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 |
|---|---|---|---|---|---|---|
Newly married couple comes to OPD for preconception counselling . Both husband and wife are achondroplastic dwarfs. Which of the following should NOT be counselled to the couple? | [
"Intelligence of the child is not affected",
"Delivery would most likely require C-section",
"There is a 50 % chance of baby having normal stature",
"Inheritence is autosomal dominant"
] | C | Achondroplasia: Autosomal dominant inheritance, intelligence is typically normal. Most common non lethal skeletal dysplasia. 98 percent of cases are due to a specific point mutation in the FGFR3 gene 80 percent of cases result from a new mutation Characterized by long bone shoening that is predominantly rhizomelic, an enlarged head with frontal bossing, depressed nasal bridge, exaggerated lumbar lordosis, and a trident configuration of the hands. Condition is usually not diagnosed until late in pregnancy. When both parents have heterozygous achondroplasia (as in this case as homozygous achondroplasia is mostly lethal), there is a 75 % chance of the fetus being affected (25 % would be lethal homozygous and 50% would be affected heterozygous achondroplasia) and 25 % chance of fetus being normal. Father Aa x mother Aa A a A AA (lethal homozygous affected) Aa (non lethal heterozygous affected) a Aa ( non lethal heterozygous affected) aa (unaffected) The fetus can be homozygotes (which is 25 percent of the offsprings of heterozygous parents) the condition is characterized by greater long bone shoening and is lethal Affected women almost always require C- section because of the distoed shape of the pelvis | train | med_mcqa | null |
Platelets transfusion must be completed in how many hours after entering the bag | [
"1 hour",
"2 hour",
"3 hour",
"4 hour"
] | D | Answer- D. 4 hour Once the blood bag is opened hy puncturing one of the sealed pos, the platelets must be administered within 4 hours | train | med_mcqa | null |
The main mechanism of hyperpyrexia induced by atropine is? | [
"Vasodilation",
"inhibition of sweating",
"Through central actions",
"Increase in basal metabolic rate"
] | B | Ref:KD Tripathi pharmacology 7th edition (page.no: 115) Rise in body temperature by Atropine occurs at higher doses. It is due to both inhibition of sweating as well as stimulation of temperature regulating centre in the hypothalamus. | train | med_mcqa | null |
Wisdom tooth erupts at which age - | [
"6-8 years",
"10-12 years",
"12-15 years",
"17-20 years"
] | D | Ans. is 'd' i.e., 17-20 years o Wisdom teeth are permanent third molarsEruption of temporary teeth(Primary dentition)ToothAge in range (months)Average age (months)Lower CI6-87Upper CI7-98Uppler LI7-98Lower LI10-12111 molar12-1413Canine17-1817[?]5II molar20-3025 Eruption of permanent teeth(Secondary dentition) Age in range (year)Average age (year)First m olar6-76[?]5Central incisor7-87Lateral incisor8-98First PM9-1110Second PM10-1211Canine11-1211[?]5Second molar12-1413Third molar17-2517 | train | med_mcqa | null |
Bupivacaine toxicity leads to? | [
"Cardiac toxicity",
"Neural toxicity",
"Renal toxicity",
"Hepatic toxicity"
] | A | Ans. is 'a' i.e., Cardiac toxicity * Bupivacaine is the most cardiotoxic local anesthetic.* Has been explained in previous sessions. | train | med_mcqa | null |
In AIDS, lymphadenopathy is most often due to ? | [
"TB",
"Lymphoma",
"Non specific enlargement of lymph node",
"Kaposi's sarcoma"
] | C | Answer is 'c' i.e. Non specific enlargement of lymph node In AIDS, the lymphadenopathy is most often due to the chronic non specific lymphadenitis producing follicular hyperplasia. | train | med_mcqa | null |
All the muscles of the face are supplied by facial nerve except : | [
"Levator anguli oris",
"Corrugator supercilli",
"Leavator palpebrae superioris",
"Risorius"
] | C | C i.e. Levator palpebrae superioris | train | med_mcqa | null |
A 38-year-old woman presents with painless post-coital bleeding. She had a cone biopsy for carcinoma in situ five years ago. Her last pap smear was three months after the biopsy. Her last period was six weeks ago. Most probable diagnosis is | [
"Carcinoma of cervix",
"Ectopic pregnancy",
"Endometrial carcinoma",
"Uterine fibroids"
] | A | The recurrence of abnormal vaginal bleeding in a patient with a previous history of a cone biopsy would raise concerns of carcinoma of the cervix.Her last smear was nearly five years ago, indicating she defaulted from follow-up after her cone biopsy.Six weeks amenorrhoea might raise concerns about an ectopic pregnancy but the absence of pain makes this unlikely.It would always be wise to perform a pregnancy test and scan if in any about. | train | med_mcqa | null |
An eye surgery was performed using propofol as the intravenous anaesthetic agent succinylcholine as the muscle relaxant. Recovery from anaesthesia was uneventful. However the patient complains of pain in the muscles. Which of the following is thelikely reason for this? | [
"Propofol",
"succinylcholine",
"Muscle infarction",
"None of the above"
] | B | Succinylcholine is the depolarising muscle relaxant. It causes fasciculations that causes muscle pains(myalgia,muscle weakness) | train | med_mcqa | null |
Bonds in cellulose that make it resistant to digestion is: | [
"b1-4",
"a1-6",
"b1-6",
"a1-6"
] | A | Cellulose is the chief constituent of plant cell walls. It is insoluble and consists of b-D -glucopyranose units linked by b,1-4 bonds to form long, straight chains strengthened by cross-linking hydrogen bonds. Mammals lack any enzyme that hydrolyzes the b1 -4 bonds, and so cannot digest cellulose. Ref: Harper 28th edition, chapter 14. | train | med_mcqa | null |
A patient presented with shock and suspecting it due to hypoglycemia. The treatment should be based on- | [
"IV glucose after clinical assessment",
"Urine sugar",
"Blood sugar",
"TV access"
] | C | Severe hypoglycemia, or insulin shock, is a serious health risk for anyone with diabetes. Also called insulin reaction, as a consequence of too much insulin, it can occur anytime there is an imbalance between the insulin in your system, the amount of food you eat, or your level of physical activity . Ref Davidson 23rd edition pg 630 | train | med_mcqa | null |
All are true regarding diphtheria toxin except | [
"Toxins blocks elongation of protein",
"Beta lysogenic strain produces toxin",
"Iron is critical for toxin production",
"Toxic is necessary for local wound infection"
] | D | Virulent strains of diphtheria bacilli produce a very powerful exotoxin. The pathogenic effects of the bacillus are due to the toxin. Almost all strains of gravis and intermedius are toxigenic. The toxin is extremely potent and the lethal dose for a 250 g guinea pig is 0.0001g. The toxin has a special affinity for ceain tissues such as the myocardium, adrenals and nerve endings. Reference: Textbook of Microbiology; Anathanarayan and panicker's; 10th edition; Page no: 240 | train | med_mcqa | null |
True about H. Pylori is all except - | [
"It splits urea & produces ammonia to survive",
"Produces Gastric Ca",
"Gram -ye curved rods",
"Cag-A gene is not associated with-risk of duodenal ulcer"
] | D | null | train | med_mcqa | null |
All are features of a normally decomposed body except - | [
"Greenish discoloration of skin over caecum",
"Blisters over skin",
"Mummification",
"Small miliary skin granules"
] | C | Mummification is not seen in a normally decomposed body. Mummification is a modification of putrefaction and occurs in conditions specially suited for it. | train | med_mcqa | null |
Heterophile agglutination test is? | [
"Heterophile antibody that reacts with the microorganism or cells of unrelated species due to common antigen sharing.",
"Test is performed in hypertonic saline (5%saline) or albumin saline.",
"Coomb, Mourant and Race devised a reagent: Rabbit anti-human gamma globulin.",
"Helps to detect the blood group and f... | A | Ans. A. Heterophile antibody that reacts with the microorganism or cells of unrelated species due to common antigen sharing.Heterophile antibody: An antibody that reacts with the microorganism or cells of unrelated species due to common antigen sharing. e.g. Weil Felix test, Monospot test. | train | med_mcqa | null |
Semen analysis of a patient is given below. Where is the site of block, if there is Azoospermia
Normal semen volume
Fructose present | [
"Testicular",
"Below level of seminal vesicles",
"Above level of seminal vesicles",
"Pituitary"
] | C | null | train | med_mcqa | null |
Salt and Pepper pot appearance of skull seen in: | [
"Hyperparathyroidism",
"Multiple myeloma",
"Hypehyroidism",
"Pseudo hyperparathyroidism"
