question stringlengths 1 6.54k | choices listlengths 4 4 | answer stringclasses 4 values | rationale stringlengths 0 22.5k ⌀ | split stringclasses 1 value | dataset stringclasses 6 values | subject stringclasses 1 value |
|---|---|---|---|---|---|---|
A 60-year-old man has resting tremor, pill-rolling movements, rigidity, and bradykinesia. Which of the following is most likely to be decreased in this man? | [
"Serotonin neurons in the raphe nuclei",
"GABA neurons in the caudate nucleus and putamen",
"Dopamine neurons in the substantia nigra",
"Acetylcholine neurons in the forebrain"
] | C | The clinical features points toward a diagnosis of Parkinson disease. It is characterized by loss of dopaminergic neurons that project from the substantia nigra to the putamen. Other options: Serotonergic raphe neurons have been implicated in the control of mood and descending pain modulation (analgesia) pathway. GABAergic pathway loss from striatum (caudate nucleus + putamen) results in hyperkinetic disorder, Huntington disease. Loss of nucleus basalis of Meyne in the basal forebrain, a diffuse cholinergic projection to the entire neocoex, the amygdala, and the hippocampus leads to Alzheimer disease. | train | med_mcqa | null |
True about Neisseria gonorrhoea? | [
"Kidney shaped",
"Isolated in PIKES medium",
"It is not transmitted through sexual contact",
"Protein II is useful for typing"
] | A | ANSWER: (A) Kidney shapedREF: Jatvetz Microbiology, 24th Ed, Ch. 21GONOCOCCIThe typical neisseria is a gram-negative, nonmotile diplococcus, approximately 0.8 urn in diameter. Individual cocci are kidney-shaped: when the organisms occur in pairs, the flat or concave sides are adjacent.In 48 hours on enriched media (eg, Mueller-Hinton, modified Thayer-Martin), gonococci and meningococci form convex, glistening, elevated, mucoid colonies 1-5 mm in diameter. Colonies are transparent or opaque, nonpigmented, and nonhemolytic.Outer membrane proteinsGonnococd outer membrane proteinsName of proteinAlso calledPropertiesPor I- Por A''Por BPorin protein/ Protein I (Por A & Por B are immunologically distinct forms)- Heat stable- Por A & Por B are never expressed together- Influences the killing of organisms in PMN's by preventing phagosome-lysosome fusion & diminishing the oxidative burst- Anti por antibodies are used commercially for identification of N gonorrhoeaOpa (proteinOuter membrane opacity protein, Protein II, PII- Augment pilus mediate adherence to mucosal surfaces- Heat labileRmp proteinReduction modifiable protein, Protein III, P III- Homologous with E coli outer membrane protein (Omp A)Serologic typing of Por by agglutination reactions with monoclonal antibodies has distinguished 18 serovars of PorA and 2S serovars of PorB.Gonorrhea is exclusively transmitted by sexual contact, often by women and men with asymptomatic infections. The infectivity of the organism is such that the chance of acquiring infection from a single exposure to an infected sexual partner is 20-30% for men and even greater for women.The infection rate can be reduced by avoiding multiple sexual partners, rapidly eradicating gonococci from infected individuals by means of early diagnosis and treatment, and finding cases and contacts through education and screening of populations at high risk. Mechanical prophylaxis (condoms) provides partial protection. Chemoprophylaxis is of limited value because of the rise in antibiotic resistance of the gonococcus. | train | med_mcqa | null |
CIN III progresses to carcinoma in how many % of cases | [
"25%",
"5%",
"0%",
"60%"
] | A | CIN: Cervical intraepithelial neoplasia-pa or whole of the thickness of cervical squamous epithelium is replaced by the cell of varying degrees of atypiaCIN: Microinvasive carcinoma- invasive carcinoma cervix (over several years)Mostly asymptomatic, diagnosed by routine screening done yearly after women become sexually active. If 3 consecutive smears normal in a low risk woman do once in 3 yearsCIN I-Abnormality in lower 1/3rd of epitheliumCIN II-Abnormality in lower 2/3rd of epitheliumCIN III-Abnormality in >2/3rd of epitheliumHigh-risk factor--Age <18 yr at the initiation of coitusMultiple sex paners, the husband with multiple panersHPV infectionHigh oncogenic risk-type 16, 18, 31, 45, 56Low oncogenic risk-type 6, 11CMV, HSV II infectionSmokingPoor socioeconomic statusAneuploid lesionOral contraceptive use. | train | med_mcqa | null |
The noh Kerelia project evaluate risk factors of | [
"Diabetes",
"Coronary hea disease",
"Cancers",
"Obesity"
] | B | Noh kerelia project:Noh Kerelia is a county in the eastern pa of Finland, where CHD is paicularly common. A multiple risk factor intervention trial was staed in 1972. The project had two aims: 1. to reduce the high levels of risk factors for cardiovascular diseases and 2. to promote the early diagnosis, treatment and rehabilitation of patients with cardiovascular disease. Ref: Park; 23rd ed; Pg 371 | train | med_mcqa | null |
False statement regarding myocardial infarction and depression is: | [
"Depression is a risk factor for MI",
"MI is a risk factor for depression",
"SSRI's can be used post MI for treatment of depression",
"Only cognitive behavioral therapy is used after MI"
] | D | The first three options are correct. Depression and myocardial infarction are risk factors for each other. The treatment of depression after MI involves both medications and CBT. | train | med_mcqa | null |
The best index for calculation of the nutritional value of protein is which one of the following: | [
"Biological Value",
"Net protein utilization",
"Protein digestibility",
"Protein efficiency rates"
] | B | Ans. (b) Net protein utilizationRef: K. Park 23th ed.* The net protein utilization, or NPU, is the ratio of amino acid converted to proteins to the ratio of amino acids supplied. This figure is somewhat affected by the salvage of essential amino acids within the body, but is profoundly affected by the level of limiting amino acids within a foodstuff.* NPU can range from 1 to 0, with a value of 1 indicating 100% utilization of dietary nitrogen as protein and a value of 0 an indication that none of the nitrogen supplied was converted to protein. Certain foodstuffs, such as eggs or milk, rate as 1 on an NPU chart. | train | med_mcqa | null |
Which of the following is normally present in urine of a pregnant woman in 3rd trimester: | [
"Glucose",
"Fructose",
"Galactose",
"Lactose"
] | A | Glycosuria in pregnancy Repeat and random blood samples taken on one or more occasions throughout pregnancy reveals glycosuria in about 5 -50% cases.During pregnancy renal threshold is diminished due to the combined effect of increased GFR and impaired tubular reabsorption. It is present most commonly in mid pregnancy.Blood sugar level may be well below 180mg/100 ml.No treatment is required and the condition disappears after delivery D.C.DUTTA&;S TEXTBOOK OF OBSTETRICS,Pg no:281,7th edition | train | med_mcqa | null |
Onion skin thickening of aeriolar wall is seen in? | [
"Atherosclerosis",
"Median calcific sclerosis",
"Hyaline aeriosclerosis",
"Hyperplastic aeriosclerosis"
] | D | Ans. is 'd' i.e., Hyperplastic aeriosclerosis | train | med_mcqa | null |
Oxygenated blood from placenta goes to fetal heart via: | [
"Ductus arteriosus",
"Ductus venosus",
"Foramen ovale",
"Umbilical artery"
] | B | Ans. (b) Ductus venosusRef: D.C. Dutta 8th ed. / 36; William's Obstetrics 23rded, Ch: 4* Ductus venosus carries oxygenated blood from placenta and drains into IVC.* Ductus arteriosus is a connection between aorta and pulmonary arteries, thereby bypassing lung. Persistence of ductus arteriosus leads to a congenital heart condition called Patent Ductus Arteriosus.* Foramen ovale is connection between right atrium and left atrium.* Umbilical artery carries deoxygenated blood from fetus to mother.Also KnowImportant vessles and their remnantsDUCTUSVENOSUSLigamentum VenosumDUCTUS ARTERIOSUSLigamentum arteriousmUmbilical ArteriesMedial umbilical arteryLeft umbilical veinLigamentum Teres of Liver | train | med_mcqa | null |
Blood brain barrier is permeable to all except | [
"Water",
"Gas",
"Lipophilic drug",
"Protein"
] | D | D i.e. Protein In the brain, with the exception of choroid plexus, pituitary and the area postrema, cerebral blood vessels are unique in that the junctions between vascular endothelial cells are nearly fused (8 A pore size in comparison to 65 A of body's capillary). The paucity of pores is responsible for blood brain barrier (BBB). The movement across BBB is influenced by the size, charge, lipid solubility and degree of protein binding (in blood) of substance. So carbondioxide (CO2), oxygen (02), lipid soluble substances (as most anesthetics) and water freely enter brain ( BBB) whereas most ions (even small), protein and large substance such as mannitor penetrate poorlyQ. | train | med_mcqa | null |
