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 |
|---|---|---|---|---|---|---|
Antipsychotics are safer in the patient with | [
"Infertility",
"Hypertension",
"Epilepsy",
"All of the above"
] | B | (B) Hypertension # CVS:> Neuroleptics produce hypotension (primarily postural) by a central as well as peripheral action on sympathetic tone.> Chlorpromazine lowers seizure threshold and can precipitate fits in untreated epileptics.> The piperazine side chain compounds have a lower propensity for this action.# Endocrine:> They reduce gonadotropin secretion but amenorrhoea and infertility occur only occasionally.> ACTH release in response to stress is diminished -- corticosteroid levels fail to increase under such circumstances.> Release of GH is also reduced but this is not sufficient to cause growth retardation in children or to be beneficial in acromegaly. | train | med_mcqa | null |
All of the following drugs reduce afterload, except: | [
"Enalapril",
"Propranolol",
"Hydralazine",
"Sodium nitroprusside"
] | B | Ref:KDT 6/e p504 Afterloadis reduced by the drugs having aerioler dilating propey. Propanolol is a non-selective beta-blocker. It can cause vasoconstriction by antagonizing beta2 mediated vasodilation. It, therefore do not decrease afterload. | train | med_mcqa | null |
Least soluble cement | [
"Resin",
"ZOE",
"Polycarboxylate",
"Silicate Cement"
] | A | null | train | med_mcqa | null |
A 36-year-old man from China presents with increasing fatigue. He has a 3-year history of tuberculosis, and CBC shows a mild microcytic anemia. Blood work-up demonstrates low serum iron, low iron-binding capacity, and increased serum ferritin. The pathogenesis of anemia in this patient is most likely caused by which of the following mechanisms? | [
"Clonal stem cell defect",
"Hypoxemia",
"Impaired utilization of iron from storage sites",
"Synthesis of structurally abnormal globin chains"
] | C | - History given in the question suggests the diagnosis of Anemia of chronic disease. - Chronic diseases leads to ineffective use of iron from macrophage stores in the bone marrow , resulting in functional iron deficiency, although storage iron is normal or even increased. - However, in contrast to iron deficiency anemia, total iron binding capacity tends to be decreased in this d/t decreased production of Transferrin. - All other choices are not related to anemia of chronic diseases. -->Causes of microcytic hypochromic anemia are: Sideroblastic anemia, Iron deficiency anemia, Thalassemia and Anemia of chronic diseases Blood work up done: a. Percentage of saturation and serum iron is decreased in iron deficiency anemia and anemia of chronic disease. b. Total iron binding capacity is increased in iron deficiency anemia. it is decreased in case of anemia of chronic disease 2. Biopsy can be done : a. Iron store are decreased /absent in iron deficiency anemia b. In Anemia of chronic disease, iron is present, but is restricted/ increased within macrophages | train | med_mcqa | null |
Most important mediator of chemotaxis is: | [
"C3b",
"C5a",
"C5-7",
"C2"
] | B | Role of different mediators in Inflammation | train | med_mcqa | null |
Following is feature of Fusch's hetero chromic iridocyclitis - | [
"Heterochromia of iris",
"Keratic precipitates",
"Posterior subcapsular cataract",
"All the above"
] | D | (Ref: Atals of clinical ophthalmology 4th/e p.295; Khurana 7th/e p.174 & 4th/e p.160) Fuch's heterochromic iridocyclitis (Fush's uveitis syndrome) It is a form of anterior and intermediate uveitis. The condition is usually unilateral and chronic in nature and is characterized by a chronic non-ganulomatous uveitis and eventually results in iris heterochromia. | train | med_mcqa | null |
Pick the wrong statement regarding the lipid abnormalities seen in patients with type 2 diabetis mellitus: | [
"Increase in hepatic VLDL production",
"Decrease in plasma levels of HDL cholesterol",
"Elevated levels of plasma LDL cholesterol",
"Elevated plasma triglycerides"
] | C | The most common pattern of dyslipidemia is hyperiglyceridemia and reduced HDL cholesterol levels. DM itself does not increase levels of LDL, but the LDL paicles found in type 2 DM are small and dense and are more atherogenic. Must know: Other lipid abnormalities seen in DM are: 1. Decrease in LPL activity resulting in reduced catabolism of chylomicrons and VLDLs 2. Increase in the release of free fatty acid from the adipose tissue 3. Increase in fatty acid synthesis in the liver 4. Increase in hepatic VLDL production Elevated plasma LDL-C levels usually are not seen in of diabetes mellitus and suggest the presence of an underlying lipoprotein abnormality or may indicate the development of diabetic nephropathy. Ref: Harrisons principles of internal medicine, 18th edition, Page: 3155 | train | med_mcqa | null |
A fluid filled elevated lesion of skin is called | [
"Bulla",
"Macule",
"Papule",
"Nodule"
] | A | null | train | med_mcqa | null |
According to Census 2011, Child sex ratio is :- | [
"908",
"919",
"927",
"940"
] | B | According to Census 2011, Child sex ratio is 919. Child Sex ratio = x 1000. Highest in Mizoram. Lowest in Haryana. CSR-919 Adult sex ratio- 943/1000 males Highest - Kerala Lowest- Daman and diu(U.T), haryana(state) | train | med_mcqa | null |
All are histiocytosis except - | [
"Letterer siwe syndrome",
"Chloroma",
"Hand schuller christian triad",
"Eosinophilic granuloma"
] | B | null | train | med_mcqa | null |
In which case spontaneous regression is not seen? | [
"Malignant melanoma",
"Osteosarcoma",
"Neuroblastoma",
"Choriocarcinoma"
] | B | Tumors with spontaneous regression Neuroblastoma Choriocarcinoma Renal cell carcinoma Malignant melanoma Retinoblastoma | train | med_mcqa | null |
Normal vital capacity in an adult is - | [
"1200 ml",
"2500 ml",
"3000 ml",
"4700 ml"
] | D | Ans. is 'd' i.e., 4700 ml Respiratory Volumes and Capacities for an Average Young Adult MaleMeasurementTypical valueDefinition Respiratory volumes1.Tida] volume (TV)500 mlAmount of air inhaled or exhaled in one breath during relaxed, quiet breathing2.Inspiratory reserve volume (IRV)3000 mlAmount of air in excess of tidal inspiration that can be inhaled with maximum effort3.Expiratory reserve volume (ERV)1200 mlAmount of air in excess of tidal expiration that can be exhaled with maximum effort4.Residual volume (RV)1200 mlAmount of air remaining in the lungs after maximum expiration, keeps alveoli inflated between breaths and mixes with fresh air on next inspirationRespiratory Capacities5.Vital capacity (VC)4700 mlAmount of air that can be exhaled with maximum effort after maximum inspiration (ERV-rTV-s-IRV); used to assess strength of thoracic muscles as well as pulmonary function6.Inspiratory capacity (1C)3500 mlMaximum amount of air that can be inhaled after a normal tidal expiration (TV + IRV)7.Functional residual capacity (FRC)2400 mlAmount of air remaining in the lungs after a normal tidal expiration (RV + ERV)8.Total lung capacity (TLC)5900 mlMaximum amount of air the lungs can contain (RV - VC) | train | med_mcqa | null |
Spore of which bacteria is used as sterilization control of Plasma sterilization: | [
"B. subtilis",
"B. pumilis",
"Cl. tetani",
"B. stearothermophilus"
] | D | Biological Sterilization Indicator of plasma sterilization: B. stearothermophillus, B. subtilis subspecies niger | train | med_mcqa | null |
A man presents with fever, wt loss and cough. Mantoux reads an induration of 17 x 19 mm, Sputum cytology is negative for AFB. Most likely diagnosis is | [
"Pulmonary tuberculosis",
"Fungal infection",
"Viral infection",
"Pneumonia"
] | A | null | train | med_mcqa | null |
Following drug inhibits release of calcium from sarcoplasmic reticulum - | [
"Dantrolene",
"Caffiene",
"Rocuronium",
"Succnylcholine"
] | A | Ans. is 'a' i.e., Dantrolene Dantrolene* This muscle relaxant is chemically and pharmacologically entirely different from neuromuscular blockers; effect superficially resembles that of centrally acting muscle relaxants.* Neuromuscular transmission or MAP are not affected, but muscle contraction is uncoupled from depolarization of the membrane.* Dantrolene acts on the RyRl (Ryanodine Receptor) calcium channels in the sarcoplasmic reticulum of skeletal muscles and prevents Ca2+ induced Ca2+ release through these channels.* Intracellular release of Ca2+ needed for excitation-contraction coupling is interfered with.* Fast contracting 'twitch* muscles are affected more than slow contracting 'antigravity* muscles.* Since Ca2+ channels in the sarcoplasmic reticulum of cardiac and smooth muscles are of a different subtype (RyR2), these muscles are affected little by dantrolene. | train | med_mcqa | null |
Which premolar resembles a canine: | [
"Maxillary first premolar.",
"Mandibular first premolar.",
"Maxillary second premolar.",
"Mandibular second premolar."
