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 |
|---|---|---|---|---|---|---|
In the mandibular arch, first preference major connector for tooth-supported RPD is: | [
"Lingual bar.",
"Lingual plate.",
"Kennedy bar.",
"All of the above."
] | A | null | train | med_mcqa | null |
Omalizumab is indicated for which of the following conditions : | [
"Multiple myeloma",
"Psoriasis",
"Bronchial asthma",
"Rheumatoid arthritis"
] | C | null | train | med_mcqa | null |
Nephrogram phase of IVP is because of dye in: | [
"Proximal convoluted tubules",
"Renal pelvis",
"Nephron",
"Collecting tubules"
] | A | Ans. Proximal convoluted tubules | train | med_mcqa | null |
Osteoahritis not seen in ? | [
"Ankle joints",
"Knee joints",
"Hip joints",
"I stmetacarpophalangeal joint"
] | A | Ans. is 'a' i.e., Ankle joints OA affects ceain joints, yet spares others. Commonly affected joints include the cervical and lumbosacral spine, hip, knee, and first metatarsal phalangeal joint (MTP). In the hands, the distal and proximal interphalangeal joints and the base of the thumb are often affected. Usually spared are the wrist, elbow, and ankle. Our joints were designed, in an evolutionary sense, for brachiating apes, animals that still walked on four limbs. We thus develop OA in joints that were ill designed for human tasks such as pincer grip (OA in the thumb base) and walking upright (OA in knees and hips). Some joints, like the ankles, may be spared because their aicular cailage may be uniquely resistant to loading stresses. | train | med_mcqa | null |
Modafinil is approved by FDA for treatment of all except : | [
"Obstructive sleep apnea syndrome (OSAS)",
"Shift work syndrome (SWS)",
"Narcolepsy",
"Lethargy in depression"
] | D | Modafinil (Provigil) :
Modafinil is an oral drug that is used for improving wakefulness in patients with excessive sleepiness.
Modafinil is used to promote wakefulness in patients with excessive sleepiness associated with :
Narcolepsy.
Obstructive sleep apnea/hypopnea syndrome and
Shift work sleep disorder.
The exact mechanism of action of modafinil is not clear. It seems that modafinil increases the release of monoamines specifically the catecholamines (norepinephrine and dopamine) from the presynaptic terminals. However, modafinil also elevates hypothalamic histamine levels (in contrast to amphetamine-like stimulant which only releases catecholamines, but not histamine). | train | med_mcqa | null |
42 yrs old man presented with dizziness on standing, SBP falls by 50 mm Hg and HR is 52/min likely cause is - | [
"CHF",
"Inferior wall MI",
"Pheochromocytoma",
"Theophylline toxicity"
] | B | Cardiac arrest due to bradyarrhythmias or asystole (B/A cardiac arrest) is managed differently. The patient is promptly intubated, CPR is continued, and an attempt is made to control hypoxemia and acidosis. Epinephrine and/or atropine are given intravenously or by an intracardiac route. External pacing devices are used to attempt to establish a regular rhythm. The success rate may be good when B/A arrest is due to ACUTE INFERIOR WALL MYOCARDIAL INFARCTION or to correctable airway obstruction or drug-induced respiratory depression or with prompt resuscitation effos. ref:harrison&;s principles of internal medicine,ed 18,pg no 2245 | train | med_mcqa | null |
6 month old baby with severe pallor and hepatospenomegaly. Similar history with the sibling. Investigation of choice – | [
"Bone marrow biopsy",
"Hb electrophoresis",
"Hb estimation",
"Platelet count"
] | B | null | train | med_mcqa | null |
Relation of renal vein with aorta is - | [
"Anterior , above Superior mesenteric artery",
"Anterior, below Superior mesenteric artery",
"Anterior, below Inferior mesenteric artery",
"Posterior, below Superior mesenteric artery"
] | B | Left renal vein passes behind and below the superior mesenteric artery, crossing in front of the aorta. | train | med_mcqa | null |
With oral iron therapy, rise in hb% can be seen after | [
"1 week",
"3 weeks",
"4 weeks",
"6 weeks"
] | B | The improvement should be evident within 3 weeks of the therapy. After a lapse of few days, the hemoglobin concentration is expected to rise at the rate of about 0.7 gm/100 mL per week. Reference: Textbook of Obstetrics; Sheila Balakrishnan; 2nd Edition; Page no: 287 | train | med_mcqa | null |
All of the following are TRUE about isometric exercises, EXCEPT: | [
"S3,S4 is accentuated",
"Useful in ventricular arrhythmia",
"Increases systemic vascular resistance",
"Diastolic murmur of Mitral stenosis becomes louder"
] | B | Isometric exercise results in transient but sigificant increase in systemic vascular resistance, aerial pressure, hea rate, cardiac output, left ventricular filling pessure and hea size. Patients wit ventricular arrhythmia or myocardial infarction should avoid this as tey can increase their intensity. Isometric exercises can cause, S3,S4 is accentuated Diastolic murmur of Mitral stenosis becomes louder Diastolic murmur of aoic regurgitation,systolic murmur of mitral regurgitation and ventricular septal defect increases. Systolic murmur of aoic stenosis and systolic murmur of hyperophic obstructive cardiomyopathy diminishes. Ref: Primary Cardiology, edited by Eugene Braunwald, 2nd Edition, Page 157. | train | med_mcqa | null |
In school health services the most impoant functionary should be - | [
"School teacher",
"Health worker",
"Medical officer",
"Health assistant"
] | A | In school health services the most impoant functionary is school teacher. REF. PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICAL 21ST EDITION. PAGE NO - 533 | train | med_mcqa | null |
Megaloblastic anaemia is caused by all EXCEPT : | [
"Aspirin",
"Primidone",
"Methotrexate",
"N2O"
] | A | null | train | med_mcqa | null |
Which drug is given in the pain due to diabetic neuropathy? | [
"Lamotrigine",
"Na valproate",
"Gabapentin",
"Morphine"
] | C | Ans. is 'c' i.e., Gabapentin Gabapentin* This is lipophilic GABA derivatve.* Gabapentin enhances GABA release but itself does not act as a agonist at the GABAA receptor.* It crosses to the brain and enhances GABA release but does not act as agonist at GABAA receptor.* Gabapentin is considered to be a first line drug for pain due to diabetic neuropathy and postherpetic neuralgia.Usesi) GTCS and partial seizuresii) Postherpetic neuralgiaiii) Pain due to diabetic neuropathyiv) Prophalaxis of migraine | train | med_mcqa | null |
Which of the following is not an ESTER? | [
"Amethocaine",
"Benzocaine",
"Procaine",
"Bupivacaine"
] | D | Ans. d (Bupivacaine ) (Ref. Lee anaesthesia 12th/ 591 & Anaesthesia by Ajya yadav, 2nd, pg 105)LOCAL ANESTHETIC AGENTSEstersAmidesAll metabolised by pseudocholinesterase except cocaineMetabolised in liverHigh chances of allergic reactionsLow chances of allergic reactionsUntable solutionStable solutionEg: Amethocaine (Tetracaine)BupivacaineBenzocaineEtidocaineCocaineLignocaineChlorprocaineMepivacaineProcainePrilocaineHint: Letter Y appears twice in the name of ail amides, while it appears only once in esters.Local anesthetic agentsSubclassMechanism of ActionEffectsClinical ApplicationsPharmacokinetics, ToxicitiesAmidesLidocaineBlockade of sodium channelsSlows, then blocks action potential propagationShort-duration procedures- epidural, spinal anesthesiaParenteral-duration 30-60 min - 2-6 h with epinephrine - Toxicity: CNS excitationBupivacaineSame as lidocaineSame as lidocaineLonger-duration proceduresParenteral-duration 2-4 h. Toxicity: CNS excitation-cardiovascular collapsePrilocaine, ropivacaine, mepivacaine, levobupivacaine: like bupivacaineEsters ProcaineLike lidocainelike lidocaineVery short proceduresParenteral.duration 15-30 min-30-90 min with epinephrine. Toxicity: Like lidocaineCocaineSame as above also has sympa- thomimetic effectsSame as aboveProcedures requiring high surface activity and vasoconstrictionTopical or parenteral, duration l-2h Toxicity: CNS excitation, convulsions, cardiac arrhythmias, hypertension, strokeTetracaine: Used for spinal, epidural anesthesia, duration 2-3 h | train | med_mcqa | null |
Albuminocytological dissociation is associated with | [
"Guillain-Barre syndrome",
"Subarachnoid haemorrhage",
"Pyogenic meningitis",
"Encephalitis"
