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 |
|---|---|---|---|---|---|---|
Lysozyme is present in | [
"Saliva",
"Human milk",
"Tears",
"Mucus"
] | A | There are numerous defense proteins present in the saliva. Some of these defense proteins, like salivary immunoglobulins, and salivary chaperokine HSP70/HSPA, are involved in both innate and acquired immune activation . Salivary cationic peptides and other salivary defense proteins, like lysozyme, BPI, BPI-like and PLUNC proteins, salivary amylase, cystatins, proline-rich proteins, Ref: <a href=" | train | med_mcqa | null |
In Sickle Cell Anaemia defect is in which chain: | [
"Alphachain",
"Beta chain",
"Both the chains",
"None of these"
] | B | Beta chain | train | med_mcqa | null |
In a child with acute liver failure, the most important abnormal serum biochemical test that indicates poor prognosis: | [
"Increasing transaminases",
"Increasing bilirubin",
"Increasing prothrombin time",
"Reversal of serum albumin-globulin ratio"
] | C | C. Increasing prothrombin time(Ref: Nelson's 20/e p 1967)Hepatic synthetic function is reflected in serum albumin and protein levels and in the PT or INRUnresponsiveness of PT to vitamin K suggests severe hepatic diseasePersistently low levels of factor VII are evidence of a poor prognosis in fulminant liver diseaseSerum aminotransferase activities do not correlate well with the severity of the illness. | train | med_mcqa | null |
National Leprosy Eradication Programme was started in – | [
"1949",
"1955",
"1973",
"1983"
] | D | null | train | med_mcqa | null |
DNA fingerprinting is based on possessing in DNA of - | [
"Constant Tandem Repeat",
"Variable Number Tandem Repeats (VNTR)",
"Non-repeatative sequence",
"Exon"
] | B | Variable number of tandem (one after another) repeats (VNTR), is unique for any individual & therefore serves as molecular DNA fingerprint. VNTR may be short tandem (microsatellite) or large tandem (minisatellite) repeats. | train | med_mcqa | null |
Asteroid bodies and cigar shaped globi may be produced by- | [
"Histoplasmosis",
"Sporotrichosis",
"Candida",
"Aspergillus"
] | B | Sporotrichosis or Rose Gardner's disease - Chronic subcutaneous pyogranulomatous disease Caused by a thermally dimorphic fungus Sporothrix schenckii. Mould: Flower like sporulation Laboratory Diagnosis: Direct Microscopy by H and E staining of tissue sections reveals cigar shaped asteroid bodies. It is described as central basophilic yeast cell surrounded by eosinophilic mass, composed of antigen-antibody complexes. Such eosinophilic halo is described as Splendore-Hoeppli phenomenon. | train | med_mcqa | null |
Substance ideal for GFR estimation is? | [
"Inulin clearance",
"PAH clearance",
"Urea clearance",
"All of the above"
] | A | Ans: a (Inulin clearance)^/: Ganong, 22nd ed,p. 706GFR can be measured in intact experimental animals and humans by measuring the excretion and plasma level of a substance that is freely filtered through the glomeruli and neither secreted nor reabsorbed in the tubules.Inulin is a polymer of fructose with a molecular weight of 5200 obtained from Dahlia tubers, meets the above criterion and is extensively used to measure GFR.Remember Ideal substance to measure GFR-InulinSubstance used for practical purposes-CreatinineSubstance used to measure renal blood flow-PAHNormal GFR of human beings-125 ml/min ClearanceCx=UVP=Urine concentrationsne flow/time (V)Plasma concentration. | train | med_mcqa | null |
True about pterygium is - | [
"It is common on the temporal side",
"It is common with exposure to UV rays",
"It is a neoplastic condition",
"All pterygia need to be operated"
] | B | Ans. is 'b' i.e., It is common with exposure to UV rays Pterygiumo Pterygium is a non-cancerous (non-neoplastic) growth of conjunctiva, characterized by a wing-shaped fold of conjunctiva encroaching upon the cornea from either side within the interpalpebral fissure. Pterygium is always situated in the palpebral aperture.o Pathologically Pterygium is a degenerative and hyperplastic condition of conjunctiva. The subconjunctival tissue undergoes elastotic degeneration and proliferates as vascularized granulation tissue under the epithe Hum, which ultimately encroaches the cornea. The corneal epithelium, Bowman's layer and stroma are destroyed.Etiology & Clinical featureso Pterygium is more common in people with excess outdoor exposure to sunlight (UV rays), dry heat, high wind and abundance of dust. Therefore it is more common in those who work outdoorso Clinically it presents as a triangular fold of conjunctiva encroaching the cornea in the area of palpebral aperture, usually on the nasal side. Other findings are Stocker's line (deposition of iron)o Ptergyium is an asymptomatic condition in the early stages, except for cosmetic intolerance. Visual disturbance or corneal astigmatism may occur. Visual disturbances are due to encroachment of pterygium on pupillary area or corneal astigmatism.Occasionally diplopia may occur due to limitation of ocular movements.Treatmento Asymptomatic pterygium which is not progressive is best left alone. Surgical excision is the only satisfactory treatment and is indicated for:1) Cosmetic reasons,2) Continued progression threatening to encroach onto the pupillary area (once the pterygium has encroached pupillary area, wait till it crosses on the other side),3) Diplopia due to interference in ocular movement.o Simple excision ('bare sclera' technique) is associated with high recurrence rate (upto 80%) that may be more aggressive than the initial lesion. Thus conjunctival autografting is currently most popular approach. Adjunctive treatment with mitomycin C, beta-irradiation, and amniotic membrane patch grafting can also be used for aggres sive lesions. | train | med_mcqa | null |
19 years old girl has multiple papulo pustular erythematous lesions on face and neck, the likely diagnosis is | [
"Acne rosacae",
"Acne Vulgaris",
"Pityriasis Versicolour",
"Lupus Vulgaris"
] | B | B i.e. Acne Vulgaris | train | med_mcqa | null |
Which is not true about cystic hygroma | [
"Aspiration is diagnostic",
"About 50% of them are present at bih",
"Presents as posterior cervical swelling",
"Sequestration of lymphatic tissue"
] | A | Cystic hygroma Cystic hygroma is a swelling usually occurring in the lower third of the neck It is most commonly seen in the posterior triangle of the neck, but may also occur in axilla, groin & mediastinum It results due to sequestration of a poion of the jugular lymph sac from the lymphatic system. It usually manifests in the neonate or in early infancy (occasionally present at bih) The swelling is soft and paially compressible and invariably increases in size when the child coughs or cries. The characteristic that distinguishes it from all other neck swellings is that it is brilliantly translucent. The cysts are filled with clear lymph and are lined by endothelium. Mostly these are multiple cysts but occasionally they can be unilocular. It may show spontaneous regression. "Roughly 50% to 65% of hygromas prsent at bih, with most becoming apparent by the second year of life." Ref : Sabiston 18/e p2052 | train | med_mcqa | null |
Which of the following is most preferred graft in CABG? | [
"Saphenous vein",
"Radial aery",
"Internal mammary aery",
"Internal jugular vein"
] | C | Vascular graft Bioprosthetic Synthetic Autograft Homograft (allograft) Heterograft (xenograft) Tissue engineered Textile Dacron Non textile ePTFE Polyurethane Best natural vascular graft: Reversed saphenous vein Best synthetic vascular graft: Dacron Best vascular graft for supra inguinal bypass: Dacron Best vascular graft for infra inguinal bypass: Saphenous vein Best vascular graft for aoa: Dacron Most preferred graft for CABG: LIMA (left internal mammary aery) > Saphenous vein MC used graft for CABG: Saphenous vein | train | med_mcqa | null |
About Retinitis pigmentosa all are true EXCEPT: | [
"Night blindness",
"Waxy disc",
"Early loss of central vision",
"Attenuation of retinal vessels"
] | C | ANSWER: (C) Early loss of central visionREF: khurana 4th ed p. 260-262Retinitis pigmentosaNight blindness is earliest featureDefective dark adaptationPartial or ring scotomaTubular visionLoss of central vision by age of 50-60 yearsFundus changesRetinal pigmentary changes typically perivascular and resemble bone corpuscles in shapeAttenuated or narrowed retinal arteriolesPale and waxy optic discs | train | med_mcqa | null |