Hea rate increase with one of the following? | [
"Stimulation of trigeminal nerve pain receptor",
"Increased intracranial tension",
"Decreased stimulation of Baroreceptors",
"Increased parasympathetic stimulation"
] | C | The baroreflex or baroreceptor reflex is one of the body's homeostatic mechanisms that help to maintain blood pressure at nearly constant levels. The baroreflex provides a rapid negative feedback loop in which an elevated blood pressure reflexively causes the hea rate to decrease and also causes blood pressure to decrease. Decreased blood pressure decreases baroreflex activation and causes hea rate to increase and to restore blood pressure levels. The baroreflex can begin to act in less than the duration of a cardiac cycle (fractions of a second) and thus baroreflex adjustments are key factors in dealing with postural hypotension, the tendency for blood pressure to decrease on standing due to gravity. The baroreceptors are stretch-sensitive mechanoreceptors. At low pressures, baroreceptors become inactive. When blood pressure rises, the carotid and aoic sinuses are distended fuher, resulting in increased stretch and, therefore, a greater degree of activation of the baroreceptors. At normal resting blood pressures, many baroreceptors are actively repoing blood pressure information and the baroreflex is actively modulating autonomic activity. Active baroreceptors fire action potentials ("spikes") more frequently. The greater the stretch the more rapidly baroreceptors fire action potentials. Many individual baroreceptors are inactive at normal resting pressures and only become activated when their stretch or pressure threshold is exceeded. Ref: guyton and hall textbook of medical physiology 12 edition page number:216,217,218 | train | med_mcqa | null |
Dye is injected in which vessel in cerebral angiography: | [
"Brachial aery",
"Cubital vein",
"Femoral aery",
"Carotid aery"
] | D | D i.e. Carotid aery | train | med_mcqa | null |
Storage form of energy in liver is - | [
"Glycogen",
"Triacylglycerol",
"Cholesterol ester",
"Protein"
] | A | Ans. is 'a' i.e., Glycogen* Humans carry supplies of fuel within their body. Calories are stored in the body as fat (triglycerides), glycogen and some protein.Provider of energyGramsKilocaloriesPlasma glucose1248Hepatic glycogen70280Muscle glycogen2801120Fat (Triglyceride) in adipose tissue13,000117, 000Muscle protein10,00040,000* Thus, fat in the adipose tissue is the largest reserve of energy in the body, i.e. adipose tissue is the storehouse in the body. However, liver glycogen is the first main provider of energy, for example after absorptive period (when all the dietary glucose is utilized), liver glycogen is the first source of energy. Liver glycogen maintains the blood glucose level between meals. | train | med_mcqa | null |
Clinical GOAl recommended by WHO for Prevention of CAD is | [
"Cholesterol / LDL ratio",
"Cholesterol / HDL ratio",
"Triglycerides / LDL ratio",
"Triglycerides / HDL ratio"
] | B | null | train | med_mcqa | null |
Cabbage like odour is found from body fluids in which of the following metabolic disorders? | [
"Phenylketonuria",
"Tyrosinemia",
"Maple syrup urine disease",
"Isovaleric academia"
] | B | Cabbage like odour is found from body fluids in- Tyrosinemia | train | med_mcqa | null |
Planter flexion is brought about by which of these muscles: | [
"Plantaris",
"FHL",
"Soleus",
"All"
] | D | A. i.e. Plantans; B. i.e. FHL; C. i.e. Soleus | train | med_mcqa | null |
True regarding animals that are chronically exposed to cold? | [
"Increased sympathetic stimulation",
"Increased vagal action",
"Increased insulin levels in blood Decrease",
"blood supply to adipose tissue"
] | A | A i.e. Increased sympathetic stimulation | train | med_mcqa | null |
The contraceptive which is contraindicated in DVT is? | [
"OCP",
"Barrier method",
"Billing's method",
"Non hormonal IUCD"
] | A | Hormonal contraceptives Estrogen - aerial thrombosis Progesterone - venous thrombosis Progesterone or estrogen preparations are therefore not preferred in DVT patient. | train | med_mcqa | null |
AUDIT test is used for which of the following | [
"Alcohol use disorder",
"Cannabis abuse",
"Opioid use disorder",
"Schizophrenia"
] | A | AUDIT (Alcohol used disorders indentification test) is used in the screening of alcohol use disorders. | train | med_mcqa | null |
Which of the following is NOT a CONTRAINDICATION for laparoscopic surgery: March 2013 | [
"Severe cardiac compromise",
"Hiatus hernia",
"Bowel herniation",
"Endometriosis"
] | D | Ans. D i.e. Endometriosis Routine laparoscopy in women with unexplained infeility ?nay reveal endometriosis in 10% of cases | train | med_mcqa | null |
Precocious pubey in a girl is defined as breast development before the age of? | [
"6 years",
"8 years",
"12 years",
"10 years"
] | B | Precocious pubey: Precocious pubey is defined by the onset of secondary sexual characteristics before the age of 8 years in girls and 9 years in boys. | train | med_mcqa | null |
The commonest cause of significantly lower gastrointestinal bleed in a middle aged person without any known precipitating factor may be due to: March 2008, September 2010 | [
"Ulverative colitis",
"Ischemic colitis",
"Angiodysplasia",
"Diveiculum of sigmoid colon"
] | D | Ans. D: Diveiculum of sigmoid colon Most people with uncomplicated colonic diveiculosis are asymptomatic. A small propoion of these patients may have troublesome symptoms, such as colicky abdominal pain, bloating, flatulence, or altered bowel habit. The symptoms characteristically disappear after defecation or passage of flatus. On clinical examination, they may have tenderness in the left iliac fossa with no signs or symptoms of peritonitis or systemic illness, and all laboratory values may be within normal limits. The clinical picture of symptomatic uncomplicated diveiculosis often overlaps with that of irritable bowel syndrome (IBS), because these two clinical entities are usually diagnosed after other pathologies are excluded. Bleeding alone can sometimes be the only sign of colonic diveiculosis | train | med_mcqa | null |
True about Celiac disease except | [
"Crypt hyperplasia",
"Increase in thickness of the mucosa",
"Increase in intraepithelial lymphocytes",
"Increase in inflammatory cells in lamina propyria"
] | B | Celiac disease There is variable degree of flattening of the mucosa, paicularly of the upper jejunum, and to some extent of the duodenum and ileum. The surface epithelial cells are cuboidal or low columnar type. There may be paial villous atrophy which is replacement of normal villous pattern by convolutions, or subtotal villous atrophy characterised by flat mucosal surface. Lamina propria shows increased number of plasma cells and lymphocytes. TEXTBOOK OF PATHOLOGY 6TH EDITION HARSH MOHAN PAGE NO:575 IMAGE REF: | train | med_mcqa | null |
"Therapeutic" index is: | [
"an approximate assessment of the safety of the drug.",
"The dose expected to kill one half of population",
"The dose produces desired response",
"The dose produces 1000 mortality"
] | A | null | train | med_mcqa | null |
Which of the following antitubercular drug is preferred in severe liver disease ? | [
"Streptomycin + Isoniazid",
"Streptomycin + Ethambutol",
"Isoniazid + Rifampicin",
"Rifampicin + Ethambutol"
] | B | null | train | med_mcqa | null |
OCP protects against all EXCEPT: September2012 | [
"Hepatic adenoma",
"Fibroadenoma breast",
"Carcinoma ovary",
"Uterine malignancy"
] | A | Ans. A i.e. Hepatic adenoma OCP's administration may result in hepatic adenoma. Oral contraceptive pills Protects against: - Uterine Ca, - Ovarian Ca, - RA, - Endometriosis etc. | train | med_mcqa | null |
Interpeduncular fossa contains | [
"Mammillary bodies, pineal gland, oculomotor nerve, infundibulum",
"Oculomotor nerve, mammillary bodies, infundibulum, posterior perforating substance",
"Tuber cinerium, mammillary bodies, oculomotor nerve, anterior perforating substance",
"Oculomotor nerve, mammillary bodies, optic chiasma, anterior perforat... | B | Contents of interpeduncular fossa are
Infundibulum
Mammillary bodies
Oculomotor nerve
Posterior perforating substance. | train | med_mcqa | null |
A pregnant patient with a positive test for gonorrhea and no testing for chlamydial infection should be treated with which of the following? | [
"Ceftriaxone 250 mg IM once and azithromycin 1 g orally once",
"Cefixime 400 mg orally once",
"Erythromycin 500 mg orally four times daily for 7 days",
"Azithromycin 1 g orally once and amoxicillin 500 mg orally three times daily for 7 days"
] | A | Treatment of Uncomplicated Gonococcal Infections During Pregnancy Ceftriaxone. 250 mg intramuscularly as a single dose Or Cefixime, 400 mg orally in a single dose Or Spectinomycin, 2g intramuscularly as a single dose Plus Treatment for chlamydial infection unless it is excluded The current treatment for uncomplicated gonococcal infection during pregnancy is 250 mg of ceftriaxone intramuscularly plus 1 g of azithromycin orally. The latterprovides another drug with a different mechanism of action against N gonorrhoeaeand treats chlamydial co-infections. | train | med_mcqa | null |