] | A | (A) Guillain-Barre syndrome# GUILLAIN-BARRE SYNDROME> Diagnosis of GBS usually depends on findings such as rapid development of muscle paralysis, areflexia, absence of fever, and a likely inciting event.> Cerebrospinal fluid analysis (through a lumbar spinal puncture) and electrodiagnostic tests of nerves and muscles (such as nerve conduction studies) are common tests ordered in the diagnosis of GBS.> Typical CSF findings include albumino-cytological dissociation. As opposed to infectious causes, there is an elevated protein level (100-1000 mg/dL), without an accompanying increased cell count pleocytosis. A sustained increased white blood cell count may indicate an alternative diagnosis such as infection. | train | med_mcqa | null |
Which of the following hazardous chemical is used as anti-knocking agent in gasoline: | [
"Arsenic",
"Asbestos",
"Lead",
"Mercury"
] | C | Another prominent lead product was tetraethyl lead, a gasoline additive invented in 1921 to solve "knocking" problems that had become commonplace with the development of high compression engines operating at high temperatures. Soon after reaching its peak 50 years later, the use of this lead compound declined as the installation of catalytic conveers became mandatory on the exhaust systems of passenger cars and also by environment protection laws. Ref : | train | med_mcqa | null |
A 40-year-old man is brought to the doctor by his family for the rapid intellectual decline. Examination shows fast semi-purposive movements in hands. His father and grandfather had a similar illness. What is the diagnosis? | [
"Pre-senile Dementia",
"Lewy body dementia",
"Coicobasilar degeneration",
"Huntington chorea"
] | D | The fast semi-purposive movements - Chorea. With advancing age chorea reduces and dystonia, rigidity, and myoclonus appear. Huntington's disease has an autosomal dominant pattern of inheritance . The intellectual decline is a common feature. Presenile dementia is seen in Down's syndrome Lewy body dementia presents with hallucinations, delusions, and dementia. Coicobasal degeneration/Alien hand syndrome-Asymmetric dystonia, apraxia (Loss of visuospatial skills), focal limb myoclonus | train | med_mcqa | null |
Sitz Bath consists of which of the following ? | [
"Patient bathed in normal saline",
"Bathed in molten wax",
"Sits in a basin containing warm antiseptic lotion",
"Sits in a basin conatining molten wax"
] | C | Ans. is 'c' i.e., Sits in a basin containing warm antiseptic lotion | train | med_mcqa | null |
which of the following Is not an adverse effect of growth hormone therapy? | [
"Carpal tunnel syndrome",
"Hypoglycemia",
"Intracranial hypeension",
"Slipped femoral epiphysis"
] | B | Hypoglycemia is not an adverse effect of growth hormone therapy. growth hormone or somatotropin cause hyperglycemia by increasing the insulin resistance (REF.Essential of medical pharmacology K D TRIPATHI 6 Edition, Page No 234,235) | train | med_mcqa | null |
Treatment of squamous cell carcinoma of anal canal not involving the deeper structures include | [
"Abdomino pereneal resection",
"Wide local excision + Radiotherapy",
"Wide local excision + Chemoradiation",
"Chemoradiation"
] | D | Anal cancer # Uncommon tumour, which is usually a squamous cell carcinoma # Associated with HPV # More prevalent in patients with HIV infection # May affect the anal verge or anal canal # Lymphatic spread is to the inguinal lymph nodes # Treatment is by chemoradiotherapy in the first instance # Major ablative surgery is required if the above fails Ref: Bailey & Love&;s Sho Practice of Surgery,E25,Page-1269 | train | med_mcqa | null |
Wof is the fastest acting inhaled bronchodilator | [
"Ipratropium bromide",
"Salbutamol",
"Salmeterol",
"Formoterol"
] | B | Salbutamol (Albuterol):- A highly selective b2 agonist when inhaled from pressurized metered dose inhaler (pMDI) produces bronchodilatation within 5 min and the action lasts for 2-4 hours(sho acting,fast acting),therefore used to abo and terminate attacks of asthma, but is not suitable for round-the-clock prophylaxis. side effects:- Muscle tremors are the dose related side effect. Palpitation, restlessness, nervousness, throat irritation and ankle edema can also occur. Hypokalaemia is a possible complication. Formoterol, Salmeterol are long acting B2 agonists, formoterol is fast acting compared to Salmeterol. Ref:- kd tripathi; pg num:- 223 | train | med_mcqa | null |
Structures passing through foramen magnum include all | [
"Spinal accessory nerve",
"Spinal cord",
"Veebral aery",
"Veebral venous plexus"
] | B | B. i.e. Spinal cord Lower pa of medulla oblongata (not the spinal cord)Q passes through posterior pa of foramen magnum, and veebral aeries are transmitted through the subarachnoid space in foramen magnum.Q | train | med_mcqa | null |
At birth, which of the following structures is nearest to the size it will eventually attain in adulthood? | [
"Cranium",
"Mandible",
"Middle Face",
"Nasal capsule"
] | A | Timing of Cranial Base Growth: | train | med_mcqa | null |
Radiosensitive tumor is - | [
"Ewings sarcoma",
"Osteosarcoma",
"Renal cell carcinoma",
"Pancreatic carcinoma"
] | A | Ans. is 'a' i.e., Ewings sarcoma Radiosensitivity of different tumorsHighly sensitiveModerately sensitiveRelative resistantHighly resistanto Lymphomao Seminomao Multiple myelomao Ewings sarcomao Wilm's tumoro Dysgerminomao Small cell carcinoma of lungo Breast cancero Basal cell carcinomao Medulloblastomao Teratomao Ovarian cancero Nasopharyngeal carcinomao Squamous cell carcinoma of lungo Renal cell carcinomao Rectal carcinomao Colon carcinomao Bladder carcinomao Soft tissue sarcomao Cervical carcinomao Melanomao Osteosarcomao Pancreatic cancero Hepatic carcinoma | train | med_mcqa | null |
Sulphur granules are seen in - | [
"Sulphur poisoning",
"Actinomycosis",
"H2SO4 poisoning",
"Staphylococcal infection"
] | B | Ans. is 'b' i.e., Actinomycosis Laboratory diagnosis of actinomycosis* The diagnosis is most commonly made by microscopic identification of sulphur granules (an in-vivo matrix of bacteria calcium phosphate, and host material).* The sulfur granules are bacterial colonies and will be found to consist of a dense network of thin Gram positive filaments, surrounded by a peripheral zone of swollen radiating club shaped structures, presenting a sun ray appearance. The 'clubs' are believed to be antigen - antibody complexes. Colonies resemble a molor tooth.* Granules of actinomyces are yellow colored.* Diagnosis can also be made by isolation of actinomyces in culture. The culture media used are :# Thioglycollate liquid medium# Brain heart infusion agar* In thioglycollate:# A. bovis produces general turbidity# A. israelic grows as fluffy balls at the bottom of the tube.* On solid media :# A. isralii produces small spidery colonies.# A. isralii produces colonies which give a bread crumb appearance. | train | med_mcqa | null |
An infant with severe respiratory distress is found to have double aoic arch during investigation. Double aoic arch is due to persistence and continued patency of the segment of ? | [
"Right dorsal aoa between the right seventh intersegmental aery and its junction with the left dorsal aoa",
"Right dorsal aoa between the right sixth intersegmental aery and its junction with the left dorsal aoa",
"Left dorsal aoa between the right seventh intersegmental aery and its junction with the left dors... | A | Aoic arch development involves the sequential development and then involution of six arch pairs, which arise from paired dorsal aoae that fuse distally. The fifth aoic arch is rudimentary. Double aoic arch is the result of persistence and continued patency of the segment of the right dorsal aoa between the origin of the right seventh intersegmental aery and its junction with the left dorsal aoa. Ref: Keller B.B., Markwald R.R., Hoying J.B. (2011). Chapter 9. Molecular Development of the Hea. In V. Fuster, R.A. Walsh, R.A. Harrington (Eds), Hurst's The Hea, 13e. | train | med_mcqa | null |
Flail chest which of the following is not true - | [
"It can be life threatening",
"Three or more ribs should be broken at two or more places",
"The flail segment moves opposite to the chest wall",
"Work of breathing is not increased"