A patient presents with B/L proptosis, heat intolerance and palpitations; most unlikely diagnosis here would be - | [
"Hoshimoto's thyroiditis",
"Thyroid adenoma",
"Diffuse thyroid goitre",
"Reidel's thyroiditis"
] | C | Ans. is 'c' i.e., Riedel's Thyroiditis As already mentioned above, a patient with Reidel's thyroiditis may present with hypothyroidism, but never with hypehyroidism. But one should be aware that thyroid ophthalmopathy is seen mainly in Grave's disease and very rarely in any other cause of hypehyroidism. Also know Diff. between hypehyroidism and thyrotoxicosis Thyrotoxicosis is the state of thyroid hormone excess and hypehyroidism means excessive thyroid function. Both are not synonyms, however the major causes of thyrotoxicosis are hypehyroidism caused by Grave's disease, toxic multinodular goitre and toxic adenomas. Causes of Thyrotoxicosis Primary hypehyroidism Grave's disease Toxic multinodular goitre Toxic adenoma Functioning thyroid carcinoma metastasis Activating mutation of the TSH Receptor - Activating mutation of Gsa (McCune-Albright syndrome) Struma ovarii (thyroid tissue within ovarian tumor) Jod-Basedow phenomenon (or iodine-induced hypehyroidism) : thyrotoxicosis may occur in patients with multinodular goitre, after intake of large amounts of iodine, in the diet or in the form of radiographic contrast material or drugs, especially amiodarone. Thyrotoxicosis without hypehyroidism Subacute thyroiditis - Silent thyroiditis Hashimoto's thyroiditis - transient hypehyroidism is seen during the initial destructive phase Other causes of thyroid destruction : amiodarone, radiation, infarction of adenoma Thyrotoxicosis factitia : thyrotoxis due to ingestion of excessive amounts of exogenous thyroid hormone or thyriod tissue Secondary hypehyroidism TSH secreting pituitary adenoma Thyroid hormone resistance syndrome : occasional patients may have features of thyrotoxicosis. Chorionic gonadotropin-secreting tumors Gestational thyrotoxicosis. | train | med_mcqa | null |
Low serum haptoglobin in hemolysis masked as - | [
"Pregnancy",
"Liver disease",
"Bile duct obstruction",
"Malnutrition"
] | C | . Bile duct obstruction | train | med_mcqa | null |
Not true about Intracapsular neck fracture | [
"< 1 inch shortening",
"< 45 degree of external rotation",
"Trivial trauma can cause fracture",
"Severe pain around hip"
] | D | null | train | med_mcqa | null |
Which of the following if seen on day 10 of life is worrisome? | [
"Unconjugated hyperbilirubinemia",
"Conjugated hyperbilirubinemia",
"No weight again",
"Doll's eye reflex"
] | B | Ans. b. Conjugated hyperbilirubinemia (Ref: Nelson 19/e p34, 640)Conjugated hyperbilirubinemia, if seen on day 10 of life is worrisome.'Hyperbilirubinemia is a common and, in most cases, benign problem in neonates. Nonetheless, untreated, severe indirect hyperbilirubinemia is potentially neurotoxic, and conjugated-direct hyperbilirubinemia often signifies a serious hepatic or systemic illness. Jaundice is observed during the 1st week of life in approximately 60% of term infants and 80% of preterm infants. - Nelson 19/e p640Neonatal Period (First 4 weeks)Visual Milestone: May fixate face or light in line of vision; 'doll's-eye' movement of eyes on turning of the body.Hyperbilirubinemia is a common and. in most cases, benign problem in neonates. Nonetheless, untreated, severe indirect hyperbilirubinemia is potentially neurotoxic, and conjugated-direct hyperbilirubinemia often signifies a serious hepatic or systemic illness. Jaundice is observed during the 1st week of life in approximately 60% of term infants and 80% of preterm infants. | train | med_mcqa | null |
The optical density of gross fog is: | [
"0.6-3.0",
"0.2-0.3",
"0.2-0.6",
"None of the above"
] | B | An unexposed film, when processed, shows some density. This appearance is caused by the inherent density of the base and added tint and the development of a few unexposed silver halide crystals. This minimal density is called base plus fog and typically is 0.2 to 0.3.
White and Pharoah's Oral Radiology Principles and Interpretation 8th edition | train | med_mcqa | null |
Hyper viscosity is seen in | [
"Cryoglobulinemia",
"Multiple myeloma",
"MGUS",
"Lymphoma"
] | A | Ref William hematology 6/e p1268 The term cryoglobulinemia refers to the presence in the serum of proteins that precipitate at temperatures below 37 degrees C and redissolve on rewarming. ... The elective treatment for hyperviscosity syndrome, whether associated with monoclonal, mixed, or polyclonalcryoglobulinemia, is plasma exchange. | train | med_mcqa | null |
The tests which usually help in determine the Gunshot residue in the clothing's except: | [
"Modified Greiss test",
"Sodium rhodizonate reaction",
"Energy dispersive X-ray (EDX)",
"Vaccum metal deposition method"
] | D | Clothing may be tested for presence of GSR Modified Greiss test(specific for nitrites):- - It uses chemicals (alpha-naphthol) to produce visual display of GSR pattern and density of paicles. Sodium rhodizonate reaction - detects lead from primer or bullet wipe. Energy dispersive X-ray (EDX) - detects barium, antimony, lead and copper around the entry wound in clothing - It can be used to determine the range of fire. Vaccum metal deposition method- used for fingerprint development. | train | med_mcqa | null |
Raynaud's syndrome occurs in all of the following except: September 2007 | [
"SLE",
"Rheumatoid ahritis",
"Osteoahritis",
"Cryoglobulinemia."
] | C | Ans. C: Osteoahritis Although Raynaud phenomenon has been described with various autoimmune diseases, the most common association is with progressive systemic sclerosis (90% in individuals with scleroderma) and mixed connective-tissue disease (85% prevalence). Raynaud phenomenon has also been described with such diverse diseases as systemic lupus erythematosus (SLE), rheumatoid ahritis and other disorders not classified as autoimmune, including frostbite, vibration injury, polyvinyl chloride exposure, and cryoglobulinemia. | train | med_mcqa | null |
Klinefelter syndrome is diagnosed by: | [
"USG abdomen",
"Echocardiography",
"Triple test",
"Karyotyping"
] | D | Klinefelter's syndrom (XXY) can be detected by karyotyping Karyotyping Study of chromosome Best technique for Monosomy/Trisomy But can be only done during Metaphase Sample used: Blood, Bone marrow, Amniotic fluid, Placental tissue Fixative : Carnoy's fixative (Methanol and Glacial Acetic acid in ratio 3:1) Most common stain: Geimsa/G-banding Limitations Can't be done in any phase of cell cycle Can't detect amplifications, microdeletions and complex translocations Low resolution i.e. subchromosomal alterations can't be detected | train | med_mcqa | null |
Conscious sedation is ? | [
"CNS depression with uncociousness",
"Sedation with inability to respond to command",
"Sedation with ability to respond to command",
"Any of the above"
] | C | Ans. is 'c' i.e., Sedation with ability to respond to command Conscious sedation is a technique in which drugs are used to produce a state of CNS depression (but not unconsciousness), enabling surgical procedure to be carried out while maintaining communication with the patient who is able to respond purposefully to commands and maintain a patent airway throughout. The protective airway reflexes are not lost, therefore conscious sedation is safer. However, by itself, it is not able to suppress pain of dental procedures; local anaesthetic must be injected in addition. Drugs used for conscious sedation are - N,O Diazepam or midazolam Propofol IM promethazine IV fentanyl | train | med_mcqa | null |
Human genome contains -- base pairs | [
"3xl09",
"3xl08",
"3xl07",
"3xl06"
] | A | (3 x 109) (445 - Lippencott's 3rd) (321-HP27th)The human genome contains DNA with approximately three billion (109) base pairs that encode 30.000 to 40,000 genes located on 23 pairs of chromosomes | train | med_mcqa | null |
Well defined rounded opacity is the lung with cause irregular calcification is a feature of: | [
"Hamaoma",
"Hydatid cyst",
"Amoebic abscess",
"Ca lung"
] | A | Ans. Hamaoma | train | med_mcqa | null |
The causes of homogenous opacity on X-ray is all except: | [
"Pleural effusion",
"Diaphragmatic hernia",