] | B | null | train | med_mcqa | null |
Chandler index is used for - | [
"Anchylostoma duodenale",
"Ascariasis",
"Guinea worm infestations",
"Filariasis"
] | A | <p> Chandlers index is used for hook worm infestation. Reference:Park&;s textbook of preventive and social medicine,K.Park,21st edition,page no:221 & 22nd edition, pg no:221. <\p> | train | med_mcqa | null |
True regarding Nitrous oxide is: March 2013 (d) | [
"Stored at room temperature",
"Blunts ventilatory response to hypoxia",
"Highly inflammable",
"Complete anaesthetic agent"
] | B | Ans. B i.e. Blunts ventilator response to hypoxia Nitrous oxide Discovered by: Priestly Cylinder colour: Blue PIN index (code): 3,5 Also known as: Laughing gas, Adverse effects: - Megaloblastic anemia, - Bone marrow suppression, Second gas effect/ diffusion hypoxia C/I in: - Pneumothorax, - Air embolism etc. | train | med_mcqa | null |
All of the following may occur in Down&;s syndrome except | [
"Hypothyroidism",
"Undescended testis",
"Ventricular septal defect",
"Brushfield's spots"
] | B | Congenital or acquired hypothyroidism,brush field spots in iris,and ventricular septal defect IS seen in a case with down syndrome. Undescended testis is not a feature. Reference: Nelson TB of pediatrics 19th edtn pg 402 | train | med_mcqa | null |
Bile duct strictures are seen in all except | [
"CBD stone",
"Cholangiocarcinoma",
"Trauma",
"Acute pancreatitis"
] | D | Causes of biliary strictures Benign Congenital Biliary atresia Operative injury Cholecystectomy Choledochotomy Gastrectomy Hepatic resection Transplantation Inflammatory Stones Cholangitis Parasitic Sclerosing cholangitis Radiotherapy Trauma Idiopathic Malignant Cholangiocarcinoma CA head of pancreas Ampullary carcinoma Metastasis to liver or biliary tract Ref: Sabiston 20th edition Pgno :1509-1510 | train | med_mcqa | null |
Aery piercing the oblique popliteal ligament of knee - | [
"Superior genicular",
"Inferior genicular",
"Middle genicular",
"Popliteal"
] | C | Middle genicular Oblique popliteal ligament is an expansion from the tendon of semimembranosus attachment to intercondylar line of femur. It is closely related to popliteal aery and is pierced by middle genicular vessels and nerve and the terminal pa of the posterior division of the obturator nerve. | train | med_mcqa | null |
MDR defined as | [
"INH only",
"INH & Rifampicin",
"More than two drugs",
"INH, Pyrazinamide, Ethambutol."
] | B | (INH & Rifampicin): (180-Park 22nd/ edition; K. Park 20th/ed p-173. K. Park21st/ed p 178-79, New RNTCP Module, www.tbcindia.org)WHO defines a multi drug resistant (MDR) strain as one that is at least resistant to isoniazid and rifampicin, with or without resistant to other anti TB drugsMultidrug Resistant TB - is defined by WHO as tuberculosis disease where the bacilli is resistant to Isonaiazid (H) and Rifampicin (R). with or without resistance to other drugs- Most common cause - Irregular consumption & frequent interruption in antitubercular treatment- In India 2-3% in new cases and 14%-17% in re-treatment cases - Estimated 99,000 cases every year- Prevention of MDR-TB is given priority under RNTCP rather than its treatmentManagement of MDR-TB is preferably undertaken at DOTS Plus site with experience, expertise and availability of required diagnostic and treatment facilities.Criteria for Identification of MDR-TB suspects:- A new smear positive patient remaining smear positive at the end of fifth month- A new smear negative patient becoming smear positive at the end of fifth month- A patient treated with regimen for previously treated remaining positive at fourth month- Smear positive contacts of an established / confirmed MDR-TB caseDiagnosis - Culture & drug susceptibility testing from a quality- assured laboratoryMDR - TB treatment regimen* Intensive Phase - 6-9 months, Comprises of 6 drugs (Kanamycin ), Levofloxacin (Ivx) Ethionamide , Pyrazinamide , Ethambutol and Cycloserine .* Continuation Phase - 18 months. Comprises of 4 drugs (Ivx, Eto, E and Cs) p-aminosalicylic acid (PAS) is a substitute drug if any of the bactericidal drug (Kanamycin / Ethonamide) is not tolerated.* Dosages of the drugs are based upon three weight bands * II patients receive drugs under direct observation on 6 days of the week. On the 7th day (Sunday), the oral drugs will be administered unsupervised and kanamycin will be omitted* If intolerance occurs to the drugs, ethionamide, cycloserine and PAS may be split into two dosages and the morning dose administered under DOT. The evening dose self - administered* The empty blister packs of the self -administered doses will be checked the next morning during DOT* 100 mg of pyridoxine is administered to all patients on the RNTCP MDR-TB treatment regimen.* If a patient gains at least 5 kg weight during treatment & crosses the weight- bands range, DOTS - plus site committee may consider moving the patient to higher weight-band drug dosages, whenever the patient is due for next 3-monthly supply of drugs in normal course of treatment .Follow-up schedule - Smear examination should be done monthly during IP and at least quarterly during CP.Culture examination should be done at least at 4, 6, 12, 18 and 24 months of treatmentExtensively Drug Resistant TB (XDR-TB)Q - is a subset of MDR- TB* TB bacilli, in addition to being resistant to R and H, are also resistant to fluoroquinolones and any one of the 2nd line injectable drugs (namely Kanamycin, Capreomycin, or Amikacin).* XDR-TB has been reported in India | train | med_mcqa | null |
In one single visit, a 9 month-old, un-immunized child can be given the following vaccination - | [
"Only BCG",
"BCG, DPT-1, OPV-1",
"DPT-1, OPV-1, Measles",
"BCG, DPT-1, OPV-1, Measles"
] | D | null | train | med_mcqa | null |
Which of the following is not a 2 way communication – | [
"Lectures",
"Group discussion",
"Panel discussion",
"Symposium"
] | A | Communication
Communication is a process of transferring information from one source to another.
There are following types of communication :-
1. One-way communication (Didactic method)
One way communication is one in which information is always transferred in only one preassigned direction, i.e. from communicator to the audience.
Example - Lectures, demonstration, mass media communication (TV, radio, internet).
2. Two-way communication (Socratic method)
It is method of communication in which both the communicator and the audience take part and the information is transferred in both direction.
Examples →Group discussion, Panel discussion, symposium, workshop, conferences.
Verbal communication → communication by words of mouth.
Non-verbal communication → communication without words, by whole range of bodily movements, postures, gestures, facial expressions (e.g. smiling, frown).
Formal and informal education
Follows lines of authority → Formal communication.
From channels that fall outside the formal communication → informal (grape-vine) communication.
Visual communication → charts, graphs, tables etc.
Telecommunication and internet → Telecommunication is the process of communication over distance using electromagnetic instruments designed for the purpose.
Examples → Radio, TV and internet. | train | med_mcqa | null |
All the following are Secondary lymphoid organs except: | [
"Spleen",
"Lymph node",
"Bone marrow",
"MALT"
] | C | Ans: C (Bone marrow) Ref: Grays Anatomy 40th Ed pg . 127Explanation:Organs of the Immune System:The immune system is made up of many different organs and tissues dispersed throughout the body.PRIMARY lymphoid organs are the sites of lymphocyte hirth, maturation, in an Antigen independent fashion.SECONDARY lymphoid organs are the sites of mature lymphocyte selection and expansion in an Antigen dependent fashion.Primary Lymphoid Tissues:Generate and/or mature and educate cells of the immune systemMaturation and central selectionDiversity created in an Antigen independent fashionBone Marrow---------B cellsThymus-----------T cellsSecondary Lymphoid Tissues:Site where mature, immunocompetent lymphocytes are exposed to AntigenAg is collected and brought to tissue and lymphocytes are exposed to Antigen.Lymph nodes-- Antigen from intracellular tissue fluidsSpleen--blood-borne AntigenMALT--Antigen from mucosal surfaces. Includes Pever's patches, tonsils, and adenoids | train | med_mcqa | null |
Adult polycystic kidney disease is inherited: March 2005 | [
"X-linked dominant",
"X-linked recessive",
"Autosomal recessive",
"Autosomal dominant"
] | D | Ans. D: Autosomal dominant Autosomal dominant polycystic kidney disease (ADPKD) is one of the most common inherited disorders. It is the most frequent genetic cause of renal failure in adults, It is a multisystemic and progressive disorder characterized by the formation and enlargement of cysts in the kidney and other organs (e.g., liver, pancreas, spleen). Clinical features usually begin in the third to fouh decade of life, but cysts may be detectable in childhood and in utero. Some other autosomal dominant disorders: Huntington chorea Neurofibromatosis Myotonic dystrophy Hereditary spherocytosis Marfan syndrome Osteogenesi imperfect Achondroplasia | train | med_mcqa | null |
'Lock and Key model' of enzyme action was proposed by | [
"Emil Fisher",
"Daniel Koshland",
"Lenor Michaelis",
"Maud Menten"
] | A | Lock and key hypothesis By emil Fischer Active site is rigid Substrate has complimentary shape Demerits: 1. Rigid active site in reversible reaction. 2. Stabilization of transition state Ref: G n G 13th ed. | train | med_mcqa | null |
The drug which is not suitable for patients with acute porphyria for intravenous induction is – | [
"Thiopentone sodium",
"Propofol",
"Midazolam",
"Etomidate"
] | A | All barbiturates (including thiopentone) are absolutely contraindicated.
There is controversy regarding etomidate because some text books (miller) consider it safe, while other (Lee, Wylie), consider it unsafe :-
Miller (7th/e 1115) has given etomidate amongst the safe drugs.
Lee and Wylie have opinion different to Miller :-
"Etomidate is potentially porphyriogenic in animal models and at least one crisis has followed its use in human subjects, although its safe use has also been reported, on balance, etomide should be considered unsafe".
