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 |
|---|---|---|---|---|---|---|
50 year old man with dashboard injury in RTA. Dislocation was reduced after 3 days, started complaining of pain in left hip after 6 months x-ray pelvis is normal. most relevant investigation | [
"MRI",
"USG",
"CT",
"HR - CT"
] | B | null | train | med_mcqa | null |
MCH located on - | [
"Chromosome number 6",
"Chromosome number 7",
"Chromosome number 8",
"Chromosome number 9"
] | A | (A) (Chromosome number 6) (136 Baveja 4lh) (106 D. Greenwood 18th)MAJOR HISTOCOMPATIBILITY COMPLEX (MHO* The MHC in human is known as human leucocyte antigen (HLA) complex.* The HLA complex of genes is located on short arm of chromosome 6.* They are arranged over a region of between 2000 and 4000 kilobases is size, containing sufficient DNA for more than 200 genes.HLA Complex (MHC complex)||||Class IClass 11Class III* Comprising A, B and C loci* 'D' region - DR, DQ, DPComplement region encodes* Responsible for* Responsible for* C2&C4# Graft rejection# Graft versus host response* Properdin factor B# Cell mediated cytolysis# Mixed leucocyte reaction* Heat shock protein* Found on the surface of all nucleated cells and platelets* Found only on cells of the immune system* TNF a and b* Enzyme 21 hydroxylaseIndications of HLA typing:* Tissue typing prior to transplantation.* Paternity determination.* Disease and HLA - associationHLA - B27 - Ankylosing spondylitis.HLA - DR4 - Rheumatoid arthritis | train | med_mcqa | null |
Neurogenic cause of dysphagia includes following except: | [
"Multiple sclerosis",
"Tetanus",
"Parkinsons's disease",
"Tetany"
] | D | null | train | med_mcqa | null |
Which of the following is most characteristic of sleep in a 45-year-old woman with major depressive disorder? | [
"Sleeping too many hours at night",
"Falling asleep suddenly during the daytime",
"Walking up too early in the morning",
"Having difficulty coming fully awake after sleep"
] | C | Although excessive sleeping may also occur, the sleep problem most characteristic of the major depressive disorder is early morning awakening, commonly called "terminal insomnia." Falling asleep suddenly during the daytime is narcolepsy, and cessation of breathing during sleep is sleep apnea. "Sleep drunkenness" involves difficulty in coming fully awake after sleep. | train | med_mcqa | null |
Treatment of choice for sarcoma botryoides is | [
"Surgical excision",
"Radio therapy",
"Chemotherapy",
"Palliative therapy"
] | C | Ans is 'c' i.e., ChemotherapySarcoma BotryoidesSarcoma botryoides is a rare tumour seen in children.This tumour arises in the mesenchymal tissues of the vagina and in rare cases, in the cervix before the age of 2 years.It presents as a haemorrhagic grape-like polyp or as a fleshy mass and consists of rhabdomyoblasts with vacuolated cytoplasm, myxoedema and stroma with fusiform cells.The tumour spreads by local infiltration, lymphatics and blood stream.Examination is done under anaesthesia; biopsy confirms the diagnosis. CT and MRI indicate its spread.Treatment. Chemotherapy with VAC (vincristine, adriamycin and cyclophosphamides) is the gold standard in treating this tumour. Other drugs used are cisplatin, actinomycin, cyclophosphamide and ifosfamide.Surgery is limited to the local residual tumour. Intersti- tial radiation is used in advanced stage. | train | med_mcqa | null |
Following genetic counseling in a family for Familial polyposis coli for a 15 year old person, APC gene mutation is present. Next step of screening is | [
"colonoscopy from now",
"Colonoscopy from 10 years before the detection of Ca. In family",
"Occult blood in stools every year till 30 years.",
"CECT + colonoscopy"
] | A | If APC gene mutation is present colonoscopy done from 10 years of age. | train | med_mcqa | null |
Pain sensation from the lateral extremities is transmitted by: | [
"Spino thalamic tract",
"Dorsal column",
"Corticospinal tract",
"Spinocerebellar tract"
] | A | null | train | med_mcqa | null |
A shift to the right in the biological activity dose- response curve for a hormone with no accompanying change in the maximal response indicates: | [
"Decreased responsiveness and decreased sensitivity",
"Increased responsiveness",
"Decreased sensitivity",
"Increased sensitivity and decreased responsiveness"
] | C | Ans. C. Decreased sensitivityRight or left shifts in dose-response curves indicate changes in sensitivity. Changes in maximal biological response indicate changes in responsiveness. Because there is no change in maximal response, the correct answer must relate to a change in sensitivity only. A right shift indicates decreased sensitivity. | train | med_mcqa | null |
Select the statement which best characterises lymph capillaries | [
"Have smaller diameter than blood capillaries",
"Less permeable than blood capillaries",
"Have no endothelial lining",
"Have a discontinuous basement membrane"
] | D | Lymph capillaries - Lymph capillaries (or lymphatic capillaries) begin blindly in tissues where they form a network. The structure of lymph capillaries is basically similar to that of blood capillaries, but is adapted for much greater permeability. There is an inner lining of endothelium. The basal lamina is absent or poorly developed. Pericytes or connective tissue are not present around the capillary. As compared to blood capillaries, much larger molecules can pass through the walls of lymph capillaries. These include colloidal material, fat droplets, and paiculate matter such as bacteria. It is believed that these substances pass into lymph capillaries through gaps between endothelial cells lining the capillary; or by pinocytosis. Lymph capillaries are present in most tissues of the body. They are absent in avascular tissues (e.g., the cornea, hair, nails); in the splenic pulp; and in the bone marrow. It has been held that lymphatics are not present in nervous tissue, but we now know that some vessels are present. REF : Inderbir Singh's Textbook of Human Histology, seventh edition, pg.no., 130. | train | med_mcqa | null |
The maximum occlusal force exerted by a patient, who is edentulous would be? | [
"50 Psi",
"150 Psi",
"250 Psi",
"> 300 Psi"
] | A | null | train | med_mcqa | null |
Incubation period less than few hours | [
"Food poisoning",
"Hepatitis A",
"Influenza",
"Rabies"
] | A | Incubation period of food poisonings:
Food poisoning - Incubation period
Salmonella - 12 – 24 hours
Staphylococcal - 1 – 6 hours
Botulism - 12 – 36 hours
Cl. perfirengens - 6 – 24 hours
B. cereus (emetic form) - 1 – 6 hours
B. cereus (diarrhoel form) - 12 – 24 hours | train | med_mcqa | null |
Commonest cause of Cushing syndrome is | [
"Adrenal adenoma",
"Carcinoma",
"Atrophy",
"Hyperplasia"
] | D | MC cause of Cushing's syndrome is iatrogenic exogenous administration of steroids. MC endogenous cause of Cushing's syndrome is bilateral adrenal hyperplasia secondary to hypersecretion of ACTH from pituitary or from an ectopic non-pituitary source | train | med_mcqa | null |
Postnatally when is the growth velocity maximum ? | [
"In the first year of life",
"In the second year of life",
"In the seventh year of life",
"In adolescence"
] | A | Growth follows a sigma shaped curve.
The fetus grows fast in the first half of gestation, thereafter the rate of growth is slowed down till the baby is born.
In the early postnatal period velocity of growth is high during the first few months.