Health promotion comes under: March 2013 (e) | [
"Primary level of prevention",
"Secondary level of prevention",
"Teiary level of prevention",
"Primordial prevention"
] | A | Ans. A i.e. Primary level of prevention Primary Prevention It is used before the person gets the disease. Primary prevention aims to prevent the disease from occurring. So primary prevention reduces both the incidence and prevalence of a disease. Encouraging people to protect themselves from the sun's ultraviolet rays is an example of primary prevention of skin cancer. Secondary Prevention Secondary prevention is used: -- After the disease has occurred, but -- Before the person notices that anything is wrong. A doctor checking for suspicious skin growths is an example of secondary prevention of skin cancer. The goal of secondary prevention is to find and treat disease early. In many cases, the disease can be cured. Teiary Prevention Teiary prevention targets the person who already has symptoms of the disease The goals of teiary prevention are: Prevent damage and pain from the disease - Slow down the disease - Prevent the disease from causing other problems (These are called "complications.") - Give better care to people with the disease - Make people with the disease healthy again and able to do what they used to do Developing better treatments for melanoma is an example of teiary prevention. Examples include better surgeries, new medicines, etc. | train | med_mcqa | null |
Proteins which have DNA binding domain in its structure is | [
"Zinc finger",
"b - Sheet",
"b - band",
"Beta meander"
] | A | Zinc finger: Two types of zinc finger have been repoed, called the C2H2 finger and the C4 finger. The C2H2 zinc finger is a loop of 12 amino acids with two cysteines and two histidines at the base of the loop that tetrahedrally coordinates a zinc ion The a-helix contains a number of conserved basic amino acids and interacts directly with the DNA, binding in the major groove of the double helix. Transcription factors that contain zinc fingers often contain several such motifs; usually at least three zinc fingers are needed for tight DNA binding of the protein. Indeed RNA polymerase III transcription factor contains nine zinc fingers! The SP1 transcription factor, which binds to the SP1 box, has three zinc fingers. | train | med_mcqa | null |
Fibrin degradation product help in detection of | [
"haemophilia",
"DIC",
"Thrombocytopenic purpura",
"Thrombasthenia"
] | B | null | train | med_mcqa | null |
Blood pressure in the dead (i.e., when hea is not beating) is: | [
"Zero",
"6-7 mm Hg",
"20 mm Hg",
"40 mm Hg"
] | B | Beating of the hea causes the pressure in the aeries and aerioles, which allows the blood to flow through the tissues, in spite of the tissue pressure surrounding the vessels. When hea stops beating, the pressure in the vessels will equilibrate with the tissue pressure - about 6-7 mm Hg. | train | med_mcqa | null |
True about SLE is- | [
"Autoimmune disease",
"Childhood SLE had poor prognosis than adult SLE",
"Presence of ANA",
"All are true"
] | D | Ans. is 'd' i.e., All are true SLE (Systemic Lupus Erythematosus) Autoimmune disorder Inflammation of the blood vessel Childhood SLE had poor prognosis than adult SLE Hallmark of SLE is the presence of antinuclear antibody (ANA) More common in the female. Malar rash in pathognomic of SLE Non - erosive arthritis Nephritis Encephalopathy Pleuritis f Pericarditis Cytopenia | train | med_mcqa | null |
All are false statement about pyridoxine except - | [
"Deficiency can cause hemolytic anemia",
"Deficiency can cause hypochromic anemia",
"RDA for pyridoxine 5 mg",
"Can cause burning foot syndrome"
] | B | Answer- B. Deficiency can cause hypochromic anemiaVitamtin B deficiency cause hypochromic mictocytic anemia since its derivative pyridoxal phosphate (PLP) b a cofactor for the enzyme aminolevullanate synthase which is the first enzyme involved in heme biosynthesis. | train | med_mcqa | null |
Consider the following 1.Lactic Acid 2.Sorbic Acid 3.Sulphurous acid Which of the above are food preservatives | [
"1 and 2 only",
"2 and 3 only",
"None of these",
"1, 2 and 3"
] | D | Food preservatives Substances, which if added to food, are capable of inhibiting, retarding or arresting the process of fermentation acidification or other decomposition Class I preservatives Class II preservatives Common salt Benzoic acid Sugar, Dextrose, Glucose Sulphuric acid Spices Sorbic acid, Lactic acid Honey Nicin Vinegar, Acetic acid Propionic acid Ref : THE PFA Act 1954 Pgno : 91 | train | med_mcqa | null |
What is the other name of Hallervorden-Spatz syndrome? | [
"Mitochondrial encephalomyopathy; Lactic acidosis; Stroke",
"Pantothenate kinase - associated neurodegeneration",
"Thiamine-responsive megaloblastic anemia syndrome",
"Riboflavin sensitive myopathy"
] | B | Hallervorden-Spatz syndrome : Pantothenate kinase - associated neurodegeneration Rare Autosomal recessive Excessive accumulation of iron containing pigments in brain Accumulation of N-Pantothenoyl-Cysteine and Pantetheine, leading to free radical cell damage Characterized by Parkinson like features & mental retardation | train | med_mcqa | null |
Carotid body contains islands of two types of cells, type I and type II cells, surrounded by fenestrated sinusoidal capillaries. Type I cells are excited by hypoxia, and the principal transmitter appears to be | [
"Serotonin",
"Adrenaline",
"Dopamine",
"Potassium"
] | C | Carotid & Aoic Bodies There is a carotid body near the carotid bifurcation on each side, and there are usually two or more aoic bodies near the arch of the aoa.Each carotid and aoic body (glomus) contains islands of two types of cells, type I and type II cells, surrounded by fenestrated sinusoidal capillaries.Type I cellsThe type I or glomus cells are closely associated with cup-like endings of the afferent nerves.The glomus cells resemble adrenal chromaffin cells and have dense-core granules containing catecholamines that are released upon exposure to hypoxia and cyanide.The cells are excited by hypoxia, and the principal transmitter appears to be dopamine, which excites the nerve endings by way of D2 receptors.Type II cellsThe type II cells are glia-like, and each surrounds four to six type I cells. Their function is probably sustentacular. | train | med_mcqa | null |
Regarding anterior choroidal aery syndrome, all are true except- | [
"hemiparesis",
"hemi sensory loss",
"predominant involvement of anterior limb of internal capsule",
"homonymous hemianopia"
] | C | Anterior choroidal aery is a branch of internal carotid aery. It supplies posterior limb of internal capsule. Block leads to Anterior choroidal aery syndrome:- homonymous hemianopia sensory motor loss of contralateral upper limb, trunk and lower limb (face is spared as genu is supplied by direct branch of internal carotid aery) auditory problems Anterior limb of internal capsule supplied by- Recurrent branch of Heubner branch of anterior cerebral aery. | train | med_mcqa | null |
The action of adrenaline is potentiated in the presence of all except: | [
"Halothane",
"Ethyl chloride",
"Cyclopropane",
"Ether"
] | D | null | train | med_mcqa | null |
Which of the following genetic abnormalities is associated with the development of hyperkalemia: | [
"11b - hydroxylase deficiency",
"Liddle's syndrome",
"Gitelman syndrome",
"Autosomal dominant polycystic kidney disease"
] | D | 11 beta hydroxylase deficiency Androgen excess- masculinization of female newborns and precocious pubey in male Hypeension, which may or may not be associated with mineralocoicoid excess, hypokalemia, and metabolic alkalosis Liddle syndrome AD, hypeension associated with low plasma renin activity, metabolic alkalosis, hypokalemia, and normal to low levels of aldosterone Autosomal dominant polycystic kidney disease Since ESRD will ensue in these patients, hyperkalemia will always be a feature of ADPKD Gitelman syndrome Hypokalemic metabolic alkalosis | train | med_mcqa | null |
The best investigation for the diagnosis of amyloidosis is | [
"Colonoscopy",
"Rectal biopsy",
"Upper GI endoscopy",
"CT scan"
] | B | Diagnosis Microscopic examination - biopsies from kidney, gingiva, rectum Congo red staining on abdominal fat aspirates Serum & urine protein electrophoresis Bone marrow aspiration - to r/o plasmacytosis Scintigraphy with radiolabelled serum amyloid P (SAP) component | train | med_mcqa | null |
Defective neutrophil function is seen in all except: | [
"Juvenile periodontitis",
"Diabetes",
"Papillon lefeure syndrome.",
"Gingivitis"
] | D | Severe periodontitis occurs in patients with neutrophil defects.
