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 |
|---|---|---|---|---|---|---|
Primary Urban Health Centre should be for a population of: | [
"30,000",
"50,000",
"10,000",
"1,000,000"
] | B | URBAN HEALTH CARE DELIVERY MODEL :- Community level: Community outreach services. Sub-primary level: Swasthya chowki 1 Swasthya chowki per 10,000 population. 1 ANM + 1 Community health worker. Primary level: I Primary urban health Centre (PUHC) 1 PUHC/UHC per 50,000 (1 per 25000-30000 in slums). Referral level: Public or empanelled secondary / teiary care providers. Secondary level Urban Health Centre - Metros- 1 per 5,00,000 ; Non-metros - 1 per 2,50,000. | train | med_mcqa | null |
Positive Rinne test indicates | [
"AC > BC",
"BC > AC",
"BC = AC",
"None"
] | A | In this test air conduction of the ear is compared with its bone conduction. It is a test for conductive deafness. Rinne Positive: AC > BC Rinne Negative: BC > AC (conductive deafness in that ear) Ref: Dhingra; 6th Edition; pg no 22 | train | med_mcqa | null |
As per WHO guidelines, iodine deficiency disorders are endemic in the community when prevalence of goitre in school age children is more than – | [
"1%",
"5%",
"10%",
"15%"
] | B | null | train | med_mcqa | null |
Aminoacyl tRNA synthetase is required for all except: | [
"Lysine",
"Cysteine",
"Methionine",
"Hydroxyproline"
] | D | Some proteins contain additional amino acids that arise due to post-translational modification of existing amino acyl residues. Examples: Vitamin C mediated hydroxylation of proline and peptidyl lysine to 4-hydroxyproline and 5-hydroxylysine Vitamin K mediated g-carboxylation of glutamate Methylation Formylation Acetylation Prenylation (addition of fatty acid residues) Glypiation (addition of Glycosyl PI anchor) Phosphorylation Therefore Aminoacyl tRNA synthetase is not required by these. | train | med_mcqa | null |
Staphylococcus can cause | [
"Pharyngitis",
"Tuberculosis",
"Migraine",
"Dermatitis"
] | A | Staphylococcal infections are the most common bacterial infections and range from tril to fatal. The common pyogenic staphylococcal infections are: Skin and soft tissue infections: Folliculitis, furuncle, abscess, wound infections, carbuncle, impetigo, paronychia and less often cellulitis. 2. Musculoskeletal: Osteomyelitis, ahritis, bursitis and pyomyositis. 3. Respiratory: Tonsillitis, pharyngitis, sinusitis, otitis, bronchopneumonia, lung abscess, empyema and rarely pneumonia 4. CNS: Abscess, meningitis and intracranial thrombophlebitis 5. Endovascular: Bacteremia, septicemia, pyemia, endocarditis Ref: Textbook of Microbiology; Ananthanarayan and Paniker's; 10th Edition; Page No: 204 | train | med_mcqa | null |
Accommodation is due to - | [
"Relaxation of ciliary' muscles",
"Contraction of ciliary'1 muscles",
"Contraction of dilator pupillae",
"None"
] | B | Ans. is 'b' i.e., Contraction of ciliary muscles Accommodationo Accommodation of the eye refers to the act of physiologically adjusting crystalline lens elements to alter the refractive powrer and bring objects that are closer to the eye into sharp focus,o Our eyes have been provided with a unique mechanism by which we can even focus the diverging rays coming from a near object on the retina in a bid to see clearly,o This mechanism is the accommodation,o In accommodation there occurs increase in the power of crystaline lens due to increase in the curvature of its surfaces.o Accommodation is due to contraction of ciliary muscles,o Near point and far point are related to accommodationThe near point is the closest distance between an object and eye that makes possible the formed image to be focused, i.e.j it is the point in w'hich accommodation is maximum (ciliary' muscles are maximally contracted),Far point is the most distant point from the eye in w'hich an object can be placed and its image is still focused, i.e., it is the situation of maximum relaxation of ciliary muscles.In myopia near point and far point of vision come closer and in hypermetropic near point becomes more distant.o Anomalies of accommodation are : (i) Presbyopia, (ii) Insufficiency of accommodation, (iii) Spasm of accommodation, (iv) Paralysis of accommodation. | train | med_mcqa | null |
LEIGH disease is due to the accumulation of- | [
"Glycogen",
"Pyrodoxine",
"Sphingomyelin",
"None"
] | D | Ans. is 'None' | train | med_mcqa | null |
The characteristic feature of apoptosis on light microscopy is: | [
"Cellular swelling",
"Nuclear compaction",
"Intact cell membrane",
"Cytoplasmic eosinophlia"
] | B | Ans. (b) Nuclear compaction(Ref: Robbins 9th/pg 53)Here student gets confused in 2 options b and c..On light microscopy, most characteristic feature is condensation of nuclear chromatin and not intactness of cell membraneIntact cell membrane and lack of inflammation differentiates apoptosis from necrosis. | train | med_mcqa | null |
Anesthectic agent with least minimum alveolar concentration (MAC): | [
"Nitrous oxide",
"Isoflurane",
"Desflurane",
"Xenon"
] | B | Ans: (b) IsofluraneRef: Stoelting's Pharmacology and Physiology in Anesthetic Practice, 4th editionMAC (MINIMUM ALVEOLAR CONCENTRATION)MAC is the concentration of inhalational agent in alveoli at 1 atm that prevents skeletal muscle movement in response to a supra-maximal painful stimulus (surgical skin incision) in 50% of patients.It is used to measure potency of inhalational agentsMAC[?]1/PotencyPotency is a measure of drug activity expressed in terms of the amount required to produce an effect of given intensity.Lesser amounts of drug required to produce maximum effect is called as more potent drug.For inhalational anaesthetic agents potency are measured by MAC valueLesser the MAC more is the potency (MAC [?]1 /Potency)Inhalational agents order from maximum potent to minimum potentMeth oxyflurane>Trilene>Halothane>Chloroform>Isoflurane>Enflurane>Sevoflurane>Ether>Sevoflurane>Xenon>N2O*MAC of Common Inhalational Agents:Inhalational agentsMACMethoxyflurane0.16Trilene0.2Halothane0.75Chloroform0.8Isoflurane1.17Enflurane1.63Sevoflurane1.8Ether1.9Desflurane6.6Xenon71N20104Factor Affecting MAC:Increase of MACDecrease of MACNo Change of MAC*. Hyperthermia*. Hypernatremia (|Na)*. Sympathomimetic drugs*. Cyclosporine*. Excessive pheomelanin production (red hair)*. Hypothermia*. Increasing age (6% per decade)*. Alpha 2 agonist agents*. Acute alcohol ingestion*. Pregnancy and postpartum upto 72 hours*. Lithium*. Lidocaine*. Hyponatremia*. Ketanserine*. Adrenergic antagonist agents*. BP<40 mm Hg*. PaO<38 mm Hg*. Chronic alcohol abuse*. Gender*. Duration of anaesthesia*. PaCO 15 - 95 mm Hg*. PaO>38 mm Hg*. BP>40 mm Hg*. Hyper or Hypokalemia*. Thyroid dysfunction*. Anaesthetic metabolism | train | med_mcqa | null |
Which of following clostridia is non-invasive: | [
"Clostridium novyi",
"Clostridium botulinum",
"Clostridium perfringens",
"Clostridium tetani"
] | B | Ans. is. 'b' i. e. Clostridium botulinum | train | med_mcqa | null |
The enzyme used to "flush" the sticky ends of DNA is | [
"Klenow fragment",
"Polynucleotide kinase",
"Alkaline phosphatase",
"Primase"
] | A | Flushing of sticky ends means to remove the sticky ends (3' overhangs) for producing blunt-ended DNA (no overhangs). The sticky ends has 3' overhangs which can be digested with Klenow fragment (has 3'-5' exonuclease activity) to produce blunt-end DNA. Tool Role Type II restriction enzymes Cleaves DNA at specific sites DNA ligase Phosphodiester bond formation between 2 fragments Klenow fragments (DNA polymerase I without 5' to 3' exonuclease activity) Used previously for polymerization in PCR reactions Polynucleotide kinase Catalyse the transfer of g phosphate from ATP Alkaline phosphatase Removes the phosphate group from 5' end to prevent self annealing of sticky ends of DNA Reverse transcriptase RNA dependent DNA polymerase for cDNA synthesis RNAase H Removes RNA from DNA-RNA hybrid Exonuclease III Removes nucleotide from 3' end Phage g exonuclease Removes nucleotide from 5' end Terminal nucleotidyl transferase In homopolymer tailing to conve blind end to sticky end | train | med_mcqa | null |
IL-1 is activated by | [
"Caspase 1",
"Caspase 3",
"Caspase 5",
"Caspase 8"
] | A | * Pyroptosis is associated with release of cytokine IL 1 * Microbial products that enter the cytoplasm of the cell are recognised by cytoplasmic immune receptors and activates a multiprotein complex called INFLAMMASOME * Inflammasome will activate CASPASE 1 (also called Interleukin 1 beta conveing enzyme) and releases the active form of IL 1 * Several NORs (NOD like receptor) signal INFLAMMASOME * Gain of function in NLR can cause periodic fever syndromes called AUTO INFLAMMATORY SYNDROMES * They respond to IL-1 antagonists * IL 1 activates fibroblasts to synthesize collagen and stimulates the proliferation of mesenchymal cells * IL 1 also stimulates Th17 responses * Initiator caspase in Intrinsic pathway of apoptosis - IL 9 * Initiator caspase in Entrinsic pathway of apoptosis - IL 8, 10 * Executioner caspase of apoptosis IL 3 & IL 7 Ref:- Robbins Basic Pathology 9th Edition; Pg num:- 59,86,188 | train | med_mcqa | null |