] | D | Ans. is 'd' i.e., Work of breathing is not increased Flail chest* Flail chest is a life-threatening medical condition that occurs when a segment of the rib cage breaks under extreme stress and becomes detached from the rest of the chest wall. It occurs when multiple adjacent ribs are broken in multiple places, separating a segment, so a part of the chest wall moves independently.* The number of ribs that must be broken require three or more ribs in two or more places.* Some sources quote 2 or more ribs at 2 or more places.* The flail segment moves in the opposite direction to the rest of the chest wall: because of the ambient pressure in comparison to the pressure inside the lungs, it goes in while the rest of the chest is moving out, and vice versa. This so-called "paradoxical breathing" is painful and increases the work involved in breathing. | train | med_mcqa | null |
Glyeaemic control in diabetes is best assessed by: | [
"HbAIC",
"Urinary glucose",
"Fasting glucose",
"Post prandial glucose"
] | A | Answer is A (HbAl C): Measurment of Glycated Hemoglobin (HbAlC) is the standard method of assessing long term glycaemic control. HbA IC should be measured in all individuals with Diabetes Mellitus as pa of their comprehensive diabetic care. | train | med_mcqa | null |
This is a sonogram demonstrating CRL of an 8 weeks fetus. The arrow in the field points to which of the following? | [
"Blighted ovum",
"Pseudo-gestational sac",
"Yolk sac",
"Gestational sac"
] | C | The above USG image shows Anaechoic (black) gestational sac with an embryo and yolk sac (arrow). The yolk sac is seen as a small well-defined anaechoic structure in side the Gestational sac.Presence of yolk sac or fetal pole within the gestation sac confirms pregnancy. Double decidua sign of the gestational sac is due to the interface between the decidua and the chorion, which appears as two distinct layers of the wall of the gestation sac. | train | med_mcqa | null |
A random sample suggests that | [
"A person in a control group will not be a member of the experimental group",
"Any member of a group to be studied has an equal opportunity to be included in the study",
"Every nth name on a list is selected",
"Subjects are volunteers"
] | B | null | train | med_mcqa | null |
Trisomy 21 is ? | [
"Down's syndrome",
"Turner syndrome",
"Kleinfelter syndrome",
"Edward syndrome"
] | A | Ans. is 'a' i.e., Down's syndrome | train | med_mcqa | null |
Penile ulcer is painful in: | [
"Syphilis",
"LGV",
"Donovanosis",
"Chancroid"
] | D | Ans. is. 'd' i. e., Chancroid | train | med_mcqa | null |
Centre of air pollution control by WHO - | [
"Hyberabad",
"Bombay",
"Nagpur",
"Kanpur"
] | C | International action : To deal with air pollution on a world-wide scale, the WHO has established an international network of laboratories for the monitoring and study of air pollution. The network consists of two international centres at London and Washington, three centres at Moscow, Nagpur and Tokyo and 20 laboratories in various pas of the world . These centres will issue warnings of air pollution where and when necessary Ref: Park 25th edition Pgno : 774 | train | med_mcqa | null |
Organisms associated with fish consumption and also causes carcinoma Gallbladder | [
"Gnathostoma",
"Anglostrongyloidosis cantonensis",
"Clonorchis sinensis",
"H.dimunata"
] | C | Clonorchis sinensis Clonorchis sinensis is a liver fluke, acquired by Ingestion of raw or inadequate cooked freshwater fishes In human body, it lives within bile ducts and causes Inflammatory reaction leading to cholangiohepatitis and biliary obstruction. It is well known risk factor for cholangiocarcinoma It is a rare, but mentioned risk factor for carcinoma Gallbladder Ref: www.ncbi.nlm.gov/pubmed/3993073 | train | med_mcqa | null |
The normal process by which the existing epithelial cells of skin are replaced by new epithelial cells is called | [
"Apoptosis",
"Autolysis",
"Both",
"Any of these"
] | A | Apoptosis is a form of programmed cell death that occurs in multicellular organisms . Biochemical events lead to characteristic cell changes and death. These changes include blebbing , cell shrinkage , nuclear fragmentation , chromatin condensation , chromosomal DNA fragmentation, and mRNA decay. The average adult human loses between 50 and 70 Billion cells each day due to apoptosis. For an average human child between the ages of 8 to 14 years old approximately 20 to 30 billion cells die per day. Ref - sciencedirect.com | train | med_mcqa | null |
Projections from substantia nigra pars compacta to striatum releases | [
"GABA",
"Dopamine",
"Glutamate",
"Aspartate"
] | B | null | train | med_mcqa | null |
Which of the following is the best parameter to assess fluid intake in a poly-trauma patient? | [
"Urine output",
"BP",
"Pulse",
"Pulse oximetry"
] | A | null | train | med_mcqa | null |
Intraspecies competition is the competition among ? | [
"Species",
"Individuals of a population",
"Individuals of a community",
"Populations and their regulatory factors"
] | B | Ans. is 'b' i.e., Individuals of a population . Intraspecies competition - competition within a single population . Interspecies competition - is between two or more different population. | train | med_mcqa | null |
Highly repetitive DNA is seen in: | [
"Centromere",
"Microsatelite DNA",
"Telomere",
"All"
] | A | A i.e. Centromere; B ie. Microsatelite DNA ; C i.e. Telomere | train | med_mcqa | null |
All of the following are true regarding cephalosporins, except: | [
"Bacteriocidal agents",
"Active against only gram negative",
"Resistant to beta lactamases by Bird generation cephalosporins",
"None of the above"
] | B | Bacteriocidal agents | train | med_mcqa | null |
A 4-month-old boy is brought to the you. His parents repo that the child stopped breathing at home, turned blue around his lips, and felt limp. After vigorous shaking of the infant and several mouth-to mouth breaths, the boy's color returned to normal, and he resumed breathing. The infant's condition is best described as: | [
"Obstructive apnea",
"Central apnea",
"Apparent life-threatening event (ALTE)",
"Pneumonia"
] | C | An apparent life-threatening event (ALTE) is an episode of apnea associated with marked change in color and muscle tone. Such that an observer typically believes the infant will die without vigorous stimulation or resuscitation. Central apnea is cessation of breathing without respiratory effo, whereas obstructive apnea is cessation of airflow at the mouth and nose with continued respiratory effo. Apnea may be a symptom of many diseases in infants and should be labeled an ALTE only if no cause can be found, Sudden infant death syndrome (SIDS) is the death of an infant without adequate explanation by history or autopsy examination. Less than 10% of infants who die of SIDS have had a prior ALTE. | train | med_mcqa | null |
A 6 year old patient, who was admitted for a dog bite on the face, unexpectedly developed anaphylaxis to a test dose of Augmentin. He developed stridor which needs immediate intubation. You are the only available doctor at the time. You have a No.3 curved blade laryngoscope ready and you have asked for an Endotracheal Tube (ET) to the nurse. What should be the appropriate internal diameter of the tube? | [
"3.5mm",
"4.5mm",
"5.5mm",
"6.5mm"
] | C | Internal diameter of an ET tube in children = (age in years/4) + 4.0 mm = (6/4) +4.0 mm = 5.5 mm 3-3.5 is the internal diameter for a neonate For an adult male - 8.5 mm For an adult female - 7.5 mm Ref: Oxford Handbook of Clinical Specialities, Page 627 | train | med_mcqa | null |
A 30-year-old man who was recently staed on haloperidol 30mg/day developed hyperpyrexia, muscle rigidity, akinesia, mutism, sweating, tachycardia and increased blood pressure. The investigations showed increased VVBC count, increased creatinine phosphokinase. There is no history of any other drug intake or any signs of infection. The most likely diagnosis is: | [
"Drug overdose",
"Neuroleptic malignant syndrome",
"Drug induce Parkinsonism",
"Tardive dyskinesia"
] | B | B i.e. Neuroleptic malignant syndrome | train | med_mcqa | null |
Keloid formulation is not seen over | [
"Ear",
"Face",
"Neck",
"Eyelids"
] | D | null | train | med_mcqa | null |
The most common neoplasm of kidney is | [
"Wilm' s tumour",
"Renal cell carcinoma",
"Renal adenoma",
"Haemagioma"
] | B | null | train | med_mcqa | null |
In transtentorial herniation, a pa of the brain is displaced from the supratentorial to the infratentorial compament through the tentorial opening. It results in all of the following, EXCEPT: | [
"Cheyne stokes respiration",
"Decerebration",