A second phase of accelerated growth is during puberty. | train | med_mcqa | null |
The number of girls a woman would bear if she passes through her reproductive age with the same feility rate gives: March 2009 | [
"Total feility rate",
"Feility rate",
"Gross reproductive rate",
"Net reproductive rate"
] | C | Ans. C: Gross reproductive rate The net reproduction rate (NRR) measures the effective feility in a population, taking account not only of bihs but also of the fact that not all women born will survive to their own reproductive years. The NRR is the average number of daughters of reproductive age that a woman would have if she experienced over her lifetime the prevailing age-specific rates of feility and if her daughters experienced the prevailing rates of moality. The gross reproduction rate (GRR) for a paicular year is the average number of daughters that a woman would have if she experienced over her lifetime the age-specific feility rates of that year. In that it refers only to the number of daughters born to women, not the total number of children, it is a special case of the (period) total feility rate; in most circumstances (unless the sex ratio at bih is highly unequal) the GRR equals roughly half the TFR. The general feility rate is similar to the crude bih rate except that it uses a more restricted denominator, the female population of childbearing age, ages 15 to 49. Age-specific feility rates (also called age-specific bih rates) are similar to the crude bih rate but are calculated for specific age groups of women of childbearing age. The range of childbearing ages is conventionally considered to be ages 15 to 49 (sometimes 15 to 44 is used), and a full set of age-specific feility rates would span this interval-usually either in single-year age groups or, more commonly, in five-year groups: 15 to 19, 20 to 24, ..., 45 to 49. Marital feility rates can be calculated either for the full range of reproductive ages (15 to 49 or 15 to 44) or as age-specific rates. The numerator is usually taken as the total number of live-bihs to women in the specified age range, regardless of the marital status of the mother; the denominator is the number of currently married women in the specified age range The total feility rate (TFR) at a given time (technically referred to as the period total feility rate) is the average number of children a woman would bear in her life if she experienced the age-specific feility rates prevailing at that time. | train | med_mcqa | null |
Massive aminoaciduria without a corresponding increase in plasma amino acid level is characteristic of which one of the following diseases? | [
"Homocystinuria",
"Hartnup disease",
"Tyrosinemia",
"Maple syrup urine disease"
] | B | b. Hartnup disease(Ref: Nelson's 20/e p 636-642, Ghai 8/e p 653-655)Laboratory findings in Hartnup disorder:Aminoaciduria, involving neutral amino acids (alanine, serine, threonine, valine, leucine, isoleucine, phenylalanine, tyrosine, tryptophan, histidine); Plasma concentrations of neutral amino acids are usually normal.This seemingly unexpected finding occurs because these amino acids are absorbed as dipeptides and the transport system for small peptides is intact in Hartnup disorder. | train | med_mcqa | null |
"Poers of Infection" are - | [
"Anopheles",
"Housefly",
"Aedes",
"Cockroaches"
] | B | Houseflies are commonest and familiar insects which live close to man. House flies are exceptionally efficient mechanical spreaders of disease. They transpo microorganisms on their feet and hairy leg. Pathogenic organisms, ova, and cysts have been recovered from bodies of the housefly. House flies are called 'poers of infection'. Most impoant are: Musca domestica,M.vicinia,M.nebulo,M.sorbens. REFERENCE: PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE, 25TH EDITION, PG NO. 834 | train | med_mcqa | null |
Call Exner bodies are found in - | [
"Granulosa Cell Tumour",
"Embryonal cell carcinoma",
"Choriocarcinoma",
"Androblastoma"
] | A | Ans. is 'a' i.e., Granulosa Ceil Tumour "The formation of Call - Exner bodies is a distinct feature of granulose cells and can be readily recognised in certain types of granulosa cell tumours. " | train | med_mcqa | null |
All electrolyte abnormalities are seen in immediate postoperative period, except: | [
"Negative Nitrogen balance",
"Hypokalemia",
"Glucose intolerance",
"Hyponatremia"
] | D | null | train | med_mcqa | null |
False about CA pancreas | [
"Most common site is head and uncinate process",
"Pain suggests unresectability",
"Two third patients present with diabetes",
"Acute pancreatitis never occurs in CA pancreas"
] | D | Clinical features of Carcinoma Pancreas MC site is head and uncinate process Patients with lesions that occur near the bile duct, such as those near the ampulla, head of the pancreas and uncinate process, are much likely to have obstructive jaundice Those with lesions in the body or tail of the pancreas are more likely to complain pain Pain suggests unresectability in carcinoma pancreas Two third (65%) patients present with diabetes in carcinoma pancreas Patients may also have acute pancreatitis secondary to obstruction of the pancreatic duct Elderly patients with acute pancreatitis but without a history of alcohol use or gallbladder stones should be screened for a neoplasm Ref: Sabiston 20th edition Pgno :1544 | train | med_mcqa | null |
Pigment providing colour to stool is - | [
"Stercobilinogen",
"Urobillinogen",
"Mevobilirubin",
"Bilirubin"
] | A | The characteristic brown colour of feces is due to the presence of pigment stercobilin (derived from stercobilinogen).
So, actually it is stercobilin (not stercobilinogen) which is responsible for the brown color of feces. Stercobilin is derived from stercobilinogen and therefore stercobilinogen is the best answer amongst the options provided. | train | med_mcqa | null |
In treatment of papillary carcinomas thyroid, radioiodine destroys the neoplastic cells predominantly by: | [
"X-rays",
"Beta rays",
"Gamma rays",
"Alpha particles"
] | B | Ans. (b) Beta raysRef: Schwartz 10th edition, Page 1546* I-131 emits Beta radiation and penetrates the thyroid tissue up to 0.5mm without damaging the adjacent structures like parathyroid. | train | med_mcqa | null |
Insulin release due to closure of K+ channels is seen with ? | [
"Nataglinide",
"Acarbose",
"Exenatide",
"Sitagliptin"
] | A | Ans. is 'a' i.e., Nataglinide "Sulfonylureas and Meglititinides (nonsulfonylureas) are the two classes of Insulin secretogogues stimulate insulin secretion by interacting with the ATP-sensitive potassium channel on the beta cell." | train | med_mcqa | null |
A 65-year-old man is brought to the emergency room in a disoriented state. The patient has an odor of alcohol on his breath. Physical examination reveals palmar erythema, diffuse spider angiomata on the upper trunk and face, and gynecomastia. A liver biopsy shows micronodular cirrhosis, massive steatosis, and Mallory hyaline. Serum levels of ammonia are elevated. Which of the following is the most likely underlying cause of gynecomastia in this patient? | [
"Hyperbilirubinemia",
"Hyperestrogenism",
"Hypersensitivity vasculitis",
"Hypoalbuminemia"
] | B | This patient is in hepatic coma and likely suffers from cirrhosis. Chronic liver failure in men leads to feminization, characterized by gynecomastia, female body habitus, and a change in pubic hair distribution. Other features of chronic liver disease include spider angiomata and palmar erythema. These findings are attributed to reduced hepatic catabolism of estrogens (i.e., hyperestrogenism). The other choices are unrelated to feminization.Diagnosis: Alcoholic liver disease | train | med_mcqa | null |
Which of the following is FALSE regarding breast cancer during pregnancy? | [
"Axillary lymph node metastases in 75% of affected women",
"Mammography is sensitivity during pregnancy",
"Radiation cannot be considered for treatment",
"Less than 25% of the breast nodules are cancerous"
] | B | Breast cancer occurs in 1 of every 3000 pregnant women, and axillary lymph node metastases are present in up to 75% of these women. The average age of the pregnant woman with breast cancer is 34 years. Less than 25% of the breast nodules developing during pregnancy and lactation will be cancerous. Ultrasonography and needle biopsy are used in the diagnosis of these nodules. Open biopsy may be required. Mammography is rarely indicated because of its decreased sensitivity during pregnancy and lactation Because of the potential deleterious effects of radiation therapy on the fetus, radiation cannot be considered until the fetus is delivered. A modified radical mastectomy can be performed during the first and second trimesters of pregnancy, even though there is an increased risk of spontaneous aboion after first-trimester anesthesia. Ref: 1. Robinson DS, Sundaram M, et al: Carcinoma of the breast in pregnancy and lactation, in Bland KI, Copeland EM III (eds): The Breast: Comprehensive Management of Benign and Malignant Diseases. Philadelphia: WB Saunders, 1998, p 1433. 2. Hunt K.K., Newman L.A., Copeland E.M., Bland K.I. (2010). Chapter 17. The Breast. In F.C. Brunicardi, D.K. Andersen, T.R. Billiar, D.L. Dunn, J.G. Hunter, J.B. Matthews, R.E. Pollock (Eds), Schwaz's Principles of Surgery, 9e. | train | med_mcqa | null |
Indirect ophthalmoscopy is done for | [
"Central retina",
"Periphery of retina",
"Sclera",
"Angle of anterior chamber"
] | B | Applications: Indirect ophthalmoscopy is essential for the assessment and management of retinal detachment and other peripheral retinal lesions. It allows 3 D stereoscopic view of the lesion . It also depicts the presence of shifting fluid,which is pathognomic of exudative retinal detachment. Reference : A K KHURANA Comprehensive Ophthalmology edition 4; page-567 | train | med_mcqa | null |
Which is a reverse transcriptase? | [
"Topoisomerase 2",
"Telomerase",
"RNA polymerase 2",
"DNA polymerase alpha"
] | B | Telomerase, a multisubunit RNA template-containing complex related to viral RNA-dependent DNA polymerases (reverse transcriptases), is the enzyme responsible for telomere synthesis and thus for maintaining the length of the telomere. Since telomere shoening has been associated with both malignant transformation and aging, this enzyme has become an attractive target for cancer chemotherapy and drug development.Ref: Harper&;s Biochemistry; 30th edition; Page no: 375 | train | med_mcqa | null |
Increased PT and Normal PTT are found in? - | [
"Von Willibrand's disease",
"Factor 7 deficiency",
"Factor 8 deficiency",
"Thrombin deficiency"
] | B | Answer is option 2, factor seven deficiency The investigations revealed normal platelet counts, deranged prothrombin time (PT) with International normalised ratio (INR) of 6.2. Activated paial thromboplastin time (aPTT) was within normal limits. Ref Robbins 9/e pg 449 | train | med_mcqa | null |
Best range of UV light used for treatment of skin diseases | [
"100 – 200 nm",
"200 – 400 nm",
"400 – 700 nm",
"> 700 nm"
] | B | UV light most commonly used in dermatology are UVB (290 - 320 mn), narrow band UVB (311 nm), and UVAi (360 - 380 nm). | train | med_mcqa | null |
Pontine hemorrhage most common cause is | [
"Hypeension",