Defective neutrophil function is seen in:
Papillon Lefeure syndrome.
Chediak Higashi syndrome.
Juvenile periodontitis.
Neutropenia
Agranulocytosis
Diabetes | train | med_mcqa | null |
Cow's milk contains what % proteins - | [
"1.1",
"3.2",
"3.5",
"4.1"
] | B | Cow milk contain 3.2%of proteinREF. PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICAL 21ST EDITION. PAGE NO - 582 | train | med_mcqa | null |
A man had Egg omelet 1-4 hours back and developed diarrhea, vomiting and abdominal cramps. Most likely cause of poisoning. | [
"Staphylocoocus",
"Salmonella",
"Bacillus cereus",
"Clostridium"
] | A | null | train | med_mcqa | null |
Charcot's triad: | [
"Abdominal Pain, fever, jaundice",
"Fever, jaundice, abdominal distention",
"Fever, Vomiting, Jaundice",
"Jaundice, Fever, Diarrhea"
] | A | Ans: A (Adbominal Pain, Fever, Jaundice) Ref: Bailey anti Love's Short Practice of Surgery 25th Edition, Robbins Pathology 8th ed, Nelson Pediatrics 19th ed, Harrison Principles of internal medicine, 18th ed,Explanation:Charcot's TriadSeen in cholangitisPainJaundiceFeverFew important triads in medicineSaint's TriadDiverticulosisGall stonesHiatus herniaWhipple's triadSeen in Insulinoma (most common functioning tumor of the endocrine pancreas)FasHng-induced neuroglvopenic symptoms of hypoglycemia (diaphoresis, shaking, mental confusion, obtundation, and seizures)Low blood glucose levels (40 to 50 mg/dl)Relief of symptoms after the administration of glucose.Beck's TriadSeen in Cardiac TamponadeHypotensionSoft or absent heart soundsJugular venous distention (increased JVP)Murphy's TriadSeen in Acute appendicitisPain FeverVomiting Madder's triadSeen in Boerhaave's syndromePainVomiting andSubcutaneous emphysemaSandbolnrs triadSeen in HemobiliaPainjaundiceHematemesisChiari triadSeen in Aorto enteric listulaMidthoracic painSentinel arterial hemorrahageExsanguinationVirchow's triadAbnormalities that lead to thrombus formationEndotheli al i nj u ryStasis or turbulent blood flowHypercoagulability of the bloodCurrarino triadAnorectal malformations (ectopic anus, anal stenosis, imperforate anus)Sacral bone anomalies (hypoplasia, poor segmentation)Presacral anomaly (anterior meningoceles, teratoma, cyst)Female athlete triadDisordered eatingAmenorrheaOsteoporosisKartagener triadSitus inversus totalisChronic sinusitisBronchiectasisSamter triadNasal polypsAspirin sensitivityAsthmaCarney triadGastric GISTParagangliomaPulmonary chondromaClassical triad of features in DiseasesFeltv syndrome - Triad of Rheumatoid arthritis, Splenomegaly, and NeutropeniaWhipple disease - Triad of Diarrhea, Weight loss, and Malabsorption.Reiter syndrome - Triad of Arthritis, Urethritis, and ConjunctivitisWegener granulomatosis - Triad ofAcute necrotizing granulomas of the upper & lower respiratory tractNecrotizing or granulomatous vasculitis affecting small to medium-sized vesselsGlomerulonephritisPlummer-Vinson syndrome- Triad of Esophageal webs, Microcytic hypochromic anemia & atrophic glossitisAchalasia cardia - Triad of incomplete LES relaxation. increased LES tone, esophageal aperistalsisSolitary rectal ulcer - Triad of rectal bleeding, mucus discharge, and an inflammatory lesion of the anterior rectal wall.Spasmus nutans - Triad of nystagmus, head tilt, and head noddingHepatopulmonary syndrome (HPS) - Triad of chronic liver disease, hypoxemia, and intra-puimo- nary vascular dilations (TVPD)Hemochromatosis - Triad of pigment cirrhosis with hepatomegaly, skin pigmentation, and diabetes meltitusAnhidrotic ectodermal dysplasia - Triad of absence of sweat glands, anomalous dentition, and hypotrichosisDRESS syndrome - Triad of Fever, rash and hepatitisGradenigo syndrome - Triad of suppurative OM. paralysis of the external rectus muscle, and pain in the ipsilateral orbit.Infantile glaucoma - Triad of epiphora (tearing), photophobia (sensitivity to lightt. and blepharospasm (eyelid squeezing)Kearns-Savre syndrome - Triad of progressive external ophthalmoplegia, pigmentary degeneration of the retina, and onset before age 20 yr.Andersen-Tawil syndrome - Triad of periodic paralysis. potentially fatal cardiac ventricular ectopyHemolytic uremic syndrome - Triad of Microangiopathic hemolytic anemia, thrombocytopenia, and renal insufficiencyPrune-belly syndrome, also called triad syndrome or Eagle-Barrett syndromeMacCune Albright Syndrome - Triad of Polyostotic disease. Precocious puberty, and Cutaneous pigmentationBotulism - Triad of acute onset of a symmetric flaccid descending paralysis with clear sensorium. no fever, and no paresthesiasKlippel-Feil syndrome - Triad of short neck, low hairline, and restriction of neck motion | train | med_mcqa | null |
The common HLA type associated with Behcet disease is _________ | [
"HLA DR4",
"HLA B27",
"HLA B51",
"HLA CW6"
] | C | Behcet disease is associated with HLA haplotype B51 in paicular. Behcet disease is a neutrophilic vasculitis affecting small to medium-sized vessels that classically presents as a clinical triad of recurrent oral aphthous ulcers, genital ulcers, and uveitis. Here (Th17) T helper 17 cells play an impoant contribution in recruitement of neutrophils, which will later infiltrate into the vessel wall. There can also be gastrointestinal and pulmonary manifestations, with disease moality related to severe neurologic involvement or rupture of vascular aneurysms. Reference : nelson textbook of pediatrics 21st edition Pgno: 1289 | train | med_mcqa | null |
True about Nephrotic syndrome in a child – a) Minimal change disease is commonest causeb) Proteinuria of 4 gm/m2 hr is characteristicc) Cyclosporine & Azathioprine is mainstay of therapyd) Pretreatment biopsy is done in all casese) Spontaneous bacterial peritonitis is associated with it | [
"a",
"ae",
"ab",
"ad"
] | B | Nephrotic syndrome in children
Most children (90%) with nephrotic syndrome have a form of idiopathic nephrotic syndrome.
Causes of idiopathic nephrotic syndrome are -
i) Minimal change disease (85%)
ii) Mesangial proliferative GN
iii) FSGS
Infections are a common complication of minimal change disease (Nephrotic syndrome)
Commonly seen infections are - Spontaneous bacterial peritonitis (most common), UTI, Sepsis, pneumonia and cellulitis.