"Ipsilateral hemiparesis",
"Ipsilateral oculomotor paresis"
] | C | The uncus (on the medial aspect of the temporal lobe) herniates under the tentorium cerebelli. The uncus can compress the oculomotor nerve (CN III), compromising the parasympathetic fibers and resulting in ipsilateral pupillary dilation with associated ophthalmoplegia ("down and out"). Cheyne-Stokes respirations are commonly seen with mesial temporal transtentorial herniation. If the uncus is forced fuher medially, it compresses the cerebral peduncle, producing contralateral hemiparesis. After the brain herniates, the patients are decerebrate and comatose, have fixed and dilated pupils, and eye movements are absent. Ref: Cowan J.A., Thompson B. (2010). Chapter 36. Neurosurgery. In G.M. Dohey (Ed), CURRENT Diagnosis & Treatment: Surgery, 13e. | train | med_mcqa | null |
Not true about Zika virus, | [
"Microcephaly",
"Transmitted by Aedes mosquito",
"Mother to child transmission via Breast feeding",
"Zika is Flavi virus"
] | C | null | train | med_mcqa | null |
All of the following anticancer drugs are cell cycle non-specific except? | [
"Cisplatin",
"Vincristine",
"Mitomycin-C",
"Cyclophosphamide"
] | B | CELL CYCLE NON-SPECIFIC DRUGS 1. Alkylating agents Melphalan Cyclophosphamide Nitrosourea 2. Platinum compounds Cisplatin Carboplatin Oxaliplatin 3. Anthracyclines Doxorubicin Daunorubicin Epirubicin Mitoxantrone 4. Antitumor antibiotics Dactinomycin Mitomycin-C | train | med_mcqa | null |
Period of cornmunicability of measles is- | [
"3 days before and 10 days after appearance of rashes",
"3 weeks after appearance of rashes",
"I week before appearance of rashes",
"4 days before and 5 days after appearance of rashes"
] | D | Ans. is 'd' i.e., 4 days before and 5 days after appearance of rashes t Ref: Park 24th/e p. 157; Community Medicine with Recent by Suryakantha 4th/e p. 328]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.Rubella : 7 days before symptoms to 7 days after appearance of rash.Mumps : 4 - 6 days before symptoms to 7 days thereafter.Influenza : 1 - 2 days before to 1 - 2 days after onset of symptoms.Diphtheria : 14 - 28 days from disease onset.Peussis : 7 days after exposure to 3 weeks after paroxysmal stage. | train | med_mcqa | null |
All of the following statements about SIADH are true except: | [
"Serum sodium is low, typically < 135 meq/1",
"Urinary sodium excretion is low / normal",
"Water loading test may be used",
"Vaptans are new FDA approved agents for treatment of SIADH"
] | B | Answer is B (Urinary sodium excretion is low / normal): SIADH is typically characterized by high urinary sodium (Increased rate of excretion of. odium). Syndrome of Inappropriate ADH Secretion (SIADH) is associated with increased secretion of vasopressin (ADH), which leads to increased absorption of water producing dilutional hyponatremia (serum sodium typically < 135 meq/l) along with concentrated or hyperosmolar urine. Excessive retention of water stimulates compensatory mechanisms that enhance Watriuresis'. Natriuresis results in increased urinary sodium excretion rate increased urinary sodium concentration) and is believed to compensate for increased volume from inappropriaye ADH secretion preventing a state of clinical hypervolemia, hypeension or edema. SIADH is associated low serum sodium levels ( Cardinal features of SIADH include: Hyponatremia (dilutional hyponatremia with Na+ < 135 mmo1/1) Decreased plasma osmolality (increased urine osmolality > 150 m osm). High Urine sodium (over 20 meq4) Low Blood urea Nitrogen < 10 mg/L Hypouricemia ( Clinical Euvolemia - Absence of signs of hypervolemia (edema, ascitis) - Absence of signs of hypovolemia (ohostatic hypotension, tachycardia, features of dehydration) Absence of cardiac, liver or renal disease Normal thyroid and adrenal function A high BUN suggests a volume contracted state and excludes a diagnosis of SIADH. Water loading test may be used to help diagnosis of SIADH Water loading test is recognized as a 'supplemental criteria' in establishing a diagnosis of SIADH. The 'Water Loading Test' is of value when there is unceainity regarding the etiology of modest degrees hypo-osmolality in euvolemic patients but it does not add useful information if the plasma osmolality is < 275 mOsm/kg H2O Test Objective / Principle Abnormal Water Loading Test Criteria Fixed quantity of water is given to a patient and the amount of Abnormal water load urine produced and changes in blood/urine osmolality are Inability to excrete at least 90% of a 20m1/kg recorded. water load in 4 hours, and/or Inability to excrete a normal water load (decreased urinary Failure to dilute urine (osm) to < 100 mOsm/kg output) or failure to dilute urine is considered abnormal H-,O. Vaptans are new FDA approved agents for treatment of SIADH `Vaptans' are a new class of drugs that have emerged for treatment of hyponatremia. These medications act as Vasopressin receptors antagonists blocking the action of AVP in renal tubule, pituitary or smooth muscles depending upon receptor selectivity. Conivaptan , itravenous use) Conivaptan is a combined V1/V2 receptor antagonist is FDA approved for sho-term intravenous use fin- treatment of hospitalized patients with SIADH. Tolivaptan (Oval use) Tolivaptan is a V2 receptor antagonist that has received FDA approval far oral use 100 mOsmol/kg H20 with normal renal function) at some level of hypoosmolality. (Urinary concentration must be inappropriate for Plasma Hyposmolality) * Clinical euvolemia, as defined by the absence of signs of hypovolemia (ohostasis, tachycardia, decreased skin rurgor, dry mucous membranes) or hypervolemia (subcutaneous edema, ascites). * Elevated urinary sodium excretion while on normal salt and water intake. * Absence of other potential causes of euvolemic hypoosmolality: hypothyroidism, hypocoisolism (Addison's disease or pituitary adrenocoicotropic hormone insufficiency) and diuretic use. Supplemental * Abnormal water load test (inability to excrete at least 90% of a 20 mL/kg water load in 4 hours and/or failure to dilute Uosm to < 100 mOsmol/kg H-0). * Plasma AVP level inappropriately elevated relative to plasma osmolality. * No significant correction of serum insufficiency) and diuretic use. Supplemental Abnormal water load test (inability to excrete at least 90% of a 20 mL/kg water load in 4 hours and/or failure to dilute Uosm to < 100 mOsmol/kg H-0). Plasma AVP level inappropriately elevated relative to plasma osmolality. No significant correction of serum [Nal with volume expansion but improvement after fluid restriction Assessment of Extracellular Fluid Volume (ECFV) Clinical Findings Type 1, Hypervolemic Type II, Hypervolemic Type III, Hypervolemic SIADH Euvolemic History CHF, cirrhosis, or nephrosis Yes No No No Salt & water loss No Yes No No ACTH- coisol deficiency and/or nausea and vomatiting No No Yes No Physical examination Generalized edema, ascites Yes No No No Postrlial hypotension May be May be May be" No Laboratory BUN, creatinine High-normal High-normal Low-normal Low-normal Uric acid High-normal High-normal Low-normal Low-normal Serum potassium Low-normal Low-normal Normal Normal Serum albumin Low-normal High-normal Normal Normal Serum coisol Normal-high Normal-high Low Normal Plasma renin activity High High Low Low Urinary sodium (Meg unit of time) Low Low High High | train | med_mcqa | null |
Feature of Apoptosis | [
"Cell is enlarged",
"Karyorrhexis",
"Plasma membrane intact",
"Enzymatic digestion"
] | C | Features of Necrosis and ApoptosisFeatureNecrosisApoptosisCell sizeEnlarged (swelling)Reduced (shrinkage)NucleusPyknosis - karyorrhexis - karyolysisFragmentation into nucleosome-sizefragmentsPlasmamembraneDisruptedIntact; altered structure,especially orientation of lipidsCellularcontentsEnzymatic digestion;may leak out of the cellIntact; may be released inapoptotic bodiesAdjacentinflammationFrequentNoPhysiologic orpathologicroleInvariably pathologic(culmination ofirreversible cellinjury)Often physiologic, means ofeliminating unwanted cells;may be pathologic after someforms of cell injury, especiallyDNA damageRef: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Chapter 2; Cellular Responses to Stress and Toxic Insults: Adaptation, Injury, and Death | train | med_mcqa | null |
In Alzheimer&;s disease (AD) which of the following is not seen: | [
"Aphasia",
"Acalculia",
