question stringlengths 1 6.54k | choices listlengths 4 4 | answer stringclasses 4 values | rationale stringlengths 0 22.5k ⌀ | split stringclasses 1 value | dataset stringclasses 6 values | subject stringclasses 1 value |
|---|---|---|---|---|---|---|
A person was found dead with bluish green frothy discharge at the angle of mouth and nostrils. What is the diagnosis? | [
"Arsenic poisoning",
"Copper poisoning",
"Mercury poisoning",
"Lead poisoning"
] | B | Clinical Features Acute Poisoning Ingestion: * Metallic taste,* Increased salivation * Colicky abdominal pain * Nausea and vomiting. Vomitus is bluish or greenish in color * Diarrhea * Myalgia * Pancreatitis * Methemoglobinemia * Hemolysis * Jaundice * Oliguria and renal failure * Convulsions * Delirium * Coma. Inhalation of Copper Fumes or Dust Causes * Respiratory tract irritation * Cough * Conjunctivitis * Metal fume fever. Chronic Poisoning * Abdominal pain * Greenish line on dental margins of gum (Clapton's line) * Vineyard Sprayer's lung disease: Copper sulphate is used as an insecticide spray in vineyards. During spraying, chronic inhalation of copper sulphate causes this disease. * Greenish hair discolouration * Wilson's disease. REF;THE SYNOPSIS OF FORENSIC MEDICINE:KS NARAYANA REDDY;28th EDITION;PAGE NO 309 | train | med_mcqa | null |
A newborn infant is noted to have numerous, light brown macules dispersed across her skin. The significance of this feature is due to its strong association with the development of which of the following tumors? | [
"Basal cell carcinoma",
"Neuroblastoma",
"Neurofibroma",
"Retinoblastoma"
] | C | Congenital "cafe au lait" spots are present in more than 90% of patients with neurofibromatosis. This autosomal dominant disorder is characterized by multiple neural tumors, especially neurofibromas, pigmented hamaomas of the iris (Lisch nodules), and cafe au lait spots, which usually occur over nerve trunks. Although the majority of neurofibromas in this disease are benign, the tumors can be quite disfiguring and psychologically damaging. Basal cell carcinoma is a common, slow-growing tumor of sun-exposed skin. It develops in adulthood after years of chronic sun damage. Although malignant melanoma may arise from large congenital nevi, BCC does not. Neuroblastoma is a common childhood tumor that arises anywhere along the sympathetic chain, and most commonly in the adrenal medulla. The tumor usually presents as an abdominal mass and is not associated with skin findings. The ocular neoplasm associated with neurofibromatosis is the Lisch nodule, not the retinoblastoma. Retinoblastoma is a neuroepithelial tumor usually identified by funduscopic examination of a child with visual changes. Ref: Listernick R., Charrow J. (2012). Chapter 141. The Neurofibromatoses. In L.A. Goldsmith, S.I. Katz, B.A. Gilchrest, A.S. Paller, D.J. Leffell, N.A. Dallas (Eds),Fitzpatrick's Dermatology in General Medicine, 8e. | train | med_mcqa | null |
C-reactive protein is synthesized exclusively in: | [
"Kidney",
"Pancreas",
"Liver",
"Thymus"
] | C | null | train | med_mcqa | null |
A child presents with swelling in the right groin region. When this selling was reduced by hand, a gurgling sound was heard and the swelling reduced. Which of the following is a true statement in relation to the above? | [
"The child has right direct hernia",
"The processus vaginalis has been completely obliterated",
"Hernial sac contains greater omentum only",
"Hernial sac contains intestine"
] | D | Ans. (d) Hernial sac contains intestineRef: Bailey 26th edition Page 930* Hernial sac containing Intestine will reduce with gurgling sound, Initial part will be difficult to reduce in Enterocele.* Hernial sac containing Omentum will be Easy to reduce initially but difficult to reduce the last part. (Omentocele)* In children Hernia is due to Persistent Processus Vaginalis.* In children mostly Indirect hernia is only seen. Only congenital direct hernia is Ogilvie's hernia | train | med_mcqa | null |
The ability of an alloy to withstand mechanical stresses without permanent deformation is reflected by its: | [
"Resilience",
"Elastic limit/Elastic strain",
"Hardness",
"Fatigue resistance"
] | B | Elastic strain—Amount of deformation that is recovered instantaneously when an externally applied force or pressure is reduced or eliminated.
Strain may be either elastic, plastic, elastic and plastic, or viscoelastic.
Elastic strain is reversible. The object fully recovers its original shape when the force is removed. Plastic strain represents a permanent deformation of the material; it does not decrease when the force is removed. When a prosthetic component such as a clasp arm on a partial denture is deformed past the elastic limit into the plastic deformation region, elastic plus plastic deformation has occurred, but only the elastic strain is recovered when the force is released. Thus, when an adjustment is made by bending an orthodontic wire, a margin of a metal crown, or a denture clasp, the plastic strain is permanent but the wire, margin, or clasp springs back a certain amount as elastic strain recovery occurs.
Reference: PHILLIPS’ SCIENCE OF DENTAL MATERIALS, 12th ed page no 48,51 | train | med_mcqa | null |
Flea bitten kidney is seen in all of the following except: September 2007 | [
"Malignant hypeension",
"Henoch-Schonlein purpura",
"DM",
"Polyaeritis nodosa"
] | C | Ans. C: DM Diseases such as microscopic polyaeritis, accelerated hypeension and Henoch-Schonlein purpura (and other disorders in which there is destruction of small vessel walls) produce microinfarcts, which are usually multiple ('flea-bitten kidney'). | train | med_mcqa | null |
ADHD is characterized by all, except - | [
"Impulsivity",
"Distractibility",
"Hyperactivity",
"Hallucinations"
] | D | Ans. is 'd' i.e., Hallucination o Characteristic triad of Attention deficit hyperactivity disorder (ADHD) includesi) Hyperactivity,ii) Impulsiveness andiii) Inattention (distractibility or lack of concentration)o ADHD is one of the most common psychiatric problem in school age population. It usually arises in the first 5 years of life and is three times more common in boys than in girlso ADHD is characterized by an age inappropriate hyperactivity, impulsiveness and inattention. Hyperactivity is usually the first symptom noticed.o The disorder is dividede into three classes:-# Class I (most common):- All three symptoms are present, i.e., hyperactivity, impulsiveness and inattention. Therefore, it is known as combined subtype.# Class II:- First two symptoms are present, i.e., hyperactivity and impulsiveness. It is known as hyperactiveimpulsive subtype.# Class III (least common):- Only inattention is present. It is known as inattentive subtype.Diagnostic criteria1) Six (or more) of the following symptoms of inattention have persisted for at least 6 months to a degree that is maladaptive and inconsistent with development level.a) Often make careless mistakesb) Often has difficulty sustaining attentionc) Often does not listend) Often fails to follow through on instruction or of finish taskse) Often has difficulty organizing tasks and activitiesf) Often avoids tasks requiring sustained attentiong) Often looses thingsh) Often is easily distracted by external stimulii) Often is forgetful in daily activities2) Six (or more) of the following symptoms of hyperactivity impulsivity have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental levelHyperactivity:a) Often fidgets or squirmsb) Often leaves seatc) Often moves excessively (may feel restless)d) Often has difficulty playing or engaging in leisure activities quietlye) Is often "on the go"f) Often talks excessivelyImpulsivity:g) Often blurts out answersh) Often has difficulty awaiting turni) Often inerrupts or intrudes on otherso Other features: - Nonlocalizing neurological soft signs such as clumsiness, left-right confusion, perceptual motor discordination.Treatment of ADH D1) Pharmacotherapy:- Pharmacological treatment is considered to be the first line of treatment of ADHD. Drugs used for ADHD are:-a) CNS stimulants:- These are drugs of choice for ADHD. Methylphenidate is the drug of choice. Other CNS stimulants used are dexmethylphenyldate, dextroamphetamine, Dextroamphetamine + amphetamine, and modafinil (Provigil). Methylphenidate should be used in children of 6 years or above and amphetaminesm should be used in children of 3 years & above.b) Nonstimulant drugs:- Atomoxetine, Bupropion, venlafaxine, alpha-adrenergic agonists (Clonidine, guanfacine).2) Psychological treatment:- The child and parents should be educated with regard to the ways in which ADHD can affect learning, behavior, self esteem and skills. Goal should be set for the family to improve the child's interpersonal relationships, develop study skills, and decrease disruptive behaviors.3) Behavior therapy:- The goal of behavior therapy is to identify targeted behavior that cause impairment in child's life so that child can work on pregressively improving his or her skill in these area. It includes management of disruptive behavior at home & class room and improving academic performance. | train | med_mcqa | null |
