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 25-year-old man is brought to the emergency department after sustaining a stab wound to the lower back. Examination shows right leg weakness in all muscle groups and loss of vibration and proprioception on the same side. There is loss of pain and temperature sensation but preserved motor strength in the left leg. He has no problems with bladder or bowel retention. Motor strength is preserved in the upper extremities.
His presentation is most consistent with which one of the following spinal cord syndromes? | [
"Anterior cord syndrome",
"Cauda equina syndrome",
"Central cord syndrome",
"Hemisection of the cord"
] | D | null | train | med_mcqa | null |
A young female presents with history of dyspnea on exertion. On examination, she has wide, fixed split S2 with ejection systolic murmur (III/VI) in left second intercostal space. Her ECG shows left axis deviation. The most probable diagnosis is: | [
"Total anomalous pulmonary venous drainage",
"Tricuspid atresia",
"Ostium primum atrial septal defect",
"Ventricular septal defect with pulmonary arterial hypertension"
] | C | c. Ostium primum atrial septal defect(Ref: Nelson's 20/e p 2189, Ghai 8/e p 413)Wide fixed splitting of S2 in association with ejection systolic murmur suggests the diagnosis of atrial septal defectThe presence of left axis deviation in A.S.D., suggests ostium primum type of defect. | train | med_mcqa | null |
Following drugs are used in the treatment of ADHD: | [
"Amphetamine",
"Modafinil",
"Methylphenidate",
"All of the above"
] | D | Pharmacotherapy: Stimulants Non stimulants Methylphenidate, dexmethylphenidate Atomoxetine Amphetamines Bupropion Modafinil Clonidine, Guanfacine Venlafaxine - Stimulants are the preferred group of drugs in children with ADHD - Methylphenidate is the drug of choice for ADHD children * Atomoxetine is efficacious for ADHD and has modest antidepressant activity. * Similarly, many studies have shown efficacy for depressive and ADHD symptoms with the use of bupropion. However, it is known to lower the seizure threshold and as such would not be a recommended drug of choice in a patient with a history of seizure disorder. | train | med_mcqa | null |
Down's syndrome is | [
"Triploidy",
"Monosomy",
"Trisomy",
"Aneuploidy"
] | C | Ans. c (Trisomy). (Ref Harrison, Medicine, 18th/Ch. 62. Chromosome Disorders)Clinically, the most important of numerical abnormality is trisomy 21, the most frequent cause of Down syndrome.Depending on the maternal age structure of the population and the utilization of prenatal testing, the incidence of trisomy 21 ranges from 1/600 to 1/1000 livebirths, making it the most common chromosome abnormality in live-bom individuals.Like most trisomies, the incidence of trisomy 21 is highly correlated with maternal age, increasing from about 1/1500 livebirths for women 20 years of age to 1/30 for women 45 years.In addition to trisomy 21, only two other autosomal trisomies, 13 and 18, occur with any frequency in livebirths.Incidence rates for trisomies 13 and 18 in livebirths are 1/20,000 and 1/10,000, respectively. Unlike trisomy 21 that is associated with near-normal life expectancy, both trisomies 13 and 18 are associated with death in infancy, typically occurring during the first year of life.Three sex chromosome trisomies the 47,XXX, 47,XXY (Klinefelter's syndrome), and 47,XYY conditions are quite common, with each occurring in about 1/2000 newborns. Of all the trisomic conditions, three have fewest phenotypic complications. In fact, with the exception of infertility in klinefelter's sundrome, it is likely that most individuals with such trisomies may go undetected.TableNumerical chromosomal abnormalities includePolyploidye.g. triploidy = haploid x 3 (69XYY =23x3 common but lethal)AneuploidyAny chromosome number, which is not an exact multiple of haploid number e.g., Down syndrome 47 XY+ 21 or Klinefelter syndrome 47 XXY.TrisomyState of having three representatives of a given chromosome instead of the usual pair, as in trisomy 21 (Down syndrome). | train | med_mcqa | null |
Which of the following reduces the development of unexposed Ag halide crystals, and also acts as antifog agent? | [
"Phenidone",
"Potassium hydroxide",
"Sodium sulfite",
"Sodium bromide"
] | D | null | train | med_mcqa | null |
By 2 week of age, infants normally show all of the following signs EXCEPT | [
"Copying facial expression",
"Stepping",
"Palmar grasp",
"A negative Babinski reflex"
] | D | By 2 weeks of age, infants show stepping, palmar grasp, the rooting reflex, and the copying of facial expressions. The Babinski reflex is normally positive until a child is approximately 12 months of age. | train | med_mcqa | null |
A 62 year old woman with keratoconjunctivitis sicca is most likely to demonstrate corneal staining in which location? | [
"Superior third",
"Middle third (interpalpebral)",
"Inferior third",
"Diffuse over entire cornea"
] | B | Rose Bengal staining is a very useful test for detecting even mild cases of Kerato conjuctivitis sicca .Depending upon the severity of Kerato conjunctivitis sicca three staining patterns A, B and C have been described: 'C' pattern represents mild or early cases with fine punctate stains in th.e interpalpebral area; 'B' the moderate cases with extensive staining; and 'A' the severe cases with confluent staining of conjunctiva and cornea. Thus the women is most likely to demonstrate staining in interpalpebral area. | train | med_mcqa | null |
Which is MC genetic cause of Mental Retardation | [
"Tuberous sclerosis",
"Cri-du-chat syndrome",
"Fragile-x-syndrome",
"Angle's syndrome"
] | C | Most common cause of MR is fragile X syndrome. Fragile X syndrome (FXS) is a genetic disorder. FXS is caused by changes in a gene that scientists called the fragile X mental retardation 1 (FMR1) gene when it was first discovered. The FMR1 gene usually makes a protein called fragile X mental retardation protein (FMRP). FMRP is needed for normal brain development. People who have FXS do not make this protein. People who have other <a href=" X-associated disorders</a> have changes in their FMR1 gene but usually make some of the protein. Reference: GHAI Essential pediatrics, 8th edition | train | med_mcqa | null |
All of the following are excitatory neurotransmitters except | [
"Gamma-aminobutyric acid",
"Acetylcholine",
"Dopamine",
"Serotomin"
] | A | GABA is the major inhibitory mediator in the brain, including being responsible for presynaptic inhibition. GABA, which exists as b-aminobutyrate in the body fluidsReference: Ganong review of medical physiology 23rd edition Page no; 141 | train | med_mcqa | null |
Which of the following is a peroxisomal disorder? | [
"Zellweger syndrome",
"Dicarboxylic aciduria",
"Jamaican vomiting sickness",
"Refsum disease"
] | A | Zellweger syndrome is a rare disease characterized by the absence of functional peroxisomes. The long chain fatty acids (C26-C36) are not oxidized. They accumulate in tissues, paicularly in brain, liver and kidney. Hence the disorder is also known as cerebrohepatorenal syndrome. This condition is apparent at bih and is characterized by profound neurologic impairment, victims often dying within a year. Two closely related conditions are neonatal adrenoleukodystrophy and infantile Refsum disease. Zellweger syndrome and these two conditions represent a spectrum of overlapping features, with Zellweger syndrome being the most severe (many proteins affected) and infantile Refsum disease the least severe Dicarboxylic aciduria - characterized by the excretion of C6--C10 o-dicarboxylic acids and by nonketotic hypoglycemia, and is caused by a lack of mitochondrial medium-chain acyl-CoA dehydrogenase. Jamaican vomiting sickness - caused by eating the unripe fruit of the akee tree, which contains the toxin hypoglycin. This inactivates medium and sho-chain acyl-CoA dehydrogenase, inhibiting b-oxidation and causing hypoglycemia. Refsum disease - defect in the alpha-oxidation due to the deficiency of the enzyme phytanic acid alpha-oxidase. Phytanic acid cannot be conveed to a compound that can be degraded by beta-oxidation. Cerebral ataxia and peripheral neuropathy. Phytanic acid mostly found in plant .it's also present in milk and dairy products so this food is restricted in patient of refsum disease. | train | med_mcqa | null |
Which of the following surgical approach for first described by Orringer for the management of carcinoma oesophagus | [
"Tranhiatal",
"Thoracoscopic",
"Left thoracoabdominal",
"Right thoracoabdominal"
] | A | Transhiatal approach for esophagectomy was described by Orringer. Useful in cancers of lower third of oesophagus Other methods or two-stage Ivor-Lewis method with thoracic and abdominal incisions and a three-stage McKeown operation with additional neck incision, paicularly useful in proximal cancers. Reference: Bailey and Love 26 th edition page: 1011 | train | med_mcqa | null |
A 13-year-old boy with patchy depigmented skin on the right flank and upper thigh in segmental distribution. The depigmentation started 1 year back but has been static for last 4 months. Mother reports use of topical steroids which was ineffective. | [
"Piebaldism",
"Segmental vitiligo",