"Agnosia",
"Apraxia"
] | C | Aphasia, Apraxia, Acalculia and Agnosia may all be seen in Alzheimer&;s Dementia. Agnosia in Alzheimer&;s disease usually presents late in the disease and is not included in the ICD-10 Diagnostic criteria for dementia in Alzheimer&;s disease with early onset and hence may be selected as the single best answer by exclusion REF: Harrison book of internal medicine 21ST EDITION | train | med_mcqa | null |
Indicator of severe pre-eclampsia: | [
"lUGR",
"Diastolic BP>110 mm of Hg",
"Pulmonary edema",
"Systolic BP> 160"
] | A | Severe preeclampsia is characterised by DBP 110 mm of Hg or more ,SBP 160 mm of Hg or more ,proteinuria 5 g in 24 hrs,headache,visual disturbances,epigastric pain,oliguria,thrombocytopenia,increased liver enzymes,increased creatinine,IUGR and pulmonary edema. Refet page np 257 of Text book of obstetrics,sheila balakrishnan,2 nd edition. | train | med_mcqa | null |
In the etiology of dental caries, one of the following is
not an environmental factor | [
"Saliva",
"Micro organisms",
"Refined carbohydrates",
"Structure of the tooth"
] | D | null | train | med_mcqa | null |
Localised langerhans cells histiocytosis affecting head & neck is - | [
"Letterer-siwe disease",
"Pulmonary langerhans cell histiocytosis",
"Hand-schuller-christian disease",
"Eosinophilic granuloma"
] | D | Unifocal and multifocal unisystem Langerhans cell histiocytosis(eosinophilic granuloma)is characterised by proliferation of Langerhans cells admixed with variable number of eosinophils , lymphocytes , plasma cell, and neutrophils .Eosinophils are usually , but not always a prominent component of the infiltrate .It typically arises within the medullary cavities of bones, most commonly the calvarium, ribs and femur. ref: Robbins pathologic basis of disease ; 8th edition ; pg 632 | train | med_mcqa | null |
Choriocarcinoma commonly metastasize to:
a.Brain
b. Lung
c. Vagina
d. Ovary
e. Cervix | [
"ab",
"bc",
"cd",
"de"
] | B | Most common sites of metastases in choriocarcinoma are:
Lung (80%) > Vagina (30%) > Pelvis (20%) > Liver (10%) and Brain (10%) | train | med_mcqa | null |
All of the following are seen in lead poisoning except: | [
"Hallucinations",
"GIT disturbances",
"Peripheral neuritis",
"Encephalitis"
] | A | null | train | med_mcqa | null |
True about iron deficiency anemia in children – a) Iron absorption from terminal ileumb) Cow milk contain less iron than breast milkc) Serum ferritin depletes firstd) Decreased alertnesse) Decreased Red cell distribution width (RDW) | [
"ab",
"bc",
"cd",
"ac"
] | C | Iron is absorbed from proximal small intestine mainly from the duodenum.
Cow milk has a slightly more amount of iron than breast milk, However, the bioavailability of iron of breast milk is much greater than cow milk.
Clinical manifestations
Pallor is a most important sign of iron deficiency. In fact WHO recommended the use of palmar pallor as a screening measure for anemia.
Pagophagia, the desire to ingest unusual substances such as ice or dirt may be present.
In some children, the ingestion of lead containing substances may lead to concomitant plumbism & helminthic parasitic infection.
In severe anemia, irritability and anorexia are prominent. Tachycardia and cardiac dilatation occur. A systolic murmur is often present.
Iron deficiency affects attention span, alertness and learning in both infant and adolescents.
Laboratory findings
S. ferritin depletes first
Next, serum iron level decreases, the iron binding capacity of serum (serum transferrin) increases, and percent saturation (transferrin saturation) is reduced.
RDW is increased in iron deficiency anemia. | train | med_mcqa | null |
A patient with a hyperlipoproteinemia would most likely benefit from a low-carbohydrate diet if the lipoproteins that are elevated in the blood belong to which class of lipoproteins? Choose the one best answer. | [
"Chylomicrons",
"VLDL",
"LDL",
"HDL"
] | B | VLDL is produced mainly from dietary carbohydrate, LDL is produced from VLDL, and chylomicrons contain primarily dietary triacylglycerol. Elevated HDL levels are desirable and are not considered to be a lipid disorder. HDL also contains low levels of triglyceride. A low-carbohydrate diet would be expected to reduce the level of circulating VLDL because of reduced fatty acid and triglyceride synthesis in the liver. | train | med_mcqa | null |
Perthes affects age group- | [
"< 4 yrs",
"4 - 8 yrs",
"10 - 25 yrs",
"> 25 yrs"
] | B | Ans. is 'b' i.e., 4-8 yrs PERTH E'S DISEASE (LEGG-CALVE PERTHE S DISEASE)o Perthe's disease is also known as osteochondritis deformans juvenilis or Coxa plana or Pseudocoxalgia. Perthe's disease is an osteochondritis of the epiphysis of the femoral head (capital femoral epiphysis). In the disease, the femoral head becomes partly or wholly avascular and deformed. The disease occurs commonly in males in the age group of 5-10 years.Etiology of Perthe's diseaseo Perthes disease is the most common form of osteochondroses (osteochondroses are characterized by avascular necrosis (AVN) and defective endochondral ossification of primary or secondary' ossification centers)o The etiology remains unknow n, but is currently accepted that the disorder is caused by an interruption of the blood supply to the capital femoral epiphysis, causing avascular necrosis.Clinical features of Perthes diseaseo Perthes disease is common in male of age group 5-10 years.o Pain in the hip, often radiating to knee,o Limp (antalgic limp).o Limitation of movementAbduction, internal rotation and extension are limited, therefore there is adduction, external rotation, and flexion deformity',o Shortening of limb.o Positive trendelenburg test.o During the disease process, bone age is 1-3 years lower than the normal. After healing, bone age returns to normal.Radiological investigations for Perthe's diseaseo Following radiological investigations are usedX-ray hipFindings are :-Increased medial joint spaceWidening of femoral neckLateral extrusion (lateral subluxation)Metaphyseal cysts and rarefaction of metaphysisHorizontal physis with speckled calcification lateral to it Fragmentation of femoral head with increased density (irregular densities in the epiphysis)Bone scanMay show a decrease uptake by femoral head.MRIIt is the investigation of choice as it can diagnose Perthes disease in early stages when X-ray is normal.MRI tells aboutExtent of area involvedSphericity of the headSubluxation of the headThus MRI helps better in planning for management. | train | med_mcqa | null |
A 45-year-old male with history of recurrent ureteric calculi presented with fever. Right-sided nephrectomy was performed. Gross view and histology have been provided. What is your diagnosis? | [
"Chronic pyelonephritis with hydronephrosis",
"Renal cell carcinoma",
"Autosomal dominant polycystic kidney disease",
"Cystic dyspiastie kidney"
] | A | Ans. a. Chronic pyelonephritis with hydronephrosis (Ref: Robbins 9/e p933-935, 8/e p943-961)In a 45-year old male with history of recurrent ureteric calculi, who presented with fever: Right-sided nephrectomy was performed. Grossly kidney shows hydronephrosis with evidence of scarring. Microscopically changes predominantly involve tubules and interstitium. Most probable diagnosis would be Chronic pyelonephritis with hydronephrosis.Chronic Pyelonephritis* Insidious in onset, may present with clinical manifestations of acute recurrent pyelonephritis with back pain, fever, frequent pyuria, and bacteriuria.* Gross examination: Irregularly scarred kidney; if bilateral, the involvement is asymmetric.* Hallmark of chronic pyelonephritis: Coarse, discrete, corticomedullary scar overlying a dilated, blunted, or deformed calyx.* Most of the scars are in the upper and lower poles, consistent with the frequency of reflux in these sites.* Microscopic changes: Predominantly involve tubules and interstitium.* Dilated tubules with flattened epithelium may be Ailed with colloid casts (thyroidization).* Glomeruli may appear normal except for periglomerular fibrosis, but a variety of glomerular changes may be present, including ischemic fibrous obliteration as well as secondary changes related to hypertension.Adult Polycystic Kidney Disease* Gross Appearance: Kidneys are usually bilaterally enlarged and may achieve enormous sizes.