─ Wylie
"Etomidate should probably be avoided because it is potentially porphyrinogenic in animals, although reports in humans are conflicting".
─ Lee
Anyways, whatever opinion about etomidate, the answer of this question is thiopentone for sure as there is no confusion about contraindication of barbiturates in porphyria. | train | med_mcqa | null |
Most common determinant of energy expenditure in a resting state is: | [
"Lean Body Mass",
"Adipose tissue",
"Resting Hea Rate",
"Exercise"
] | A | Energy expended in the resting state depends primarily on the lean body mass and the metabolic cost for processing ingested nutrients. Ref: New Developments in Obesity Research By Lawrence F. Ditmier, Page 131; Handbook of Obesity: Etiology and Pathophysiology By George A. Bray, Page 705 | train | med_mcqa | null |
All are features of haemolytic uremic syndrome, except? | [
"Hyperkalemia",
"Anaemia",
"Renal microthrombi",
"Neuro psychiatric disturbances"
] | D | Ans. is 'd' i.e., Neuropsychiatric manifestations Hyperkalemia is seen in hemolytic urenic syndrome as a result of renal failure. ABOUT NEUROPSYCHIATRIC MANIFESTATIONS Neurological manifestations are used to distinguish between Hemolytic uremic syndrome and Thrombotic Thrombocytopenic Purpura. H.U.S. is distinguished from T.T.P by the absence of neurological symptoms and the prominence of acute renal failure. Recent studies, however have tended to blurr these clinical distinctions. Many adult patients with "TT.R "lack one or more of the five criteria and patients with "HUS" have fever and neurological dysfunction. Hemolvtic uremic syndrome Hemolytic uremic syndrome is characterized by the triad of : Anemia (microangiopathic hemolytic anemia). Renal failure (microangiopathy of kidney involving glomerular capillaries and aerioles). Thrombocytopenia (due to platelet consumption). Hemolytic uremic syndrome is most common is children under 2 years of age. It usually follows an episode of acute gastroenterities, often triggered by E coli. The prodrome is usually of abdominal pain, diarrhoea and vomiting. Sholy thereafter, signs and symptoms of acute hemolytic anemia, thrombocytopenia and acute renal failure ensue. Sometimes neurological findings also occur. (But usually absent and differentiate HUS from TTP.) Rarely HUS may follow respiratory tract infection. Etiology Gastrointestinal infection in infants with the following organism : E coli, Shigella dysenteriae, Streptococouus pneumoniae Hematological findings in a case of microangiopathic hemolytic anemia : Presence of schistocytes (fragmented red cells). This is the hallmark of microangiopathic hemolytic anemia. Neutrophil leukocytosis. Thrombocytopenia. Hemoglobinuria is mild to moderate with hemosiderinuria. Blood urea and serum creatinine levels are high. PT and APTT normal. Elevated serum LDH | train | med_mcqa | null |
Which of the following statements about hemochromatosis is not true | [
"Hypogonadism may be seen",
"Ahropathy may occur",
"Diabetes mellitus may develop",
"Dimercaprol is treatment of choice"
] | D | Characteristics of hereditary hemochromatosisThe liver is the first organ to be affected.Excessive skin pigmentation is present.Diabetes mellitus occurs in about 65% of patients.Cardiac involvement may be seen.Hypogonadism may occur Ahropathy may occur.TreatmentThe therapy of hemochromatosis involves removal of the excess body iron and suppoive treatment of damaged organs. Iron removal is best accomplished by weekly or twice-weekly phlebotomy of 500 mL.An effective oral iron chelating agent, deferasirox, has recently become available but is still in clinical trials.Desferrioxamine, when given parenterally, remove 10-20 mg iron per day, which is much less than that mobilized by once-weekly phlebotomy.Ref: Harrison's 18/e p2312, 17/e p1764, 2433 | train | med_mcqa | null |
Which of the following occurs in Charcot's triad ? | [
"Pain abdomen",
"Fever and chills",
"Jaundice",
"All"
] | D | Ans. (a) Pain abdomen (b) Fever and chills; (c) Jaundice | train | med_mcqa | null |
According to national health policy, a sub center caters to population in hilly and tribal areas : | [
"3000",
"5000",
"1000",
"2500"
] | A | Ans. is 'a' 3000. Remember the following facts A subcentre caters a population of* - 5000 in general 3000 in hilly, tribal & backward areasA PHC caters a population of* - 30,000 in general 20,000 in hilly, tribal & backward area.A Community health centre caters a population of * - 80,000 to 1.2 lakh.A health assistant (male & females) are at a population of * - 30,000 in general or(20,000 in hilly, tribal or backward area.)Male and female health workers are at a population of * - 5000 in general or3000 in hilly, tribal or backward area.Health guide caters a population of* - 1000Anganwadi workers* - 1000 | train | med_mcqa | null |
Artery not supplying Kisselbacks plexus is- | [
"Anterior ethmoidal artery",
"Greater Palatine artery",
"Sphenopalatine artery",
"Ascending pharyngeal artery"
] | D | Ans. is 'd' i.e., Ascending pharyngeal artery * Kiesselbach's plexus, which lies in KiesselbaclTs area or Little's area, is a region in the anteroinferior part of the nasal septum where four arteries anastomose to form a vascular plexus. The arteries arei) Anterior ethmoidal artery (branch of the ophthalmic artery)ii) Sphenopalatine artery (terminal branch of the maxillary artery)iii) Greater palatine artery (from the maxillary artery)iv) Septal branch of the superior labial artery (from the facial artery) | train | med_mcqa | null |
Which is the ideal (most scientific) setting for an epidemiological study | [
"Case-Control study",
"Coho study",
"Experimental study",
"Cross-section study"
] | C | Experimental or intervention studies are similar in approach to coho studies excepting that conditions in which study is carried out are under the direct control of the investigator.The aim of experimental studies may be stated as followsa) to provide &;scientific proof&; of aetiological factors or risk factorsb) to provide a method of measuring the effectiveness and efficiency of health servicesPark 23e pg:80 | train | med_mcqa | null |
HLA B27 is not seen in- | [
"SLE",
"Ankylosing spondylitis",
"Reiter's syndrome",
"Psoriotic ahritis"
] | A | Harshmohan textbook of pathology 7th edition. SLE is associated with immuno regulatory function of class 2 HLA gene includes HLADR, HLADQ, HLADP.. | train | med_mcqa | null |
Protein pa of an enzyme is called | [
"Holoenzyme",
"Coenzyme",
"Cofactor",
"Apoenzyme"
] | D | The protein without the prosthetic group is called the apoenzyme: it is catalytically inactive. Many enzymes require an additional small molecule, known as a cofactor to aid with catalytic activity. A cofactor is a non-protein molecule that carries out chemical reactions that cannot be performed by the standard 20 amino acids. Cofactors can be either inorganic molecules (metals) or small organic molecules (coenzymes).Cofactors, mostly metal ions or coenzyme, are inorganic and organic chemicals that function in reactions of enzymes. Coenzymes are organic molecules that are nonproteins and mostly derivatives of vitamins soluble in water by phosphorylation; they bind apoenzyme protein molecule to produce active holoenzyme.Apoenzyme- An enzyme that requires a cofactor but does not have one bound. An apoenzyme is an inactive enzyme, activation of the enzyme occurs upon binding of an organic or inorganic cofactor.Ref: Reginald H.Garrett and Charles M. Grisham, page no: 385 | train | med_mcqa | null |
A 48 yr old woman comes with b/1 progressive weakness of both lower limbs, spasticity & mild impairment of respiratory movements. MRI shows an intradural mid-dorsal midline enhancing lesion. What is the likely diagnosis: | [
"Intradural lipoma",
"Meningioma",
"Neuroenteric cyst",
"Dermoid cyst"
] | B | B i.e. Meningioma | train | med_mcqa | null |
Artery of anatomical snuftbox- | [
"Radial",
"Ulnar",
"Brachial",
"None"
] | A | Ans, is 'a' i.e., Radial Anatomical Snuffboxo Triangular depression on the dorsal and radial aspect of the hand become visible when thumb is fully extended. Boundarieso Medial/Posterior--Tendon of the extensor pollicis longus.o Lateral/ Anterior--Tendon of the extensor pollicis brevis and abductor pollicis longus.o Roof--Skin and fascia with beginning of cephalic vein and crossed by superficial branch of the radial nerve,o Floor--Styloid process of radius, trapezium, scaphoid and base of 1 st metacarpal,o Contents--The radial artery. | train | med_mcqa | null |
32 year old man, presented with painless ulcer with a black eschar on his leg. Smears of exudate show non motile organisms which are in chains. Spores are absent in the smear. Most probable organism is: | [
"Proteus",
"Diphtheroids",
"Clostridium",
"Bacillus anthracis"
] | D | Bacillus anthracis is a large gram-positive rod with square ends, frequently found in chains. It is non motile, whereas other members of the genus are motile. Spores are usually not seen in smears of exudate because spores form when nutrients are insufficient, and nutrients are plentiful in infected tissue. Also know: Anthrax toxin is encoded on one plasmid, and the polyglutamate capsule is encoded on a different plasmid. Its antiphagocytic capsule is composed of D-glutamate. (This is unique--capsules of other bacteria are polysaccharides.) Ref: (2012). Chapter 17. Gram-Positive Rods. In Levinson W (Eds), Review of Medical Microbiology & Immunology, 12e. | train | med_mcqa | null |
Which of the following statements about 'Valves of Houston' is true - | [
"The middle valve corresponds to the middle convex fold to the Right",
"The upper valve corresponds to peritoneal reflections",
"The valves contain all three layers of muscle wall",
"Valves disappear after mobilization of Rectum."