"Diabetes",
"Trauma",
"Aneurysmal rupture"
] | A | Pontine haemorrhage, a form of Ref Harrison20th edition pg 2456 | train | med_mcqa | null |
Which of the following drugs can cause hypotension by release of histamine from mast cells? | [
"Aspirin",
"Procaine",
"Morphine",
"Sulfadiazine"
] | C | Basic drugs like morphine, d-TC(tubocurarine) and amphotericin B etc. act as histamine liberators and can cause acute reaction leading to itching and hypotension. | train | med_mcqa | null |
About 20 gms of hairs required to be preserved in | [
"Heavy metal poisoning",
"Aconite poisoning",
"Iodine poisoning",
"Codeine poisoning"
] | A | Hair and nails are preserved in heavy metal poisoning e.g. arsenic, antimony, radium, thalium. | train | med_mcqa | null |
Homeobox gene is responsible for: | [
"Segmental organization of embryo in craniocaudal direction",
"Proper organization along dorsal ventral axis",
"Stimulation for lengthening of limbs",
"All of the above"
] | A | Ans. A Segmental organization of embryo is craniocaudal directionRef: Netter's Atlas of Human Embryology, 2012 ed. pg. 10* Homeobox (HOX) gene is involved in segmental organization of embryo in cranio-caudal direction. The mutation in gene leads to formation of appendages in wrong locations.* Sonic hedge-hog gene is involved in patterning in A-P axis. The mutation in this gene leads to holoprosencephaly. | train | med_mcqa | null |
Which of the element is found in the active site of glutathione peroxidase for its function? | [
"Chromium",
"Manganese",
"Zinc",
"Selenium"
] | D | In red blood cells, the pentose phosphate pathway is the sole source of NADPH for the reduction of oxidized glutathione catalyzed by glutathione reductase, a flavoprotein containing FAD. Reduced glutathione removes H2O2 in a reaction catalyzed by glutathione peroxidase, an enzyme that contains the selenium analog of cysteine (selenocysteine) at the active site. Ref: Bender D.A., Mayes P.A. (2011). Chapter 21. The Pentose Phosphate Pathway & Other Pathways of Hexose Metabolism. 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 |
Infection spreading via lymphatics from the lower lip first enter the blood stream at the | [
"Brachiocephalic vein",
"Inferior labial vein",
"Inferior labial artery",
"Pterygoid venous plexus"
] | A | null | train | med_mcqa | null |
A 4-year child presents with a history of hoarseness, croupy cough and aphonia, the child has dyspnoea with wheezing. The most probable diagnosis is ? | [
"Asthmatic bronchitis",
"Laryngeal foreign body",
"Bronchopneumonia",
"Retropharyngeal abscess"
] | B | Ans. is 'b' i.e., Laryngeal foreign body | train | med_mcqa | null |
All of the following are associated with hypergonadotrophic hypogonadism in males, EXCEPT: | [
"Viral orchitis",
"Klinefelter's syndrome",
"Kallman's syndrome",
"Noonan syndrome"
] | C | Kallman's syndrome is associated with hypogonadotropic hypogonadism resulting in decreased or absent GnRHsecretion. This syndrome is characterized clinically by anosmia, hypogonadism and other midline defects (cleft lip/palate, colour blindness, seizures, anosmia etc). This syndrome is due to impaired migration of GnRH releasing neurons to hypothalamus during the embryonic period. Ref: Cancer and Sexual Health By John P. Mulhall page 197; Organic psychiatry: the psychological consequences of cerebral disorder By William Alwyn Lishman page 526; Manual of Endocrinology and Metabolism By Norman Lavin page 292; The immunoassay handbook By David Wild page 567 | train | med_mcqa | null |
Virginia bridge is | [
"Cast perforated resin retained fpd",
"Etched cast resin retained fpd",
"Macroscopic mechanical retention resin retained fpd",
"Chemical bonding resin retained fpd"
] | C | Macroscopic mechanical retention resin retained FPDs ("virginia bridge") | train | med_mcqa | null |
A 35 years old man gets up from sleep with sudden onset breathlessness, anxiety, palpitation, shaking hand, profuse sweating, discomfort in chest & fear of dying. There is history of similar episodes in past. Physical examination is normal. Probable diagnosis is- | [
"Panic attack",
"Anxiety disorder",
"Conversion disorder",
"Acute psychosis"
] | A | Ans. is 'a' i.e., Panic attack * Sudden onset of breathlessness, anxiety, palpitation and feeling of impending doom suggest the diagnosis of panic attack (severe anxiety)* A panic attack has following characteristics: -A. Discrete episode of intense fearB. Abrupt onset (sudden onset)C. Reaches as maximum within few minutes and lasts for some minutes.D. At least four of the following symptoms : - 1) Palpitation 2) Sweating 3) Shortness of breath (Breathlessness) 4) Feeling of choking 5) Chest pain or discomfort (chest constriction) 6) Nausea or abdominal distress 7) Trembling or shaking 8) Dizziness, unsteady, fainting 9) Derealization or depersonalization 10) Fear of losing control 11) Fear of dying (impending doom) 12) Paresthesias 13) Chills or hot flushesE. At least one of the attack is followed by 1 month (or more) of one (or more) of the following ; - a) Persistent concern of future attacks, b) Worry about the consequences of attacks (Heart attack, Stroke) c) Significant change in behavior related to attack. | train | med_mcqa | null |
When do progesterone levels rise to their highest point during the female hormonal cycle? | [
"Between ovulation and the beginning of menstruation",
"Immediately before ovulation",
"When the blood concentration of LH is at its highest point",
"When 12 primary follicles are developing to the antral Stage"
] | A | The corpus luteum is the only source of progesterone production, except for minute quantities secreted from the follicle before ovulation. The corpus luteum is functional between ovulation and the beginning of menstruation, during which time the concentration of LH is suppressed below the level achieved during the preovulatory LH surge | train | med_mcqa | null |
Burkholderia cepacia is intrinsically resistant to | [
"Ciprofloxacin",
"Polymyxin",
"Cotrimoxazole",
"Ceftazidime"
] | B | (B) Polymyxin[?]BURKHOLDERIA CEPACIA COMPLEX is a group of Gram negative, catalase positive and lactose non fermenting species (nine species).oThis microrganism causes pneumonia in immunocompromized patients and lung disease in patients affected by cystic fibrosis or chronic granulomatosis disease.oPathogenesis: organisms may be found in water or in soil and can survive in wet areas, also person to person spread has been documented.oInfection can cause a rapid decline in the lung function resulting in death.oB. cepacia complex is naturally resistant to many common antibiotics including Aminoglicosides or Polimixyn B (used for identification of organism: polymixin bacitracin lactose agar)oB. cepacia complex strains are intrinsically resistant to a wide range of antimicrobial agents, including aminoglycosides, polymyxin, first and second generation cephalosporins, and carboxypenicillinsoAntimicrobial agents that are effective against B. cepacia complex include meropenem, ceftazidime, piperacillin, temocillin, and trimethoprim-sulfamethoxazole.Burkholderia cepacian-'Burkholderia cepacia' How resistant?-Biodegradation of synthetic herbicides and petroleum oxidants.-Panresistance to antibiotics.-Can utilize penicillin as nutrient!-Resistance to natural antimicrobial peptides (defensins) of amoebae, insects, animals and humans - explains CGD.Other Options[?]CiprofloxacinoHighly susceptible-E. coli, K. pneumoniae, Enterobacter, Salmonella typhi, other Salmonella, Shigella, Proteus, Neisseria gonorrhoeae, N. meningitidis, H. influenzae, H. ducreyi, Campylobacter jejuni, Yersinia enterocolitica, Vibrio choleraeoModerately susceptible-Pseudomonas aeruginosa, Staph, aureus, (including few MRSA), Staph, epidermidis, Branhamella catarrhalis, Legionella, Brucella, Listeria, Bacillus anthracis, Mycobact. tuberculosis[?]CotrimoxazoleoThe fixed dose combination of trimethoprim and sulfamethoxazole is called cotrimoxazole.oSpectrum of action Antibacterial spectra of trimethoprim and sulfonamides overlap considerably.oAdditional organisms covered by the combination are-Salmonella typhi, Serratia, Klebsiella, Enterobacter, Yersinia enterocolitica, Pneumocystis jiroveci and many sulfonamideresistant strains of Staph, aureus, Strep, pyogenes, Shigella, enteropathogenic E. coli, H.influenzae, gonococci and meningococci.[?]CeftazidimeoThe most prominent feature of this third generation cephalosporin is its high activity against Pseudomonas.oIt has been specifically used in febrile neutropenic patients with haematological malignancies, burn, etc.oIts activity against Enterobacteriaceae is similar to that of cefotaxime, but it is less active on Staph, aureus, other gram positive cocci and anaerobes like Bact. fragilis. | train | med_mcqa | null |
Fatty liver with hepatomegaly is seen in: | [
"Marasmus",
"Metabolic syndrome",
"Wilson disease",
"Nutmeg liver"
] | B | OPTION B: Metabolic syndrome - Obesity - Fatty liver Option A: Marasmus do not have hepatomegaly rather kwashiorkor will have hepatomegaly Option C: Wilson disease leads to Cirrhosis Option D: Nutmeg liver leads to Cirrhosis Best test for fatty liver = Gamma GGT Alcoholic liver disease + fatty liver - Best Test - SGOT / SGPT Ratio more than 2 | train | med_mcqa | null |
In Toxoplasmosis , the oocyst and pseudocyst are respectively seen in : | [
"Tissue, faeces",
"Human, cats",
"Cats, human",
"Feces, tissue"
] | C | Toxoplasmosis Cat -Enteric cycle occurs-Oocyst formed Man-Pseudocysts (Tissue cysts) contain slowly dividing forms called bradyzoites.(no oocyst formation) Tachyzoites are crescent shaped trophozoites. | train | med_mcqa | null |
Acute intermittent porphyria is precipitated by which of the following drug/s? | [
"Chlorpropamide",
"Phenytoin",
"Griseofulvin",
"All the above"
] | D | Ans. is 'd' i.e., All the above * Barbiturates* Griseofulvin* Chlorpropramide* Rifampicin* Oral contraceptives* Estrogen* Phenytoin* Sulfonamides SAFE drugs in Porphyria* Narcotic analgesics* Penicillin and derivatives* Glucocorticoids* Bromides* Aspirin* Streptomycin,* Insulin* Atropine,* Acetaminophen* Benzodiazepines* Muscle relaxants* Bupivacaine | train | med_mcqa | null |
As a nasal decongestant, pseudoephedrine should be used cautiously in patient with any of the following conditions except: | [
"Hypertension",
"Hyperthyroidism",
"Ischemic heart disease",
"Urinary incontinence"
] | D | Pseudoephedrine, a mixed direct- and indirect-acting sympathomimetic, may raise blood pressure and cardiac oxygen requirement, potentiate the cardiac effects of thyroid hormone, and increase urinary retention in patients with prostatic hypertrophy. It is not contraindicated in cases of urinary incontinence, and may actually be useful in select patients with the condition because it contracts the bladder sphincter. | train | med_mcqa | null |
The number of ciliary processes is about: | [
"20-30",
"50-60",
"70-80",
"90-100"
] | C | Ans. 70-80 | train | med_mcqa | null |
True about multipotential connective tissue cells is: | [
"These are most radiosensitive",
"These are most radioresistant",
"They have intermediate sensitivity",
"None of the above"
] | C | Multipotent connective tissue cells:
These cells have intermediate sensitivity.