"Massive consolidation",
"Emphysema"
] | D | Ans. Emphysema | train | med_mcqa | null |
Which is non-sense codon - | [
"UGG",
"AUG",
"UGA",
"CCA"
] | C | Ans. is 'c' i.e., UGA Stop codons or nonsense codons or termination codonso Three of the 64 possible nucleotide triplets UAA (amber), UAG (Ochre) and UGA (opal) do not code for any amino acid.o They are called nonsense codons that normally signal termination of polypeptide chains.o Thus, though there are 64 possible triplet codons, only 61 codes for 20 amino acids (as remaining three are non-sense codons). | train | med_mcqa | null |
What is the sequence in which the following milestones are attained? | [
"A - B - C - D",
"C - B - A -D",
"D - C - B - A",
"C - B - D - A"
] | D | A - Ties shoe laces -5 years B - Copies circle - 3 years C - Feeds self with spoon - 18 months D- Buttons & unbuttons - 4 years | train | med_mcqa | null |
AH of the following are true about H. pylori EXCEPT | [
"Maximum concentration is in gastric pit",
"Urease breath test is sensitive",
"Gram negative spiral rod",
"Blood group A is more susceptible"
] | A | (A) Maximum concentration is in gastric pit# H. pylori is a Gram-negative spiral rod, motile by a unipolar tuft of lopotrichous flagella.> The bacteria are present only in the overlying mucus & do not invade the mucosa. Gastric antrum is the commonest site of colonization, though any part of the stomach may be involved. | train | med_mcqa | null |
omission was given by | [
"wernicke",
"alois alzeimer",
"skinner",
"pruisner"
] | C | Behavioral therapy is learning given by BF Skinner , according to him all behaviors are learned phenomenon and thus can be unlearned Positive reinforcement a type of reinforcement when a behavior is rewarded there is more chance that the behavior is repeated Negative reinforcement is that when a behavior is done and an aversive response is removed, the behavior is repeated. When I go and meet my girlfriend, she checks my messages and picks up fight (aversive response) suddenly I delete all messages one day and that day there was no fight (no aversive response) then that behavior is repeated (delete all messages before meeting my girlfriend) Extinction is the type of reinforcement where a behavior is done and a rewarding response is removed the chance is that behavior will not be repeated A child likes to play with children( reward) but when the child fights with other children( undesirable behavior) the child will be removed from playing( removing a reward) , then the child stops fighting with other children( reduction of undesirable behaviour) Ref. kaplon and sadock synopsis, 11 th edition, pg no. 845 | train | med_mcqa | null |
A normal child develops the ability to uses 10 words with meaning at the age of _______ | [
"12 months",
"15 months",
"18 months",
"24 months"
] | C | Developmental milestones:- GROSS MOTOR DEVELOPMENT: 2 months: Holds head in plane of rest of the body when held in ventral suspension. In prone position in bed, the chin lifts momentarily. 3 months:lift head above the plane of the body. Head control stas by 3 months and fully developed by 5 months. 4 months:Remain on forearm suppo if put in prone position, lifting the upper pa of the body off the bed. 5 months: Rolls over. 6 months:sit in tripod fashion. 8 months: sits without suppo., crawling 9 months: Takes a few steps with one hand held. Pulls to standing and cruises holding on to furniture by 10 months. 10 months: creeps 12 months:creeps well, walk but falls, stand without suppo. 15 months: walks well, walks backward/ sideways pulling a toy. May crawl upstairs. 18 months: Runs, walks upstair with one hand held. Explores drawers 2 years: walk up and downstairs, jumps. 3 years : rides tricycle, alternate feet going upstairs. 4 years: hops on one foot, alternate feet going downstairs. 5 years:skips FINE MOTOR DEVELOPMENT:- 2 months- eyes follow objects to 180 deg. 3 months-Grasp reflex disappears and hand is open most of the time. 4 months- Bidextrous approach( reaching out for objects with both hands). 6 months- Unidextrous approach( Reach for an object with one hand). 8 months- radial grasp sta to develop. Turns to sound above the level of ear. 9 months- immature pincer grasp, probes with forefinger. 12 months-Unassisted pincer grasp. Releases object on request.Uses objects predominantly for playing, not for mouthing. Holds block on each hand and bang them together. 15 months- imitate scribbling , tower of two blocks 18 months- scribbles, tower of 3 blocks.turn pages of a book, 2-3 at a time. 2 years- tower of 6 blocks, veical and circular stroke. 3 years-Tower of 9 blocks, dressing and undressing with some help, can do buttoning. 4 years- copies cross, bridge with blocks 5 years- copies triangle, gate with blocks. SOCIAL AND ADAPTIVE MILESTONES: 2 months: social smile(smile after being talked to).watches mother when spoken to and may smile. 3 months:Recognizes mother, anticipates feeds. 4 months: Holds rattle when placed in hand and regards it . Laughs aloud. Excited at the sight of food. 6 months:recognizes strangers, stranger anxiety . Enjoy watching own image in mirror, shows displeasure when toy pulled off. 9 months:waves bye bye 12 months:comes when called, plays simple ball game.kisses the parent on request. Makes postural adjustments for dressing. 15 months:jargon, stas imitating mother. 18 months: copies parents in tasking, dry by day, calls mother when he wants potty, points to three pas of body on request. 2 years: ask for food, drink, toilet, pulls people to show toys. 3 years:shares toys, know fullname and gender, dry by night. 4 years:Plays cooperatively in a group, goes to toilet alone, washes face, brushes teeth. Role play . 5 years:helps in household task , dresses and undresses. LANGUAGE MILESTONES: 1 month: Ales to sound. 2 month:respond to sound by stale or quitening to a smooth voice. 3 months: babbles when spoken to. Makes sounds (ahh,coos, ) laughs. 4 months: laughs aloud. 6 months: monosyllables 9 months: understands spoken words, bisyllables. 12 months: 1-2 words with meaning. 18 months: vocabulary of 10 words. Can name one pa of body. 2 years: 3 word simple sentences 3 years:asks questions, knows full name and gender. 4 years: says songs or poem, tells story, knows three colours. 5 years: ask meaning of words. Reference: GHAI Essential pediatrics, 8th edition | train | med_mcqa | null |
ORS required during first 4 hours in a 20 kg child - | [
"200-400 ml",
"400-600 ml",
"600-800 ml",
"1200-2200 ml"
] | D | null | train | med_mcqa | null |
Post coital test showing non motile sperms in the cervical smear and Motile sperms from the posterior fornix suggests: | [
"Faulty coital practice",
"Immunological defect",
"Hypospadias",
"Azoospermia"
] | B | Post coital test showing non motile sperms in the cervical smear and motile sperms in the posterior forix suggest that the sperms are normal and motile when they reach forenix. After that in cervix they become inmotile, i.e antisperm artibodies are present in the cervix, i.e imunlogical defect seen. | train | med_mcqa | null |
Drugs used for recurrant depressive episode: | [
"Imipramine",
"Carbazepine",
"None",
"Na valproate"
