a and two b globin chains arranged into a heterotetramer. In thalassemia, patients have defects in either the a or b globin chain, causing production of abnormal red blood cells (In sickle-cell disease, the mutation is specific to b globin). The thalassemias are classified according to which chain of the hemoglobin molecule is affected. In a-thalassemias, production of the a globin chain is affected, while in b-thalassemia, production of the b globin chain is affected. The b globin chains are encoded by a single gene on chromosome 11; a globin chains are encoded by two closely linked genes on chromosome 16 Thus, in a normal person with two copies of each chromosome, two loci encode the b chain, and four loci encode the a chain.Thalassemias are genetic disorders inherited from a person's parents. There are two main types, alpha thalassemia and beta thalassemia.] The severity of alpha and beta thalassemia depends on how many of the four genes for alpha globin or two genes for beta globin are missing. | train | med_mcqa | null |
An infant weighing 1600 g (3 1/2 lb) is born at 32 weeks' gestation. Initial evaluation was benign, and the infant was transferred to the level 2 nursery for prematurity. The nurse there calls at 1 hour of life and reports the infant is tachypneic. Vital signs include a heart rate of 140 beats per minute, a respiratory rate of 80 breaths per minute, a temperature of 35degC (95degF), and a peripheral oxygen saturation of 98%. The lungs are clear with bilateral breath sounds and there is no murmur; the infant is in no distress. The child's chest radiograph is shown. Which of the following is the most appropriate next step in evaluating the infant? | [
"Obtain a complete blood count and differential.",
"Perform a lumbar puncture.",
"Administer intravenously 5cc of D50W.",
"Place the infant under a warmer."
] | D | (d) Source: (Hay et al, pp 30-31. Kliegman et al, pp 536-537. McMillan et al, p 259. Rudolph et al, pp 171-172.) The radiograph is normal. However, the vignette describes a cold infant. A room temperature of 24degC (approximately 75degF) provides a cold environment for newborn infants. Aside from the fact that these infants emerge from a warm, 37.6degC (99.5degF) intrauterine environment, at birth, infants (and especially preterm infants) are wet, have a relatively large surface area for their weight, and have little subcutaneous fat. Within minutes of delivery, the infants are likely to become pale or blue and their body temperatures will drop. In order to bring body temperature back to normal, they must increase their metabolic rate; ventilation, in turn, must increase proportionally to ensure an adequate oxygen supply. Because a preterm infant is likely to have respiratory problems and be unable to oxygenate adequately, lactate can accumulate and lead to a metabolic acidosis. Infants rarely shiver in response to a need to increase heat production. If the tachypnea persists after warming the infant, sepsis, pneumonia, and primary surfactant deficiency are all possible; several of the alternative answers then may be appropriate. | train | med_mcqa | null |
Example of type 4 hypersensitivity is | [
"Farmer's lung",
"Contact hypersensitivity",
"Immediate hypersensitivity",
"Myasthenia gravis"
] | B | Ref Robbins 9/e p209 Delayed-type hypersensitivity (DTH), described next, is an illustrative model of T cell-mediated inflammation and tissue injury. The same reactions are the underlying basis for several diseases. Contact dermatitis is an example of tissue injury resulting from T cell-mediated inflammation. It is evoked by contact with pentadecylcatechol (also known as urushiol, the active component of poison ivy and poison oak, which probably becomes antigenic by binding to a host protein). On reexposure of a previously exposed person to the plants, sensitized TH1 CD4+ cells accumulate in the dermis and migrate toward the antigen within the epidermis. Here they release cytokines that damage kera- tinocytes, causing separation of these cells and formation of an intraepidermal vesicle, and inflammation manifested as a vesicular dermatitis. It has long been thought that several systemic diseases, such as type 1 diabetes and mul- tiple sclerosis, are caused by TH1 and TH17 reactions against self antigens, and Crohn disease may be caused by uncon- trolled reactions involving the same T cells but directed against intestinal bacteria. T cell-mediated inflammation also plays a role in the rejection of transplants, described later in the chapter. Delayed-Type Hypersensitivity DTH is a T cell-mediated reaction that develops in response to antigen challenge in a previously sensitized individual. In contrast with immediate hypersensitivity, the DTH reac- tion is delayed for 12 to 48 hours, which is the