There is increased susceptibility to infections in minimal change disease because of -
Urinary losses of immunoglobulin’s & properdin factor B
Malnutrition
Defective cell-mediated immunity
Oedema/ascites
Immunosuppressive therapy
The bacteria most commonly implicated in these cases are Streptococcus pneumoniae (most common) and E. coll. | train | med_mcqa | null |
A 52-year-old man presents with a chronic cough and shortness of breath. He admits to smoking two packs of cigarettes a day for 30 years. Pulmonary function tests reveal chronic obstructive pulmonary disease. In counseling this patient, you advise him to stop smoking immediately You also mention that, in addition to emphysema, which of the following organs carries a significantly increased risk of smoking-related cancer? | [
"Brain",
"Liver",
"Pancreas",
"Skin"
] | C | Cancer of the pancreas has shown a steady increase in incidence, which is partly related to cigarette smoking. The risk for adenocarcinoma of the pancreas in male smokers is elevated two- to threefold, and a clear dose-response relationship exists. In fact, men who smoke more than two packs a day have a five times greater risk of developing pancreatic cancer than nonsmokers. Smoking does not increase the risk of cancer for the other choices.Diagnosis: Chronic obstructive pulmonary disease | train | med_mcqa | null |
Chocolate cyanosis seen in | [
"Wilson's disease",
"Zinc poisoning",
"Methemoglobinemia",
"Mercurialentis"
] | C | Methemoglobinemia Signs and symptoms Headache, nausea, vomiting, breathlessness, confusion, coma, convulsion, severe metabolic acidosis. Hemolysis may occur in G6PD deficiency. Blood is chocolate brown in color (chocolate cyanosis) Ref: FORENSIC MEDICINE AND Toxicology Dr PC IGNATIUS THIRD EDITION PAGE 430 | train | med_mcqa | null |
In urea cycle, hydrolysis of arginine forms - | [
"Citrulline",
"Ornithine",
"Carbomoyl phosphate",
"Arginosuccinase"
] | B | Ans. is 'b' i.e., Ornithine o Arginase catalyses the formation of urea from arginine by hydrolytic cleavage of arginine to yield urea and ornithine to yield urea and ornithine.Urea cvcleo Ammonia is ultimately disposed of by formation of urea by "Kreb's Henseleit urea cycle" in the liverr. Urea cycle takes place both in mitochondria and cytosol. First two reactions of urea cycle occur in the mitochondria, and remaining reactions occurs in cytosolr.o Biosynthesis of urea occurs in five steps.Carbamoyl phosphate synthase-I (CPS-I), a mitochondrial enzyme, catalyzes the formation of carbamoyl phosphater by condensation of CO2 and ammonia. Two molecules of ATP are required for the reaction. CPS-I is the rate limiting enzyme of urea cycle0. It is an allosteric enzyme and allosterically activated by N-acetyl glutamater.Ornithine transcarbamoylaser catalyzes the formation of citruliine from carbamoyl phosphate and ornithiner.Arginosuccinate synthase6 catalyzes the formation of arginosuccinate from citruliine and aspartate. This reaction requires 1ATP, but 2 high energy phosphate bonds are consumed as ATP is converted to AMP + PPi. The amino group of aspartate provides one of the two nitrogen atoms that appear in urear (The other one is provided by ammonia NH4 r).Arginosuccinate lyase (arginosuccinase) catalyses the cleavage of arginosuccinate into arginine and fumarate. Fumarate enters in TCA cycle.Arginaser catalyses the formation of urea from argininer by hydrolytic cleavage of arginine to yield urea and ornithine. Ornithine is thus regenerated and can enter mitochondria to initiate another round of the urea cycle.o The source of two nitrogen atoms of urea one from ammoniar and one from amino group of aspartate6. Source of carbon is CO2r. Thus out of all amino acids in%rolved in urea cycle aspartate is consumed, while there is no net loss or gain of ornithine, citruliine, arginosuccinate or arginine. There is production of fumarate as by productr.o 3 molecules of ATP are consumed (2 in first reaction and 1 in third reaction). However, 4 high energy phosphatebonds are utilized as 3rd ATP is converted to AMP+PPi. | train | med_mcqa | null |
All of the following are components of the Apgar score except: | [
"Color",
"Hea rate",
"Respiratory rate",
"Muscle tone"
] | C | Respiratory rate is not a component of Apgar score; however, respiratory effo is: The Apgar score is an objective method of evaluating the newborn&;s condition using the 5 parameters stated below It is performed at 1 minute and 5 minutes after bih Components of APGAR score: Color (A Appearance) Hea rate (P Pulse) Response to a catheter in nostril (G Grimace) Muscle tone (A activity) Respiratory effo (R) (not respiratory rate) Apgar score is not used to guide resuscitation, and resuscitation must be initiated before the 1-minute score The change of score at sequential time points following bih reflects how well the baby is responding to resuscitative effos. Ref: Nelson textbook of pediatrics 21st edition Pgno: 872 | train | med_mcqa | null |
Killian dehiscence is in - | [
"Superior constrictor",
"Inferior constrictor",
"Middle constrictor",
"None"
] | B | Ans. is 'b' i.e., Inferior constrictor o Inferior constrictor has two partsUpper Propulsive Part - Thyropharyngeus with oblique fibers.Lower Sphineteric part - Cricopharyngeus with transverse fibers.o Between these two parts exists a potential gap called "Killian's dehiscence".o it is also called "Gateway of tears" as perforation can occur at this site during esophagoscopy.o This is also the site for herniation of pharyngeal mucosa in cases of pharyngeal pouch (pharyngeal diverticulum) | train | med_mcqa | null |
Most common cranial nerve palsy in basilar skull
fracture | [
"Optic nerve",
"Olfactory nerve",
"Facial nerve",
"Auditory nerve"
] | C | null | train | med_mcqa | null |
Schneiderian First rank symptoms are found in : | [
"Schizophrenia",
"Organic delusional disorder",
"Schizoaffective disorder",
"All"
] | D | A >> B, C The presence of one of these Schneider's first rank symptoms (SFRS) in the absenc of intoxication, brain injury or clear affective illness, was sometimes taken as sufficient for making diagnosis of schizophrenia (Kaplan). SFRS are not specifc for schizophrenia and may be seen in other psychiatric disorders such as mood disorderQ and organic psychiatric disordersQ (Ahuja)/affective psychosis (New oxford) Schneider first rank symptoms, which he believed were pathognomic of schizophrenia (& became the forerunner of notion of positive signs & symptoms ), are now known not to be specific for schizophrenia, for they may also occur in mania, drug induced states, other disordersQ (CDTP) Classification of schizophrenia like disorders include cases that resemble schizophrenia in some respects and yet do not meet the criteria for diagnosis. These include ICD-10 DSM - IV Schizoaffective disorder Schizo affective disorder Persistent delusional disorders Induced delusional disorder Delusional disorder Shared psychotic disorder Acute & transient psychotic disorder Acute schizophrenia like psychotic disorder Brief psychotic disorders Schizophreniform disorder Unspecified non organic psychosis Psychotic disorder not otherwise specified Schizotypal disorder, Other non organic psychotic disorders ? | train | med_mcqa | null |
Boundaries of quadrilateral space include all except - | [
"Teres major",
"Long head of triceps",
"Neck of humerus",
"Deltoid"
] | D | - Boundaries of quadrilateral space
Superior- Sub scapularis, Shoulder joint capsule and teres minor
Medial- Long head of triceps
Lateral- Surgical neck of humerus
Inferior- Teres major
Content- axillary nerve and posterior circumflex humeral vessels. | train | med_mcqa | null |
Integrin binds to? | [
"Fibronectin",
"Vitronectin",
"Collagen",
"Laminin"
] | D | Ans. (d) Laminin > FibronectinIntegrins localised in the plasma membrane are the major adhesion receptors connecting cells with components of the extracellular matrix. Integrins interact directly with laminin, fibronectin present in the basal lamina and intracellularly contact actin through intermediate proteins, such as alpha-actinin, vinculin,and talin. | train | med_mcqa | null |
Suppos of uterus are all except: | [
"Uterosacral ligaments",
"Mackenrodt's ligament",
"Broad ligament",
"Levator ani"
] | C | DeLancey level of suppo. Level I --Uterosacral and cardinal ligaments/Mackenrodt suppo the uterus and vaginal vault Level II -- Formed by Paravaginal tissue and their attachment to levator ani muscles and white line. Level III-- Made by Perineal body and muscles attached to it. Includes Levator ani muscle. | train | med_mcqa | null |
Regarding Suxmethonium all are true except | [
"Is metabolised principally by plasma cholinesterase.",
"Use cautiously in patients using echothiopate eye drops for glaucoma",
"Recommended in patients with burns",
"Can cause hyperkalemia"
] | C | Succinylcholine causes hyperkalemia in burns patients. | train | med_mcqa | null |
site of deposition of a mitochondira seen in organs of all cells except ? | [
"brain",
"hea",
"kidney",
"muscles"
] | C | DYSTROPHIC CALCIFICATION : Pathogenesis : The final common pathway is the formation of crystalline calcium phosphate Process - two major phases: initiation (or nucleation) and Propagation * Both can occur intracellularly and extracellularly * Initiation of intracellular calcification occurs in the mitochondria * Initiators of extracellular dystrophic calcification include phospholipids found in membrane-bound vesicles - matrix vesicles Sites of Metastatic calcification * May occur in any normal tissue of the body but affects the following organs more commonly: * Kidneys, especially at the basement membrane of tubular epithelium and in the tubular lumina causing nephrocalcinosis * Lungs, especially in the alveolar walls. * Stomach, on the acid-secreting fundal glands. * Blood vessels, especially on the internal elastic lamina. * Cornea: another site affected by metastatic calcification. * Synovium of the joint causing pain and dysfunction. Tubular basement membrane in nephrocalcinosis due to hypercalcaemia REF : robbins 10th ed | train | med_mcqa | null |
Glucose can be synthesised from all of the following, EXCEPT: | [
"Lactic acid",
"Aminoacid",
"Acetoacetate",
"Glycerol"
] | C | Ketone body cannot synthesize glucose because the conversion of acetyl coA to pyruvate is irreversible. Glucose can be synthesised by Lactic acid, glycerol & gluconeogenic amino acid. | train | med_mcqa | null |
Father of distraction osteogenesis is: | [
"Codivilla.",
"Snyder",
"Ilizarov.",
"Alexander."