"Hypomelanosis of Ito",
"Hypopigmented streaks"
] | B | Ans. (b) Segmental vitiligo.* Vitiligo is an acquired autoimmune condition targeting melanocytes and present with localized or widespread white depigmented patches. Thyroid autoimmune dysfunction is associated.* Piebaldism is an autosomal dominant condition characterized by white forelock and circumscribed depigmented patches affecting the body. It is caused by a defect in proliferation and migration of melanocytes during embryo- genesis. Unlike vitiligo, it is congenital and non-progressive. In the question the depigmentation started at age of 12 years and patient presented at 13 years.* Nevoid hypomelanosis is characterized by hypopigmented patches or streaks which follow the lines of Blaschko. They are present at birth and may develop in the first 2 years of life. | train | med_mcqa | null |
Glanzmann thrombasthenia is due to | [
"Decreased GpIb",
"Decreased GpIIb/IIa",
"Anti-GpIIb/IIIa antibodies",
"Inhibition or deficiency of ADAMTS 13"
] | B | Glanzmann thrombasthenia is an autosomal recessive disorder. There is a failure of primary platelet aggregation with ADP or collagen due to inherited deficiency of two platelets membrane glycoproteins. It is caused due to deficiency of glycoprotein IIb- IIa. | train | med_mcqa | null |
Cyclosporine inducced HTN is treated by a) Clonidine b) Enalapril c) Nifedipine d) Methyl dopa | [
"ad",
"bc",
"ac",
"bd"
] | B | null | train | med_mcqa | null |
An unruptured ectopic pregnancy patient underwent salpingostomy procedure, where | [
"Tubal incision is left open for secondary healing",
"Tubal Incision is closed with sutures",
"Milking of the tube is done",
"Paial excision of tube"
] | A | SalpingostomyThis procedure is typically used to remove a small unruptured pregnancy. A 10- to 15-mm linear incision is made on the antimesenteric border of the fallopian tube over the pregnancy. The products usually will extrude from the incision. Small bleeding sites are controlled with needlepoint electrocoagulation, and the incision is le unsutured to heal by secondary intention. Serum b-hCG levels are used to monitor response to both medical and surgical therapy.SalpingectomyTubal resection may be used for both ruptured and unruptured ectopic pregnancies. To minimize the rare recurrence of pregnancy in the tubal stump, complete excision of the fallopian tube is advised.Reference: William's Obstetrics; 25th edition; Chapter 19; Ectopic pregnancy | train | med_mcqa | null |
100 % Oxygen therapy used in | [
"Cluster headache",
"Migraine",
"Congenital spherocytosis",
"COPD"
] | A | (A) Cluster headache # CLUSTER HEADACHES are rare, extremely painful, & debilitating headaches that occur in groups or clusters.> These headaches affect one side of the head (unilateral) & may involve tearing of the eyes & a stuffy nose.> Unlike migraines, more men experience this type of headache than women.> They can affect people of any age, but are most common between adolescence & middle age.> No discernable pattern can be found among families in the development of cluster headaches.> While no specific cause has been found for the disorder, it appears to be related to a sudden release of histamine or serotonin by the body tissue.> Onset is sudden & most commonly happens during the dreaming (REM) phase of sleep.> Headaches may occur daily for months, alternating with periods without the headaches (episodic), or they can recur for a year or more without stopping (chronic).> A person may experience alternating chronic & episodic phases.> Some people who experience cluster headaches are heavy smokers.> Alcohol, glare, stress, or certain foods may trigger an attack.> The goal of treatment is to relieve the symptoms.> Smoking, alcohol use, specific foods, and other factors that seem to trigger cluster headaches should be avoided.> A headache diary may be helpful in identifying triggers.> When a headache occurs, record the date and time it starts.> In addition, list all activities, substances used, and food/drink consumed within the previous 24 hours, as well as any other factors that seem significant.> HBOT seems to be useful in the treatment of cluster headaches, particularly for frequent headaches that occur at night.> Side effects of mild ear and sinus pressure have been reported | train | med_mcqa | null |
A trained dai caters for a population of - | [
"1000",
"2000",
"3000",
"4000"
] | A | Ans. is 'a' i.e., 1000 Local dais (Traditional birth attendants)o Under Rural Health Scheme, all categories of local dies are trained to improve their knowledge in the elementary concepts of: -o MCHii) Sterilization (Small family norm)Trainingo Training is for 30 working days.o They are paid a stipend of Rs. 300 during training period.o Training is given for 2 days in a week at PHC, subcentre or MHC centre.o On the remaining four days of the week they accompany the health worker female.o During her training period each dai is required to conduct at least 2 deliveries under the supervision of health worker,o The national target is to train one local dai in each village.Note : One village is equivalent to 1000 rural population. | train | med_mcqa | null |
Which of the following drugs used to treat type-II diabetes mellitus causes weight loss | [
"Metformin",
"Glimepiride",
"Repaglinide",
"Gliclazide"
] | A | Ans. is 'a' i.e., Metformin Effect of antidiabetic drugs on weight Increased : Sulfonylureas, insulin, pioglitazone Decreased : Metformin, GLP-1 antagonists, pramlinitide No effect: DPP-4 inhibitors | train | med_mcqa | null |
| HIAA urine levels are suggestive of | [
"Carcinoid tumors",
"Colon cancer",
"Malignant melanoma",
"None of the above"
] | A | Patients with renal disease may have falsely low 5-HIAA levels in the urine. 5-HIAA is increased in untreated patients with malabsorption, who have increased urinary tryptophan metabolites. Such patients include those with celiac disease, tropical sprue, Whipple disease, stasis syndrome, and cystic fibrosis. Ref: guyton and hall textbook of medical physiology 12 edition | train | med_mcqa | null |
Larger DNA segments can be cloned in | [
"Plasmids",
"Bacteriophage",
"Cosmids",
"Bacterial Aificial Chromosomes"
] | D | Hybrid DNA molecules can be constructed in cloning vectors typically using bacterial plasmids, phages, or cosmids. A clone is a large population of identical molecules, bacteria, or cells that arise from a common ancestor. Molecular cloning allows for the production of a large number of identical DNA molecules, which can then be characterized or used for other purposes. Cloning capacities of vectors Plasmid 0.01-10 kb Lambda phage 10-20 kb Cosmids 35-50 kb Bacterial aificial chromosome 50-250 kb Yeast aificial chromosome 500-3000 kb | train | med_mcqa | null |
Hutchisons traid is seen – | [
"Primary syphilis",
"Congenital syphilis",
"Secondary syphilis",
"Tertiary syphilis"
] | B | null | train | med_mcqa | null |
Late complication of elbow dislocation | [
"Median nerve injury",
"Brachial aery injury",
"Myositis ossificans",
"paresthesia on medial elbow"
] | C | Myositis ossificans: MYOSITIS OSSIFICANS * Acquired development of non neoplastic heterotopic ossification within soft tissues * Most often in response to localized trauma * Although the process most commonly develops within skeletal muscle, the term itself is a misnomer, because nonmuscular tissue may be involved, and inflammation is rare. * Adolescents & young adults, predominantly men, are affected most frequently, although it has been repoed in infancy as well Treatment * Once diagnosis is established, usually clinically, any surgical biopsy is contraindicated in FOP. * No established medical therapy exists. * Pain medications * suppoive measures -gentle occupational and/or physical therapy. Ref maheshwari 6/e p102 | train | med_mcqa | null |
Goitre is prevalent at higher altitude, is an example of - | [
"Direct association",
"Indirect association",
"Causal association",
"Temporal association"
] | B | null | train | med_mcqa | null |
Four numbered instrument formula other than G.M.T. is: | [
"Chistle",
"Hoe",
"Angle former",
"Hatchet"
] | C | null | train | med_mcqa | null |
Which of the following is/are true about dobutamine: | [
"Selective (3 2 receptor agonist",
"T ventricular filling pressure",
"Half life is about 2 min",
"Dopamine receptor agonist"
] | C | Ans. (C) Half life is about 2 minDobutamine:Derivative of dopamine, but not a Dl ot D2 receptor agonist.Has action on alpha & beta receptors also.Yet, only prominent action of clinically employed doses is increased force of cardiac contraction & outPut, without significant change in hea rate, peripheral resistance & BP.Considered to be a relatively selective beta-1 agonist.Half-life of about 2 minutes & onset of action is rapid.Used as an inotroPic agent in pump failure accompanying myocardial infarction, cardiac surgery & for sho term management of severe congestive hea failure. | train | med_mcqa | null |
Structural proteins are: | [
"Fibrous",
"Globular",
"Branched",
"Compound"
] | A | A i.e. Fibrous | train | med_mcqa | null |
ESI act does not cover which of the following:September 2010 | [
"Hotel employee",
"Transpoters",
"Railway employees",
"Factory employees"