Which of the following is not a content of buccal space? | [
"Buccal branches of the facial nerve",
"Stenson duct",
"Transverse facial artery and vein",
"Buccal fat pad"
] | A | Facial nerve is not present in buccal space. | train | med_mcqa | null |
Cutaneous lesions may be produced by the following mycobacteria except- | [
"M. intracellulare",
"M. Leprae",
"M. marinum",
"M. tuberculosis"
] | A | . Ans. is 'a' i.e., M. intracellulare Principal types of oppounist mycobacterial disease in man and the usual causative agents. Diseases Usual causative agent Lymphadenopathy M. avium complex M. scrofulaceum Skin lesion Post-trauma abscess M. chelonae M.fouitum M. terrae Swimming pool granuloma M.marinum Buruli ulcer M. ulcerans Pulmonary disease M. avium complex M. kansasii M.xenopi M.malmoense Disseminated disease AIDS-related M. avium complex M.genevense M.avium complex M. chelonae . M. leprae grows in cooler tissues (the skin, peripheral nerve, testis, anterior chamber of eye, upper respiratory tract) Cutaneous manifestations of M. tuberculosis include abscesses and chronic ulcer, scrofuloderma, lupus vulgaris, erythma nodosum, and maliary lesions. | train | med_mcqa | null |
The ideal method for restoring a fractured tooth is | [
"Open faced stainless steel crown",
"Reattachment of fractured tooth segment",
"Strip crown",
"Composite resin restoration"
] | B | null | train | med_mcqa | null |
Brodie -Trendlenburg test demonstrates? | [
"Mid - thigh perforation",
"Deep vein thrombosis",
"Sapheno -- femoral incompetence",
"Calf perforators"
] | C | Ans. is 'c' i.e., Sapheno-femoral incompetence | train | med_mcqa | null |
Double rise of temperature in 24 hrs is seen in case of - | [
"Kala azar",
"Malaria",
"TB",
"Hodgkin's lymphoma"
] | A | Double rise of temperature in 24 hrs is seen in case of Kala azar. Option 1, 2, 3, 4 1. L. donovani donovani, infection of the classic kala-azar ("black sickness") or dumdum fever type occurs in many pas of Asia, Africa and Southeast Asia. 2. Kala-Azar Fever: In the early stages of the disease, there is a mild irregular fever becoming intermittent at later stage and in 20% cases pyrexia shows a double rise in 24 hrs. Bone marrow involvement leads to: Anemia, leucopenia, thrombocytopenia Hypergammaglobulinemia Spleen |, Liver | Fever and Hyperpigmentation (Indian cases) LN| (African but not in Indian cases) | train | med_mcqa | null |
An adult presented with hemetemesis and upper abdominal pain. Endoscopy revealed a growth at the pyloric antrum of the stomach. CT scan showed growth involving the pyloric antrum without infiltration or invasion into surrounding structures and no evidence of distant metastasis. At Laparotomy neoplastic growth was observed to involve the posterior wall of stomach and the pancreas extending 6cm up to tail of pancreas. What will be the most appropriate surgical management? | [
"Closure of the abdomen",
"Antrectomy and vagotomy",
"Paial Gastrectomy + Distal pancreatectomy",
"Paial Gastrectomy + Distal pancreatectomy + splenectomy"
] | C | Gastric cancer have various treatment modalities. Based on this scenario, this patient falls in to T4N0M0, i.e., tumor spreading to adjacent tissues (pancreas), no regional lymphnodes involvement and no metastasis will have to go paial gastrectomy and distal pancreatectomy. Ref: Surgery in the Multimodal Management of Gastric Cancer By Giovanni De Manzoni, Walter Siquini, Franco Roviello, 2012, Page 60 | train | med_mcqa | null |
The demographic goal of Net Reproduction Rate is equal to one (NPR=1) can be achieved only if the Couple Protection Rate exceeds | [
"40%",
"50%",
"60%",
"70%"
] | C | (C) 60%[?]Couple protection rate (CPR)oCouple protection rate (CPR) is an indicator of the prevalence of contraceptive practice in the community.oIt is defined as the per cent of eligible couples effectively protected against childbirth by one or the other approved methods of family planning, viz. sterilization, IUD, condom or oral pills.oSterilization accounts for over 60 per cent of effectively protected couples.oCouple protection rate is based on the observation that 50 to 60 per cent of births in a year are of birth order 3 or more.oThus attaining a 60 per cent CPR will be equivalent to cutting off almost all third or higher order births, leaving 2 or less surviving children per couple.oTherefore, the previous National Population Policy was to attain a CPR of 42 per cent by 1990 (end of Seventh Five Year Plan), and 60 per cent by the year 2000.oHowever about 60 per cent eligible couples are still unprotected against conception.oA state-wise break-up of the figures reported indicates that while some states notably Punjab, Gujarat, Maharashtra, Karnataka, Haryana and Tamil Nadu etc. are forging ahead to cover more than half of their fertility level population by contraception.oDifferent Family Planning methods used for Acceptors of Couple Protection Rate include:-Sterilization-Vasectomy-Tubectomy-IUD insertion-Condom users-Oral Contraceptive Pill UsersoNRR = 1 can be achieved only if the CPR >60%[?]Net Reproduction Rate (NRR)oNet Reproduction Rate (NRR) is defined as the number of daughters a newborn girl will bear during her lifetime assuming fixed age-specific fertility and mortality rates.oNRR is a demographic indicator. NRR of 1 is equivalent to attaining approximately the 2-child norm.oIt is 'the number of daughters a newborn girl will bear during her lifetime assuming fixed age-specific fertility and mortality rates'.oIt is a demographic indicator.oNRR of 1 is equivalent to attaining approximately the 2-child norm. If the NRR is less than 1, then the reproductive performance of the population is said to be below replacement level.oThe average number of Daughters a women would bear in her life if she experiences the age-specific fertility (fro daughters) prevailing at the study period, & if her daughters experienced the prevailing rates of mortality.oIf the age schedules of both fertility & mortality remain constant, the Net Reproduction Rate would be a measure of generational Replacement.oE.g.-NRR =1.1 - Next generation will be 10% larger than the present generation (growth)-NRR =1.0 - Next generation will be the same as the present generation (replacement level)-NPR =0.9 - next generation will be 10% smaller than the present generation (depopulation)[?]Net Reproduction Rate, Pros & Cons.oPros-Taking into account both fertility & survival in getting one indicator of reproductivity of a PopulationoCons-Requires detailed data on fertility & survival of women, up to age 50 years-Does not take into account that women born in different years may have different fertility & survival. | train | med_mcqa | null |
Hypokalemia in an infant may be due to all of the following except - | [
"Adrenal tumor",
"Adrenal tumor",
"Thiazide therapy",
"Diarrhea"
] | B | Ans. is 'b' i.e., Acute Renal failure Hypokalemia o Hypokalemia is defined as serum potassium values of less than 3.5 meq/L. Impoant causes of hypokalemia in children Spurious Decreased intake Renal losses o Leukemia o Aorexia nervosa o Distal A Transcellular shift o External loss o Proximal A o Alkalosis o Diarrhea o Hypomagnesemia o b-agonists o Laxative use o Gitelman syndrome o Theophylline o Bater syndrome Cushing sync ,ine due to adrenal adenoma or hyperplasia Drugs : Diuretics, Cisplatin, amphotericin, Aminoglycosides. | train | med_mcqa | null |
Benzodiazepine (BZD) receptor antagonist is - | [
"Nalorphine",
"Carbamazepine",
"Naloxone",
"Flumazenil"
] | D | Ans. is 'd' i.e., Flumazenil o Flumazenil is a benzodiazepene analogue which competes with BZD agonists as well as inverse agonists for the BZD receptor and reverses their depressant or stimulant effects respectively.o It also antagonizes the action of Zolpidem, Zopiclone and Zopeplon as these drugs also act on BZD site. | train | med_mcqa | null |
A woman aged 60 yrs suffers a fall; her lower limb is extended and externally rotated; likely diagnosis is: | [
"Neck of femur fracture",
"Interochanteric femur fracture",
"Posterior dislocation of hip",
"Anterior dislocation of hip"
] | A | An aged woman presents with extended & externally rotated lower limb following a fall indicates fracture of neck of femur. Ref: Essential Ohopedics By Maheshwari 2nd Edition, Page 197 ; Apley's System of Ohopaedics and Fractures, 8th Edition, Page 685 | train | med_mcqa | null |
A patient with tubercular pleural effusion falls under category of WHO grading of TB -a) Ib) IIc) IIId) IV | [
"a",
"ac",
"ad",
"b"
] | B | null | train | med_mcqa | null |
Most common side effect of DH Ps calcium channe blockers is - | [
"Headache",
"Constipation",
"Diarrhoea",
"Muscle cramps"
] | A | Ans. is `a' i.e., Headache o The most common side effects caused by the Ca" channel antagonists, paicularly the dihydropyridines, are due to excessive vasodilator. Symptoms include dizziness, hypotension, headache, flushing, digital dysesthesia, and nausea. | train | med_mcqa | null |
Ailurophobia is | [
"Fear of height",
"Fear of water",
"Fear of cats",
"Fear of strangers"
] | C | Acrophobia : Fear of height.