] | A | * Pepperpot skull is occasionally used in place of salt and pepper skull to describe the typical radiographic appearance of multiple small radiolucent lesions of the skull vault. * In primary hyperparathyroidism, extensive resorption bone in the skull in combination with cystic areas of osteopenia are termed pepper pot skull. * Classically seen in hyperparathyroidism, and is occasionally used (inaccurately) to describe the raindrop skull of multiple myeloma REF : DAVID SUTTON 7 TH ED | train | med_mcqa | null |
Absolute contraindication for IVP is: | [
"Idiosyncrasy to iodine",
"Multiple myeloma",
"Raised blood urea",
"All of the above"
] | A | Ans. Idiosyncrasy to iodine | train | med_mcqa | null |
A 28 year old male presented to you with lower abdominal pain associated with pain in the groin. He also complains of nausea. Elevation of the testis relieves his pain. What is your diagnosis? | [
"Ureteric colic",
"Prostatitis",
"Epididymo orchitis",
"Torsion of testis"
] | C | Here since elevation of testis decreases the pain, it is a case of Epididymo orchitis and manipulation surgery should be performed at the earliest to keep the testis ble. In Torsion testis the pain increseas on elevation of the testis. In prostatitis pain occurs on performing a digital rectal examination. Ref: Bailey, Edition 24, Page - 1406 | train | med_mcqa | null |
True about polio: | [
"Paralytic polio is most common",
"Spastic paralysis seen",
"IM injections and increased muscular activity lead to increased paralysis",
"Polio drops in pulse polio immunisation given only in <3 years old children"
] | C | False 90-95% of polio infections are asymptomatic False Acute flaccid paralysis is seen in Polio & not spastic paralysis True Risk of paralytic polio is increased by tonsillectomy, strenous physical exercise, tooth extraction,Injection (intramuscular) False OPV drops are given to all children less than 5 yr age in pulse polio immunisation | train | med_mcqa | null |
All of the following are true about erythema infectiosum EXCEPT? | [
"Slapped cheek appearance seen",
"Caused by parvovirus",
"Rash initially appears on trunk",
"Known as 'fifth disease'"
] | C | Erythema infectiosum (fifth disease) A benign, self-limited exanthematous illness of childhood, caused by Parvovirus B19 Hallmark is the characteristic rash ("slapped-cheek" appearance). | train | med_mcqa | null |
Pulmonary artery pressure is- | [
"120/80 mm Hg",
"25/0 mm Hg",
"25/8 mm Hg",
"120/0 mm Hg"
] | C | Ans. is 'c' i.e., 25/8 mm Hg Pressures in various portions of CVSo Right ventricle-25/0 mm Hg (systolic/diastolic)o Left ventricle-120/0 mm Hgo Right atrium-2 mm Hgo Left atrium-5mmHgo Aorta-120/80 mm Hgo Pulmonary artery-25/8 mm Hg | train | med_mcqa | null |
True about diphtheria is | [
"Capsulated bacteria causes infection",
"Ratio of carriers and clinical cases is one",
"Gram positive and motile",
"Lysogenic phase causes disease"
] | D | The toxigenicity of the diphtheria bacillus depends on the presence of corynephages(tox+) in it which acts as the genetic determinant controlling toxin production. Non-toxigenic strains may be rendered toxigenic by infecting them with the beta or some other phage. This is known as lysogenic or phage conversion. The toxigenicity remains only as long as the bacillus is lysogenic. When the bacillus is cured of its phage, as by growing it in the presence of antiphase serum, it loses its toxigenic capacity. Reference: Textbook of Microbiology; Anathanarayan and panicker's; 10th edition; Page no: 240 | train | med_mcqa | null |
Oro-oculo-genital syndrome occurs due to | [
"Vit. A deficiency",
"Vit. B1 deficiency",
"Vit. B2 dificiency",
"Nicotininc acid dificiency"
] | C | null | train | med_mcqa | null |
Uremia is not associated with hypeension in which of the following situations? | [
"Renal polyaeritis nodosa",
"Narrowing of the renal aery",
"Renal amyloidosis",
"Hyperplastic aeriolar nephrosclerosis"
] | C | Option A: Polyaeritis Nodosa- Renal Aery aneurysm | Decrease Blood supply to kidney | | GFR | Stimulate RAAS: | Renin (High Renin HTN) Option B: Narrow Renal aery- | Blood supply to kidney | | GFR- stimulate RAAS= | Renal HTN Option C: Renal Amyloidosis- B/L Enlarged Kidneys & present With Nephrotic range proteinuria without |BP. Option D: Hyperplastic Aeriolar Nephrosclerosis- Again | GFR = stimulate RAAS= | Renal HTN | train | med_mcqa | null |
The commonest cause of acute pancreatitis is - | [
"Biliary calculi",
"Alcohol abuse",
"Infective",
"Idiopathic"
] | A | null | train | med_mcqa | null |
H1N1 strain of influenza is responsible for- | [
"Avian influenza",
"Bird flu",
"Swine flu",
"None of the above"
] | C | Ans. is 'c' i.e., Swine flu * Swine flu, also called swine influenza, or pig influenza, is caused by influenza virus.* Incubation period is about 1-3 days and the symptoms of swine flu in humans are similar to most influenza infections, e.g. fever, cough, rhinorrhea, fatigue and headache.* Swine flu is most commonly caused by HJNI inflenza A.* Other influenza virus causing swine flu, occasionally, are H1N2, H2N1, H3N2 and H2N3. | train | med_mcqa | null |
Chromosome mutation can by detected all, except: | [
"Single stranded confirmation polymorphism",
"Di deoxy chain termination method",
"Agarose gel electrophoresis",
"Denaturing gradient gel electrophoresis"
] | C | . Agarose gel electrophoresis | train | med_mcqa | null |
Fejereskov and Thylstrup index is used for | [
"Caries Index in primary teeth",
"Index to measure Fluorosis",
"Gingival Bleeding Index",
"Periodontal Index"
] | B | null | train | med_mcqa | null |
Which type of osteogenesis imperfecta is also known as imperfecta with blue sclera? | [
"Type 1",
"Type 2",
"Type 3",
"Type 4"
] | A | Clinical types of osteogenesis imperfecta:
Osteogenesis imperfecta, type I
Osteogenesis imperfecta tarda
Osteogenesis imperfecta with blue sclerae
Osteogenesis imperfecta congenital; type II
Osteogenesis imperfecta congenital, neonatal lethal
Vrolik type of osteogenesis imperfecta
Osteogenesis imperfecta, progressively deforming, with normal sclerae: type III
Gene map locus 17q21.31-q22,7q22.1
Osteogenesis imperfecta, type IV
Osteogenesis imperfecta with normal sclerae
Ref: Shafer's textbook of oral pathology 7th edition page 699 | train | med_mcqa | null |
Functional basis of ionising radiation depends on: | [
"Functional basis of ionising radiation depends on:",
"Removal of orbital electron",
"Linear energy transfer",
"Adding orbital electron"
] | B | B i.e. Removing orbital electrons | train | med_mcqa | null |
The diagnostic feature of congenital diaphragmatic hernia on prenatal ultrasonography is: | [
"A cyst behind the left atrium",
"Mediastinal shift with normal hea axis",
"Peristalsis in the thoracic cavity",
"Abnormal large abdominal circumference"
] | C | Congenital diaphragmatic hernia are left-sided and posterior in 90 percent, and the most common sonographic finding is repositioning of the hea to the middle or right side of the thorax by the stomach and bowel. With improved technology, visualization of the liver within the thorax is increasingly common. Associated findings include absence of the stomach bubble within the abdomen, small abdominal circumference, and bowel peristalsis seen in the fetal chest. Ref: Cunningham F.G., Leveno K.J., Bloom S.L., Hauth J.C., Rouse D.J., Spong C.Y. (2010). Chapter 16. Fetal Imaging. In F.G. Cunningham, K.J. Leveno, S.L. Bloom, J.C. Hauth, D.J. Rouse, C.Y. Spong (Eds), Williams Obstetrics, 23e. | train | med_mcqa | null |
Stimulation of Gastric Acid Secretion is done by all EXCEPT | [
"Histamine",
"Prostaglandin",
"Gastric distension",
"Gastrin"
] | B | (B) Prostaglandin # Basic Factors Stimulating GASTRIC SECRETION are Acetylcholine, Gastrin, and Histamine.> Acetylcholine released by parasympathetic stimulation excites secretion of pepsinogen by peptic cells, hydrochloric acid by parietal cells, and mucus by mucous cells.> In comparison, both gastrin and histamine strongly stimulate secretion of acid by parietal cells but have little effect on the other cells.# Inhibition of Gastric Secretion by other Post-Stomach Intestinal Factors.> Although intestinal chyme slightly stimulates gastric secretion during the early intestinal phase of stomach secretion, it paradoxically inhibits gastric secretion at other times.> This inhibition results from at least two influences.> Presence of food in the small intestine initiates a reverse enterogastric reflex, transmitted through the myenteric nervous system and extrinsic sympathetic and vagus nerves, that inhibits stomach secretion.> This reflex can be initiated by distending the small bowel, by the presence of acid in the upper intestine, by the presence of protein breakdown products, or by irritation of the mucosa.> Presence of acid, fat, protein breakdown products, hyperosmotic or hypo-osmotic fluids, or any irritating factor in the upper small intestine causes release of several intestinal hormones.> One of these is secretin, which is especially important for control of pancreatic secretion.> Secretin opposes stomach secretion.> 3 other hormones-gastric inhibitory peptide (glucose-dependent insulinotropic peptide), vasoactive intestinal polypeptide, and somatostatin-also have slight to moderate effects in inhibiting gastric secretion. | train | med_mcqa | null |
