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 |
|---|---|---|---|---|---|---|
Which is called as peripheral hea ? | [
"Popliteus",
"Soleus",
"Plantaris",
"None"
] | B | Ans. is 'b' i.e., Soleus Soleus is known as 'peripheral hea' as it helps in venous return from lower limb. | train | med_mcqa | null |
Most common causative organism of acute suppurative parotitis: | [
"Staphylococcus aureus.",
"Streptococcus pyogens.",
"Corynebacterium.",
"None"
] | A | null | train | med_mcqa | null |
Maternal moality is more in ? | [
"HAV",
"HBV",
"HCV",
"HEV"
] | D | Ans. is 'd' i.e., HEV Hepatitis E virus Also known as enterically transmitted non-A non - B (NANB) virus or epidemic NANB. It is classified in the genus Herpesvirus under the family caliciviridae. It is a RNA virus with single - stranded positive sense RNA It is transmitted by fecal-oral route. In India, HEV is responsible for the majority of epidemic and sporadic hepatitis in adults. An epidemiological feature that distinguishes HEV from other enteric agents is the rarity of secondary person to person transmission (Secondary attack rate is very low 2-3% as against 10-20 % in HAV infection) A unique feature is the clinical severity and high case fatality rate of 20-40 % in pregnant women, especially in the last trimester of pregnancy. It is characteristically associated with cholestasis | train | med_mcqa | null |
Most difficult site to remove cholesteatoma in sinus tympani is related with: | [
"Anterior facial ridge",
"Posterior facial ridge",
"Epitympanum",
"Hypotympanum"
] | B | The sinus tympani (Posterior facial ridge) is the posterior extension of the mesotympanum and lies deep to both the promontory and facial nerve. The medial wall of sinus tympani becomes continuous with the posterior poion of the medial wall of the tympanic cavity. This is the worst region for access because it is above pyramid, posterior to intact stapes and medial to facial nerve. A retro facial approach mastoid is not possible because the posterior semi circular canal blocks the access. | train | med_mcqa | null |
In postductal coarctation of aoa, collaterals may be formed by all of the following, except | [
"Veebral aery",
"Suprascapular aery",
"Subscaular aery",
"Posterior Intercostals aery"
] | A | In post-ductal coarctation of the aoa, an extensive collateral circulation develops involving the branches of subclan & axillary aeries with the distal aeries given by aoa Veebral aery does not play a significant role in this collateral circulation. Ref: Gray's 40e/p984 | train | med_mcqa | null |
The normal P wave is biphasic in lead | [
"V1",
"LII",
"aVF",
"aVR"
] | A | The normal P wave in lead V1 may be biphasic with a positive component reflecting right atrial depolarization, followed by a small (<1 mm2 ) negative component reflecting left atrial depolarization. Ref Harrison 20th edition pg 1455 | train | med_mcqa | null |
The Drug of choice for a pregnant woman in 2nd trimester with pustular psoriasis is: | [
"Prednisolone",
"Dapsone",
"Acitretin",
"Methotrexate"
] | A | Systemic coicosteroids are not teratogenic and they are the recommended treatment of choice for pustular psoriasis in a pregnant woman. Ref: Obstetric Dermatology: A Practical Guide By Arieh Ingber, Chapter 13, Page 135 | train | med_mcqa | null |
Crescent formation is characteristic of the following glomerular disease - | [
"Minimal change disease",
"Rapidly progressive glomerulonephritis",
"Focal and segmental glomerulonephritis",
"Rapidly non progressive glomerulonephritis"
] | B | Rapidly progressive glomerulonephritis (RPGN) is characterised by rapid loss of renal function over days to weeks, usually in association with hypeension and oedema. Non-visible haematuria is almost always present with variable amounts of proteinuria, while characteristic red cell casts and dysmorphic red cells may be observed on urine microscopy . Renal biopsy typically shows crescentic lesions , often associated with necrotising lesions within the glomerulus , paicularly in small-vessel vasculitides. This pattern of presentation is typical of post-infectious glomerulonephritis, anti-GBM disease and small-vessel vasculitides It can also be observed in SLE and occasionally in IgA and other nephropathies . Ref Harrison20th edition pg 292 | train | med_mcqa | null |
Bilirubin is absent in urine because it is - | [
"Distributed in the body fat",
"Conjugated with glucoronide",
"Not filterable",
"Lipophilic"
] | D | Unconjugated bilirubin cannot be excreted in urine because:-
(i) It is lipophilic (lipid soluble) but not water soluble, i.e. it is hydrophobic
(ii) It is tightly bound to albumin, thus cannot be filtered at glomeruli. | train | med_mcqa | null |
Type of cataract in chalcosis is | [
"Sunflower cataract",
"Blue dot Cataract",
"Snowflake cataract",
"Polychromatic lustre"
] | A | Answer- A. Sunflower cataract | train | med_mcqa | null |
Skin stigmata of Liver disease include all of the following, Except | [
"Parmar Erythema",
"Paper money skin",
"Drumstick fingers",
"Subcutaneous nodules"
] | D | Answer is D (Subcutaneous nodules): Subcutaneous nodules are not recognized as an established stigmata of Liver disease. Parmar Erythema, Paper-money skin and Drum stick fingers are all established cutaneous stigma of chronic liver disease. Drum-Stick fingers can be observed in chronic liver patients with a hepatopulmonary syndromes. These changes are due to increased blood supply to the distal phalanges and the opening of av anastamoses with relative hypoxia to tissues as well as more extensive formation of connective tissue between nail and bone. | train | med_mcqa | null |
Which of the following is a feature of unilateral oculomotor nerve palsy? | [
"Drooping of eyelid",
"Accommodation reflex is absent",
"Visual loss",
"Pupillary light reflex is completely absent"
] | A | Oculomotor nerve innervates levator palpebrae superioris, complete lesion of this nerve produces closure of affected eye due to paralysis of this muscle. Oculomotor nerve innervates all the extraocular muscles of the eye except lateral rectus and superior oblique. Oculomotor nerve lesion result in lateral detion of the eye due to unopposed action of lateral rectus. Patients develop diplopia in all directions of gaze except for lateral gaze towards the side of involvement. Pupillary function may be normal or impaired. Ref: Greenberg D.A., Aminoff M.J., Simon R.P. (2012). Chapter 7. Neuro-Ophthalmic Disorders. In D.A. Greenberg, M.J. Aminoff, R.P. Simon (Eds),Clinical Neurology, 8e. | train | med_mcqa | null |
A 12-year-old girl has a history of recurrent bulky stools and abdominal pain since 3 years of age. She has moderate pallor and her weight and height are below the 3rd percentile. Which of the following are the most appropriate investigations to make a specific diagnosis? | [
"Small intestinal biopsy",
"Barium studies",
"24 hours fecal fat estimation",
"Urinary d–xylose test"
] | A | Clinical profile of the child given in question makes the diagnosis of malabsorption syndrome associated with chronic diarrhoea.
Intestinal biopsy is necessary to differentiate chronic diarrhoea due to different pathophysiologic reasons.