] | C | Ans. C: Railway employeesThis act covers all employees including engaged through the contracts but whose remuneration does not exceed Rs. 10, 000 p.m. including staff in the class of administrative, canteen, loading-unloading, security, etc.Apprentices who are appointed for learning the work with no right of being absorbed in service, do not come with the ambit of this act. | train | med_mcqa | null |
Most common cause of Thrombotic Pulmonary Embolism is | [
"progesterone pills",
"Deep vein thrombosis",
"Septicemia",
"Idiopathic"
] | B | (B) Deep vein thrombosis# DEEP VENOUS THROMBOSIS in the leg or in the pelvis is most likely the cause of pulmonary embolism, but in about 80-90%, it occurs without any previous clinical manifestations.> Pulmonary embolism: Following dislodgement of venous thrombi generally from femoral and iliac veins.> Causes: Multiple trauma, tumor embolus, amniotic fluid.> Sign and symptoms: Pleurisy, haemoptysis, crackles, shortness of breath.> Sign and symptoms of right heat failure and raised CVP> Diagnosis: Ventilation perfusion scan (confirm the diagnosis). Contrast enhanced CT scan (most accurate technique).> Treatment: Thrombolytic agents (streptokinase, TP factors).> Pulmonary embolectomy (may be required).> Lung transplantations indicated in: End stage parenchymal or pulmonary vascular disease> Cystic fibrosis and irreversible pulmonary hypertension with right ventricular failure. | train | med_mcqa | null |
All of the following drugs act on ionic channels except: | [
"Nicotine",
"Insulin",
"Glibenclamide",
"Diazepam"
] | B | Ans. B. Insulina. insulin acts on enzymatic (tyrosine kinase) receptorsb. Nicotine acts on NM and NN receptors which are ion channel receptorsc. Diazepam acts on GABA-BZD-Cl channel complex that mediates entry of chlorided. Glibenclamide is a sulfonylurea that acts on ACh sensitive K+ channels. | train | med_mcqa | null |
For which of the following disorders enzyme replacement therapy is available? | [
"Gaucher disease",
"Niemann Pick disease",
"Mucolipidosis",
"Metachromatic leukodystrophy"
] | A | Gaucher disease is an autosomal recessive disorder causing a deficiency of beta-glucocerebrosidase, which causes an accumulation of sphingolipid within phagocytic cells throughout the body. Clinical features include, Anemia and thrombocytopenia Hypersplenism Pathologic fractures Bone marrow aspirates reveal typical Gaucher cells, which have an eccentric nucleus and periodic acid-Schiff (PAS)-positive inclusions, along with wrinkled cytoplasm and inclusion bodies of a fibrillar type. A recombinant form of the enzyme glucocerebrosidase (imiglucerase) for intravenous administration on a regular basis now permits a reduction in total body stores of glycolipid and improvement in ohopedic and hematologic manifestations. Ref: Pyeritz R.E. (2013). Chapter 40. Clinical Genetic Disorders. In M.A. Papadakis, S.J. McPhee, M.W. Rabow (Eds), CURRENT Medical Diagnosis & Treatment 2013. | train | med_mcqa | null |
All of the following conditions are associated with the development of Necrotizing papillitis, EXCEPT: | [
"Diabetes mellitus",
"Sickle cell disease",
"Analgesic nephropathy",
"Tuberculous pyelonephritis"
] | D | Common causes of papillary necrosis are diabetes mellitus, analgesic nephropathy, sickle cell disease and urinary tract obstruction. Diabetes mellitus is the most common cause of renal papillary necrosis. Analgesic nephropathy is associated with the use of more than 1 kg analgesics. Ref: Radiology Illustrated: Uroradiology By Seung Hyup Kim, 2nd Edition, Pages 471-2 | train | med_mcqa | null |
No of inpatient beds in PHC ? | [
"6",
"10",
"20",
"25"
] | A | Medical care OPD services- 4 hours in the morning and 2 hours in the afternoon/evening 24 hour emergency services Referral services Inpatient services-6 beds (refer pgno:905 park 23rd edition) | train | med_mcqa | null |
Vidian neurectomy is done in - | [
"Vasomotor rhinitis",
"Allergic rhinitis",
"Infective rhinitis",
"Rhinitis sicca"
] | A | (A) (Vasomotor rhinitis) (183- Dhingra 5th)* Vidian neurectomy (sectioning the parasympathetic secretomotor fibre to nose) is the treatment of choice for vasomotor rhinitis.* Vasomotor rhinitis is due to over activity of the parasympathetic system.* Alternating nasal obstruction, early morning rhinorrhea are its characteristic symptoms.* Precipitating factors include climate changes, exercise and emotional factors and endocrine changes.* Nasal mucosa appears normal but may be sometimes congested, Mulberry hypertrophy of the turbinate are seen in long standing cases.POINTS TO REMEMBER* Modified Young's operation* is the surgical of choice in Atrophic rhinitis (OZAENA).* Rhinitis sicca is a condition which occurs in drug and dusty atmosphere characterized by dirty black crust formation in the anterior aspect of nasal cavity.* Tuberculosis and leprosy of the nose commonly affects the cartilaginous part of nasal septum.* Lupus and Rhinoscleroma commonly affects the vestibule of the nose.* Stewart's granuloma is a rare form of nasal T-cell lymphoma.* Allergic rhiritis - is an IgE mediated type I hypersensitivity reaction of the nasal mucosa and antigenic substances (Allergen).(i) Pollen and house dusts are the common inhaled allergent (75%).(ii) Prick Test is the most popular, practical and safe test for nasal allergy screening sometimes nasal smear**(iii) Sodium chromoglycate prevents mast cell degranulation.* Mikulicz and Russel bodies are characteristic of Rhinoscleroma** caused by Klebsiella - rhinoscleromatis or Frisch bacillius** (Bacterial)* Rhinitis medimentosa is due to prolonged use of local nasal decongestants (more than a week) | train | med_mcqa | null |
Fat halo sign is associated with | [
"Ulcerative colitis",
"Crohn's disease",
"Plummer Vinson syndrome",
"Chiladiti syndrome"
] | B | The 'Fat halo sign' refers to a feature seen on CT examination of the abdomen, and represents infiltration of the submucosa with fat, between the muscularis propria and the mucosa. It is characterized by an inner (mucosa) and outer (muscularis propria and serosa) ring of enhancing bowel wall along with a non-enhancing middle layer (submucosa). | train | med_mcqa | null |
Scrub typhus is transmitted by: | [
"Flea",
"Mite",
"Tick",
"Mosquito"
] | B | Mite | train | med_mcqa | null |
Caseous necrosis is seen in? | [
"CMV infection",
"Staphylococcal infection",
"Treponemal infection",
"HSV infection"
] | C | Ans. is 'c' i.e., Treponemal infection o Caseous necrosis is a feature of syphilis which is caused by tremonemal infection.Caseous necrosiso It is a variant of coagulative necrosis. It is most commonly encountered when cell death is attributable to certain organisms e.g., mycobacterium tuberculosis (TB), syphilis and fungi (Histoplasma, Coccidioidomycosis).o In contrast to coagulative necrosis where tissue architecture is maintained, in caseous necrosis, the tissue architecture is completely obliterated. So, it has been called caseous because of its cheesy white appearance of the area of necrosis. | train | med_mcqa | null |
A group of expes discuss a health topic in front of an audience, with no specific order of speeches. This method of communication is: | [
"Focused group discussion (FGD)",
"Panel discussion",
"Symposium",
"Seminar"
] | B | Panel discussion: 1. '4-8 persons' who are qualified to talk about the topic sit and discuss a given problem / topic in front of a target group of audience. 2. Panel comprises of a chairman or moderator, and 4 - 8 speakers. 3. There is 'no specific agenda, no order of speaking and no set speeches'. 4. After the speakers explore the topic, audience is invited to take pa. - News channel discussions is a type of panel discussion. Group discussion : A group is an aggregation of people interacting in a face to - face situation. | train | med_mcqa | null |
which of the following is a SNRI | [
"duloxetine",
"seraline",
"citalopram",
"ironiazid"
] | A | SNRI * IMPOANCE Dual antidepressant like TCA but better than TCA has it has no dryness of mouth, hypotension, sedation * MECHANISM Inhibits the reuptake of both serotonin and dopamine * DRUGS VENLEFEXINE DESVENLEFEXINE DULOXETINE * USE Duloxetine===PAIN ASSOSIATED WITH DIABTIC NEUROPATHY and STRESS URINARY INCONTINENCE Milnacipran===Fibromyalgia * SIDE EFFECTS DIASTOLIC HYPEENSION DELAYED ORGASM WITHDRAWL SYNDROME ON DISCONTINUATION, hence should not be abruptly stopped. To try slow tapering Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no. 955 | train | med_mcqa | null |
Bilious vomiting is seen in all except: | [
"Jejunal atresia",
"Volvulus of small intestine",
"Duodenal atresia",
"Pyloric stenosis"
] | D | Ans: d (Pyloric stenosis)Ref: Bailey & Love, 24th ed, p. 1033 & 23rd ed, p. 899 | train | med_mcqa | null |
For which of the following seizures would carbamazepine, phenytoin, and primidone be prescribed as the appropriate drug treatment for prevention? | [
"Complex paial",
"Simple paial",
"status epilepticus",
"Generalized tonic clonic"