Hydrophobia : Fear of water.
Ailurophobia : Fear of cats.
Xenophobia : Fear of strangers. | train | med_mcqa | null |
In the treatment of which of the following poisoning cholinesterase reactivator is used? | [
"Curare",
"Organophosphorus compounds",
"Amanita muscaria",
"All of the above"
] | B | Ans. b (Organophosphorus compounds) (Ref. KDT 5th/pg. 100, 105)The commonly used cholinesterase inhibitors fall into three chemical groups:# Simple alcohols bearing a quaternary ammonium group, e g., edrophonium;# Carbamic acid esters of alcohols bearing quaternary or tertiary ammonium groups (carbamates, eg, neostigmine); and# Organic derivatives of phosphoric acid (organophosphates, e.g., echothiophate).CHOLINESTERASE REACTIVATORS# Used to restore neuromuscular transmission in case of organophosphate antiChE poisoning.# Pralidoxime (2-P AM) has a quartemary nitrogen: attaches to the anionic site of the enzyme which remains unoccupied in the presence of organophosphate inhibitors. Its oxime end reacts with the phosphorus atom attached to the esteratic site: the oximephosphonate so formed diffuses away leaving the reactivated ChE.# It is ineffective as an antidote to carbamate antiChEs (physostigmine, neostigmine, carbaryl, propoxur) in which case the anionic site of the enzyme is not free to provide attachment to pralidoxime.# It is rather contraindicated in carbamate poisoning because not only it does not reactivate carbamylated enzyme, it has weak anti ChE activity of its own.# Pralidoxime (800 mg/20 mL infusion) is injected i.v. slowly in a dose of 1-2 g (children 20-40 mg/kg).# It causes more marked reactivation of skeletal muscle ChE than at autonomic sites and not at all in the CNS (does not penetrate).# Treatment should be started as early as possible (within 24 hours), before the phosphorylated enzyme has undergone 'aging' and become resistant to hydrolysis. Doses may be repeated according to need (max. 12 g in first 24 hrs, lower doses according to symptoms for 1-2 weeks). The use of oximes in organophosphate poisoning is secondary to that of atropine.# Other oximes are obidoxime (more potent than pralidoxime) and diacetylmonoxime (DAM). DAM lacks quartemary nitrogen and is lipophilic. It combines with free organophosphate molecule in body fluids, rather than with those bound to the ChE. Hence, it is less effective, but reactivates ChE in the brain as well. | train | med_mcqa | null |
In Endodontics Endotec is used | [
"with lateral condensation and heated gutta percha",
"with cold lateral compaction",
"with vertical compaction",
"with Chloro Percha Technique"
] | A | null | train | med_mcqa | null |
Allen's test is useful in evaluating which of the following conditions? | [
"Digital blood flow",
"Presence of cervical rib",
"Integrity of palmar arch",
"Thoracic outlet compression"
] | C | Allen's test is performed to check the patency of radial and ulnar aeries at the wrist. Thus this test is useful in evaluating the integrity of the palmar arch. In this test, the examiner compresses both the radial and ulnar aeries at the wrist and then asks the patient to flex and extend the fingers repetitively. After the hand blanches, pressure is released from the radial aery while compression is maintained on the ulnar aery. The examiner observes how long it takes for each of the fingers to regain its pink color. The test is then repeated for the other aery. Return of the normal pink colour within 5 seconds indicate normal distal aery circulation. Ref: Bailey and Love Sho Practice of Surgery, 25th Edition, Pages 504-05; CURRENT Diagnosis and Treatment in Ohopedics, 4th Edition, Chapter 10; CURRENT Medical Diagnosis and Treatment, 2012, Chapter 24. | train | med_mcqa | null |
An elderly male presents with headache, recurrent infections and multiple punched out lytic lesions of x-ray skull. The investigation that will best help in establishing a diagnosis is: | [
"Protein Electrophoresis",
"Serum calcium",
"Alkaline phosphatase levels",
"Acid phosphatase levels"
] | A | Answer is A (Protein Electrophoresis) Presence of symptoms of hyperviscocity syndrome (Headache), recurrent infections (ineffective defense against infections) and multiple punched out lytic lesions in the skull suggest a diagnosis of Multiple myeloma Protein electrophoresis will help demonstrate a characteristic 'M spike' and help in establishing the diagnosis of inultipk myeloma. Serum Calcium is likely to be elevated while serum alkaline phosphatase levels are likely to be normal. Although both serum calcium and serum alkaline phosphatase levels may be done to suppo a diagnosis of Multiple Mveloma, demonstration of the charachteristic 'M spike' on protein electrophoresis is the single preferred investigation. Classic Triad of Multiple Myeloma Relevant investigations Marrow plasmacytosis > 10% (Bone Marrow examination: Not provided in options) Lytic bone lesions (X-Ray skull: Already performed in patient) Serum/urine M component (Protein Electrophoresis: Suggested next investigation) | train | med_mcqa | null |
Normal capacity of renal pelvis is | [
"7 ml",
"12 ml",
"15 ml",
"20 ml"
] | A | The renal pelvis is roughly pyramidal, with the base facing the parenchyma and the apex funneling down into the ureter. It usually has a capacity of 3 to 10 mL of urine. ref : campbell - walsh urology 11th ed , chapter 42 , pg no : 973 | train | med_mcqa | null |
Human immunoglobulin A can be described by which of the following statements? | [
"It is the predominant immunoglobulin in plasma",
"It exists in four subclasses, of which IgA 2 is predominant",
"It can prevent attachment of microorganisms to epithelial cell membranes",
"It is prominent early in the immune response and is the major class of antibody in cold agglutinins"
] | C | Immunoglobulin A is the predominant immunoglobulin in body secretions (IgG is predominant in serum). Each secretory IgA molecule is a dimer consisting of a secretory component and a J chain. The secretory component, a protein of molecular weight 70,000, is synthesized by epithelial cells and facilitates IgA transpo across mucosal tissues. The J chain is a small glycopeptide that aids the polymerization of immunoglobulins. IgA exists as two subclasses: IgAI (75% of the total) and IgA2 (25% but more prevalent in secretions). IgA provides defense against local infections in the respiratory, gastrointestinal, and genitourinary tracts, and prevents access of foreign substances to the general systemic immune system. It also can prevent virus binding to epithelial cells. IgM, not IgA, is the principal immunoglobulin in the primary immune response and is the usual antibody in cold agglutinins. The half-life of IgA is about 6 days; IgE has the shoest half-life, approximately 2 to 2.5 days. Ref : Ananthanarayana textbook of Microbiology 9th edition Pgno : 97 | train | med_mcqa | null |
The most common cause of Addison's disease is - | [
"Autoimmune adrenalitis",
"Meningococcal septicemia",
"Malignancy",
"Tuberculosis"
] | A | Most common cause (60%-70%) of primary adrenocorticol insufficiency (Addison'discases) is autoimmune adrenelitis.
Other common cause are.
Tuberculosis → Most common cause of Addison's disease in India.