Endolymph in ear equivalent to | [
"ICF",
"Lymph",
"CSF",
"Blood"
] | A | The inner ear (labyrinth) is made up of two pas, one within the other. The bony labyrinth is a series of channels in the Petros poion of the temporal bone. Inside these channels, surrounded by a fluid called perilymph, is the membranous labyrinth. This membranous structure more or less duplicates the shape of the bony channels. It is filled with a K+rich fluid called endolymph, and there is no communication between the spaces filled with endolymph and those filled with perilymph.Reference: Ganong review of medical physiology 23rd edition Page no; 205 | train | med_mcqa | null |
The protective titre of antitoxin to diphtheria following vaccination is | [
"0.01 IU/ml",
"0.05 IU/ml",
"0.1 IU/ml",
"0.5 IU/ml"
] | A | Active immunization by vaccination with diphtheria toxoid is the key in preventing diphtheria. . Serum antitoxin concentration of 0.01 IU/mL is usually accepted as the minimum protective level. 0.01 IU/mL is considered to provide basic protection and 0.1 IU/ml is considered to provide complete or total protection. | train | med_mcqa | null |
Which is not produced enteroendocrinally | [
"Intrinsic factor",
"Secretin",
"Motilin",
"GIP"
] | A | Enteroendocrinal cells are the hormone secreting cells present in the glands or mucosa of the GIT particularly stomach & intestine. The enteroendocrinal cells present in gastric glands are
G cells- secrete gastrin
Enterochromaffin (EC) cells- secrete serotonin
Enterochromaffin like (ECL) cells- secrete histamine | train | med_mcqa | null |
Granular deposition of IgA at dermal papillae on immunofluorescence is seen in: | [
"Herpes gestationalis",
"Dermatitis herpetiformis",
"Bullous pemphigoid",
"IgA dermatosis of childhood"
] | B | Ans. b. Dermatitis herpetiformis Granular deposition of IgA at dermal papillae on immunofluorescence is seen in dermatitis herpetiformis.Dermatitis Herpetiformis: Diagnosis is confirmed by direct immunofluorescence microscopy of normal appearing or faintly erythematous perilesional skin (adjacent to active lesion), by demonstration of granular deposits of IgA (with or without complements) in papillary dermis** and along the epidermal basement membrane zone (EBMZ)."Dermatitis Herpetiformis (Duhring Disease)* Associated with Subclinical gluten sensitive enteropathy^* Associated with HLA-B8 (60%)/DRW3 (95%) and HLA-DQW2 haplotype (95-100%)* Increased incidence of autoimmune disorders e.g. thyroid abnormalities (mostly hypothyroid), achlorhydria, atrophic gastritis, and antigastric parietal cell antibodies, insulin dependent DM. SLE, Sjogren syndrome, vitiligo, RA. UC, myasthenia and gastrointestinal non Hodgkins Lymphoma.* Dietary gluten sensitivity in DH is associated with IgA endomysial autoantibodies that target tissue transglutaminase.* On direct immunofluorescence, IgA autoantibodies against epidermal transglutaminase and granular deposits of IgA in papillary dermis (dermal papillae),Dermatitis Herpetiformis (Duhring Disease)Clinical Feature:* Most common in 2nd- 4th decade* Intensely (itchy) pruritic0. papulovesicular/urticarial skin ds characterized by lesions symmetrically distributed over extensor surfaces (i.e. elbows, knees, buttocks, back, scalp and posterior neck)0* Primary lesion is a papule, papulovesicles or urticarial plaque.* Because pruritus is prominent, patients may present with excoriation and crusted papules with no observable primary lesion0.* Pruritus may have a distinctive burning or stinging component.Diagnosis:* Lesion biopsy reveal subepidermal blister with neutrophils in dermal papillae i.e. subepidermal bullae with papillary tip abscess0* Diagnosis is confirmed by direct immunofluorescence microscopy of normal appearing or faintly erythematous perilesional skin (adjacent to active lesion), by demonstration of granular deposits of IgA (with or without complements) in papillary dermis0and along the epidermal basement membrane zone (EBMZ)Treatment:* IgA deposits in skin are unaffected by control of disease w ith medication dapsone; but decrease or disappear in patients maintained on long periods on a strict gluten-free diet (treatment of choice).Dapsone (diaminodiphenvlsulfone: Drug of choice), sulfoxone (diasone) and sulfapyridine control but do not cure disease.* Elemental diet (composed of free amino acids, short chain polysaccharides and small amount of triglycerides) without full proteins can alleviate skin disease within few weeks.* Atkins diet with high protein, unlimited fat and low carbohy drate also lead to complete resolution of skin disease | train | med_mcqa | null |
Paramyxoviruses enters the body ? | [
"Blood",
"Respiratory route",
"Conjunctiva",
"Fecal-oral route"
] | B | Ans. is 'b' i.e., Respiratory route Myxoviruses Myxoviruses are enveloped RNA viruses. They are characterized by ability to adsorb on to mucoprotein (affinity for mucin) on erythrocytes causing agglutination of erythocytes. | train | med_mcqa | null |
Endemic disease is defined as - | [
"Disease occuring regularly in expected frequency",
"Disease occuring irregularly",
"Disease occuring in excess of expected freqency",
"Disease affecting a large population"
] | A | Ans. is 'a' i.e., Disease occuring regularly in expected frequency Sporadic - Disease occuring irregularly from time to time.Endemic - Disease occuring regularly in expected frequency.Epidemic - Disease occuring in excess of expected frequency.Pandemic - Epidemic affecting a large proportion of population over a wide geographic area. | train | med_mcqa | null |
Cranial Nerve VIII exits through which of the following ? | [
"Foramen ovale",
"Foramen rotundum",
"Internal accoustic meatus",
"Stylomastoid foramen"
] | C | The Vestibulocochlear nerve emerges from the brain at the cerebellopontine angle and exits the cranium the internal acoustic meatus of the temporal bone. Within the distal aspect of the internal acoustic meatus, the vestibulocochlear nerve splits, forming the vestibular nerve and the cochlear nerve . Ref - Sciencedirect.com | train | med_mcqa | null |
Goniometer is used for : | [
"Amount of vaginal secretions",
"To measure width of genital hiatus",
"Gonococcal colony count",
"Urethrovesical Angle"
] | D | Goniometer It is used to measure baseline urethral angle and maximum strain angle of urethra with a cotton tip swab in place The bladder forms an angle of 100 degree with posterior urethral wall which is also responsible for maintaining urinary continence Ref: Berek and Novak's Gynecology; 15th edition; Chapter 27 | train | med_mcqa | null |
Trendelenberg test is positive in palsy of | [
"Gluteus maximus",
"Gluteus medius",
"Rectus femoris",
"Vastus medialis"
] | B | Ans. is 'b' i.e., Gluteus medius Trendelenberg test : It tests the stability of the hip and paicularly of the abductor mechanism of the limb on which the patient is standing. Principle of the test : Normally when one leg is raised from the ground the pelvis tilts upwaras on that side, through the action of the hip abductors of the standing limb. If the abductors are inefficient they are unable to sustain the pelvis against the body weight and it tilts downwards instead of rising up on the side of the lifted leg. Note that the test is performed with the patients standing on the affected leg. Abductor mechanism : It can be compared with the lever, with the body weight being trying to tilt the pelvis down; the hip joint being the fulcrum and the abductor muscles being the power acting throught the lever arm (from the head of the femur to attachment of the abductor muscles on the greater trochanter - the neck of the femur). Causes of positive trendelenberg test : Any failure of abductor mechanism causes dipping of the pelvic (ASIS) on the normal side. There are three fundamental causes : 1) Paralysis of the abductor muscles (Supplies gluteus medius & minimus) eg. Polio. Paralysis of superior gluteral nerve 2) Marked approximation of the inseion of the abductor muscles to their origin by upward displacement of the greater trochanter ; so that the muscles are slack. eg. Severe coxa vara, dislocation of hip 3) Absence of stable fulcrum & lever arm about which the abductor muscles can act Neck femur fracture Dislocation of hip, Destructruction of head as in Pehe's diseases. | train | med_mcqa | null |
Protractor of scapula is? | [
"Serratus anterior",
"Rhomboidis major",
"Deltoid",
"Pectoralis major"
] | A | Serratus anteriorREF: Gray's anatomy 39th ed p. 829, 830Movements of scapula:MovementMusclesElevationTrapezius and Levator scapularProtractionSerratous anterior and Pectoralis minorRetractionRhomboids and TrapeziusLateral rotationupper trapezius and lower serratousMedial rotationLevator scapulae , Rhomboids and Pectoralis minor | train | med_mcqa | null |