False about chorionic villi biopsy: | [
"strongly associated with faciomandibular defects",
"Done in 10-12 weeks",
"Rh immunoglobulin prophylaxis is necessary",
"Done to diagnose genetic disorders"
] | A | Done in 10-12 weeks in transcervically done to diagnose genetic disorders Rh immunisation:Anti-Dimmunoglobulin 50 microgm IM should be administered following the procedure to a Rh negative woman. complications: oromandibular limb deformities,vaginal bleeding and fetal D.C.DUTTA'S TEXTBOOK OF GYNECOLOGY,Pg no:107,7th edition | train | med_mcqa | null |
Continuous GnRH is useful in all except: | [
"Precautious puberty",
"Prostate cancer",
"Male infertility",
"Endometriosis"
] | C | Ans. (C) Male infertility(Ref: Goodman Gilman 13th E/P781)GnRH agonists can be used by pulsatile and non-pulsatile or continuous dosing.By pulsatile dosing they increase release of LH/FSH and cause ovulation, spermatogenesis and increase synthesis estrogen and testosterone. Hence used for treatment of anovulation, oligospermia (male infertility), delayed puberty and sexual infantilism.By continuous dosing, they decrease synthesis of estrogen and testosterone. Hence used for treatment of estrogen and testosterone dependent conditions like ER positive breast cancer, endometriosis, uterine fibroids and prostate cancer. | train | med_mcqa | null |
The ejection systolic murmur in hyperophic obstructive cardiomyopathy is diminished when a patient - | [
"Parforms the valsalva maneuver",
"Lies down",
"Inhales amyl nitrite",
"Stands up"
] | B | Ref:Harrison&;s 19th E pg 1568. This increases venous return. And hence amount of blood in LV. In HOCM the blood acts as a physical barrier between hyperophied septum and anterior mitral leaflet. As the patient lies down, venous return increases, fuher increasing the blood coming to the ventricles. This blood prevents the hyperophied septum coming in contact with the anterior leaflet of the mitral Valve. Hence murmur reduces. | train | med_mcqa | null |
Transient myleoproliferative disorder of the newborn is seen in association with | [
"Turnur's syndrome",
"Down's syndrome",
"Neurofibromatosis",
"Ataxia telangiectasia"
] | B | Approximately 10% of children with Down syndrome develop a preleukemic clone,transient myeloproliferative disorder,with somatic mutations in hematopoietic transcription factor GATA1.These children have a high leukocyte count,circulating blasts in peripheral blood,hepatosplenomegaly,effusions,anemia and thrombocytopenia in the neonatal period,which resolves by 3 months.About 20% of children with transient myeloproliferative disorder develop AML. Reference:Essential pediatrics-Ghai,8th edition,page no:605. | train | med_mcqa | null |
All are true about hyperophic cardiomyopathy, except : | [
"Systolic dysfunction",
"Concentric hyperophy",
"Diastolic dysfunction",
"Double apical impulse"
] | A | Answer is A (Systolic dysfunction) 'The ubiquitous pathophysiological abnormality in hyperophic obstructive cardiomyopathy is not systolic but rather diastolic dysfunction' Note: It has now been demonstrated that systolic dysfunction characterized by an outflow tract pressure gradient is present only in about one quaer of patients with HCM. The pathophysiological abnormality that has now been demonstrated is diastolic dysfunction characterized by increased stiffness of the hyperophied muscle. | train | med_mcqa | null |
Which of the following is FALSE about Infectious mononucleosis | [
"Non-Suppurative, painless Lymphadenopathy",
"Maculo-papular rash or petechial rash",
"Lymphocytosis is usually demonstrable, with >10% atypical lymphocytes",
"Transient bilateral upper lid Edema"
] | A | Atypical lymphocytosis -points diagnosis towards Infectious mononucleosis (EBV) (kissing disease) among the given other options. Essentials of Diagnosis Malaise, fever, and (exudative) sore throat Palatal petechiae, lymphadenopathy, splenomegaly, and, occasionally, a maculopapular rash Positive heterophile agglutination test (Monospot) Atypical large lymphocytes in blood smear; lymphocytosis Complications:hepatitis, myocarditis, neuropathy, encephalitis, airway obstruction from adenitis, hemolytic anemia, thrombocytopenia General Consideration EBV is ubiquitous; infects > 95% of the adult population worldwide and persists for the person's lifetime Infectious mononucleosis is a common manifestation of EBV and may occur at any age EBV is largely transmitted by saliva but can also be recovered from genital secretions Saliva may remain infectious during convalescence, for 6 months or longer after symptom onset The incubation period lasts several weeks (30-50 days) In the United States the incidence of EBV infection is declining although prevalence of EBV remains high for those aged 12-19 years Clinical Findings Symptoms and Signs Fever, sore throat, fatigue, malaise, anorexia, and myalgia typically occur in the early phase of the illness Physical findings include Lymphadenopathy (discrete, nonsuppurative, slightly painful, especially along the posterior cervical chain) Transient bilateral upper lid edema (Hoagland sign) Splenomegaly (in up to 50% of patients and sometimes massive) Conjunctival hemorrhage, exudative pharyngitis, uvular edema, tonsillitis, or gingivitis may occur Soft palatal petechiae may be noted Other manifestations Hepatitis Interstitial pneumonitis (sometimes with pleural involvement) Cholestasis Gastritis Kidney disease (mostly interstitial nephritis) Epiglottitis Nervous system involvement (in 1-5%) | train | med_mcqa | null |
A 35-year-old woman presents with several days of increasing fatigue and shortness of breath on exertion. She was recently diagnosed with Mycoplasma pneumoniae. Physical examination reveals BP 113/67, HR 114 beats/min, and respiratory rate 20 breaths/min. She appears icteric and in mild respiratory distress. Her hemoglobin is 9.0 g/dL and MCV is 110. Which of the following is the best next diagnostic test? | [
"Serum protein electrophoresis",
"Flow cytometry",
"Peripheral blood smear",
"Glucose-6-PD level"
] | C | Macrocytic anemia and indirect hyperbilirubinemia suggest hemolysis, which in this patient is likely due to IgM antibodies which may follow Mycoplasma infections and which cross-react with RBC surface molecules of the I/i system These antibodies are termed cold-reacting antibodies because they react at temperatures less than 37degC (98degF). Examination of the peripheral blood smear is the first step in evaluation of hemolytic anemia. The young red cells (which would show up as reticulocytes when properly stained) are much larger than mature RBCs, accounting for the macrocytosis (the MCV can be as high as 140 with vigorous reticulocytosis). The presence of micro spherocytes suggests immune-mediated hemolysis, while the presence of fragmented RBCs or schistocytes suggests a mechanical cause of hemolysis, as seen in the microangiopathic hemolytic anemias. Serum protein electrophoresis is useful to diagnose multiple myeloma, which is rarely associated with hemolysis, but this would not be the best initial test; the anemia in multiple myeloma is normocytic. Flow cytometry can detect surface proteins such as CD55, CD59 on granulocytes and red blood cells in paroxysmal nocturnal hemoglobinuria (a rare cause of hemolysis), but again is not the best first test. Glucose-6-PD levels might be useful once hemolytic anemia is established by a peripheral smear and negative Coombs test. Bone marrow biopsy would show erythroid hyperplasia but is usually not required to diagnose hemolytic anemia. | train | med_mcqa | null |
The threshold value for workers in the mercury industry is: | [
"200 to 400 µg per day",
"100 to 200 µg per day",
"350 to 500 µg per day",
"500 to 700 µg per day"
] | C | The threshold value for workers in the mercury industry is 350 to 500 µg per day.