AIDS
Metastatic cancers | train | med_mcqa | null |
Gamekeepers thumb is | [
"Thumb metacarpophalangeal joint ulnar collateral ligament rupture",
"Thumb metacarpophalangeal joint radial collateral ligament rupture",
"Thumb interphalangeal joint ulnar collateral ligament rupture",
"Thumb interphalangeal joint radial collateral ligament rupture"
] | A | Injury to the thumb metacarpophalangeal joint ulnar collateral ligament is commonly referred to as gamekeeper thumb or skier's thumb, although the original "gamekeeper" description (Campbell, 1955) referred to an attritional ulnar collate-earl ligament injurySnow skiing accidents and falls on an outstretched hand with forceful radial and palmar abduction of the thumb are the usual cases(Refer: Mohindra's Fundamentals of Ohopedics, 2nd edition, pg no. 177, 495) | train | med_mcqa | null |
True regarding GERD is all except - | [
"Avoid coffee & tea",
"Transient lower esophageal relaxation",
"Lower esophageal sphincter length and its pressure is impoant",
"Proton pump inhibitor is the treatment of choice"
] | C | Gastro-oesophageal reflux disease Gastro-oesophageal reflux resulting in heaburn affects approximately 30% of the general population. Pathophysiology Occasional episodes of gastro-oesophageal reflux are common in healthy individuals. Reflux is normally followed by oesophageal peristaltic waves that efficiently clear the gullet, alkaline saliva neutralises residual acid and symptoms do not occur. Gastro- oesophageal reflux disease develops when the oesophageal mucosa is exposed to gastroduodenal contents for prolonged periods of time, resulting in symptoms and, in a propoion of cases, oesophagitis. Abnormalities of the lower oesophageal sphincter The lower oesophageal sphincter is tonically contracted under normal circumstances, relaxing only during swallowing (p. 766). Some patients with gastro-oesophageal reflux disease have reduced lower oesophageal sphincter tone, permitting reflux when intra-abdominal pressure rises. In others, basal sphincter tone is normal but reflux occurs in response to frequent episodes of inappropriate sphincter relaxation. Hiatus hernia Hiatus hernia causes reflux because the pressure gradient is lost between the abdominal and thoracic cavities, which normally pinches the hiatus. In addition, the oblique angle between the cardia and oesophagus disappears. Many patients who have large hiatus hernias develop reflux symptoms but the relationship between the presence of a hernia and symptoms is poor. Hiatus hernia is very common in individuals who have no symptoms, and some symptomatic patients have only a very small or no hernia. Neveheless, almost all patients who develop oesophagitis, Barrett's oesophagus or peptic strictures have a hiatus hernia. Delayed oesophageal clearance Defective oesophageal peristaltic activity is commonly found in patients who have oesophagitis. It is a primary abnormality, since it persists after oesophagitis has been healed by acid-suppressing drug therapy. Poor oesophageal clearance leads to increased acid exposure time. Ref Davidson edition23rd pg791 | train | med_mcqa | null |
Hess's (Tourniquet) test is a feature of - | [
"Idiopathic Thrombocytopenic Purpura (I.T.P)",
"Secondary thrombocytopenia",
"Allergic purpura",
"Senile purpura"
] | A | null | train | med_mcqa | null |
Hyperpigmentation is seen in all except | [
"peutz jeghers syndrome",
"addison's disease",
"cushing's sydrome",
"Aright syndrome"
] | C | null | train | med_mcqa | null |
Which of the following has strong affinity for hemoglobin and acts in blood to act as "mop-up" molecule to bind hemoglobin? | [
"Ferritin",
"Transferrin",
"Haptoglobin",
"Albumin"
] | C | Ans. c (Haptoglobin). (Ref. Robbin, Pathology, 7th ed., 624; Harrison, Internal medicine 15th ed., s608)Free Hb in plasma is promptly bounded by an alphal globulin, the haptoglobin that acts as 'mop-up' producing a complex that is rapidly cleared by mononuclear phagocyte system, thus preventing excretion in urine; hence in intravascular hemolysis serum haptoglobin is decreased.GENERAL FEATURES OF HEMOLYTIC DISORDERSGeneral examinationJaundice, pallorOther physical findingsSpleen may be enlarged; bossing of skull in severe congenital casesHemoglobinFrom normal to severely reducedMCV, MCHUsually increasedReticulocytesIncreasedBilirubinIncreased (mostly unconjugated)LDHIncreased (up to 10X normal with intravascular hemolysis)HaptoglobinReduced to absent | train | med_mcqa | null |
Glomerulonephritis associated with AIDS is- | [
"Focal segmental GN",
"PSGN",
"MPGN",
"Membranous GN"
] | A | null | train | med_mcqa | null |
Slit shaped nipple seen in | [
"Duct ectasia",
"Duct pappiloma",
"Paget's disease",
"CA breast"
] | A | Answer- A. Duct ectasiaDuct ectasia is dilatation of lactiferous ducts associated with periductal inflammation.Chronic inflammation and scarring will lead to indrawing and slit-shaped inversion of the nipple.If secondary infection supervenes, a mammary duct fistula can also develop. | train | med_mcqa | null |
The nerve responsible for Cremasteric reflex is: | [
"Hypogastric nerve",
"Genito femoral nerve",
"Ilioinguinal nerve",
"All of the above"
] | B | Genito femoral nerve | train | med_mcqa | null |
MHC CLASS III CODES for all except – | [
"complement C3",
"properdin",
"TNF –alpha",
"heat shock proteins."
] | A | null | train | med_mcqa | null |
All are impoant laboratory features of hemolytic anemia , EXCEPT: | [
"Normal AST",
"Elevated urobilinogen in stool",
"Reduced haptoglobin",
"Macrocytes in blood smear"
] | A | The laboratory features of Hemolytic anemia: Increase in unconjugated bilirubin and aspaate transaminase (AST) Urobilinogen increased in both urine and stool. Hemoglobinuria (often associated with hemosiderinuria) in intravascular hemolysis Lactate dehydrogenase (LDH) is increased Increase in reticulocytes Increased mean corpuscular volume (MCV) On the blood smear-presence of macrocytes Haptoglobin is reduced. ( Please NOTE) Ref: Harrison, E-18,P-872. | train | med_mcqa | null |
The active principal in calotropis is all, except | [
"Calotoxin",
"Calactin",
"Uscharin",
"Bhilawanol"
] | D | Bhilawanol is an active principle of Semecarpaus anacardium. Active principles of calotropis: Uscharin, calotoxin and calotropin | train | med_mcqa | null |
Feature of slow sand filter | [
"Fit in a little space",
"Filter is cleaned by back washing",
"Can be handled by less killed person",
"Used in Big cities"
] | C | null | train | med_mcqa | null |
Which of the following estimating the burden of a disease in the community is | [
"Disease specific mortality",
"Proportional mortality rate",
"Maternal mortality rate",
"Child mortality rate"
] | B | (Proportional mortality rate) (23 - Park 19th) (25, 54-Park 20th)Proportional mortality rate - The simplest measures of estimating the burden of a disease in the community is proportional mortality rate i.e. - the proportion of all deaths currently attributed to it.* The proportional mortality rate from communicable disease has been suggested as a useful health status indicator* It indicate the magnitude of preventable mortality | train | med_mcqa | null |
Rice contains - | [
"6 % protein",
"12 % protein",
"14 % protein",
"0.6 % protein"
] | A | The protein content of rice varies from 6-9 percent. REF. PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE 21ST EDITION. PAGE NO - 627 | train | med_mcqa | null |
Which one of the following life-threatening congenital anomalies in the newborn presents with polyhydramnios, aspiration pneumonia, excessive salivation and difficulty in passing a nasogastric tube? | [
"Gastroschisis",
"Diaphragmatic hernia",
"Tracheo-esophageal fistula",
"Choanal atresia"
] | C | c. Tracheo-esophageal fistula(Ref: Nelson's 20/e p 1783, Ghai 8/e p 176)Presence of polyhydramnios, aspiration pneumonia, excessive salivation and difficulty in passing a nasogastric tube all point towards a diagnosis of tracheoesophageal fistula, which is usually accompanied by esophageal atresia.Esophageal atresia (EA) and TEF (Tracheoesophageal fistula):Important features* EA is the most frequent congenital anomaly of esophagus; 90% of EA babies have TEF* Most common type is upper esophagus ends in a blind pouch and TEF connected to distal esophagusTypical presentation* Maternal polyhydramnios is seen; New born presents with respiratory distress and excess oral frothing;* Newborn regurgitates all of its feeds; Saliva pours almost continuously from the mouth of the infant* Attacks of coughing and cyanosis occurs on feeding; Feeding tube cannot be passed more than 10cmDiagnosis* Chest X-ray with a red rubber catheter passed per orally shows coiled rubber catheter in a lucent proximal esophageal pouch* X-ray abdomen; Gas in the stomach is seen if there is communication between the lower part of the esophagus and trachea, which occurs in the commonest variety of tracheoesophageal fistula | train | med_mcqa | null |
A patient developed breathlessness and chest pain, on second postoperative day after a total hip replacement. Echo-cardiography showed right ventricular dilatation and tricuspid regurgitation. What is the most likely diagnosis- | [
"Acute MI",
"Pulmonary embolism",
"Hypotensive shock",
"Cardiac tamponate"
] | B | *Onset of chest pain and breathlessness, together with echocardiographic evidence of right ventricular dilatation and tricispid regurgitation after a high risk procedure like total hip replacement suggests a diagnosis of pulmonary embolism. REF:Campbell's 11th/e Chapter-7 | train | med_mcqa | null |
A child with pyoderma becomes toxic and presents with respiratory distress. His chest radiograph shows patchy areas of consolidation and multiple bilateral thin-walled air containing cysts. The most likely etiological agent in this case is – | [
"Mycobacterium tuberculosis",
"Staphylococcus aureus",
"Mycobacterium avium intracellulare",
"Pneumocystis carinii"
] | B | Pneumonia with pneumatoceles (multiple thin-walled breaths of air containing cysts) is s/o staphylococcal pneumonia.