These cells divide when there is a demand for more cells.
Eg: Endothelial cells, fibroblasts, mesenchymal cells. | train | med_mcqa | null |
All are treatment modalities of OCD except: | [
"Exposure & response prevention",
"Psychoanalytic psychotherapy",
"Clomipramine",
"MAO inhibitors"
] | D | D i.e. MAO inhibitor | train | med_mcqa | null |
In what period, following delivery, does the cardiac output return to the pre-pregnancy state? | [
"4 hours",
"4 weeks",
"6 weeks",
"8 weeks"
] | B | Cardiac output returns to pre labour values by one hour following delivery and pre pregnancy level by 4 weeks. Cardiac output: It stas to increase from 5th week of pregnancy reaches a peak 40-50% at about 30-34 weeks. It increases fuher during labour (50%) and immediately following delivery (70%) over pre labour values. Increase in cardiac output is due to: Increased blood volume To meet the additional oxygen required due to increased metabolic activity during pregnancy. Ref: Textbook of Obstetrics By D.C Dutta, 6th edn, page 53 | train | med_mcqa | null |
Management of Appendicular mass/ abscess: March 2013 (a, c, e, f, g, h) | [
"Antibiotics only",
"Immediate appendectomy",
"Antibiotics and appendectomy 6 weeks later",
"Wait & watch"
] | C | Ans. C i.e. Antibiotics and appendectomy 6 weeks later Append icular abscess The conservative management of appendicular mass can be summarized by mnemonic "ABCDEF" which is A: Analgesic, Antibiotic, antipyretic B: Bed rest C: Chaing (vital sign, size of the mass) D: Diet (Keep Nil by Mouth) E: Exploratory laparotomy KIV. F: Fluid maintenance The initial school of thought regards this condition to be managed conservatively, with the famous one being the Ochsner-Sherren regimen. The idea behind this is that, surgery would be hazardous and increase the moality rate. Surgeon who hold with this choice differs in opinion whether there is a need for interval appendectomy which usually perform after 3-6 week after the conservative management. The idea behind the interval appendectomy is to prevent recurrence of acute appendicitis and to exclude other gastrointestinal pathology especially malignancy. | train | med_mcqa | null |
Which of the following ovarian tumor is most prone to undergo torsion during pregnancy? | [
"Serous cystadenoma",
"Mucinous cystadenoma",
"Dermoid cyst",
"Theca lutein cyst"
] | C | Ans. is c, i.e. Dermoid cystRef. Novak 14/e, p 510; Dutta Obs. 6/e, p 310"Incidence of dermoid cyst increases two times in pregnancy and it becomes the most commonly diagnosed ovarian tumour during pregnancy." --Dutta Obs. 7/e, p 310"A benign cystic teratoma is the most common neoplasm to undergo torsion." --Novak 14/e, p 510Note: Benign cystic teratoma is another name for dermoid cyst.From the above two lines it is clear that dermoid cyst is the most common ovarian tumour to undergo torsion during pregnancy.For more details on dermoid cyst and other ovarian tumours kindly see "Self Assessment and Review Gynaecology" by the same author. | train | med_mcqa | null |
Which of the following conditions are associated with paucity - immune crescentic glomerulonephritis? | [
"Henoch - Schonlein Nephritis",
"Lupus Nephritis (SLE)",
"Microscopic polyangitis",
"Nephritis in Alpo's syndrome"
] | C | Microscopic polyangiitis is an ill-defined autoimmune disease characterized by a systemic, pauci-immune, necrotizing, small-vessel vasculitis without clinical or pathological evidence of necrotizing granulomatous inflammation. It is type III Rapidly progressive glomerulonephritis (RPGN). Around 90% patient s will have P-ANCA positive. Ref: Emil A. Tanagho, Jack W. McAninch (2004), Chapter 31, "Diagnosis of Medical Renal Diseases", In the book, "Smith's General Urology", USA, Page 523; Robbin's Basic Pathology, 7th Edition, Page 977 | train | med_mcqa | null |
Maximum amount of incisor retraction achieved is: | [
"7 mm",
"16 mm",
"9 mm",
"26 mm"
] | A | null | train | med_mcqa | null |
The following regarding colostomy are true except : | [
"A colostomy is an artificial opening made in large Bowel to divert the faeces to the exterior",
"Temporary colostomy is established to defunction an anastomosi",
"Permanent colostomy is formed after the resection of Rectum by the abdominoperinea technique",
"Double barreled colostomy is commonly done nowaday... | D | • Bailey says “Double-barrelled colostomy was designed so that it could be closed by crushing the intervening ‘spur’ using an enterotome or a stapling device. It is rarely used now, but occasionally the colon is divided so that both ends can be brought to the surface separately, ensuring that the distal segment is completely defunctioned".
• May be colostomy or ileostomy.
• May be temporary or permanent.
• Temporary or defunctioning stomas are usually fashioned as loop stomas.
• An ileostomy is spouted; a colostomy is flush.
• Ileostomy effluent is usually liquid whereas colostomy effluent is usually solid.
• Ileostomy patients are more likely to develop fluid and electrolyte problems.
• An ileostomy is usually sited in the right iliac fossa.
• A temporary colostomy may be transverse and sited in the right upper quadrant.
• End-colostomy is usually sited in the left iliac fossa.