Reference: Phillip’s Science of Dental Materials, Pg-361 | train | med_mcqa | null |
Posterior wall of the axilla is formed by all of the following muscles, EXCEPT: | [
"Teres major",
"Teres minor",
"Subscapularis",
"Latissimus dorsi"
] | B | Posterior wall of axilla consists of teres major, subscapularis and latissimus dorsi. The impoant relations of the posterior wall are subscapular vessels, subscapular and thoracodorsal nerves and posterior or subscapular lymph nodes. The posterior axillary fold is formed by the teres major and latissimus dorsi muscles and it becomes prominent when the arm is adducted against resistance. Anterior wall of the axilla consists of pectoralis major, pectoralis minor, clavipectoral fascia, and subclavius muscle. The lateral thoracic vessels and anterior or pectoral group of lymph nodes are present inside this wall. Ref: Clinical Anatomy: (a Problem Solving Approach) By Kulkarni page 94. | train | med_mcqa | null |
Which of the following is multi-enzyme complex? | [
"HMG-CoA synthase",
"Malic enzyme",
"Fatty acid synthase",
"Fatty acid oxidase"
] | C | Ans. c (Fatty acid synthase). (Ref. Harper's biochemistry 27th ed. Pg. 238 Chapter 23)KEY STEPS OF FATTY ACID SYNTHESIS# Fatty acid entry into mitochondrion is via Camiitine shuttle.2# Fatty acid entry into cytosol is via Carnitine shuttle.# Fatty acid synthase is a polypeptide multi-enzyme complex.2# Acyl carrier protein is a integral part of this polypeptide complex and functions as CoA.# Being a single unit; great efficiency freedom from interference and co-ordinated synthesis of all enzymes encoded by a single gene as advantage of this fatty acid synthase multi-enzyme complex.# Another example of multienzyme complex is:- pyruvate dehydrogenase complex (complex contains 3 enzymes that require 5 cofactors).The Fatty Acid Synthase Complex Is a Polypeptide Containing Seven Enzyme Activities# In bacteria and plants, the individual enzymes of the fatty acid synthase system are separate, and the acyl radicals are found in combination with a protein called the acyl carrier protein (ACP).# However, in yeast, mammals, and birds, the synthase system is a multienzyme polypeptide complex that incorporates ACP, which takes over the role of CoA. It contains the vitamin pantothenic acid in the form of 4'-phosphopantetheine.# In mammals, the fatty acid synthase complex is a dimer comprising two identical monomers, each containing all seven enzyme activities of fatty acid synthase on one polypeptide chain. Initially, a priming molecule of acetyl-CoA combines with a cysteine --SH group catalyzed by acetyl transacylase.# Malonyl-CoA combines with the adjacent --SH on the 4'-phosphopantetheine of ACP of the other monomer, catalyzed by malonyl transacylase (reaction lb), to form acetyl (acyl)-malonyl enzyme.# It is liberated from the enzyme complex by the activity of a seventh enzyme in the complex, thioesterase (deacylase).# The free palmitate must be activated to acyl-CoA before it can proceed via any other metabolic pathway. Its usual fate is esterification into acylglycerols, chain elongation or desaturation, or esterification to cholesteryl ester.# In mammary gland, there is a separate thioesterase specific for acyl residues of C8, C10, or C12, which are subsequently found in milk lipids. | train | med_mcqa | null |
Bidextrous grasp is seen at what age? | [
"3 months",
"5 months",
"6 months",
"9 months"
] | B | 3 months - Holds an object when placed in hands 4 months - Tries to reach for an object, but overshoots 5 months - Bidextrous grasp 6 months - Unidextrous/palmar grasp 7 months - Transfers objects from 1 hand to another 9 months - Immature/Assisted pincer grasp 12 months - Mature/ Unassisted pincer grasp | train | med_mcqa | null |
Fecal soiling in children is most commonly due to - | [
"Hirschsprung's disease",
"Chronic constipation",
"Rectal atresia",
"None of the above"
] | B | null | train | med_mcqa | null |
Single umbilical aery is associated with all of the following except : | [
"Polyhydramnios",
"Advanced maternal age",
"Fetal growth retardation",
"Increased incidence of fetal malformation"
] | B | Advanced maternal age | train | med_mcqa | null |
Ionophores have following action except | [
"Abolish proton gradient",
"Inhibit ADP to ATP conversion",
"Hydrophilic in character",
"Abolish pH gradient"
] | C | Hydrophilic in character
Inophors are lipophilic (not hydrophilic).
Inophors inhibit ATP formation by inhibiting oxidative phosphorylation by abolishing proton gradient or pH gradient. | train | med_mcqa | null |
Pain and temperature are carried by: | [
"Anterior spinothalamic tract",
"Lateral spinothalamic tract",
"Dorsal column",
"None"
] | B | VENTROLATERAL SPINOTHALAMIC TRACT
Fibers from nociceptors and thermoreceptors synapse on neurons in the dorsal horn of the spinal cord. The axons from these dorsal horn neurons cross the midline and ascend in the ventrolateral quadrant of the spinal cord, where they form the ventrolateral spinothalamic pathway. Fibers within this tract synapse in the VPL. | train | med_mcqa | null |
Tender Bubos seen are used in the diagnosis of: | [
"Gonorrhoea",
"Herpes",
"Chancroid",
"Granuloma venereum"
] | C | Chancroid | train | med_mcqa | null |
Following amino acid form an integral part of collagen synthesis: | [
"Lysine",
"Leucine",
"Arginine",
"Glutamic acid"
] | A | Ans: A (Lysine) Ref: Harpers illustrated Biochemistry. 28th editionExplanation:CollagenCollagen is a fibrous proteinMost abundant structural proteinAccounts for 25% of the total body proteinsFound in skin, joints, skeleton, tendons, cartilage, cornea and blood vesselsUnusual right-handed triple helix3 polypeptide chains, an unusual amino acid composition33% glycine, 10% proiine, 10% hydroxyproline (Hyp)The sequence Gly-X-Y-Gly-X-Y is repetitiveHvdroxylated amino acid (pro, lys)characteristic of collagenSynthesized post- translationally. a step requiring vitamin C.Vitamin C deficiency symptoms explained by- disturbances in collagen biosynthesis.Collagen molecules tend to associate with one another to form larger, more complex cylindrical fibrils (diameter 20-500nm)At either end. the individual collagen molecules are cross-linked via modified lysine residues.This gives tensile strength to collagenExtent of cross-linking increases with age | train | med_mcqa | null |
Poland syndrome all of the following are seen except - | [
"Absence of lattissimus dorsi",
"Absence of pectoralis major",
"Syndactyly of digits",
"Sho index fingers"
] | A | Poland syndrome is a bih defect characterized by an underdeveloped chest muscle and sho webbed fingers on one side of the body.Sho ribs, less fat, and breast and nipple abnormalities may also occur on that sideTypically the right side is involved. People generally have normal movement and health The cause is unknown. One theory is that it is due to disruption of blood flow during development before bih. The condition is generally not inherited from a person's parents.No genes that contribute to the disorder have been identified. Diagnosis is based on symptoms.Often people remain undiagnosed and some may not realize they are affected until pubey. Treatment depends on the severity and may include surgical correction.About 1 in 20,000 newborns are affected. Males are affected twice as often as females. It is named after Alfred Poland who described the condition when he was a student in 1841 Signs and symptoms Abnormal gastrointestinal tract Absent pectoral muscles Brachydactyly (Sho fingers) Dextrocardia Diaphragmatic hernia/defect Humerus absent/abnormal Liver/biliary tract anomalies Maternal diabetes Oligodactyly/missing fingers Radius absent/abnormal Ref Davidson 23rd edition pg 845 | train | med_mcqa | null |
Thyroglossal fistula develops due to - | [
"Developmental anomaly",
"Injury",
"Incomplete removal of thyroglossal cyst",
"Inflammatory disorder"
] | C | Thyroglossal fistula is never congenital. It follows infection or inadequate removal of a thyroglossal cyst. | train | med_mcqa | null |
Which is not true regarding varicocele - | [
"Testicular veins involved",
"More common on the right side",
"May be the first feature of a renal tumour",
"Feels like a bag of worms"
] | B | Ans:B.)More common on Right Side.VaricoceleA varicocele is an abnormal enlargement of the pampiniform venous plexus in the scrotum. This plexus of veins drains blood from the testicles.The varicoceles might be noticed as soft lumps, usually above the testicle and mostly on the left side of the scrotum. Some people who have them feel pain or heaviness in their scrotum. An obvious varicocele is often described as feeling like a bag of worms.Varicoceles are much more common (approximately 80-90%) in the left testicle than in the right because of several anatomic factors, including the following:The angle at which the left testicular vein enters the left renal veinThe lack of effective antireflux valves at the juncture of the testicular vein and renal veinThe increased renal vein pressure due to its compression between the superior mesenteric aery and the aoa (ie, nutcracker effect).Varicocele may be seen in Renal Tumor due to obstruction of the testicular vein | train | med_mcqa | null |
A 10 year old boy has a fracture of femur. biochemical evaluation revealed Hb 11.5 gm/dl and ESR 18 mm 1st hour. Serum calcium 12.8 mg/dL, serum phosphorus 2.3 mg/dL, alkaline phosphate 28 KA units and blood urea 32 mg/dl. Which of the following is the most probable diagnosis in his case – | [
"Nutritional ricicets",
"Renal rickets",
"Hyperparathyroidism",
"Skeletal dysplasia"
] | C | You can solve the question just looking at calcium value. Amongst the given options only hyperparathyroidism causes hypercalcemia.