Clinical features of staphylococcal pneumonia
The illness usually follows upper respiratory tract infection, pyoderma or another associated purulent disease.
Besides the usual features of pneumonia child has fever and anorexia and is listless and irritable.
The abdomen is usually distended due to septicemia and ileus.
Cyanosis may be present
Progression of the symptoms and signs is rapid.
Diagnosis-
The diagnosis of staphylococcal pneumonia is suspected in a newborn or an infant with respiratory infection who has evidence of staphylococcal infection elsewhere in the body (here it is pyoderma).
Complications such as pyopneumothorax and pericarditis are highly suggestive of diagnosis (Empyeina in a child below 2 yrs of age is nearly always staphylococcal in etiology)
Presence of Pneumatoceles is considered pathognomic for staphylococcal pneumonia (It can also be seen in pneumonia due to Klebsiella)
Note: Pyoderma or impetigo is a superficial infection of the skin caused primarily by group A streptococci and occasionally by other streptococci and staphylococci.
Tachypnea is the most consistent clinical manifestation of pneumonia. - Nelson 18th /e 1797 | train | med_mcqa | null |
True about denaturation of proteins is all except: | [
"Unfolding occurs",
"Disruption of secondary structure occurs",
"Sequence of amino acids remain the same",
"Biological activity is retained"
] | D | D i.e. Biological activity is retained | train | med_mcqa | null |
Nerve of Latarjet is seen in | [
"Thorax",
"Neck",
"Stomach",
"Hea"
] | C | The nerve of Latarjet or the posterior nerve of the lesser curvature is a branch of the anterior vagal trunk which supplies the pylorus. BD CHAURASIA S HUMAN ANATOMY Vol 3 | train | med_mcqa | null |
Nerve supply of the tympanic membrane is by the | [
"Auriculotemporal",
"Lesser occipital",
"Greater occipital",
"Parasympathetic ganglion"
] | A | A i.e. Aurico-temporal nerve | train | med_mcqa | null |
Which type of refractive error is seen in keratoconus- | [
"Irregular astigmatism",
"Regular astigmatism",
"Myopia",
"Hypermetropia"
] | A | Ans. is 'a' i.e., Irregular astigmatism. Examination findings o The hallmark of keratoconus is central or paracentral stromal thinning, apical protrusion of the anterior cornea and irregular astigmatism. The cornea thins near the center and progressively bulges forwards, with the apex of cone always being slightly below the center of the cornea. o Corneal topography is the most sensitive method for detecting keratoconus, it can document the presence of keratoconus even before keratometric or slit lamp findings become apparent o On examination following findings are there:- i) Distorted window reflex (corneal reflex). ii) Placido disc examination shows irregularity of the circles. iii) Keratometry shows irregular astigmatism where the principle meridian are no longer 90deg apart and the mires cannot be superimposed, i.e., malaligned mires. iv) Slit lamp examination shows : - a) Thinning and ectasia of central cornea b) Opacity at the apex c) Fleisher's ring at the base of the cone. d) Folds in Descemet's and Bowman's membrane e) Very fine, vertical, deep stromal stria (Vogt lines) which disappear with external pressure on the globe. v) On retinoscopy: - A Yawning reflex (Scissor reflex) and high oblique or irregular astigmatism is obtained. vi) On distant direct ophthalmoscopy: - Oil droplet reflex, i.e., an annular dark shadow which separates the central and peripheral areas of the cornea. vii) Munson's signs: - Localized bulging of the lower lid when the patient looks down. It is a late sign. viii) Prominent corneal nerves. | train | med_mcqa | null |
A soft contact lens users has corneal keratitis cause is | [
"Acanthamoeba-ulcer",
"Erosion of cornea",
"Pseudomonas infection",
"Herpes infection"
] | C | C i.e. Pseudomonas infection | train | med_mcqa | null |
Localized formation of dentin on the pulp-dentin border formed in reaction to caries or restorative procedures is known as | [
"Tertiary dentin",
"Secondary dentin",
"Primary dentin",
"Interglobular dentin"
] | A | null | train | med_mcqa | null |
A neonate with respiratory distress and the following chest X ray most likely has: | [
"Cystic fibrosis",
"CLE",
"CCAM",
"Pneumonia"
] | B | null | train | med_mcqa | null |
Which of the following is not a structural gene of HIV - | [
"Gag",
"Polio",
"ENV",
"Tat"
] | D | tat is a nonstructural and regulatory gene of HIV REF:ANANTHANARAYANAN TEXT BOOK OF MICROBIOLOGY 9EDITION PGNO.572 | train | med_mcqa | null |
Prolonged exposure to noise levels greater than the following can impair hearing permanently: | [
"40 decibels",
"85 decibels",
"100 decibels",
"140 decibels"
] | C | A noise of 90 dB SPL, 8 hours a day for 5 days per week is the maximum safe limit as recommended by ministry of labour, govt of India-rules under factories act. | train | med_mcqa | null |
Urgent reversal of warfarin induced bleeding can be done by the administration of | [
"Cryoprecipitate",
"Platelet concentrates",
"Fresh frozen plasma",
"Packed red blood cells"
] | C | Fresh frozen plasma contains clotting factors . Hence given immediately in warfarin induced bleeding. From essential of medical pharmacology K D Tripati 7th edition Page no 620 | train | med_mcqa | null |
A 70-year-old patient presents with dizziness and headache followed by left sided hemiparesis with right eye dilatation and ptosis. Most probable blood vessel damaged is: | [
"Middle cerebral artery",
"Anterior communicating artery",
"Posterior cerebral artery",
"Basilar artery"
] | C | Ans: (c) Posterior cerebral arteryRef: Adams and Victor's Principles of Neurology, 10th edition, Page 804; Localisation in Clinical Neurology, 6th edition, Chapter 105EponymSiteCranial nerves involvedTracts involvedSignsArteries involvedWeber SyndromeBase of midbrainIIICorticospinal tractOculomotor palsy with crossed hemiplegiaProximal posterior cerebral arteryClaude syndromeTegmentum of midbrainIIIRed nucleus, superior cerebellar peduncles after decussationOculomotor palsy with contralateral cerebellar ataxia and tremorProximal posterior cerebral arteryBenedict syndromeTegmentum of midbrainIIIRed nucleus, corticospinal tract superior cerebellar peduncles after decussationOculomotor palsy with contralateral cerebellar ataxia, tremor, and corticospinal signs, choreoathetosisProximal posterior cerebral arteryNothnagel syndromeTectum of midbrainUnilateral or bilateral III nerveSuperior cerebellar pedunclesOcular palsies (IV), paralysis of gaze, nystagmus and ataxia Parinaud syndromeDorsal midbrain Supranuclear mechanism for upward gaze and dorsal midbrain, periaqueductal gray matterParalysis of upward gaze and accommodation; fixed pupils Millard Gubler syndromeUnilateral lesion of the ventrocaudal ponsFascicles of cranial nerves VI and VIIPyramidal tract, cranial nerve VI, cranial nerve VIIContralateral hemiplegia, Ipsilateral lateral rectus paresis, Ipsilateral peripheral facial paresis Raymond SyndromeUnilateral lesion of the ventral medial ponsAbducens nerve fascicles and the corticospinal tract but spares cranial nerve VIIPyramidal tract, cranial nerve VIIpsilateral lateral rectus paresis, contralateral hemiplegia Locked-in syndromeBilateral ventral pontine lesions Bilateral corticospinal tract involvement in the basal pontis, involvement of the corticobulbar fibers innervating the lower cranial nerve nucleiQuadriplegia, Aphonia Foville syndromeDorsal pontine tegmentumInvolvement of the nucleus and fascicle (or both) of cranial nerve VIICorticospinal tract, involvement of the PPRF or abducens nucleus, or bothContralateral hemiplegia (with facial sparing), Ipsilateral peripheral type facial palsy, Inability to move the eyes conjugately to the ipsilateral side involvement of the PPRF or abducens nucleus, or both Raymond- Cestan syndromeRostral lesions of the dorsal pons Involvement of the cerebellum, medial lemniscus and the spinothalamic tract, PPRFCerebellar signs (ataxia), Contralateral hypoesthesia with reduction of all sensory modalities (face and extremities), contralateral hemiparesis, paralysis of conjugate gaze toward the side of the lesion Marie-Foix syndromeLateral pontine lesions brachium pontis Involvement of cerebellar connections, corticospinal tract, spinothalamic tractIpsilateral cerebellar ataxia, Contralateral hemiparesis,Variable contralateral hemihypesthesia for pain and temperature Wallenburg syndromeLateral tegmentum of medullaSpinal V, IX, X, XILateral spinothalamic tract,spinocerebellar and ollivocerebellar tractsIpsilateral V, IX, X,XI palsy, Horner syndrome,-cerebellar ataxia; contralateral loss of painand temperature senseIntracranial vertebral artery or posterior inferior cerebellar arteryMedial Medullary syndrome (Dejerine's Anterior Bulbar Syndrome)Medial medullaXIICranial nerveXII,Corticospinal tract,medial lemniscusIpsilateral paresis, atrophy, and fibrillation of the tongue, Contralateral hemiplegia, Contralateral loss of position and vibratory sensationVertebral artery, anterior spinal artery, or the lower segment of the basilar arteryAvellis syndromeTegmentum of medullaXSpinothalamic tractParalysis of soft palate and vocal cord and contralateral hemianaesthesia Thalamic syndrome of Dejerine and Roussy Occlusion of thalamogeniculate branches of PCA | train | med_mcqa | null |
Which of the following is not an indicator for disability? | [
"HALE",
"DALY",
"Pearl index",
"Sullivan's index"
] | C | Pearl index is a measure of effectiveness of a contraceptive method. It is expressed as failure rate per 100 woman years and is not related to disability. Note: HALE - Health Adjusted Life Expectancy DALY - Disability Adjusted Life Years Ref: Park's Textbook of Preventive Medicine, 17th Edition, Pages 22, 351. | train | med_mcqa | null |
Zika Virus is transmitted by | [
"Anopheles",
"Culex",
"Aedes",
"Mansonia"
] | C | Zika virus is transmitted to people primarily through the bite of an infected Aedes species mosquitoRef: Park; Pg. No: 293 | train | med_mcqa | null |
Atopic Dermatitis is diagnosed by: | [
"Patch test",
"Wood Lamp",
"Clinical Examination",
"#NAME?"