] | A | A i.e. Imipramine There is no ideal antidepressant. First choice is determined by side effect profile least objectionable to patient's physical status, severity of disorder including self harm, patient preference & nature of any associated illnessQ In recurrent depression, continuation treatment of choice will be which ever (any) antidepressant has been effective & well toleratedQ. Guidelines for medical management of (unipolar) major depression Objective of treatment is remission of symptoms, not just symptom reduction as patients with residual symptoms are more likely to experience relapse or recurrence. Significant therapeutic effect may take 3-4 weeks although some may be seen earlier. Most common mistake 1/t unsuccessful trial is the use of too low a dosage for too sho time. An antidepressant need to be continued for a minimum duration of 6 weeks (oxford) /4-5 weeks (kaplan) at adequate or high dose before being considered as unsuccessful. If not responding, plasma conc. of drug is obtained at 2 or 3 weeks to find out non compliance or unusual pharmacokinetics. There is no ideal antidepressant. First choice is determined by side effect profile least objectionable to patient's physical status, severity of disorder including self harm, patient preference & nature of any associated illnessQ Since SSRIs are comparatively free of side effects and are not costly, they are generally recommended as first choice antidepresantsQ. Where there is a previous h/o response to a specific drug or class, the best first choice is that antidepressantQ. Symptom pattern and therapeutic use of side effects (such as sedating amitriptyline for more anxious and more activating desipramine for psychomotor retardation) is not a good guide to treatment. Despite widespread use of SSRIs, there is no evidence that this class is more efficacious than TCA. Selecting second option: Switching to a new single treatment rather than augmenting is preferred after initial medication failure. Whereas augmentation is helpful with patients who have gained some benefit from initial treatment but who have not achieved remission. Switch should be to an antidepressant of a different class or to broad action SNRI. Lithium > thyroid hormone are best documented augmentations. For non responsive & resistant cases not responding to Li or thyroid hormone variety of other augmenters such as tryptophan, pindolol, buspirone, and combinations of antidepressants such as SSRIbupropion (widely used), SNRI-mitrazepine, TCA-MAOI may be tried. ECT is an alteranative 2^d choice in very severe depression or for repeatedly non responsive cases. Begin new medication at 1/3 to 1/2 target dose if drug is TCA, bupropion, venlafaxine or mitrazapine, or full dose as tolerated if drug is an SSRI. For sedative ADD, administration of 2/3 of drug dose at night may avoid hypnotic. Bed time doses of stimulant anti depressant (ADD) such as SSRIs and older MAOIs should be avoided. ECT may be used as 1s, choice treatment in severe depression with psychomotor retardation or mood congruent depressive delusions, or where an antidepressant has failed, and for moderately severe depressions which have not responded to 1 or 2 courses of AD.UK-NICE recommend its use only to achieve rapid improvement where other treatment has failed or the condition is potentially life threatening, in severe depression, catatonia & prolonged or severe mania. Antidepressant or Li are advisable after ECT. Patient should be completely free of residual symptom for atleast 4 months before AD is withdrawn. Withdrawal should be slowly over 2-3 months, to minimize the risk of relapse & withdrawal symptoms (oxford). AD treatment should be maintained for atleast 6 months or length of previous episode, whichever is greater. Prophylactic treatment is effective in reducing the number & severity of recurrences. (Kaplan). Continuation treatment for 9-12 months should be routine following response to acute treatment. Full dose should be resumed, f/b continuation for fuher 912 months if depressive symptoms return (relapse). Several recurrences (>2 in last 2 years or >3 in 5 yrs) require maintenance treatment for 2 to 5 years or even life long where 2 or 3 attempts to withdraw have been followed by another episode within year Maintenance treatment of choice will be whichever antidepressant has been effective and well toleratedQ Condition Preferred antidepressants (AD) Atypical depression (hysteroid dysphoria) MAOIs or SSRIs or bupropion Melanocholic AD with dual action on both depression serotonin & noradrenergic receptors (SNRIs) Psychotic - Antidepressant SNRIs or TCA (delusion) rather than SSRIs and an depression atypical antipsychotic combinationQ - ECT is perhaps more effective than pharmacotherapy - Antipsychotic alone is not adequate and it is refractory to psychotherapy Seasonal Light (photo) therapyQ Winter depression Suicidal risk Requires consideration of lethality of AD in over dose. So SNRIs & TCA should be avoided. SSRIs & most new drugs are comparatively safe in overdose, with careful monitoring for increased risk early in treatmentQ Elderly SSRIs & newer AD are preferable to TCAQ Children & adolescents AD are not first choice, psychological therapy is preferred. In non improving & severe depression, SSRIs (fluoxetine is best) preferred. For adolescents, combination of SSRIs with CBT is useful. Pregnancy & TCA is safe. Lithium & Lactation anticonvulsants carry risk of foetal malformation & are contraindicated in the early months of pregnancy. Cardiac SSRI or other new non TCA? problems non-SNRI antidepressant is indicated. MAOIs lower BP as dose related effect & should be avoided. T/t of depression after MI enhance survival Epilepsy Only AD established not to be epileptogenic are older MAOIs Depression SSRIs, SNRIs or clomipramine with OCD are preferable to noradrenergic AD Depression with panic disorder TCA and SSRIs Depression Abstinence often results in with remission in substance induced substance abuse mood disorder | train | med_mcqa | null |
Fluoroacetate acts on ---- enzyme to inhibit the Citric acid cycle? | [
"Citrate synthase",
"Aconitase",
"Succinate dehydrogenase",
"a-ketoglutarate"
] | B | The poison fluoroacetate is found in some of the plants, and their consumption can be fatal to grazing animals. Some fluorinated compounds used as anticancer agents and industrial chemicals (including pesticides) are metabolized to fluoroacetate. It is toxic because fluoroacetyl-CoA condenses with oxaloacetate to form fluorocitrate, which inhibits aconitase, causing citrate to accumulate. Reference: Harper; 30th edition; Page no: 162 | train | med_mcqa | null |
The superior oblique muscle is supplied by: | [
"3rd cranial nerve",
"4th cranial nerve",
"5th cranial nerve",
"6lh cranial nerve"
] | B | B i.e. 4th cranial nerve | train | med_mcqa | null |
Pulp capillary pressure | [
"14 cm of H2O",
"25 cm of H2O",
"80 cm of H2O",
"120 cm of H2O"
] | A | null | train | med_mcqa | null |
Hypercalcemia is seen in all except (NOT RELATED-MEDICINE) | [
"Sarcoidosis",
"Multiple myeloma",
"Chronic renal failure",
"Prolonged immobilization"
] | C | . | train | med_mcqa | null |
Cardiomyopathy is not a feature of | [
"Duchenne's Muscular Dystrophy",
"Friedriech's ataxia",
"Pompe disease",
"Lowe's syndrome"
] | D | Lowe&;s syndrome is not associated with cardiomyopathy. Cardiomyopathy is are associated with genetic disorder like duchenne dystrophy,Friedrich ataxia ,pompe disease. Ref : Harrison&;s principles of internal medicine, 19th edition, p.no:1555 | train | med_mcqa | null |
Parakeratosis is defined as? | [
"Retained nuclei in stratum corneal cells",
"Elongation of rete ridges",
"Increased number of cells in stratum spinosum",
"Increased thickness of corneal layer"
] | A | ANSWER: (A) Retained nuclei in stratum corneal cellsREF: IADVL text book of dermatology 3rd e p. 91Some terminology related to dermatohistopathologyHyperkeratosisThickening of startum comeumHypergranulosisThickening of stratum granulosumParakeratosisRetention of nuclei in stratum comeumPapillomatosisPapillary dermal hyperplasiaSpongiosisIntercellular edema in stratum soinosumAcanthosisThickening of Spinous layerAcantholysisSeparation of keratinocytes after application of pressure | train | med_mcqa | null |
Synaptic transmission in the autonomic ganglion is usually | [
"Adrenergic",
"peptidergic",
"Cholinergic",
"Mediated by substance P"
] | C | Ref:KD Tripathi pharmacology 7th edition (page.no: 121) Katzung 10/e p76 Acetylcholine is the primary excitatory neurotransmitter in both sympathetic and parasympathetic ganglia Other adrenergic , peptidergic receptors bring secondary , slowly developing changes in membrane potential in ganglia | train | med_mcqa | null |
Which of the following melanomas do not have an in situ growth phase? | [
"Superficial spreading melanoma",
"Nodular melanomas",
"Lentigo maligna melanoma",
"Desmoplastic melanoma"
] | B | Nodular melanomas are the only type in which the malignant melanoma cells appear to have the capacity for invasive growth into the dermis and beyond from the beginning, without an in situ phase, and these tumours develop rapidly and is difficult to diagnose at an early stage. Ref: Rook's textbook of dermatology, 8th edition, Pg 54.36. | train | med_mcqa | null |
Superior thyroid aery is related to? | [
"External laryngeal nerve",
"Internal laryngeal nerve",
"Superior laryngeal nerve",
"Recurret laryngeal nerve"