] | D | Generalized tonic-clonic seizures are convulsive and can be the result of paial seizures. Carbamazepine, phenytoin, and primidone are among the drugs recommended for generalized seizures. Primidone is a prototype deoxy barbiturate. Phenytoin is a hydantoin and these drugs are highly fat soluble. They stabilize membranes by decreasing Na+ conductance during the period of high-frequency firing. Ref: Greenberg D.A., Aminoff M.J., Simon R.P. (2012). Chapter 12. Seizures & Syncope. In D.A. Greenberg, M.J. Aminoff, R.P. Simon (Eds), Clinical Neurology, 8e. | train | med_mcqa | null |
Primary action of superior oblique: March 2013 (a) | [
"Adduction",
"Intorsion",
"Abduction",
"Extorsion"
] | B | Ans. B i.e. Intorsion Extraocular muscles Intoors of the eye: Superior oblique & Superior rectus Action of superior oblique: Abduction, Inoion & Depression Nerve supply of superior oblique: Trochlear (4th cranial nerve) Levator palpebrae superioris is supplied by: 3rd cranial nerve (oculomotor) Muscle attached to posterior tarsal margin: Muller's muscle | train | med_mcqa | null |
SABE is most commonly due to:March 2013 | [
"Staphylococcus aureus",
"Streptococcus pneumonia",
"Streptococcus viridans",
"HACEK group bacteria"
] | B | B i.e. Streptococcus viridansSubacute bacterial endocarditis/Endocarditis lentaIt can be considered a form of Type III hypersensitivity.It is usually caused by a form of streptococci viridians bacteria that normally live in the mouth and throat (Streptococcus mutans, mitis, sanguis or milleri).Osler's nodes can indicate this condition.Nail clubbing is also often seen in subacute endocarditis.In cases of subacute bacterial endocarditis, the causative organism (streptococcus viridans) needs a previous hea valve disease to colonize and cause such disease.On the other hand, in cases of acute bacterial endocarditis, the organism can colonize on the healthy hea valve, causing the disease. | train | med_mcqa | null |
All the following are causes of acute pancreatis except - | [
"Gall stone",
"Alcohol",
"Hemachromatosis",
"Hypercalcemia"
] | C | Ans. is 'c' i.e., HemochromatosisCauses of Acute PancreatitisCommon causes Gallstones (including microlithiasis) - most commonHyperiglyceridemiaEndoscopic retrograde cholangiopancreatography (ERCP), especially after biliary manometry.Trauma (especially blunt abdominal trauma)Postooperative (abdominal and nonabdominal operation)Drugs ( L-asparginase, thiazide diuretics, frusomide, estrogens, azathioprime, 6-mercaptopurine, methyldopa, sulfonamide, tetracyclin, valproic acid, anti-HIV medicacations)Sphincter of Oddi dysfunctionUncommon causesVascular causes and vasculitis (ischemic-hypoperfusion states after cardiac surgery)Connective tissue disorders and thrombotic thrombocytopenic purpura (TTP)Cancer of the pancreas HypercalcemiaPeriampullary diveiculum Pancreas divisumHereditary pancreatitis Cystic fibrosisRenal failureRare causesInfections (mumps, coxsackievirus, cytomegalovirus, echovirus, parasites).Autoimmune (i.e., Sjogren's syndrome)Causes to consider in patients with recurrent bouts of acute pancreatitis without an obvious etiologyOccult disease of the biliary tree or pancreatic ducts, especially microlithiasis,sludge Drugs Pancreaticcancer IdiopathicHyperiglyceridemia Sphincter of Oddi dysfunctionPancreas divisum Cystic fibrosis | train | med_mcqa | null |
The maximum contribution to the floor of the orbit is by - | [
"Maxilla",
"Sphenoid",
"Palatine",
"Zygomatic"
] | A | The orbital floor is mainly formed by the orbital surface of the maxilla.
Other contributions are:-
The lower part of the orbital surface of the zygomatic bone, anterolaterally.
The orbital process of palatine bone at the posterior angle. | train | med_mcqa | null |
Most common site for berry aneurysm rupture | [
"Anterior circulation of brai",
"Posterior circulation of brain",
"Ascending aoa",
"Descending aoa"
] | A | Ans. is 'a' i.e., Anterior circulation of brain The most common sites in descending order of frequency are - Li Proximal poion of anterior communicating aery (at the junction of anterior communicating aery with cerebral aery) At the origin of the posterior communicating aery from the stem of the internal carotid aery. At the first major bifurcation of middle cerebral aery. At the bifurcation of internal carotid into middle and anterior cerebral aeries. Veibrobasilar bifurcation (3%) | train | med_mcqa | null |
Meiosis in spermatogenesis occurs in which of the following step - | [
"Primary spermatocyte to intermediate spermatocyte",
"Primary spermatocyte to secondary spermatocyte",
"Secondary spermatocyte to round spermatid",
"Round spermatid to elongated spermatid"
] | B | null | train | med_mcqa | null |
Gastrointestinal enteritis necroticans is caused by- | [
"Clostridium difficile",
"Clostridium perfringens",
"Cl. botulinum",
"C. Jejuni"
] | B | null | train | med_mcqa | null |
Glycogenolysis is mediated by: | [
"Alpha 1 receptor",
"Alpha l+beta2 receptor",
"Beta 2 receptor",
"Alpha 2 + beta 1 receptor"
] | B | Ans: b (Alpha 1 + beta 2 receptors) Ref: Katzung, 10th ed, p. 130Glycogenolysis is mainly mediated by beta 2 receptors in the liver, but role of alpha 1 receptors have been mentioned in Katzung.Relative selectivity of adrenoceptor agonists. Relative Receptor AffinitiesAlpha agonists Phenylephrine, methoxaminea, > a 2 >>>>> bClonidine, methylnorepinephrinea 2> a1 >>>>> bMixed alpha and beta agonists Norepinephrinea1= a 2; b,>> b 2Epinephrinea1= a 2; b,= b 2Beta agonists Dobutamine b1 > b 2>>>> aIsoproterenol b1 = b 2>>>> aTerbutaline MetaproterenolAlbuterolRitodrine}b 2 >> b1>>>> aDopamine agonists Dopamine D1 =D2 >> b >> aFenoldopam D1 >> D2 | train | med_mcqa | null |
Antacid drug that typically causes diarrhea? | [
"Sodium bicarbonate",
"Magnesium hydroxide",
"Calcium bicarbonate",
"Aluminium hydroxide"
] | B | Ans. b (Magnesium hydroxide) (Ref. KDT 6th/pg. 635).Mag. hydroxide has low water solubility: its aqueous suspension (milk of magnesia) has low concentration of OH- ions and thus low alkalinity. However, it reacts with HCI promptly and is an efficacious antacid (1 g mEq HCI). Rebound acidity is mild and brief. All Mg salts have a laxative action-by generating osmotically active MgCI, in the stomach and through Mg2+ ion induced cholecystokinin release. Soluble Mg salts are used as osmotic purgatives.Sodium bicarbonateIt reacts rapidly with HCI to produce carbon dioxide and NaCI. Formation of carbon dioxide results in gastric distention and belching. Unreacted alkali is readily absorbed, potentially causing metabolic alkalosis when given in high doses or to patients with renal insufficiency. Sodium chloride absorption may exacerbate fluid retention in patients with heart failure, hypertension, and renal insufficiency.Calcium carbonateIt is less soluble and reacts more slowly than sodium bicarbonate with HCI to form carbon dioxide and CaCI2. Calcium carbonate is used for a number of other indications apart from its antacid properties (bone mineral homeostasis). Excessive doses of either sodium bicarbonate or calcium carbonate with calcium-containing dairy products can lead to hypercalcemia, renal insufficiency, and metabolic alkalosis (milk-alkali syndrome).Magnesium hydroxide or aluminum hydroxideReact slowly with HCI to form magnesium chloride or aluminum chloride and water.Because no gas is generated, belching does not occur.Metabolic alkalosis is also uncommon because of the efficiency of the neutralization reaction.Unabsorbed magnesium salts may cause an osmotic diarrhea and aluminum salts may cause constipation patients with renal insufficiency should not take these agents long-term. | train | med_mcqa | null |
ERCP in pancratitis is done to know about – a) Gall stoneb) Associated cholangitisc) Ascitesd) Pancreatic divisume) Annular pancreas | [
"abcd",
"abde",
"acde",
"ade"
] | B | ERCP can be used in pancreatitis to evaluate conditions which can predispose to pancreatitis (e.g. Gall stone, pancreatic divisum, annular pancreas) and associated biliary cholangitis. | train | med_mcqa | null |
Which one of the following organism normally inhabits the healthy human oral cavity? | [
"M. fermentans",
"M. hominis",
"M. pneumoniae",
"M. orale"
] | D | Members of the mycoplasma group that are pathogenic for humans include M. pneumoniae and U. urealyticum. M. pneumoniae is best known as the causative agent of primary atypical pneumonia (PAP), which may be confused clinically with influenza or legionellosis. It also is associated with arthritis, pericarditis, aseptic meningitis, and the Guillain-Barn5 syndrome. M. pneumoniae can be cultivated on special media and identified by immunofluorescence staining and "fried egg" colonies on agar.
U. urealyticum (once called tiny, or T, strain) has been implicated in cases of nongonococcal urethritis. As the name implies, this organism is able to split urea, a fact of diagnostic significance. U. urealyticum is part of the normal flora of the genitourinary tract, particularly in women.
Both M. orale and Mycoplasma salivarium are inhabitants of the normal human oral cavity. These species are commensals and do not play a role in disease.
The only other species of Mycoplasma associated with human disease is M. hominis. A normal inhabitant of the genital tract of women, this organ ism has been demonstrated to produce an acute respiratory illness that is associated with sore throat and tonsillar exudate, but not with fever.