Work-up of a child suspected to have chronic diarrhoea and malabsorptions includes the following investigations -Repeated stool examination (especially for giardia), Fecal fat excretion studies, D-xylose test, Intestinal biopsy, Specific tests e.g. sweat chloride for cystic fibrosis, serology for celiac disease, exocrine pancreatic function. | train | med_mcqa | null |
Protein structure not lost in denaturation is? | [
"Primary structure",
"Secondary structure",
"Tertiary structure",
"Quaternary structure"
] | A | ANSWER: (A) Primary structureREF: Lehninger 4th Edition page 14, Lippincott's 4th Ed page 22See previous questionRepeat Biochemistry December 2010 | train | med_mcqa | null |
Ketone bodies are used by all except | [
"Brain",
"RBCs",
"Skeletal muscles",
"Hepatocytes"
] | B | In the fasting state, glucose must be spared for use by the central nervous system (which is largely dependent on glucose) and the red blood cells (which are wholly reliant on glucose). Therefore, tissues that can use fuels other than glucose do so; muscle and liver oxidize fatty acids and the liver synthesizes ketone bodies from fatty acids to expo to muscle and other tissues.Ref: Harper&;s Biochemistry; 30th edition; chapter 14; overview of Metabolism & the Provision of Metabolic Fuels | train | med_mcqa | null |
Meckel's diverticulum is a derivative of - | [
"Allantoic diverticulum",
"Vitellointestinal duct",
"Ventral mesogastrium",
"Ductus arteriosus"
] | B | null | train | med_mcqa | null |
T.U.R. (transurethral resection) syndrome is due to - | [
"Hyponatremia",
"Hypokalemia",
"Hypovolaemia",
"Hypoxia"
] | A | TUR syndrome and water intoxication syndrome are same. They are caused due to dilutional hyponatremia. | train | med_mcqa | null |
5-FU is the chemotherapeutic agent of choice for all except - | [
"Ca Breast",
"Ca Stomach",
"Ca Pancreas",
"Ca Colon"
] | C | Ans. is 'c' i.e., Ca pancreas | train | med_mcqa | null |
The conditioned gingival enlargement | [
"Requires presence of local irritants",
"Exacerbates existing inflammation",
"Pregnancy & puberty are the examples",
"All of the above"
] | D | null | train | med_mcqa | null |
Spironolactone bodies are seen in- | [
"Neuron",
"Mitocnondria",
"Hippocampus",
"None of the above"
] | D | null | train | med_mcqa | null |
atypical depression is managed with | [
"MAOI",
"SSRI",
"NDRI",
"SNRI"
] | A | MAOI * IMPOANCE First class of antidepressant drugs that were introduced * MECHANISM There are three monoamines namely dopamine, adrenaline and serotonin. These mon amines are degraded by monoamine oxidase. MAOI inhibit this enzyme and acts increasing monoamines * DRUGS Phenelezine Tranylcipromine * USE ATYPICAL DEPRESSION, depression with reverse vegetative symptoms * SIDE EFFECTS Hypeensive crisis Cheese reaction When a patient on MAOI takes tyramine rich food like tyramine there will be increased release of monoamines. These excess monoamines cannot be degraded by MAO as it is blocked by MAOI. Thus, this may result in hypeensive crisis. Paresthesia's due to pyridoxine deficiency LIKE IPRONIAZID WEIGHT gain SEXUAL dysfunction ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no. 966 | train | med_mcqa | null |
In compression of the inferior mesenteric vein just before it joins the splenic vein, which of the following vein is most likely enlarged | [
"Middle colic vein",
"Left gastroepiploic vein",
"Inferior pancreaticoduodenal vein",
"Left colic vein"
] | D | In compression of the inferior mesenteric vein its tributaries like left colic vein gets enlarged - Venous drainage of Hind-Gut territory. Middle colic vein (option 1) is a tributary of superior mesenteric vein - Venous drainage of Mid-Gut territory. Left gastroepiploic (gastro-omental) vein (option 2) drains into splenic vein. Inferior pancreaticoduodenal vein (option 3) drains into supperior mesenteric vein- Venous drainage of Hind-Gut territory. *Poal vein is formed posterior to the neck of pancreas by the union of the splenic vein and superior mesenteric vein. The inferior mesenteric vein usually ends by joining the splenic vein.The blood within the poal vein carries high levels of nutrients from the GI tract and products of red blood cell destruction from the spleen. | train | med_mcqa | null |
Theophylline Overdose causes: | [
"Bradycardia",
"Seizures",
"Drowsiness",
"Bronchospasm"
] | B | Theophylline has a narrow margin of safety. Adverse effects are primarily to the g.i.t., CNS and CVS. Children are able to develop CNS toxicity. Adverse effects include Dyspepsia, headache, nervousness, insomnia Restlessness, tremors, vomiting, palpitation, diuresis Agitation, tachypnoea, flushing, hypotension Death Convulsions, shock, arrhythmias Delirium, Increased muscle lone, extrasystoles, flashes of light seen. ESSENTIALS OF MEDICAL PHARMACOLOGY 6TH EDITION KD TRIPATHI Page No :221 | train | med_mcqa | null |
A patient is having a malignancy and has been suffering from severe pain. Which of the following opioid analgesics can be used as a transdermal patch for the alleviation of pain in him? | [
"Morphine",
"Pentazocine",
"Fentanyl",
"Tramadol"
] | C | null | train | med_mcqa | null |
Which of the following is not a feature of biologic requirement of tooth preparation | [
"Conservation of tooth structure",
"Avoidance of overcontouring",
"Subgingival margins",
"Harmonious occlusion"
] | C | null | train | med_mcqa | null |
Following clinical feature is seen in which condition? | [
"Hyper parathyroid",
"Cushing disease",
"Addison Disease",
"Grave Disease"
] | D | Ans. D. Grave Diseasea. This image shows clubbing of the fingersb. This is nonspecific finding which can be seen in many conditionsc. If it is associated with thyroid disorder, then it is specifically called as thyroid acropachy. It is seen in Grave's Disease. | train | med_mcqa | null |
A patient, Rama was diagnosed to be having febrile convulsions in the paediatric emergency. Which of the following can be used for the treatment of this patient? | [
"Intramuscular phenobarbitone",
"Intravenous phenytoin",
"Rectal diazepam",
"Oral sodium valproate"
] | C | Diazepam is the drug of choice for febrile convulsions. It is administered intravenously. If i.v. access is not possible, rectal diazepam can be used. Diazepam can be given to counter the overdose of local anesthetic drug | train | med_mcqa | null |
Doc for Heparin induced thrombocytopenia is? | [
"Argatroban",
"Warfarin",
"Low molecular weight heparin",
"Dabigatran"
] | A | DOC for HIT is direct thrombin inhibitor like argatroban. Dabigatran could be used but it has more serious complications so not frequently used. | train | med_mcqa | null |
Anti CD20 is | [
"Alemtuzumab",
"Bevacizumab",
"Gemtuzumab",
"Tositumomab"
] | D | anti cd20 mabs: KD Tripathi 8th ed | train | med_mcqa | null |
Champagne glass pelvis is seen in - | [
"CDH",
"Down's syndrome",
"Cretinism",
"Achondroplasia"
] | D | Radiological features of Achondroplasia : Macrocephaly. Frontal bossing J shaped sella Caudal narrowing of interpedicular distance Champagne glass pelvis Trident hand | train | med_mcqa | null |
The dental surveyors were introduced to the field of dentistry in 1918 by: | [
"Applegates",
"Kennedy",
"Kroll",
"AJ Fortunati"
] | D | null | train | med_mcqa | null |
Microsatellite sequence is: | [
"Small satellite",
"Extra chromosomal DNA",
"Short sequence (2-5) repeat DNA",
"Looped-DNA"
] | C | Ans. C. Short sequence (2-5) repeat DNA(Ref: Robbins 9/e page 179)Repeat length Polymorphism or Short Tandem Repeats or Variable Number Tandem RepeatsDepending on the repeat size it is divided into Microsatellite-- Repeat size of 2-6bp.Minisatellite - Repeat size of 15-70bp. | train | med_mcqa | null |
Cardiac myxoma most common seen in ? | [
"Right Atrium",
"Right Ventricle",