] | A | Superior thyroid aery is the first anterior branch of the external carotid aery.it runs downwards and forwards in intimate relation to the external laryngeal nerve.after giving branches to adjacent stuctures, it pierces the bpretracheal fascia to reach the upper pole of lobe where the nerve detes medically.at the upper pole the aery divides into anterior and posterior branches. The anterior branch descends on the anterior border of the lobe and cintinues along the upper border of the isthmus to anastomose with its fellow of the opposite side. Ref BDC volume:3 , 6th edition | train | med_mcqa | null |
Shock index (HR/SBP) can be used to know the severity of the bleeding in cases of hemorrhage. Which of the following is most indicative for significant PPH | [
"0.3-0.5",
"0.5-0.7",
"0.7-0.9",
"0.9-1.1"
] | D | Ans. d. 0.9-1.1 elevated shock index (hea rate/systolic blood pressure >0.9) maybe signs of tissue hypoperfusion Shock Index Shock index (SI), defined as the ratio of hea rate (HR) to systolic blood pressure (SBP). Shock index >0.9: Sign of tissue hypoperfusionQ Shock index (SI) = Hea rate (HR)/ Systolic blood pressure (SBP) | train | med_mcqa | null |
In dermatophytosis, which antifungal drug is not indicated: | [
"Fluconazole",
"Terbinafine",
"Griseofulvin",
"Amphotericin B"
] | D | Various combinations of systemic antifungals that are in vogue for treating chronic or recalcitrant dermatophytosis are as follows: Fluconazole/itraconazole + terbinafine. Griseofulvin + terbinafine. Griseofulvin + fluconazole/itraconazole | train | med_mcqa | null |
Boundaries of upper triangular space include all except | [
"Teres minor",
"Teres major",
"Subscapularis",
"Triceps"
] | C | Boundaries of upper triangular space is formed by : Superior- Inferior border of teres minor Lateral- Medial border of the long head of triceps brachii Inferior- Superior border of teres major REF: BD Chaurasia 7th edition Page no: 75. Figure :5.14,page no:69-Textbook of anatomy- upper limb & thorax - vishram Singh, 2nd edition | train | med_mcqa | null |
A man 25-yrs-old presents with renal failure. His uncle died of renal failure 3 yrs ago. On slit lamp examination, keratoconus is present. Diagnosis is - | [
"ADPCKD",
"ARPCKD",
"Aloport's syndrome",
"Denysh-Drash syndrome"
] | C | null | train | med_mcqa | null |
Drug not acting on P2y12 receptor is ? | [
"Ticlopidine",
"Clopidrogel",
"Dipyridamole",
"Prasugrel"
] | C | Ans. is 'c' i.e., Dipyridamole Dipyridamole: inhibits phosphodiesterase as well as blocks uptake of adenosine to increase platelet cAMP which in turn potentiates PGI2 and interferes with aggregation. Ticlopidine, Clopidogrel and prasugrel act on the P2y12 receptor and inhibits ADP as well as fibrinogen induced platelet aggregation. Note: Prasugrelis the latest most potent and fastest acting P2Y12 purinergic receptor blocker. It is used in acute coronary sydromes and when strong antiplatelet action is required). | train | med_mcqa | null |
Tripod fracture is | [
"Displaced fracture of calcaneum",
"Zygomatiomaxillary fracture",
"Sphenoid Wing Fracture",
"Coronal shear pilon Fracture"
] | B | Zygomaticomaxillary complex (ZMC) fractures, also known as a tripod, tetrapod, quadripod, malar or trimalar fractus, are seen in the setting of traumatic injury to the face. They comprise fractures of the:Zygomatic archInferior orbital rim, and anterior and posterior maxillary sinus wallsLateral orbital rim(Refer: Mohindra's Fundamentals of Ohopedics, 2nd edition, pg no. 109) | train | med_mcqa | null |
Duret hemorrhages are found in: PGI 08,10,11; Kerala 11 | [
"Brain",
"Hea",
"Kidney",
"Liver"
] | A | Ans. Brain | train | med_mcqa | null |
Wavelength of light is | [
"400-700 nm",
"500-800 nm",
"700-900 nm",
"300-600 nm"
] | A | Ans: a (400-700nm) Ref: Vasudevan 4th ed p. 479Wavelength of visible light is 400-700nm.Violet- 420 nmBlue- 470 nmGreen- 520 nmYellow- 580 nmRed- 680 nm | train | med_mcqa | null |
In a young patient presenting with recurrent vitreous hemorrhage, diagnosis is- | [
"Eale's disease",
"CRVO",
"Proliferative retinopathy",
"Coat's disease"
] | A | Ans. (a) Eale's diseaseRef: Pearson's 22/e, p. 344Eale's disease is characterized by recurrent bilateral vitreous hemorrhage in young adult (20 - 30 yrs) males. | train | med_mcqa | null |
Which anaesthetic gas has high propensity to accumulate in cavities? | [
"Halothane",
"Nitrous oxide",
"Ether",
"Sevoflurane"
] | B | N2O can increase pressure significantly in closed air spaces (cavities) because for 1 mole of nitrogen removed 35 moles of N2O is replaced. | train | med_mcqa | null |
A patient presented with blunt trauma to the abdomen to the emergency depament. His hea rate is 150/min and his BP 80/50 mm Hg.He is scheduled to undergo an emergency laparotomy. Which of the following is anaesthetic agent of choice? | [
"Thiopentone",
"Midazolam",
"Ketamine",
"Propofol"
] | C | The cardiovascular stimulatory effects make ketamine a desirable drug for the induction of anesthesia in unstable cardiovascular patients suffering from hypovolemia, hemorrhagic shock, or cardiovascular depression in sepsis. Ketamine bronchodilation and profound analgesia allowing the use of high oxygen concentrations make ketamine an excellent choice for induction of anesthesia in patients with reactive airway disease. Patients who have sustained trauma with extensive blood loss are typical candidates for rapid-sequence anesthesia induction with ketamine. Patients with septic shock also may benefit from ketamine. The intrinsic myocardial depressant effect of ketamine may manifest in this situation if trauma or sepsis has caused depletion of catecholamine stores before the patient's arrival in the operating room. The use of ketamine in these patients does not obte the need for appropriate preoperative preparation, including restoration of intravascular blood volume. Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e | train | med_mcqa | null |
A 42-year-old woman presents with brown papules located around her eyes and on the malar cheeks. Several of her aunts were similarly affected at the same age. She would like them removed. Which of the following treatments is most likely to cause hypopigmentation? | [
"Liquid nitrogen",
"Low voltage hyfrecation",
"Keratolytic moisturizer",
"Snip excision"
] | C | Lesions appear to be was. Electrosurgical diathermy (cold cautery; hyfrecation) TOC for was. No hypopigmentation known. Keratolytics : Most commonly used keratolytics are salicylic acid and benzoyl peroxide. These can cause hypopigmentation. T/t of was with liquid nitrogen may be painful. There is a potential for scarring the matrix with aggressive freezing. Pain and erythema may be reduced by a single application of very potent steroid. | train | med_mcqa | null |
Sulfonamide useful in treating ulcerative colitis is - | [
"Sulfadiazine",
"Sulfasalazine",
"Sulfamethoxazole",
"Sulfadimidine"
] | B | null | train | med_mcqa | null |
Which of the following is expanded criteria donor (ECD) for kidney transplantation? | [
"Donors with extremes of age",
"Donors with excess alcohol intake",
"Donors having cerebrovascular accident",
"All of the above"
] | D | Extended criteria Donors Kidney Transplant Liver Transplant -Donor >60 years of age -Donor age 50-59 years with at least two of the following: 1) Cerebrovascular accident as cause of death 2)Pre-existing hypeension 3)Terminal serum creatinine >1.5 mg/dL -Mild to moderate steatosis -Hepatitis C positive -Hepatitis B- core antibody positive | train | med_mcqa | null |
During acclimatization to high altitude all of the following take place except: | [
"Increase in minute ventilation",
"Increase in the sensitivity of central chemoreceptors",
"Increase in the sensitivity of carotid body to hypoxia",
"Shift in the oxygen dissociation curve to the left"
] | D | Ans. (d) Shift in the oxygen dissociation curve to the left(Ref: Guyton, 13th ed/p.563)Shift in the oxygen dissociation curve to the right occurs in high altitude because of hypoxia | train | med_mcqa | null |
All of the following are risk factors for increased lactic acidosis in patients on metformin therapy except | [
"Advanced age",
"Liver dysfunction",
"Renal dysfunction",
"Smoking"
] | D | Metformin can result in lactic acidosis and the risk factors includes old age,renal and liver insufficiency, alcoholics.