• All patients should be counseled by a stoma care nurse before operation. | train | med_mcqa | null |
Person having heterozygous sickle cell trait is protected from infection of | [
"P. falciparum",
"P. vivax",
"neumococcus",
"Salmonella"
] | A | Ans. a. P. falciparum | train | med_mcqa | null |
In which of the following tissues is glucose transpo into the cell enhanced by insulin? | [
"Brain",
"Lens",
"Red blood cells",
"Adipose tissue"
] | D | Under conditions of low insulin, most GLUT4 is sequestered in intracellular vesicles in muscle and fat cells.Insulin induces a rapid increase in the uptake of glucose by inducing the translocation of GLUT4 from these vesicles to the plasma membrane.As the vesicles fuse with the plasma membrane, GLUT4 transpoers are inseed and become available for transpoing glucose, and glucose absorption increases.Ref: DM Vasudevan, 7th edition, page no: 320 | train | med_mcqa | null |
Which of the following molecules delivers iron to tissues by binding to specific cell surface receptors: | [
"Ferritin",
"Ferredoxin",
"Hemosiderin",
"Transferrin"
] | D | Transferrin is a b1-globulin synthesized in the liver and is the transpoer of iron. Transpo of Iron For transpo, ferrous iron needs to be oxidised to ferric iron. This is done by hephaestin, a membrane-associated ferroxidase protein. In the blood, ceruloplasmin, a copper-containing ferroxidase oxidises any ferrous iron to ferric iron Transferrin can carry 2 molecules of ferric ion. (apo transferrin + 2 Fe3+ = Holo-transferrin) Transferrin delivers the iron to different tissue cells by recpetor mediated endocytosis. The iron can be incorporated into various iron-containing proteins or stored in ferritin. Additional edge Iron storage form: Ferritin and Haemosiderin (Fe3+). Regulate iron transpo in circulation: Hepcidin (Fe2+). The presence of carbohydrate-deficient transferrin (CDT), which can be measured by isoelectric focusing (IEF), is used as a biomarker of chronic alcoholism. | train | med_mcqa | null |
In a middle aged male having back pain, syndesmophytes involving4 continous vertebrae are seen on Xray. The patient has - | [
"DISH",
"Ankylosing spondylitis",
"Rheumatoid arthritis",
"Osteoarthritis"
] | B | Ans. is 'b' i.e., Ankylosing spondylitiso Back pain with syndesmatophytes in a middle aged man suggest the diagnosis of ankylosing spondylitis.Ankylosing spondylitis (marie-strumpell disease)o Ankylosing spondylitis is a chronic progressive inflammatory disease of the sacroiliac joints and the axial skeleton,o Prototype of seronegative (absence of rheumatoid factor) spondyloarthropathies,o Inflammatory disorder of unknown cause.o Usually begins in the second or third decade with a median age of 23, in 5% symptoms begin after 40.o Male to female ratio is 2-3 :1o Strong correlation with HLA-B27o 90-95% of cases are positive for HLA - B27.Joints involved in ankylosing spondylitiso Ankylosing spondylitis primarily affects axial skeleton.o The disease usually begins in the sacro-iliac joints and usually extends upwards to involve the lumbar, thoracic, and often cervical spine.o In the worst cases the hips or shoulders are also affected. Hip joint is the most commonly affected peripheral joint,o Rarely knee (Ebenzar 4th/6 593) and ankle (Apley's 9th/e 67) are also involved. Pathologyo Enthesitis i.e. inflammation of the insertion points of tendons, ligaments or joint capsule on bone is one of the hallmarks of this entity of disease.o Primarily affects axial (spinal) skeleton and sacroiliitis is often the earliest manifestation of A.S..o Involvement of costovertebral joints frequently occur, leading to diminished chest expansion (normal > 5 cm)o Peripheral joints e.g. shoulders, and hips are also involved in l/3rd patients.o Extraarticular manifestations like acute anterior uveitis (in 5%); rarely aortic valve disease, carditis and pulmonary fibrosis also occur.o Pathological changes proceed in three stages-Inflammation with granulation tissue formation and erosion of adjacent bone.Fibrosis of granulation tissueOssification of the fibrous tissue, leading to ankylosis of the joint.Radiological features of ankylosing spondylitiso Radiographic evidence of sacroiliac joint is the most consistent finding in ankylosing spondylitis and is crucial for diagnosis. The findings areSclerosis of the articulating surfaces of SI jointsWidening of the sacroiliac joint spaceBony ankylosis of the sacroiliac jointsCalcification of the sacroiliac ligament and sacro-tuberous ligamentsEvidence of enthesopathy - calcification at the attachment of the muscles, tendons and ligaments, particularly around the pelvis and around the heel.o X-ray of lumbar spine may showSquaring of vertebrae : The normal anterior concavity of the vertebral body is lost because of calcification of the anterior longitudinal ligament.Loss of the lumbar lordosis.Bridging kosteophytes' (syndesmophytes)Bamboo spine appearance | train | med_mcqa | null |
Albe&;s stain is used for | [
"Staphylococcus",
"Corynebacterium diphtheriae",
"Clostridium Perfringes",
"Clostridium Tetani"
] | B | Albe 's or Neisser's stain: smears of Corynebacterium diphtheriae when stained with Albe's stain will show the bacilli with metachromatic granules. Delicate green bacilli with purple-blue metachromatic granules can be seen. Bacilli take up stain due to metachromatic granules which are composed of polymetaphosphate and serve as storage granules. Reference: Textbook of Microbiology; Anathanarayan and paniker's; 10th edition; page no 242 | train | med_mcqa | null |
vital capacity of 45 yr old male patient is 4000ml , with IRV = 500ml , ERV = 500ml with respiratory rate of 22/min, calculate minute ventilation of the patient ? | [
"66",
"120",
"33",
"100"
] | A | minute ventilation = tial volume x respiratory rate ref : guyton andhall | train | med_mcqa | null |
Damage to trochlear nerve causes which muscle palsy? | [
"Superior Oblique",
"Lateral Rectus",
"Inferior oblique",
"Inferior rectus"
] | A | Ans. is 'a' i.e., Superior Oblique Oculomotor nerveMedial rectus. Inferior rectus, Superior rectus, Inferior obliqueTrochlear nerveSuperior ObliqueAbducensLateral rectus | train | med_mcqa | null |
Interval between Primary case and Secondary case known as:- | [
"Incubation period",
"Serial interval",
"Generation time",
"Case detection time"
] | B | Serial Interval - Interval between primary case and secondary case. Incubation Period- Entry of organism till first sign / Symptom. Generation time - Interval between entry of organism till maximum infectivity of that person or case. | train | med_mcqa | null |
All of the following are true about intrinsic Asthma,Except: | [
"Increasing Incidence",
"Allergic Asthma is more common in young patients",
"Idiosyncratic Asthma is more common older patients",
"IgE is increased in Idiosyncratic Asthma"
] | D | Answer is D (IgE is increased in Extrinsic Asthma) Asthma Extrinsic Asthma / Allergic Asthma History of Atopy is present Attacks related to environmental exposures IgE antibody levels are | ed Early onset of disease (young) Usually is less severe, intermittent Asthma that may however progress to severe persistent Asthma Intrinsic Asthma /Idiosyncratic Asthma No history of Atopy (Concomitant nasal polyps are usually present and patients may be aspirin sensitive) Attacks not related to environmental exposures: Occur without provocation IgE antibody levels are normal Delayed onset of disease (Adult onset Asthma) Usually have more severe persistent Asthma Idiosyncratic Asthma (Intrinsic Asthma) is associated with normal IgE levels. The incidence of Asthma is increasing There is a rising incidence ofAsthtna in developing countries | train | med_mcqa | null |
A premature baby of a diabetic mother was kept in incubator in neonatal ICU following respiratory distress. Which of the following indicates RDS in a newborn? | [
"Onset after 6 hours of age",
"Antenatal coicosteroid therapy in mother",
"Air bronchogram on chest X-ray",
"Term gestation"
] | C | Radiological features of respiratory distress syndrome (RDS): Reticulogranular pattern Ground glass opacity Low lung volume Air bronchogram Whiteout lung (in severe disease) Must know: Hyaline membrane disease (HMD) or respiratory distress syndrome (RDS): It is common in preterm babies less than 34 weeks of gestation. It is the commonest cause of respiratory distress in a preterm neonate. Respiratory distress usually occurs within the first 6 hours of life. In addition to prematurity, asphyxia, acidosis, maternal diabetes, and cesarean section can increase the risk of developing RDS. Antenatal coicosteroid therapy in mother will decrease the incidence of RDS. Prenatal diagnosis: Determining L/S ratio in the amniotic fluid. Ref: Essential Pediatrics by O.P. Ghai, 7th edition, Page 143. | train | med_mcqa | null |
The following drug is not helpful in the treatment of ectopic pregnancy: | [
"Methotrexate",
"Misoprostol",
"Actinomycin-D",
"RU486"
] | B | Misoprostol (PGE1) has been used for cervical ripening which is used for induction of labour. It doesn't have any role in management of ectopic pregnancy. Ref:Text Book of Obstetrics By Dutta, 6th Edition, Pages 175, 189, 505 | train | med_mcqa | null |
Dicumarol is a drug that impairs the utilization of vitamin K by the liver. Dicumarol therapy, therefore, would decrease the plasma concentration of which of the following procoagulants? | [
"Prothrombin",