* The external surface appears to be composed solely of a mass of cysts, up to 3 to 4 cm in diameter, with no intervening parenchyma.* Microscopic examination reveals functioning nephrons dispersed between the cysts.* The cysts may be filled with a clear, serous fluid or, more usually, with turbid, red to brown, sometimes hemorrhagic fluid.Renal Cell Carcinoma* Usually presents as a yellowish, spherical mass in one pole of the kidney.* In clear cell carcinoma, the growth pattern varies from solid to trabecular (cordlike) or tubular (resembling tubules). The tumor cells have a rounded or polygonal shape and abundant clear or granular cytoplasm; the latter on special stains contains glycogen and lipids.* Papillary carcinoma is composed of cuboidal or low columnar cells arranged in papillary formations. Psammoma bodies may be present. The stroma is usually scanty but highly vascularized.* Chromophobe renal carcinoma is made up of pale eosinophilic ceils, often with a perinuclear halo, arranged in solid sheets with a concentration of the largest cells around blood vessels.* Collecting duct carcinoma is a rare variant showing irregular channels lined by highly atypical epithelium with a hobnail pattern.* Sarcomatoid changes arise infrequently in all types of renal cell carcinoma and are a decidedly ominous feature of these tumors.Cystic Dysplastic Kidney* Dysplasia can be unilateral or bilateral and is almost always cystic.* Gross appearance: Kidney is usually enlarged, extremely irregular, and multicystic.* The cysts vary in size from microscopic structures to some that are several centimeters in diameter.* The characteristic histologic feature is the presence of islands of undifferentiated mesenchyme, often with cartilage, and immature collecting ducts. | train | med_mcqa | null |
True about suspended animation: PGI 10 | [
"Common phenomenon",
"Can be voluntary",
"Similar to molecular death",
"None"
] | B | Ans. Can be voluntary | train | med_mcqa | null |
Macrophages- false statement is? | [
"Derived from monocytes",
"Harbor Mycobacteria",
"Involved in Type 3 HSN",
"Produces TNF and interleukins"
] | C | Ans. (c) Involved in Type 3 HSN(Ref: Robbins 9th/pg 210)A. TrueMonocytes in tissues are known as MacrophagesB. TrueMacrophages engulf Mycobacteria but are not able to kill it; So they harbor MycobacteriaC. FalseMacrophages are involved in Type 4 Hypersensitivity & not type 3, which is immune- complex mediatedD. True*. Macrophages secrete TNF, IL-1, and chemokines, which promote inflammation*. Macrophages also produce IL-12, thereby amplifying the TH1 response | train | med_mcqa | null |
Which of the following support the Spring ligament? | [
"Tibialis posterior",
"Peroneus longus",
"Abductor hallucis",
"All of the above"
] | A | Ans. A. Tibialis posterior.The plantar calcaneonavicular ligament (spring ligament) is a ligament on the underside of the foot that connects anterior margin of the sustentaculum tali of the calcaneus to the plantar surface of the navicular. This ligament not only serves to connect the calcaneus and navicular, but supports the head of the talus. The dorsal surface of the ligament presents a fibrocartilaginous facet, lined by the synovial membrane, and upon this a portion of the head of the talus rests. The spring ligament lies deep to the tibialis posterior tendon separated from it by a gliding layer. It measures approximately 5mm in medial to lateral dimension.# Around the ankle, there are three ligaments in the superficial layer named for their origin and insertion. Two of these run between bony structures. The anterior ligament is the tibionavicular and the posterior is the tibiocalcaneal ligament. The transverse component of the medial ligament complex is the spring ligament. The spring ligament represents one component of a ligament complex passing between the os calcis and the navicular, which is the superoficial calcaneonavicular ligament.# The function of tibialis posterior in maintaining the medial arch of the foot is supported by the spring ligament.# The tendon of the tibialis posterior supports its plantar surface; its medial border is blended with the forepart of the deltoid ligament of the ankle-joint.# The plantar calcaneonavicular ligament helps to maintain the medial longitudinal arch of the foot and by providing support to the head of the talus bears the major portion of the body weight. It is the main part of the spring ligament complex.Other ligaments of ankle joint:Principle supports of the Medial longitudinal arch of the foot:e# Spring ligament# Plantar fascia: acts as a tie by means of its attachments to the heel and metatarsal heads.# Abductor hallucis and flexor digitorum brevis (spring ties)# Tibialis anterior: elevates arch with Peroneus longus forms a supporting sling.# Tibialis posterior: adducts mid-tarsal joint and reinforces the action of spring ligament# Flexor hallucis longus | train | med_mcqa | null |
Oral evidence is more impoant than written testimony as: | [
"Oral evidence cannot be cross-examined",
"Oral evidence can be cross-examined",
"Documentary evidence requires no proof",
"None"
] | B | Oral evidence is more superior to documentary evidence, as the witness can be cross examined. Doctor's repo is accepted only when he comes and deposes oral evidence in the cou ( S. 45 IEA). Exceptions to oral evidence: Dying declaration. Expe opinion given in a book or treatise. Evidence of doctor recorded in a lower Cou. Evidence by witness in a previous judicial proceedings. Repos of chemical examiner, explosives expe, fingerprint expe, serologist etc. Public records like death, bih ceificate. Hospital records | train | med_mcqa | null |
Lateral skull view of palatal tori is used to know | [
"Extent",
"Pneurnatization",
"Bone pattern",
"Location"
] | C | null | train | med_mcqa | null |
Pathognomic features of Maxillary sinusitis is | [
"Mucopus in the middle meatus",
"Inferior turbinate hyperophy",
"Purulent nasal discharge",
"Atrophic sinusitis"
] | A | Clinical features of maxillary sinusitis: Constitutional symptoms: fever, general malaise and body ache. Headache Pain: It is typically situated over the jaw but may be referred to gums or teeth. Occasionally, it is referred to the ipsilateral supraorbital margin. Tenderness: pressure or tapping over the anterior wall of the antrum produces pain. Redness and oedema of the cheek: lower eyelid may become puffy. Nasal discharge: Anterior rhinoscopy shows pus/mucopus in the middle meatus. Mucosa of the middle meatus and terminate may appear red and swollen. Postnatal discharge: Pus may be seen on the upper soft palate on posterior rhinoscopy or nasal endoscopy. (Ref: Textbook of Diseases of ENT, 7th edition, PL Dhingra, pg no. 214) | train | med_mcqa | null |
Reslizumab is used in : | [
"Psoriasis",
"RSV infection",
"Asthma",
"Crohn's disease"
] | C | Reslizumab is a monoclonal antibody against IL - 5 and thus inhibits recruitment of eosinophils. It is used in cases of asthma. | train | med_mcqa | null |
Cataract is caused by all except – | [
"Ultraviolet radiation",
"MRI",
"Infrared radiation",
"Microwave radiation"
] | B | Radiation cataract is caused by ionizing & non-ionizing radiations e.g. UV rays, neutron, radium, ultrasonics; but MRI has no radiation exposure. | train | med_mcqa | null |
The largest organ of the body is: | [
"Skin",
"Liver",
"Gluteus maximus",
"Femur"
] | A | (Skin): Ref: 278, 281-K=-Sembulingam physiology3rd* The liver is the largest gland in the body and has a wide variety of functions (265-Snell7th)* The liver is the largest gland in the body. (283-BDC-2)* Femer is the longest and the strongest bone of the body (16-B DC-2)* Skin is the largest organ of the body (278-K- Sembulingam physiology)* Skin is considered as the largest sense organ in the body it has many nerve endings, which are specialized to form cutaneous receptors (281-K. Sembulingam physiology3rd) | train | med_mcqa | null |
Carotene is not found in high amounts in – | [
"Tomato",
"Cabbage",
"Potato",
"Spinach"
] | C | null | train | med_mcqa | null |
Which one of the following statements about biguanides is not true - | [
"Don't stimulate insulin release",
"Don't stimulate insulin release",
"Renal Dysfunction is not a contraindication for their use",
"Renal Dysfunction is not a contraindication for their use"