The patient in question has an increased serum Ca', decreased serum phosphorus and increased values of alkaline phosphatase, all of which characterize hyperparathyroidism. | train | med_mcqa | null |
Stalactite growth in ghee broth is due to the following organism? | [
"Y.pestis",
"T.palladium",
"H.influenzae",
"C.diphtheriae"
] | A | Cultural characteristics of Yersinia pestis: 1. When grown in a flask of broth with oil / ghee floated on top (ghee broth) a characteristic growth occurs which hangs down into the broth from the surface, resembling stalactite. 2. On nutrient agar, colonies are small, delicate, transparent discs, becoming opaque on continued incubation. 3. On blood agar colonies are dark brown due to absorption of the hemin pigment. 4. On MacConkey agar colourless colonies are formed. 5. In broth a flocculent growth occurs at the bottom and along the sides of the tube. Ref: Textbook of Microbiology Ananthanarayanan, 8th edition | train | med_mcqa | null |
Dracunculosis is most common in - | [
"Gujarat",
"Rajasthan",
"Madhya Pradesh",
"Orissa"
] | B | Park's Textbook of Preventive and Social Medicine 23rd edition Page no: 245 In India , the last case was repoed in July 1996. Now India is declared free of guineaworm disease | train | med_mcqa | null |
Most microorganisms pathogenic for humans grow best in the laboratory when cultures are incubated at | [
"15-20degC",
"20-30degC",
"30-37degC",
"38-50degC"
] | C | Most human pathogens are neutralophiles (grow best at pH of 6.0-8.0) and mesophilic (grow best at 30-37degC).Ref: Jawetz; 27th edition; Page no: 78 | train | med_mcqa | null |
Denominator refers to: | [
"Pa of the presentation which lies over the Internal os",
"Relation of different pas of fetus to one another",
"Bony fixed point of reference on presenting pa",
"Pa of fetus lying in the lower segment of uterus"
] | C | Denominator : It is an arbitrary bony fixed point on the presenting pa which comes in relation with the various quadrants of maternal pelvis. Denominators in different presentations : Occiput in veex Mentum in chin Frontal eminence in brow Sacrum I'm breech Acromion in shoulder. Ref: Datta Obs 9e pg 70. | train | med_mcqa | null |
The recommended daily energy intake of an adult woman with heavy work is - | [
"1800",
"2100",
"2300",
"2900"
] | D | -The recommended daily energy intake of an adult woman with heavy work is 2850 kcal /day. Reference : Park's textbook of preventive and social medicine, 23rd edition, pg no:634,table 24. | train | med_mcqa | null |
All of these are true about GnRH analogues used in treatment of endometriosis , EXCEPT? | [
"Continuous administration causes downregulation of pituitary gonadotropins",
"The risk of osteoporosis decreases with prolonged use as the estrogen mediated osteoblastic action continues",
"Add back therapy includes estrogens",
"Discontinuation causes recurrence"
] | B | GnRH is given continuously to downregulate and suppress pituitary gonadotropins and cause atrophy of endometriotic tissue. The risk of osteoporosis increases after prolonged use as the estrogen mediated osteoblastic action stops while the estrogen independent osteoclast action continues Add back therapy is given to reduce the risk of hypoestrogenic side effects like osteoporosis, hot flushes, vaginal dryness, urogenital atrophy. Drugs include: progesterones, low dose estrogens, tibolone Discontinuation causes recurrence within a year in upto 50 % cases Commonly used GnRH agonists are: Leuprolin Naferelin Goserelin Buserelin | train | med_mcqa | null |
A patient with pneumonia for 5 days is admitted to the hospital now with an altered sensorium. He suddenly ceases to recognize the doctor and staff. He thinks that he is in jail and complains of scorpion attacking him. His probable diagnosis is | [
"Acute Dementia",
"Acute delirium",
"Acute schizophrenia",
"Acute paranoia"
] | B | Ans.B. i.e. Acute deliriumDeliriumAcute confusional state occurring in various medical, surgical, metabolic, toxic & post-operative conditions. It is characterized by acute agitation, disorientation, and inability to sustain attention, form memories or reason. Characteristic features include- Clouding of consciousness (i.e, decreased awareness & decreased ability to respond to environmental stimuli)- Disorientation (in time > place > person)- Hallucinations (mostly visual) & illusions- Autonomic dysfunction, agitation, insomnia- Carphologia/floccilation (picking movements at clothes coversheets) & occupational delirium (pantomimes as if continuing the usual occupation in a hospital bed)This patient in question has- disturbance in consciousness (altered sensorium) - disorientation - to place (thinks, he is in jail)- ceases to recognize the doctor & staff- hallucination (complaints of scorpions attacking him) - after an acute medical illness.All these features are consistent with the diagnosis delirium. | train | med_mcqa | null |
All the following indicators are used to measure disability rates in a community except ? | [
"Suillivan's index",
"Human povey index",
"Health adjusted life expectancy",
"Disability adjusted life yea"
] | B | Ans. is 'b' i.e., Human povey index | train | med_mcqa | null |
Age independent anthropometric measure of malnutrition is? | [
"Weight/height",
"Mid arm circumference",
"Head circumference",
"Mid arm circumference/height"
] | B | ANSWER: (B) Mid arm circumferenceREF: Ghai 7th ed p. 64Age independent anthropometric measurements:IndexRatioValueKanawati IndexHead Circumference (cm)/Mid arm Circumference (cm)0.32-0.33Rao's IndexWt. In Kg/CHtcm) square x 1000.15 - 0.16Dug dale's IndexWt (Kg) / Ht (cm) to power 1.6 x 1000.88 - 0.97Mid arm circumference Jeliffe's ratioHead circumference/ chest circumference< 1 in a lyr old child is malnourished | train | med_mcqa | null |
'Saturnism' is seen in: | [
"Chronic lead poisoning",
"Chronic mercury poisoning",
"Chronic phosphorus poisoning",
"Chronic gold poisoning"
] | A | Chr. Lead poisoning = Plumbism = Saturnism = Saturnine poisoning- ALA in urine, Coproporphyrin in urine, facial pallor, Basophilic stippling/Punctate basophilia (dark blue, pin-head spots in cytoplasm of RBCs), Buonian line (blue line gums' margin, PbS, 50-70% cases, near carious/diy teeth, Lead palsy, Pb encephalopathy, wrist drop, foot drop, Colic, Constipation, Menstrual irregularity, Sterility, Nephropathy, X-ray- radio-opaque bands at metaphyses of long bones, Pb >0.03mg% in blood is diagnostic. | train | med_mcqa | null |
Nikshay software is used for | [
"Filaria",
"Malaria",
"Kala azar",
"Tuberculosis"
] | D | Nikshay software is a web based solution for monitoring TB patients under Revised National Tuberculosis Control Programme (RNTCP). It was developed by National Informatics Center (NIC). | train | med_mcqa | null |
Lumbar sympathectomy is of value in the management of | [
"Intermittent claudication",
"Distal ischaemia affecting the skin of the toes",
"Aeriovenous Fistula",
"Back pain"
] | B | . Ans: b (Distal ischemia affecting the skin of toes) (Ref. Textbook of surgery by S. Das-3rd ) - Indications for sympathectomy: 1. Circulatory insufficiency of the limbs (Limb warms, pain reduces and ulcers may show signs of regression) o Atherosclerosis (with rest pain, impending gangrene of toes) o Raynaud's Syndrome (temporary relief) o Buerger's disease 2. Hyperhidrosis 3. Causalgia | train | med_mcqa | null |
Drugs Contraindicated in pregnancy - | [
"Enalapril",
"CCB",
"Beta-blockers",
"Propylthiouracil"