] | D | Valves of Houston are lost after full mobilization of the Rectum.
The middle valve is located on the Right Wall but corresponds to the middle convex fold to the left.
The middle valve (and not upper valve) corresponds to the level of peritoneal reflection.
Valves of Houston do not contain all three layers of the muscle wall. | train | med_mcqa | null |
Palpation on the costoveebral angle produces pain and tenderness in acute adrenal insufficiency.This is | [
"Rotch's sign",
"Rossolimo\"s sign",
"Rogoff's sign",
"Osler's sign"
] | C | Costoveebral angle pain and tenderness in acute adrenal insufficiency is known as Rogoff's sign. | train | med_mcqa | null |
Which dengue serotype has higher risk of causing Dengue hemorrhagic fever as Secondary infection? | [
"DENV-1",
"DENV-2",
"DENV-4",
"DENV-3"
] | B | Secondary infection with dengue serotype 2 or multiple infection with different serotypes lead to severe form dengue DHF/DSS. | train | med_mcqa | null |
Retraining approach in a pediatric patient, all are true, Except: | [
"Discrimination",
"Avoidance",
"De-emphasis and substitution",
"Distraction"
] | A | Retraining approach includes:
Avoidance.
De- emphasis and substitution.
Distraction. | train | med_mcqa | null |
Renauld Braud phenomenon is seen in | [
"Candida albicans",
"Candida psittaci",
"Histoplasma",
"Cryptococcus"
] | A | Candida albicans has the ability to form germ tubes within 2hours when incubated in human serum at 37C - Reynolds-Braude phenomenon. Ref: Textbook of Microbiology, Ananthanarayan and Paniker; 9th edition | train | med_mcqa | null |
Incoagulable states are - | [
"Snake envenomation",
"Acute-promyelocytic leukemia",
"Abruptio placenta",
"Heparin overdose"
] | A | Answer is option 1, snake envenomation Snakebite envenomation is common and may result in systemic coagulopathy. Antivenom can correct resulting laboratory abnormalities; however, despite antivenom use, coagulopathy may recur, persist, or result in death after a latency period. Ref Robbins 9/e pg449-450 | train | med_mcqa | null |
Ketamine can be used in all of the situations except a) Status asthmaticusb) For analgesia & sedationc) Obstetric hemorrhaged) Ischemic heart diseasee) Aortic aneurysm | [
"ab",
"de",
"cd",
"bd"
] | B | Ketamine increases BP, HR & myocardial O2 demand, therefore it is contraindicated in IHD, hypertensive heart disease and aortic aneurysm. | train | med_mcqa | null |
OPV can be used if vaccine l monitor is showing? | [
"Colour of outer circle is same as inner square",
"Colour of outer circle is darker than inner square",
"Colour of outer circle is lighter than inner square",
"None of the above"
] | B | Ans. is 'b' i.e., Colour of outer circle is darker than inner square | train | med_mcqa | null |
Dorsalis pedis artery is the continuation of: | [
"Anterior tibial artery",
"Posterior tibial artery",
"Popliteal artery",
"Lateral tarsal artery"
] | A | Ans. a (Anterior tibial artery). (Ref. BD Chaurasia 3rd ed. Vol.2.104)The anterior tibial artery commences at the bifurcation of the popliteal, at the lower border of the Popliteus, passes forward between the two heads of the Tibialis posterior, and through the aperture above the upper border of the interosseous membrane, to the deep part of the front of the leg: it here lies close to the medial side of the neck of the fibula. It then descends on the anterior surface of the interosseous membrane, gradually approaching the tibia; at the lower part of the leg it lies on this bone, and then on the front of the ankle-joint, where it is more superficial, and becomes the dorsalis pedis.The branches of the anterior tibial artery are:1. Posterior Tibial Recurrent2. Fibular3. Anterior Tibial Recurrent4. Muscular5. Anterior Medial Malleolar6. Anterior Lateral MalleolarThus, the dorsalis pedis artery (DPA) is the continuation of the anterior tibial, passes forward from the ankle-joint along the tibial side of the dorsum of the foot to the proximal part of the first intermetatarsal space, where it divides into two branches, the first dorsal metatarsal and the deep plantar. DPA frequently curves lateral ward, lying lateral to the line between the middle of the ankle and the back part of the first interosseous space.Branches of DPA:1. Lateral Tarsal, 2. Medial Tarsal, 3. Arcuate and 4. First Dorsal Metatarsal. | train | med_mcqa | null |
Which nerve is responsible for referred pain in ear? | [
"Trochleal",
"Olfactory",
"Glossopharyngeal",
"Abducent"
] | C | Pharyngitis may cause referred pain in the ear as both are supplied by IX nerve. Ref: BD Chaurasia's HUMAN ANATOMY, Volume 3, 4th edition. | train | med_mcqa | null |
Which drug is given in delayed vomiting after chemotherapy - | [
"Metoclopramide",
"Hyoscine",
"Domperiodone",
"Aprepitant"
] | D | Ans. is 'd' i.e., Aprepitant o Cisplatin can induce vomiting within 24 hours or after 2 days. DOC for the early vomiting is ondensetron while for delayed vomiting is aprepitant (substant P antagonist). | train | med_mcqa | null |
All of the following muscles elevate scapula, EXCEPT? | [
"Trapezius",
"Levator scapulae",
"Latissimus dorsi",
"Rhomboid major"
] | C | The latissimus dorsi acts on the humerus causing powerful adduction, extension, and medial rotation of the arm.Superior fibers of the trapezius cause scapular elevation and upward rotation. Middle fibers causes scapular retraction. Inferior fibers causes scapular depression and upward rotation.The levator scapula muscle attaches to the cervical veebrae and the superior angle of the scapula, causing elevation and downward rotation of the scapula.The rhomboid muscles attach to the spinous processes of C7-T5 and the medial border of the scapula, resulting in scapular retraction also also helps in elevation of scapula. | train | med_mcqa | null |
Appearance of Breast bud is known as: March 2013 | [
"Menarche",
"Thelarche",
"Pubarche",
"Anarche"
] | B | Ans. B i.e. Thelarche Thelarche is the onset of secondary (postnatal) breast development, usually occurring at the beginning of pubey in girls. | train | med_mcqa | null |
Thick pus of streptococci is conveed thin by enzyme - | [
"DNAase",
"Streptokinase",
"RNAase",
"C5a peptidase"
] | A | Ans. is 'a' i.e.,DNAase Deoxyribonuclease (DNAase) of streptococcus is also called as streptodornase.They cause depolymerization of DNA. They liquefy highly viscous DNA that accumulates in thick pus.This is responsible for the thin serous character of streptococcal exudates. | train | med_mcqa | null |
Which of the following best describes the mechanism of action of Colchicine in Acute Gout? | [
"Inhibition of chemotactic Factors",
"Tubulin binding and inhibition of leukocyte migration",
"Enhanced metabolism of Urate crystals",
"Enhanced excretion of Uric acid"
] | B | Colchicine produces its anti-inflammatory effects by binding to the intracellular protein tubulin, thereby preventing its polymerization into microtubules and leading to the inhibition of leukocyte migration. Colchicine-treated neutrophils develop a &;drunken walk&;. Colchicine is neither a uricosuric nor an analgesic agent, although it relieves pain in acute attacks of gout. Colchicine does not alter the metabolism or excretion of urates. Colchicine: It is an alkaloid from Colchicicum autumnalev which was used in gout since 1763. Beacause it has a narrow therapeutic window and a high rate of side effects, paicularly at higher doses it is considered as second-line therapy. Colchicine is neither analgesic nor anti-inflammatory, but it specifically suppresses gouty inflammation. Colchicine produces its anti-inflammatory effects by binding to the intracellular protein tubulin, thereby preventing its polymerization into microtubules and leading to the inhibition of leukocyte migration and phagocytosis. Colchicine-treated neutrophils develop a &;drunken walk&; It also inhibits the formation of leukotrienes B4 and IL-1b. It relieves the pain and inflammation of gouty ahritis in 12-24 hours without altering the metabolism or excretion of urates and without other analgesic effects. It is indicated for acute gout and is also used between attacks ("Inter-critical Period") for prolonged prophylaxis (at low doses) It often causes diarrhea and occasionally causes nausea, vomiting and abdominal pain. Hepatic necrosis, acute renal failure, disseminated intravascular coagulation, and seizures have also been observed. Ref: Katzung 14th edition Pgno: 660 | train | med_mcqa | null |
A boy alleging age 9 years is brought for medical examination. The total number of teeth at this age would be: | [
"20",
"24",
"28",
"32"
] | B | Period of Mixed dentition- 6-11 years In this period, all the temporary teeth are replaced by permanent teeth and there is no addition. Calcification and eruption of permanent teeth Tooth Calcification begins Eruption Calcification complete First molar At bih 6 to 7 years 9 to 10 years Central incisor 3 to 4 months 6 to 8 years 10 years Lateral incisor 1 year 7 to 9 years 11 years First bicuspid 1 1/2 years 9 to 11 years 12 to 13 years Second bicuspid 2 years 10 to 12 years 12 to 14 years Canine 4 to 5 months 11 to 12 years 12 to 13 years Second molar 2 1/2 to 3 years 12 to 14 years 14 to 16 years Third molar 8 to 10 years 17 to 25 years 18 to 25 years | train | med_mcqa | null |
Iron deficiency is best demonstrated by: | [
"RDW",
"S. ferritin",
"BM examination",
"d......."