M. fermentans is an animal isolate. | train | med_mcqa | null |
Forceps are applied in all the following except : | [
"After coming head in breech presentation",
"Face presentation",
"Occipitoposterior",
"Brow presentation"
] | D | Brow presentation | train | med_mcqa | null |
Oil drop is seen in | [
"Psoriasis of nails",
"Clubbing",
"Lichen planus of nails",
"Tinea unguium"
] | A | Oil drop sign is seen in nail psoriasis IADVL textbook of dermatology page 1035 | train | med_mcqa | null |
Most common cause of Pseudomyxoma Peritonei is | [
"Mucinous tumour of appendix",
"Ovarian tumour",
"Colorectal carcinoma",
"None of the above"
] | A | Most common cause of Pseudomyxoma Peritonei is mucinoous tumour of appendix > mucinous tumour of ovary. | train | med_mcqa | null |
Which of the following is true of 'placebo' ? | [
"Placebo is a dummy medication",
"Placebo is the inert material added to the drug for making tablets",
"Placebos do not produce any effect",
"All patients respond to placebo"
] | A | null | train | med_mcqa | null |
Not true about parapharyngeal abscess | [
"Torticollis",
"Drooling of saliva",
"Trismus",
"Horner's syndrome"
] | B | null | train | med_mcqa | null |
A patient operated for thyroid surgery for a thyroid swelling, later in the evening developed difficulty in breathing. There was swelling in the neck. The immediate management would be | [
"Epinephrine injection",
"Tracheostomy",
"IV calcium gluconate",
"Open the wound sutures in the ward"
] | D | Haemorrhage is the most frequent life-threatening complication of thyroidectomy. Around 1 in 50 patients will develop a haematoma, and in almost all cases this will develop in the first 24 hours. If an aerial bleed occurs, the tension in the central compament pressure can rise until it exceeds venous pressure. Venous oedema of the larynx can then develop and cause airway obstruction leading to death. If a haematoma develops, clinical staff should know to remove skin sutures in order to release some pressure and seek senior advice immediately. Endotracheal intubation should be used to secure the airway while the haematoma is evacuated and the bleeding point controlled.Ref: Bailey and Love, page no: 815 | train | med_mcqa | null |
True about primary peritonitis | [
"Mostly monobacterial",
"It is chemical peritonitis proceeds secondary peritonitis",
"Needs peritoneal lavage",
"Occurs with Cirrhosis of liver"
] | D | (D) Occurs with Cirrhosis of liver # # PRIMARY (SPONTANEOUS) BACTERIAL PERITONITIS> Peritonitis is either primary (without an apparent source of contamination) or secondary.> The types of organisms found and the clinical presentations of these two processes are different. In adults, primary bacterial peritonitis (PBP) occurs most commonly in conjunction with cirrhosis of the liver (frequently the result of alcoholism).> However, the disease has been reported in adults with metastatic malignant disease, postnecrotic cirrhosis, chronic active hepatitis, acute viral hepatitis, congestive heart failure, systemic lupus erythematosus, and lymphedema as well as in patients with no underlying disease. PBP virtually always develops in patients with ascites.> While enteric gram-negative bacilli such as Escherichia coli are most commonly encountered, gram-positive organisms such as streptococci, enterococci, or even pneumococci are sometimes found.> In PBP, a single organism is typically isolated; anaerobes are found less frequently in PBP than in secondary peritonitis, in which a mixed flora including anaerobes is the rule. In fact, if PBP is suspected and multiple organisms including anaerobes are recovered from the peritoneal fluid, the diagnosis must be reconsidered and a source of secondary peritonitis sought. | train | med_mcqa | null |
Fibers more susceptible to hypoxia are: | [
"Preganglionic",
"Postganglionic",
"Both",
"None"
] | A | Preganglionic nerve fibers are more susceptible to hypoxia Ref:Guyton and Hall textbook of medical physiology 12th edition ,pag number:72,73 | train | med_mcqa | null |
True about antenatal doppler analysis is all except | [
"Reduction in end diastolic flow is associated with poor out come",
"Reduction in EDF is associated with IUGR",
"In normal gestation placental resistance is high",
"S/D ratio is high in IUGR"
] | C | C i.e. In normal gestation placental resistance is high Doppler ultrasound analysis in pregnancy The routine use of doppler in pregnancy is constroversialQ. TVS (transvaginal sonography) is method of choice for monitoring infeility disorders, diagnosis of ectopic pregnancy & differentiating abnormal & normal 1st trimester pregnancy. The advantages of TVS is that it can be performed in empty bladder and its ability to use higher frequency trandsducer nearer the organs of interst thus providing higher resolution of uterus, ovaries, cul de sac & adnexa. - Doppler may prove valuable in assessment of pregnancy complications & at risk factusQ. Both fetoplacental & uteroplacental circulations can be assessed. As normal pregnancy progresses, placental blood flow increases d/t reduction in placental vascular resistanceQ. - Increased placental resistance results in reduced blood flow, manifesting as decreased or absent end diastolic flow. Systolic diastolic (S/D) ratio, resistive & pulsatility indices are used to quantify these changes. Increased values of S/D ratio & R-P indices and reduction in end diastolic flow are associated with IUGR & poor fetal outcomeQ. (d/t fetoplacental insufficiency). Other associations include pregnancy induced hypeension, oligohydramnios, & cesarian section for fetal distress. Doppler USG is either continuous wave or duplex (pulsed) wave. The duplex wave from uterine & umblical aeries is useful in assessment of IUGR whereas colour & power doppler are invaluable in assessment of fetal hea & outflow tracts and other fetal vessels such as intracerebral & renal aeries. Although, predictive value of continuous wave doppler for IUGR is relatively low, reversed diastolic flow indicates severely hypoxic fetus. In head spared IUGR, diastolic flow to brain (cerebra aery obtained by colour doppler) is increased, an indication that the head is spared from the diminished flow to the body. | train | med_mcqa | null |
A patient with abdomen injury presents to the emergency depament with signs of peritonitis and shock. Airway and breathing were secured and IV fluids were staed with two large bore cannulas. The next line of management should be | [
"FAST",
"Exploratory laparotomy under general anaesthesia",
"Inseion of abdominal drain followed by laparotomy",
"Laproscopy"
] | B | . Haemodynmically unstable-investigations need to be suspended as immediate surgical correction needed. Pg No. 372 bailey 27th edition | train | med_mcqa | null |
All are chemical carcinogens except | [
"Beta carotene",
"Benzene",
"Thorostat",
"Nitrates"
] | A | Ans. a (Betacarotene). (Ref. Robbin Pathology, 6th ed., 307)CHEMICAL CARCINOGENSDirect actingProcarcinogensOthersa-propiolactoneBenzopyreneThorostatDimethyl sulfateDibenzanthraceneNitrosamineDiepoxybutane3-methyl cholanthrineVinyl chlorideAnticancerous drugsAromatic aminesNickel1-acetyl imidazoleAmidesChromiumDimethyl carbamyl chlorideAzo dyesInsecticides BenzidineFungicides a-naphthlaminePolychlorinated biphenyls Aflatoxin B1 Griseofulvin Betel nuts Safrole Cycasin | train | med_mcqa | null |
Third hea sound is seen in all except | [
"Athletes",
"Mitral stenosis",
"Constrictive pericarditis",
"LVF"
] | B | Ref Harrison 19 th ed pg 1448 The third hea sound (S3 ) occurs during the rapid filling phase of ventricular diastole. It can be a normal finding in children, adolescents, and young adults; however, in older patients, it signifies hea failure. A left-sided S3 is a low-pitched sound best heard over the left ventricu- lar (LV) apex. A right-sided S3 is usually better heard over the lower left sternal border and becomes louder with inspiration. A left-sided S3 in patients with chronic hea failure is predictive of cardiovascu- lar morbidity and moality. Interestingly, an S3 is equally prevalent among hea failure patients with and without LV systolic dysfunction | train | med_mcqa | null |
Kartagener's syndrome includes - | [
"Situs inversus",
"Bronchiectasis",
"Male infertility",
"All of the above"
] | D | null | train | med_mcqa | null |
Myofibroblast is seen in - | [
"Normal connective tissue",
"Muscle septa",
"Wound margin",
"Bronchus"
] | C | Ans. is 'c' i.e., Wound margin | train | med_mcqa | null |
Soft tissue mass in chest with rib erosion in X-Ray is seen in all except: | [
"Leukemia",
"Ewing's sarcoma",
"Multiple myeloma",
"Osteosarcoma"
] | D | D i.e. Osteosarcoma Soft tissue mass with rib erosion can be seen in leukemia (osteolytic expanding geographical lesion caused by collection of leukaemic cells/chloroma-Grainger 1777 ), lymphoma (rib involvement is common with multiple lytic occasionally expanding lesions with soft tissue masses-Grainger 1779), Ewing's sarcoma (osteolytic destructive rib lesions d/ t primary Ewing's or secondaries from it b/o large soft tissue component; while sclerosis when present should not be interpreted as tumor bone production, as seen in osteosarcoma, but is a secondary reactive phenomenon- Grainger 1646) and even Osteosarcoma, (but it is rarest and is more commonly a/w sclerosis and calcification). General rule: Rib erosion /destruction is caused by many infective, (granulomatous infections like TB & fungal are more common), metabolic (Pagets & Brown tumor) and neoplastic lesions. (secondary more common than primary; and malignant primary more common than benign primary). Chondrosarcoma & osteosarcoma have tendency to calcify. Causes of Expansile (Focal) Rib lesion Neoplastic Metastases (Secondary Malignant) - From bronchus, kidney, prostate or breast - Leukemia/lymhomaQ -Ewing's sarcoma (most common malignant tumor affecting ribs of children & adult)Q, Neuroblastoma in children - Desmoid tumor, Osteosrcoma (rare) Primary Malignant - Multiple myeloma/Plasmacytoma (common) - Chondrosrcoma (calcified matrix; mc) - Askin tumor (PNET) uncommon tumor of intercostal nerves - Lymphoma, fibrosarcoma, osteosarcoma (rare)Q Primary Benign Tumor Fibrous dysplasia (most common; predomnantly posterior location) Osteochondroma (exostosis), Enchondroma (both at costo chondral/costoveebral junction) Eosinophilic granuloma (LCH), Xanthogranuloma Giant cell tumor, Aneurysmal bone cyst Osteoid osteoma, Osteoblastoma, Chondroblastoma Benign coical defect, Hemangioma, Enostosis (bone island, lipoma, chondroma, neurofibroma) Nonneoplastic Fibrous dysplasia, Paget's disease Brown's tumor of hyper parathyroidismQ Osteomyelitis (tubercular, fungal, actinomyces infection) Gaucher's disease, Hurler's syndrome (generalized expansion sparing proximal ends), Thalassemia (trabecular pattern & expansion most marked proximally) | train | med_mcqa | null |
