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 |
|---|---|---|---|---|---|---|
A dental surgeon appointed in a rural health centre reports an increased incidence of dental caries in the people of that area. Research team confirmed that water supply of that area is deficient in | [
"Chloride",
"Sodium",
"Calcium",
"Fluoride"
] | D | null | train | med_mcqa | null |
The prognosis of bleaching of a discoloured tooth is good in all the given conditions except: | [
"Discolouration due to products of pulp decomposition.",
"Discolouration due to food debris.",
"Discolouration due to metallic salts.",
"Discolouration due to chromogenic bacteria."
] | C | The prognosis for bleaching of a discolored pulpless tooth is good when the discoloration is due to products of pulp decomposition, food debris, or chromogenic bacteria that gain access to the dentinal tubules. When the discoloration is due to metallic salts, bleaching is less successful. | train | med_mcqa | null |
Which of the following ACE inhibitor is not a prodrug | [
"Fosinopril",
"Enalapril",
"Ramipril",
"Lisinopril"
] | D | Refer katzung 11e 183 KDT 6/e p23, 24,487 All ACE inhibitor are prodrug except captopril and Lisinopril | train | med_mcqa | null |
The causative organism of rheumatic heart disease associated with rheumatic fever are: | [
"Beta hemolytic streptococci",
"Beta hemolytic staphylococci",
"Alpha hemolytic streptococci",
"Gamma hemolytic streptococci"
] | A | null | train | med_mcqa | null |
Minimum dose of tetracycline which will show tooth discoloration and enamel hypoplasia: | [
"5 mg/kg body weight",
"15 mg/kg body weight",
"30 mg/kg body weight",
"50 mg/kg body weight"
] | D | null | train | med_mcqa | null |
Down beat nystagmus is seen in? | [
"Arnold chiari malformation",
"Brain stem damage",
"Pontine hemorrhage",
"Labyrinthine damage"
] | A | Ans. is 'a' i.e., Arnold chiari malformation Down-beat nystagmus are seen in cerebellar lesion and Arnold-chiary malformation | train | med_mcqa | null |
All of the following lead to increased dissociation of O2 from Hb except | [
"HbF",
"Increased CO2",
"Increase H+",
"Increase Temperature"
] | A | Fetal hemoglobin or fetal hemoglobin, (also hemoglobin F or HbF) is the main oxygen transpo protein in the human fetus during the last seven months of development in the uterus and in the newborn until roughly 6 months old.Ref: Ganong&;s Review of Medical Physiology; 24th edition; page no:641 | train | med_mcqa | null |
Trapezoid body is associated with | [
"Auditory pathway",
"Visual pathway",
"Touch pathway",
"Pain pathway"
] | A | Ans: a (Auditory pathway) Ref: IB Singh 6th ed/p. 107Trapezoid body is concerned with auditory pathway.Auditory Pathway:First order neurons start from the spiral ganglion and end in the dorsal and ventral cochlear nuclei.From there, the second order neurons end in superior olivary nucleus of both sides. Some fibres do not relay in superior olivary nucleus, instead go through the Trapezoid body.From both the trapezoid body and superior olivary nuclei, the fibres pass through the lateral lemniscus, to reach the inferior colliculus.From there, it goes to the medial geniculate body and is projected to superior temporal gyrus. Note:-Fibres arising from the ventral cochlear nucleus pass through the trapezoid body.Some fibres arising from the dorsal cochlear nucleus does not pass through the trapezoid body and project directly into the superior colliculus.Superior olivary nucleus receives fibres from both cochlea (bilateral).Fibres from both dorsal and ventral cochlear nucleireach superior olivary nucleus. | train | med_mcqa | null |
Which of the following is false regarding malignant otitis externa? | [
"ESR is useful in the monitoring of response to antibiotics",
"Sensorineural hearing loss is common presentation",
"Common in diabetics",
"Granulation tissue in external ear canal"
] | B | (b) Sensorineural hearing loss is common presentation(Ref. Cummings, 6th ed., 2118)Invasion of inner ear to result into SN hearing loss is unusual and if it all occurs, will be a very late feature. | train | med_mcqa | null |
Hostile witness is covered under IPC section ? | [
"191",
"192",
"193",
"194"
] | A | Ans. is 'A' i.e., 191. Hostility is one form of perjury. A hostile witness is one who's provided an eyewitness account of a criminal event or other information to help the prosecution build a case, but has later turned in cou, giving a different version of events or contradictory information. A witness is termed hostile, when he gives a ceain statement on his knowledge about commission of a crime before the police but refutes it when called as witness before the cou during trial. IPC 191 - Giving false evidence (Perjury) | train | med_mcqa | null |
All of the following is involved in tumor metastasis cascade except - | [
"Fibronectin",
"e-cadherin",
"Type IV collagenase",
"Tyrosine kinase"
] | D | Invasion and metastasis of tumor
Invasion and metastasis are biological hallmarks of malignant tumors.
This involve a series of steps -
Detachment of tumor cells
Detachment of tumor cells is the first step in metastasis.
Normally cells are glued to each other by adhesion molecules E-cadherin.
Normal function of E-cadherin is dependent on catenins that helps in linkage of cytoskeleton to E-cadherin.
Down regulation of expression of either E-cadherins or catenins results loosening of cells that helps in metastasis.
Attachment to ECM (including basement membrane)
Tumor cells express integrins that helps in the attachement of cells to many components of ECM like fibronectin, laminin, vitronectin, and collegen.
Degradation of ECM
After attachement to ECM components, tumor cells must create passageways for migration.
This require enzymatic degradation of ECM.
Tumor cells secrete proteolytic enzymes themselves or stimulate macrophages and fibroblasts to secrete these enzymes.
The most important proteases are metalloproteinases (MMPs) including collagenase IV.
Vascular dissemination and homing of tumor cells
After travelling through ECM, tumor cells enter into the vessels.
In the vessels, tumor cells tend to aggregate in clumps.
This is due to adhesion between tumor cells and blood cells, particularly platelets.
This clump is carried away at distant site where it adhere to endothelium, followed by extravasation from the vessels.
Adhesion to endothelium and further travelling through ECM require same mechanism, as was required initially for attachement and degradation of ECM.
At new site, tumor cells proliferate and develops new blood supply → metastatic secondary tumor mass.
Note → Among adhesion molecule CD44 is of particular interest, which is expressed on normal T-cells and is used by these cells to migrate to selective sites in lymphoid tissue.
Also know
Ezrin is the only metastatis gene, that has been identified till now. It is necessary for metastasis of rhabdomyosarcoma and osteosarcoma.