"Left Atrium",
"Left Ventricle"
] | C | Ans. is 'c' i.e., Left AtriumCardiac myxomasMost common primary tumor of the adult hea.Benign neoplasms thought to arise from primitive multipotentmesenchymal cells.Familial syndromes associated with myxomas have activating mutations in the GNAS1 gene, encoding a subunit of G protein (Gsa) (in association with McCune-Albright syndrome) or null mutations in PRKAR1A, encoding a regulatory subunit of a cyclic-AMP- dependent protein kinase (Carney complex).About 90% of myxomas arise in the atria, with a left-to-right ratio of approximately 4 : 1. | train | med_mcqa | null |
Class 3 antiarrhythmic drugs is | [
"Amiodarone",
"Phenytoin",
"Propafenone",
"Pindolol"
] | A | Refer kDT 6/e p 511 Class III agents have the potential to prolong the QT interval of the EKG, and may be proarrhythmic (more associated with development of polymorphic VT). Class III agents include: bretylium, amiodarone, ibutilide, sotalol, dofetilide, vernakalant and dronedarone | train | med_mcqa | null |
Best investigation for Bronchiectasis is? | [
"Chest X Ray",
"MRI",
"Pulmonary Function Tests",
"HRCT"
] | D | ANSWER: (D) HRCTREF: Harrison's Internal Medicine 17th edition chapter 252Though the chest radiograph is important in the evaluation of suspected bronchiectasis, the findings are often nonspecific. CT, especially with high-resolution images 1.0-1.5 mm thick, provides an excellent view of dilated airways. Consequently, it is now the standard technique for detecting or confirming the diagnosis of bronchiectasis. | train | med_mcqa | null |
A 2 year old child with purulent nasal discharge,fever and pain since 2 months. His fever is 102-103 F, and leucocyte count is 12000 cu/mm.X ray PNS showed opacification of left ethmoidal air cells.The culture of the eye discharge was negative. which of the following would be most useful fuher step in evaluation of this patient? | [
"CT Scan",
"Urine culture",
"Blood culture",
"Repeat culture of the eye discharge"
] | A | The best method to assess the state of ethmoidal air cells and it's complications is CT Scan. "CT is paicularly useful in ethmoid and sphenoid sinus infections and has replaced studies with contrast material". Ref Dhingra 5/e,p 209. | train | med_mcqa | null |
Ifosfamide belong to which group of anticancer drugs | [
"Alkylating agents",
"Antimetabolites",
"Metotic inhibitors",
"Topoisomerase inhibitors"
] | A | Ifosfamide is an alkylating agent closely related to cyclophosphamide. Used in testicular tumours, lymphoma, soft tissue tumour.Katzung 12e pg: 953 | train | med_mcqa | null |
Atheromatous changes of blood vessels affects early which of the following organ? | [
"Kidney",
"Hea",
"Liver",
"Spleen"
] | B | Large elastic aeries (e.g., aoa, carotid, and iliac aeries) and large and medium-sized muscular aeries (e.g., coronary, renal, and popliteal aeries) are the vessels most commonly involved by atherosclerosis. Accordingly, atherosclerosis is most likely to present with signs and symptoms related to ischemia in the hea, brain, kidneys, and lower extremities. Myocardial infarction (hea attack), cerebral infarction (stroke), aoic aneurysms, and peripheral vascular disease (gangrene of extremities) are the major clinical consequences of atherosclerosis. ( Robbins Basic Pathology, 9 th edition, page 342 ) | train | med_mcqa | null |
Most common site of gall stone impactation is - | [
"Duedenojejunal junction",
"Proximal to iliocaecal junction",
"Distal to iliocaecal junction",
"Colon"
] | B | Ans is 'b' i.e., Proximal to Ileocaecal junction | train | med_mcqa | null |
Mechanism of action of actinomycin D is ? | [
"Inhibits DNA dependent RNA synthesis",
"Activates DNA dependent RNA synthesis",
"Inhibits RNA dependent DNA synthesis",
"Activates RNA dependent DNA synthesis"
] | A | Ans. is 'a' i.e., Inhibits DNA dependent RNA synthesis The anticancer antibiotics are Actinomycin - D (Dactinomycin) Daunorubicin (Rubidomycin) Mitomycin C Doxorubicin Mitoxantrone Mithramycin (plicamycin) Bleomycins These anticancer, antibiotics obtained from micro-organisms and have prominent antitumour activity. Mechanism of action : They are intercalated between DNA strands and interfere with its template function. Actinomycin `D' inhibits DNA dependent RNA synthesis. Bleomycin cause DNA breakage and free radical formation . Doxo-and daunorubicin inhibit Topoisomerase I & II. Mitomycin acts like alkylating agents. Mitoxantrane binds to DNA to produce strand breakage and inhibits both DNA & RNA synthesis. Remember All antitumor antibiotics are cell cycle nonspecific except for bleomycin which acts in G2 phase. | train | med_mcqa | null |
Anesthesia agent with least analgesic propey | [
"N20",
"Halothane",
"Ether",
"Propane"
] | B | B i.e. Halothane | train | med_mcqa | null |
NOT a feature of dementics: WB 09 | [
"Loss of sensorium",
"Wearing of diy clothes",
"Forgetfulness",
"Loss of neurons in brain matter"
] | A | Ans. Loss of sensorium | train | med_mcqa | null |
A 15-year-old female presents to your office with secondary amenorrhea. As part of your evaluation, you find that she is pregnant. After informing her of the pregnancy, you continue to explain that young mothers have a higher risk of several pregnancy-related complications, including which of the following? | [
"Twin gestation",
"Low-birth weight infants",
"Hypotension",
"Excessive weight gain"
] | B | Adolescents are typically healthy and do not have chronic disease. However, several pregnancy complications occur more frequently in teens, including poor weight gain in the mother, premature delivery, low birth weight, and an increased risk of pregnancy-induced hypertension. The risk of violence is also elevated for teen mothers. As both parents age, the risk of genetic defects in their infant increases. Teen mothers have a lower risk of twin gestation. | train | med_mcqa | null |
Amylase increased in pleural fluid is seen in following except: | [
"Rheumatoid ahritis",
"Esophageal perforation",
"Malignancy",
"Gall stone pancreatitis"
] | A | Answer is A (Rheumatoid ahritis): Rheumatoid Ahritis is not associated with increased amylase in pleural fluid. Conditions with High Amylase in pleural Fluid Esophageal RuptureQ Pancreatic effusionQ MalignancyQ | train | med_mcqa | null |
All are true about nasopharyngeal angiofibroma except: | [
"Seen exclusively in age group of 10-20 years",
"Seen exclusively in males",
"Recurrent bleeding is most common presentation",
"X-ray is IOC"
] | D | Ans: D (X...) NASOPHARYNGEAL ANGIOFIBROMA P.LDhingra 6th/246-50As the tumour is predominantly seen in adolescent males in the second decade of life, it is thought to be testosterone dependentAge & sex: Tumour is seen exclusively in males in age group of 10-20 yearsProfuse, recurrent & spontaneous epistaxis is the most common presentationOther clinical features include: progressive nasal obstruction & denasal speech; conductive hearing loss & otitis media with effusion; mass in the nasopharynx etcCT scan of head with contrast is now the investigation of choiceSurgical excision is the treatment of choice though radiotherapy & chemotherapy singly or in combination have also been used | train | med_mcqa | null |
The burden of disease is given by? | [
"Incidence",
"Crude death rate",
"specific death rate",
"Propoional moality rate"
] | D | ref: Park's 23rd edition pg 58 Propoional moality rate is the number of deaths due to a paicular cause (or in a specific age group) per 100 (or 1000) total deaths. hence it actually gives burden of disease. | train | med_mcqa | null |
An adolescent child complains of night pain in the knee. It could be due to - | [
"Juvenile rheumatoid ahritis",
"Idiopathic growth pain",
"Osteosarcoma",
"Paget's disease"