Smoking is not a risk factor. | train | med_mcqa | null |
Type D personality are recently found to be at risk of developing: | [
"Coronary aery disease",
"Depression",
"Schizophrenia",
"Mania"
] | A | A i.e. Coronary aery disease - Type A personality (behavior pattern) includes competitiveness, time urgeny, and hostilityQ.- Type D (distressed) personality is not only a risk factor for development of ischemic hea disease, it also leads to worse prognosis following a myocardial infarctionQ.Type - A Personality- It is originally characterized by competitiveness, time urgency, hostility and angerQ (last two components are pathogenic). Ambitiousness, aggressiveness, competitiveness, impatience, muscle tenseness, aleness, rapid and emphatic vocal style, irritation, and cynicism are other features.- Are hard working workaholics who deny emotional or physical vulnerability. Their self esteem is dependent on achievement i.e. they are impatient, achievement oriented people.- These individuals show a greater physiological reactivity (eg B P, hea rate) and are more likely to get engaged in unhealthy habbits eg, drinking alcohol, smoking. And if these individuals smoke they inhale smoke for a longer time. Associated with significantly high risk of coronary hea disease.Type B PersonalityIt includes carefree, easy going, relaxed individualsType D Personality- It includes people with distressed personality who suffer from high degree of emotional distress (negative emotions/affectivity) but they consciously suppress their feelings (=social inhibition).Type D personality is both a prognostic and risk factor for IHDQ. These persons have worse prognosis after MI with an - 4 times increased risk of sudden cardiac death, recurrent MI & moality.- These persons have an impaired/poor quality of life and are more likely to experience anxiety & depression (mood swings)Q.* Risk factor for cardiac disase include major depressive disorder, type D personality and type A personalityQ (esp anger & hostality) | train | med_mcqa | null |
A 27-year-old G2P1 woman at 34 weeks' gestation presents to the emergency depament following a motor vehicle collision. In the trauma bay her hea rate is 130/min and blood pressure is 150/90 mm Hg. She is ale and oriented to person, place, and time. She complains of severe abdominal pain that began immediately after the collision. Physical examination reveals bruising over her abdomen, along with a hypeonic uterus and dark vaginal bleeding. A sonogram reveals a placental abruption, and the fetal hea tracing reveals some decelerations. Emergency laboratory tests reveal an International Normalized Ratio of 2.5, with elevated fibrin degradation products. Which of the following is the most appropriate first step in'management? | [
"Administer a tocolytic",
"Administer a coicosteroid.",
"Administer fresh frozen plasma.",
"Deliver the fetus immediately by LSCS"
] | C | From the history of given case senario,it is DIC (disseminated intravscular coagulation).This can be managed by management of the underlying causes,fluid replacement,blood component therapy by stored blood cells,fresh frozen plasma(FFP),platelet concentrates and cryoprecipitate are to be given as soon as possible. Refer page no 320,321 of Text book of obstetrics,sheila balakrishnan,2 nd edition. | train | med_mcqa | null |
The major contribution of amniotic fluid after 20 weeks of gestation : | [
"Ultrafiltrate and maternal plasma",
"Fetal urine",
"Fetal lung fluid",
"Fetal skin"
] | B | Origin of amniotic fluid : Early week -Maternal plasma 2 nd trimester - Fetal skin Beyond 20 weeks -Fetal urine Ref: Datta Obs 9e pg 34. | train | med_mcqa | null |
Drugs that carry definitive risk of clinical hemolysis in patients with G 6 PD deficiency are all except? | [
"Primaquine",
"Chloroquine",
"Dapsone",
"Nalidixic acid"
] | B | Ans. is 'b' i.e., Chloroquine | train | med_mcqa | null |
Drug not used in CMV retinitis: | [
"Acyclovir",
"Foscarnet",
"Ganciclovir",
"Cidofovir"
] | A | Ref: Goodman & Gillman's 13th ed. P 1106-7* Acyclovir's clinical use is limited to herpes viruses. Acyclovir is most active against HSV-1.* Approximately half as active against HSV-2, and a tenth as potent against VZV and EBV.* Book states: "Acyclovir is ineffective therapeutically in established CMV infections, but ganciclovir is effective for CMV prophylaxis in immunocompromised patients* EBV-related oral hairy leukoplakia may improve with acyclovir.* Drugs which can be used in treatment of CMV retinitis are cidofovir, ganciclovir, foscarnet, valaciclovir.* DOC for CMV retinitis: Ganciclovir* Fomivirsen is active against CMV strains resistant to ganciclovir, foscarnet, and cidofovir. Fomivirsen is given by intravitreal injection unresponsive to other therapies. | train | med_mcqa | null |
A person with mitral stenosis has the following radiological signs except | [
"Straightening of left heart border",
"Double density sign",
"Elevation of Right main bronchus",
"Kerley B lines"
] | C | Elevation of left main bronchus with widening of Carina - Mitral stenosis | train | med_mcqa | null |
Which of the following is the most troublesome source of bleeding during a radical retropubic prostatectomy. | [
"Dorsal venous complex",
"Inferior vesical pedicle",
"Superior vesical pedicle",
"Seminal vesicular aery"
] | A | Radical retropubic prostatectomy is performed for Ca Prostate. Haemorrhage is the most common intraoperative complication and the most commonly injured vessel is Dorsal venous complex. Ref : Cambell's Urology 8/e p3126 | train | med_mcqa | null |
Pulmonary lymph flow rate is | [
"20 ml/hour",
"40 ml/hour",
"50 ml/hour",
"60 ml/hour"
] | A | Pulmonary lymph flow rate is 20 ml per hour Ref: guyton and hall textbook of medical physiology 12 edition | train | med_mcqa | null |
The ratio of chest compressions to ventilation in a newborn is | [
"1:01",
"2:01",
"3:01",
"4:01"
] | C | If the hea rate does not improve after 30 sec with bag-and-mask (or endotracheal) ventilation and remains below 100 beats/min, ventilation is continued and chest compression should be initiated over the lower third of the sternum at a rate of 90 compressions/min. The ratio of compressions to ventilation is 3 : 1 (90 compressions:30 breaths). If the hea rate remains <60 beats/min despite effective compressions and ventilation, administration of epinephrine should be considered.Ref: Nelson; 20th edition; Page no: 845 | train | med_mcqa | null |
Which of the following has high molecular weight and possess no role in transpo mechanism is? | [
"Albumin",
"Alpha-globulin",
"Beta globulin",
"Fibrinogen"
] | D | Fibrinogen is with molecular weight of 3,40,000 and it helps in coagulation of blood. Ref: Textbook of medical physiology by N Geetha, 2nd edition, page no. 67 | train | med_mcqa | null |
Schwann cells are supporting cells of: | [
"CNS",
"PNS",
"ANS",
"All of the above"
] | B | (B) PNS # CNS/PNS Supportive Cells:> Astrocytes--physical support, repair, K+ metabolism.> Microglia--phagocytosis.> Oligodendrocytes--central myelin production.> Schwann cells--peripheral myelin production.> Ependymal cells--inner lining of ventricles. | train | med_mcqa | null |
Which of the following is yeast like fungi | [
"Candida",
"Rhizopus",
"Cryptococcus neoformans",
"Trichophyton"
] | A | Cryptococcus is a yeast. Rhizopus is a mould. Trichophyton is a dermatophyte which is a mould. Reference: Textbook of Microbiology; Baveja; 4th edition | train | med_mcqa | null |
Single gene autosomal recessive disease is | [
"Wilson's disease",
"Tuberous sclerosis",
"Huntington's disease",
"Schizophrenia"
] | A | Single gene autosomal recessive disease is Wilson's disease.
Tuberous sclerosis, Huntington's disease are autosomal dominant disorder
Schizophrenia is a multifactorial disease. | train | med_mcqa | null |
True about juvenile nasopharyngeal angiofibroma -a) Surgery is treatment of choiceb) It is malignant tumourc) ↑Incidence in femalesd) Hormones not used in Rxe) Miller's sign positive | [
"a",
"b",
"ae",
"ad"
] | C | JNA is a benign tumor.
It occurs almost exclusively in males.
Hormones are used in the treatment
Preoperative estrogen to reduce the vascularity
As the primary or adjunctive treatment → Flutamide can be used
Antral sign or Holman - Miller sign is pathognomic of NFA.