In contrast, several antimetastasis gene have been recognized. The important ones are → NM 23, KAI - 1, Kiss gene. | train | med_mcqa | null |
Anti-tubercular drug susceptibility can be done by all of the following methods, except - | [
"Resistance ratio method",
"Disc diffusion method",
"Molecular method",
"Radiometric broth method"
] | B | null | train | med_mcqa | null |
A pilot whose plane is about to crash, spends five minutes explaining the technical details of the engine malfunction to his copilot. The defense mechanism that the pilot is using is. | [
"Repression",
"Sublimation",
"Dissociation",
"Intellectualization"
] | D | Excessive use of intellectual processes to deal with unpleasant emotions is called as intellectualisation. | train | med_mcqa | null |
Which of the following is false regarding glomerular capillaries: | [
"Oncotic pressure is higher in the blood column than that in glomerular capillaries",
"Constriction of the afferent arteriole produces fall in capillary BP",
"Concentration of glucose is equal in glomerular capillaries and ultrafiltrate",
"Hematocrit is raised in the glomerular capillaries"
] | A | Ans. A. Oncotic pressure is higher in the blood column than that in glomerular capillariesThe factors governing filtration across the glomerular capillaries are the same as those governing filtration across all other capillaries, that is, the size of the capillary bed, the permeability of the capillaries, and the hydrostatic and osmotic pressure gradients across the capillary wall. For each nephron:GFR-Kf [(PGC -PT )-(pGC -pT )Kf , the glomerular ultrafiltration coefficient, is the product of the glomerular capillary wall hydraulic conductivity (ie, its permeability) and the effective filtration surface area. PGC is the mean hydrostatic pressure in the glomerular capillaries, PT the mean hydrostatic pressure in the tubule (Bowman's space), pGC the oncotic pressure of the plasma in the glomerular capillaries, and pT the oncotic pressure of the filtrate in the tubulea. Now the oncotic pressure of the glomerular capillaries is the same as in any other systemic capillary i.e. 25 mm Hgb. Constriction of the afferent arteriole causes a fall in capillary BP resulting in decreased GFRc. Due to filteration of plasma, RBC are more in glomerular capillaries, so the GFR increases Concentration of all freely filtered substances like glucose are equal in glomerular capillaries and ultrafiltrate | train | med_mcqa | null |
Flowcytometry of an AML patient showed CD41 and CD61 positivity, it belongs to which FAB classification? | [
"M0",
"M3",
"M5",
"M7"
] | D | Acute megakaryoblastic leukaemia can often be diagnosed only by expression of the platelet-specific antigens CD41 and/or CD61.It is classified under the AML-M7 category of the FAB classificationRef: Harrison 19th edition pg: 678 | train | med_mcqa | null |
Moon’s molars seen with: | [
"Syphilis",
"Leprosy",
"Amyloidosis",
"Actinomycosis"
] | A | null | train | med_mcqa | null |
Hydrocephalus in infant is best diagnosed by | [
"USG cranium",
"CT scan head",
"Encephalogram",
"Lumbar-puncture"
] | A | Ans. a (USG cranium). (Ref. Grainger, Diagnostic Radiology, 4th ed., 2469)Cranial ultrasound of Infants# USG cranium is best method to diagnose hydrocephalus through the anterior and posterior fontanalles.# Progression of hydrocephalus can be estimated by comparison with previous studies.# USG is also helpful in following ventricular decompression in patients treated for hydrocephalus.# Neonatal hydrocephalus can also be evaluated by Doppler to assess indirectly intracranial pressure and help to determine the need for shunt placement.Cranial CT# CT enable us to evaluate the brain structure and ventricular size by noninvasive highly reliable technique.# But due to the ionizing radiations hazard, CT as a screening investigation is less preferable.Qhstretk. (Fetal) Cranial ultrasound# Obstretic ultrasound study is one of the best methods for antenatal diagnosis of hydrocephalus as it is noninvasive & hazard free not only to fetus as well as to mother. However assessment prior to GA of 20 weeks may be difficult, as ventricles constitute a large portion of cranial vault.# Signs suggestive of fetal hydrocephalus on obstretic USG study are:- Atrial size > 10 mm- Dangling "Choroid plexus" sign- BPD > 95th percentile- +- PolyhydramniosEducational points:# Lemon sign:- Concave/linear frontal contour abnormality located at coronal suture strongly associated with spina bifida.# Banana sign:- Cerebellum wrapped around posterior brainstem + obliteration of cisterna magna secondary to small posterior fossa + downward traction of spinal cord in Chiari II malformation.# Key points about Obstetric color Doppler study:- Assessment of flow in MCA is important parameter to diagnose fetal anemia.- Assessment of flow in umbilical vessels is important parameter to diagnose fetoplacental insufficiency.- Reduced diastolic flow in umbilical artery is the earliest sign of fetoplacental insufficiency.- Reversal of flow in umbilical artery (as well as pulsatile flow in umbilical vein) is the most ominous sign and may indicate impending fetal death. | train | med_mcqa | null |
Treatment of extragonadal germ cell tumour is | [
"Chemotherapy",
"Radiotherapy",
"Surgery",
"Immunotherapy"
] | A | Chemotherapy of extragonadal GCT utilizes BEP regimen; a combination of Bleomycin & Etoposide Cisplatin (Platinol) | train | med_mcqa | null |
Positive Trendelenburg's sign is seen in all EXCEPT: | [
"Paralysis of gluteus Maximus",
"Paralysis of gluteus medius & minimus",
"Fracture neck femur",
"Interochanteric fracture"
] | A | Paralysis of gluteus Maximus REF: Essential Clinical Anatomy, Keith .L. Moore 4th edition p.348/354 See APPENDIX-3 for list of "Gait abnormalities"Repeat in June 2010A positive Trendelenburg test is found in:Any condition that brings the origin and inseion of gluteus medius together:Subluxation or dislocation of the hipCoxa varaGreater trochanter fracturesSlipped upper femoral epiphysisFracture neck of femurAbductor paralysis or weakness e.g.:PolioNerve root lesionSuperior gluteal nerve damageMuscle-wasting diseaseAny painful hip disorder which results in gluteal inhibitionPositive Trendelenburg's sign due to Injury to Superior Gluteal Nerve:The Trendelenburg's sign is said to be positive if, when standing on one leg, the pelvis drops on the side opposite to the stance leg. The weakness is present on the side of the stance leg. The body is not able to maintain the center of gravity on the side of the stance leg. Normally, the body shifts the weight to the stance leg, allowing the shift of the center of gravity and consequently stabilizing or balancing the body. However, in unilateral superior gluteal nerve injury, when the patient lifts the opposing leg, the shift is not created and the patient cannot maintain balance leading to instability. Bilateral superior gluteal nerve injury results in a waddling gaitNOTE:Not to be confused with Trendelenburg's sign. TheTrendelenburg Test or Brodie-Trendelenburg test is a test which can be carried out as pa of a physical examination to determine the competency of the valves in the superficial and deep veins of the legs in patients with varicose veins | train | med_mcqa | null |
Most common presentation of trichobezoar is | [
"Obstruction",
"Peritonitis",
"Hemorrage",
"Asymptomatic"
] | A | Ans) a (Obstruction) Ref: Sabiston's textbook of surgery 18th editionTrichobezoars are concretions of hair, generally found in long-haired girls or women who often deny eating their own hair (trichophagy). Symptoms include pain from gastric ulceration and fullness from gastric outlet obstruction & occasional gastric perforation | train | med_mcqa | null |
Endoscope tube is sterilized by- | [
"Glutaraldehyde",
"Formalin",
"Autoclaving",
"Boiling"
] | A | null | train | med_mcqa | null |
A 42 yr old female was diagnosed with cystic neoplasm of pancreas containing ovarian-type stroma. She was most likely suffering from? | [
"Mucinous cystadenoma",
"Serous cystadenoma",
"Solid Pseudopapillary neoplasm",
"Intraductal papillary mucinous neoplasm"
] | A | Diagnosis is Mucinous cystadenoma Most common cystic neoplasm of pancreas Up to 95% are seen in women Usually arise from the tail of pancreas Cystic cavities usually filled with thick mucinous material Columnar mucin-producing epithelium that lines the cysts is associated with a dense stroma similar to ovarian stroma Precursor to invasive carcinoma, up to 1/3rd are associated with invasive adenocarcinoma CECT showing peripheral egg shell calcification Surgical resection is curative for noninvasive mucinous cystic neoplasms (distal pancreatectomy). | train | med_mcqa | null |
A Bennet's fracture is difficult to maintain in reduced position because of the pull of | [
"Extensor pollicis longus",
"Extensor pollicis brevis",