] | A | Ans. is 'a' i.e., Juvenile rheumatoid ahritis Causes of knee pain in adolescence (..)Time of the knee pain helps in the diagnosis of the disorders : - I. Night pain indicates i) Inflammatory disorder ---)Juvenile rheumatoid ahritis. ii) Bursitis, synovitis iii) Tumor Osteosarcoma Pain at the end of the day and after activity indicates i) Mechanical pain due to injury Continuous pain present day and night indicates i) Infection ---> Osteomyelitis, Septic ahritis ii) Idiopathic adolescent anterior knee pain syndrome (Chondromalacia patella). | train | med_mcqa | null |
Most common site of sub ependymal astrocytoma (Giant cell): | [
"Trigone of lateral ventricle",
"Foramen of Monro",
"Temporal horn of lateral Ventricle",
"4th Ventricle"
] | B | SubEpendymal Giant cell Astrocytoma Most common site of subependymal giant cell astrocytoma is the ependymal wall of lateral ventricle near the foramen of Monro Causes obstruction at the foramen of Monro leading to ventricular enlargement and raised ICT Presence of multiple periventricular calcific foci (calcified subependymal nodules) suggest the diagnosis of Tuberous sclerosis with subependymal giant cell astrocytoma Ref: Neurology in Clinical practice 4th edition Pgno: 428 | train | med_mcqa | null |
Therapeutic exposure is form of_______ therapy. | [
"Psychoanalytical",
"Supportive",
"Cognitive",
"Behavioural"
] | D | Ans. D. Behavioral.(Ref: Kaplan & Sadockfs Synopsis of Psychiatry, Xth/Ch.35.8, Page no, 954).Therapeutic exposure is form of Behavioral therapy.A behavioral therapist would most likely instruct the patient to change his/her behavior as an antecedent to recovery (such as exercising or another activity).No medication has proven to be effective in treating specific phobias. The Rx of choice for specific phobias is exposure, in vivo or using techniques of guided imagery, pairing relaxation exercises with exposure to the feared stimulus. The patient can be exposed to the feared stimulus gradually or can be asked to immediately confront the most anxiety- provoking situation (flooding).Discussion:LEARNING THEORY & BEHAVIORAL THERAPY# Goals = change behavior & think more accurately# Specific phobia: ex. dogs, flying, heights, snakes- Therapy* Behavioral - Exposure therapy6# Prolonged & frequent (6-10) sessions# Gradual exposure to stimulus# End when anxiety reduced- Learning principles* Conditioning (stimulus elicits maintained response)* Negative reinforcement (behavior repeated to avoid a negative emotion)* Habituation (fear eliminated by prolonged contact w/ phobic stimulus)# Social phobia: ex. public speaking; fear of being scrutinized by others- Therapy* Cognitive - Cognitive restructuring- Correct irrational thinking* Behavioral - Exposure therapy & social skills training# Social distance, eye contact, movement, content- Learning principles* Modeling (observe others)* Shaping (acquire behavior by reinforcement)* Positive reinforcement (behavior ? in frequency by reward)* Punishment (behavior ? in frequency)* Irrational thinking (inaccurate beliefs that others are scrutinizing)i. Psychoanalysis would also use the understanding of the patient and the recreation of the past through clarification, confrontation, and interpretation, but typically the patient comes to the office more frequently than once per week, and often, though not always, the patient lies on a couch facing away from the therapist.ii. An experiential-humanistic therapist would focus on developing a supportive and gratifying relationship with the patient to help provide the empathic responsiveness that was hypothesized as absent in the patient's past.iii. A cognitive therapy would most likely focus on the negative worldview of the patient and attempt to restructure those thoughts. Cognitive therapy is based on the principle that psychopathology derives from the patient's faulty, distorted beliefs about him- or herself and the world (schemas). | train | med_mcqa | null |
Management of stone on CBD includes following except | [
"ERCP",
"Laparoscopic CBD exploration",
"Medical dissolution of stone",
"Endosphincteric removal"
] | C | Medical dissolution of stone is used for gallstones, not the CBD stones CBD ctones are rarely asymptomatic, often present with complication CBD stones should be treated, if diagnosed. Treatment options include ERCP, laparoscopic or open CBD exploration Ref : Bailey and love 27th edition Pgno : 1200 | train | med_mcqa | null |
Swarming motility is shown by: | [
"Proteus",
"Cholera",
"Shigella",
"Salmonella"
] | A | Ref: Ananthnaraycm R, Paniker CKJ. Textbook of Microbiology. 8th Edition. Hyderabad: Universities Press; 2009. Pg 280-1Explanation:OrganismCharacteristic motilityVibrioDarting motilityListeria monocytogenesTumbling motilityClostridium tetaniStately motilitySpirochaetesCork-screw motilityProteus and Clostridium tetaniSwarmingSalmonellaSluggishly motile with oeritrichous flaaellaShioellaNon-motileSwarming of ProteusProteus mirabilis and Proteus vulgaris swarm on solid culture media.Discrete colonies are seen in young cultures but thereafter actively motile cells spread on the surface of the plate in successive waves to form a thin filmy layer in eoneentrie circles.Several methods have been used to inhibit swarming:Increased (600) concentration of agarIncorporation of chloral hydrate (1:500), sodium azide (1:500), alcohol (5-6 %), sulphonamide, surface active agents or boric acid (1:1 000).Swarming does not occur on MacConkey's medium, on which smooth colourless colonies are formed. | train | med_mcqa | null |
A pregnant lady was found to be HIV positive in First trimester. Next line of management is: | [
"Sta A now, continue throughout pregnancy and till 6 weeks after delivery",
"Sta A now, continue throughout pregnancy and till lifelong",
"Sta A after First trimester, continue throughout pregnancy and till 6 weeks after delivery",
"Sta A after First trimester, continue throughout pregnancy and till lifelong"... | B | Current guidelines A should be staed at any CD4 count Any age Any clinical staging Any & all population New born of HIV +ve mother should be given nevirapine & cotrimoxazole, after delivery In HIV +ve pregnant female,sta A As soon as possible , throughout pregnancy & lifelong | train | med_mcqa | null |
A child presents with unilateral proptosis which is compressible and increases on bending forwards. It is non-pulsalite and has no thrill or bruit. MRI shows retroorbital mass with echogenic shadows. Which of the following is the most probable diagnosis? | [
"Orbital varix",
"Orbital Encephalocoele",
"Orbital A - V malformation",
"Neurofibromatosis"
] | A | The patient in question is presenting with characteristic signs of orbital varix. Proptosis from orbital varix is unilateral (most cases) non pulsalite and has no thrill or bruit. It is compressible and is characteristically precipitated by increasing venous pressure as in assuming a dependent position, (bending forwards). MRI may show echogenic shadows from phebolititis (Venous stasis leads to formation of pheboliths). Ref: Yanojf and Ducker ophthalmology 2nd Edition, Page 731 - 740; Kanski Clinical Ophthalmology 3rd Edition, Page 180 -188. | train | med_mcqa | null |
Gynaecomastia and infertility is caused by? | [
"Flutamide",
"Cimetidine",
"Ranitidine",
"Methotrexate"
] | B | ANSWER: (B) CimetidineREF: APPENDIX-39 below for "DRUGS CAUSING GYNAECOMASTIA"Repeat Pharmacology 2013 Session 2Indirect repeat Pharmacology 2012 Session II, 2006 APPENDIX - 39Causes Of Gynecomastia:IdiopathicDrugs (partial list)Physiologic causesNeonatal periodPubertyAgingObesityAlcoholAlkylating agentsAmiodaroneAnabolic steroidsAndrogensBicalutamideBusulfanChorionic gonadotropinCimetidineCiomipheneCyclophosphamideDiazepamDiethylstilboestro!Digitalis preparationsEstrogens (oral or topical)EthionamideFinasterideFlutamideGoserelinHAARTHaloperidolHydroxyzineIsoniazidKetoconazoleLeuprolideMarijuanaMethadoneMethyldopaMetoclopramideOmeprazoleOpioidsPenicillaminePhenothiazinesProgestinsProtease inhibitorsReserpineRisperidoneSomatropin (growth hormone)SpironolactoneTestosteroneThioridazineTricyclic antidepressants | train | med_mcqa | null |