] | B | Ans b (Se Ferritin)Ref: Davidson, 21 edpg. 1018Ferritin (n = 50 - 200 microg//)A measure of iron stores in the tissue and is the single best test to confirm iron deficiency Less than normal value of Se. ferritin is seen in:1. Iron deficiency2. Hypothyroidism3. Vitamin c deficiency Raised Se.ferritin value is seen in:1. Liver disease2. As an acute phase responseS. Iron (n= 50-150 microg/d/)Low in Iron deficiency anaemia (<30); also in anaemia of chronic disease, during acute phase response.Se. iron is raised in liver disease and also in haemolysisTIBC (n= 300-360 microg/dl)High in iron deficiency anaemia Low in anaemia of chronic diseaseLow iron-+ Low TIBC = ACDLow iron+ High TIBC = IDATransferrin saturation (n = 30-50%)<16% is consistent with IDA but less specific than ferritin.Transferrin saturation is less in ACD & IDA; normal orincreased in thalassaemia & sideroblastic anaemiaTransferrin levels are low in malnutrition. Nephrotic syndrome,liver disease as well as during acute phaseresponse.Transferrin levels are high in pregnancy & OCP use.Red cell distribution width (RDW) (n = 11.5 - 14.5)Coefficient of variation of RBC volume. Normal RDW - anaemia of chronic disease, aplastic anaemiaIncreased RDW - iron deficiency, B12 defeciency, folic acid deficiency | train | med_mcqa | null |
True regarding specificity: | [
"Identifies false +ve",
"Identifies false -ve",
"Identifies true + ve",
"Identifies true -ve"
] | D | .specificity is defined as the ability of a test to identify correctly those who do not have the disease,that is "true negatives". ref:park&;s textbook of preventive and social medicine,22nd edition,pg no 131 | train | med_mcqa | null |
All of the following conditions are observed in Marasmus, Except | [
"Hepatomegaly",
"Muscle wasting",
"Low insulin levels",
"Extreme weakness"
] | A | Hepatomegaly is seen in kwashiorkor. The liver is enlarged with rounded lower margin and soft consistency in about one-third of cases. Histology shows fatty infiltration. Ref: Page 105; Ghai essential pediatrics; 6th edition | train | med_mcqa | null |
Apical transportation is also known as | [
"Curing",
"Zipping",
"Ledging",
"Apical perforation"
] | B | null | train | med_mcqa | null |
The primary action of the neurotransmitter Nitric oxide (NO) in the gastrointestinal tract is: | [
"Vasodilatation",
"Vasoconstriction",
"Gastrointestinal smooth muscle relaxation",
"Gastrointestinal slow smooth muscle contraction"
] | C | Nitric oxide (NO) is an inhibitory neurotransmitter of enteric motor neurons that mediates Gastrointestinal smooth muscle relaxation. Unlike most neurotransmitters and hormones, NO does not act a membrane bound receptor. Instead NO readily diffuses into adjacent target cells to directly activate guanylcyclase and mediate smooth muscle relaxation. Ref: Review of Medical Physiology by William ganong, 22nd edn/page 598-9 | train | med_mcqa | null |
Mineral with antioxidant property: | [
"Molybdenum",
"Selenium",
"Copper",
"Zinc"
] | B | Ans. b (Selenium). (Ref. Harper, Biochemistry, 25th ed., 659,766)SeleniumFeaturesConstituent of glutathione peroxidaseSynergistic anti-oxidant with vitamin EEssential trace elementSelenocysteine is an L--amino acid found in a handful of proteins. As its name implies, a selenium atom replaces the sulfur of its structural analog, cysteine. The pK3 of selenocysteine, 5.2, is 3 units lower than that of cysteine. Since selenocysteine is inserted into polypeptides during translation, it is commonly referred to as the "21st amino acid."However, unlike the other 20 genetically encoded amino acids, selenocysteine is not specified by a simple three-letter codon.Trace elements TRACE ELEMENTDEFICIENCY STATESEXCESS STATES1ArsenicAcute Fatty (Yellow)liverHCCNeurologic dysfunctionGIT diseasesSkin cancerMee's linesAngiosarcoma of liverNCPF2Cadmium-Madness, paralysis agitans,3CopperGrowth failureWilson's diseaseNeutropenia CVS disordersGenu valgumMenke's kinky hair disease04ChromiumPEM, CVS diseaseArthritisDermatitisDiarroeaSeptal perforation5IodineGoiter, growth failureJod basedow phenomenonWolf chekoff phenomenon6Lead-Abdominal ColicAnaemiaBlue gum linesBasophilic stipplingConstipationConvulsionsDeliriumPeripheral neuropathy & ParalysisFailure of kidneysMetaphyseal lines7ManganeseImpaired growthAtaxiaManganese madnessParalysis agitansCVS disorders8MolybdenumGrowth failureGout bony defects Oral & esophageal carcinomaGenu valgum9Mercury-Minimota's disease Mercural erythesim (Hatter's shake)10SeleniumPEM, muscle dystrophy, CVS diseases(DCM), diarrhea, Keshan diseaseArthritis, dermatitis11AluminiumAlzheimer's diseaseOsteodystrophy12ZincNight blindnessHypogonadismImpaired wound healingAcrodermatitis enteropathicaGI irritationGrowth retardationFlaky paint dermatitis, loss of taste | train | med_mcqa | null |
False about gradenigo's syndrome- | [
"Retrobulbar pain",
"Otitis media",
"Facial palsy",
"Petrositis"
] | C | null | train | med_mcqa | null |
Which of the following is associated with > 20% risk of chromosomal anomalies? | [
"Omphalocele",
"Gastroschisis",
"Cleft lip",
"Spina bifida"
] | A | Omphalocele is a midline abdominal wall defect. The abdominal viscera (commonly liver and bowel) are contained within a sac composed of peritoneum and amnion from which the umbilical cord arises at the apex and center. When the defect is less than 4 cm, it is termed a hernia of the umbilical cord; when greater than 10 cm, it is termed a giant omphalocele. Associated abnormalities occur in 30-70% of infants and include, in descending order of frequency, Chromosomal abnormalities (trisomy 13, 18, 21) Congenital hea disease (tetralogy of Fallot, atrial septal defect) Beckwith-Wiedemann syndrome (large-for-gestational-age baby; hyperinsulinism; visceromegaly of kidneys, adrenal glands, and pancreas; macroglossia; hepatorenal tumors; cloacal extrophy) Pentalogy of Cantrell Prune belly syndrome (absent abdominal wall muscles, genitourinary abnormalities, cryptorchidism) Ref: Albanese C.T., Sylvester K.G. (2010). Chapter 43. Pediatric Surgery. In G.M. Dohey (Ed), CURRENT Diagnosis & Treatment: Surgery, 13e. | train | med_mcqa | null |
What is the actual intention of doing sentinel surveillance? | [
"To know the total number of cases",
"For health planning",
"To know the natural history of the disease",
"To prevent the disease"
] | A | Sentinel surveillance A method for identifying the missing cases and thereby supplementing the notified case is required Sentinel surveillance is extrapolated to the entire population to estimate the disease prevalence in the total population(Refer: K. Park's Textbook of Preventive and Social Medicine, 24th edition, pg no: 45) | train | med_mcqa | null |
First polar body is formed after - | [
"Mitosis",
"First meiosis",
"Second meiosis",
"Fertilization"
] | B | Ans. is 'b' i.e., First meiosisOogenesiso Oogenesis refers to the process of formation of ova from the primitive germ cells. Unlike fetal testis (in which spermatogenesis beings at puberty ), the fetal ovary begins oogenesis by 10 weeks of gestation.o The sequence of events in oogenesis are :The primitive germ cells undergo mitotic divisions to form oogonia (diploid cells). Oogonium is unique in that it is the only female cell in which both 'X' chromosomes are active.The oogonia proliferate by mitosis to form primary oocytes (diploid cells).Primary oocytes formed from the oogonia enter a prolonged prophase (diplotene stage) of the first meiotic division and remain in this stage until ovulation occurs after puberty .Primary oocytes completes the first meiotic division at puberty just before ovulation to form secondary oocyte (haploid cell) and 1st polor body.Secondary oocyte immediately begins second meiotic division but this division stops at metaphase and is completed only if the mature ovum (ootid) is fertilized with sperm. At that time second polor body (polocyte) is extruded and the fertilized ovum proceeds to form a new individual. Fertilization normally occurs in the ampulla of fallopian tube. | train | med_mcqa | null |
Characteristic Direct immunofluorescence findings in Herpes gestationis? | [
"Epidermal cell-surface deposits of IgG and C3",
"Linear, homogeneous deposits of IgG and C3 at the dermal-epidermal junction",
"Linear homogeneous deposits of C3 at the dermal-epidermal junction",
"Focal granular deposits of IgA at the papillary tips"
] | B | DIRECT IMMUNOFLUORESCENCE FINDINGS IN AUTOIMMUNE BLISTERING DISEASE. Disease Pattern and nature of immunoreactants Pemphigus Epidermal cell-surface deposits of IgG and C3 Bullous pemphigoid Linear, homogeneous deposits of IgG (epidermal side on salt-split skin) and C3 at the dermal-epidermal junction. Linear IgA dermatosis Linear homogeneous deposits of IgA at the dermal-epidermal junction Herpes gestationis Linear homogeneous deposits of C3 >IgG at the dermal-epidermal junction Epidermolysis bullosa acquisita Linear homogeneous deposits of IgG (dermal side on salt-split skin) and C3 at the dermal-epidermal junction. Cicatricial pemphigoid Linear homogeneous deposits of IgG and C3 at the dermal-epidermal junction Dermatitis herpetiformis Focal granular deposits of IgA at the papillary tips Bullous eruption of lupus erythematosus Linear homogeneous, or non-homogeneous, deposits of multiple immunoglobulins, C3 and fibrin at the dermal-epidermal junction. | train | med_mcqa | null |
A patient underwent complicated surgery for chronic pancreatitis. The most preferred route for supplementary nutrition in this patient would be:- | [
"Total parenteral nutrition",
"Feeding gastrostomy",
"Feeding jejunostomy",
"Oral feeding"
] | C | Enteral nutrition is preferred over Total parenteral nutrition as it Maintains gut barrier integrity Limits bacterial translocation Less expensive Fewer complications Order of preference - Feeding jejunostomy > Feeding gastrostomy Oral feeding is staed at later stages | train | med_mcqa | null |
The risk factor in cholangiocarcinoma | [
"Pancreatitis",
"Ulcerave coltis",
"Pyelonephritis",
"Caroli disease"
] | D | Cholangiocarcinoma is a malignancy of the biliary tree, arising from bile ducts within or outside the liver,
o Risk factors All risk factors for cholangiocarcinomas cause chronic inammation and cholestasis,
which presumably promote the occurrence of somatic mutations or epigenetic alterations in cholangiocytes. Primary sclerosing cholangitis.