"Abductor pollicis longus",
"Abductor pollicis brevis"
] | C | C i.e. Abductor pollicis longus | train | med_mcqa | null |
Among technical quality concern, both maxillary & mandibular removable partial denture maximally lacks? | [
"Retention",
"Integrity",
"Stability",
"Support"
] | C | null | train | med_mcqa | null |
Dihydroergotamine differs from ergotamine in the following respect : | [
"It is a more potent oxytocic",
"It has antiemetic property",
"It has high oral bioavailability",
"It is more potent α-adrenergic blocker and less potent vasoconstrictor"
] | D | Hydrogenation of ergot alkaloids decrease their vasoconstrictor action and increase the α-blocking activity. | train | med_mcqa | null |
Which category of ICD is associated with mood disorders? | [
"F0",
"F1",
"F2",
"F3"
] | D | Ans. is 'd' i.e., F3 International classification of disease-10 (ICD-10)o ICD -10 is WHO classification for all diseases and health problems (and not only psychiatric disorders). ICD-10 uses alpha numeric code made of an alphabet (in contrast DSM-IV uses numerical coding) - 'F' is for mental disorders. There are 10 main categories denoted by digits 0 to 9.CodeCategoryF0Organic, including symptomatic mental disorders.FIMental and behaviuor disorders due to psychoactive substance useF2Schizophrenia, schizotypal and delusional disordersF3Mood (affective) disordersF4Neurotic, stress-related and somatoform disorders.F5Behavioral syndromes associated with physiological disturbances and physical factorsF6Disorders of adult personality and behaviourF7Mental retardationF8Disorders of psychological developmentF9Behavioural and emotional disorders with onset usually occuring in childhood or adolescence. | train | med_mcqa | null |
The characteristic features of E1 tor cholera are all except - | [
"More of subclinical cases",
"Mortality is less",
"Secondary attack rate is high in family",
"E1 tor vibrio is harder and able to survive longer"
] | C | null | train | med_mcqa | null |
Linear abrasion is the other name for | [
"Graze",
"Scratch",
"Pressure abrasion",
"Impact abrasion"
] | B | Linear abrasion (scratch abrasion) Linear abrasions are produced by horizontal or tangential movements of the tip of a pointed object like thorn, nail, tip of pointed knife, pin,etc. In this type of abrasion, the width is minimal. There may be heaping of the denuded cuticle at one end and from this, the direction of application of force and the relative position of the victim and assailant can be found out. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 112 | train | med_mcqa | null |
True about status marmoratus is: | [
"Present in basal ganglia",
"Associated with asphyxia",
"Have a marbled appearance",
"All of the above"
] | D | d. All of the above(Ref: Nelson's 20/e p 1126)Status MarmoratusIt is a congenital condition due to maldevelopment of corpus striatum, associated with choreoathetosis, in which the striate nuclei have a marble-like appearance caused by altered myelination in the putamen, caudate and thalamus.It results from acute total asphyxia in basal ganglia of full-term infants. | train | med_mcqa | null |
Inferior thyroid aery is related to? | [
"Superior laryngeal nerve",
"Recurrent laryngeal nerve",
"Glossopharyngeal nerve",
"XII nerve"
] | B | The Recurrent laryngeal nerve lies very close to the inferior thyroid aery near the base of the thyroid lobe. | train | med_mcqa | null |
Hypocretin system plays a critical role in which of the following disorders? | [
"Insomnia",
"Depression",
"OCD",
"Narcolepsy"
] | D | Ans. D. NarcolepsyIt has become apparent that the hypo cretin system plays a critical role in narcolepsy. Narcolepsy is the prototypical example of sleepiness produced by a basic central nervous system dysfunction of sleep mechanisms. The etiology stems from a genetically triggered hypo cretin dysfunction and deficit. Insomnia is defined as difficulty initiating sleep or maintaining sleep or having nonrestorative sleep for 1 month or more. The insomnia or resulting sleepiness must cause clinically significant impairment or distress. To qualify as primary insomnia, the etiology must not be rooted in psychiatric conditions, parasomnias, substance use or abuse, sleep-disordered breathing, or circadian rhythm disorders. | train | med_mcqa | null |
The commonest Primary immunodeficiency is - | [
"Common variable immunodeficiency",
"Isolated IgA immunodeficiency",
"Wiskott-Aldrich syndrome",
"AIDS"
] | B | Selective immunoglobulin A (IgA) deficiency (SIgAD) is a genetic immunodeficiency, a type of hypogammaglobulinemia. People with this deficiency lack immunoglobulin A (IgA), a type of antibody that protects against infections of the mucous membranes lining the mouth, airways, and digestive tract. It is defined as an undetectable serum IgA level in the presence of normal serum levels of IgG and IgM, in persons older than 4 years. It is the most common of the primary antibody deficiencies. Most such persons remain healthy throughout their lives and are never diagnosed. | train | med_mcqa | null |
What is the type of wire formed by twisting five tempered wire over a common wire? | [
"Twisted wire",
"Braided wire",
"Axial wire",
"Co-axial wire"
] | D | Coaxial Archwire
Coaxial archwires are made of a central core wire of 0.006 inch diameter wire with 5 or 6 outer wires.
These wires are more flexible and were very frequently used for initial alignment of the teeth before the advent of Ni-Ti wires.
Textbook of Orthodontics Gurkeerat Singh 2nd ed pg no 335 | train | med_mcqa | null |
Kinesthetic sensation is: | [
"Transmitted by the (3-type of sensory nerve)",
"Located in Merkl's disc",
"Transmitted by Meissner's corpuscles",
"Means abnormal perception of sensation"
] | A | A i.e. Transmitted by the 13- type of sensory nerve Kinesthetic sensation is ability to perceive the extent, direction or rate of movements. i.e. perception of touch and pressure and is therefore transmitted by Afl type of fibersQ. | train | med_mcqa | null |
Which of the following is not a component of the hypogastric sheath? | [
"Broad ligament",
"Uterosacral ligament",
"Transverse cervical ligament",
"Lateral ligament of the bladder"
] | A | Pas of the hypogastric sheath:Anterior lamina - Lateral ligament of bladder.Middle lamina - Transverse cervical ligament, rectovesical septum in males.Posterior lamina - Presacral fascia, uterosacral ligament. | train | med_mcqa | null |
The elevator can be used to advantage when: | [
"The tooth to be extracted is isolated",
"The interdental bone is used as a fulcrum",
"The adjacent tooth is not to be extracted",
"Multiple adjacent teeth are to be extracted"
] | D | null | train | med_mcqa | null |
Rubella is caused by | [
"Ohomyxovirus",
"Paramyxovirus",
"Toga virus",
"Arbovirus group B"
] | C | Family Togaviridae includes Genus Alphavirus --> Western Equine Encephalitis (WEE) , Eastern Equine Encephalitis (EEE) , Venezuelan Equine Encephalitis (VEE) and Chikungunya fever (CGF) Genus Rubivirus --> Rubella Rubella: Aka German measles. I.P - 14-21 days Source : cases Mode of transmission : Respiratory / air droplets Period of communicability: 1 week before symptoms & 1 week after rash. Vaccine: Live attenuated; RA 27/3 strain | train | med_mcqa | null |
Most common cause of native valve endocarditis? | [
"Staphylococcus aureus",
"Coagulase negative staphylococcus",
"Streptococcus",
"Enterococcus"
] | A | Ans. is 'a' i.e., Staphylococcus aureus See above explanation. | train | med_mcqa | null |
A patient presents with thrombocytopenia, eczema and recurrent infection - | [
"Wiskott - Aldrich syndrome",
"Digeorge syndrome",
"Agammaglobulinemia",
"SCID"
] | A | Wiskott-Aldrich syndrome is X linked disease. - characterised by eczema, thrombocytopenic purpura and recurrent infections. Affected boys do not survive first decade of life, death due to infection, hemorrhage and lymphoreticular malignancy. - CMI undergoes progressive deterioration associated with cellular depletion of thymus and the paracoical areas of lymph nodes. Reference : Anathanarayan & paniker's 9th edition, pg no: 174 <\p> | train | med_mcqa | null |
In Down's syndrome, 2nd trimester quadruple test includes all EXCEPT: | [
"Alpha fetoprotein",
"HCG",
"Inhibin A",
"PAPP"
] | D | Ans. (d) PAPP* The triple test measures the following three levels in the maternal serum: (sensitivity 71%)# Alpha-fetoprotein (AFP)# Human chorionic gonadotropin (hCG)# Unconjugated estriol (UE3)* Quadruple test include: triple test + Inhibin A: increases sensitivity upto 80%The levels may indicate increased risk for certain conditions: hCGAssociated conditionsLowLowHighDown's syndromeLowLowLowTrisomy 18 (Edward's syndrome)High--NTD, omphalocoele, gastrochisis | train | med_mcqa | null |
Which is a characteristic finding in AGN? | [
"Red blood cell cast",
"Hematuria",
"Proteinuria",
"Epithelial Cells"