Testicular feminisation syndrome is associated with : | [
"46 XX",
"Presence of vagina",
"Primary amenorrhea",
"Sho stature"
] | C | Primary amenorrhea | train | med_mcqa | null |
All are non-proliferative glomerulonephritis, except: | [
"Membranous glomerulonephritis",
"Mesangiocapillary glomerulonephritis",
"Diabetic glomerulosclerosis",
"Amyloidosis"
] | B | Conditions with Proliferative Glomerulonephritis : SLE (paicularly class II) HIV Membranoproliferative/Mesangiocapillary glomerulonepritis Neoplasia (CLL and MALT lymphoma) Post streptococcal glomerulonephritis Rest all options are the conditions with non proliferative glomerulonephritis. | train | med_mcqa | null |
Which of the following is a commonest cause for neuralgic pain in foot? | [
"Injury to deltoid ligament",
"Shoening of plantar aponeurosis",
"Exaggeration of longitudinal arches of foot",
"Compression of communication between medial and lateral planter nerves"
] | D | Compression of communication between medial and lateral plantar nerves is a common cause for neuralgic pain in foot. At the flexor retinaculum, the tibial nerve divides into the lateral and medial plantar nerves, compression here results in tarsal tunnel syndrome. Tarsal tunnel is located deep to the flexor retinaculum and posterior and inferior to the medial malleolus. It contains the posterior tibial nerve, tibialis posterior, flexor or digitorum longus and flexor hallucis longus tendons along with posterior tibial aery and vein. Posterior tibial nerve divides within the tarsal tunnel into 3 branches: medial calcaneal nerve, lateral plantar nerve and medial plantar nerve. Tarsal tunnel syndrome result from the entrapment of posterior tibial nerve and one of its branches. Patients presents with poorly localized burning pain and parasthesia along the plantar surface of the foot and toes. Ref: Musculoskeletal Diseases 2009-2012: Diagnostic Imaging By J. Hodler, Page 55. | train | med_mcqa | null |
Intracorpuscular hemolytic anemia is seen in ? | [
"Autoimmune hemolytic anemia",
"TTP",
"Thalassemia",
"Infection"
] | C | Ans. is 'c' i.e., Thalassemia | train | med_mcqa | null |
IUCD with highest incidence of ectopic pregnancy is : | [
"Lippe's loop",
"Copper T",
"Progestase",
"All have equal incidence"
] | C | Progestase | train | med_mcqa | null |
Researchers surveyed the causes of vitamin D deficiency and its geographic distribution. They found that exposure to ultra violet rays is crucial for its adequacy, which when get excessively filtered by the skin result in its deficiency. This deficiency is more common in | [
"Asians",
"Black Africans",
"Mongoloids",
"Europeans"
] | B | null | train | med_mcqa | null |
Cysteine is formed from - | [
"Methionine and serine",
"Methionine and glycine",
"Alanine and glycine",
"Serine and glycine"
] | A | Ans. is 'a' i.e., Methionine and Serine o Cysteine, while not nutritionally essential, is formed from methionine, which is nutritionally essential. Following conversion of methionine to homocysteine , homocysteine and serine form cystathionine, whose hydrolysis forms cysteine and homoserine .o The sulfur of cysteine derives from methionine and the carbon skeleton from serine. | train | med_mcqa | null |
True about complete mole:a) Presence of foetal parts and cardiac activityb) Normal uterine sizec) Beta hCG doubling time is 7-10 daysd) Pre eclampsia at < 24 weekse) Per vaginal bleeding is commonest presentation | [
"bde",
"ade",
"ace",
"bce"
] | A | Complete Mole – Is that variety of H. mole in which no evidence of fetal tissue is seen. (i.e. option a is incorrect) M/C presenting symptom in H. mole is vaginal bleeding.
“Vaginal bleeding is the most-common symptom causing patient to seek treatment for complete mole pregnancy.” Novak 14/e, p 1585 (i.e. option ‘e’ is correct)
Early onset preeclampsia – if features of precampsia are present in < 24 weeks, complete mole should always be suspected (i.e. option ‘d’ is correct)
On P/A examination in molar pregnancy –size of the uterus in more than the expected period of amenorrhea in 70%,it corresponds with the period of amenorrhea in 20% and is smaller than the period of amenorrhea in 10% cases Thus normal size uterus may be seen in case of H. mole.
“Excessive uterine enlargement relative to gestational age is one of the classic signs signs of complete mole, although it is present in only about one half of the patients.
Novak 14/e, p 1585.
The clinical presentation of a complete mole has changed considerably over the past few decades.
“More than half of the patients diagnosed in the 1960’s and 1970’s had anemia and uterine size in excess of that predicted for gestational age. Complete moles, however, present infrequently today with these traditional signs and symptoms.”
Willimams Gynae 1/e, p757
So from above lines, it is clear that uterine size more than the period of amenorrhea, was earlier a more common and typical presentation of complete H. moles. These days more common picture is uterine size corresponding of the period of amenorrhea. Thus, I am including option ‘b’ in correct answers.
As far as hCG levels are concerned :
In case of molar pregnancy, levels of b-hCG are higher than that which are expected for that gestational age (due to trophoblastic proliferation), but the doubling time is same i.e. 1.4-2 days | train | med_mcqa | null |
Accidental injury of the ureter during abdominal operation should be managed by all except; | [
"Deligation",
"End-to-end anastomosis through an ureteric catheter",
"Implantation into the bladder",
"Colonic implantation"
] | D | Management when injury is recognised during operation Urethral ligation:Deligation immediately -> assessment of bility of blood flow and urethral peristalsis. Ureteric implantation:Into the bladder must be done without any tension.High mobilisation of bladder is required and bladder dome is sutured to the psoas muscle on that side. End to end anastamosis through an ureteric catheter urethral sheath denudation urethral kinking bladder flap procedure D.C.DUTTA&;S TEXTBOOK OF GYNAECOLOGY,Pg no:426,427,6th edition | train | med_mcqa | null |
True about helicobacter pylori are all except - | [
"Urea breath test is diagnostic",
"Grain negative, flagellate bacilli",
"Risk factor for development of adenocarcinoma of stomach",
"It provides life long immunity"
] | D | null | train | med_mcqa | null |
Hydroxylation of proline requires - | [
"Vitamin B1",
"Vitamin D",
"Vitamin C",
"Vitamin E"
] | C | Ans. is 'c' i.e., Vitamin C o Hydroxylation of proline and lysine residue takes place during post-translational modification in rough ER. The enzyme catalyzing the reactions are prolyl hydroxylase (for proline) and lysyl hydroxylase (for lysine). Both these enzymes are dioxygenases using molecular oxygen (O2) and cofactor for both these enzymes is vitamin C (ascorbic acid). a-Ketoglutatrate is a coreductant, which is oxidized to succinate.Proline (or lysine) + a-ketoglutarate + O2Prolyl (or lysyl) hydroxylase-----------------------Vitamin 'C'Hydroxyproline (or hydroxylysine)+Succinateo These hydroxylated amino acids are not reprsented in the genetic code (i.e. there is no t-RNA for these), therefore they have to be synthesized post-translationally from proline and lysine residue in the polypeptides. | train | med_mcqa | null |
Band forms are evident at what stage of the plasmodium malariae life cycle? | [
"Trophozoite",
"Schizont",