] | C | Ans. is 'c' i.e., Renal dysfunction is not a contraindication for their use o Biguanides are contraindicated in hypotensive states, cardiovascular, respiratory, hepatic and renal disease and in alcoholics because of increased risk of lactic acidosis. About other options o Biguanides do not cause insulin release. o Their major action is to suppress hepatic gluconcogenesis (Decreased hepatic glucose production). o Biguanides may be combined with sulfonylureas and thiazolidinediones in type 2 DM in whom oral monotherapy is ineffective. | train | med_mcqa | null |
All of the following come in relation with the urethral crest which is situated in the prostatic pa of the urethra, except: | [
"Ejaculatory ductus",
"Prostatic utricle",
"Prostatic sinus",
"Colliculus seminalis"
] | A | Ejaculatory ductus | train | med_mcqa | null |
Sub acute - Sclerosing pan - encephalitis (SSPE) is caused by | [
"Measles",
"Mumps",
"Rubella",
"Small pox"
] | A | (Measles) (137-Park 20th)* Subacute sclerosing pan-encephalitis (SSPE) is a rare complication which develops many years after the initial measles infections. It is characterized by progessive mental deterioration leading to paralysis, probably due to persistence of the virus in the brain.* Measles vaccination definitely constitutes a protection against the neurological and other complications by preventing natural measles from occurring* **A11 cases of severe measles and all cases of measles in areas with high case fatality rates should be treated with vitamin A | train | med_mcqa | null |
Monitoring for Iodine levels is done by | [
"Urinary excretion of Iodine",
"TSH, T3 and T4 levels",
"Iodine level in soil",
"All of the above"
] | D | null | train | med_mcqa | null |
Which of the following is true for phosphofructokinase | [
"It uses fructose 1, 6 bisphosphate as substrate",
"It generates ATP",
"It catalyses an irreversible reaction in glycolysis",
"It is activated by increased levels of ATP and citrate"
] | C | Phosphofructokinase catalyses the first committed step of glycolysis. It is the rate limiting enzyme of glycolysis. The reaction is irreversible. | train | med_mcqa | null |
Where is torus aoicus located | [
"Left atrium",
"Right atrium",
"Aoa",
"Left ventricle"
] | B | Torus aoicus is a buldge in the right atrial septum sited superiorly and anteriorly. It is produced due to adjacent nonocoronary aoic sinus at the base of ascending aoa. It is superior to coronary sinus and anterior to fossa ovalis. | train | med_mcqa | null |
DNA supercoiling is done by | [
"DNA polymerase I",
"DNA polymerase II",
"DNA polymerase III",
"DNA topoisomerase"
] | D | Enzymes that catalyze topologic changes of DNA are called topoisomerases. Topoisomerases can relax or inse supercoils, using ATP as an energy source. DNA gyrase is a type of topoisomerase Harper30e pg: 362 | train | med_mcqa | null |
Which is the most common metastatic disease causing SVC syndrome? | [
"Ca Bronchus",
"Ca Breast",
"Ca Veebrae",
"Ca Stomach"
] | B | Breast cancer is the most common metastatic disease causing SVC syndrome. Lung cancer is the most common cause of SVC syndrome. Non Hodgkins lymphoma is the second most common cause. Primary mediastinal malignancies such as thymoma and germ cell tumors account for less than 2% cases. | train | med_mcqa | null |
Temperature of pasteurization: | [
"121 degrees for 15 minutes",
"63 degrees for 30 minutes",
"160 degrees for 1 hour",
"140 degrees for 1 hour"
] | B | Ans. B. 63 degrees for 30 minutes.a. Holder method of pasteurization-moist heat at 63 C for 30 minutesb. Flash method of pasteurization-moist heat at 72 C for 15-20 seconds followed by quickly cooling to 13 C.c. Ultra-High Temperature (UHT) of pasteurization-moist heat 140degC for 15 sec/ 149deg C for 0.5 sec. | train | med_mcqa | null |
All are effect of parasympathetic system on hea except - | [
"Negative chronotropic",
"Negative ionotrophic",
"Negative dromotropic",
"All are seen"
] | B | Ans. is 'b' i.e., Negative inotropic | train | med_mcqa | null |
Distention of abdomen with passage of large amount of urine is known as? | [
"Dietl's crisis",
"Anderson's Hynes crises",
"Meteriorism",
"None"
] | A | Ans. a (Dietl's crisis). (Ref. Bailey and Love, 25th/pg.l293)Position of stoneSite of PainAt PUJ or upper ureterPain radiates to the testiclesAt middle of the ureter (i.e. at crossing of gonadal vessels and ureter)Pain is referred to Me Burneys point on the right side resembling appendicitis and on left side simulates diverticulitis.At lower ureter or at pelvic brimPain is referred to inner side of thighIn the intramural ureterStrangury (painful and fruitless desire to micturate.UNILATERAL HYDRONEPHROSISThe female:male ratio of unilateral hydronephrosis (most common\y caused by idiopathic pelviureteric junction obstruction or calculus) is 2:1; the right side is more commonly affected.Presenting features include the following.# Insidious onset of mild pain or dull aching in the loin. There is often a sensation of dragging heaviness which is made worse by excessive fluid intake. An enlarged kidney may be palpable if the cause is pelviureteric junction obstruction.# Attacks of acute renal colic may occur with no palpable swelling.# Intermittent hydronephrosis. After an attack of acute renal pain a swelling in the loin is found. Some hours later, following the passage of a large volume of urine, the pain is relieved and the swelling disappears (Dietl's crisis)Some important termsCHILAIDUI'S SYNDROMEColonic loop between liver and diaphragm (pseudoperitoneum)--Chilaiditi's syndromeDIETL'S CRISISAfter an attack of acute renal pain a swelling in loin is found. Sometimes later, following the passage of large volume of urine, the pain is relieved and swelling disappears. This is Dietl's crisis, a feature of intermittent hydronephrosis, is seen in PUJ obstruction.STRANGURYWhen the stone is in the intramural ureter, the pain is referred to the tip of the penis. In both sexes there may be strangury.STEINSTRASSEImmediately after ESWL, the treated stone may look larger, appear less dense, and have margins that are more indistinct. The fragments may disperse and conform to the shape of the pelvicalyceal system or ureter. Multiple small stone fragments that columnize in the ureter are common and are known as Steinstrasse, or "street of stone". Ureteral obstruction may occur from a solitary fragment or from Steinstrasse.OLIGURIALess than 300 ml of urine is excreted in a day.MEGENBLASSEDistension of Splenic flexure causing pain due to heavy fatty diet.METEORISMAbdominal distension 24--48 hours after renal injury is probably due to retroperitoneal haematoma implicating splanchnic nerves.MITTELSCHMERZPain ovulation with abdominal discomfort at regular intervals, usually about 14th day and may be associated with spotting due to estrogen withdrawal. | train | med_mcqa | null |
Live attenuated vaccine: | [
"Measles",
"Rabies",
"Hepatitis B",
"Typhoid"
] | A | Answer: A. Measles. (Ref Park's Textbook of PSM 22nd/Pg.99)Answer is measles not typhoid as typhoid may be inactivated also but measles is always live attenuated.LIVE VACCINES (e.g., BCG, measles, oral polio etc.)Live vaccines are prepared from live (generally attenuated) organisms. These organisms have been passed repeatedly in the laboratory in tissue culture or chick embryos and have lost their capacity to induce full blown disease but retain their immunogenicity.In general, live vaccines are more potent immunizing agents than killed vaccines, reasons being:(i) live organisms multiply in the host and the resulting antigenic dose is larger than what is injected,(ii) live vaccines have all the major and minor antigenic components,(iii) live vaccines engage certain tissues of the body, as for example, intestinal mucosa by the oral polio vaccine# When two live vaccines are required they should be given either simultaneously at different sites or with an interval of at least 3 weeks.# In the case of live vaccines, immunization is generally achieved with a single dose.# The exception is polio vaccine which needs three or more doses to be given at spaced intervals to produce effective immunity.# Live vaccines usually produce a durable immunity, but not always as long as that of the natural infection.# Live vaccines must be properly stored to retain effectiveness.# Serious failures of measles and polio immunization have resulted from inadequate refrigeration prior to use. | train | med_mcqa | null |