A 40 year old lady with breast cancer has undergone MRM and is on Tamoxifen for 1 year. She now has presents with bleeding per vaginum 4-5 times. What is the probable cause: | [
"Bleeding disorder",
"Endometrial cancer",
"Ovarian cancer",
"Cervical cancer"
] | B | Ans. (b) Endometrial cancerRef: KDT 6th ed. / 304-5* Tamoxifen is selective estrogen receptor modulator (SERM).* It is having agonistic activity at uterine endometrium.Action of TamoxifenAgonistic activityAntagonistic activityUterus: causes proliferation of endometrium - can cause vaginal bleeding as seen in the caseBreast CABone: decrease resorptionBlood vesselsLipid profile: decrease LDL without affecting HDL ->> decrease risk of CAD | train | med_mcqa | null |
A 40-year-old patient is diagnosed with a localized 1 cm infiltrating ductal cancer after a needle core biopsy of the lesion. She is clinical node negative; a lumpectomy and sentinel lymph node biopsy are performed. The patient develops an anaphylactic response during the case. Which of the following substances was the likely causative agent? | [
"Fluorescein",
"99 Tc radiolabeled colloid",
"Isosulfan blue dye",
"Methylene blue dye"
] | C | Both methylene blue or isosulfan (lymphazurin) blue dye can be used for sentinel lymph node identification and have been associated with some allergic reactions. Isosulfan blue has been associated with rare anaphylactic reactions in <1% of patients. Methylene blue can cause skin necrosis if injected too superficially. Fluorenscein and indigo carmine are not given in these surgeries. 99 Tc is given for the lymphoscintigraphy and gamma probe isolation of the sentinel node and has no known anaphylactic reactions. | train | med_mcqa | null |
A baby girl presents with bilateral inguinal masses, thought to be hernias but are found to be testes in the inguinal canals.Which karyoty pe would you expect to find in the child - (AIIMS Nov 04) | [
"46. XX",
"46.XY",
"47,XXY",
"47,XYY"
] | B | Ans. is 'b' i.e., 46, XY o Presence of abdominal or inguinal testis suggests testicular feminisation syndrome.o The characteristic features of these disorders are that they are genotypically male (AT) while phenotypically they are female.o These cases usually present as female with abdominal testis.Prepubertal children with this disorder are often detected when inguinal masses prove to be a testis or when a testis is unexpectedly found during herniorrhapy in phenotypically female.o It is called testicular feminisation syndrome but the name is both stigmatising and inaccurate (the testes do not produce feminising factors).o The preferred name, complete androgen insensitivity syndrome (CAIS) reflects the underlying aetiology,o The cause of androgen insensitivity svndrome is the abnormality of the androgen receptor.o In the fetus with CAIS testes forms normally due to the presence of the (SRY gene) on chromosome Y.o At the appropriate time, these testes secretes anti Mullerian hormone leading to the regression of mullerian ducts. Hence CAIS 'women ' do not have a uterus.o Testosterone is also produced at the appropriate time. However due to the complete inability of the androgen receptor to respond, the external genitalia do not virilise and instead undergo female development.o These patients have vagina instead of penis.o Other areas where testosterone may have important fetal effects, such as \hc brain, will also develop along the female path,o The result is a female (both physically and psychologically) with no uterus, testis present which is found at some point in their line of descent through the abdomen from the pelvis to the inguinal canal.o During puberty, breast development will be normal: however, the effects of androgens will not be seen, so pubic and axillary hair growth will be minimal.o Majority of women with CAIS have shortened vagina, when compared with normal average length of 10-12 cm.o The cause of this lies in the embroyological development of the vagina,* Upper portion of vagina-develops from mullerian ducts* Lower portion of vagina-develops from urogenital sinus. o In CAIS mullerian duct regresses, under the effect of mullerian inhibiting hormone, leaving just the part derived from the urogenital sinus.Clinical features of CAISo Female external genitaliao 46 xy karyotypeo Intrabdominal or inguinal testeso Absent uteruso Primary amenorrhoeao Reduced or absent sexual hair (pubic and axillary)o Norma! breast developmento Vaginal hypoplasia | train | med_mcqa | null |
Osteogenesis imperfecta is due to defect in? | [
"Type I collagen",
"Type II collagen",
"Type II collagen",
"Type IV collagen"
] | A | Osteogenesis imperfecta is due to qualitatively or quantitatively abnormal type I collagen. | train | med_mcqa | null |
Trans-Cervical Endometrial Resection (TCER) is used in A/E : | [
"Endometriosis",
"DUB",
"Carcinoma endometrium",
"Submucous fibroid"
] | B | Ans. is b i.e. DUB Transcervical endometrial resection (Hysteroscopic endometrial ablation) is a technique for management of DUB. Aim of the procedure is to produce a therapeutic Asherman's syndrome and produce amenorrhea. It destroys the endometrium --4 formation of synchea Asherman syndrome --) amenorrhea. It is essential to destroy endometrial functionalis and basalis as well as 3mm of rnyometrial depth. Procedure : After appropriate inspection of the landmarks and endometrial cavity, a wire loop electrode is used to resect several strips of endornyometrium, to a depth of 4mm. Resected tissue is used for pathologic examination and documentation of the absence of cellular atypia. After a few strips are resected initially from the posterior uterine wall, resection of almost all the remaining surface with loop electrode by vaporisation is performed. The procedure should be performed soon after menstruation or the woman should be given progesterone. danazol or GnRH to suppress the endometrium. Result : Sho term and long term studies show amenorrhea rates of 20 - 50%, overall improved bleeding patterns (including amenorrhea) in 85 - 95%, with failure rates of 5 - 10% which requires additional surgery i.e. hysterectomy. Extra Edge: A COG recommends endometrial sampling prior to surgery. Women should with endometrial hyperplasia or cancer Absolution contraindications for endometrial ablation : Genital tract malignancy Women wishing to preserve their feility Pregnancy Expectation of amenorrhea Acute pelvic infection Prior uterine surgery - Classical cesarean delivery, transmural myomectomy -- Uterine size > 12wks Adenomyosis as TCRE causes dysmenorrhea | train | med_mcqa | null |
Genital infection in females presenting with thick curdy or flaky discharge may be: March 2004 | [
"Candidiasis",
"Trichomoniasis",
"Syphilis",
"Gonorrhoea"
] | A | Ans. A i.e. Candidiasis | train | med_mcqa | null |
A 24-year-old woman presents to the emergency department with symptoms of fever, chills and rigors. On physical examination, she looks unwell; the temperature is 39.4degC, blood pressure 100/60 mm Hg, pulse 110/min, and oxygen saturation 95%. There is a 3/6 pansystolic murmur at the right sternal border, which increases with inspiration. Her arms have multiple tattoos and needle marks from injection drug use. Blood cultures (2/2 sets) are positive for S aureus, and she is started on appropriate antibiotics. Her renal function is mildly impaired and her urinalysis is positive for protein, and microscopy reveals red cell casts. Which of the following mechanisms is the most likely explanation for her renal abnormalities? | [
"septic emboli",
"cardiac failure with prerenal azotemia",
"a high level of circulating immune complexes",
"fungal disease"
] | C | Glomerulonephritis, arthritis, and many of the mucocutaneous lesions are secondary to circulating immune complexes. The clinical manifestations of infective endocarditis are a result of three factors: (1) direct infection in the heart, (2) septic emboli, and (3) high levels of circulating immune complexes. Renal emboli cause hematuria and flank pain, but rarely impair renal function. | train | med_mcqa | null |
The blood-air barrier consists of all of the following Except | [
"Alveolar pores",
"A layer of surfactant",
"Type I alveolar cell cytoplasm",
"Fused basal lamina of alveolar and endothelial cells"
] | A | Alveolar pores connect neighboring alveoli and function in equalizing pressure in the alveoli and enable collateral circulation of air. They do not constitute pa of the blood-air barrier. | train | med_mcqa | null |
In thyroglossal cyst, carcinoma which arises is - | [
"Follicular",
"Medullary",
"Papillary",
"Anaplastic"
] | C | null | train | med_mcqa | null |
Which of the following is not true about resuscitation in burns patient? | [
"Ringers lactate is the preferred crystalloid solution",
"Fluid shift from intravascular to extravascular compartment in the burns patient is maximum in the first 24 hrs",