Hepatolithiasis. Congenital bro-polycystic disease of the biliary system (Caroli disease, choledochal cyst). Hepatitis B and C. Exposure to thorotrast.
Opisthorchissinensis and clonorchiasis infection | train | med_mcqa | null |
You evaluate an 18 yrs old male who sustained a right sided cervical laceration during a gang fight. Which of the following is a relative rather than an absolute indication for neck exploration? | [
". Expanding hematoma",
"Dysphagia",
"Dysphonia",
"Pneumothorax"
] | D | Pneumothorax Repos of a more than 50% incidence of negative explorations of the neck, iatrogenic complications, and serious injuries overlooked at operation have caused a reassessment of the dictum that all penetrating neck wounds that violate the platysmaQ must be explored. Stable patients with zone II (between the angle of the mandible and the skull) or zone I (inferior to the cricoid cailage) injuries, or multiple neck wounds, should undergo initial angiographyQ irrespective of the ultimate treatment plan. Algorithms exist for nonoperative management of asymptomatic patients that employ observation alone or combinations of vascular and aerodigestive contrast studies and endoscopy. Neveheless, recognition of acute signs of airway distress (stridor, hoarse ness, dysphonia), visceral injury (subcutaneous air, hemoptysis, dysphagia), hemorrhage (expanding hematoma, unchecked external bleeding), or neurologic symptoms referable to carotid injury (stroke or altered mental status) or lower cranial nerve or brachial plexus injury requires formal neck exploration. Pneumothorax would mandate a chest tube; the necessity for exploration would depend on clinical judgment and institutional policy. | train | med_mcqa | null |
Regarding torsades de pointes, false statement is: | [
"More Common in males",
"Hypocalcemia can be a causative false",
"IV.mg is initial treatment of choice for acquired cause.",
"Congenital cause is treated with beta blocker"
] | A | Ans. A. More Common in malesCAUSES OF TORSADES DE POINTES:I. CongenitalII Acquired: BradycardiaHypokalemiaDrugs- Quinidine, procainamide, sotalol, amiodaroneDisopyramide, phenothiazine, TCATorsades de pointes is more common in females (because of |QT)Mechanism - Initiation by early after depolarization- Perpetuation by transmural entryTreatment-I. Congenital: Betablocker, pacing, ICII Acquired: I.V Magnesium, pacing | train | med_mcqa | null |
Cystic fibrosis is inherited as an autosomal recessive condition. A normal couple has one daughter affected with the disease. They are now planning to have another child. What is the chance of her sibling being affected by the disease? | [
"3-Apr",
"2-Jan",
"4-Jan",
"4-Mar"
] | C | Siblings have one in four chance of being affected in Autosomal recessive diseases. Ref: Robbin's Basic Pathology, 7th Edition, Page 215. | train | med_mcqa | null |
Features of innate immunity A/E- | [
"Recognizes foreign antigen in blood",
"C reactive protein",
"Complement protein is a pa of innate immune system",
"Includes phagocytes and natural killer cells"
] | D | Robbins basic pathology 9th edition page no 105 Heading=the early innate immune response to microbes Innate immunity includes phagocytes like macrophages and neutrophils. Natural killer cells kill viruse infected cells and produce macrophage activating cytokine IFN-gamma. | train | med_mcqa | null |
Antibody specificity is determined by the amino acid sequence within the: | [
"Fc region",
"Constant region",
"Variable region",
"Fc receptors"
] | C | Ans. C. Variable regionAntibody specificity is dictated by the sequence of amino acids within the variable regions of the light and heavy chains.a. The Fc region is a site for antibody docking to effector cells and does not play a role in antigen binding.b. The constant region has a similar structure in antibodies of widely divergent specificity and, therefore, does not dictate specificity.c. Fc receptors are sites on immune effector cells that interact with the Fc region of the antibody molecule and do not define an antibody's specificity.d. The J chain is a unique portion of secreted IgA molecules that allows the molecule to move from the circulation through mucous membranes. | train | med_mcqa | null |
A 2yr old child was brought to ER after drinking a disinfectant liquid. On examination, he was in coma, pupils constricted, pulse 120/min; respiratory rate:-40/min, urine was few and it&;s colour changed to green on exposure to air. What is the diagnosis | [
"Atropine",
"Organophosphates",
"Nitric acid",
"Carbolic acid"
] | D | CARBOLIC ACID (phenol; OH) Systemic Effects:- Phenol is a depressant of the nervous system, especially the respiratory centre. Headache, giddiness, unconsciousness and coma occur. The temperature is subnormal, the pupils are contracted, breathing is steorous, pulse is rapid, feeble and irregular, face covered with cold sweat, and there is dusky cyanosis, respiratory alkalosis and metabolic acidosis. Liver may be damaged. In severe cases haemolysis and methaemoglobinaemia is a characteristic feature. There is a strong odour of phenol in breath. Convulsions and lock-jaw sometimes occur. Urine:- It is scanty and contains albumin and free haemoglobin; suppression may follow. It may be colourless or slightly green at first, but turns green or even black on exposure to air. In the body, phenol is paly oxidised to hydroquinone and pyrocatechol, which with unchanged phenol are excreted in the urine, paly free, and paly in unstable combination with sulphuric and glucoronic acids. The fuher oxidation of hydroquinone and pyrocatechol in the urine is the cause of green colouration. This is known as carboluria. Ref:- k s narayan reddy; pg num:-534,535 | train | med_mcqa | null |
In the treatment of hypothyroidism, thyroxine is preferred over liothyronine because of thyroxine: | [
"Is faster acting",
"Has higher affinity for thyroid hormone receptors",
"Has a longer half life",
"Can be made more easily by recombinant DNA technology"
] | C | Liothyronine (T3) as compared to thyroxine (T4) is:
Fast acting
More potent
Short half-life
An indication of liothyronine includes myxedema coma and for most of the indications, thyroxine is used because it has a long half-life thus can be used less frequently than T3. | train | med_mcqa | null |
PR interval corresponds to ECG changes as | [
"Ventricular depolarization",
"Ventricular depolarization and atrial rcpolarization",
"Atrial depolarization and conduction through AV node",
"Ventricular repolarization"
] | C | C. i.e. (Atrial - depolarization and conduction through AV node) (551 - Ganong 22nd) (494- Ganong 23rd)ECG IntervalsIntervalNormal Durations (S)Events in the heart during intervalAverageRangePR interval0.180.12-0.20**Atrial depolarization and conduction through AV nodeQRS duration0.08to 0.10Ventricular depolarization and atrial repolarizationQT interval0.40to 0.43Ventricular depolarization plus ventricular repolarizationST interval (QT minus QRS)0.32 Ventricular repolarization* QRS complex denotes - ventricular depolarization*** The normal direction of mean QRS vector is generally said to be - 30 to + 110 on the coordinate system*** U wave - It is due to slow repolarization of papillary muscle* TP segment - It represents polarized state of whole heart* J-point - point between 'S' wave and ST segment. It is a point of "no" electrical activity (305-A.K Jain 3rd) | train | med_mcqa | null |
Muscle attached to medial border of scapula is- | [
"Rhomboidus Major",
"Teres Major",
"Deltoid",
"Infraspinatus"
] | A | Ans. is 'a' i.e., Rhomboidus Major * Lateral border of scapula (posteriorly) : Origins of teres minor and teres major.* Medial border of scapula : (i) Anteriorly : Insertion of serratus anterior; (ii) Posteriorly : Insertions of levator scapulae, rhomboideus major and minor. | train | med_mcqa | null |
Dose of pralidoxime in OPC poisoning: NIMHNS 13 | [
"1-2 mg IV",
"1-2 mg IM",
"1-2 g IV",
"1-2 g oral"
] | C | Ans. 1-2 g IV | train | med_mcqa | null |
Best diagnostic aid in blunt trauma abdomen is - | [
"CT scan",
"4 quadrant aspiration",
"Peioneal lavage",
"Ultrasound"
] | D | Ans. is 'd' i.e., Ultrasound | train | med_mcqa | null |
Normal portal vein pressure is | [
"< 3 mm Hg",
"3-5 mm Hg",
"5-10 mm Hg",
"10 to 1 2mm of Hg"
] | C | • Normal portal vein pressure: 5-10 mm Hg
• Variceal formation occurs when portal pressure is >10 mm Hg.