Surgery is the treatment of choice. | train | med_mcqa | null |
Malignant hypeension causes- | [
"Flea bitten kidney",
"Irregular granular contracted kidney",
"Large white kidney",
"No change in kidney"
] | A | Malignant nephrosclerosis Flea-bitten kidney: It is characterized by the presence of small, pinpoints petechial hemorrhages on the coical surface due to rupture of aerioles or glomerular capillaries. Histology: Fibrinoid necrosis and onion-skinning of aerioles. Fibrinoid necrosis of aerioles Causes of the flea-bitten kidney: Malignant hypeension Subacute bacterial endocarditis Rapidly progressive GN Henoch-Schonlein purpura. Ref: RAM DAS NAYAK EXAM PREPARATORY MANUAL FOR UNDERGRADUATES 2nd ed. pg no: 621 | train | med_mcqa | null |
Acromegaly is associated with all of the following EXCEPT: | [
"Nasal sinus enlargement",
"Increased heel pad thickness",
"Diabetes mellitus",
"Muscle hyperophy"
] | D | Screening - IGF-1 | IOC - glucose challenge Test Rx - Transsphenoidal Sx (Definitive Rx) DOC- Octreotide Other drugs Pegvisomant Cabergoline Bromocriptine | train | med_mcqa | null |
Cailaginous pa of external auditory canal is | [
"Medial 1/3",
"Lateral 1/3",
"Medial 2/3",
"Lateral 2/3"
] | B | Lateral 1/3rd of the external auditory canal is cailaginous and medial 2/3rd is bony.Ref: Hazarika; 3rd ed; Pg 9 | train | med_mcqa | null |
The lipid bilayer of cell membrane exist as | [
"Solid",
"Semisolid",
"Gel",
"Fibres"
] | C | The lipid bilayer shows free lateral movement of its components, hence the membrane is said to be fluid in nature. Fluidity enables the membrane to perform endocytosis and exocytosis. However, the components do not freely move from inner to outer layer or outer to inner layer (flip-flop movement is restricted). During apoptosis (programmed cell death), flip-flop movement occurs. Somewhat similar to a gel.Ref: DM Vasudevan, page no: 11 | train | med_mcqa | null |
Which of the following statement is not true about the Schatzki's ring? | [
"Located at the lower esophagus",
"It may result from GERD or be congenital in origin",
"Causes dysphagia for both liquids and solids",
"Asymptomatic rings and webs may be present in 10% of normal individuals"
] | C | A lower esophageal mucosal ring (Schatzki ring) is a thin, web like constriction located at the squamocolumnar mucosal junction at or near the border of the LES. It may result from GERD or to be congenital in origin. It invariably produce dysphagia when the lumen diameter is < 1.3 cm. Dysphagia to solid is the only symptom, and is usually episodic. A lower esophageal ring is one of the common cause of dysphagia. Asymptomatic rings may be present in 10% normal individual. Symptomatic rings and webs are treated by dilation. Ref: L & B 25/e, page 1041 ; CSDT 11/e, page 500 | train | med_mcqa | null |
Scrofula is a tuberculosis of: | [
"Skin",
"Lymphnode",
"Spine",
"Lungs"
] | B | null | train | med_mcqa | null |
The following Flipped pattern of LDH blood levels are seen in Myocardial infarction: | [
"LDH1>LDH3",
"LDH3>LDH1",
"LDH2>LDH1",
"LDH1>LDH2"
] | D | (D) LDH1>LDH2[?]Lactate Dehydrogenase (LDH)oRises within 24 to 48 hours of MIoPeaks at 3 - 5 days and returns to baseline by 7-10 daysoUsefulness in patients who are admitted to hospital 2-3 days after onset of symptomsoLevel of LDH-1 greater than LDH-2 = myocardial necrosisoNormally, the level of LDH-2 Is higher than the LDH-1. 29-39% of total activity against 14-26%oAn LDH-1 level higher than that of LDH-2, a phenomenon known as 'flipped LDH', is strongly indicative of a myocardial infarction.oThe flipped LDH usually appears within 12-24 hours after a heart attack.oA normal LDH-1/LDH-2 ratio is considered reliable evidence that a heart attach has not occurred.[?]In normal serum, LDH2 (H3 M) predominant isoenzyme & LDHs is rarely seen.oIn myocardial infarction, LDH1 (H4 ) levels are greater than LDH2 , called flipped pattern.oMegaloblastic anemia (50 times upper limit of LDH1 & LDH2 ).oMuscular dystrophy, LDH5 (M4 ) is increased.oToxic hepatitis with jaundice (10 times more LDH5 )oMyocardial infarction (LDH1>LDH2)oMegaloblastic anemia... Marked | in LD activity-Up to 50 times the upper reference limit - ineffective-Erythropoiesis - release of LD1 & LD-2 isozymes.oLactate dehydrogenase, tetrameric enzyme with 4 subunits,o4 Subunits with 2 isoforms - H isoform (Heart) & M isoform (Muscle)-Heart & RBCs - LDH-1 (4H);-Reticuloendothelial system - LDH-2 (3H1M)-Lungs - LDH-3 (2H2M)-Kidneys, placenta, & pancreas - LDH-4 (1H3M)-Liver & striated muscle - LDH-5 (4M)oUses:-LDH levels are more in RBC-Helpful in assessment of Hemolysis/Tissue breakdownoFlipping effect:-Usually LDH 2 in predominant in serum & LDH 1 is predominant in heart-Higher levels of LDH 1 than LDH 2 (Flipped pattern) is suggestive of myocardial infarction-Damaged cardiac tissues release LDH 1 into bloodstream. | train | med_mcqa | null |
True statements with regard to sampling | [
"Snowball sampling is used for hidden population",
"More sample in systematic random sampling",
"In stratified random sampling population is divided into strata",
"Cluster sampling is less cost - effective"
] | A | . | train | med_mcqa | null |
SLE like reaction is caused by? | [
"Hydralazine",
"Rifampicin",
"Paracetamol",
"Furosemide"
] | A | ANSWER: (A) HydralazineREF: Harrison's Internal Medicine 17th ed chapter 113The list of substances that can induce lupus-like disease is long. Among the most frequent are;Antiarrhythmic: procainamide, disopyramide, and propafenoneAntihypertensive: hydralazine; several angiotensin-converting enzyme inhibitors and beta blockersAntithyroid: propylthiouracilAntipsychotics: chlorpromazine and lithiumAnticonvulsants: carbamazepine and phenytoinAntibiotics: isoniazid, minocycline, and macrodantinAntirheumatic: sulfasalazineDiuretic: hydrochlorothiazideAntihyperlipidemics: lovastatin and simvastatinInterferons and TNF inhibitors | train | med_mcqa | null |
Medium used to isolate M. tuberculosis contains all except ? | [
"Malachite green",
"Hen's egg",
"Bromothymol blue",
"Glycerol"
] | C | Ans. is 'c' i.e., Bromothymol blue Lowenstein-Jensen Medium (LT medium)LJ medium consists of mineral salts, asparagine, glycerol, malachite green and hen's egg.The malachite green prevents the growth of other microorganism on medium.It is used as a primary isolation medium for mycobacteria.Mineral salts are monopotassium phosphate, magnesium or sodium citrate and magnesium sulphate | train | med_mcqa | null |
Methanol toxicity causes blindness due to the formation of: March 2010 | [
"Formic acid",
"Formaldehyde",
"Lactic acid",
"Pyruvic acid"
] | A | Ans. A: Formic Acid The initial step in the metabolism of methanol involves the enzyme alcohol dehydrogenase (ADH). First, methanol is slowly oxidized by ADH to yield formaldehyde. Next, formaldehyde is oxidized by formaldehyde dehydrogenase to yield formic acid (or formate, depending on the pH). This oxidation occurs rapidly so that little formaldehyde accumulates in the serum. Finally, formic acid is metabolized to carbon dioxide and water, which are excreted by the kidneys and lungs. The accumulation of formic acid is responsible for the presence of metabolic acidosis. Formic acid also inhibits cellular respiration leading to lactic acidosis. The ocular injury caused by methanol may be due to retinal injury, which results from intra-retinal metabolism of methanol and the accumulation of formic acid. Alternatively, it may be caused be the inhibition of normal metabolism in optic nerve calls. | train | med_mcqa | null |
The important feature of psoriasis is – | [
"Crusting",
"Scaling",
"Oozing",
"Erythema"
] | B | Psoriasis is a papulosquamous disorder characterized by papule and scales. | train | med_mcqa | null |
Gene expert used for getting a diagnosis of TB in - | [
"1-2 hrs",
"5 hrs",
"10 hrs",
"20 hrs"
] | A | Ans. is 'a' i.e., 1-2 hrs. o Results are obtained from unprocessed sputum samples in 90 minutes, with minimal biohazard and very little technical training required to operate. GeneXpert MTB/RIF o The Xpert MTB/RIF detects DNA sequences specific for Mycobacterium tuberculosis and rifampicin resistance by polymerase chain reaction. o It is based on the Cepheid GeneXpert system, a platform for rapid and simple-to-use nucleic acid amplification tests (NAAT). o The Xpert MTB/RIF purifies and concentrates Mycobacterium tuberculosis bacilli from sputum samples, isolates genomic material from the captured bacteria by sonication and subsequently amplifies the genomic DNA by PCR. o The process identifies all the clinically relevant rifampicin resistance-inducing mutations in the RNA polymerase beta (rpoB) gene in the Mycobacterium tuberculosis genome in a real-time format using fluorescent probes called molecular beacons. o Results are obtained from unprocessed sputum samples in 90 minutes, with minimal biohazard and very little technical training required to operate. | train | med_mcqa | null |
A drug having narrow therapeutic range is | [
"Lithium",
"Sertraline",
"Reboxetine",
"Dothiepin"
] | A | Therapeutic range is bounded by the dose which produces a minimal therapeutic effect and the dose which produces a maximal acceptable adverse effect.