"Fibrinogen",
"Factor XI",
"Ac-globulin (factor V)"
] | A | Dicumarol inhibits the action of vitamin K, which is a necessary cofactor for the enzyme that catalyzes the conversion of glutamic acid residues to g-carboxyglutamic acid residues.Six of the proteins involved in clotting require conversion of a number of glutamic acid residues to g-carboxyglutamic acid residues before being released into the circulation, and hence all six are vitamin K-dependent. These proteins include factors II (prothrombin)Others are; factors VII, IX, and X, protein C, and protein S Ref: Ganong's Review of Medical Physiology Twenty-Third Edition Page No: 535 | train | med_mcqa | null |
Factors which reduce postprandial glycaemia include all of the following EXCEPT - | [
"Small particle size of food",
"Presence of enzyme inhibitors in food",
"Inadequate cooking of starch",
"Resence of protein and fat in association with carbohydrate"
] | A | null | train | med_mcqa | null |
The histological features of shock includes? | [
"ATN",
"Pulmonary congestion",
"Depletion of lipids in adrenal coex",
"All"
] | D | Ans. is 'a' i.e., ATN; 'b' i.e., Pulmonary Congestion; 'c' i.e., Depletion of lipid in adrenal coex Morphological changes in shock o The cellular and tissue changes induced by shock are essentially of those of hypoxic injury as final pathway in all types of shock is reduced tissue perfusion and decreased oxygen supply. Since shock is characterized by failure of multiple organ system the cellular changes may occur in any organ. o They are paicularly evident in Brain, Hea, Lungs, Kidney, Adrenal and GIT. Brain ---> Ischemic encephalopathy Kidney --> Acute tubular necrosis (ATN) Hea --> Coagulative necrosis with subendocardial hemorrhage. Adrenal ---> Stress reaction i.e., coical cell lipid depletion. GIT --> Hemorrhagic enteropathy. Liver --> Fatty changes and in severe case central hemorrhagic necrosis. Lung Lungs are seldom affected in pure hypovolemic shock because they are resistant to hypoxic injury. When shock is caused by sepsis or trauma, change of diffuse alveolar damage with pulmonary congestion may occur -4 Shock lung. | train | med_mcqa | null |
Which of the following is the selective media for vibrio? | [
"TCBS",
"Stua",
"Skirrows",
"MYPA"
] | A | Vibrios are curved, Gram-negative rods commonly found in saltwater. Cells may be linked end to end, forming S shapes and spirals. They are highly motile with a single polar flagellum, non-spore-forming, and oxidase-positive, and they can grow under aerobic or anaerobic conditions. The cell envelope structure is similar to that of other Gram-negative bacteria. Vibrio cholerae is the prototype cause of a water-loss diarrhea called cholera. Cholera is limited to O1 and O139 serotypes, Serotype O139 is encapsulated. The organism grows on common clinical laboratory media such as blood agar and MacConkey agar, but its isolation is enhanced by a selective medium (thiosulfate-citrate-bile salt-sucrose agar). TCBS Agar is highly selective for the isolation of V. cholerae and V. parahaemolyticus as well as other vibrios. Also Know: Typical colonial morphology on TCBS agar: V.cholerae -- Large Yellow colonies V.Parahaemolyticus -- Colonies with blue to green centers V.alginolyticus -- Large yellow mucoid colonies Ref: Ray C.G., Ryan K.J. (2010). Chapter 32. Vibrio, Campylobacter, and Helicobacter. In C.G. Ray, K.J. Ryan (Eds), Sherris Medical Microbiology, 5e. | train | med_mcqa | null |
Alpha methyldopa is primarily used for: | [
"Pregnancy induced hypertension",
"Renovascular hypertension",
"First line agent in hypertension",
"Refractory hypertension"
] | A | Ans. (A) Pregnancy induced hypertension(Ref: Katzung 11th/e p173)'Methyl-dopa was widely used in past but is now used primarily for hypertension in pregnancy | train | med_mcqa | null |
Action of metalloproteinase ? | [
"Degradation of collagen",
"Polymerization of collagen",
"Oxidation of collagen",
"Stimulation of collagen"
] | A | Ans. is 'a' i.e., Degradation of collagenDegradation of collagen and other ECM (extracellular matrix) proteins is achieved by matrix metalloproteinases (MMPs).MMPs is a family of enzymes that have in common a 180-residue zinc protease domain.Matrix metalloproteinases include :-Interstitial collagenase (MMP-1, 2, and 3) : Cleave the fibrillar collagen types I, II and III.Gelatinases (MMP-2 and 9) : Degrade amorphous collagen and fibronectin.Stromelysins (MMP-3, 10 and 11) : Act on proteoglycans, laminin, fibronectin and amorphous collagen.Membrane-bound MMPs (ADAMs) : Cleave membrane-bound precursor forms of TNF and TGF-a, releasing the active molecule. | train | med_mcqa | null |
Most common viral infection in kidney transplant recipients- | [
"B3V",
"HSV",
"CMV",
"HBV"
] | C | Cytomegalovirus is the most common infection in renal transplant recipients. The most common oppounistic infections in renal transplant recipients - Peritransplant (<1month) Wound infections Herpes virus Oral candidiasis Urinary tract infection Early (1-6months) Pnemocystis carinii CMV Legionella listeria Hep -B, C Late(>6 months) Aspergilla Nocardia Bk virus(polyoma) Hep-B, C Herpes zoster Ref:Harrison 20 th edition pg no 2130 tab-307-4 | train | med_mcqa | null |
Psoriasis is exacerbated by- | [
"Lithium",
"B- blockers",
"Antimalarials",
"All of the above"
] | D | D. i.e. All | train | med_mcqa | null |
During water analysis in a hostel, amoebic cysts were seen. The best step to manage it is – | [
"Iodine",
"Boiling",
"U.V Rays",
"Chlorination"
] | A | "Amoebic infection is spread by ingestion of food or water contaminated with cysts. since an asymptomatic carrier may excrete upto 15 million cysts/day. Prevention of infection requires adequate sanitation and eradication of cyst carriage. In high risk areas infection can be minimized by avoidance of unpeeled fruits and the use of Bottled water.
Because cysts are resistant to readily attainable levels of chlorine, disinfection by iodination (Tetraglycine hyperiodide) is recommended." - Harrison | train | med_mcqa | null |
Inclusions in oligodendrogliocytes is a feature of aEUR' | [
"Creutzfeldt-Jakob disease",
"CIDP",
"HSV",
"Progressive multifocal leukoencephalopathy"
] | D | Progressive multifocal leukoencephalopathy Progressive multifocal leucoencephalopathy :? . Progressive multifocal leucoencephalopathy is a progressive disorder cause by J.C. virusdeg. . The main cells affected in the disease are oligodendrocytesdeg. . Since oligodendrocytes are concerned with myelination, progressive multifocal leucoencephalopathy is characterized by multifocal areas of demyelinationQ of varying size distributed throughout the brain but sparing the spinal cord and optic nerves. Pathology . Besides demyelination there are characteristis cytological alterations in both astrocytes and oligodendrocytes : - AstrocytesQ . Enlarged and contain, hyperchromatic, deformed and bizarre nuclei and frequent mitotic figures. OligodendrocytesQ . These have enlarged densely staining nuclei that contains virus inclusions.formed by crystalline arrays. Symptoms of progressive multifocal leucoencephalopathy :? Visual defects (45%) --> Homonymous hemianopia, Conjugate gaze abnormalities Mental impairment (38%) Dementia, confusion, personality changes Weakness --> Hemi or monoparesis and ataxia Seizures (20%) ---> Speech defect aphasia, hemiparesis, ataxia Focal neurological signs . Progressive multifocal leucoencephalopathy is predominantly seen in patients with immunosuppressive disorders: ? . Most commonly associated conditions are: ? - AIDS (80%)Q - Hematological malignancies (13%) - Transplant recipients (5%) - Chronic inflammatory disease (2%) Prognosis of progressive multifocal leucoencephalopathy . In most cases death occurs in 3-6 months .from onset of neurological symptoms and even more rapidly in patients with AIDS unless aggressive interetrul treatment is undeaken. Diagnosis . MRI is used for the diagnosis of PML. . MRI is better than CT scan in the diagnosis of PML and is frequently used for the diagnosis of PML. . On MRI the lesion appears as multrfocal asymmetric coalescing white matter located periventricularly. . These lesions have increased signals on T2 and FLAIR images and decrease signal on T,-weighted images. . PML lesions are classically nonenhancingQ. . Other impoant diagnostic tool in PML is the PCR amplification of JCV DNA. . The PCR amplification of JCV DNA in association with typical MRI lesion in the appropriate clinical setting is diagnostic of PML. I am not sure of the answer, visual symptoms, aphasia dysahria are commonly seen in PML. | train | med_mcqa | null |
The laryngeal muscle most responsible for stretching (elongating) the vocal ligament is the: | [
"Posterior cricoarytenoid",
"Lateral cricoarytenoid",
"Thyroarytenoid",
"Cricothyroid"
] | D | Cricothyroid draws the thyroid cailage forward, tensing the vocal ligaments. This is the one muscle innervated by the external branch of the superior laryngeal nerve. Posterior cricoarytenoid is a very impoant muscle; it's the only muscle that adducts the the vocal folds. This muscle is innervated by the inferior laryngeal nerve, which is a continuation of the recurrent laryngeal nerve. If this muscle is denervated, the vocal folds may be paralyzed in an adducted position, which would prevent air from entering the trachea. Lateral cricoarytenoid, thyroarytenoid, and arytenoid are all muscles that adduct the vocal folds. They are all innervated by the inferior laryngeal nerve. | train | med_mcqa | null |