] | C | C i.e. Clinical Examination Itch (or pruritis)Q is a major diagnostic criteria whereas, Denny Morgan infra orbital fold is a minor criteria for diagnosis of atopic dermatitis. Atopic dermatitis most commonly involves flexural surfaces like antecubital and popliteal fossa Q. However, in infantile phase, face and extensor surface (convexities) are more commonly involved. Spongiosis of epidermis Q is the histological hallmark of dermatitis (eczema). Contact dermatitis is diagnosed by patch testQ & Atopic dermatitis is diagnosed by clinical examinationQ. Clinical criteria for diagnosis of atopic dermatitis Family h/o allergy/atophy Personal history of allergy/atophy i.e. presence of other atopic condition asQ - rhinitis, hay fever, asthma, food allergy or eczemaQ. Extremily pruritic lesions commonly on antecubital or popliteal fossaf2 Dienny morgan foldQ, white dermographism Exacerbation & remissions. Pruritis and scratching made worse by environmental alteration, changes in temperature, sundry (in rainy season) & rough (woolen) clothingQ and leading to excoriation, lichenificationQ, dryness & Dennie's line. Clinical course lasting longer than 6 weeksQ. Lesions typical of eczematous dermatitis i.e. papules, erythematous macules and vesicles, which can coalesce to form patches and plaques. Disease Diagnosis made by Atopic Dermatitis Clinical ExaminationQ Contact Dermatitis Patch TestQ Donovanosis MicroscopyQ (demonstration of Donovan bodies or safety pin appearance)Q Syphilis Dark field microscopyQ, FTA-ABS, VDRL, MHA-TP, TPI Chancroid Gram stainine (gram -ve cocco? bacilli, school of fish or rail road appearance)Q LGV - Microscopic examination of giemsa stained scrapings for inclusion or elementary bodies - Culture, ELISA Tinea (Dermatophytes) KOH SmearQ Lupus vulgaris BiopsyQ | train | med_mcqa | null |
A one month old baby presents with frequent vomiting and failure to thrive, There are features of moderate dehydration, Blood sodium is 122 m Eq/i and potassium is 6.1 in Eq/L The most likely diagnosis is | [
"Gitelman syndrome",
"Bater syndrome",
"21 hydroxylase deficiency",
"11 B-hydroxylase deficiency"
] | C | 21 Hydroxylase deficiency - (A) Salt losing form of CALL due to associated with aldosterone deficiency, these patients presents with severe vomiting, and vascular collapse. Hyponatreniia hypochloremia and hyperkalemia (B) A Cryptic form of CAH is asymptomatic - presents with menstrual irregularities, acne, hirsutism * Female pseudo hermaphroditism in female 11 b hydroxylase deficiency - presents with hypeension, and hypokalemia Bater's syndrome - - Presents during childhood, having growth retardation, normal to low BP, hypokalemia secondary to renal K+ wasting, metabolic alkalosis, nephrocalcinotic Gitelman's syndrome - (Variant of Bater's syndrome presents during adolescence/adult hood) * Hypokalemia, hypocalciuria, hypomagnesemia and normal prostaglandin production * Metabolic alkalosis | train | med_mcqa | null |
Lymphogranuloma venerum is caused by - | [
"Chlamydia trachomatis",
"Calymmatobacter granulomatis",
"Haemophilus ducreyii",
"Treponema pallidum"
] | A | Ans. is 'a' i.e., Chlamydia trachomatis | train | med_mcqa | null |
A 42-year-old woman presents with a diffuse swelling in front of the neck. Thyroid function tests are within normal limits. A fine-needle biopsy reveals malignant cells. The tumor is excised and examined. The tumour cells are positive for calcitonin on immunohistochemistry. What is the appropriate pathologic diagnosis? | [
"Anaplastic carcinoma",
"Follicular carcinoma",
"Medullary carcinoma",
"Papillary carcinoma"
] | C | Medullary carcinoma thyroid microscopic features: Composed of polygonal to spindle-shaped cells, which may form nests, trabeculae, and even follicles. Small, more anaplastic cells are present in some tumors and may be the predominant cell type. Amyloid deposits derived from calcitonin polypeptides are present in the stroma in many cases. Calcitonin is readily demonstrable within the cytoplasm of the tumor cells as well as in the stromal amyloid by immunohistochemical methods. Electron microscopy reveals variable numbers of membrane-bound electron-dense granules within the cytoplasm of the neoplastic cell. | train | med_mcqa | null |
Quality indicator of MCH services ? | [
"IMR",
"MMR",
"CMR",
"None"
] | A | Ans. is 'a' i.e., IMR IMR is best indicator for:? Health status of a community. Level of living. Effectiveness of MCH services. IMR is second best indicator of socioeconomic status of country (under 5 moality rate is more refined indicator for socioeconomic status). | train | med_mcqa | null |
Central dot sign is seen in? | [
"Primary sclerosing cholangitis",
"Liver Hamaoma",
"Caroli's disease",
"Polycystic liver disease"
] | C | Ans is c i.e. Caroli's disease Caroli's disease is a rare congenital abnormality in which there is communicating cavernous ectasia of the intrahepatic biliary ducts. Caroli's disease is equivalent to type V choledochal cyst. It is commonly associated with congenital hepatic fibrosis and cystic lesions of the kidney.Patients present in late childhood or early adulthood with cholangitis. Ultrasound and CT shows cystic lesions within the liver. A central dot within the cystic lesions is specific for Caroli's disease. The central dot represents the poal vein surrounded by the dilated bile duct. Choledochal cyst A choledochal cyst is an isolated or combined congenital dilatation of the extrahepatic or intrahepatic biliary tree. | train | med_mcqa | null |
Devesh is working as a CEO in a company. He has a traveling job. He is a known diabetic, controlled on oral hypoglycemic drugs. On his recent visit to the doctor, his blood pressure was found to be 164/102 mm Hg. Most suitable drug for this patient should be? | [
"Propanolol",
"Enalapril",
"Clonidine",
"Hydrochlohiazide"
] | B | ACE inhibitors (Enalapril) are safe and effective agents in diabetic patients with hypeension. Thiazides and b-blockers (Propanolol) are contraindicated in diabetic patients. As the patient has frequent travelling job, he is likely to miss the doses. Therefore, clonidine should be avoided to prevent rebound hypeension. | train | med_mcqa | null |
Amongst various current criteria for FUO (Fever of Unknown origin), one relates to body temperature = | [
"98.4deg F",
"99.4deg F",
"100deg F",
"101deg F"
] | D | Ans. d (101deg F). (Ref: Harrison's 17th edition, P. 130).PUO/FUO# Petersdorf and Beeson (1961)# Temperature > 101deg F (38.3degF) on several occasions# Duration of fever > 3 weeks# Failure to reach diagnosis despite inpatient investigations for 1 week.Also Remember:Neutropenic FUO# Neutrophil count < 500/cmmHIV Associated FUO# Duration of fever >4 weeks# And inpatient investigation with failure to reach diagnosis is > 3 daysMost common cause of PUO# Infection (26%) -m/c extrapulmonary TBMost common cause of PUO in elderly# Multisystem disease (Giant cell artheritis)Undiagnosed Cause for FUO# 25-30Malignancies associated with FUO# Ca colon (most common cause)# Hepatoma# Gall bladder Ca# Lymphoma, leukemia# Pancreatic cancer# Renal cell cancer# Sarcoma# Atrial myxoma# Renal angiomyoliposa | train | med_mcqa | null |
What is meant by suppositious child - | [
"Second born of a twin pregnancy",
"Child born out of wedlock",
"Child rear up by a woman & She claims the child",
"Heterozygous mother & father"
] | C | Ans. is 'c' i.e., Child rear up by a woman & She claims the child Suppositious child Suppositious child means a factitious child. o Women may pretend pregnancy as well as delivery & later produces a child as if it is her own. She may substitute a living male child for a dead child or for a living female child born of her. | train | med_mcqa | null |
Recurrant interosseous aery is a branch of | [
"Posterior interosseous aery",
"Anterior interosseous aery",
"Radial aery",
"Ulnar aery"
] | A | Near its origin , posterior interosseous aery gives off interosseous recurrent aery which runs upwards , and ends by anastomosing with middle collateral aery behind lateral epicondyle . B D Chaurasia 7th edition Page no : 113 | train | med_mcqa | null |