Systemic steroids are not used in treatment of? | [
"Pemphigus vulgaris",
"Bullous pemphigoid",
"Dermatitis herpetiformis",
"Pemphigus foliaceus"
] | C | Systemic steroids are not required in DH Dapsone is D.O.C. S/E of Dapsone: Hemolysis and Methemoglobinemia. | train | med_mcqa | null |
About lidocaine, all are true except : | [
"LA effect",
"Cardiac arrhythmia",
"Ester",
"Acts on mucous membranes"
] | C | C i.e. Ester | train | med_mcqa | null |
Tripod fracture is the name given for - | [
"Zygomatic fracture",
"Maxillary fracture",
"Mandibularfracture",
"Temporal fracture"
] | A | Ans. is 'a1 i.e., Zygomatic fracture o Zygoma fracture is also known as tripoid fracture.Clinical features of zygoma fractureo Considerable swelling over zygomatic arch is common and makes clinical diagnosis more difficult.o Flattening of malar prominence.o Step-deformit of infraorbital margin.o Anaesthesia in the distribution of infraorbital nerve.o Trimus, due to depression of zygoma on the underlying coronoid process.o Oblique palpebral fissure, due to the displacement of lateral palpebral ligament.o Restricted ocular movement, due to entrapment of inferior rectus muscle. It may cause diplopia.o Periorbital emphysema, due to escape of air from the maxillary sinus on nose-blowing.o The mucosa of the maxillary sinus may be lacerated and cause epistaxis on that side.o Fracture of the zygoma may or may not be painful to palpation and running a finger along the zygomatic arch may give a feel of a depressedfracture or a small dimple. The cheek may appear flattened; compared symmetry with the opposite side. This may be obvious immediately following trauma or several days later once swelling has subsided. | train | med_mcqa | null |
Tibialis posterior is inseed in all the tarsal bones, except: | [
"Calcaneus",
"Intermediate cuneiform",
"Cuboid",
"Talus"
] | D | Talus | train | med_mcqa | null |
All of the following organs contain aneurysm in polyarteritis nodosa except ? | [
"Liver",
"Lung",
"Kidney",
"Pancreas"
] | B | null | train | med_mcqa | null |
Vinca alkaloids act on: | [
"G phase",
"S phase",
"Mitotic spindle",
"M phase"
] | C | Ans. C. Mitotic spindleVinca alkaloids are mitotic inhibitors. They disrupt the polymerization of microtubules. They inhibit the chromosomes to move apart and there is metaphase arrest. They are cell cycle specific and act on mitotic spindle. | train | med_mcqa | null |
Contraindication of local anaesthesia is | [
"Diabetes mellitus",
"Clotting disorder",
"Hypertension",
"Renal disease"
] | B | (Clotting disorders): Ref: 50. LB (199-B &L 25th)* Contraindication of LA are local infection and clotting disorders, Not only does local infiltration spread the infection, but local anaesthetic drugs are ineffective in condition of acidity as produced by infection. Local infiltration in the presence of a clotting disorder may result in haemorrhage or may produce haematoma, which is potentially fatal in the airway, as may occure in dental surgery. | train | med_mcqa | null |
Tuberculate macroconidia is characteristic of | [
"Darling's disease",
"Gilchrist's disease",
"Chicago disease",
"Desert rheumatism"
] | A | Tuberculate macroconidia seen in Histoplasmosis also called Darling's disease. | train | med_mcqa | null |
The MOST sensitive test to diagnose GERD is: | [
"24 hour ambulatory pH monitoring",
"Upper GI endoscopy",
"Basal acid output measurement",
"Bernstein test"
] | A | Gastroesophageal Reflux Disease (GERD) Classic symptoms of gastroesophageal reflux are - water brash and substernal heaburn. Endoscopy is a sensitive test for diagnosis of esophagitis but will miss nonerosive reflux disease (NERD) MUST KNOW: The most sensitive test for diagnosis is 24-h ambulatory pH monitoring. Ref: Harrison, Edition-18, Page-2417. | train | med_mcqa | null |
Which of the following statements about Insulinoma is true: | [
"Present in Pancreas",
"Mostly malignant",
"Surgery is usually not required",
"Usually multiple"
] | A | Answer is A (Present in Pancreas): The most common site of Insulinomas is the Pancreas. | train | med_mcqa | null |
Causative particle in asbestosis is? | [
"Amphibole",
"Crysolite",
"Tridymite",
"Gristobalite"
] | A | Ans. (a) Amphibole(Ref: Robbins 9th/pg 689)Serpentine Q (M.C) and Amphibole Q (more pathogenic) as particles are asbestor particle associated with asbestosis. | train | med_mcqa | null |
Moderate increase in serum aminotransferases with ASTiALT > 3 is suggestive of | [
"Acute viral hepatitis",
"Prolonged hypotension",
"Alcoholic liver disease",
"Drug hepatotoxicity"
] | C | Ans. c (Alcoholic liver disease) (Ref: Harrison's Internal medicine 18th/Table 307-2)AST, ALTPredictors of alcoholic liver diseaseMild to moderate increaseMarked increaseAST> ALT= 2:1- suggestive.Fatty Liver pregnancyDrug-induced hepatitisAST > ALT = 3:1- Highly suggestive.Alcoholic liver diseaseCCFr GTP- Raised in all alcoholicsChronic hepatitisViral hepatitis (Acute)ALP- Moderate TPOOR PREDICTORS OF ALCOHOLIC HEPATITIS# PMN > 55,00/c mm# Discriminant score > 32# D.S = 4.6 X Prothrombin time control + Serum Bilirubin# Drug used for treatment: Prednisolone (DOC)-preferred choice; others-Pentoxiphylline, TNF a InhibitorsLaboratory Diagnosis of Alcoholic Fatty Liver and Alcoholic HepatitisTestCommentASTIncreased two- to sevenfold, <400 U/L, greater than ALTALTIncreased two- to sevenfold, <400 U/LAST/ALTUsually >1GGTP (maglutamyl transpeptidase)Not specific to alcohol, easily inducible, elevated in all forms of fatty liverBilirubinMay be markedly increased in alcoholic hepatitis despite modest elevation in alkaline phosphatasePolymorphonuclear cellsIf >5500/L, predicts severe alcoholic hepatitis when discriminant function >32 | train | med_mcqa | null |
Which of the following statement are not related to pathogenesis of idiopathic pulmonary fibrosis? | [
"Smoking",
"Age less than 20 years",
"Loss of function mutation in TE and TERC gene",
"Mutations in genes encoding components of surfactant"
] | B | Idiopathic pulmonary fibrosis aka Cryptogenic fibrosing alveolitis It is characterized by recurrent alveolar epithelial injury. SMOKING is one of the most impoant etiological factor. Seen in patient more than 50 years It is also associated with altered activity of surfactant. Histopathological Hallmark -Usual interstitial Pneumonia Rx-Lung transplant | train | med_mcqa | null |
Widmark's formula is used for estimating ? | [
"Time since death",
"Stature of a person",
"Quantity of alcohol consumed",
"Time since infliction of injury"
] | C | Widmark evolved a formula which takes into account the size and sex of the person and the type of alcoholic liquor consumed. The formula is a = prc,where a, is weight of alcohol(in g)in the body,p,is the body weight(in kg);c, is the concentration of alcohol in the blood(in mg per kg);and r is a constant(0.6 for men and 0.5 for women) Ref: K.S.N.Reddy 29th Ed Page 516 | train | med_mcqa | null |
Long acting insulin preparations are frequently administered by: | [
"Oral route",
"Intramuscular route",
"Intradermal route",
"Subcutaneous route"
] | D | null | train | med_mcqa | null |
Thymoma with hypogammaglobulinemia is also known as: | [
"Goods syndrome",
"Capgras syndrome",
"Fregoli syndrome",
"Todd syndrome"
] | A | Thymoma with hypogammaglobulinemia : Good's syndrome. The Capgras syndrome is a disorder in which a person thinks that a friend, spouse, parent, or other close family member has been replaced by an identical impostor. Fregoli syndrome is the delusional belief that one or more familiar persons, usually persecutors following the patient, repeatedly change their appearance. Alice-in-Wonderland syndrome also known as Todd's syndrome or lilliputian hallucinations, is a disorienting neurological condition that affects human perception. Sufferers may experience micropsia, macropsia, or size distoion of other sensory modalities. Ref: Harrison, E-18, Chapter e-20. | train | med_mcqa | null |
24 hour normal fluid requirement for a one year old child weighing 8 kg is | [
"700 ml",
"800 ml",
"900 ml",
"1000 ml"
] | B | Ans: (b) 800 mlRef : OP Ghai 8th ed./73f 293The fluid requirement of children less than 10 kg is 100ml per kg of body weight. The preffered fluid shall be N/5 in 5% dextrose with added potassium for daily requirements. | train | med_mcqa | null |
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