] | A | * RBC casts indicate glomerular bleeding and are seen with acute glomerulonephritis. * Hematuria can be seen with even kidney stones or bladder cancer and hence is not a characteristic finding of AGN. | train | med_mcqa | null |
Which hormone levels are increased in prader Willi syndrome | [
"TSH",
"GH relin",
"Growth hormone",
"Peptide YY"
] | B | GH relin levels are increased in Prader willi syndrome. | train | med_mcqa | null |
Submental lymph nodes drains from ? | [
"Centre of lower lips",
"Posterior 1/3 of tongue",
"Anterior 2/3 of tongue",
"Angle of mouth"
] | A | Submental lymph nodesThese lymph nodes lie on the mylohyoid in the submental triangle. The receive afferents from superficial tissue below chin, central pa of lower lip, adjoining gums, anterior pa of the floor of the mouth and tip of the tongue. These nodes, themselves, drain into (efferent) into submandibular nodes. | train | med_mcqa | null |
Cutaneous Larva currens is a feature of | [
"Ancyclostoma braziliense",
"Ancyclostoma Caninum",
"Strongyloides stercoralis",
"Loa loa"
] | C | Cutaneous larva currens / racing larva, is a feature of strongyloides stercoralis. | train | med_mcqa | null |
First change of improvement, noted after iron therapy is initiated | [
"Decreased irritability",
"Reticulocytosis",
"Increase in serum iron levels",
"Replenishment of iron stores"
] | A | 12-24 hr Replacement of intracellular iron enzymes; subjective improvement; decreased irritability; increased Appetite 36-48 hr Initial bone marrow response; erythroid hyperplasia 48-72 hr Reticulocytosis, peaking at 5-7 days 4-30 days Increase in hemoglobin level 1-3 mo Repletion of stores | train | med_mcqa | null |
The organism causing biliary duct obstruction? | [
"Clonorchis sinensis",
"Ankylostoma duodenale",
"Strongyloides stercoralis",
"Enterobius vermicularis"
] | A | Hepatobiliary ParasitismCommon in Southern China Biliary tract is infested by adult helminths or their ovaCauses:Trematodes (Liver or biliary flukes): Most CommonClonorchis sinensisOpisthorchis viverrini or O. felineusFasciola hepaticaNematode (Ascaris lumbricoides by intraductal migration of adult worm) | train | med_mcqa | null |
The drug possessing antagonistic action at histamine, serotonin and muscarinic receptors is: | [
"Promethazine",
"Terfenadine",
"Cyproheptadine",
"Hydroxyzine"
] | C | -Cyproheptadine blocks 5HT2A, H1 and muscarinic receptors. -It increases appetite and can be used to promote weight gain in children. | train | med_mcqa | null |
Elimination of alcohol follows | [
"Zero order kinetics",
"First order kinetics",
"Second order kinetics",
"Third Order kinetics"
] | A | Elimination of alcohol from blood is always linear with time, i.e., zero order kinetics. Ref-KDT 6/e p38 | train | med_mcqa | null |
Cell surface markers expressed by both TH1 cells and macrophages include: | [
"Immunoglobulin",
"CD3",
"TCR",
"MHC Class I"
] | D | Ans. D. MHC Class Ia. Class I antigens are expressed on all nucleated cells and platelets.b. Hence both T helper cells and macrophages will express MHCI. | train | med_mcqa | null |
Most common CNS neoplasm in HIV patient ? | [
"Meduloblastoma",
"Astrocytoma",
"Primary CNS lymphoma",
"Ependymoma"
] | C | Ans. is `c' i.e., Primary CNS lymphoma o Primary CNS lymphoma accounts for 2% of extranodal lymphomas and 1% of intracranial tumors. o It is the most common CNS neoplasm in immunosuppressed patients, including those with AIDS and immunosuppression after transplantation. | train | med_mcqa | null |
All of the following mechanisms of action of oral contraceptive pills are true, except : | [
"Inhibition of ovulation",
"Prevention of feilization",
"Interference with implantation of feilized ovum",
"Interference with placental functioning"
] | D | Mechanism of Action of OCPs: 1.The combined oral pill suppresses pituitary hormones,FSH and LH peak and through their suppression prevents ovulation. 2.Progestogen causes atrophic changes in the endometrium and prevents nidation. Progestogen also acts on the cervical mucus making it thick and tenacious and impenetrable by sperms. 3.It also increases the tubal motility, so the feilized egg reaches the uterine cavity before the endometrium is receptive for implantation. Reference: Shaw's Textbook of Gynaecology, 16th edition,page273. | train | med_mcqa | null |
Anti-gliadin antibodies are seen in: September 2008 | [
"Tropical sprue",
"Ulcerative colitis",
"Crohn disease",
"Ceeliac disease"
] | D | Ans. D: Celiac disease Celiac sprue/celiac disease/gluten-sensitive enteropathy is a chronic disease of the digestive tract that interferes with the digestion and absorption of food nutrients. People with celiac sprue cannot tolerate gliadin, the alcohol-soluble fraction of gluten. Gluten is a protein commonly found in wheat, rye, and barley. Most patients with celiac disease tolerate oats, but they should be monitored closely. When people with celiac sprue ingest gliadin, the mucosa of their intestines is damaged by an immunologically mediated inflammatory response, resulting in maldigestion and malabsorption. Patients with celiac disease can present with failure to thrive and diarrhea (the classical form). However, some patients have only subtle symptoms (atypical celiac disease) or are asymptomatic (silent celiac disease). Blood for specific screening tests should be drawn before the patient is placed on a gluten-free diet. Current screening tests include IgA antibodies to tissue transaminase, IgA/IgG antigliadin antibodies and IgA antiendomysial antibody. Combined presence of antiendomysial antibody and antigliadin antibody is almost predictive of intestinal mucosal atrophy but if both antibody tests are negative, mucosa is almost normal. Antiendomysial antibody screening is an excellent test for the diagnosis and follow-up of celiac disease and for identification of asymptomatic patients. Antiendomysial antibodies are highly specific but less sensitive than other antibodies. The absence of HLA-DQ2 or HLA-DQ8 is useful for its high negative predictive value, but they are not helpful in confirming the diagnosis. Individuals with celiac disease have a higher than normal rate of malignancy. The most common celiac disease associated malignancy is enteropathy-associated T-cell lymphoma and small intestinal adenocarcinoma. | train | med_mcqa | null |
A 30 year old female presents with history of itching under right breast. On examination annular ring lesion was present under the breast. The diagnosis is – | [
"Trichophyton rubrum",
"Candida albicans",
"Epidermophyton",
"Microsporum"
] | A | The findings of itchy annular ring lesions on the trunk point towards the diagnosis of Tinea corporis.
Though Tinea corporis can be caused by all the three - Trichophyton, Epidermophyton and Microsporum; Trichophyton rubrum is the most common cause. | train | med_mcqa | null |
A 40 year old male patient complains of diminished vision during night and dryness of eyes. Patient gives history of recurrent bacterial infections. The plasma level of retinol binding protein in this patient will be: | [
"Decreased",
"Increased",
"Unchanged",
"Fluctuating"
] | A | Night blindness (nyctalopia) is one of the earliest symptoms of vitamin A deficiency. Severe deficiency of vitamin A leads to xerophthalmia. The plasma level of retinol binding protein is decreased in vitamin A deficiency.
Satyanarayana- Biochemistry, 3rd edition, pg-123 | train | med_mcqa | null |
Which of the following statements about clinical uses of the aminoglycosides is FALSE? | [
"Owing to their polar nature,aminoglycosides are not absorbed following oral adminissstration",
"Aminoglycosides are often used in combination with cephalosporibns in the empirical treatment of life-threatenting bacterial infections",
"The spectrum of antimicrobial activity of aminoglycosides includes Bacteroid... | C | (Ref:KDT 6/e p719, 720; Katzung 10/e p758) These are bactericidal inhibitors of protein synthesis. Due to formation of ionic nolecules in GIT, these are ineffective orally. Combination of aminoglycosides with penicillins is synergistic and is used for pseudomonas and enterococcal infections. | train | med_mcqa | null |
Inter cellular IgG deposition in epidermis is seen in: | [
"Pemphigus",
"Sub corneal pustular dermatosis",
"Bullus pemphigoid",
"Dermatitis Herpetiformis"
] | A | A. i.e. Pemphigus | train | med_mcqa | null |
A granuloma is seen in all except- | [
"TB",
"Yersinia",
"Mycoplasma",
"Leprosy"
] | C | L-forms are seen in several species of bacteria, developing either spontaneously or in presence of penicillin or other agents that interfere with cell wall synthesis.
L-forms may be unstable in that the morphological abnormality' is maintained only in the presence of penicillin, or stable, when the aberrant form becomes the permanent feature of the strain and is retained in serial subcultures.