A patient having prinzmetal angina is started with ISMN. Patient got symptomatic relief from angina. What is the MOA? | [
"Endothelium independent coronary vasodilatation",
"Reduced cardiac contractility",
"Increased left ventricular end diastolic volume",
"Decreased diastolic perfusion pressure"
] | A | ANS. A# Important points on nitrates1. All nitrates have high FPM metabolism except ISMN (Isosorbide mononitrate)2. Skin rashes are maximum with Pentaerythritol tetranitrate3. Nitrates used in acute attack: NTG and ISDN (Isosorbide dinitrite) | train | med_mcqa | null |
Same or closely related antigens present in different biological species are known as | [
"Sequestrated antigens",
"Isoantigens",
"Haptens",
"Heterophile antigens"
] | D | null | train | med_mcqa | null |
A composite index combining indicators representing longevity, knowledge and income is | [
"Physical quality of life index",
"Human development index",
"Sullivan's index",
"Human poverty index"
] | B | null | train | med_mcqa | null |
n–3 PUFA is present in all except – | [
"Mustard oil",
"Corn oil",
"Fish oil",
"Groundnut oil"
] | D | POLYUNSATURATED FATTYACEDS
Polyunsaturated fatty acids have more than one double bond. According to the position of first double bond they or divided into
1) n-3 fatty acids or ω-3 fatty acids or omega-3 fatty acids
This are long-chain polyunsaturated fatty acids, with first double bond beginning at the third carbon atom (when counting form the methyl end of fatty acid).
Example are α- linolenic acid, Timnodonic (Eicosapentaenoic) acid, cervonic (Docosahexaenoic acid).
Rich sources → wheat, bajara, mustard, fish, lobia, rajmah, black gram, soybean, green leafy vegetables.
2) n-6 or ω-6 or omega-6 fatty acids
First double bond begins at the 6th carbon atom.
Examples Linoleic acid, Arachidonic acid, γ-linolenic acid.
Rich sources → Groundnut oil & corn oil
Coming back to question
Both groundnut oil and corn oil are devoid of (0-3 fatty acids.
However, corn oil has trace amount of w-3 fatty acids.
So, best answer of this question is groundnut oil.
Following information have been added in 21st/e of Park
The WHO/FAO expert Group on diet, nutrition and prevention of chronic diseases endorse that qualitative composition of fats in the diet has a significant role to play in modifying risk factors for CHD and set the following ranges for population nutrient goals (% of energy) : -
Total fat intake, 20-30% of total energy intake (at least 20% energy is consistent with good health).
Saturated fatty acids, less than 10% of total energy intake.
PUFAs, 6-10% of total energy intake (minimum of 6%). ω-6 should be about 5-8% and ω-3 should be about 1-2%.
Trans fatty acids should be less than I% of total energy intake.
Cholesterol should be less than 300 mg a day.
It is worth noting here that above values are for prevention of CHD. However, minimum intake levels for essential fatty acids to prevent deficiency symptoms are estimated to be 2.5% of total intake for lenoleic acid and 0.5% for Lenolenic acid (ALA). | train | med_mcqa | null |
Last skull suture to close is: | [
"Occipital sutures",
"Frontal suture",
"Coronal suture",
"Sagittal suture"
] | A | Ref. Textbook of forensic medicine. Krishnan Vij. Page. 45
Occipital suture is the other name for lambdoid suture. Look at above question for detail | train | med_mcqa | null |
Naming and fluency is impaired in: | [
"Broca's aphasia",
"Wernicke's aphasia",
"Anomic aphasia",
"Transcortical sensory aphasia"
] | A | Ans. a. Broca's aphasia (Ref: Harrison 19/e p279, 18/e p203, 3286)Naming and fluency is impaired in Broea's aphasia,"Broca's Aphasia: Speech is nonfluent, labored, interrupted by many word-finding pauses, and usually dysarthric. It is impoverished in function words but enriched in meaning-appropriate nouns. Abnormal word order and the inappropriate deployment of bound morphemes (word endings used to denote tenses, possessives, or plurals) lead to a characteristic agrammatism. Speech is telegraphic and pithy but quite informative. Output may be reduced to a grunt or single word ("yes " or "no"), which is emitted with different intonations in an attempt to express approval or disapproval. In addition to fluency, naming and repetition are impaired. '- Harrison 19/e p279 ComprehensionRepetition of spoken languageNamingFluencyWernicke'sImpairedQImpairedQImpairedQPreserved or increasedQBroca'sPreserved (except grammar)QImpairedQImpairedQDecreasedQGlobalImpairedQImpairedQImpairedQDecreasedConductionPreservedQImpairedQimpairedQPreservedQNonfluent (motor) transcorticalPreservedQPreservedQImpairedImpairedFluent (sensory) transcorticalImpairedPreservedQImpairedPreservedIsolationImpairedEcholaliaQImpairedNo purposeful speechAnomicPreservedQPreservedQImpairedPreserved except for wordfinding pausesQPure word deafnessImpaired only for spoken languageimpairedPreservedPreservedPure alexiaImpaired only for readingPreservedPreservedPreservedBroca's AphasiaSpeech is nonfluent, labored, interrupted by many word-finding pauses, and usually dysarthric.It is impoverished in function words but enriched in meaning-appropriate nouns.Abnormal word order and the inappropriate deployment of bound morphemes (word endings used to denote tenses, possessives, or plurals) lead to a characteristic agrammatism.Speech is telegraphic & pithy but quite informativeQ.In the following passage, a patient with Broca's aphasia describes his medical history: "I see ... the dotor, dotor sent me ... Bosson. Go to hospital. Dotor ... kept me beside. Two, tee days, doctor send me home.''Output may be reduced to a grunt or single word ("yes" or "no"), which is emitted with different intonations in an attempt to express approval or disapproval.In addition to fluency, naming & repetition are impairedQ.Comprehension of spoken language is intact except for syntactically difficult sentences with a passive voice structure or embedded clauses, indicating that Broca's aphasia is not just an "expressive" or "motor" disorder and that it also may involve a comprehension deficit in decoding syntax.Even when spontaneous speech is severely dysarthric, the patient may be able to display a relatively normal articulation of words when singing. This dissociation has been used to develop specific therapeutic approaches (melodic intonation therapy) for Broca's aphasiaQ.Causes of Broca's Aphasia:The cause is most often infarction of Broca's area (inferior frontal convolution) & surrounding anterior perisylvian & insular cortex due to occlusion of superior division of middle cerebral arteryQ.Mass lesions, including tumor, intracerebral hemorrhage & abscess, also may be responsible.Associated features:Patients with Broca's aphasia can be tearful, easily frustrated & profoundly depressed.Additional neurologic deficits: Right facial weakness, hemiparesis or hemiplegia & buccofacial apraxia characterized by an inability to carry out motor commands involving orophary ngeal and facial musculature.Insight into their condition is preserved, in contrast to Wernicke's aphasiaQ.Prognosis:When the cause of Broca's aphasia is stroke, recovery of language function generally peaks within 2 to 6 months, after which time further progress is Limited.Speech therapy is more successful than in Wernicke's aphasia | train | med_mcqa | null |
Unilateral small smooth kidney is seen in - | [
"Reflux nephropathy",
"Lobar infarction",
"Renal artery stenosis",
"Chronic glomerulonephritis"
] | C | null | train | med_mcqa | null |
Most common cause of poal hypeension in children is _______ | [
"Extrahepatic compression",
"Budd chiari syndrome",
"Veno-Occlusive disease",
"Post necrotic"
] | A | Causes of poal hypeension pre sinusoidal extrahepatic(mostcommoon):poal vein/splenic vein thrombosis,splenic AV fistula,massive splenomegaly intrahepatic:sarcoidosis,schistosomiasis,congenital hepatic fibrosis,myeloproliferative disorders,nodular degenerative hyperplasia,idiopathic poal fibrosis sinusoidal cirrhosis due to any cause post sinusoidal budd chiari syndrome,right hea failure,constrictive pericarditis,web in inferior venacava Ref : ESSENTIAL PEDIATRICS,O.P.GHAI,PG NO:289,7th edition | train | med_mcqa | null |
WE - are absorbed in the DCT: | [
"Water",
"Potassium",
"Potassium",
"Sodium"
] | B | B i.e. PotassiumPotassium once filtered in the tubular fluid is reabsorbed only in the proximal tubules. Nowhere else it is reabsorbed so it is not reabsorbed in the DCT, rather it is secreted into the tubular fluid in DCTQ.Water reabsorption in DCTEarly pa of distal tubule is impermeable to water.Late DCT becomes permeable under the influence of ADH. | train | med_mcqa | null |
In acoustic neuroma all are seen except - | [
"Loss of corneal reflex",
"Tinnitus",
"Facial palsy",
"Diplopia"
] | C | In Acoustic Neuroma
Loss of corneal reflex is seen – due to the involvement of Tringeminal nerve
Tinnitus – due to pressure on cochlear nerve
Large tumors can cause diplopia
As far as facial nerve palsy is concerned – Scott Brown 7th/ed vol-3 pg 3931
“Vestibular schwannomas, although inevitably grossly distort the VIIth nerve, very rarely present as a VIIth nerve palsy. If there is a clinical evidence of a cerebellopontine angle lesion and if the VIIth nerve is involved, alternative pathology is more likely”.