"Male gametocyte",
"Female gametocyte"
] | A | Ans. is 'a' i.e., Trophozoite | train | med_mcqa | null |
The tail of pancreas related with - | [
"Splenicorenal ligament",
"Gastrosplenic ligament",
"Phrenico colic ligament",
"Falciform ligament"
] | A | The tail of pancreas is related to splenorenal (linorenal) ligament. | train | med_mcqa | null |
Which of the following is a marker for neural tube defects – | [
"↑ Phosphatidyl Esterase",
"↑ Pseudocholinesterase",
"↑ Acetylcholinesterase",
"↑ Butyrylcholinesterase"
] | C | null | train | med_mcqa | null |
True regarding Crohn&;s disease is all Except | [
"Scleroderma",
"Transmural involvement",
"Cobble stone appearence",
"Skin involvement"
] | A | Features of Chron's disease mnemonic: FIND CASH Fissures Ileum Non-caseating granuloma Distoion of mucosal architecture Creeping fat, Crypt abscess, Cobblestone appearance. Aphthous ulcer Skip lesions Hose pipe like bowel | train | med_mcqa | null |
The term catatonia is coined by - | [
"Kahlbaum",
"Freud",
"Maxwell jones",
"Adler"
] | A | null | train | med_mcqa | null |
A person who subsisted on taking maize only for many years reported to a health facility with the signs of glossitis. His history suggested frequent attacks of diarrhea and memory loss. The likely condition is | [
"Iron deficiency",
"Riboflavin deficiency",
"Beri Beri",
"Pellagra"
] | D | null | train | med_mcqa | null |
The following separation technique depends on the molecular size of protein: | [
"Chromatography on a carboxymethyl (CM) cellulose column",
"Isoelectric focusing",
"Gel filtration chromatography",
"Chromatography on a diethyl amino ethyl (DEAE)cellulose column"
] | C | Ans. is 'c' ie., Gel filtration chromatography These are different techniques of purification of proteins. They take advantage of one or other property of protein for their separationOption (a) and (d)Chromatography on carboxymethyl cellulose column or diethyl aminomethyl cellulose column separate protein depending on the net electric charge of the proteinsOption (b)Isoelectric focusing separates proteins according to their isoelectric pointsOption (c)Gel filtration chromatography separates protein according to their molecular sizesLehninger states - "Gel filtration column matrix is a cross-linked polymer with pores of selected size. larger proteins migrate faster than smaller ones because they are too large to enter the pores in the beads and hence take a more direct route through the column. The smaller proteins enters the pores and are slowed by the more labyrinthine path they take through the column" | train | med_mcqa | null |
All of the following are indicators of air pollution except | [
"CO",
"SO2",
"Soiling index",
"Smoking index"
] | D | Soiling index or smoke index is used to monitor air pollution. Best indicators of air pollution are sulfur dioxide, smoke index, grit and dust measurement, coefficient of haze and Air pollution index. Smoking index is measured by multiplying the number of cigarettes smoked per day by the number of years the person has smoked. Park's Textbook of Preventive and Social Medicine, 25th Edition, Pg 796 | train | med_mcqa | null |
Ubiquitin role in: | [
"Protein degradation",
"Protein synthesis",
"Protein folding",
"Protein transpoation"
] | A | Proteins that are misfolded or destined for degradation are marked for destruction by , highly conserved protein called ubiquitin. Ubiquitinated proteins are rapidly degraded by a cytosolic complex known as the proteasome. | train | med_mcqa | null |
Hallucinations are seen after ............... anaesthesia: | [
"Ketamine",
"Thiopentone",
"Fentanyl",
"Nitrous oxide"
] | A | Ketamine anesthesia produces hallucination and delirium(pyschomimetic effect). Thiopentone , Fentanyl and nitrous oxide are devoid of these effects. From padmaja 4th edition Page no 196,195 | train | med_mcqa | null |
Expression and consequent release of previously repressed emotion is | [
"Regression",
"Passive aggression",
"Abreaction",
"Undoing"
] | C | Abreaction is a process by which repressed material is remembered back, relived again along with expression of associated emotions.
It is a type of Catharasis (purging of emotions) used as therapy in few psychiatric disorders. | train | med_mcqa | null |
Paramyxovirus includes - | [
"Retrovirus",
"Poliovirus",
"Parainfluenza",
"Rabies"
] | C | Paramyxoviridae consists of new castle disease virus, mumps virus, parainfluenza virus, mumps virus, and respiratory syncytial viruses. REF:ANATHANARAYAN AND PANIKER'S TEXTBOOK OF MICROBIOLOGY 9TH EDITION PAGE NO:496 | train | med_mcqa | null |
Most important step in cholera control - | [
"Chemoprophylaxis",
"Vaccination",
"Early treatment",
"Water sanitation"
] | D | Ans. is 'd' i.e., Water sanitationControl of cholera (WHO guidelines)o Measures taken to control cholera epidemic are1) Verification of diagnosis: Identification of V. cholera 01 in stools of few patients is sufficient. It is not necessary to culture stools of all cases or contacts.2) Notification: Cholera is notifiable disease locally, nationally and internationally. Under the International health Regulations, cholera is notifiable to WHO within 24 hours of its occurrence by national government. An area is declared free of cholera when twice the incubation period (i.e., 10 days) has elapsed since the death, recovery or isolation of the last case.3) Early case finding4) Establishment of treatment centers.5) Rehydration therapy: Oral (ORS) or intravenous.6) Adjunct to therapy: Antibiotic should be given as soon as vomiting has stoped. Doxycyclone (tetracycline) in single dose is the treatment of choice in adults. In children, cotrimoxazole is the drug of choice. Furazolidine is preferred in pregnant females.7) Epidemiological investigation: Epidemiological studies.8) Sanitation measures: As water is the most important vehicle, provision of safe water (chlorination or boiling) is most important. Other important measures are proper excreta disposal, food sanitation and disinfection of stools/vomits/clothes etc by cresol.9) Chemoprophylaxis: Chemoprophylaxis to close contact is indicated. Mass chemoprophylaxis is not advised. Drug of choice is tetracycline.10) Vaccination: They are of no value in controlling epidemic.11) Health education: The most effective prophylactic measure. | train | med_mcqa | null |
Which of the follow ing causes urine discoloration- | [
"Isoniazid",
"Rifampin",
"Streptomycin",
"Ethambutol"
] | B | Ans. is 'b' i.e., Rifampin Drugs causing urine discolourationo Chloroquineo Iron saltso Levodopao Metbyldopao Metronidazoleo Naphthaleneo Nitrofurantoino Phenacetino Quinineo Sulfonamideso Anthraquinoneo Methylene blueo Triamtereneo Amitriptylineo Primaquineo Rifampino Aminosalicylic acido Indomethacino Chlorzoxazoneo Heparino Phenazopyridineo Phenindioneo Sulfasalazineo Warfarino Aminopyrineo Phenolphthaleino Daunorubicino Doxorubicino Riboflavin | train | med_mcqa | null |
The connective tissue cells of pulp are derived from | [
"The pool of undifferentiated mesenchymal cells",
"The pool of fibroblasts",
"The pool of undifferentiated ectodermal cells",
"The pool of osteoblasts"
] | A | null | train | med_mcqa | null |
Which of the following does not stimulate enterogastric reflex? (NOT RELATED) | [
"Products of protein digestion in the duodenum",
"Duodenal distension",
"H+ ions bathing duodenal mucosa",
"Cholecystokinin"
] | D | . | train | med_mcqa | null |
Wilson disease is caused by defect in | [
"ATP 7A mutation",
"ATP 6A mutation",
"ATP 6B mutation",
"ATP 7B mutation"
] | D | ATP 7B gene on chromosome 13 is mutated in Wilson disease. | train | med_mcqa | null |
which of the following is a type of Type A disorder | [
"acheivement oriented",
"magical thinking",
"odd and excentric",