] | A | Ans is 'a' i.e., Enalapril o Enalapril is an ACE inhibitors used as antihypertensive drugs,o ACE inhibitors are C/I in pregnancyACE inhibitor are fetopathic, These can cause fetal growth retardation hypoplasia of organs and fetal death may occur if ACE inhibitors are given during later half ofpregnancy.A recent report indicates 2.7 fold higher malformation rate in fetus exposed to ACE inhibitors in 1st trimester .ACE inhibitors must be stopped when woman conceives.Safer for antihypertensive used in pregnancy-o Methyldopa, Hydralazine, Atenolol, Metoprolol (b blockers). Nifedipine (CCB), Clonidine.o List of some common tetratogenic (fetopathic) drugs -a) Fluoroquinolesk) Astemizoleb) Tetracycline1) Cisapridec) Chloramphenicolm) Amphotericin B, Ketoconazole, Griseofulvind) Streptomycinn) Efavirenze) Kanamycino) Foscarcnet, Ganciclovirf) Tinidazolep) ACE inhibitor, AT antagonistsg) Pyrimethamine + sulfadoxineq) Redioactive iodineh) Quinnine, Primaquiner) Fluphenazinei) Albendazole, Mebendazoles) Warfarinj)DECt) Ketotifen | train | med_mcqa | null |
Glutamate entering into the brain along with ammonia transforms into the following amino acid: | [
"Glutamine",
"Arginine",
"Glyceride",
"Glycine"
] | A | The brain's uptake of glutamate is approximately balanced by its output of glutamine. Glutamate entering the brain associates with ammonia and leaves as glutamine. The glutamate--glutamine conversion in the brain--the opposite of the reaction in the kidney that produces some of the ammonia entering the tubules--serves as a detoxifying mechanism to keep the brain free of ammonia. Ammonia is very toxic to nerve cells, and ammonia intoxication is believed to be a major cause of the bizarre neurologic symptoms in hepatic coma. Ref: Barrett K.E., Barman S.M., Boitano S., Brooks H.L. (2012). Chapter 33. Circulation through Special Regions. In K.E. Barrett, S.M. Barman, S. Boitano, H.L. Brooks (Eds), Ganong's Review of Medical Physiology, 24e. | train | med_mcqa | null |
In corneal reflex efferent is carried by | [
"occulomotor",
"trochlear",
"abducens",
"facial"
] | D | null | train | med_mcqa | null |
True about Rx of fracture neck of femur? | [
"SP nail is very popular especially in management of pediatric cases.",
"Austin Moore prosthesis is most preferred Rx in younger patients.",
"An impacted fracture is treated conservatively in all age groups.",
"Meyer's operation should be avoided in treating the fractures presenting late and those with signif... | C | Ans. C. An impacted fracture is Rxed conservatively in all age groups.Rx of fracture neck femur:a. This is rightly termed as "unsolved " because of the high incidence of complications.b. This invariable needs operative treatment.c. An impacted fracture is Rxed conservatively in all age groups (hip spica in children and Thomas splint in adults).Unimpacted or displaced fracture:* <60 yrs: internal fixation.* >60 yrs: head excised and replaced by prosthesis done as a primary procedure.* In Some younger patients, especially those presenting late, open reduction of is done.* Internal fixation can be done using any of the following implant:a. Multiple cancellous screws - most commonly used.b. Dynamic hip screws (DHS)c. Multiple Knowles's pins/More's pins - used in children.d. SP nail - not popular now.e. At some centers in general an inter-trochanteric osteotomy (McMurray's osteotomy is preferred).f. Hemiarthroplasty is used for elderly patients & Austin Moore prosthesis is used most commonly.This cannot be used as a method of Rx in younger patients as prosthesis becomes loose over a period of time (8-10 yrs).g. Meyer's procedure ( reduced by exposing it from behind and it is fixed with multiple screws and supplemented with vascularized muscle pedicle bone graft). It is used in treating the fractures presenting late and those with significant comminution. It is also used for non-union of the femoral neck . | train | med_mcqa | null |
Imatinib used in CML acts by | [
"inhibiting Bcr/abl translocation tyrosine kinase",
"Blocking the action of P-glycoprotein",
"Competitive inhibition of ATP binding site of Abl kinase",
"C-kit kinase inhibition"
] | C | Competitive inhibition _of ATP binding site of ABL kinase [Ref. Harrison 16thie p 4781 CML is characterized by the presence of a distinctive molecular abnormality namely philadelphia chromosome. Philadelphia chromosome in formed as a result of reciprocal translocation between long arm of chromosome 22 and chromosome 9 i.e. t (9 ; 22). ABL protooncogene from chromosome 9 is translocated to chromosome 22 where BCR is present and results in formation of BCR-ABL fusion chimeric gene. The drug imatinib mesylate is a BCR-ABL tyrosine kinase signal transduction inhibitor. This drug acts as a inhibitor of the ATP binding site on the protein and prevents its phosphorylation and thus its activity. An impoant point CML is caused by reciprocal translocation between BCR and ABL gene located on chromosome 9 and 22. Imatinib mesylate does not block this translocation i.e., BCR ABL translocation. - Instead, it blocks the constitutive abnormal tyrosine kinase, BCR-ABL that is created by the Philadelphia chromose (BCR-ABL). - The drug inhibits the proliferation and induces apoptosis in BCR-ABL positive cells. Also know Protein tyrosine kinase inhibitors Protein kinases are ubiquitous and critical components of signal transduction pathways that transmit information concerning extra cellular or cytoplasmic conditions to the nucleus, thereby influencing gene transcription and/or DNA synthesis. The protein kinases can be classified into three categories: (i) Tyrosine kinase (ii) Serine threonine kinase (iii) Kinases with activity for all three residues Abnormal activation of specific tyrosine kinase has been demonstrated in many human neoplasms. Thus they can be targeted in ceain cancer therapies. There currently are three small-molecular weight protein tyrosine kinase inhibitors that are FDA approved and many others are in clinical trials. i) Imatinib Imatinib has efficacy in diseases in which the ABL, KIT or PDGFR have dominant roles in driving the proliferation of the tumour. Thus, imatinib shows remarkable therapeutic benefits in patients with - CML (BCR-ABL) - GIST (KIT mutation positive) - CMML (EVT6-PDGFR) ii) Gefitinib The epidennal growth factor receptor (EGFR) belongs to the family of tyrosine kinase. Gefitinid is a specific inhibitor of the EGFR tyrosine kinase that competitively inhibits ATP binding. EGFR is overexpressed in non-small cell carcinoma of lung, thus Gefitinib has been approved for use in non-small cell carcinoma. iii) Erlotinib It is a human HERI/EGFR tyrosine kinase inhibitor. It is indicated for patients with locally advanced or metastatic non-small cell lung cancer. | train | med_mcqa | null |
Which of the following helps in generating reactive 02 intermediates in neutrophils? | [
"NADPH Oxidase",
"Superoxide dismutase (SOD)",
"Catalase",
"Glutathione peroxidase"
] | A | Ans. is 'a' i.e., NADPH oxidase | train | med_mcqa | null |
Positive predictive value depends on all except ? | [
"Sensitivity",
"Specificity",
"Prevalence",
"Incidence"
] | D | Ans. is 'd' i.e., Incidence Positive predictive value (PPV) of a screening test depends on : - Sensitivity Specificity Prevalence of disease As the sensitivity and specificity of a test are relatively constant, positive predictive value is mainly dependent on the prevelance of disease. | train | med_mcqa | null |
Which of the following lobes of Cerebrum is related to the inferior horn of the lateral ventricle? | [