"Quantity of crystalloid needed is calculated using the parkland formula - 6m/Kg body weight per % of the total body surface area burnt",
... | C | Ans. is 'c' i.e., Quantity of crystalloid needed is calculated using the parkland formula-6m/Kg body weight per % of the total body surface area burnt * Proper fluid management is critical to survival in a burn patient.* The hypovolemic shock in burn patient is special in the sense that the total body water remains unchanged in a burn patient. The thermal injury leads to a massive fluid shift from intravascular compartment to the extravascular compartment (interstitial + intracellular) leading to edema formation (in both burned parts and non burned parts of body)* This fluid shift is maximum in the first 24 hrs.* Fluid resuscitation begins with an isotonic crystalloid solution - Ringer's lactate solution (RL) is the preferred solution (Normal saline should be avoided as the volumes required for resuscitation may lead to hyperchloremic metabolic acidosis). The concept behind the continuous fluid resuscitation is that the burn (and/or inhalation injury) drives an inflammatory response that leads to capillary leak; as the plasma leaks into the extra vascular space, crystalloid administration would maintain the intravascular volume.# The quantity of crystalloid needed for adequate resuscitation is determined by Parkland formula i.e. 4 mL/kg per % of TBSA burn. (Note that a number of formulas exist for calculating fluid needs during burn resuscitation, suggesting that no one formula benefits all patients. Parkland is one of the most commonly used formulas)# Half of the calculated fluid is given in first 8 hrs and half in next 16 hrs.* Colloids are given in the next 24 hrs. The reason behind it being the observation that in the initial period, the vascular permeability is so large that even larger protein molecules leak from the capillaries. (But some workers, prefer to use colloids after 8 to 12 hrs, while there are some who use it from the very beginning)* A number of parameters are widely used to assess burn resuscitation, but the most common remain the simple outcomes of blood pressure and urine output. As in any critically ill patient, the target MAP is 60 mmHg to ensure optimal end-organ perfusion. Goals for urine output should be 30 mL/h in adults and 1 to 1.5 mL/kg per hour in pediatric patients.* There is no use of diuretics in burn resuscitation.* Children under 20 kg have the additional requirement that they do not have sufficient glycogen stores to maintain an adequate glucose level in response to the inflammatory response. Specific pediatric formulas have been described, but the simplest approach is to add maintenance IV fluid with glucose supplementation in addition to the calculated resuscitation fluid with lactated Ringer's. | train | med_mcqa | null |
During examination in injury, hair bulbs are crushed. The probable type of wound is | [
"Abrasion",
"Laceration",
"Stab injury",
"Incision"
] | B | HAIR BULBS ARE CRUSHED IN LACERATION Laceration - is the tearing of skin or muscles or mucous membrane caused by a shearing or a crushing force, and produced by application of a blunt force to a broad area of the body. - If the blunt force produces extensive bruising and laceration of deeper tissue, it is called crush injury. | train | med_mcqa | null |
Cause of "bloody" vomitus in a neonate - | [
"Meckel's diveiculum",
"Intussusception",
"Malrotation",
"None"
] | D | Ans. is None Causes of bloody vomitus in neonates --> Stress gastritis, Hemarrhagic disease of newborn, Swallowed maternal blood | train | med_mcqa | null |
Eruption of Mandibular Central incisor occur at | [
"8-9 years",
"6 years",
"19-20 years",
"15-16 years"
] | B | null | train | med_mcqa | null |
Most fulminant fungal meningitis is caused by - | [
"Coccidioides",
"Histoplasma",
"Cryptococcus",
"Mucormycosis"
] | C | null | train | med_mcqa | null |
Law under oath is not necessary in - | [
"Wound ceificate",
"Medical ceificate",
"Postmoem ceificate",
"Expe opinion expressed in a treatise"
] | D | Law under oath is not necessary in expe opinion expressed in a treatise Ref:synopsis of forensic medicine (Dr.K.S.Narayan Reddy), pg no:9,28th edition. | train | med_mcqa | null |
The most common cause of seizures in a patient of AIDS is | [
"Toxoplasmosis",
"Cryptococcal meningitis",
"Progressive multifocal leucoencephalopathy",
"CNS lymphoma"
] | A | Ans. is 'a' i.e., Toxoplasmosis Neurological manifestations of H.I.V. AIDS dementia complex (HIV encephalopathy) is a result of direct effects of HIV on CNS (not an oppounistic disease). It is subcoical dementia. Most common cause of seizures --> Toxoplasma Most common cause of meningitis --> Cryptococcus M.C. cause of focal neurological deficit --> Toxoplasma Toxoplasmosis is the most common CNS infection in AIDS. CNS lymphoma and prograssive multifocal leukoencephalopathy may occur. | train | med_mcqa | null |
In a Pt. with head injury, unexplained hypotension warrants evaluation of : | [
"Upper cervical spine",
"Lower cervical spine",
"Thoracic spine",
"All"
] | B | B i.e. Lower cervical spine In a patient unconscious from a head injury, or facial trauma a fracture cervical spine should be assumed untill proven otherwiseQ. Lower cervical spine fractures and dislocations are more common in incidence and are more commonly associated with spinal cord damage in comparison to upper cervical spine fractures. (d/t lesser spinal canal diameter) Due to vital functions of the nearby neurovascular structures, injuries to the upper cervical spine carry a high liklihood of death. Craniocervical injuries (occipital condyle fracture) may cause palsy of IX, X, XI and XII cranial nerves. Approximately 20% of patients with cervical trauma are hypotensive upon presentation, and most of them are lower cervical spine fractureQ. The hypotension is neurogenic in origin in about 70% of cases and is related to hypovolemia in 30% Neurogenc shock is due to loss of normal vasoconstrictive sympathetic control of the peripheral vasculature thus causing loss of normal sympathetic response to low blood pressure. In distinction from hemorrhagic shock, in which compensatory tachycardiaQ is usually present neurogenic shock results in hypotension accompanied by bradycardiaQ. Differences Neurogenic Shock Hypovolemic Shock As the result of loss of sympathetic outflow As a result of hemorrhage Hypotension Hypotension BradycardiaQ TachycardiaQ Warm extremities Cold extremeties Normal urine output Low urine output Management Treatment of neurogenic shock is pharmacological intervention to augment peripheral vascular tone Fluid - over load from excessive fluid volume administration, typically in treatment of hemorrhagic shock , can result in pulmonary edema in setting of neurogenic shock. So pressure should be restored by a combination of postural maneuvers (Trendelenburg position), judicial fluid infusion & vasopressor - administration. | train | med_mcqa | null |
Which of the following manifestation of rheumatic fever disappears completely ? | [
"Carditis",
"Arthritis",
"Chorea",
"Subcutaneous nodules"
] | B | There is no residual damage in the joint affected by rheumatic arthritis and there is complete resolution. | train | med_mcqa | null |
Cystine is formed from | [
"Arginine",
"Histidine",
"Cysteine",
"Alanine"
] | C | The difference in structure of cysteine and cystine. Two molecules of cysteine are joined together by S--S bond to form one molecule of cystine.Ref: M.N. Chatterjea - Textbook of Biochemistry, 8th edition, page no: 504 | train | med_mcqa | null |
Which of the following is not seen in Von-gierke's disease? | [
"Type lb has defective translocase",
"Patients may present with hypoglycemia and lactic acidosis in the neonatal period",
"Easy bruising and epistaxis can be seen",
"Hyperuricemia is not seen"
] | D | Ans. is 'd' i.e., Hyperuricemia is not seen Type I glycogen storage disease (glucose-6-phosphatase or translocase deficiency, von Gierke's disease)* Type I glycogen storage disease is an autosomal recessive disorder caused by glucose-6-phosphatase deficiency in liver, kidney, and intestinal mucosa.* There are two subtypes of GSDI: type la, in which the glucose-6-phosphatase enzyme is defective, and type Ib, in which the translocase that transports glucose-6-phosphate across the microsomal membrane is defective.* The defects in both subtypes lead to inadequate conversion in the liver of glucose-6- phosphate to glucose and thus make affected individuals susceptible to fasting hypoglycemia.Clinical and laboratory findings* Persons with type I disease may develop hypoglycemia and lactic acidosis during the neonatal period; however, more commonly, they exhibit hepatomegaly at 3-4 months of age.* These children usually have doll-like faces with fat cheeks, relatively thin extremities, short stature, and a protuberant abdomen that is due to massive hepatomegaly. The kidneys are enlarged, but the spleen and heart are of normal size. The hepatocytes are dis- tended by glycogen and fat with large and prominent lipid vacuoles. Despite hepatomegaly, liver enzymes are usually normal or near normal.* Easy bruising and epistaxis are associated with a prolonged bleeding time as a result of impaired platelet aggregation/adhesion.* Hyperuricemia is present.* Hyperlipidemia includes elevation of triglycerides, cholesterol, and phospholipids.* Type Ib patients have additional findings of neutropenia and impaired neutrophil function, resulting in recurrent bacterial infections and oral and intestinal mucosal ulceration.* GSD I patients may experience intermittent diarrhea, which can worsen with age. In GSD lb, it is largely due to loss of mucosal barrier function caused by inflammation. | train | med_mcqa | null |