All can be used for systematic fungal infections except: | [
"Ketoconazole",
"Fluconazole",
"Amphotericin B",
"Griseofulvin"
] | D | Griseofulvin: It was one of the early antibiotics extracted from Penicillium griseofulvum. However, because of lack of antibacterial activity, little attention was paid to it: clinical utility in dermatophytosis was demonstrated only around 1960. Griseofulvin is active against most dermatophytes, including Epidermophyton, Trichophyton, Microsporum, etc, but not against Candida and other fungi causing deep mycosis. Bacteria are also insensitive. Dermatophytes actively concentrate it: this feature probably accounts for its selective toxicity. Resistance can be induced in vitro and this is associated with loss of concentrating ability. However, emergence of resistance during clinical use is rare. Griseofulvin interferes with mitosis-multinucleated and stunted fungal hyphae result from its action. It also causes abnormal metaphase configurations. However, unlike the typical mitotic inhibitors (colchicine, vinca alkaloids), it does not cause metaphase arrest; rather the daughter r tuclei fail to move apa or move only a sho distance. It does not inhibit polymerization of tubulin (microtubular protein which pulls the chromosomes apa), but binds to polymerized microtubules and somehow disorients them. Pharmacokinetics The absorption of griseofulvin from g.i.t. is somewhat irregular because of its very low water solubility. Absorption is improved by taking it with fats and by microfining the drug paicles; now ultramicrofine paicle preparations from which absorption is still better are available. Griseofulvin gets deposited in keratin forming cells of skin, hair and nails; it is especially concentrated and retained in tinea infected cells Because it is fungistatic and not cidal, the newly formed Keratin is not invaded by the fungus, but the fungus persists in already infected keratin. till it is shed off. Thus, the duration of treatment is dependent upon the site of infection, thickness of infected keratin and its turnover rate. Griseofulvin is used orally only for dermatophytosis . It is ineffective topically. Systemic azoles and terbinafine are equally or more efficacious; preferred now. Majority of localized tinea infections are treated with topical agents. Griseofulvin should be reserved for cases with nail, hair or large body surface involvement. It is effective in athletes foot, but not in pityriasis versicolor. ESSENTIALS FROM MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:760,761 | train | med_mcqa | null |
Mitsuda reaction is read after: | [
"3 days",
"3 hours",
"3 weeks",
"3 months"
] | C | Lepromin Test is type IV HSR It is a PROGNOSTIC test not a diagnostic test 2 reactions are seen in Lepromin test- Early Reaction/ Fernandez- Erythema and induration develops in 24-48 hours and remain for 3-5 days and it is read after 3 days Late Reaction/Mitsuda Reaction- It stas in 1-2 weeks, reaching a peak in 4 weeks and this is read after 3 weeks | train | med_mcqa | null |
Which of the following structures pass through aoic hiatus? | [
"Thoracic duct and azygos vein",
"Thoracic duct and gastric aery",
"Vagus nerve with oesophagus",
"Aorla with oesophagus"
] | A | The aoic hiatus situated at the level of T12 veebra. Structures passing through aoic hiatus along with aoa are:Thoracic ductAzygos veinHemiazygos vein | train | med_mcqa | null |
The earliest muscle to be involved in dermatomyositis is | [
"Deltoid",
"Gluteal",
"Lumbricals",
"Quadriceps"
] | D | Dermatomyositis (DM) is a long-term inflammatory disorder which affects muscles. Its symptoms are generally a skin rash and worsening muscle weakness over time.These may occur suddenly or develop over months.Other symptoms may include weight loss, fever, lung inflammation, or light sensitivity.Complications may include calcium deposits in muscles or skin. People with DM experience progressively worsening muscle weakness in the proximal muscles (for example, the shoulders and thighs).Tasks that use these muscles: standing from sitting, lifting, and climbing stairs, can become increasingly difficult for people with dermatomyositis .(quadriceps are first effected) Ref Robbins 9/e pg 172 | train | med_mcqa | null |
WHO ORS contains - | [
"Sodium chloride 2.5 g",
"Potassium chloride 1.5 g",
"Glucose 20g",
"Shift of water from ECF to ICF"
] | B | Ans. is 'b' i.e., Potassium chloride-1.5 gm Because of the improved effectiveness of reduced osmolarity ORS solution, WHO and UNICEF are recommending that countries manufacture and use the following formulation in place of the previously recommended ORS solution. | train | med_mcqa | null |
Bell clapper testis predisposes to: | [
"Torsion testis",
"Varicocele",
"Cancer of testis",
"Hydrocele"
] | A | Testicular torsion is a condition in which testicle twists in such a way that the blood supply is compromised. Abnormalities which lead to torsion of the testis: 1. High investment of tunica vaginalis causing the testis to hang within the tunica like a clapper in the bell bilaterally. 2. Inversion of the testis. 3. Separation of the epididymis from the pedicle that connects the testis. | train | med_mcqa | null |
Apical lung carcinoma commonly manifests as: September 2009 | [
"Pleural effusion",
"Pericardial involvement",
"Homer's syndrome",
"Tumour obstruction of the airway"
] | C | Ans. C: Homer's syndrome The bulk of a true Pancoast tumor is extrathoracic, originating in an extreme peripheral location with a plaque like extension over the lung apex and principally involving the chest wall structures rather than the underlying lung parenchyma. Bronchogenic carcinomas occurring in the narrow confines of the thoracic inlet invade the lymphatics in the endothoracic fascia and include, by direct extension, the intercostal nerves, the lower roots of the brachial plexus, the stellate ganglion, the sympathetic chain, and adjacent ribs and veebrae. Carcinomas in the superior pulmonary sulcus produce Pancoast syndrome, thus causing pain in the shoulder and along the ulnar nerve distribution of the arm and hand. (These carcinomas also cause Horner syndrome.) These apical lung tumors tend to be locally invasive early. | train | med_mcqa | null |
IUCD is contraindicated in : | [
"Anemia",
"Hypeension",
"Infection",
"All of the above"
] | C | Infection | train | med_mcqa | null |
Posterolateral lesions of ventral spinal cord leads to | [
"Pyramidal signs",
"loss of joint sense",
"Loss of pressure,touch",
"Loss of pain temperature"
] | C | (C) Loss of pressure, touch | train | med_mcqa | null |
Drug of choice for prophylaxis of TB is?(DNB 2012-section-1) | [
"Rifampicin",
"Isoniazid",
"Pyrizinamide",
"Streptomycin"
] | B | Ans. (b) IsoniazidRef .KDT 6/e / 740-743 | train | med_mcqa | null |
Matrix vesicles play important role in the mineralization of | [
"Dentin",
"Enamel",
"Pulp",
"Periodontal ligament"
] | A | null | train | med_mcqa | null |
A 62-year-old man is discovered to have hyperlipidemia on screening tests after a routine physical examination. Laboratory studies show total serum cholesterol of 285 mg/dL, LDL of 215 mg/dL, HDL of 38 mg/dL, and triglycerides of 300 mg/ dL. This patient is most at risk of developing an aneurysm in which of the following anatomic locations? | [
"Abdominal aorta",
"Ascending aorta",
"Circle of Willis",
"Coronary artery"
] | A | Abdominal aortic aneurysms, which are defined as an increase in aortic diameter of 50% or more, are the most frequent aneurysms, usually developing after the age of 50 years. The most common cause of these abdominal aortic aneurysms is atherosclerosis. Aneurysms secondary to atherosclerosis are less common in the other anatomic locations listed.Diagnosis: Atherosclerosis | train | med_mcqa | null |
Most variable absorption is seen with which route | [
"oral",
"Intramuscular",
"Intravenous",
"Per rectal"
] | A | Ref-Goodman and gillman 12th/20 Oral route has maximum variability in absorption | train | med_mcqa | null |