"Frontal",
"Parietal",
"Temporal",
"Occipital"
] | C | null | train | med_mcqa | null |
ECG change seen in Hypokalemia | [
"Tall 'T' wave",
"U wave",
"Sine wave configration",
"Shoening of QT interval"
] | B | Hypokalemia (plasma K+ +-3.5 meq/L). PR interval = 0.2 s; QRS interval = 0.06 s; ST-segment depression. A prominent U wave is now present immediately following the T. Tall T wave is present in hyperkalemiaIf the U wave is erroneously considered a pa of the T, a falsely prolonged QT interval of 0.6 s will be measured in hypokalemia but true QT interval remain same in severe hypokalemia (plasma K+ +-2.5 meq/L)Ref: 23rd Edition of Ganong's Review of Medical Physiology pg no:503 | train | med_mcqa | null |
What is true about Histoplasmosis ? | [
"In early stages it is indistinguishable from T.B.",
"Culture is not diagnostic",
"Hyphal forms are infectious form",
"Person to person spread occurs by droplet infection"
] | A | In early stages it is indistinguishable from T.B. Histoplasmosis Histoplasmosis is a dimorphic fungi i.e. it grows in two forms myeclia and yeast. It grows as mycelia forms, producing spores at 25degC on sabroud's agar and at 37degC it grows as a yeast form. This dimorphism plays a pa in human infection i.e. in their natural habitat (the soil) they grow us mycelia and release spores into the air. These spores are inhaled by humans and at the human temperature of 37degC they grow as yeast cells (Hyphae). Histoplasmosis resembles tuberculosis in ceain ways Like T.B. histoplasma infection is acquired by inhalation. Histoplasmosis is acquired by inhalation of dust paicles contaminated with bird or bat dropings that contain small spores (microconidia), the infectious form of the fungus. The clinical presentation and morphological lesions of histoplasmosis also strikingly resemble those of tuberculosis I. A self limited and often latent primary pulnionan' involvement which may result in coin lesions on chest radiography. 2. Chronic, progressive secondary lung disease which is localized to the lung apices and cause cough, fever and night sweats. 3. Localized lesions in extrapulmonary sites including mediastinum, adrenals, liver or meninges. 4. Widely disseminated involvement paicularly in immunosuppressed individual. An impoant distinguishing point in histoplasma infection is that it is never transmitted from 'non to ratan. Diagnosis of Histoplasma infection Fungal culture remains the gold standard diagnostic test for histoplasmosis. However, culture results may not be known for upto I months. Staining of the biopsy material also yields diagnostic results. Serological diagnosis is useful in self limited pulmonary infection, however at least 1 month is required for the production of antibodies. | train | med_mcqa | null |
Galea aponeurotica lies in which layer of scalp | [
"Skin",
"Superficial fascia",
"Deep fascia",
"Pericranial layer"
] | C | deep fascia is in the form of the epicranial aponeurosis or galea aponeurotica with the occipitofrontalis muscle. The epicranial aponeurosis, or galea aponeurotica is freely movable on the pericranium along with the overlying and adherent skin and fascia. | train | med_mcqa | null |
True about ASHA are all except | [
"One per 1000 rural population",
"Mobiliser of antenatal care",
"Female voluntary worker",
"Skilled bih attendant"
] | D | ASHA is not a skilled bih attendant. she will arrange esco/accompany pregnant women. All others are true. Ref: PARK&;S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE 23rd edition pg 449 | train | med_mcqa | null |
true about fracture shaft femur in infant is: | [
"Child abuse is commonest cause",
"Heals rapidly",
"Traction is all that usually required",
"Fat embolism is common"
] | D | D i.e. Fat embolism is common | train | med_mcqa | null |
All are true regarding somatization disorder except: | [
"Maintain sick role",
"4-Pain symptoms",
"1-Sexual symptom",
"1-Pseudo neurological symptom"
] | A | Ans:A-Maintain sick roleSomatic symptom disorder (SSD formerly known as "somatization disorder" or "somatoform disorder") is a form of mental illness that causes one or more bodily symptoms, including pain.The symptoms may or may not be traceable to a physical cause including general medical conditions, other mental illnesses, or substance abuse. But regardless, they cause excessive and dispropoionate levels of distress.The symptoms can involve one or more different organs and body systems, such as:PainNeurologic problemsGastrointestinal complaintsSexual symptomsMany people who have SSD will also have an anxiety disorder.People with SSD are not faking their symptoms. The distress they experience from pain and other problems they experience are real, regardless of whether or not a physical explanation can be found. And the distress from symptoms significantly affects daily functioning. | train | med_mcqa | null |
Partogram help in the detection of - | [
"PPH",
"Abruption placetae",
"Obstracted labour",
"Incordinate uterine action"
] | C | Ans-C | train | med_mcqa | null |
The dangerous paicle size causing pneumoconiosis varies from ? | [
"100-150 m",
"50-100 m",
"10-50 m",
"1-5 m"
] | D | Ans. is 'd' i.e., 1-5 m Pneumoconiosis o Pneumoconiosis is an occupational lung disease caused by the inhalation of dust. o The development of pneumoconiosis depends on - (i) The amount of dust retained in the lungs and airways. (ii) The size, shape of the paicles --> The most dangerous paicle ranges from Ito 5 m in diameter because they may reach the terminal small airway and air sacs and settle in their linings. (iii) Paicle solubility and physiochemical reactivity. (iv) Additional effects of other irritants (e.g. concomitant smoking). Impoant pneumoconiosis o Cool worker's pneumoconiosis (CWP) --> Coal dust o Silicosis (grinder's disease) --> Silica dust o Asbestosis --> Asbestos dust o Beryliosis --> Berylium dust o Siderosis --> Iron dust o Byssinosis --> Cotton dust | train | med_mcqa | null |
Donepezil is used in treatment of: | [
"Alzheimer's dementia",
"Schzophrenia",
"Anxiety disorder",
"Anxiety disorder"
] | A | A i.e. Alzheimer's disease | train | med_mcqa | null |
Total-etch concept was put forth by | [
"Nakabayhashi",
"Buonocore",
"Bowen",
"Fusayama"
] | D | null | train | med_mcqa | null |
Non - union is a complication of : | [
"Scaphoid",
"Colle's",
"Inter- trochanteric of hip",
"Supra condylor of the humerus"
] | A | A i.e. Scaphoid Fracture Fracture head & neck femur, fracture body of talus and fractures through waist of scaphoid most commonly leads to nonunion and avascular necrosis due to poor blood supplyQ | train | med_mcqa | null |
Testosterone production is mainly contributed by - | [
"Leydig cells",
"Sertoli cells",
"Seminiferous tubules",
"Epididymis"
] | A | Ans. is 'a' i.e.. Ley dig cells o Androgens (including testosterone) are produced by ley dig cells (interstitial cells).o Leydig cells have receptors for LH and secrete androgens, i.e. Testosterone, dihydrotestosterone (DHT), androstenedione, and dehydroepiandrosterone (DHEA).o Sertoli cells have receptors for FSH and secrete ABP, inhibin and MIS. sertoli cells also have receptor for testosterone. | train | med_mcqa | null |
Infective endocarditis is least likely to occur in | [
"Aerial septal defect",
"Small ventricular septal defect",
"Mitral valve prolapse",
"Tetrology of hea"