Coenzyme A is formed from which vitamin? | [
"C",
"B4",
"Nicotinic acid",
"Pentothenic acid"
] | D | CoA biosynthesis requires cysteine, pantothenate (vitamin B5), and adenosine triphosphate (ATP).it is naturally synthesized from pantothenate (vitamin B5), which is found in food such as meat, vegetables, cereal grains, legumes, eggs, and milk.Pantothenate (vitamin B5) is phosphorylated to 4'-phosphopantothenate by the enzyme pantothenate kinase (PanK; CoaA; CoaX). This is the committed step in CoA biosynthesis and requires ATP.A cysteine is added to 4'-phosphopantothenate by the enzyme phosphopantothenoylcysteine synthetase (PPCS; CoaB) to form 4'-phospho-N-pantothenoylcysteine (PPC). This step is coupled with ATP hydrolysis.PPC is decarboxylated to 4'-phosphopantetheine by phosphopantothenoylcysteine decarboxylase (PPC-DC; CoaC)4'-phosphopantetheine is adenylylated (or more properly, AMPylated) to form dephospho-CoA by the enzyme phosphopantetheine adenylyl transferase (PPAT; CoaD)Finally, dephospho-CoA is phosphorylated to coenzyme A by the enzyme dephosphocoenzyme A kinase (DPCK; CoaE). This final step requires ATP. | train | med_mcqa | null |
Which of the following is an approach in health education: | [
"Regulatory approach",
"Service approach",
"Educational approach",
"All of the above"
] | D | Approaches in Health Education:
Regulatory approach
Service approach
Educational approach
Primary Health Care approach | train | med_mcqa | null |
Which of the following alpha-blocker drug is used in the treatment of benign hypertrophy of prostate without producing significant hypotension? | [
"Dexazosin",
"Phentolamine",
"Terazosin",
"Tamsolusin"
] | D | Ans. d (Tamsulosin). (Ref. KD Tripathi 6th/pg. 135)DRUG USED FOR BHP# Alpha-adrenergic blockers:- Terazosin,- Tamsulosin,- Doxazosin:# A 5-a reductase inhibitor - finasteride- Finasteride prevents conversion of testosterone to dihydrotestosterone.# Cyproterone acetate (Anti-androgenic drug) is used for medical castration.Terazosin# It is reversible al-selective antagonist that is effective in hypertension;# It has also been approved for use in men with urinary symptoms due to BPH.# Terazosin has high bioavailability# But is extensively metabolized in liver (only a small unchanged fraction excreted in urine)# The half-life of terazosin is 9-12 hours.Doxazosin# Is efficacious in the treatment of hypertension and BPH.# It differs from prazosin and terazosin in having a longer half-life of about 22 hours.# It has moderate bioavailability and is extensively metabolized, with very little parent drug excreted in urine or feces.# Doxazosin has active metabolites, although contribution to the drug's effects is probably small.Tamsulosin# It is an uroselective a1A/1D antagonist with a structure quite different from that of most other al-receptor blockers.Q# It has high bioavailability and a long half-life of 9-15 hours.# It is metabolized extensively in the liver.# Tamsulosin has higher affinity for alA and alD receptors than for the alB subtype.# The drug's efficacy in BPH suggests that the alA subtype may be the most important subtype mediating prostate smooth muscle contraction.# Furthermore, compared with other antagonists, tamsulosin has less effect on standing blood pressure in patients (causes minimal vascular side effects).# Dizziness and retrograde ejaculation are the only vital side-effects.Alfuzosin# is an al-selective quinazoline derivative that has also been shown to be efficacious in BPH. It has bioavailability of 60%, is extensively metabolized, and has elimination halflife of about 5 hours.Indoramin# It is another al-selective antagonist that also has efficacy as an antihypertensive.Urapidil# It is an al antagonist (its primary effect) that also has weak 2-agonist and 5-HTlA-agonist actions and weak antagonist action at al receptors.# It is used in Europe as an antihypertensive agent and for benign prostatic hyperplasia. | train | med_mcqa | null |
Paradoxical suicide is | [
"Suicide seen in caretakers of depression",
"Suicide seen in children of depressed individuals",
"Suicide seen in parents of depressed individuals",
"Suicide seen after initiation of treatment"
] | D | "Paradoxical suicide": Antidepressants to patients cures the motor symptoms first followed by mood, hence the patient after initiation of antidepressants become active enough and may commit suicide. | train | med_mcqa | null |
Which of the follwoing statements is false regarding simple benign febrile seizures? | [
"It is the commonest seizure disorder of childhood",
"Has no genetic predisposition",
"Commonly occurs between 6 months to 1 year of age",
"It is usually a generalised tonic clonic seizure"
] | B | Studies have mapped the febrile seizure gene to chromosome 19p and 18q. An autosomal dominant inheritance pattern is demonstrated in some families. Reference: 1. O P Ghai, 5th Edition, Page 407 2. Nelson, 17th Edition, Page 2310 | train | med_mcqa | null |
Progressive cognitive impairment in Alzheimer's disease is characterized by - | [
"Nominal aphasia",
"Recent memory loss",
"No behavioral abnormalities",
"All"
] | B | Alzheimer's disease is characterized by early impairment of recent memory. | train | med_mcqa | null |
Lipids are transferred from intestine to liver by | [
"Chylomicrons",
"VLDL",
"HDL",
"LDL"
] | A | . | train | med_mcqa | null |
Drug indicated in case of subarachnoid hemorrhage: | [
"Nimodipine",
"Amlodipine",
"Diltiazem",
"Verapamil"
] | A | Ans. A. NimodipineNimodipine is cerebro selective calcium channel blocker. Given in patients with hemorrhagic stroke. Nicardipine also have similar effects. This drugs reverse the cerebral vasospasm. | train | med_mcqa | null |
Sun-ray appearance is characteristic of | [
"Osteoclastoma",
"Osteosarcoma",
"Ewing's sarcoma",
"Osteoid osteoma"
] | B | Osteosarcoma is the second most common, and a highly malignant primary bone tumour. Sun-ray appearance: In X-ray, as the periosteum is unable to contain the tumour, the tumour grows into the overlying soft tissues. New bone is laid down along the blood vessels within the tumour growing centrifugally, giving rise to a 'sun-ray appearance' on the X-ray. Reference: Maheshwari; Essential Ohopaedics; 9th ed Page no: 240 | train | med_mcqa | null |
Structure related to ligamentum arteriosum - | [
"Left recurrent laryngeal nerve",
"Right recurrent laryngeal nerve",
"Internal carotid artery",
"External carotid artery"
] | A | Ans. is 'a' i.e., Left recurrent laryngeal nerve Recurrent laryngeal nerveso Recurrent laryngeal nerves (right and left) are branches of inferior ganglion of vagus nerve.o On right side it arises in the root of neck and winds around first part of right subclavian artery. It may be anterior (superficial) or posterior (deep) to inferior thyroid artery.o On left side it arises in thorax (superior mediastinum) and wind's around the arch of aorta immediately behind the attachment of ligamentum arteriosum. It is usually posterior (deep) to inferior thyroid artery or between its branches.o Recurrent laryngeal nerve supplies all intrinsic muscles of larynx (except cricothyroid) and mucous membrane of larynx below vocal fold. It also gives branches to deep cardiac plexus, trachea, esophagus and inferior constrictiono Inferior thyroid artery is ligated away from gland to avoid injury to nerve. Left nerve is more liable to damage. | train | med_mcqa | null |
Which of the following Non invasivemethod is used in detecting position of the tubes in ventilation | [
"Oximatry",
"Capnograph",
"PCB tube",
"ECG"
] | B | (Capnograph): (192- Davidson 21st edition)CAPNOGRAPHY - The CO2 concentration in inspired gas is zero, but during expiration-after clearing the physiological dead space. It rises progressively to reach a plateau which represents the alveolar or end tidal CO2 concentration. This cyclical changes in CO2 concentration or Capnogram is measured using an infrared sensor inserted between the ventilator tubing and the endotracheal tube. In normal lungs, the end tidal CO2 closely mirrors Paco2 and can be used to assess the adequacy of alveolar ventilation. However its use is limitedas there may be marked discrepancies in lung disease or impaired pulmonary perfusion (eg due to hypo volaemia) In combination with the gas flow and respiratory cycle data from ventilator. CO2 production and hence metabolic rate may be calculated.In clinical practice end tidal CO2 is used to confirm correct placement of an endotacheal tube, in the management of head injury, and during the transport of ventilated patients. | train | med_mcqa | null |
"Learned behavior which has been socially acquired" is called - | [
"Culture",
"Custom",
"Acculturation",
"Euthenics"
] | A | Culture is defined as Learned behavior which has been socially acquired Acculturation means culture contact , when there is contact between two people with different types of culture, there is diffussion of culture both ways The mere existence of a society, the mere pluralityof individuals gives rise to customs from which no single member of the community can escape Euthenics ; the mere improvement of genotype is no use unless the improved genotypes is given acces to suitable environment,this environmental manipultion is called as euthenics ref ;(page no;828,671)23rd edition of PARK&;s textbook of Preventive and Social medicine | train | med_mcqa | null |