Example of the narrow therapeutic range are lithium, Phenytoin. | train | med_mcqa | null |
Most common cause of painful defecation is associated with | [
"Fissure in ano",
"Fistula in ano",
"External haemorrhoid",
"Internal haemorrhoid"
] | A | ANAL FISSURE Definition An anal fissure (synonym: fissure-in-ano) is a longitudinal split in the anoderm of the distal anal canal, which extends from the anal verge proximally towards, but not beyond, the dentate line. Clinical features Although simple epithelial splits, acute anal fissures are, because of their location involving the exquisitely sensitive anoderm, characterised by severe anal pain associated with defaecation, which usually resolves spontaneously after a variable time only to recur at the next evacuation, as well as the passage of fresh blood, normally noticed on the tissue after wiping. Chronic fissures are characterised by a hyperophied anal papilla internally and a sentinel tag externally (both consequent upon attempts at healing and breakdown), between which lies the slightly indurated anal ulcer overlying the fibres of the internal sphincter. When chronic, patients may also complain of itching secondary to irritation from the sentinel tag, discharge from the ulcer or discharge from an associated intersphincteric fistula, which has arisen through infection penetrating the fissure base. Although most sufferers are young adults, the condition can affect any age, from infants to the elderly. Men and women are affected equally. Anterior fissures account for about 10% of those encountered in women (and many of these may occur postpaum) but only 1% in men. A fissure sited elsewhere around the anal circumference or with atypical features should raise the suspicion of a specific aetiology, and the inability to be able to conduct an adequate examination in the clinic should prompt early examination under anaesthesia, with biopsy and culture to exclude Crohn's disease, tuberculosis, sexually transmitted or human immunodeficiency virus (HIV)-related ulcers (syphilis, Chlamydia, chancroid, lymphogranuloma venereum, HSV, cytomegalovirus, Kaposi's sarcoma, B-cell lymphoma) and squamous cell carcinoma. Ref: Bailey and love 27th edition Pgno : 1352 | train | med_mcqa | null |
Which one of the following is not consistent with Aedes aegypti's life cycle - | [
"Breeds aificial collection of water",
"Eggs are boat shaped",
"Larva has siphon tube",
"Wings unspotted in the adult"
] | B | Features of Aedes: Breeds in the aificial collection of water Eggs are laid singly, cigar-shaped and don't have lateral folds Larvae have a siphon tube Pupae with long and narrow siphon tube Adults have stripes on body and legs Fly up to 100 m Aka Tiger mosquitoes Park's Textbook of Preventive and Social Medicine, 25th Edition, Pg 831 | train | med_mcqa | null |
Alderman's nerve is a branch of - | [
"Superior cervical ganglion",
"Inferior cervical ganglion",
"Auricular branch of vagus nerve",
"None"
] | C | C i.e. Auricualr branch of vagus nerve The auricular branch of vagus nerve is often termed as Alderman's nerve or Arnold's nerveQSince the Alderman of the Anglo-saxon empire was habitually eating and then putting some cold water in the ear to stimulate this nerve to initiate vomiting, this name came into being. In this way they could empty their stomach quickly and resta eating. | train | med_mcqa | null |
Acquire IgA deficiency may occur in ? | [
"Severe Congenital toxoplasmosis",
"Severe Measles infection",
"Severe Brucellosis",
"Severe Leptospirosis"
] | A | Severe Congenital toxoplasmosis Block in B cell differentiation due to defective interaction between T and B cells. Naive B cells are not able to differentiate into IgA - producing cells. | train | med_mcqa | null |
30 years old primipara in labour with transverse lie. Treatment of choice is : | [
"Internal cephalic version",
"Emergency cesarean section",
"Wait and watch",
"External cephalic version"
] | B | Ans. is b i.e. Emergency cesarean section Patients in labour with transverse lie can be managed by external cephalic version followed by surgical rupture of the membrane. But it is impoant to note that the patient is a primigravida with age 30 years i.e. elderly primi, so, ECV is contraindicated. | train | med_mcqa | null |
Superior thyoid artery is a branch of - | [
"External carotid artery",
"Internal carotid artery",
"Common carotid artery",
"Arch of aorta"
] | A | Ans. is 'a' i.e., External carotid artery Branches of external carotid arteryFrom medial sideAscending pharyngealFrom frontSuperior thyroid arteryLingual arteryFacial arteryFrom behindOccipital arteryPosterior auricular arteryTerminal branchesSuperficial temporal arteryMaxillary artery | train | med_mcqa | null |
True about quinsy is: | [
"Penicillin is used in treatment",
"Abscess is located in capsule",
"Commonly occurs bilaterally",
"Immediate tonsillectomy should be done"
] | A | Quinsy is collection of pus outside the capsule (not in capsule) in peritonsillar area It is usually unilateral Patient presents with toxic symptoms due to septicemia as well as local symptoms (e.g. dribbling of saliva from mouth) Antibiotics: High-dose penicillin. (IV benzipenicillin) is the DOC. In patients allergic to penicillin, erythromycin is the DOC. If antibiotics fail to relieve the condition within 48 hours, then the abscess must be opened and drained. | train | med_mcqa | null |
In bilateral abductor palsy of vocal cords following is done except - | [
"Teflon paste",
"Cordectomy",
"Nerve muscle implant",
"Arytenoidectomy"
] | A | null | train | med_mcqa | null |
The last to receive electrons in electron transpo system is: | [
"Coenzyme-Q",
"FADH2",
"2",
"Cytochrome-C"
] | C | Ans. c. 02 | train | med_mcqa | null |
Egg-shell calcification in hilar lymph nodes is seen in : | [
"Sarcoidosis",
"Histoplasmosis",
"Tuberculosis",
"Carcinoma lung"
] | B | B i.e. Waterston Cooley's shunt | train | med_mcqa | null |
Gas absent from intestine (gasless abdomen) on x-ray is seen in which condition? | [
"Acute pancreatitis",
"Necrotizing enterocolitis",
"Intussusception",
"Ulcerative collitis"
] | A | Acute pancreatitis - In acute pancreatitis due to damaged duct and acini there is extravasation of pancreatic enzymes such as lipase into the peritoneal cavity. - This causes digestion of fat of greater omentum which in turn leads to formation of fatty acid & glycerol. - Free fatty acid combines with calcium and leads to formation of chalky white deposits known as "SAPNOFICATION" - Patients of pancreatitis presents with hypocalcaemia as calcium is used up for saponification. - The pancreatic enzymes that entered into peritoneal cavity also causes Paralytic ileus - X-ray findings of Paralytic ileus: Gasless abdomen Ground Glass appearance Sentinel loop Colon cut-off sign | train | med_mcqa | null |
Mercedes Benz sign is seen in: | [
"Gall stone",
"Bladder stone",
"Renal stones",
"Foreign body bronchus"
] | A | ANSWER: (A) Gall stoneREF: Suttons textbook of radiology, 7th edition, volume 1 page 713 Mercedes Benz sign/Seagull sign/Crow feet sign:Gall bladder stone if radiopaque has a stellate faceted appearance with gas containing fissures on the plain radiograph and is called as Mercedes Benz sign/Seagull sign or Crowr feet sign | train | med_mcqa | null |
All of the following are examples of traction epiphysis, EXCEPT: | [
"Mastoid process",
"Condyles of tibia",
"Trochanter of femur",
"Tubercles of humerus"
] | B | Traction epiphysis is caused by the pull of muscles. Greater and lesser trochanter of femur, greater and lesser tubercle of humerus, medial and lateral epicondyles of humerus and mastoid process are all examples of traction epiphysis. Condyles of tibia is a type of pressure epiphysis. | train | med_mcqa | null |
Which one of the following disinfectant is effective in killing spores - | [
"Alcohol",
"Aldehyde",
"Halogens",
"Phenol"
] | C | Halogens are potent bactericidal, fungicidal, sporicidal, tuberculocidal, and virucidal. Others are given are only slowly effective against spores. Park's textbook of preventive and social medicine.K Park. Edition 23.Pg no: 128 | train | med_mcqa | null |
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