] | A | Ref Harrison 19 th ed pg 816 Infection most commonly involves hea valves but may also occur on the low-pressure side of a ventricular septal defect, on mural endocardium damaged by aberrant jets of blood or foreign bodies, or on intracardiac devices themselves. The analogous process involving aeriovenous shunts, aerio-aerial shunts (patent ductus aeriosus), or a coarctation of the aoa is called infective endaeritis. | train | med_mcqa | null |
Most common site of osteomyelitis in children | [
"Diaphysis",
"Metaphysis",
"Epiphysis",
"Growth plate"
] | B | Overall Most common location of osteomyelitis is metaphysis. It is due to high vascularity, hair-pin loop system of blood supply, more prone to trauma and monocyte-macrophage system is weaker. Most common pa of osteomyelitis is lower end of Femur. Most common organism of osteomyelitis is staphylococcus aureus. | train | med_mcqa | null |
Maximum level of beta HCG is seen on which day of gestation? | [
"6 weeks",
"9 weeks",
"28 weeks",
"36 weeks"
] | B | Ans. is 'b' i.e., 9 weeks o Maximum levels of beta HCG occur on 66th day of pregnancy, i.e. 9 weeks 3 days.Human Chorionic Gonadotropino Produced almost exclusively in placenta, low levels in fetal kidneyo Molecular weight - 36000 - 40000 Da.o Highest carbohydrate content of any hormone - 30 percent.o It has a long half life - 36 hours as against only 2 hours of LH; as the carbohydrate component, and especially the terminal sialic acid, protects the molecule from catabolismo Alpha subunit of LH, FSH, TSH and HCG are structurally related to each other. Recombination of alpha and beta subunits of these four hormones gives a molecule with biological activity characteristic of the hormone from which the beta subunit was derivedo Principal form in plasma - Intact hCGo Principal form in urine - beta core fragment (terminal hCG degradation product).Functionsa) Maintainence of corpus luteum till 6 weeks of pregnancy.b) Stimulation of fetal testicular testosterone secretion which is maximum approximately when hCG levels peak. Thus at a critical time in male sexual differentiation, hCG enters fetal plasma from the syncytiotrophoblast. In the fetus, it acts as an LH surrogate to stimulate Leydig cell replication and testosterone synthesis to promote male sexual differentiation. Before approximately 110 days, there is no vascularization of the fetal anterior pituitary from the hypothalamus. Thus, pituitary LH secretion is minimal,and hCG acts as LH before this time. Thereafter as hCG levels fall, pituitary LH maintains modest testicular stimulation.c) Immunosuppressive activity, inhibits maternal processes of immunorejection of the fetus as a homograft.d) Stimulates maternal thyroid (thyrotropic action).e) Promotes relaxin secretion from corpus luteum.o Choriocarcinoma is associated with increased secretion of beta - hCG that is glycosylated to a greater degree, so called hyperglycosylated hCG, sometimes called invasive trophoblast antigen. | train | med_mcqa | null |
The type of stress to which dental amalgam is most resistant: | [
"Shear's stress",
"Tensile stress",
"Compressive stress",
"Impact stress"
] | C | null | train | med_mcqa | null |
All are the measures of dispersion except | [
"Variance",
"Standard deviation",
"Mode",
"Range"
] | C | null | train | med_mcqa | null |
Velvety appearance of stomach is seen in poisoning with:(1995) | [
"Abrus precatorius",
"Barbiturates",
"Arsenic",
"lead"
] | C | Ans: cRef: Parikh, 6th ed, p. 9.10 and 5th ed, p. 748 | train | med_mcqa | null |
In pupillary reflex nerve tested is - | [
"2nd",
"3rd",
"Both 2nd and 3rd",
"4th"
] | C | Afferent nerve for light reflex → optic (2nd) nerve.
Efferent nerve for light reflex → occulomotor (3rd) nerve. | train | med_mcqa | null |
Schizophrenia is characterized by: Kerala 06 | [
"Delusion and hallucination",
"Tremor and delusion",
"Obsession and delusion",
"Autonomic disturbance"
] | A | Ans. Delusion and hallucination | train | med_mcqa | null |
All of the following condition are associated with granulomatous pathology, EXCEPT: | [
"Wegner's Granulomatosis (WG)",
"Takayasu Aeritis (TA)",
"Polyaeritis Nodosa (Classic PAN)",
"Giant Cell Aeritis (GCA)"
] | C | Classic PAN is characterised by segmental transmural necrotizing inflammation of small to medium sized aeries in all organs except lung. Ref: Robbin's Basic Pathology, 7th Edition, Page 350, 347 - 352. | train | med_mcqa | null |
Tuberculosis in children true is | [
"Commonly sputum negative",
"Incidence < 5% of all TB cases",
"Clinically child does not show sign of florid TB",
"All of the above"
] | D | Tuberculosis in children :
Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis.
Cases of tuberculosis represent 5 - 15 percent of all tubercular cases.
Clinical manifestations of TB in children :
The majority of children with tuberculosis infection develop no signs or symptoms at any level.
Occasionally.
Infection is marked by low - grade fever, mild cough, malaise and u - like symptoms.
A) Primary pulmonary disease the lung is the portal of entry in > 98% of cases.
The primary complex of tuberculosis includes local infection at the portal of entry and regional lymph nodes that drain the area.
The combination of the parenchymal pulmonary - lesion and corresponding lymph node is called Ghon complex.
Asymptomatic pleural effusion is so frequent in primary - tuberculosis that it is basically a component of the primary complex.
Nelson, It may have one of the following course : - Heating by brosis and calcification.
Progressive primary > tuberculosis. Cavity Obstructive emphysema If the incomplete obstruction is caused by lymph nodes.
Resorption atelectasis If the complete obstruction is caused by lymph nodes.
Tubercular bronchitis & bronchiectasis Hematogenous dissemination During early bacteremia seeding may occur at apex Simon's focus.
Miliary tuberculosis Collapse consolidation (segmental lesion) A combination of pneumonitis and atelectasis.
B) Chronic pulmonary tuberculosis :
Infrequent in young children.
Children above the age of seven years, especially girls are more vulnerable.
The commonest site of chronic pulmonary tuberculosis is the apex of lung Puhl's lesion.
Infraclavicular lesion of chronic pulmonary tuberculosis is called Assman's focus.Regional lymph nodes are not involved in chronic pulmonary TB (in contrast to primary TB). Lab investigations of pediatric TB.
ESR and blood counts : No value in diagnosis or follow up of TB.
Demonstration of AFB.
Children don't expectorate out sputum, but swallow it.
Therefore sputum is not available for examination.
A laryngeal swab may be obtained for smear and culture examination for mycobacteriaIt is customer to examine the gastric lavage in children for bacteriological examination on 3 consecutive days, Aspiration of early morning gastric contents (before breakfast) is done with a Ryle's tube and sent for bacteriological examination. Adding vancomycin to the sample improves the yield of mycobacterium. The CSF, Pleural did or bronchial aspirate, urine and discharges from tuberculous sinuses are examined for tubercle bacilli. Histopathology : Material for histopathology may be obtained by biopsy or FNAC.
PCR : High sensitivity and specificity for pleural uid and low for gastric aspirate. CXR and CT may show characteristic features.
USG may be helpful for the detection of enlarged abdominal lymph nodes,
Serology : Elisa or other methods have no utility in pediatric TB. Antitubercular drugs used in children.
First line drugs : Isoniazid, Rifampicin, EthambutoL Streptomycin, Pyrazinamide.
Second line drugs : Cycloserine, Ethionamide, PAS, Capreomycin, Kanamycin.