Hence although Acoustic neuroma may involve the 7 nerve but complete palsy is never seen | train | med_mcqa | null |
A patient presents with sudden onset of breathlessness after a subclan vein cannulation. On examination, breath sounds are absent while the chest is hyper-resonant on percussion on one side. Most likely cause is: | [
"latrogenic Pneumothorax",
"Subclan Vein air embolus",
"Malposition of cannula",
"Cardiac Arrhythmia"
] | A | Answer is A (Iatrogenic Pneumothorax): Subclan vein cannulation is an impoant cause of iatrogenic pneumothorax. Absence of breath sounds and Hyper-resonance of chest wall on percussion alongwith sudden breathlessness after attempted subclan vein cannulation suggests a diagnosis of Iatrogenic Pneumothorax. Common causes of Iatrogenic Pneumothorax (Decreasing order of frequency) Transthoracic Needle Lung Biopsy Subclan vein cannulation Thoracocentesis Pleural Biopsy Positive Pressure ventilation Iatrogenic Pneumothorax History History of Procedure known to cause iatrogenic pneumothorax (subclan vein cannulation) Sudden onset Breathlessness Chest discomfo / chest pain Examination Inspection/ palpatum * Reduced movements over affected side * Mediastinal shift to opposite side * Decreased vocal fremitus Percussion Hyper-resonant Auscultation Diminished or absent breath sound | train | med_mcqa | null |
Primary hemostasis is disturbed in | [
"Platelet disorder",
"lupus anticoagulant",
"hemophilia",
"Liver disease"
] | A | null | train | med_mcqa | null |
Which of the following does not posses both DNA and RNA? | [
"Bacteria",
"Fungus",
"Virus",
"Spirochete"
] | C | Ans. c. Virus | train | med_mcqa | null |
Maxwell Lyon's sign is a feature of: | [
"Trachoma",
"Spring catarrh",
"Epidemic keratoconjunctivitis",
"Acanthamoeba keratitis"
] | B | A/K/A warm weather ketratoconjuctivitis /Vernal ketratoconjuctivitis more common in young boys spontaneously resolves at age of pubey type of type 1 HSN (IgE mediated )type 1>type 4. features - cobblestone appearance (hall mark)(large papillae) Maxewell lyon sign - coagulated coppy dishrage forming psudomembrane seen on the eversion of the eyelid. Horner tranta spots DOC-sodium cromoglycolate (Mast cell stabliser) | train | med_mcqa | null |
A 35 year old patient complains of abdominal cramps along with profuse diarrhea. The treating physician wants to process the stool specimen for isolation of Campylobacter jejuni. Which of the following is the method of choice for the culture of stool ? | [
"Culture on TCBS medium incubated at 37degC under aerobic conditions",
"Culture on Skirrow's medium incubated at 42degC under micro-aerophilic conditions.",
"Culture on MacConkey's medium incubated at 42degC under anaerobic contions",
"Culture on Wilson and Blair's medium incubated at 37deg under microaerophi... | B | Ans. is 'b' i.e., Culture on skirrow's medium incubated at 42degC under micro-aerophilic conditions . Compylobacter jejuni is thermophilic, growing well at 42degC. Inoculated plates are incubated under microaerophilic conditions with an atmosphere of 5% 02, 10% CO2 and 85% N2 at 42degC. . Plating media commonly used are 1) Skirrow's medium 2) Butzler's medium 3) Campy BAP medium . Transpo medium - Cary-Blair medium . The jejunum and the ileum are the primary sites of colonization. . C. jejuni is invasive pathogen, may involve mesentric lymph node and cause bacteremia. Treatment . Most cases resolve without antimicrobial therapy with fluid and electrolyte replacement. . When needed, erythromycin is the drug of choice. | train | med_mcqa | null |
One Krebs cycle generates how many ATP ? | [
"6",
"12",
"24",
"36"
] | B | Ans. is 'b' i.e., 12 This question is slightly different from previous one. Here the examiner is asking about the generaion of ATPs per TCA cycle.In a single TCA cycle 10 molecules of ATP are produced (12 molecules according to older calculations). | train | med_mcqa | null |
Blood brain barrier is not present in - | [
"Anterior pituitary",
"Cerebellum",
"Areapostrema",
"Cingulate gyrus"
] | C | Ans. is 'c' i.e., Area postremao Certain areas of brain have fenestrated capillaries and because of their permeability, are said to be outside blood- brain barrier.o These areas are located around the third ventricle and are therefore called circumventricular organs,o These areas are:-Posterior pituitary (neurohypophysis) and the adjacent ventral part of median eminence of the hypothalamusThe area postremaThe organ vase ulusum of lamina terminalis (O VLT).o Although the blood-brain barrier is deficient in the circumventricular organs, the blood-CSF barrier in theseorgans is quite effective due to the presence of tight-junctions between the modified ependymal cells of the third ventricle called the 'tancytesV | train | med_mcqa | null |
VDRL is a - | [
"Slide flocculation test",
"Tube floccolation test",
"Gel precipitation test",
"Indirect haemagglutination test"
] | A | The VDRL test for syphilis is an example of a slide flocculation test. When a drop each of the antigen and the antiserum are placed on a slide and mixed by shaking, floccules appear. Reference: Anathanarayan & paniker's 9th edition, pg no: 106 <\p> | train | med_mcqa | null |
Vitamin B1 is required for which reaction | [
"Transamination",
"Oxidative decarboxylation",
"Carboxylation",
"All of the above"
] | B | Ans. is 'b' i.e.,Oxidative decarboxylation Active form (coenzyme form) of thiamine is thiamine pyrophosphate (TPP), also called thiamine diphosphate (TDP).TPP acts as coenzyme forOxidative decarboxylation:- Pyruvate dehydrogenase, a-ketoglutarate dehydrogenase, brached-chain keto acid dehydrogenase.Transketolase in PPP. | train | med_mcqa | null |
On administration of LA in an area of infection, it is not effective because of increase in | [
"Cations",
"Free base",
"Uncharged base",
"None"
] | A | null | train | med_mcqa | null |
All of the following are tumor markers, except | [
"CEA",
"HCG",
"Alpha-fetoprotein",
"Beta-2 macroglobulin"
] | D | Beta-2 microglobulin and not beta macroglobulin may be used as a tumor marker (as in multiple myeloma). | train | med_mcqa | null |
About trisomy 13, which of the following is a true statement | [
"Bilateral mircophthalmia",
"Neurofibroma",
"Rocker bottom feet",
"Dermoid cyst"
] | A | Ans. a. Bilateral mircophthalmia | train | med_mcqa | null |
Best treatment to prevent gas gangrene - | [
"Thorough debridement",
"Anti serum",
"Vaccnation",
"Antibiotics"
] | A | null | train | med_mcqa | null |
Urea cycle is linked to TCA cycle by - | [
"Arginine",
"Ornithine",
"Oxaloacetate",
"Fumarate"
] | D | Ans. is 'd' i.e., Fumarate |Ref: Harper 29th/e p. 276-277]o Fumarate is released during urea cycle, which is an intermediate of Kreb's cycle, thus linking the two.Both urea cycle and TCA cycle have been explained in previous years. | train | med_mcqa | null |
A 70-year-old patient with long-standing type 2 diabetes mellitus presents with complaints of pain in the left, ear with purulent drainage. On physical examination, the patient is afebrile. The pinna of the left ear is tender, and the external auditory canal is swollen and edematous. The white blood cell count is normal. Which of the following organisms is most likely to grow from the purulent drainage? | [
"Pseudomonas aeruginosa",
"Streptococcus pneumoniae",
"Candida albicans",
"Haemophilus influenzae"
] | A | Ear pain and drainage in an elderly diabetic patient must raise concern about malignant external otitis. The swelling and inflammation of the external auditory meatus strongly suggest this diagnosis. This infection usually occurs in older, poorly controlled diabetics and is almost always caused by P aeruginosa. It can invade contiguous structures including facial nerve or temporal bone and can even progress to meningitis. Streptococcus pneumoniae, H influenzae, and M catarrhalis frequently cause otitis media, but not external otitis. Candida albicans almost never affects the external ear. | train | med_mcqa | null |
All of the following are o3 fatty acids, EXCEPT? | [
"a-Linolenic acid",
"Eicosapentaenoic acid",
"Docosahexaenoic acid",