This incidental finding on ultrasound abdomen is suggestive of: | [
"Gall bladder stone",
"Gall bladder polyp",
"Adenomyomatosis",
"Xanthgranulomatous cholecystitis"
] | C | Adenomyomatosis: Image shows: Diamond ring sign / comet tail aefact / V - shaped aefact Hyperplasia in muscularis & hyperproliferation of mucosa in gall bladder. Rokitansky-Aschoff sinuses are deep and there is deposition of Cholesterol crystal, when ultrasound is performed it looks like a ring. Rx: Symptomatic gall stone present - Lap. Cholecystectomy | train | med_mcqa | null |
Embryologically cerebellum is derived from: | [
"Prosencephalon",
"Mesencephalon",
"Rhombencephalon",
"Metancephalon"
] | D | Metancephalon | train | med_mcqa | null |
True statement concerning placenta pre is | [
"Its incidence decreases with maternal age",
"The initial hemorrhage is usually painless and rarely fatal",
"Management no longer includes a double setup",
"Vaginal examination should be done immediately on suspicion of placenta pre"
] | B | The initial haemorrhage in placenta pre is usually painless and rarely fatal.If the fetus is premature and if haemorrhage is not severe, vaginal examination of a woman suspected of having placenta pre frequently can be delayed until 37 weeks gestation; this delay in the potentially hazardous examination reduces the risk of prematurity, which is often associated with placenta pre.Vaginal examination, when needed to determine whether a low-lying placenta is covering the internal os of the cervix, should be performed in an operating room fully prepared for an emergency cesarean section (i.e., a double setup).Increasing maternal age and multiparity are associated with a higher incidence of placenta pre. | train | med_mcqa | null |
Which is an uricosuric drug- | [
"Allopurinol",
"Probenecid",
"Indomethacin",
"Aspirin"
] | B | Ans. is 'b' i.e., Probenecid Uricosuric drugs are probenacid, sulfinpyrazone and benzbromarone. | train | med_mcqa | null |
A 52 year old lady with a vesicovaginal fistula after abdominal hysterectomy is not responding to conservative management. Most useful and impoant next investigation is: | [
"Triple Swab Test",
"Urine culture",
"Cystoscopy",
"IVP"
] | C | The most valuable investigation in an established case of a vesicovaginal fistula should be cystoscopy. Ref: Female Pelvic Health and Reconstructive Surgery By Carlin and Leong, 1st Edition; Minute Obstetrics and Gynecology consult, 2008, Page 210; Urogynecology and Female Pelvic Reconstructive Surgery : Just the Facts By Sam Siddighi, Jeffrey S. Hardesty, Page 190. | train | med_mcqa | null |
Nocturnal Enuresis is occurrence of involuntary voiding at night in a child more than | [
"2 1/2 yrs",
"3 1/2 yrs",
"4 yrs",
"5 yrs"
] | D | Ans. (d) 5yrs* OP ghai states enuresis as urinary incontinence beyond the age of 4 years for daytime and 6 years for night-time enuresis.* It is said to be present if it occurs twice per week for 3 consecutive months.* Most of children attain complete bladder control by age of 5 years* The prevalence of enuresis is 7% in boys and 3% in girls at age of 5 years and keeps on decreasing for every subsequent year.* Treatment of choice for nocturnal enuresis is alarm devices with desmopressin nasal spray. | train | med_mcqa | null |
Tigroid Pattern on MRI is associated with which of the following disease? | [
"Krabbe disease",
"Niemann Pick disease",
"Alexander disease",
"Metachromatic Leukodystrophy"
] | D | Metachromatic Leukodystrophy: Is a deep white matter leukodystrophy with sparing of subcoical U-fibers and lamellated or Tigroid pattern of the involved white matter. It is associated with Aryl Sulfatase deficiency. Characterized by bilateral symmetrical confluent areas of periventricular deep white matter signal change, in paicular around the atria and frontal horns with sparing of subcoical U fibres can also leads to a "butterfly pattern". Progression can lead to coical and subcoical atrophy. | train | med_mcqa | null |
H. pylori causes: | [
"Type A Gastritis",
"Type B Gastritis",
"Autoimmune",
"Allergic gastritis"
] | B | Chronic Gastritis: Type A Type B Autoimmune etiology Circulating antobodies to the parietal cell results in the atrophy of the parietal cell mass, resulting in hypochlorhydria and ultimately achlorydria Associated with pernicious anemia Primarily involves body and fundus Associated with H. pylori infection Primarily involves antrum Ref: Bailey 27th edition Pgno: 1115 | train | med_mcqa | null |
Most common cancer of anus: | [
"Adenocarcinoma",
"Squamous cell CA",
"Basal cell CA",
"Melanoma"
] | B | Ans. (b) Squamous cell CARef: Sabiston 19th ed. /1405-06B CARCINOMA ANAL CANAL* Carcinomas arising proximal to the (dentate line) pectinate line are known as basaloid,cuboidal, or cloacogenic tumors; about one-third of anal cancers have this histologic pattern.* Malignancies arising distal to the pectinate line have squamous histology, ulcerate more frequently, and constitute 55% of anal cancer# MC type of CA anal canal: squamous cell CA > BCC > Melanoma# Median age at diagnosis: 60 years# MC symptom: Bleeding PR# MC site of metastasis: Lung# MC site of LN metastasis: Inguinal LNsClinical Features of anal Canal CA* Most patients present with rectal bleeding and pain* Patients are frequently misdiagnosed as having a benign anorectal condition such as hemorrhoids.* Additional symptoms: Incontinence, change in bowel habits, pelvic pain, and rectovaginal or rectovesical fistulas are ominous.Diagnosis: IOC for diagnosis of CA anal canal:Proctoscopy with biopsy.Treatment* Nigro regimen: Chemoradiation is the treatment of choice.* Chemotherapy regime: 5-FU + Mitomycin, Cisplatin* More than 80% are cured by chemoradiation. If any residual tumor is left behind after chemoradiation, APR is performed. | train | med_mcqa | null |
Prolonged salmonella septicemia is caused by - | [
"S. enteritidis",
"S. cholerae-suis",
"S. typhimurium",
"S. typhi"
] | B | null | train | med_mcqa | null |
Dosage of benzyl penicillin in treatment of primary syphilis is : | [
"1.2 MU single i.m.",
"1.2 MU single i.v.",
"2.4 MU single i.m.",
"4.8 MU single i.m."
] | C | null | train | med_mcqa | null |
Zinc dose in 8 months infants - | [
"10 mg/kg x 10 days",
"20 mg/kg x 10 days",
"10 mg/kg x 14 days",
"20 mg/kg x 14 days"
] | D | Ans. is 'd' l.e., 20 mg/kg x 14 days | train | med_mcqa | null |
fibrinoid necrosis is senn all the following except ? | [
"malignant hypeension",
"acute rheumatic fever",
"polyahropathy",
"polyairitis nodosa"
] | C | Fibrinoid necrosis : alSo called "fibrinoid degeneration" It appears as strongly eosinophilic, reflexible small granules, pieces or amorphous materials, in the wall of blood vessel or in connective tissue. The original structure is destroyed. It can be seen in rheumatic fever, allergic vasculitis and other immune complex injury . * (type 3 hypersentitivity reaction) ref : robbins 10th ed | train | med_mcqa | null |
False about Peutz jegher syndrome | [
"Most Common site is small intestine",
"polypectomy on colonoscopy is treatment of choice",
"Hamaomatous polyp",
"Hyperplastic polyp"
] | D | Peutz- Jeghers Syndrome Rare autosomal dominant disorder Defined by presence of multiple gastrointestinal hamaomatous polyps and mucocutaneous hyperpigmentation, increased risk of malignancies including cancer of lung, colon, pancreas, breast, ovary, uterus and testes. Intestinal polyps are most common in small intestine, they may occur in stomach and colon, rarely in bladder and lungs. TEXT BOOK OF ROBBINS BASIC PATHOLOGY NINTH EDITION PAGE.593-594 IMAGE REF: | train | med_mcqa | null |
All are true about secretin except | [
"Inhibits gastric emptying",
"Increases bicarbonate rich pancreatic secretion",
"Potentiates action of CCK",
"| ses bile salt & bile acids"
] | D | Actions of secretin: Increases bicarbonate-rich pancreatic secretion. Stimulates bile secretion. Potentiates effect of CCK on pancreas. It causes contraction of pyloric sphincter delaying gastric emptying. Ref: Medical physiology, Indu Khurana | train | med_mcqa | null |
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