time it takes for effector T cells to be recruited to the site of antigen chal- lenge and to be activated to secrete cytokines. The classic example of DTH is the tuberculin reaction, elicited by chal- lenge with a protein extract of M. tuberculosis (tuberculin) in a person who has previously been exposed to the tuber- cle bacillus. Between 8 and 12 hours after intracutaneous injection of tuberculin, a local area of erythema and indura- tion appears, reaching a peak (typically 1 to 2 cm in diam- eter) in 24 to 72 hours and thereafter slowly subsiding. On histologic examination, the DTH reaction is characterized by perivascular accumulation ("cuffing") of CD4+ helper T cells and macrophages (Fig. 4-13). Local secretion of cyto- kines by these cells leads to increased microvascular per- meability, giving rise to dermal edema and fibrin deposition; the latter is the main cause of the tissue induration in these responses. DTH reactions are mediated primarily by TH1 cells; the contribution of TH17 cells is unclear. The tubercu- lin response is used to screen populations for people who have had previous exposure to tuberculosis and therefore have circulating memory T cells specific for mycobacterial proteins. Notably, immunosuppression or loss of CD4+ T cells (e.g., resulting from HIV infection) may lead to a nega- tive tuberculin response even in the presence of a severe infection. Prolonged DTH reactions against persistent microbes or other stimuli may result in a special morphologic pattern of reaction called granulomatous inflammation. The initial perivascular CD4+ T cell infiltrate is progressively replaced by macrophages over a period of 2 to 3 weeks. These accumulated macrophages typically exhibit morphologic evidence of activation; that is, they become large, flat, and eosinophilic, and are called epithelioid cells. The epitheli- oid cells occasionally fuse under the influence of cytokines (e.g., IFN-g) to form multinucleate giant cells. A micro- scopic aggregate of epithelioid cells, typically surrounded by a collar of lymphocytes, is called a granuloma (Fig. 4-14, A). The process is essentially a chronic form of TH1-mediated inflammation and macrophage activation (Fig. 4-14, B). Older granulomas develop an enclosing rim of fibroblasts and connective tissue. Recognition of a granuloma is of diagnostic impoance because of the limited number of conditions that can cause it (Chapter 2). | train | med_mcqa | null |
Acute renal failure results in? | [
"Hyperkalemic alkalosis",
"Hypokalemic alkalosis",
"Hyperkalemic acidosis",
"Hypokalemic acidosis"
] | C | *AKI - Hyperkalemia acidosis *Dehydration/Vomiting - Hypokalemic alkalosis *Diarrhea - Hypokalemic acidosis | train | med_mcqa | null |
Least likely to be Pre-leukemic condition is: | [
"Paroxysmal nocturnal hemoglobinuria",
"Paroxysmal cold hemoglobinuria",
"Aplastic anemia",
"Myelodysplastic syndrome"
] | B | Ans. (b) Paroxysmal cold hemoglobinuria(Ref: Wintrobe's 12th/pgchap 78)Paroxysmal nocturnal hemoglobinuria (PNH), Aplastic anemia & Myelodysplastic syndrome predispose to Leukemia | train | med_mcqa | null |
Buprenorphine is paial agonist of- | [
"Mu ( ) receptor",
"Delta (d) receptor",
"Kappa (K) receptor",
"Sigma (s) receptor"
] | A | Ans. is 'a' i.e., Mu ( ) receptor Nature of interaction of opioid ligands with the three major types of opioid receptors, along with equivalent analgesic doses Ligand (mu) lc (kappa) S (delta) Analgesic dose (mg) 1. Morphine Ago. (St) Ago. (W) Ago. (W) 10 2. Nalorphine Anta. (St) Ago. (M) 3. Pentazocine P. Ago., Anta. (W) Ago. (M) 30-60 4. Butorphanol P. Ago. (W) Ago. (St) 1-3 5. Buprenorphine P. Ago. Anta. (M) 0.3-0.4 6. Naloxone Anta. (St) Anta. (M) Anta. (W) 7. Naltrexone Anta. (St) Anta. (M) Anta. (W) 8. Met/Leu enkephalin Ago. (M) Ago. (St) 9. (3-Endorphin Ago. (St) Ago. (St) 10. Dynorphin A, B Ago. (W) Ago. (St) Ago. (W) | train | med_mcqa | null |
Which of the following CNS depressants are used in maximum for suicidal purposes? | [
"Opium",
"Cocaine",
"LSD",
"Cannabis"
] | A | Opium is selected for suicides because death is painless. It is rarely used for homicide because of its bitter taste, characteristic smell and colour. Poisoning may occur in addicts. Drugging of children by opium to keep them quiet, and overdosage of medicines containing opium may result in accidental poisoning. Fatal dose of opium is 2 g; fatal period is 6-12 weeks. Ref: The Essentials of Forensic Medicine and Toxicology by Dr K. S.Narayan Reddy, 27th edition, Page 517. | train | med_mcqa | null |
All of the following structures pass through IV compament of deep space of Extensor Retinaculum except | [
"Extensor Digitorum",
"Extensor Indicis",
"Posterior interossious nerve",
"Anterior interossious vein"
] | D | Ref: BDC 6th edition (upper limb and thorax) Pg: 137 | train | med_mcqa | null |