"g-Linolenic acid"
] | D | Delta system--when counting stas from carboxy end Omega system--when counting stas from the methyl group (omega C) o3 fatty acids are a-Linolenic acid Eicosapentaenoic acid Docosahexaenoic acid g-Linolenic acid (18:3 cis D6,9,12) is a o6 fatty acid. Fatty acid No of carbons No of double bonds Positon Dietary Source alpha-Linolenic acid 18:3 cis-(D9,12,15) 18 3 9,12,15 Flaxseed oil, Soya bean oil Eicosapentaenoic acid (EPA) (Timnodonic acid) 20 (Eicosa) 5 (penta) 5,8,11,14,17 Fish oil Docosahexaenoic acid (DHA) (Cervonic acid) 22 (Docosa) 6 (hexa) 4,7,10,13,16,19 Fish oil | train | med_mcqa | null |
Traumatic eye with late presentation of hyperaemic sclera with unilateral proptosis is due to: | [
"Retrobulbar hematoma",
"Retrobulbar cellulitis",
"Carotico-cavernous fistula",
"Pneumo-orbit"
] | A | Severe blunt trauma to the orbit can occasionally cause a retrobulbar hematoma. When a retrobulbar hematoma is large enough, it can cause an abrupt increase in intraocular pressure, causing decreased blood flow to the optic nerve and loss of vision. The conscious patient will complain of pain, proptosis, and decreasing vision. A CT scan of the orbit will demonstrate retrobulbar hemorrhage. An intraocular pressure >40 mm Hg is a consideration for emergency canthotomy. No matter what the intraocular pressure, if retrobulbar hematoma is suspected or confirmed, request emergency ophthalmology consultation. Ref: Walker R.A., Adhikari S. (2011). Chapter 236. Eye Emergencies. In J.E. Tintinalli, J.S. Stapczynski, D.M. Cline, O.J. Ma, R.K. Cydulka, G.D. Meckler (Eds), Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e. | train | med_mcqa | null |
A boy presented with multiple non-suppurative osteomyelitic dactylitis with sickle cell anaemia. What will be the causative organism? | [
"Salmonella typhi",
"S. aureus",
"H. influenzae",
"Peptococcus magnus"
] | A | (A) Salmonella typhi[?]Salmonella Osteomyelitis:Sub-acute form; Curiously, patients with sickle-cell disease are prone to infection by Salmonella typhi.More commonly in children with sickle cell anaemia.Occurs during the convalescent phase after an attack of typhoid fever.Multiple bones are affected bilaterally symmetrical.Radiologically- diaphyseal sclerosis # Causative bacteria:Staphylococcus aureus: the most commonStaph, aureus - expression of surface proteins that allow adhesion to bone matrix.E. coli and group B. strept - important causes of acute osteomyelitis in neonatesSalmonella - especially in patients with sickle cell disease.Mixed bacterial infections (e.g. anaerobes) - osteomyelitis secondary to bone trauma.50% of osteomyelitis cases - no organisms can be isolated.FOLLOWING ARE THE VARIOUS MICRO -ORGANISM INVOLVED IN OSTEOMYELITISAge groupMost common organismsNewborns (younger than 4 months)S. aureus, Enterobacter species, and group A and B Streptococcus speciesChildren (aged 4 months to 4 year)S. aureus, group A Streptococcus species, Haemophilus influenzae, and Enterobacter speciesChildren, adolescents (aged 4 year to adult)S. aureus (80%), group A Streptococcus species, H. influenzae, and Enterobacter speciesAdultS. aureus & occasionally Enterobacter or Streptococcus speciesSickle cell anemia patientsSalmonella species are most common in patients with sickle cell diseaseOther Options[?]Acute haematogenous osteomyelitis causative organisms:Acute haematogenous osteomyelitis is mainly a disease of children.[?]Staphylococcus aureus:The causal organism in both adults and children is usually Staphylococcus aureus (found in over 70% of cases), and less often one of the other Gram-positive cocci, such as the Group A beta-haemolytic streptococcus (Streptococcus pyogenes) which is found in chronic skin infections, as well as Group B streptococcus (especially in new-born babies) or the alphahaemolytic diplococcus S. pneumoniae.[?]Haemophilus influenzae:In children between 1 and 4 years of age the Gram-negative Haemophilus influenzae used to be a fairly common pathogen for osteomyelitis and septic arthritis, but the introduction of H. influenzae type B vaccination about 20 years ago has been followed by a much reduced incidence of this infection in many countries.In recent years its place has been taken by Kingella kingae, mainly following upper respiratory infection in young children.Other Gram-negative organisms (e.g. Escherichia coli, Pseudomonas aeruginosa, Proteus mirabilis and the anaerobic Bacteroides fragilis) occasionally cause acute bone infection.[?]Peptococcus magnus:Anaerobic organisms (particularly Peptococcus magnus) have been found in patients with osteomyelitis, usually as part of a mixed infection.Unusual organisms are more likely to be found in heroin addicts and as opportunistic pathogens in patients with compromised immune defense mechanisms. | train | med_mcqa | null |
A 50 year old female patient complains of difficulty in swallowing. Patient gives h/o multiple diagnostic CT-scans of the head and neck region. This patient may be predominantly susceptible to which of the following? | [
"Medullary thyroid carcinoma",
"Follicular thyroid carcinoma",
"Anaplastic thyroid carcinoma",
"Papillary thyroid carcinoma"
] | D | The incidence of thyroid carcinomas, predominantly papillary thyroid carcinomas, increases in humans after radiation exposure. There is strong dependence on age at exposure—susceptibility to radiation-induced thyroid cancer is higher in children than adults. There is little evidence for a dose response for individuals exposed during adulthood. Females are 2 to 3 times more susceptible than males to radiogenic and spontaneous thyroid cancers.
Reference: White and Pharoah, Oral radiology, ed 8th, pg-92 | train | med_mcqa | null |
Causes of acute flaccid paralysis - | [
"Poliomyelitis",
"Tick paralysis",
"ADEM",
"All of the above"
] | D | null | train | med_mcqa | null |
Fastest to slowest route of absorption of local anaesthetic is? | [
"Tracheal >Lumbar epidural > Intercostal block > Subcutaneous.",
"Tracheal > Intercostal block > Lumbar epidural > Subcutaneous.",
"Subcutaneous> Intercostal block > Lumbar epidural >Tracheal.",
"Lumbar epidural > Intercostal block >Tracheal > Subcutaneous."
] | B | According, the rate of systemic absorption is greatest with intercostal nerve blocks followed by caudal, lumbar epidural, brachial plexus block femoral and sciatic nerve blocks. Sequence of systemic absorption IV > Tracheal > Intercostal block > Para cervical block > Caudal > Lumbar epidural > Brachial Plexus > Sciatic > Subcutaneous. | train | med_mcqa | null |
Gastric emptying is decreased by all of the following EXCEPT: | [
"Protein breakdown products",
"CCK",
"Enterogastric reflexes",
"Gastrin"
] | D | Acidity of the chyme, hyper- or hypo-osmolarity of the duodenal contents, irritation of the duodenal mucosa, protein or fat breakdown products in duodenum are the factors sensed by the duodenal receptors. Gastric emptying will then be decreased, by a combination of neural and hormonal signals. Neural signals would be enterogastric reflexes in the ENS; they are triggered by the acidic chyme in the duodenum. Hormonal signals would be in the form of CCK, Secretin, G.I.P. released from duodenal mucosa. Fat in the duodenum is very potent inhibitor of gastric emptying; it causes CCK release. Hormonal factors decrease the gastric motility and cause constriction of pyloric sphincter. Other effects include: fundic relaxation, inhibition of antral motor activity. Gastrin, in physiological amounts, is known to increase gastric motility. | train | med_mcqa | null |
Delirium & dementia can be differentiated by? | [
"Loss of memory",
"Apraxia",
"Delusion",
"Altered sensorium"
] | D | ANSWER: (D) Altered sensoriumREF: Kaplan & Sadock's Synopsis of Psychiatry 10th ed chapter-10Repeat Psychiatry 2013 Session 1, June 2010 | train | med_mcqa | null |
Puerperal pyrexia is fever for 24 hours or more after child bih if temperature is more than : | [
"99' F",
"99.5deg F",
"100deg F",
"100.4deg F"
] | D | 100.4deg F | train | med_mcqa | null |
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