L-form resembles mycoplasma and it is possible that mycoplasma represents stable L-forms as yet unidentified parent bacteria. | train | med_mcqa | null |
Which among the following is the richest source of vitamin D? | [
"Milk",
"Egg",
"Green leafy vegetables",
"Fish oil"
] | D | The main natural source of vitamin D in the diet is in the livers of fish, which ingest ultraviolet-irradiated sterols (in phytoplankton and zooplankton) and store the vitamin D produced in their livers. A major source of vitamin D is its synthesis in the skin upon ultraviolet B (UV-B) (wavelength, 290-315 nm) exposure. Except for fish, food (unless foified) contains only limited amounts of vitamin D. Vitamin D2 (ergocalciferol) is obtained from plant sources and is the chemical form found in some supplements. Ref: Shoback D.M., Sellmeyer D.E. (2010). Chapter 17. Disorders of the Parathyroids & Calcium & Phosphorus Metabolism. In McPhee S.J., Hammer G.D. (Eds),Pathophysiology of Disease, 6e. | train | med_mcqa | null |
Cyst around crown of uninterrupted tooth is | [
"Periapical cyst",
"Radicular cyst",
"Dentigerous cyst",
"Odontogenous cyst"
] | C | Dentigerous cyst is a unilocular cystic swelling arising in relation to the dental epithelium from an unerupted tooth SRB,5th edition,360 . | train | med_mcqa | null |
Peripheral resistance is inversely proportional to: | [
"Radius",
"Viscosity",
"Length",
"Elasticity of blood vessels"
] | A | (Radius): Ref: 470, 488, 474-SL (542- Ganong 23rd)Peripheral Resistance: - Resistance is the friction or tension or hindrance, against which the blood flows:* It is remarkable in the peripheral vessels particularly the arterioles* Three important factors, which determine the peripheral resistance are:A. Radius of blood vesselsB. Pressure gradientC. Viscosity of bloodResistance =Pressure gradient-------------Volume of blood flow=P1-P2---QPeripheral resistance in inversely related to the radius of the blood vessels i.e., lesser the radius, more will be resistance. The radius of the arterioles is very less because of the sympathetic tone. The arterioles remain partially constricted all the time because of the symphatic tone. So the resistance is more here. The arterioles are known as resistant vessels because of this reason.1. The volume of blood flow is inversely proportional to the resistance2. The volume of blood flow is inversely proportional to the viscosity of blood3. The volume of blood flow is directly proportional to the diameter4. The diastolic blood pressure is directly proportion to peripheral resistance | train | med_mcqa | null |
An 18 year old female patient complains of prominent upper front teeth. Extra-oral examination reveals an acute nasolabial angle and lip strain. Intraoral examination shows a Class II incisor relation with 8 mm overjet and Class I molar relation. Maxillary first premolar extractions have been advised, of which almost all of the premolar space will be required for the retraction of the upper anteriors. According to Burstone’s classification for anchorage requirements, this patient can be categorized into which of the following groups? | [
"Group A",
"Group B",
"Group C",
"Group D"
] | A | It is convenient to classify an extraction arch by the differential space closure required between the anterior and the posterior teeth.
Group A arch is one in which posterior segments must remain in their original position and the full space is used for anterior retraction.
Group B arch requires that approximately one half of the space be used for retraction.
Group C arch requires that approximately all space be closed by protraction of the posterior teeth. | train | med_mcqa | null |
The periphery of the retina is visualized with | [
"Indirect binocular ophthalmoscopy",
"Direct ophthalmoscopy",
"Contact lens",
"Goldman's three mirror contact lens"
] | A | The technique of examining the fundus of the eye is called ophthalmoscopy. In indirect ophthalmoscopy, a real and inveed image is formed between the condensing lens and the observer. The advantage of stereopsis (depth perception) and a larger field of view makes indirect ophthalmoscope (IDO) more useful both in retina clinics and during posterior segment surgeries. Reference : A K KHURANA Comprehensive Ophthalmology; edition 4; page-567 | train | med_mcqa | null |
Turricephaly is: | [
"Tall head",
"Narrow head",
"Wide head",
"Sho head"
] | A | Turricephaly is cone shaped head from premature fusion of the coronal, sphenofrontal & frontoethmoidal stures. - It's a type of craniosynostosis (MC type of craniosynostosis is DOLICOCEPHALY) Abnormality Debscription Dolicocephaly (scaphocephaly) Premature closure of sagittal suture Long and narrow skull Most common form of craniosynostosis Trigoncephaly Premature fusion of metopic suture Keel-shaped forehead and hypotelorism Increased risk of forebrain abnormalities Plagiocephaly Asymmetrical flattening of 1 side of the skull | train | med_mcqa | null |
Mirena (LNG IUCD) has to be replaced after : | [
"1 year",
"5 years",
"3 years",
"6 months"
] | B | Mirena (LNG IUD) contains a total of 52 mg levonorgestrel (LNG) LNG is released into the uterine cavity at a rate of approximately 20 microgram/day. Act mainly by local progestogenic effects Effective for up to 5 years. | train | med_mcqa | null |
All of the following are viral inclusion bodies, EXCEPT: | [
"Psamomma bodies",
"Molluscum",
"Negri",
"Bollinger"
] | A | Psammoma bodies are nonrefractile calcified concretions with concentric lamellations that are sometimes found in association with papillary adenocarcinoma, both primary and metastatic. Molluscum bodies or Henderson-Patterson bodies are seen in molluscum contagiosum which is caused by a pox virus. They are intracytoplasmic eosinophilic inclusions. Negri bodies are intracytoplasmic inclusions that are pathognomonic of rabies. They are found in the pyramidal cells of the hippocampus and the Purkinje cells of the cerebellum. Bollinger bodiesare intracytoplasmic inclusion bodies in epithelial cells, seen in fowlpox. | train | med_mcqa | null |
Most sensitive investigation for diagnosis of Meckel's diverticulum is? | [
"USG",
"CT Scan",
"Barium enema",
"99m-Tc pertechnetate scan"
] | D | Ans DImaging wise Meckel diverticulum appears like normal bowel, however Meckel's bleeds because it has ectopic gastric mucosa - secretes acid - damages the mucosa. Most common presentation of Meckel's: GI bleedingQ with abdominal pain. Tc99m - pertechnate scan is most sensitive for diagnosisQ | train | med_mcqa | null |
CURB-65' includes - | [
"PaO2 less than 65 mm",
"Coagulopathy",
"Severe Azotemia",
"Base deficit (acidosis)"
] | C | null | train | med_mcqa | null |
Which of the following is not a feature of Crohn's disease? | [
"Spiking fever",
"Enterovesical fistula/ Fecaluria",
"Perianal tags",
"Proctitis"
] | D | Crohn's disease - Intraabdominal abscess causing spiking fever (High grade with chills & rigor) Hallmark - Fistula formation (Peri-anal fistula) - Fecaluria (Communication between the gut and Bladder; stool will come in urine) -Rectum is spared -MC pa involve is T. ileum -Proctitis- usually a feature of UC. MC pa involve in UC is Rectum. | train | med_mcqa | null |
A 50-year-old man presented to the ER with progressive confusion, high fever and somnolence. On examination, patient is confused and hallucinating. After admission, patient develops a tonic-clonic seizure. There is no focal neurological deficit. NCCT head was done and showed no acute bleeding or elevated ICP. CSF analysis shows elevated protein and lymphocytic leukocytosis. MRI brain was done. Which of the following histopathological patterns is most commonly associated with the above condition: - | [
"<img style=\"max-width: 100%\" src=\" />",
"<img style=\"max-width: 100%\" src=\" />",
"<img style=\"max-width: 100%\" src=\" />",
"<img style=\"max-width: 100%\" src=\" />"