] | C | null | train | med_mcqa | null |
Oesophageal motility disorder are best diagnosed by? | [
"Barium studies",
"Endoscopy",
"24 hour pH monitoring",
"Manometry"
] | B | Answer is B (Endoscopy): Dysphagia for solids alone suggests a probable mechanical cause for dysphagia such as carcinoma, stricture or esophageal web. The investigation of choice for such cases is Endoscopy. | train | med_mcqa | null |
Which of the following is not associated with malignancy - | [
"Fragile X syndrome",
"Fanconi's syndrome",
"Down's syndrome",
"Bloom syndrome"
] | A | Down syndrome is associated with incrased risk of leukemia. _____ Harrison | train | med_mcqa | null |
Cerebellopontine angle contains all except | [
"VII N",
"VIII N",
"Medullo-olivary tract",
"XII N"
] | D | Cranial nerve XII arises from the lower pa of medulla. The cerebellopontine angle is a triangular subarachnoid space that lies between the anterior surface of the cerebellum and the lateral surface of the pons. It contains CSF, arachnoid tissue, cranial nerves, and associated vessels. Contents : Facial nerve (CN VII) Vestibulocochlear nerve (CN VIII) Flocculus of the cerebellum Lateral recess of the 4th ventricle Anterior Inferior cerebellar aery. Relations: CN V lies superior to this space CN IX, CN X, and CN XI lie inferior to this space, cerebellar peduncle also. ref - vishram singh 2e pg82 | train | med_mcqa | null |
Vascular sign of narath is seen in - | [
"Dislocation of hip",
"Dislocation of knee",
"Dislocation of elbow",
"Dislocation of shoulder"
] | A | Ans. is 'a' i.e., Dislocation of hip Vascular sign of Narath* Normally femoral pulse is felt in the groin against head of the femur.* In posterior dislocation of hip the vessels fall back unsupported, so femoral arterial pulsation, which is felt against the head of the femur will be feeble or even, may not be palpable. | train | med_mcqa | null |
Peripheral iridectomy is indicated in-a) Acute angle closure glaucoma b) Open angle glaucomac) Malignant glaucomad) In ICCEe) Pupil block glaucoma | [
"acd",
"ade",
"abd",
"ad"
] | B | Indications of peripheral iridectomy
Closed angle glaucoma with papillary block.
As a part of cateract surgery: - All ICCE, some cases of ECCE.
For optical purpose (optical iridectomy) In corneal opacities
Abscission of the prolapsed iris
Iris bombe formation (annular synechiae)
For removal of foreign body, cyst or tumour of the iris
As a part of trabeculectomy operation and in penetrating keratoplasty | train | med_mcqa | null |
Laser used in LASIK? | [
"Excimer",
"Argon",
"Holmium",
"Nd-Yag"
] | A | Ans. A. Excimer. (Ref. Parsons' diseases of Eye 21st/ pg. 76)In LASIK, the Excimer laser beam LASIK with the excimer laser is the most popular and widely accepted Rx modality for myopia among all the choice available today. Surgical correction is only undertaken in individuals 21 years of age and above who have a stable refractive error, who have had unsatisfactory results with non- surgical Rx, and in whom corneal thinning disorders that lead to curvature myopia such as keratoconus have ruled out.Laser-assisted in situ keratomileusis (LASIK) SurgeryRange of myopia possible complicationsAMethods to induce flattening of the central cornea1Radial keratotomy1 to 6 DPerforation, infection, surgically induced astigmatism, corneal scarring, late rupture with trivial trauma2Intracorneal rings or segments(ICR or INTACS)1 to 6 DUnpredictable results3Excimer laser photorefractive keratotomy (PRK)1 to 4 DDelayed visual recovery, faint corneal haze, glare and loss of contrast sensitivity4Excimer laser-assisted in situ keratomileusis (LASIK)2 to 12 DDry eye, infection, diffuse lamellar keratitis, interface debris and epithelial ingrowth, flap displacement, surgically induced astigmatism or aberrations, regression, iatrogenic thinning and ectasia, glare, difficulty with night driving and retinal detachment.5Excimer laser-assisted epithelial keratomileusis (LASEK)1 to 6 DSame as LASIK except there are no microtome-related complications6Femosecond laser-assisted LASIK2 to 12 DDiffuse lamellar keratitis, incomplete flap and interstitial corneal stromal haze are still potential problemsBMethods to reduce the overall refractory power of the eye1Clear lens extraction> 15 DRetinal detachment, endophthalmitis2Phakic intraocular lens5-22 DEndophthalmitis, cataract | train | med_mcqa | null |
Which one of the following is of most serious prognostic significance in a patient of essential hypertension - | [
"Diastolic blood pressure greater than 130 mmHg",
"Transient ischaemic attacks",
"Left ventricular hypertrophy",
"Papilloedema and progressive renal failure"
] | D | null | train | med_mcqa | null |
Majocchi granuloma is due to: | [
"Microsporum gypsum",
"Epidemophyton",
"Trichophyton",
"Microsporum"
] | C | Majocchi granuloma is a type of deep folliculitis d/t dermatophyte. Majocchi's granuloma (MG) is classified into two forms: 1st form: healthy individuals, perifollicular, papular lesion induced by shaving (women - legs/ men - beard area) 2nd form : granulomatous, related to immunosuppression, seen in a nodular form, on the upper extremities MC Cause -Trichophyton rubrum. other causes: T.mentagrophytes T.violaceum T.tonsurans | train | med_mcqa | null |
A 25yr old female presents with anemia and jaundice since 2 years. On examination her spleen is enlarged. Peripheral smear showed presence of spherocytes. Which of the following investigation is used in diagnosing this condition? | [
"Osmotic fragility test",
"Coombs test",
"Reticulocyte count",
"Bone marrow aspiration"
] | B | Young female with 2 years history of anemia and peripheral smear showing spherocytes points towards the diagnosis of autoimmune haemolytic anemia (AIHA). In the above question age, gender and history of patient ours AIHA. Most impoant differential diagnosis for AIHA is hereditary spherocytosis. Diagnosis of hereditary spherocytosis is established by osmotic fragility test. Hereditary spherocytosis is an autosomal dominant inherited disorder resulting from molecular abnormalities in the cytoskeleton of red cell membrane. Diagnosis of hereditary spherocytosis is established clinically from Positive family history and splenomegaly Blood film showing spherocytes and reticulocytes Increased osmotic fragility Negative coombs test | train | med_mcqa | null |
Intensity of sensory stimulation is directly related to: | [
"Duration of action potential (AP)",
"Frequency of AP",
"Amplitude of AP",
"All of the above."