A study under Australian collaborative trial on steroids use in neonates was done. Which of the following is true – | [
"No difference between placebo & corticosteroid",
"Corticosteroid to children causes behavioural worsening",
"Corticosteroid to children causes reduction in head circumference",
"Corticosteroid to children causes neuro sensitivity degradation"
] | B | The Australian Collaborative Trial of Repeat Dose of Steroids (ACTORDS) conducted as multicentre RCT, in Australia and New Zealand by Crowther, v and colleagues enrolled 982 pregnant women less than 32 weeks to receive either single dose of intramuscular Betamethasone or saline placebo weekly till 32 weeks of gestation or delivery whichever was earlier.
This study showed some short-term benefits in the repeat corticosteroid group with a significant reduction in RDS (33% vs. 41%, RR = 0. 82. There was also the shorter duration of mechanical ventilation, lesser need for oxygen therapy and less severe lung disease.
The mean weight, length and head circumference were not different.
However the weight and head circumference Z scores were lower in the repeat steroid dose group. In the long -term follow up these infants at 18-22 months corrected age there was no difference in growth, major disability or lung disease between the two groups. There was an increased occurrence of attention problems in the repeat steroid group. | train | med_mcqa | null |
Ipsilateral Homogeneous opacification and contralateral mediastinal shift is seen in | [
"Collapse",
"Consolidation",
"Hydrothorax",
"Hemothorax"
] | C | null | train | med_mcqa | null |
Thickness of lead apron is | [
"0.25 mm",
"0.3 mm",
"0.4 mm",
"0.5 mm"
] | D | Thickness of lead apron is 0.5 mm. | train | med_mcqa | null |
Increased thickness of granular layer is found in | [
"Psoriasis",
"Lichen planus",
"Ecthyma gangreosum",
"Intertigo"
] | B | Hypergranulosis is seen in Lichen planus whereas Psariosis is characterized by absent granular layer. | train | med_mcqa | null |
Absolute contraindications for HSG are all except | [
"Pregnancy",
"Pelvic inflammatory disease",
"Mullerian anomalies",
"Genital tuberculosis"
] | C | Absolute contraindication for HSG are
Genital TB
Pelvic inflammatory disease
Pregnancy
Allergy to dye. | train | med_mcqa | null |
Hill-Sachs lesion in recurrent shoulder dislocation is | [
"Injury to humeral head",
"Rupture of tendon of supraspinatus muscle",
"Avulsion of glenoid labrum",
"None of the above"
] | A | A i.e. Injury to humeral head | train | med_mcqa | null |
Clue cells are seen in: (REPEAT 2013) | [
"Bacterial vaginosis",
"Moniliasis",
"Trichomoniasis",
"All of the above"
] | A | Ans: A (Bacterial vaginosis) Ref: Shaw's Textbook of Gynecology 15 th edition pg.131 Explanation: GARDNERELLA VAGINOSIS Alteration in normal vaginal flora A decrease in number of lactobacilli in vaginal discharge - lactobacilli reduce pH and release hydrogen peroxide toxic to other bacteria 100 fold increase in anaerobic bacteria Hemophilus vaginalis, Gardnerella,, Mobiluncus and Mycoplasma hominis--cause Vaginal discharge without discharge White, milky non-viscous discharge, pH of discharge more than 4.5 Whiff Test - Fishy odour when the vaginal discharge is mixed with 109c KOH - due to the release of amino metabolites from various organisms Presence of Clue Cells - epithelial cells with granular cytoplasm caused by gram-negative bacilli adhering on the surface Wet smear, gram stain and culture are investigations Treatment: Metronidazole 500mg bd for 7 days Ampicillin 500mg or cephalosporin 500mg hd for 7 days Tetracycline 500mg 4 times a day Doxycycline 100mg bd Sulphafurazole Ig 4 times daily for 10-14 days Clindamycin 300mg daily for 7 days Clindamycin 2%cream locally Ornidazole 500mg vaginal tablet for 7 days Lacteal is protein free acidifying lactate gel neutralizes vaginal ph 5ml applied for 7 days AMSEL CRITERIA for diagnosing Bacterial Vaginosis Thin, white, yellow, homogeneous discharge Clue cells on microscopy pH of vaginal fluid >4.5 The release of a fishy odor on adding alkali--10% potassium hydroxide (KOH) solution. At least three of the four criteria should be present for a confirmed diagnosis. | train | med_mcqa | null |
Muscle relaxant contraindicated in Renal failure is – | [
"Gallamine",
"d-TC",
"Vecuronium",
"Atracurium"
] | A | null | train | med_mcqa | null |
Strenuous exercise is not done in this glycogen storage disease: | [
"McArdle disease",
"Anderson disease",
"Pompe disease",
"Von Gierke disease"
] | A | Ans. A. McArdle disease* McArdle disease is an AR condition, one of the type V glycogen storage disease.* Enzyme deficient: Myophosphorylase enzyme* Due to enzyme deficiency there is inability to breakdown the muscle glycogen and prevents lactate production.* Patients usually complain of exercise intolerance and muscle pain on exercise. Therefore strenuous exercise is contraindicated.Gycogen-storage diseasesTypeDefective enzymeOrgan affectedGlycogen in the affected organClinical featuresI. Von GierkeGlucose 6-phosphatase or transport systemLiver and kidneyIncreased amount; normal structureMassive enlargement of the liver. Failure to thrive, Severe hypoglycemia, ketosis, hyperuricemia, hyperlipemiaII. Pompea-1, 4-Glucosidase (lysosomal)All organsMassive increase in amount; normal structureCardiorespiratory failure causes death, usually before age 2III. CoriAmylo-1,6-glucosidase (debranching enzyme)Muscle and liverIncreased amount; short outer branchesLike type 1, but milder courseIV. AndersenBranching enzyme (a-1,4 - a -1,6)Liver and spleenNormal amount; very long outer branchesProgressive cirrhosis of the liver. Liver failure causes death, usually before age 2V. McArdlePhosphorylaseMuscleModerately increased amount; normal structureLimited ability to perform strenuous exercise because of painful muscle cramps. Otherwise patient is normal and well developedVI. HersPhosphorylaseLiverIncreased amountLike type 1, but milder courseVII.PhosphofructokinaseMuscleIncreased amount; normal structureLike type VVIII.Phosphorylase kinaseLiverIncreased amount; normal structureMild liver enlargement. Mild hypoglycemiaNote: Types I through VII are inherited as autosomal recessives. Type VIII is sex linked. | train | med_mcqa | null |
Which of the following stain is used to assess tear film integrity:- | [
"Congo red",
"Alcian Blue",
"Rose bengal",
"All of the above"
] | C | Tests for Tear Film and Epithelial Integrity Stains used commonly : -Fluorescein -Rose Bengal -Lissamine green -Rhodhamine Blue Fluorescein Stains exposed basement membrane Stains cornea more than conjunctiva. For diagnosing Filamentary keratitis, measuring TBUT CORNEAL STAINING OF DRY EYE USING FLUORESCEIN STAINING CONJUNCTIVAL STAINING IN DRY EYE USING FLUORESCEIN STAINING. CONJUNCTIVAL VASCULAR TOUOUSITY IS ALSO EVIDENT Rose Bengal Stains dead and devitalised cells Healthy cells protected inadequately by a mucin coating Irritation on instillation Early or mild cases detected more easily with Rose Bengal Stain more visible on conjunctiva than cornea Interpalpebral staining of the nasal and/or inferior paracentral cornea is seen in KCS | train | med_mcqa | null |
5 year old child comes to hospital with history of loose stools but no history of fever or blood in stools. Mother says he is irritable and drinks water if given. On examination eyes sunken and on skin pinch test the skin is retracted within two seconds but not immediately. What will be the appropriate management? | [
"Administer first due of i.v antibiotic and immediately refer to higher centre",
"Give oral antibiotics and ORS and ask the mother to continue the same and visit next day",
"Consider severe dehydration, start i.v fluids, antibiotics and refer to higher centre",
"ORS with zinc for 14 days"
] | D | This child has acute diarrhoea with same dehydration. So, treatment is ORS with zinc for 14 days. | train | med_mcqa | null |
Endodontic surgical triad does not include: | [
"Magnification.",
"Patients compliance.",
"Illumination.",
"Instruments."