] | A | This is a case of Herpes simplex encephalitis. MRI image shows high signal in right temporal lobe - suggestive of herpes simplex encephalitis. Most common cause HSV-1 EEG abnormalities are seen in temporal lobe. CSF shows elevated protein and lymphocytic leukocytosis. Treatment with acyclovir. MRI shows abnormality in temporal lobes. Option A shows perivascular mononuclear cells and brain necrosis- seen in HSV encephalitis. Option B shows Negri bodies in rabies. Option C shows the classical owl eye appearance seen in CMV encephalitis. Option D shows Schwannoma | train | med_mcqa | null |
Large giant cells are found in - | [
"Alcoholic hepatitis",
"Neonatal hepatitis",
"Serum hepatitis",
"Amoebic hepatitis"
] | B | Ans. (b) Neonatal hepatitis(Ref: Robbins 9th/pg 857)The morphologic features of neonatal hepatitis include:Lobular disarray with focal liver cell apoptosis and necrosis QPanlobular giant-cell transformation of hepatocytes QProminent hepatocellular and canalicular cholestasisMild mononuclear infiltration of the portal areas,Reactive changes in Kupffer cellsExtramedullary hematopoiesis | train | med_mcqa | null |
Which is the following agents is a prerequisite for Prothrombin time (PT) assay? | [
"Tissue thromboplastin",
"Kaolin",
"Glass beads",
"Silica"
] | A | Prothrombin time (PT) assay: Time (in seconds) needed for plasma to clot after addition of tissue thromboplastin/tissue factor (e.g., brain extract) and Ca2+ ions Assesses the function of the proteins in the extrinsic pathway (factors VII, X, V, II (prothrombin), and fibrinogen) Prolonged PT can result from a deficiency of factor V, VII, X, prothrombin, fibrinogen, presence of an acquired inhibitor that interferes with the extrinsic pathway Kaolin, silica, glass beads are contact activators that trigger the intrinsic pathway and the first two agents are commonly used in paial thromboplastin time (PTT) assay. | train | med_mcqa | null |
Which of the following is true regarding mutations related to pancreatitis? | [
"Hereditary pancreatitis: PRSS1",
"Idiopathic chronic pancreatitis: CFTR",
"Tropical calcific pancreatitis: SPINK1",
"All of the above"
] | D | Syndromes Mutations Hereditary pancreatitis PRSS 1 (cationic trypsinogen)gene Idiopathic chronic pancreatitis CFTR Tropical calcific pancreatitis SPINK1 (PTSI) | train | med_mcqa | null |
Barbiturates acts on - | [
"a - adrenergic receptors",
"b - adrenergic receptors",
"Cholinergic receptors",
"GABA receptor"
] | D | Ans. is 'd' i.e., GABA receptors o Barbiturates act primarily at the GABA - BZD receptor - Cl- channel complex and potentiate GABAergic inhibition by increasing the lifetime of Cl- channel opening caused by GABA (Contrast benzodiazepines which enhance frequency of Cl- channel opening) - GABA facilitatory action.o Benzodiazepines antagonist - Flumazenilo Benzodiazepines inverse agonist - b - carboline (DMCM)Drugs affectign GABA receptorsGABAA receptoro GABA - Endogenous agonisto Muscimol - Agonisto Bicuculline - Competitive antagonistGABAB receptoro Baclofen - Agonisto Saclofen - Antagonisto Picrotoxin - Blocks Cl- channel noncompetitivelyo Barbiturate - Agonist at aliostearic site (other than BZD site)o Benzodiazepine - Agonist at aliostearic site (BZD site)o b-earboline (DMCM) - Inverse agonist at BZD siteo Flumazenil - Competitive antagonist at BZD siteo Alcohal, inhalation anaesthetic, propofol - open Cl- channel directly,o Alphaxoloneo Zopiclone, zolpidem, zoleplon - agonist at BZD site,o Anticonvulsants (Gabapentine, vigabaterine)o Ivermectin | train | med_mcqa | null |
Calabar swellings seen in: | [
"Ascaris",
"Hymenolepis",
"Loa Loa",
"Strongyloides"
] | C | Calabar swellings are localized subcutaneous edemas, a type of inflammatory reaction brought about by a host response to the worm or its metabolic products. Argyll-Robeson described the adult worms of LOA LOA that he extracted from the eye of a woman who had resided at Old Calabar in West Africa. | train | med_mcqa | null |
What is the name of this chromosomal abnormality? | [
"Translocation",
"Telomeric fusion",
"Isochromosome",
"Ring chromosome"
] | D | Ring chromosome: 2 break point event involving the ends of p & q arms, which leaves 2 sticky chromosomal ends that join to become a ring Isochromosome- During mitotic division, chromosome divides transversely Translocation- A segment of chromosome breaks off from parent chromosome & join another chromosome | train | med_mcqa | null |
Carey coombs murmur, which is false - | [
"Delayed diastolic murmur",
"Seen in rheumatic fever",
"Can be associated with A.R.",
"Low pitched murmur"
] | A | A sho, mid-diastolic murmur is rarely heard during an episode of acute rheumatic fever (Carey-Coombs murmur) and probably is due to flow through an edematous mitral valve. An opening snap is not present in the acute phase, and the murmur dissipates with resolution of the acute attack. Complete hea block with dyssynchronous atrial and ventricular activation may be associated with intermittent mid- to late diastolic murmurs if atrial contraction occurs when the mitral valve is paially closed. Mid-diastolic murmurs indicative of increased tricuspid valve flow can occur with severe, isolated TR and with large ASDs and significant left-to-right shunting. Other signs of an ASD are present ( Chap. 236 ), including fixed splitting of S 2 and a mid-systolic murmur at the mid- to upper left sternal border. TTE is indicated for evaluation of a patient with a mid- to late diastolic murmur. Harrison principal of internal medicine,20edition,pg no.1432 | train | med_mcqa | null |
Resting membrane potential is mainly due to - | [
"Na+",
"K+",
"Cl-",
"Mg++"
] | B | Ans. is 'b' i.e., K+ Genesis of RMPo The cell membrane is selectively permeable. Due to presence of potassium leak channels K+ ions are freely permeable but permeability of Na+ is much less . In the generation of RMP, following sequence of events occur :-i) K+ diffuses out of cell along its concentration gradient (K+ concentration is very high inside the cells and very low in ECF).ii) The diffusion of K+ produces an intracellular negativity (due to non-diffusible protein anion in the cells) which is not nullified by the diffusion of Na+ in the opposite direction (membrane is impermeable to Na+) or diffusion of Cl- in same direction (Cl- concentration is already very high in ECF in comparison to ICF).iii) So, intracellular negativity is produced which opposes outward diffusion of K+ and when the equilibrium is reached, the inward force on K+ due to electrical gradient balances outward force on K+ due to concentation gradient.iv) Finally, at equilibrium inner side of cell is negatively charged with respect to outer side, and resting membrane potential is produced.o So, the RMP is principally due to concentration difference (chemical difference) of K+ in ECF and ICF. In neurons, the resting membrane potential is usually about -70 mV, which is close to the equilibrium potential for K+. Here, it is worth noting that RMP is close to the equilibrium potential of K+ but the value of RMP is exactly same as equilibrium potential of Cl-. It is because other ions also diffuse through membrane, though their effect is very little. | train | med_mcqa | null |
Most of the drugs are excreted in ? | [
"Faeces",
"Urine",
"Saliva",
"None"