The abnormal swallowing pattern with the poorest prognosis is: | [
"Simple tongue thrust",
"Complex tongue thrust",
"Infantile swallow",
"Retained infantile swallow"
] | D | null | train | med_mcqa | null |
Tumour suppressor gene are not involved in? | [
"Breast carcinoma",
"Multiple endocrine neoplasia",
"Neurofibromatosis",
"Retinoblastoma"
] | B | The term multiple endocrine neoplasia (MEN) encompasses several distinct syndromes featuring tumors of endocrine glands, each with its own characteristic pattern. In some cases, the tumors are malignant, in others, benign. Benign or malignant tumors of nonendocrine tissues occur as components of some of these tumor syndromes. MEN syndromes are inherited as autosomal dominant disorders. | train | med_mcqa | null |
Pacemaker is formed by w hich of the follow ing cells in GIT - | [
"P-ceils",
"Oxyntic cells",
"Cajal cells",
"Parietal cells"
] | C | Ans. is 'c' i.e., Cajal cells o The smooth muscle cells of gastrointestinal tract has spontaneous rhythmic fluctuations in membrane potential between about -65 and -45 mV.o This is called basic electrical rhythm (BER).o This BER is initiated by pacemaker cells called intersititial cells of CajaLo During these cyclic fluctuations, if the resting membrane potential crosses the threshold for excitation, an action potential or a burst of action potential may develop.o Thus, BER itself does not cause muscle contraction, but when spike potentials (action potentials) superimposed on the most depolarizing portions of BER. muscle contraction occurs,o Pacemaker cells (interstitial cells of Cajal) are stellate mesenchymal cells with smooth muscle like features,o Pacemaker cells are absent in the esophagus and proximal stomach.o In the distal stomach and small intestine they are located in outer circular muscle layer near myentric plexus,o In the colon they are at the submucosal border of circular muscle layer.o In stomach and small intestine, pacemaker frequency is in descending gradient and the pacemaker with highest frequency usually dominates (like heart ). | train | med_mcqa | null |
Which of the following personality trait has the highest chances of acquiring schizophrenia? | [
"Borderline personality",
"Schizoid personality",
"Schizotypal Personality",
"Anti social Personality"
] | C | Schizotypal personality trait can progress to schizophrenia.
Remember : Individuals with borderline personality disorder are also called as "Ambulatory Schizophrenics". | train | med_mcqa | null |
The daily dose of thalidomide for controlling E.N.L. is : | [
"100 mg",
"200 - 300 mg",
"500 mg",
"1000 mg only"
] | B | B i.e. 200 - 300 mg | train | med_mcqa | null |
A baby presenting with multiple deformities, cleft lip, cleft palate, microcephaly, small eyes, scalp defect and polydactyly. The baby is suffering from which syndrome? | [
"Trisomy 13",
"Trisomy 18",
"Trisomy 21",
"Monosomy 2"
] | A | Trisomy 13 (Patau syndrome) symptoms: Microphthalmia Microcephaly and mental retardation Polydactyly Cleft lip and palate Renal defects (IMG: showing cleft lip, Polydactyly, Microphthalmia or no eyes.) | train | med_mcqa | null |
Which drug used in bronchial asthma needs monitoring: | [
"Theophylline",
"Cromoglycate",
"Salmeterol",
"Terbutaline"
] | A | Theophylline | train | med_mcqa | null |
Criteria for high risk infant: | [
"Have not taken 100 days folic acid",
"Working mothers",
"Preeclampsia in pregnancy",
"Malpresentation during birth"
] | B | Ans. (B) Working motherswww.ncbi.gov.india(Ref: )Risk InfantsBirth weight < 2.5 KgTwinsBirth order >=4Artificial FeedingWt. <=70% of expected weightFailure to gain weight during 3 successive monthsChildren with PEM/DiarrheaWorking mother/One parent | train | med_mcqa | null |
Better levels of factor VIII are achieved by infusion of: | [
"Cryoprecipitate",
"Desmopressin",
"Fresh frozen plasma",
"Fresh blood"
] | A | Cryoprecipitate has a higher concentration of Factor VII (80 IU in 15 ml of plasma) compared to FFP (200 IU in 200 ml). Thus, cyroprecipitate has a higher concentration on Factor VIII. | train | med_mcqa | null |
Winberger sign is present in – | [
"Rickets",
"Scurvy",
"Secondary syphilis",
"Tuberculosis"
] | B | null | train | med_mcqa | null |
The main action of muscle "GameIlius" is: | [
"Medial rotation of thigh",
"Lateral rotation of thigh",
"Flexion of hip",
"Extension of hip"
] | B | Lateral rotation of thigh | train | med_mcqa | null |
Symptom of sudden onset bilateral vocal cord palsy - | [
"Dyspnea & Stridor",
"Hoarseness of voice",
"Asymptomatic",
"Bovine cough"
] | A | Sudden onset of bilateral vocal cord paralysis produces respiratory obstruction with dysnea and stridor. | train | med_mcqa | null |
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.