] | B | Ans. is 'b' i.e. "Frequency of Action potential There are two methods by which brain detects the intensity of a sensory stimulus (differentiates between two stimuli of different intensities)by variation in the frequency of the action potentials generated by the stimulus in a given receptor.By variation in the number of receptors activated by the stimulus.Also knowWeber - Fechner law*It states that the magnitude of the sensation felt in proportionate to the log of intensity of the stimulus*.Example - A person holding 30 grams weight in his hand can barely detect a 1 gm rise in weight (a rise than 1 gm would not be detectable). But when he holds 300 gm of weighty he can rarely detect a 10 gm increase in weight (a rise less than 10 gm would not be detectable to him. So a 300 gm wt. and (Say) 307 gm of weights would appear same to him.)This is expressed mathematically asInterpreted signal strength = Log x stimulus intensity + constant | train | med_mcqa | null |
Elevation of jaw is done by all except: | [
"Temporalis",
"Masseter",
"Lateral pterygoids",
"Medial pterygoids"
] | C | Depression of the MandibleDepression of the mandible is brought about by contraction of the digastrics, the geniohyoids, and the mylohyoids; the lateral pterygoids play an impoant role by pulling the mandible forward.Elevation of the MandibleElevation of the mandible is brought about by contraction of the temporalis, the masseter, and the medial pterygoids. The head of the mandible is pulled backward by the posterior fibers of the temporalis.Protrusion of the MandibleIn protrusion, the lower teeth are drawn forward over the upper teeth, which is brought about by contraction of the lateral pterygoid muscles of both sides, assisted by both medial pterygoids.Refraction of the MandibleThe aicular disc and the head of the mandible are pulled backward into the mandibular fossa. Retraction is brought about by contraction of the posterior fibers of the temporalis.Lateral Chewing MovementsThese are accomplished by alternately protruding and retracting the mandible on each side. For this to take place, a ceain amount of rotation occurs, and the muscles responsible on both sides work alternately like turning the chin to left side produced by left lateral pterygoid and right medial pterygoid and vice versa. | train | med_mcqa | null |
Most common sinus to be involved in acute sinusitis? | [
"Ethmoid",
"Maxillary",
"Sphenoid",
"Frontal"
] | B | Ans. is 'b' i.e., Maxillary Most common sinus affected by sinusitis overall Maxillary Most common sinus affected in adult Maxillary Most common sinus affected in children Ethmoid Least common sinus affected Sphenoid Sinuses involved in order of frequency Maxillary > Frontal > Ethmoid > Sphenoid | train | med_mcqa | null |
CSF otorrhoea is caused by ? | [
"Rupture of tympanic membrane",
"Fracture of cribriform plate",
"Fracture of parietal bone",
"Fracture of petrous temporal bone"
] | D | CSF otorrhea CSF otorrhea, i.e., leakage of cerebrospinal fluid through ear structure, is a rare but potentially life threatening situation that requires rapid intervention. The underlying etiology of spinal fluid leak through temporal bone is a violation of the bony and meningeal barriers that separate the subarachoid space from the middle ear and mastoid. This means that a defect must exist not only in the bone, but also in the dura matter. Causes of CSF otorrhea are : ? 1) Congenital : - Defect in otic capsule. 2) Acquired : - More common than congenital and cause are : - Surgery : - Post-operative leakage is the most common cause of CSF otorrhea. Surgical causes are acoustic neuroma removal, skull base surgeries and sometimes mastoid surgery. Trauma : - Fracture of petrous pa of temporal can lead to CSF otorrhea. Infection 3) Spontaneous : - It is without an obvious antecedent pathology. There may be some defect in the temporal bone. | train | med_mcqa | null |
In a chronic smoker a highly malignant aggressive and metastatic lung carcinoma is | [
"Small cell carcinoma",
"Squamous cell carcinoma",
"Large cell carcinoma",
"Adenocarcinoma"
] | A | Cigarette smoking is most strongly associated with squamous cell carcinoma and small cell carcinoma. Small cell carcinoma variant is more malignant and metasizes Ref Harrison 19th edition pg 1702 | train | med_mcqa | null |
CSF Otorrhea is due to involvement/trauma of: | [
"Cribriform plate",
"Petrous temporal bone",
"Parietal bone",
"Tympanic membrane"
] | B | CSF otorrhea - CSF coming from ear due to trauma to petrous temporal bone. CSF Rhinorrhea - CSF watery discharge from nose | train | med_mcqa | null |
A 24-year old unmarried woman has multiple nodular, cystic, pustular and comadonic lesions on face, upper back and shoulders for 2 years. The drug of choice for her treatment would be: | [
"Acitretin",
"Doxycycline",
"Isotretinoin",
"Azithromycin"
] | C | Patient in the question is a case of severe nodulocystic acne. Drug of choice in this patient would be synthetic retinoid, isotretinoin. Its use is highly regulated due to its severe adverse effects such as teratogenicity. Other adverse effects includes development of extremely dry skin, cheilitis, and hyperiglyceridemia. Ref: Harrison's Principles of Internal Medicine, 18th Edition, Chapter 52. | train | med_mcqa | null |
All of the following is/are true about Rubella in pregnancy except | [
"Diagnosed when IgM antibodies are present in the neonatal serum",
"Diagnosed when IgG antibodies persist for more than 6 months",
"Most common defects are cataracts, deafness and hea defects",
"Maternal infection after 16 weeks of gestation result in major congenital defects"
] | D | Maternal infection after 16 weeks of gestation result in major congenital defects is not true. Timing of fetal infection determines the extent of teratogenic effect in fetus: Ist 2 months Abnormalities in 65-85% cases, Multiple congenital defects (cataracts, deafness and hea defects) Spontaneous aboion 3rd month of fetal life: 30% to 35% chance of developing a single defect, Deafness ,CHD. During the 4th month 10% risk for a single congenital defect Beyond the 4th month No risk to fetus The classic triad of congenital Rubella includes - Deafness Cataract Congenital hea disease (PDA and PS) | train | med_mcqa | null |
All of the following are blood-borne infections except | [
"Hepatitis B",
"Hepatitis C",
"Hepatitis G",
"Hepatitis E"
] | D | HEPATITIS E:
Enterically transmitted hepatitis non-A, non-B
HEV is essentially a waterborne disease, transmitted through water or food supplies, contaminated by faeces
Incubation Period: 2 – 9 weeks
HEV in pregnancy: Fulminant form is common in Hepatitis E infection during Pregnancy (up to 20% cases) with a high case fatality rate (up to 80%) | train | med_mcqa | null |
Brachial cyst is lined by:- | [
"Columnar epithelium",
"Cuboidal epithelium",
"Squamous epithelium",
"Ciliated columnar epithelium"
] | C | Brachial cyst is lined by squamous epithelium. A branchial cyst develops from the vestigial remnants of the second branchial cleft, is lined by squamous epithelium and contains thick, turbid fluid. The cyst usually presents in the upper neck in early or middle adulthood and is found at the junction of the upper third and middle third of the sternomastoid muscle at its anterior border. It is a fluctuant swelling that may transilluminate and is often soft in its early stages so that it may be difficult to palpate. | train | med_mcqa | null |
Glycine is useful in all of the following synthetic processes, EXCEPT: | [
"Purine synthesis",
"Creatine synthesis",
"Heme synthesis",
"Synthesis of spermine"
] | D | Glycine is incorporated into creatine, and the nitrogen and -carbon of glycine are incorporated into the pyrrole rings and the methylene bridge carbons of heme, and the entire glycine molecule becomes atoms 4, 5, and 7 of purines. Following decarboxylation of S-adenosylmethionine by methionine decarboxylase, three carbons and the alpha-amino group of methionine contribute to the biosynthesis of the polyamines spermine and spermidine. Ref: Rodwell V.W. (2011). Chapter 30. Conversion of Amino Acids to Specialized Products. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K. Murray, V.W. Rodwell (Eds), Harper's Illustrated Biochemistry, 29e. | train | med_mcqa | null |
Limey bile is | [
"Present in the CBD",
"Thin and clear",
"Like toothpaste emulsion in the gallbladder",
"Bacteria rich"
] | C | Limey Bile Calcium salts in the lumen of the GB in sufficient concentration may produce calcium precipitation and diffuse, hazy opacification of bile or a layering effect on plain abdominal X-Ray Filled with a mixture of calcium carbonate and calcium phosphate usually, the consistency of tooth paste Caused by gradual obstruction of the cystic duct or CBD by chronic pancreatitis or carcinoma pancreas Organisms are rarely grown from emulsion Diagnosis Best revealed on plain radiograph Treatment Limey bile, or milk of calcium bile, is usually clinically innocuous Cholecystectomy is recommended when it occurs in a hydropic gallbladder Ref: Harrison's 19th edition Pgno : 2082 | train | med_mcqa | null |
Which of the following is a classical symptom of depression:- | [
"Early morning insomnia",
"Weight loss",
"Guilt",
"Decreased appetite"
] | A | Symptoms of depression(SIGECAPSS) Sadness of mood Interest loss Guilt Energy loss Concentration loss Appetite loss Psychomotor agitation Suicidal thoughts Sleep disturbance - early morning insomnia is specific for depression - waking time shift up to 2 hours before -reduce latency of REM Sleep | train | med_mcqa | null |
A 10 month old child presents with two weeks history off fever, vomiting and alteration of sensorium Cranial CT scan reveals basal exudates and hydrocephalus, the most likely etiological agent is – | [
"Mycobacterium tuberculosis",
"Cryptococcus neoformans",
"Listera monocytogenes",
"Streptococcus pneumoniae"
] | A | Insiduous /gradual onset of fever over a duration of two weeks, with features of raised intracranial tension in the form of vomiting and altered sensorium with characteristic basal exudates and hydrocephalus on cranial CT scan are almost characteristic of tuberculous meningitis.
TUBERCULOUS MENINGITIS
Tuberculous meningitis usually arises from the formation of metastatic caseous lesions in the cerebral cortex or meningitis that develops during the lymphohaematogenous spread of primary infection. This initial lesion increases in size and discharges tubercle bacilli in the subarachnoid space.
This results in gelatinous basal exudate which interferes in the normal flow of CSF, in and out of the ventricular system at the level of basal cisterns leading to a communicating hydrocephalus.
Clinical manifestations of tuberculous meriins
The clinical course of TB meningitis has three stages -
Prodromal stage or stage of invasion
Insidious onset o Headache and vomiting
Low grade fever, loss of appetite o Photophobia
Disturbed sleep o Constipation
2. Stage of meningitis
Signs of meningeal irritation develops - Neck rigidity, Kernig's sign
3. Stage of coma
o Loss of consiousness o Bradycardia
Pupils are dilated & fixed ❑ Chyne-strokes or Biot type of respiration
Episodic decerebration
CT findings in TBM :
Basal cisterns are obliterated by isodense / hyperdense exudate
Post contrast there is a avid enhancement of the basal meninges extending into the ambient, sylvian, pontine and chiasmatic cisterns.
Meningeal enhancement may continue over the cerebral and cerebellar hemispheres.