] | B | Ans. is 'b' i.e., Urine Most impoant channel of excretion for most drugs is through kidney (in urine). EXCRETION OF DRUGS Drugs and their metabolites are excreted in : 1. Urine Through the kidney It is the most impoant channel of excretion for most drugs. Net renal excretion = (Glomerular filtration + tubular secretion) - Tubular reabsorption. Glomerular filtration Depends on plasma protein binding and renal blood flow. Does not depend on lipid solubility. Tubular reabsorption Depends on lipid solubility More lipid soluble drugs are absorbed more and less excreted. Ionized drugs, being less lipid soluble, are more excreted. Acidic drugs (salicylates, barbiturates) are more ionized at alkaline pH. So urine should be alkalinized in poisoning of these drugs. Similarly, urine should be acidified in poisoning of basic drugs (morphine). Tubular secretion Does not depend on plasma protein binding or lipid solubility. This is active transpo of organic acid and bases by two separate classes of relatively nonspecific transpoers (OAT and OCT). In addition, efflux transpoers P-gp and MRP2 are located in the luminal membrane of proximal tubular cells. Organic acid transpo (through OAT) for Penicillin, Probenecid, uric acid, salicylates and sulfinpyrazone. Organic base transpo (through OCT) for diuretics (thiazide, amiloride, furosamide, triameterene), quinine and procainamide. Both transpo processes are bidirectional, for drugs, secretion into the tubular lumen predominates, whereas an endogenous substrate like uric acid is predominantly reabsorbed. 2. Faeces Drugs present in the faeces are derived from unabsorbed fraction plus actively secreted into bile. Drugs that attain high concentration in bile are - Erythromycin ral contraceptives Rifampin Ampicillin Tetracycline Phenolphthalein 4. Exhaled air Gases and volatile liquids are eliminated by lungs. 4. Saliva and sweat These are of minor impoance. Lithium, Pot. iodide and rifampin are present in these secretions. 5. Milk Most drugs enter breast milk by passive diffusion. Lipid soluble and less protein bound drugs cross better. | train | med_mcqa | null |
A 62-year-old woman with multiple myeloma is given pamidronate calcium biphosphonates. This treatment has been shown to do what? | [
"Increase survival",
"Improve quality of life and protect against skeletal fractures",
"Stimulate osteoclast",
"Increase hypercalcemia"
] | B | In multiple myeloma, pamidronate calcium biphosphonates has been found to be useful as an adjunctive treatment, reducing the incidence of skeletal fractures. | train | med_mcqa | null |
Which of the following genes is not associated with Autosomal Dominant Tubulointerstitial Kidney Disease? | [
"MUC1",
"HNF1b",
"UMOD",
"NPHS2"
] | D | Autosomal recessive FSGS results from mutations in the NPHS2 gene, which maps to chromosome 1q25-q31 and encodes the protein product podocin. Autosomal dominant tubulointerstitial kidney disease (ADTKD): Previously known as medullary cystic kidney disease Variable presence of cysts, which often are not located in the medulla Now recognized to be due to following genetic mutations: MUC1 encodes mucin-1 (expressed in distal nephrons) UMOD encodes uromodulin (expressed in thick ascending limb of loop of Henle) REN encodes preprorenin (expressed by juxtaglomerular apparatus) HNF1b encodes hepatocyte nuclear factor 1b, a transcription factor that regulates multiple genes, including UMOD ADTKD is associated with non-specific clinical and pathologic findings and causes progressive renal failure in adult life The pathogenic mechanisms are unknown | train | med_mcqa | null |
Differential diagnosis of a lesion, histologically resembling giant cell tumour in the small bones of the hand/feet, include all of the following except: March 2005 | [
"Fibrosarcoma",
"Enchondroma",
"Hyperpahyroidism",
"Aneurysmal bone cyst"
] | A | Ans. A: Fibrosarcoma Lytic bony lesions: Differential Diagnosis (Mnemonic = FOGMACHINES): F = Fibrous Dysplasia 0 = Osteoblastoma G = Giant Cell Tumour M = Metastasis / Mveloma A = Aneurysmal Bone Cyst C = Chondroblastoma H = Hyperparathyroidism (brown tumours)/ Hemangioma I = Infection N = Non-ossifying Fibroma E = Eosinophilic Granuloma/ Enchondroma S = Solitary Bone Cyst | train | med_mcqa | null |
Cervical incompetence is characterised by:a) 1st trimester abortionb) 2nd trimester abortionc) Premature rupture of membraned) Circlage operation done | [
"bcd",
"acd",
"ac",
"bd"
] | A | null | train | med_mcqa | null |
In a-thalassemia, Hb Bas is said when number of gene loci affected is: | [
"1",
"2",
"3",
"4"
] | D | Answer- D. 4The alpha-thalassemias are caused by inherited deletions that result in reduced or absent synthesis of alpha-globin chains.Normally, there are four alpha-globin genes. | train | med_mcqa | null |
The Lab investigation of patient shows ↓T3, ↓T4,& ↓TSH. It can not be - | [
"Primary hypothyrodism",
"Pan - hypopitutarism",
"Liver disease",
"None of the above"
] | A | null | train | med_mcqa | null |
A 28-year-old female visits the outpatient clinic to receive the required physical examination for an insurance policy. Physical and laboratory examinations give evidence that she is probably a normal, healthy woman. A radiograph of the patient is shown below. Which of the following is the most likely diagnosis? | [
"Cholecystitis",
"Carcinoma of the liver",
"A caudal extension of the right hepatic lobe (Riedel lobe)",
"Pancreatic carcinoma"
] | C | Because physical and laboratory tests show a normal, healthy woman, the anomaly of the radiograph would be expected to be benign. Riedel's lobe is a normal variation of the liver, often an inferior extension of the right lobe of the liver, lateral to the gallbladder that extends about 4 or 5 cm below the rib cage. Carcinomas would present with abnormal laboratory examinations, and cholecystitis would present with an abnormal physical examination, as when the gallbladder is inflamed. | train | med_mcqa | null |
Which of the following is not true of Actinomycosis? | [
"Demonstration of filaments",
"Caused by Actinomyces israelii",
"Organism cannot be cultured",
"Sulphur granules in pus"
] | C | Ans. is 'c' i.e., Organism cannot be culturedRef: (Ananthanarayan, 8th/e, p. 393; 9th/e, p. 394; Harrison, 18th/e, p. 1324; Jawetz, 24th/e, p. 182)Pus containing sulfur granules are washed and cultured anaerobically in thioglycollate broth or Brain heart infusion (BHI) agar. | train | med_mcqa | null |
A 9 month old infant presents with a 2- day history of fever, cough and breathlessness following an upper respiratory infection. She is febrile and has a respiratory rate of 80/min. Intercostal and subcostal retractions and extensive rhonchi on auscultation. A chest X-ray reveals a hyperinflated chest - | [
"Bronchial asthma",
"Foreign body aspiration",
"Bacterial pneumonia",
"Bronchiolitis"
] | D | Ans. is 'd' i.e., Bronchiolitis | train | med_mcqa | null |
True about p53 -a) Tumor suppressor geneb) Protooncogenec) Proapoptoticd) Encodes 53KDe) Arrest cell cycle in G1 | [
"bce",
"bde",
"abcd",
"acde"
] | D | p 53 is a tumor suppressor gene and it is aproapoptotic factor, i.e. it promotes apoptosis if repair of DNA damage is unsuccessful at G1 arrest.
The name p53 is in reference to its apparent molecular mass; it runs as a 53 kilodalton (Kda) protein on SDS-page. But based on calculations from its amino acid residues, p53's mass is actually only 43.7 K Da.
P53 (Guardian of the Genome /Molecular Policeman)
The p53 gene is located on the short arm (p) of chromosome 17(17pl3.1)
It is the most common target for genetic alteration in human tumors Q A little over 50% of human tumors contain mutations in this gene The p53
gene derives its name from its apparent molecular mass (It is a 53 k D protein)
Q The major functional activities of the p53 protein are cell -cycle arrest & initiation of apoptosis in response to DNA damage Normal (Wild Type)
it function as a tumor suppressor gene & function as a critical gatekeeper against the deveiopment of cancel Q The p53 gene is located in the nucleus & functions
as a nuclear transcription factor Two major functions are: In blocking mitotic activity: p53 inhibit cyclins & cyclin dependent kinase(CDK)
& prevents the cell to enter G1 phase transiently'' .This allow the normal cell to repair the DNA damage In promoting apoptosis :
p53 gene directs cells that have damaged DNA to apoptosis by activating apoptosis inducing BAX genes & thus brings the defective cells to an end.