• Variceal bleeding occurs when portal pressure is >12 mm Hg.
• Normal portal vein pressure: 10-15 cm saline
• Definition: Portal pressure >10 mm Hg
• MC cause of portal hypertension in United States: Cirrhosis.
• Consequence of both increased portal vascular resistance and increased portal flow.
• Portal hypertension results in splenomegaly with enlarged, tortuous, and even aneurysmal splenic vessels.
• Cruveilhier-Baumgarten murmur: Audible venous hum in caput medusa
• Hyperdynamic portal venous circulation seems to be related to the severity of the liver failure.
• Upper G.I. bleeding is caused by the portal hypertension in about 90% of instances.
• Most bleeding episodes occur during the first 1 to 2 years after identification of varices.
• Colour Doppler is the investigation of choice for evaluation of PHT.
• About one third of deaths in patients with known esophageal varices are due to upper GI bleed
• A larger proportion dies as a result of liver failure.
• MC causes of death in cirrhosis patients: Hepatic failure
• 2nd MC causes of death in cirrhosis patients: variceal hemorrhage | train | med_mcqa | null |
Who gave the concept of "Clean tooth never Decays"? | [
"Pierre fauchard",
"Leon Williams",
"Rihanna",
"Dean"
] | B | null | train | med_mcqa | null |
Eruption of Maxillary 1st molar occur at | [
"8-9 years",
"6 years",
"4 years",
"15-16 months"
] | B | null | train | med_mcqa | null |
Drug used for obesity - | [
"Orlistat",
"Rivatat",
"Nitousoxide",
"Phenylephrine"
] | A | Orlistat inhibits pancreatic and gastric lipases and thereby decreases the hydrolysis of ingested triglycerides, reducing dietary fat absorption by approximately 30%. The drug is not absorbed and adverse side-effects relate to the effect of the resultant fat malabsorption on the gut: namely, loose stools, oily spotting, faecal urgency, flatus and the potential for malabsorption of fat-soluble vitamins. Orlistat at the standard dose of 120 mg is taken with each of the three main meals of the day; a lower dose (60 mg) is available without prescription in some countries. these effects may be explained because patients taking orlistat adhere better to low-fat diets in order to avoid unpleasant gastrointestinal side-effects. The combination of low-dose phentermine and topiramate extended release has been approved in the USA; this results in weight loss of approximately 6% greater than placebo and benefits lipids and glucose concentrations. Ref Harrison 20th edition pg 97 | train | med_mcqa | null |
Example of Type IV Hypersensitivity is/are | [
"Farmer's lung",
"Contact hypersensitivity",
"Immediate hypersensitivity",
"Myasthenia gravis"
] | B | Clinical examples of Type IV HS TB Sarcoidosis Temporal aeritis Contact dermatitis Lepromin test and PPD Patch test/contact HS Type I DM | train | med_mcqa | null |
Blood brain barrier is formed by | [
"Microglia",
"Oligodendrocytes",
"Astrocytes",
"Type II pneumatocytes"
] | C | (C) Astrocytes # Blood Brain Barrier: Astrocytes form the structural framework for the neurons and control their biochemical environment.> Astrocyte foot processes are closely associated with the blood vessels to form the blood-brain barrier.# Oligodendrocytes are responsible for the formation and maintenance of the myelin sheath, which surrounds axons and is essential for the rapid transmission of action potentials by solitary conduction.> Microglia are blood-derived mononuclear macrophages> Astrocyte foot processes are closely associated with the blood vessels to form the blood - brain barriers oligodendrocytes forms myelin sheath which surrounds axons.> Microglia are blood derived non nuclear macrophages.# Blood-brain barrier (BBB) is a membranic structure that acts primarily to protect the brain from chemicals in the blood, while still allowing essential metabolic function.> BBB is composed of endothelial cells, which are packed very tightly in brain capillaries.> This higher density restricts passage of substances from the bloodstream much more than endothelial cells in capillaries elsewhere in the body.> Astrocyte cell projections called astrocytic feet (also known as "glial limitans") surround the endothelial cells of the BBB, providing biochemical support to those cells.> BBB is distinct from the similar blood-cerebrospinal fluid barrier, a function of the choroidal cells of the choroid plexus. | train | med_mcqa | null |
Palatoprints for identification of the person is performed by taking prints from which area of the hard plate - | [
"Lateral",
"Anterior",
"Middle",
"Posterior"
] | B | Palatogram is study of rugae in anterior pa of hard palate. It is highly specific as fingerprints ref :.Dr.K.S.Narayana Reddys Synopsis of Forensic Medicine & Toxicology 27th edition pg. 48 | train | med_mcqa | null |
Most effective medication in GERD | [
"PPI",
"H, blockers",
"Antacids",
"Prokinetic drugs"
] | A | (A) PPI > They self-medicate with over the counter medicines such as simple antacids, antacid-alginate preparations and H2recepto' antagonists.> PPis, such as Omeprazole, lansoprazole and pantoprazole, are by far the most effective drug treatment for GERD. | train | med_mcqa | null |
During laparoscopy the preferred site for obtaining cultures in a patient with acute pelvic inflammatory disease is : | [
"Endocervix",
"Pouch of Douglas",
"Endometrium",
"Fallopian tubes"
] | D | Ans. is d i.e. Fallopian tube Laparoscopic visualization of the pelvis is the most accurate method of confirming diagnosis of an acute P1D. However, it is not practical to advise diagnostic laparoscopy to all patients of PID, Indications of Laparoscopy in Acute PID : - Patients not responding to therapy, in order to confirm the diagnosis. - To obtain cultures from cul-de-sac or fallopian tube. - To drain pus. if necessary. Thus, cultures can be obtained from both cul-de-sac and fallopian tube. Telinde's Operative Gynae. 9/e, p 679 fuher says "Laparoscopy is an excellent means of obtaining cultures directly from the tubes." My answer to this question is Fallopian tube. You can have your opinion. | train | med_mcqa | null |
The condition which characteristically shows bone infarcts is: | [
"Iron deficiency anaemia",
"Thalassemia",
"Sickle cell anaemia",
"Hereditary spherocytosis"
] | C | Bone marrow infarcts are frequent causes of pain in sickle cell anaemia. The heads of the femur and humerus are susceptible to avascular necrosis, a potential source of constant pain and disability. Ischemic bone becomes susceptible to bacterial osteomyelitis. Joint effusions and occasionally hemahrosis may be seen adjacent to infarcted bones. Ref: Kato G.J., Gladwin M.T. (2005). Chapter 108. Sickle Cell Disease. In J.B. Hall, G.A. Schmidt, L.D. Wood (Eds), Principles of Critical Care, 3e. | train | med_mcqa | null |
A 35 year old female has proximal weakness of muscles, ptosis and easy fatigability. The most sensitive test to suggest the diagnosis is: | [
"Muscle Biopsy",
"CPK levels",
"Edrophonium test",
"Single fiber EMG"
] | D | Single fibre electrophysiology is the most sensitive test for Myasthenia Gravis. The symptoms given in question stem are suggestive of Myasthenia Gravis which is an autoimmune neuromuscular disorder presenting with easy fatigability. Ref: Clinical adult neurology By Jody Corey-Bloomn, Page 332 | train | med_mcqa | null |
Foam cells in atherosclerosis contain lipid in the form of ? | [
"Oxidized LDL",
"Reduced LDL",
"Oxidized VLDL",
"Reduced VLDI"
] | A | Ans. is 'a' i.e., Oxidized LDLMorphology of atherosclerotic plaque There are three major components of an atherosclerotic plaques :-i) Cells : Smooth muscle cell and macrophages are the major cells with some contribution from foam cells (lipid-laden macrophages), and lymphocytes. Advanced atherosclerotic plaque may lack smooth muscles as smooth muscle cells undergo apoptosis.ii) Extracellular matrix : Collagen, elastic fibers, proteoglycans.iii) Lipids : Both intracellular and extracellular, with cholesterol and cholesterol ester being the major lipids. | train | med_mcqa | null |
An example of tumor suppressor gene is | [
"Myc",
"Fos",
"Ras",
"Rb"
] | D | Ref Robbins 7/e p300; , Harrison 17/e p499; 9/e p290 Tumor suppressor genes are the genes whose products down regulate the cell cycle. RB Gene: Governor of the Cell Cycle It is useful to begin with the retinoblastoma gene (RB), the first tumor suppressor gene to be discovered and, as it happens, a prototypical representative. As with many advances in medicine, the discovery of tumor suppressor genes was accomplished by the study of a rare disease--in this case, retinoblastoma, an uncommon childhood tumor. Approximately 60% of retinoblastomas are sporadic, and the remaining ones are familial, the predisposition to develop the tumor being transmitted as an autosomal dom- inant trait. To account for the sporadic and familial occur- rence of an identical tumor, Knudson, in 1974, proposed his now famous two-hit hypothesis, which in molecular terms can be stated as follows: * Two mutations (hits) are required to produce retinoblas- toma. These involve the RB gene, which has been mapped to chromosomal locus 13q14. Both of the normal alleles of the RB locus must be inactivated (hence the two hits) for the development of retinoblastoma (Fig. 5-21). * In familial cases, children inherit one defective copy of the RB gene in the germ line; the other copy is normal. brakes to cellular proliferation Rb gene is a tumor suppressor gene whereas My ,fos and Ra's are all example of proto oncogene Retinoblastoma develops when the normal RB gene is lost in retinoblasts as a result of somatic mutation. Because in retinoblastoma families only a single somatic mutation is required for expression of the disease, the familial