In obstruction of the large gut rupture occurs at the | [
"Cecum",
"Ascending colon",
"Transverse colon",
"Descending colon -"
] | A | null | train | med_mcqa | null |
All of the following are seen in polycythemia rubra vera except - | [
"Increased Vit B12, binding capacity (>9000 micromols/dL)",
"Decreased LAP score",
"Leucocytosis",
"Increased platelets"
] | B | null | train | med_mcqa | null |
The most common mode of transmission of Pasteurella multocida is - | [
"Animal bites or scratches",
"Aerosols or dust",
"Contaminated tissue",
"Human to human"
] | A | null | train | med_mcqa | null |
A 24-year-old woman presents with foot and leg weakness that is progressively getting worse over the past 1 week. Initially, she developed tingling in her feet and noticed that they would drag, but now she has difficulty standing and walking due to the leg weakness. Three weeks ago she had a "chest cold," which resolved on its own. On examination, muscle bulk is normal, motor strength is 2 out of 5 in the quadriceps, and 1 out of 5 in the feet. Reflexes at the ankle and knee are absent, and sensation testing is normal. The upper limb examination is normal. The CSF protein is very high, glucose is normal, and cell count is slightly elevated. Which of the following is the most likely diagnosis? | [
"diabetic neuropathy",
"alcoholic neuropathy",
"Guillain-Barre syndrome",
"cyanide poisoning"
] | C | Guillain-Barre syndrome often appears days to weeks after a viral upper respiratory or gastrointestinal (GI) infection. The initial symptoms are due to symmetric limb weakness. Paresthesia may be present. Unlike most other neuropathies, proximal muscles may be affected more than distal muscles early in the disease. Tendon reflexes are usually lost within a few days. Protein content of the CSF is usually high within a few days of onset. Diabetic and alcoholic neuropathy do not have an acute onset type presentation as this patient did. Cyanide poisoning can cause paralysis, but it is generalized not just localized to the lower limbs. | train | med_mcqa | null |
Which of the follow ing lesion is characteristic of diabetic nephropathy? | [
"Hyaline arteriosclerosis",
"Nodular glomerulosclerosis",
"Renal Amyloid deposits",
"Fibrinoid necrosis"
] | B | Ans: B (Nodular glomerulosclerosis) Ref: Robbins Pathologic Basis of Disease, 8th editionExplanation:Diabetic NephropathyThe term diabetic nephropathy is applied to the conglomerate of lesions that occur in the diabetic kidney.Most common lesions involve the glomeruli and are associated clinically with three glomerular syndromes;Non-nephrotic proteinuriaNephrotic syndromeChronic renal failureDiabetes also affects the arterioles (causing hyalinizing arteriolar sclerosis), increases susceptibility to the development of pyelonephritis and particularly papillary necrosis, and causes a variety of tubular lesions.The morphologic changes in the glomeruli includeCapillary basement membrane thickeningDiffuse mesangial sclerosisNodular glomerulosclerosis (Kimme- Istiel-Wilson lesions). Expansions non-coding regionsDiseaseProteinRepeatingSequenceSpinobulbar muscular atrophy (Kennedy Disease)Androgen ReceptorCAGHuntington DiseaseHuntingtonCAGDentatorubral-palidoluysian atrophy (Haw River Syndrome)Atrophin - 1CAGSpinocerebellar ataxia type 1Ataxin 1CAGSpinocerebellar ataxia type 2Ataxin-2CAGSpinocerebellar ataxia type 3 (Machado Joseph Disease)Ataxin 3CAGSpinocerebellar a taxia type 6Alpha 1a-Voltage-dependant calcium channel subunitCAGSpinocerebellar ataxia type 7Ataxin-7CAGThe morphology is identical in type 1 and type 2 diabetesThe Armanni-Ebstein change tor Armanni- Ebstein cells) consists of deposits of glycogen in the tubular epithelial cells (pars straight of proximal convoluted tubule and loop of Henle). | train | med_mcqa | null |
Drug having analgesic and moderate anti-inflammatory property: | [
"Paracetama!",
"Nimusulide",
"Ketorolac",
"Diflunisal"
] | C | Ans; c (Ketorolac) Ref: Tripathi, 6th ed, p. 194Ketorolac has potent analgesic and modest anti-inflammatory action. It is rapidly absorbed after oral and IM administration. It is commonly used to relieve mild to moderate post surgical pain.Nimusulide-The analgesic, antipyretic, and anti-inflammatory action of nimesulide has been rated comparable to other NS AlDs. It has been primarily used for short lasting painful inflammatory conditions.Paracetamal- (acetoaminophen) It is an active metabolite of phenacetin and is responsible for its analgesic effect. It has no significant anti-inflammatory effects.In therapeutic doses, a mild increase in hepatic enzymes may occasionally occur in the absence of jaundice; this is reversible if drug is withdrawn. Ingestion of 15 grn of acetoaminophen may be fatal, death being caused by severe hepatotoxicity with centrilobular necrosis, sometimes associated with acute renal tubular necrosis. Doses more than 4g/d are not recommended and a history of alcoholism contraindicates even this dose.Diflunisal-It is derived from salicylic acid. Analgesic and anti- inflammatory effects are 4--5 times more potent than aspirin.lt undergoes an enterohepatic cycle with reabsorption of its glucoronide metabolite followed by cleavage of the glucoronide to again release the active moiety. | train | med_mcqa | null |
The infectivity of chicken pox lasts for | [
"Till the last scab falls",
"6 days after onset of rash",
"3 days after onset of rash",
"Till the fever subsides"
] | B | Period of communicability: Chicken pox: 1-2 days before to 4-5 days after appearance of rash. Measles: 4 days before to 5 days after appearance of rash. Diphtheria: 14-28 days from disease onset Poliomyelitis: 7-10 days before and after onset of symptoms. CHICKEN POX: Also known as &;Varicella&; Causative agent: Varicella Zoster Virus (Human (alpha) Herpes Virus-3) Secondary attack rate: 90% Incubation period : 14-16 days. Rash : Chicken Pox rash Small pox Rash Dew drops on rose petal appearance Centripetal distribution Pleomorphic rash No dew drop Centrifugal distribution Non-pleomorphic MC late complication of chicken pox: Shingles (caused by reactivation of the virus decades after the initial episode of chicken pox) Aspirin must not be given to children with chicken pox: Risk of Reye Syndrome. Strain of live attenuated chicken pox vaccine: OKA strain Congenital Varicella: Most threatening if transmitted in 1st trimester of pregnancy. Ref: Park 25th edition Pgno: 157 | train | med_mcqa | null |
Trident hand is seen in - | [
"Achondroplasia",
"Mucopolysaccharidosis",
"Diphyseal achlasia",
"Cleidocranial dystosis"
] | A | Ans. is "a* i.e., Achondroplasia o Trident hand is seen in achondroplasia.Important radiological featuresDiseaseo Trident Hando Champagne glass pelviso Scottish terrier dog orScottish dog wearing a col loro Be-headed scotty dog signo Inverted napoleon's Hat signo Gulfs wing appearanceo Opera glass deformityo Cup and pencil deformityo Chondrocalcinosiso Bamboo spineo Trolly tract signo Dagger signo Licked candy stick appearanceo Lincoin - Log appearance of vertebraeo Flowing candle wax or molten wax appearance o Marble bone diseaseo Flowing candle wax appearanceAchondroplasiaAchondroplasiaOblique x-ray of ofSpondylolysisSpondylolisthesisSpondylolisthesisPsoriatic arthritisPsoriatic arthritisPsoriatic arthritisPseudogout (CPPD)Ankylosing spondylitisAnkylosing spondylitisAnkylosing spondylitisLeprosySickle cell anemiaMelorheostosisOsteopetrosisDISH (Foresteier's disease) | train | med_mcqa | null |
A 48 year old man with an onset of macules and papules, ulcers and eschars on the upper and lower extremities, hands, genitals, face, as well as nasal and oral mucosae. The rash was accompanied by severe malaise, fever, ahralgia, paraesthesia, and microhematuria. Cryoglobulins and high titers of circulating immune complexes were noted. Steroid treatment was instituted together with plasmapheresis with good results. This is most likely secondary to: | [
"Aerial ulcer",
"Venous ulcer",
"Neurotrophic ulcer",
"Vasculitic ulcer"
] | D | vasculitic ulcer * Significantly elevated antinuclear antibodies, rheumatoid factors, or other more specific immunologic tests may tend to suppo the diagnosis of vasculitic process. | train | med_mcqa | null |
According to the Bismuth / Strasberg classification 'Cystic blow out' is classified as: | [
"Type A",
"Type B",
"Type C",
"Type D"
] | A | Cystic blow out' is a type of biliary duct injury in cholecystectomy patient. According to Strasberg classification it falls into Type A injury. Ref: Complication in Surgery By Michael W. Mulholland, Gerard M. Dohe, 2nd Edition, Page 432 | train | med_mcqa | null |
The diagnositc test for cerebral cysticercosis | [
"MRI",
"Non contrast CT scan",
"Contrast CT scan",
"Plain x-ray"
] | B | null | train | med_mcqa | null |
All are side effects of steroids except | [
"Skin atrophy",
"Telangiectasia",
"Folliculitis",
"Photosentivity"
] | D | Refer KDT 6/e p 855 Steroids are used for treatment of Photosentivity Other effects like skin atrophy Telangiectasia Folkiculitis Can be caused by steroids | train | med_mcqa | null |
Mechanism of action of spermicide is : | [
"Activating acrosomal enzyme",
"Inhibit glucose transpo enzyme",
"Disrupting cell membrane motility",
"Vaginal enzyme alteration"
] | C | Disrupting cell membrane motility | train | med_mcqa | null |
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