This process operates in the cell cycle at G1 & G2 phase before the cell enters theS or M phase Q Mutant p53 gene
The wild type of p53 gene may undergo mutations that inactivates or alter the normal function of p53
Presence of mutant p53 gene in tumor celts predicts apoor response to radiotherapy & chemotherapy (poor prognostic factor) Q
Inheritance of one mutant p53 allele predisposes individua Is to develop malignant tumors because only one additional hit is needed to inactivate
the second normal allele- second hit phenomenon Q Most p53 mutation are acquired in somatic cells that inactivate or alter the normal function of p53
gene Tumors expressing mutantp53 genes are more resistant to radiation therapy & chemotherapy than tumors with wild type p53 | train | med_mcqa | null |
Which classification is used to divide the liver into segments? | [
"Couinaud",
"Muhe",
"Starzl",
"Anatomical"
] | A | Ans. (a) Couinaud'sRef: Bailey and Love 26th edition page 1066* Couinaud divided the liver into multiple segments- 8 segments* He is a French Anatomist | train | med_mcqa | null |
Process of mixing waste with cement before disposal is known as ? | [
"Ineization",
"Controlled tipping",
"Sanitary landfill",
"Burial"
] | A | Ans. is 'a' i.e., Ineization The process of ineization involves mixing waste with cement and water substances before disposal to minimize the risk of toxic substances contained in the waste migrating into surface water or groundwater. It is especially suitable for pharmaceuticals and for incineration ashes with a high metal content (in this case, the process is also called "stabilization"). | train | med_mcqa | null |
Extracellular hyaline change is seen in: September 2009 | [
"Aeriosclerosis",
"Chronic glomerulonephritis",
"Leiomyoma",
"Alcoholic hyaline"
] | A | Ans. A: Aeriosclerosis Hyaline change is any alteration within cells or in the extracellular spaces or structures that gives a homogeneous, glassy pink appearance in tissue sections stained with hematoxylin and eosin Extracellular hyaline change: - Hyaline aeriolosclerosis - Atherosclerosis - Damaged glomeruli. Intracellular hyaline change: Intracellular hyaline change is seen in renal tubular epithelium in proteinuria. - Russell bodies in plasma cells. Viral inclusions in the cytoplasm or in the nucleus. - Alcoholic hyaline. | train | med_mcqa | null |
The reaction: succinyl CoA + acetoacetate and acetoacetyl CoA + succinate occurs in all of the following Except | [
"Brain",
"Striated muscle",
"Liver",
"Cardiac muscle"
] | C | Thiophorase (acetoacetate - succinyl CO A, Co A transferase) is the enzyme responsible for the transfer of Co A to acetoacetate conveing it into acetoacetyl Co A which is responsible for utilization of ketone bodies. Liver cells do not have enzyme thiophorase and so they can not utilize ketone bodies. | train | med_mcqa | null |
A very preterm baby on 30 mL/kg of enteral feeding developed sudden severe abdominal distension with visible bowel loops on day 6 of life. The baby also showed temperature instability and lethargy. s-ray of the abdomen showed poal venous gas. The staging of NEC is: | [
"lb",
"2a",
"2b",
"3a"
] | C | Ans. c. 2b | train | med_mcqa | null |
A patient with nephrotic syndrome on longstanding coicosteroid therapy may develop all the following except: | [
"Hyperglycemia",
"Hyperophy of muscle",
"Neuropsychiatric symptoms",
"Suppression of the pituitary adrenal axis"
] | B | Answer is B (Hyperophy of muscle): | train | med_mcqa | null |
Treatment resistant hypokalemia is caused by: | [
"Administration of granulocyte colony stimulating factor",
"Clay ingestion",
"Barium toxicity",
"Hypomagnesemia"
] | D | All the given options are known to cause hypokalemia but with different mechanisms. And only hypomagnesemia is described to cause treatment resistant hypokalemia among the following. Must Know: Systemic hypomagnesemia can cause treatment resistant hypokalemia due to 1. Reduced cellular uptake of potassium 2. Exaggerated renal excretion Administration of granulocyte colony stimulating factor will lead to hypokalemia as it is an anabolic state (White blood cell production). Vitamin B12 / Folic acid administration and total parenteral nutrition also will lead to hypokalemia with similar mechanism. Clay ingestion leads to hypokalemia due to decreased intake Toxic Barium ions inhibits K channels and inhibits the passive efflux of K leading to hypokalemia. Ref: Harrison, Edition-18, page-351. | train | med_mcqa | null |
Which of the following helps in generating reactive oxygen intermediate in the neutrophil | [
"NADPH oxidase",
"SOD (superoxide dismutase)",
"Catalase",
"Glutathione peroxidase"
] | A | Ref Robbins 9/e p79 Killing and Degradation of Phagocytosed Microbes. The culmination of the phagocytosis of microbes is killing and degradation of the ingested paicles. The key steps in this reaction are the production of microbicidal substances within lysosomes and fusion of the lysosomes with phago- somes, thus exposing the ingested paicles to the destruc- tive mechanisms of the leukocytes (Fig. 2-8). The most impoant microbicidal substances are reactive oxygen species (ROS) and lysosomal enzymes. The production of ROS involves the following steps: * Phagocytosis and the engagement of various cellular receptors stimulate an oxidative burst, also called the respiratory burst, which is characterized by a rapid increase in oxygen consumption, glycogen catabolism (glycogenolysis), increased glucose oxidation, and production of ROS. The generation of the oxygen metabolites is due to rapid activation of a leukocyte NADPH oxidase, called the phagocyte oxidase, which oxi- dizes NADPH (reduced nicotinamide adenine dinucleo- tide phosphate) and, in the process, conves oxygen to superoxide ion (O2 * ) (see Fig. 1-18, B, Chapter 1). * Superoxide is then conveed by spontaneous dismuta- tion into hydrogen peroxide (O2 * + 2H+ - H2O2). These ROS act as free radicals and destroy microbes by mecha- nisms that were described in Chapter 1. * The quantities of H2O2 produced generally are insuffi- cient to kill most bacteria (although superoxide and hydroxyl radical formation may be sufficient to do so). However, the lysosomes of neutrophils (called azuro- philic granules) contain the enzyme myeloperoxidase (MPO), and in the presence of a halide such as Cl- , MPO conves H2O2 to HOCl* (hypochlorous radical). HOCl* is a powerful oxidant and antimicrobial agent (NaOCl is the active ingredient in chlorine bleach) that kills bacteria by halogenation, or by protein and lipid peroxidation. Founately, the phagocyte oxidase is active only after its cytosolic subunit translocates to the membrane of the pha- golysosome; thus, the reactive end products are generated mainly within the vesicles, and the phagocyte itself is not damaged. H2O2 is eventually broken down to water and O2 by the actions of catalase, and the other ROS also are degraded (Chapter 1). Reactive nitrogen species, paicu- larly nitric oxide (NO), act in the same way as that described for ROS. | train | med_mcqa | null |
RPGN occurs in A/E: | [
"SLE",
"Post streptococcal glomerulonephritis",
"Diabetic nephropathy",
"Good pastures syndromes"
] | C | Answer is C (Diabetic Nephropathy) Diabetic Nephropathy is not associated pith rapidv protTessive Glomerulonephritis (RPGN). Acute post streptococcal GN, SLE and Good pasture's syndrome are all associated with Rapidly progressive Glomerulonephritis. | train | med_mcqa | null |
During normal conversation sound heard at 1 meter distance is- | [
"80 dB",
"60 dB",
"90dB",
"120 dB"
] | B | Ans. is 'b' i.e., 60dB o Intensity is the strength of sound which determines its loudness. It is usually measured in decibels (dB).o Following are intensities when a person is at a distance of one meter from sound source. IntensityWhisper30 dBNormal conversation60 dBShout90 dBDiscomfort of ear120 dBPain in ear130dB | train | med_mcqa | null |
Fisch classification is used for? | [
"Paravertebral tumours",
"Glomus tumor",
"Synovial sarcomas",
"Retroperitoneal tumours"
] | B | ANSWER: (B) Glomus tumorREF: Cranial Microsurgery: Approaches and Techniques by Laligam Sekhar, Evandro de Oliveira page 487Paragangliomas of the temporal bone are generally divided intoThose that originate within the middle ear: Glomus tympankum tumorsThose that originate within the jugular fossa: Glomus jugulare tumors.Classification systems that have been developed for temporal bone paragangliomas are used for staging purposes. Surgical planning and comparison among different therapeutic modalities. The Glasscock-Jackson and Fisch classifications are the most widely employed.Glasscock-Jackson Classification of Temporal Bone ParagangliomasType I- Small tumor involving the jugular bulb, middle ear and mastoidType II- Tumor extending under internal auditory canal: might have intracranial extensionType III- Tumor extending into petrous apex: might have intracranial extensionType IV- Tumor extending beyond petrous apex into clivus or infratemporal fossa: might have intracranial extensionFisch Classification of Temporal Bone ParagangliomasClass A: Tumors limited to the middle ear cleftClass B: Tumors limited to the tympanomastoid area without destruction of bone in the infralabyrinthine compartmentClass C: Tumors extending into and destroying bone of the infralabyrinthine and apical compartments of the temporal boneCl: Tumors destroying the bone of the jugular foramen and jugular bulb with limited involvement of the vertical portion of the carotid canalC2: Tumors destroying the infralabyrinthine compartment of the temporal bone and invading the vertical portion of the carotid canalC3: Tumors involving the infralabyrinthine and apical compartments of the temporal bone with invasion of the horizontal portion of the carotid canalClass D: Tumors with intracranial extensionDl: Tumors with intracranial extension up to 2 cm in diameterD2: Tumors with an intracranial extension greater than 2 cm in diameterD3: Tumors with inoperable intracranial extension | train | med_mcqa | null |
Macula cerulea is seen in – a) Pediculosis humanis corporisb) Pediculosis capitisc) Pthiris pubisd) Lupus erythematosis | [
"a",
"ac",
"ad",
"b"
] | B | Maculae ceruleae (blue - gray macules) occur in pediculosis corporis & P. pubis. | train | med_mcqa | null |
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