] | B | Endodontic surgical triad
Magnification
Illumination.
Instruments. | train | med_mcqa | null |
Regarding xenon all are true except | [
"Inhalational anaesthetic agent with lower blood- gas partition coefficient",
"Attains lower alveolar concentration",
"Faster induction and recovery",
"Least soluble anaesthetic agent in blood."
] | B | Since xenon has lower blood gas partition coefficient, it attains higher alveolar concentration. | train | med_mcqa | null |
Venturi meter is used for – | [
"Measuring amount required for chlorination",
"Measuring air velocity",
"Measuring bed strength in slow sand filter",
"Measuring dissolving capacity of gas"
] | C | null | train | med_mcqa | null |
Wimburger sign is seen in ? | [
"Scurvy",
"Rickets",
"Osteoporosis",
"Osteomalacia"
] | A | Ans. is 'a' i.e., Scurvy Radiological features of scurvy The typical radiological features occur at the ends of long bones, paicularly around knee, i.e. lower end of femur and upper end of tibia. Other common site is proximal end of humerus. Features are - Ground glass appearace of bone Pencil thin coex White line offraenkel --> represents well calcified cailage in metaphysis. Wimburger sign --> white ring surrounding the epiphyseal centres of ossification. Winburger sign is also called ring sign as there is white ring surrounding the epiphyseal centers of ossification. Zone of rarefaction under the white line --> represents a linear break in the bone, proximal and parallel to white line and epiphyseal separation may occur along this line. Lateral pa of this rarefaction is seen as a triangular defect. Palkan spur or lateral spur --> lateral prolongation of white line. During healing phase, subperiosteal hemorrhages become calcified and the affected bone assumes a dumbbell or club shape. | train | med_mcqa | null |
Most common route of transmission of hepatitis C: | [
"IV drug abuse",
"Sexual contact",
"Factor 8 concentrate",
"Feco-oral route"
] | A | Screening of donated blood for HCV antibody has decreased the risk of transfusion-associated HCV infection Persons who inject illegal drugs with non-sterile needles or who sno cocaine with shared straws are at highest risk for HCV infection. In developed countries, most new HCV infections are related to intravenous drug abuse (IVDA). | train | med_mcqa | null |
Specificity of a test refers to its ability to detect- | [
"True positive",
"True negatives",
"False negatives",
"False positive"
] | B | Ans. is 'b' i.e., True negative Sensitivity* It is the ability of a test to identify correctly all those who have the disease, i.e., true positive.Specificity* It is the ability of a test to identify correctly those who do not have the disease i.e., true negative | train | med_mcqa | null |
L.D. bodies are seen in: | [
"Kalahazar",
"Toxoplasmosis",
"Malaria",
"Sleeping sickness"
] | A | null | train | med_mcqa | null |
Commonest source of extradural hemorrhage: UP 09 | [
"Middle meningeal aery",
"Basilar aery",
"Charcot's aery",
"Middle cerebral aery"
] | A | Ans. Middle meningeal aery | train | med_mcqa | null |
Distal clearance in surgery for carcinoma rectum is? | [
"2 cm",
"5 cm",
"10 cm",
"8 cm"
] | A | Ans. is 'a' i.e., 2 cm | train | med_mcqa | null |
Vitreous floaters are seen in | [
"Conjunctivitis",
"Keratitis",
"Anterior Scleritis",
"Posterior uveitis"
] | D | Choroiditis refers to inflammation of the choroid which in most cases also involves the adjacent retina resulting in chorioretinitis. clinical features: -Painless visual symptoms like photopsia -Vitreous Floaters : black spots in front of the eyes - represent the vitreous inflammation - opacities that cast shadows on the retina - can be seen in any condition associated with vitritis - intermediate or posterior uveitis -Micropsia or macropsia -Positive scotoma Fundus examination reveals vitreous opacities with active healed stage of retinitis. Treated by systemic steroids | train | med_mcqa | null |
Which is given to prevent relapse in multiple sclerosis? | [
"IFN-beta",
"Cyclosporine",
"Corticosteroids",
"I FIN-gamma"
] | A | Ans: a (IFN-beta) Ref: Harrison, 16th ed, p. 2467; Davidson, 20th ed, p. 1216Multiple sclerosis is characertised by a triad of inflammation, demylination and gliosis; the course can be relapsing - remitting or progressive.MS is twice more common in females. MS risk correlates with high socioeconomic status. High antibody titres against many viruses have been reported in serum and CSF of MS patients, including measles, herpes simplex, varicella, rubella, Epstein - Barr, and influenza C and some parainfluenza strains.Sensory loss is most common initial symptom followed by optic neuritis.MRI is the investigation of choice. Dawson's fingers corresponds to perivenous demylination seen in MRI in multiple sclerosisFour clinical types of MS are there.The relapsing /remitting type accounts for 85% of cases.DISEASE-MODIFYING TREATMENTS IN MSTreatmentMode of actionCommentInterferon betaImmune modulationIn widespread use for reducing relapse rateGlatiramer acetateImmune modulationSimilar efficacy to interferon betaAzathioprineImmune suppressionSimilar efficacy to interferon betaCyclophosphamideImmune suppression(cytotoxic)Occasionally used in aggressive disease.Not recommended for widespread use (no proven benefit in RCTs)MitoxantroneImmune suppression(cytotoxic)Early trials in aggressive disease (no proven benefit in RCTs)PlasmapheresisImmune modulationOccasionally used in aggressive disease (no proven efficacy in RCTs)Intravenous immunoglobulinImmune modulationOccasionally used in aggressive diseaseMonoclonal antibodies to beta-integrins(e.g. natalizumab)Immune modulation(lymphocyte entry into CNS)Encouraging experimental results (no proven efficacy in RCTs)Monoclonal antibodies to lymphocyte epitopes (e.g. campathl-H)Immune suppression(lymphocyte depletion)Encouraging experimental results (no proven efficacy in RCTs) | train | med_mcqa | null |
HIV post-exposure prophylaxis should be initiated as soon as possible after the exposure within- | [
"1-2 hrs",
"14 hrs",
"18 hrs",
"72 hrs"
] | A | Ans. is 'a' i.e., 1-2 hrs o Anti-retroviral drug for post-exposure prophylaxis should be initiated as soon as possible after the exposure within the first few hours and no later than 72 hours. o So, the best answer here is 1-2 hours (first few hours). The guidelines for post-exposure prophylaxis of HIV are For routine exposures o A combination of two nucleoside reverse transcriptase inhibitors for 4 weeks. For high risk or complicated exposures o A combination of two nucleoside reverse transcriptase inhibitors plus a protease inhibitor for 4 weeks, o In spite of the guidelines regimen B is given for all types of exposure. Note - Anti-retroviral drugs o Nucleoside reverse transcriptase inhibitors - Zidovudin, Stavudine, Lamivudine, Abacavir, Didanosine, Zalcitabin. o Nonnucleoside reverse transcriptase inhibitors - Nevirapine, efavirenz, Delavirdine. o Protease inhibitors - Ritonavir, Indinavir, Nelfmavir, Saquinavir, Lopinavir. | train | med_mcqa | null |
Which of the following best describes adenovirus? | [