"pessimistic"
] | A | there are two types of personality disorders TYPE A PERONALITY PEOPLE are called' BORN WARRIORS' who are workaholics end up having hea disease TYPE D PERSONALITY PEOPLE are called 'BORN WORRIERS' who ruminate and have high risk of hea disease Ref. kaplon and Sadock synopsis of psychiatry, 11 th edition, pg no.746 | train | med_mcqa | null |
A 70 year old male , known case of chronic renal failure suffers from a pathological fracture of Rt femur, the diagnosis is | [
"Primary Hrperparathyroidism",
"Secondary Hyperparathyroidism",
"Scurvy",
"Vitamin D Resistant rickets"
] | B | Answer- B. Secondary HyperparathyroidismIn CRF there is secondary hyperparathyroidism which causes pathological fracture. | train | med_mcqa | null |
Akalinisation of urine may be done in case of poisoning with | [
"Barbiturates",
"Amphetamine",
"Alcohol",
"Morphine"
] | A | (A) (Barbiturates)* Forced alkaline diuresis is valuable in aspirin and barbiturate poisoning (phenobarbitone).Forced alkaline diuresis* Forced alkaline diuresis implies achieving an alkaline urinary pH of 7.5 to 9* This promotes excretion of drugs that are weak acidsDrugs that can be eliminated by alkaline diuresis include* Salicylates* Barbiturates (Long acting/ phenobarbitone)* Chlorpropamide* Methotrexate**** Lithium, Isoniazid (controversial)* Alkaline dieresis is usually achieved with sodium bicarbonate** and may be forced by using urea, furesamide or mannitol infusions.Elimination of Absorbed bv DiuresisAlkaline DiuresisAcid Diuresis* Salicylates* Barbiturates* Amphetamine* Quinine* Phenylcylidine* Strychnine* Aldrich Mees lines on finger nails seen in poisoning of - Arsenic* Burtonium line seen in Lead (chronic lead poisoning)Classic Triad of chronic mercury ooisonins | |||Excessive salivation&Gingivitis*TremorsNeuropsychialnc changes* Erethism* Other features- Mercuria lends*** - Nephritis (DCT)*** - Acrodynia*** - Abortion is common** - Minimata disease * ** Rain drop pigmentation of skin, hyperkeratosis of palms, lines on nails (Mees line) and paraesthesias are classical signs of chronic arsenic poisoning.Aluminium phosphide poisoning (celphos)(i) Aluminium phosphide produces phosphine gas on coming in contact with moisture which inhibits cytochrome c- oxidase(ii) AP causes wide spread organ damage due to cellular hypoxia as a consequence of non competitive inhibition of the enzyme cytochrome oxidase of the mitochondria(iii) CP- retrosternal burning, epigastric pain and vomiting hypotension, restlessness, tachypnea, oliguria or anuria, jaundice, impaired sensorium and cardiac arrhythmias, focal myocardial necrosis and changes in action membrane potential to result of alteration in permeability of Na+ Mg++ Ca + ionsDiagnosis1. Garlicky (or decaying fish) odour from mouth with highly variable arrhythmias2. Confirmation can be done by Silver Nitrate test.3. Most specific and sensitive method for detecting the pH 3 in blood/air in gas chromatographyTreatment - No specific antidote, Gastric lavage with Pottasium permagnate + supportive | train | med_mcqa | null |
Knots in umbilical cord | [
"Caused by fetal movement",
"Very high risk of still birth",
"Dangerous in Diamniotic twins",
"Always indication for C-section"
] | A | Knots in umbilical cord are caused by fetal movements.
Common in monoamniotic twins (dangerous). C-section is not indicated always. | train | med_mcqa | null |
Which of the following characterizes Atkins diet? | [
"Severly reduced fat content",
"Severly reduced carbohydrate content",
"Severly reduced protein content",
"Reduced mineral content"
] | B | Recent data suggests that very low carbohydrate "Atkins" style diets are more effective for short-term weight loss when compared with standard caloric restriction. However, these diets have not been shown to be effective in maintaining weight loss. | train | med_mcqa | null |
A primigravida with full term pregnancy in labor for 1 day is brought to casualty after dia handing. On examination she is dehydrated, slightly pale, bulse 100/min, BP120/80 mm Hg. abdominal examination reveals a fundal height of 36 weeks, cephalic presentation, foetal heart absent, mild uterine contractions present. On P/V examination, cervix is fully dialted, head is at +1 station, caput with moulding present, pelvis adequate. Dirty, infected discharge is present. What would be the best management option after initial work-up? | [
"Cesarean section",
"Oxytocin drip",
"Ventouse delivery",
"Craniotomy and vaginal delivery"
] | A | Well friends lets first analyse the condition of patient and then think about its management:
Patient is primigravida
On examination:
– Dehydration is present
– P/R is 100/min, i.e. tachycardia present.
PIA
Fundal height-36 weeks
Presentation-cephalic
FHS-Absent
Mild uterine contractions are present.
P/V
Cervix-fully dilated
Station = + 1
Caput present
Moulding present
Dirty infected discharge is present.
Most importantly–Pelvis is adequate.
This patient is undoubtedly a case of obstructed labour. As we all know in nulliparous females in case of obstructed labour— a state of uterine exhaustion is reached manifested as weakened uterine conditions.
In such cases, if oxytocin drip is given it may lead to rupture of uterus as lower segment is thinned out (i.e. option ‘b’ ruled out).
Craniotomy and other destructive procedures are not carried out in modern obstetrics (i.e., option ‘d’ ruled out).
Mgt: of obstructed labor cesarean section | train | med_mcqa | null |
From full dilatation of cervix to complete bih of baby is? | [
"1st stage",
"2nd stage",
"3rd stage",
"4th stage"
] | B | 2nd stage. | train | med_mcqa | null |
Enzyme deficients in von gierke&;s disease | [
"Glucose 1 phosphatase",
"Glucose 6 phosphatase",
"Acid maltase",
"b Glucosidase"
] | B | Repreated question | train | med_mcqa | null |
Which of the following drugs inhibit the entry of human immunodeficiency virus (HIV) into the - | [
"Enfluviide",
"Eirenz",
"Etravirine",
"Emtricitabine"
] | A | Enfuviide (INN) is an HIV fusion inhibitor, the first of a class of antiretroviral drugs used in combination therapy for the treatment of HIV-1 infection. It is marketed under the trade name Fuzeon (Roche). Enfuviide works by disrupting the HIV-1 molecular machinery at the final stage of fusion with the target cell, preventing uninfected cells from becoming infected. A biomimetic peptide, enfuviide was designed to mimic components of the HIV-1 fusion machinery and displace them, preventing normal fusion. Drugs that disrupt fusion of virus and target cell are termed entry inhibitors or fusion inhibitors. HIV binds to the host CD4+ cell receptor the viral protein gp120; gp41, a viral transmembrane protein, then undergoes a conformational change that assists in the fusion of the viral membrane to the host cell membrane. Enfuviide binds to gp41 preventing the creation of an entry pore for the capsid of the virus, keeping it out of the cell. Enfuviide is also an activator of the chemotactic factor receptor, formyl peptide receptor 1, and thereby activates phagocytes and presumably other cells bearing this receptor (see formyl peptide receptors). The physiological significance of this activation is unknown. Ref Harrison20th edition pg 979 | train | med_mcqa | null |
Black pigmented bacteroides release ______ as agent
responsible for unpleasant smell of breath. | [
"Methyl mercaptan",
"Hydrogen sulphide",
"Dimethyl sulphide",
"Propionic acid"
] | B | null | train | med_mcqa | null |
Test used to differentiate between maternal and fetal blood in a given sample | [
"Kleihauer-Betke test",
"Osmotic fragility test",
"Apt test",
"Bubbling test"