3. Hydrocephalus is present in 45-87% of patients at time of diagnosis. | train | med_mcqa | null |
A diagnosed case of psoriasis, taking MTX since last 15 yrs presents with jaundice and abnormal LFT. So, what will be the course of management: | [
"Stop Mtx, sta dapsone",
"Mtx + cyclosporine",
"Stop Mtx, sta steroids",
"Stop Mtx, sta cyclosporine"
] | D | Methotrexate is hepatotoxic drug- Therefore, abnormal liver function test & jaundice (in history)- Next step- stop Mtx- Therefore, B is ruled out 3 systemic drugs used in psoriasis1. Mtx (Teratogenic, hepatotoxic)2. Cyclosporine (nephrotoxic)-3H( HTN, Hyperiglyceridemia , Hyperichosis)3. Acitretin- teratogenic, dyslipidemia. In psoriasis systemic steroids are C/I Dapsone have no role. | train | med_mcqa | null |
Which is not a cause of positive trendelenburg sign? | [
"Paralysis of gluteus maximus",
"Congenital dislocation of hip",
"Un-united fracture of neck",
"Coxa vara"
] | A | Ans A Paralysis of gluteus maximusRef: Maheswari Orthopaedics, 5th ed. pg. 135* When a person stands on one leg, the tendency of unsupported side to sag down is counteracted by gluteus medius and minimus. These two muscles form the abductor mechanism of hip.* In case the abductor mechanism is defective, unsupported side of the pelvis drops and is called Positive Trendelenburg sign. It is seen in:# Paralysis of gluteus medius and minimus# Congenital dislocation of Hip# Ununited fracture# Coxa vara | train | med_mcqa | null |
WHO AIDS defining illness are all except - | [
"Persistant generalised lymphadenopathy",
"Oropharyngeal candidiasis",
"CMV retinitis",
"P. Carinii pneumonia"
] | C | Oropharyngeal candidiasis . Generalised lymphadenopathy,CMV retinitis and pneumocystis carinii are AIDS defining illness. Reference:Park&;s textbook of preventive and social medicine,K.Park,23rd edition,page no:348-49. <\p> | train | med_mcqa | null |
A patient is brought to the emergency with history of trauma to his right upper limb. Extension of metacarpophalangeal is lost. There is no wrist drop and extension of IP joint is normal. The most likely nerve involved is : | [
"Ulnar nerve",
"Median nerve",
"Radial nerve",
"Posterior - interosseous nerve"
] | D | When posterior interosseous nerve is injured, there is thumb and finger drop. Extension of wrist is spared. | train | med_mcqa | null |
Drug-induced hallucinations are seen with all the following except | [
"Para-amino salicylic acid",
"Lysergic acid diethylamide",
"Isoniazid",
"Para-amino phenol"
] | D | Para-aminophenol is paracetamol for which no psychosis or hallucinations are seen. Remaining all the given drugs produce psychosis or hallucinations.Ref: HL Sharma 3rd ed. Pg 378. | train | med_mcqa | null |
A 50 year old man with history of recurrent renal stones and peptic ulcer disease. Urine examination revealed the following findings: He has been taking PPI as prescribed but to no avail. He has presented to emergency with chief complains of difficulty in peripheral vision. Which of the following laboratory workup is required in the evaluation of this patient? | [
"Gastrin",
"PTH",
"Prolactin",
"All of the above."
] | D | Urine examination reveals calcium oxalate stones CT scan: pituitary macroadenoma. Recurrent calcium oxalate stones s/o hyperparathyroidism Refractory PUD is s/o Zollinger Ellison disease Visual defects with CT findinds is s/o pituitary adenoma The above constellation is suggests diagnosis of MEN 1. Therefore, gastrin (ZES), prolactin (Pituatry adenoma) and PTH (hyperparathyroidism) needs evaluation. | train | med_mcqa | null |
A 50-year-old woman with long-standing rheumatoid ahritis complains of weakness and fatigue. She states that her stools have recently become black after taking a new nonsteroidal anti-inflammatory drug (NSAID). Gastroscopy shows numerous superficial, bleeding mucosal defects. Which of the following is the most likely diagnosis? | [
"Acute erosive gastritis",
"Early gastric cancer",
"Helicobacter pylori gastritis",
"Menetrier disease"
] | A | - Clinical features given suggests the diagnosis of Acute erosive gastritis. - Acute hemorrhagic gastritis-imbalance between protective and damaging factors Necrosis of mucosa is seen RISK FACTORS- Alcohol Drugs - NSAIDS and Anti-cancer drugs Uremia Stress- ICU, burns- curling ulcer clinical feature- Epigastric pain, nausea and vomiting. | train | med_mcqa | null |
The total volume of CSF is - | [
"50 ml",
"100 ml",
"150 ml",
"275 ml"
] | C | Ans. is 'c' i.e., 150 ml o The major source of CSF is the choroidal plexus of all 4 ventricles, mainly in two lateral ventricles,o Other sources of CSF are ependymal cells of the ventricles and the brain itself, via perivascular spaces,o The total volume of CSF in an adult is about 125-150 ml.o The rate of formation of CSF is about 500-550 mi, day.o Thus the CSF is replaced 3-4 times every day. | train | med_mcqa | null |
Metallic oxides are added in porcelain to: | [
"Increase strength",
"Provide color",
"Improve bonding with metal",
"All of the above"
] | B | null | train | med_mcqa | null |
What is drug of choice in dysentery due to shigella? | [
"Doxycycline",
"Ciprofloxacin",
"Tetracycline",
"No antibiotic is recommended"
] | B | The drug of choice for shigella is ciprofloxacin. Shigella is usually resistant to ampicillin and cotrimoxazole. Ref: Park 21st edition, page 204. | train | med_mcqa | null |
All of the following are categorised as secondary lymphoid organs except - | [
"Lymph nodes",
"Spleen",
"Thymus",
"Subepithelial collections of lymphocytes"
] | C | null | train | med_mcqa | null |
Kappa statistics is used to measure | [
"Inter examiner validity",
"Correlation",
"Regression",
"Proportion"
] | A | null | train | med_mcqa | null |
When an intervention is applied to community to evaluate its usefulness, it is termed as a trial for- | [
"Efficacy",
"Effectiveness",
"Efficiency",
"Effect modification"
] | A | . | train | med_mcqa | null |
A 40 year old male presents with chronic diarrhea for one year. On investigation, the findings obtained were crypt abcess, crypt atrophy, cryptitis and mucositis. Most likely diagnosis is - | [
"Crohn's disease",
"Ulcerative colitis",
"Microscopic colitis",
"Collagenous colitis"
] | A | Crohn's disease The major symptoms are abdominal pain, diarrhoea and weight loss. Ileal Crohn's disease may cause subacute or even acute intestinal obstruction. The pain is often associated with diarrhoea, which is usually watery and does not contain blood or mucus. Almost all patients lose weight because they avoid food, since eating provokes pain. Weight loss may also be due to malabsorption and some patients present with features of fat, protein or vitamin deficiencies. Crohn's colitis presents in an identical manner to ulcerative colitis but rectal sparing and the presence of perianal disease are features that our a diagnosis of Crohn's disease. Many patients present with symptoms of both small bowel and colonic disease. A few patients present with isolated perianal disease, vomiting from jejunal strictures or severe oral ulceration. Physical examination often reveals evidence of weight loss, anaemia with glossitis and angular stomatitis. There is abdominal tenderness, most marked over the inflamed area. An abdominal mass may be palpable and is due to matted loops of thickened bowel or an intra-abdominal abscess. Perianal skin tags, fissures or fistulae are found in at least 50% of patients Ref Davidson edition23rd pg817 | train | med_mcqa | null |
Hypoglycemic unawareness that occurs in diabetic patients when transferred from oral hypoglycemics to insulin, is due to : | [
"Autonomic neuropathy",
"Insulin resistance",
"Lipodystrophy",
"Somogi phenomenon"
] | A | Answer is A (Autonomic neuropathy): Hypoglycemic unawareness refers to a loss of warning symptoms that ale individuals to the presence of hypoglycemia and prompt them to eat and'abo the episode. Hypoglycemic unawareness can be attributed to two factors : Autonomic neuropathy Loss of catecholamine response to hypoglycemia : This means that patients with repeated attacks of hypoglycemia lose their capacity to release epinephrine and norepinephrine in response to hypoglycemia. (increase release of glucogon in response to hypoglycemia is lost very early in type I Diabetes Thus type I patients overeated with insulin may be unaware of critically low levels of blood glucose because of an adaptive blunting of their alarm systems owing to repeated episodes of hypoglycemia. | train | med_mcqa | null |
The setting reaction of dental amalgam proceeds primarily by _____. | [
"Dissolution of the entire alloy particle into mercury.",
"Dissolution of the Cu from the particles into mercury.",
"Precipitation of Sn-Hg crystals.",
"Mercury reaction with Ag on or in the alloy particle."
] | D | The trituration process mixes the amalgam components and the reaction results in the alloy particle being coated by mercury and a product being formed. | train | med_mcqa | null |
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