"Nonenveloped, double-stranded DNA virus with fibers at its veices",
"Nonenveloped, double-stranded, circular DNA virus",
"Enveloped, single-stranded, negative-sense RNA virus",
"Enveloped, double-stranded, linear DNA virus with glycoprotein spikes"
] | A | . | train | med_mcqa | null |
Transitional cell carcinoma of bladder is associated with- | [
"Schistosomiasis",
"Naphthylamine",
"Smoking",
"All"
] | D | Ans. is 'a' i.e., Schistosomiasis; 'b' i.e., Naphthylamine & 'c' i.e., SmokingRisk factors for transitional cell carcinoma (TCC) of bladder ?I. Smoking ---> Major etiological factor.Occupational exposure to chemicals Nephthylamine benzidine, aniline dyes, acrolein.Schistosoma haematobium (Bilharziasis) ---> It is a risk factor for both TCC & SCC.Drugs --> PhenacetinCyclophosphamide therapyPelvic irradiations | train | med_mcqa | null |
Typhoid ulcer ruptures at | [
"1st week",
"2nd week",
"3rd week",
"4th week"
] | C | C. i.e. (3rd week) (69- 5 B & L 25th) (995- S. Das 5th)* After the second week, signs of peritonitis usually denotes perforation, which is confirmed by the presence of free.gas seen on x-ray (69-.B & L 25th)* Perforation usually occurs during the third week it occurs through ulcerated peyer's patches in the terminal ileum (commonest site)** (995 - S-Das 5th)* Typhoid ulcer are longitudinal (Tuberculous ulcers are transverse)**** Treatment - laparotomy - close the peritoneum and leave the wound open for secondary closure* In typhoid, chronic carriers are those - Urinary carriers with anomaly*** Chronic burrowing ulcer is caused by - Microaerophilic streptococci** | train | med_mcqa | null |
Increasing severity of mental retardation in male members over generations is a result of: | [
"Mitochondrial DNA mutation",
"Frameshift mutation",
"Y-linked disorder",
"Trinucleotide repeat mutation"
] | D | Anticipation Increasing severity of disease in successive generations Trinucleotide repeats cause worsening of clinical features with each successive generation. | train | med_mcqa | null |
What is deposited in Bronze diabetes | [
"Bronze",
"Copper",
"Iron",
"Carbon"
] | C | Answer is option 3 iron overload can also damage pancreas leading to the development of diabetes as diagnosed in this case by the biochemical parameters . This type of diabetes is called "Bronze Diabetes" due to the greyish colour of skin developed from deposition of excess iron. emedicinemedscape.com | train | med_mcqa | null |
Fogo selvagem is a type of: | [
"Pemphigus vulgaris",
"Pemghigus vegetans",
"Pemphigus foliaceus",
"Bullous pemphigoid"
] | C | Endemic pemphigus foliaceus common in rural pas of South America, paicularly ceain states of Brazil is known as fogo selvagem (wild fire) caused by bite of black fly. Ref: Rook's textbook of dermatology, 8th edition, Pg 40.13 | train | med_mcqa | null |
Indications to use Collagen cross linking | [
"Herpes infection",
"Fungal corneal ulcer",
"Pachymetry less than 400 nm",
"Severe dry eye"
] | B | Riboflavin is used in collagen cross linking for keratoconus COLLAGEN CROSS LINKING C3R: Principle: Using riboflavin, we build up collagen cross links and provide cornea the strength to maintain its curvature f/b use contact lenses for few days. UV-A radiation 370 nm is used for 45 minutes. Indication: Keratoconus Post lasik ectasia Fungal corneal ulcer Corneal ectatic disorders CONTRAINDICTION Herpes infection Pachymetry less than 400 nm Severe dry eye | train | med_mcqa | null |
Cholesterol from the liver is transpoed to the peripheral tissue mainly by: | [
"HDL",
"LDL",
"VLDL",
"Chylomicrons"
] | B | Low-density lipoprotein/ LDLIt is one of the five major groups of lipoproteins, which in order of size, largest to smallest, are chylomicrons, VLDL, IDL, LDL, and HDL, that enable transpo of multiple different fat molecules, as well as cholesterol, within the water around cells and within the water-based bloodstream.LDL is often informally called bad cholesterol, (as opposed to HDL paicles, which are frequently referred to as good cholesterol or healthy cholesterol). | train | med_mcqa | null |
Following are the indications for salpinography' expect- | [
"Infertility",
"Pelvic infections",
"Recurrent abortions",
"Abnormal uterine bleeding"
] | B | Ans: B | train | med_mcqa | null |
A herd immunity of over - % is considered necessary to prevent epidemic spread of diphtheria - | [
"50%",
"55%",
"60%",
"70%"
] | D | A herd immunity of over 70% is considered necessary to prevent epidemic spread, but some believe that the critical level may be as high as 90%. | train | med_mcqa | null |
26. Bernoullis theorem explains: | [
"nasal polyp",
"Thyroglossal cyst",
"Zenkers diveiculum",
"Laryngomalacia"
] | A | Bernoulli's phenomenon: Pressure drop next to a constriction causes a suction effect pulling the sinus mucosa into the nose, usually associated with antrochoanal polyps. Nasal polyps follow the Bernoulli's theorem as, the increased speed of the air flowing through the nose decreases the pressure in the nasal cavity, which pulls down the polyp. Ref: Internet sources | train | med_mcqa | null |
Most common presentation of nasopharyngeal carcinoma is? | [
"Neck mass",
"Trotter's triad",
"Ophtalmoplegia",
"Glue ear"
] | A | Ans. is'a'i.e., Neck mass(Ref: Dhingra Sn/e p. 265)Neck mass is the most common presentation (60-90%) due to cervical lymphadenopathy. | train | med_mcqa | null |
Commonest presentation of wilm's tumour is ? | [
"Hematuria",
"Abdomial lump",
"Hydronephrosis",
"Pain in abdomen."
] | B | Ans is 'b' ie Abdominal lump "MC presentation is painless abdominal mass usually discovered by the mother while routinely bathing the baby." | train | med_mcqa | null |
You are surgeon posted at CHC. A patient of head injury come to you with rapidly deteriorating sensorium and progressive dilation and fixation of pupil. Neurosurgeon and CT scan is not available. You decide to make a burr hole to emergently relieve the intracranial pressure. Which of the following sites will you choose | [
"In the temporal region contralateral to the side of pupilary dilatation",
"In the midline if both pupils are equal or it is not known which side dilated first.",
"In the left temporal region if no localising sign is found",
"Refer to higher centre if both pupils are equal or it is not known which side delate... | C | Burr Hole to emergently relieve the intracranial pressure should be done in the left temporal region if no localising sign is found, to evaluate and decompress the dominant hemisphere Choice of side for initial Burr Hole Sta with a temporal Burr hole on the side Ipsilateral to a blown pupil: This will be on the correct side in >85% of epidural hemorrhages and other extra - axial mass lesions If both pupils are dilated, used the side of the first dilating pupil (if known) If pupils are equal, or it is not known which side dilated first, place on side of obvious external trauma If no localisation clues, place hole on left side (to evaluate and decompress the dominant hemisphere) Ref: Ramamuhi and PN Tandon's Textbook of Neurosurgery 3rd edition Vol-1 Pgno :442 | train | med_mcqa | null |
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