] | C | Ans. c. Apt test Both Apt test and Kleihauer-Betke test can be used to detect the presence of fetal blood within a sample but test used to differentiate between maternal and fetal blood in a given sample is Apt test. Apt Test: Used to detect the presence or absence of fetal blood (qualitative) in a vaginal discharge to rule out vasa pre late in pregnancy or to detect the origin of a neonatal bloody vomiting, whether it is a genuine upper GI hemorrhage/ hemoptysis or simply swallowed maternal blood during delivery or from cracked nipple. Kleihauer-Betke Test: The sample is maternal peripheral smear and is used to see how much of fetal blood (quantitative) has been transfused into the maternal serum in order to assess the risk of isoimmunization and then the risk of hemolytic disease of newborn. Both of them relies on the fact that HbF is resistant to alkali (Apt) and acids (Kleihauer-Betke) and so the HbA containing RBCs (Maternal) will be hemolyzed but not the fetal RBCs as they contain the HbF. When fetal blood needs to be differentiated from maternal blood Apt test is usedQ (Qualitative estimation) When the amount of fetal bleeding needs to be estimated Kleihauer-Betke test is usedQ (Quantitative estimation) Apt test Kleihauer-Betke test Source of sample Maternal or neonatal MaternalQ Principle Adding 1% NaOH destroys adult HbA but not fetal HbF Adding acid destroys adult HbA but not fetal Assessment Type QualitativeQ QuantitativeQ Result Positive means blood is of fetal origindeg Repoed in estimated milliliters of fetal | train | med_mcqa | null |
Head & neck burn in children is | [
"15%",
"18%",
"12%",
"32%"
] | B | Berkow formula to estimate Burn size Body pa 0-1 year 1-4 years 5-9 years Head 19 17 13 Neck 2 2 2 Anterior trunk 13 13 13 Posterior trunk 13 13 13 Ref: Sabiston 20th edition Pgno :508 | train | med_mcqa | null |
Manifestations of vitamin E deficiency includes all except: | [
"Hemolysis",
"Testicular atrophy",
"Neurological involvement",
"Thrombocytopenia"
] | D | Ref: Harrison's Principles of Internal Medicine, 18edExplanation:Vitamin Eit includes ail stereoisomers of tocopherols and tocotrienols.Vitamin E acts as a chain-breaking antioxidant and is an efficient pyroxyl radical scavenger that protects low-density lipoproteins (LDLs) and polyunsaturated fats in membranes from oxidation.A network of other antioxidants (e.g.. vitamin C. glutathione) and enzymes maintains vitamin E in a reduced state.Vitamin E also inhibits prostaglandin synthesis and the activities of protein kinase C and phospholipase .42.Absorption and MetabolismAfter absorption, vitamin E is taken up from chylomicrons by the liver, and a hepatic - tocopherol transport protein mediates intracellular vitamin E transport and incorporation into very low density lipoprotein (VLDL).The transport protein has particular affinity for the RRR isomeric form of -tocopherol; thus, this natural isomer has the most biologic activity.RequirementThe RDA for vitamin E is 15 mg/d (34.9 mol or 22.5 IU) for all adults.Dietary deficiency of vitamin E does not exist.Vitamin E deficiency is seen along with certain diseases.Prolonged malabsorptive diseasesCeliac diseaseSmall-intestinal resection Cystic fibrosisProlonged cholestasisAbetalipoproteinemiaFamilial isolated vitamin E deficiency (Detect in the -tocopherol transport protein)Clinical FeaturesAreflexiaHemolytic anemiaAxonal degeneration of the large myelinated axonsPosterior column and spinocerebellar symptomsPeripheral neuropathyAtaxic gaitDecreased vibration and position sensations.OphthalmoplegiaSkeletal myopathyPigmented retinopathyThe laboratory diagnosis of vitamin E deficiency is made on the basis of low blood levels of - Tocopherol (<5 g/mL, or <0.8 mg of - tocopherol per gram of total lipids).Treatment: Vitamin E DeficiencySymptomatic vitamin E deficiency - 800-1200 mg of -tocopherol per day.Patients with abetalipoproteinemia need high doses- 5000-7000 mg/d.Children - 400 mg/d orallyToxicityHigh doses of vitamin E (>800 mg/d)Nausea, flatulence, and diarrheaReduced platelet aggregationInterfere w ith vitamin K metabolismContraindicated in patients taking warfarin and antiplatelet agents (such as aspirin or clopidogrel). | train | med_mcqa | null |
Fouh ventricle develops from? | [
"Telencephalon",
"Mesencephalon",
"Diencephalon",
"Rhombencephalon"
] | D | Lateral ventricle develops from the cavity of telencephalon. Third ventricle develops from diencephalon. Cavity of mesencephalon remains narrow and forms the aqueduct, while the cavity of rhombencephalon forms the fouh ventricle. | train | med_mcqa | null |
Epidemiology of cholera in England was clasified by | [
"John Snow",
"Winslow",
"Chadwick",
"Howard huges"
] | A | An english epidemiologist John Snow studied the epidemiology of cholera in London from 1848 to 1854. Ref : Park&;s Textbook of Preventive and Social Medicine; 23rd edition | train | med_mcqa | null |
Maximum infant mortality is seen during which period? | [
"0-4 months",
"4-8 months",
"8-10 months",
"10-12 months"
] | A | ANSWER: (A) 0-4 monthsREF: Park 20th ed page 489First month of life is the best answer but since it is not provided in the options, 0-4 months is the best possible answer for this question. Read following line from Park"About 64.6% if infant deaths occurs with in the first month of life. The risk of death is greatest during the first 24-48 hours of life" | train | med_mcqa | null |
Which of the following is cariogenic? | [
"Selenium",
"Vanadium",
"Strontium",
"Molybdenum"
] | A | null | train | med_mcqa | null |
Best contraceptive method during lactation | [
"IUD",
"Progesterone only pill (POP)",
"Lactational amenorrhoea",
"Barrier method"
] | B | (B) (Progesterone- only pill) (491- Dutta 6th)POP/MINIPILL* POP is contain very low dose of a progestin Leuonorgestrel, Norethisterone, desogestrel, lynestrenol or norgestrel* It has to be taken daily from the first day of the cycle*** Mechanism of action - it works mainly by making cervical mucus thick and viscous, thereby prevents sperm penetration**AdvantagesDisadvantages1. Side effects attributed to estrogen in the combined pill are totally eliminated1. Acne, mastalgia headache back through bleeding2. No adverse effect on lactation (''Lactation pill")2. All the side effects, attributed to progestins may be evident3. Easy to take as there is no ''on and off' regime3. Simple cysts of the ovary may be seen, but they do not require any surgery4. It may be prescribed in patients having (medical disorder) Hypertension, fibroid DM, epilepsy, smoking and history of thrombo-embolism4. Failure rate is about o.5-2 per 100 women years of use5. Reduces the risk of PID and endometrial cancerCONTRAINDICATION1. Pregnancy2. Unexplained vaginal bleeding3. Recent breast cancer4. Arterial disease5. Thromboembolic disease* OCP do not act by interference with placental functioning* Contraceptive of choice for Rheumatic heart disease is Barrier method (condom)* Ideal contraceptive for newly married couple is combined OCP* Ideal contraceptive for a couple living in different cities meeting only occasionally - Barrier method* Best contraceptive for parous young women- IUCD* Progesterone of choice in emergency contraceptive is Levonorgestrel*** Effective life of device - Nova Cu-T (5 years) Multiload Cu-T 375 (5years) Cu-T 380A (10 years)* OCP should be avoided in patients on antiepileptic medication* The risk of chlamydial infections is increased in patients using OCP. In most patients such chlamydial infection is asymptomaticAzithromycin is drug of choice in chlaraydial infection in pregnancy* Fishy vaginal odor is most characteristic of Bacterial vaginosis due to Gardnella viginalis (Gram negative bacilli, decreased number of lactobacilli, clue cells, few leucocytes (polymorphs), PH of discharge is >4.5) | train | med_mcqa | null |
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