transmission follows an autosomal dominant inheritance pattern. * In sporadic cases, both normal RB alleles are lost by somatic mutation in one of the retinoblasts. The end result is the same: a retinal cell that has lost both of the normal copies of the RB gene becomes cancerous. Although the loss of normal RB genes initially was discovered in retinoblastomas, it is now evident that homo- zygous loss of this gene is a fairly common feature of several tumors, including breast cancer, small cell cancer of the lung, and bladder cancer. Patients with familial retinoblastoma also are at greatly increased risk for development of osteosarcomas and some soft tissue sarcoma The RB gene product is a DNA-binding protein that is expressed in every cell type examined, where it exists in an active hypophosphorylated state and an inactive hyperphosphor- ylated state. The impoance of Rb lies in its regulation of the G1/S checkpoint, the poal through which cells must pass before DNA replication commences. As background for an understanding of how tumor sup- pressors function, it is useful to briefly revisit the cell cycle: In embryos, cell divisions proceed at an amazing clip, with DNA replication beginning immediately after mitosis ends. As development proceeds, however, two gaps are incorpo- rated into the cell cycle: gap 1 (G1) between mitosis (M) and DNA replication (S), and gap 2 (G2) between DNA replica- tion (S) and mitosis (M) (Fig. 5-20). Although each phase of the cell cycle circuitry is monitored carefully, the transi- tion from G1 to S is believed to be an extremely impoant checkpoint in the cell cycle "clock." Once cells cross the G1 checkpoint they can pause the cell cycle for a time, but they are obligated to complete mitosis. In G1, however, cells can remove themselves entirely from the cell cycle, either tem- porarily (quiescence, or G0) or permanently (senescence). Indeed, during development, as cells become terminally differentiated, they exit the cell cycle and enter G0. Cells in G0 remain there until external cues, such as mitogenic sig- naling, push them back into the cell cycle. In G1, therefore, diverse signals are integrated to determine whether the cell should progress through the cell cycle, or exit the cell cycle and differentiate, and Rb is a key hub integrating external mitogenic and differentiation signals to make this decision. To appreciate this crucial role of Rb in the cell cycle, it is helpful to review the mechanisms that enforce the G1/S transition. * The initiation of DNA replication (S phase) requires the activity of cyclin E/CDK2 complexes, and expression of cyclin E is dependent on the E2F family of transcription factors. Early in G1, Rb is in its hypophosphorylated active form, and it binds to and inhibits the E2F family of transcription factors, preventing transcription of cyclin E. Hypophosphorylated Rb blocks E2F-mediated transcription in at least two ways (Fig. 5-22). First, it sequesters E2F, preventing it from interacting with other transcriptional activators. Second, Rb recruits chromatin remodeling proteins, such as histone deacetylases and histone methyltransferases, which bind to the promoters of E2F-responsive genes such as cyclin E. These enzymes modify chromatin at the promoters to make DNA insen- sitive to transcription factors. This situation is changed on mitogenic signaling. Growth factor signaling leads to cyclin D expression and activa- tion of cyclin D-CDK4/6 complexes. These complexes phosphorylate Rb, inactivating the protein and releasing E2F to induce target genes such as cyclin E. Expression of cyclin E then stimulates DNA replication and pro- gression through the cell cycle. When the cells enter S phase, they are committed to divide without additional growth factor stimulation. During the ensuing M phase, the phosphate groups are removed from Rb by cellular phosphatases, regenerating the hypophosphorylated form of Rb. * E2F is not the sole target of Rb. The versatile Rb protein binds to a variety of other transcription factors that regulate cell differentiation. For example, Rb stimulates myocyte-, adipocyte-, melanocyte-, and macrophage- specific transcription factors. Thus, the Rb pathway couples control of cell cycle progression at G0-G1 with differentiation, which may explain how differentiation is associated with exit from the cell cycle. In view of the centrality of Rb to the control of the cell cycle, an interesting question is why RB is not mutated in every cancer. In fact, mutations in other genes that control Rb phosphorylation can mimic the effect of RB loss; such genes are mutated in many cancers that seem to have normal RB genes. For example, mutational activation of CDK4 or overexpression of cyclin D ors cell proliferation by facil- itating Rb phosphorylation and inactivation. Indeed, cyclin D is overexpressed in many tumors because of gene ampli- fication or translocation. Mutational inactivation of CDKIs also would drive the cell cycle by unregulated activation of cyclins and CDKs. As mentioned earlier, the CDKN2A gene is an extremely common target of deletion or muta- tional inactivation in human tumors. The emerging paradigm is that loss of normal cell cycle control is central to malignant transformation and that at least one of the four key regulators of the cell cycle (CDKN2A, cyclin D, CDK4, Rb) is mutated in most human cancers. Fuhermore, the transforming proteins of several oncogenic human DNA viruses act, in pa, by neutralizing the growth inhibi- tory activities of Rb. For example, the human papillomavi- rus (HPV) E7 protein binds to the hypophosphorylated form of Rb, preventing it from inhibiting the E2F transcrip- tion factors. Thus, Rb is functionally deleted, leading to uncontrolled growth | train | med_mcqa | null |
Severe disability in primary osteoahritis of hip is best managed by - | [
"Ahrodesis",
"Ahroplasty",
"Mc Murray's osteotomy",
"Intra-aicular hydrocoisone and physiotherapy"
] | B | IN SEVERE DISABILITY AHROPLASTY IS MODE OF MANAGEMENT REF : MAHESWARI 9TH ED | train | med_mcqa | null |
In supracondylar fracture the fragment is often displaced: | [
"Laterally",
"Medially",
"Anteriorly",
"Posteriorly"
] | D | Ans: d | train | med_mcqa | null |
HAV is not destroyed by: | [
"0.5 ppm chlorine",
"1:4000 formalin",
"UV radiation",
"Boiling at 100degC for 5 minutes"
] | A | Ans. a. 0.5 ppm chlorine | train | med_mcqa | null |
Which of the following vitamin deficiencies is most commonly seen in short bowel syndrome - | [
"Vitamin B12",
"Biotin",
"Vitamin B1",
"Vitamin K"
] | A | null | train | med_mcqa | null |
Features of carcinoma penis include all except: March 2007 | [
"Metastasize to inguinal lymph nodes",
"Surgery is the treatment of choice",
"Hypospadias is a premalignant lesion",
"Circumcision provides protection"
] | C | Ans. C: Hypospadias is a premalignant lesion Following as risk factors for penile cancer: Human papillomavirus (HPV) infection, smoking, smegma, phimosis, treatment of psoriasis, age, and AIDS. The other etiologic factor most commonly associated with penile carcinoma is poor hygiene. Lichen sclerosus (also known as balanitis xerotica obliterans) may also be a risk factor. Symptoms Redness, irritation and a sore or a lump on the penis. Pathology Precancerous Dermatologic Lesions Carcinoma in Situ (Bowen Disease, Erythroplasia of Queyrat) Invasive Carcinoma of the Penis A Squamous cell carcinoma usually originating in the glans or foreskin is by far the most common type, occurring in 9 out of 10 cases. Staging The stages are assessed as follows: Stage I - Cancer has only affected the glans and/or foreskin. Stage II - Cancer has spread to the shaft of the penis. Stage III - Cancer has affected the penis and surrounding lymph nodes. Stage IV - Cancer has moved beyond the groin area to other pas of the body. Recurrent - Cancer that has returned after treatment. The most common treatment is one of five types of surgery: Wide local excision - The tumor and some surrounding healthy tissue are removed Microsurgery - Surgery performed with a microscope is used to remove the tumor and as little healthy tissue as possible Laser surgery - laser light is used to burn or cut away cancerous cells Circumcision - cancerous foreskin is removed Amputation (penectomy) - a paial or total removal of the penis, and possibly the associated lymph nodes. This is the most common and effective treatment. Radiation therapy is usually used adjuvantly with surgery to reduce the risk of recurrence. With earlier stages of penile cancer, a combination of topical chemotherapy and less invasive surgery may be used. More advanced stages of penile cancer usually require a combination of surgery, radiation and chemotherapy. | train | med_mcqa | null |
Acute primary meningoencephalitis true is - | [
"Meningitis caused by Acanthamoeba species is acute in nature",
"Diagnosis is done by demonstration of trophozoites in CSF",
"Caused by feco-oral transmission",
"More common in tropical climate"
] | B | Option 1, 2,3 Naegleria Fowleri: Disease: Primary amebic meningoencephalitis (PAM). Infective form: Amoeboid form is the invasive form. Mode of transmission: Man acquire infection by nasal contamination during swimming in fresh hot water bodies like ponds, river, swimming pools or lakes. option 4 Acanthamoeba species are more common in tropical climate | train | med_mcqa | null |
The following are live attenuated vaccines, except- | [
"BCG",
"Oral typhoid",
"Measles",
"Peussis"
] | D | peussis vaccine is usually given combined with tetanus toxoid and diphtheria toxoid.among them peussis is an acellular vaccineref;parks textbook,ed22,pg 154 | train | med_mcqa | null |
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