Other drugs. Quinolones Ooxacin, Rifamycin, Amikacin, Imipenem, Ampicillin. | train | med_mcqa | null |
Which of the following incision used in diaphragm surgery is safest | [
"Horizontal",
"Veical",
"Circumferential",
"Transverse"
] | C | Circumferential is the safest as it prevents injury to phrenic nerve to maintain the function of the diaphragm | train | med_mcqa | null |
Winter bottoms sign in sleeping sickness refers to - | [
"Unilateral conjunctivitis",
"Posterior cervical lymphadenopathy",
"Narcolepsy",
"Transient erythema"
] | B | Generalized or regional lymphadenopathy - Posterior cervical lymphadenopathy (Winterbottom sign) is characteristic of T brucei gambiense African trypanosomiasis | train | med_mcqa | null |
Drug efficacy refers to: | [
"Effectiveness of drug in life threatening conditions",
"The maximal intensity of response that can be produced by the drug",
"The dose of the drug needed to produce half maximal effect",
"The minimum dose of the drug needed to produce toxic effect"
] | B | null | train | med_mcqa | null |
A 6-month-old child is suffering from patent ductus arteriosus (PDA) with congestive cardiac failure. Ligation of ductus arteriosus was decided for surgical management. The most appropriate inhalational anesthetic agent of choice with minimal hemodynamic alteration fro induction of anesthesia is - | [
"Halothane",
"Sevoflurane",
"Isoflurane",
"Enflurane"
] | B | Ans. is 'b' i.e., Sevoflurane Sevoflurane is the agent of choice for inhalational induction of anesthesia in pediatric procedures.It is an excellent choice for smooth and rapid inhalational induction in pediatric procedures becauseIt has a sweet odor so induction is smoothThe rapid increase in alveolar anesthetic concentration (therefore rapid onset of action)It is low blood solubility's results in rapid fall in alveolar anesthetic concentration upon discontinuation and results in quicker emergence when compared to other inhalational agents.Cardiovascular effects of sevoflurane * Sevoflurane has minimal effect on cardiovascular system, it causes minimal hemodynamic alterations, therefore, it can be easily used as an induction agent in patients with PDA.The cardiovascular effects areMinimal cardiac depressionThe slight decrease in systemic vascular resistanceMinimal decrease in cardiac outputHalothane and isoflurane are usually avoided in children because they have a pungent odor and so the induction is not smooth. | train | med_mcqa | null |
A patient with following skin lesions is seen in a disease, which has ________ inheritance. | [
"X-linked recessive",
"X-linked dominant",
"Autosomal recessive",
"Autosomal dominant"
] | D | Lesions are multiple cutaneous neurofibromas. Neurofibromatosis is an autosomal dominant disease. It is associated with Cafe-au-lait spots as well. | train | med_mcqa | null |
Not True about Pinna of the Ear | [
"Develops from HILLOCK's of HIS",
"Tragus formed from 1st Hillock",
"Costal Rib Cartilage used as graft in treatment of Anotia",
"Reconstruction of pinna in Anotia is done as soon as possible within 1 year of age"
] | D | Reconstruction of pinna done at 6 years of age. | train | med_mcqa | null |
How would a drug that competes with ACh for receptors at the motor end plate affect skeletal muscle? It would: | [
"Produce uncontrolled muscle spasms",
"Cause the muscles to contract and be unable to relax",
"Cause muscles to relax and be unable to contract",
"Make the muscles more excitable"
] | C | Ref: KD Tripathi pharmacology 7th edition (page.no: 58) Anticholinergic drugs compete with acetylcholine for receptors at NM junction . Anticholinergic opposes the action of Ach causing relaxation of the muscle. | train | med_mcqa | null |
Size of fibrillary proteins in amyloidosis: | [
"0-5 nm",
"7.5-10 nm",
"12-17 nm",
"18-20 nm"
] | B | Ans. b (7.5-10 nm). (Robbin Pathologic Basis of Diseases 5th/231)PHYSICAL NATURE OF AMYLOID# By electron microscopy, amyloid is seen made up largely of non-branching fibrils of indefinite length and a diameter of approximately 7.5 to 10 nm.# X-ray crystallography and infrared spectroscopy demonstrate a characteristic cross (3-pleated sheet conformation.# Chemical nature:- AL (amyloid light chain)- AA (amyloid associated)- AB (Alzheimer's disease) | train | med_mcqa | null |
Os trigonum is which type of epiphysis ? | [
"Aberrant",
"Pressure",
"Atavistic",
"Traction"
] | C | C i.e. Atavistic | train | med_mcqa | null |
The bacterial cell wall has all of the following properties except: | [
"It consists of a mixed polymer called peptidoglycon",
"It is the structure principally responsible for the reaction of gram staining",
"It is a unique flexible plastic structure",
"It contains D-isomers of amino acids"
] | C | null | train | med_mcqa | null |
The tumor suppressor gene p 53 induces cell cycle arrest at - | [
"G2- M phase",
"S G2phase",
"G1 phase",
"Go phase"
] | C | Harshmohan textbook of pathology 7th edition. In blocking mitotic activity p53 inhibits the cyclins and CDKs and prevent the cell to enter G1 phase transientally. . | train | med_mcqa | null |
All have NO LYMPHATICS, except | [
"Brain",
"Internal ear",
"nail",
"Eye"
] | C | LYMPHATIC VESSELS AND CAPILLRIES - When circulating blood reaches the capillaries, pa of its fluid content passes into the surrounding tissues as tissue fluid. Most of this fluid re-enters the capillaries at their venous ends. Some of it is, however, returned to the circulation through a separate system of lymphatic vessels (usually called lymphatics). The fluid passing through the lymphatic vessels is called lymph. The smallest lymphatic (or lymph) vessels are lymphatic capillaries that join together to form larger lymphatic vessels. The largest lymphatic vessel in the body is the thoracic duct. It drains lymph from the greater pa of the body. The thoracic duct ends by joining the left subclan vein at its junction with the internal jugular vein. On the right side there is the right lymphatic duct that has a similar termination. Lymph capillaries - They are present in most tissues of the body. They are absent in avascular tissues (e.g., the cornea, hair, nails); in the splenic pulp; and in the bone marrow. It has been held that lymphatics are not present in nervous tissue, but we now know that some vessels are present. REF : Inderbir Singh's Textbook of Human Histology, seventh edition, pg.no., 127, 130. | train | med_mcqa | null |
All are true regarding cryptococcal infection,except - | [
"Occurs in immunodeficient states -",
"Capsular antigen in CSF is a rapid method of detection",
"Anticapsular antibody is protective",
"Urease +ve"
] | C | null | train | med_mcqa | null |
Tip of tongue drains inot - | [
"Occipital lymph node",
"Submental lymph node",
"Deep cervical lymph nodes",
"Tonsillar lymph nodes"
] | B | B i.e. Submental lymphnode | train | med_mcqa | null |
Which of the following antiviral drug has a dual antiviral activity that is against HBV and HIV? | [
"Saquinavir",
"Abacavir",
"Emtricitabine",
"None of the above"
] | C | Emtricitabine (FTC)
Emtricitabine, a fluoro derivative of lamivudine, inhibits both HIV and HBV.
Reference: Lippincott Illustrated Reviews: Pharmacology Wolters Kluwer Sixth Edition page no 577 | train | med_mcqa | null |
Membrane incised during hemilaryngectomy is | [
"Thyrohyoid",
"Cricothyroid",
"Aryepiglottic",
"Infralaryngeal"
] | B | Ans. is 'b' i.e., Cricothyroid Steps in hemlaryngectomyIndications and containdications* Ideal for bulky lesions of the membranous true vocal cord* Normal or slightly impaired vocal cord mobility* No involvement of the supraglottis* Tumor may extend as far as the apex of the ventricle* Subglottic extension of no more than 5 mm posteriorly (10 mm anteriorly)* The body of the arytenoid is a contraindication, although the vocal process is not* No more than one third of the contralateral vocal cord involved (consider supracricoid partial laryngectomy)Technical points* Administer perioperative antibotics* Re-encloscope the patient* Perform a preliminary tracheostomy* Make a horizontal skin incision over the thyroid ala.* Raise the flaps superiorly and inferiorly while avoiding the tracheostomy incision* Incise the perichondrium from the thyroid notch down the midline over the ericothyroid membrane.* Elevate the perichonadrium with the attached overlying strap muscles.* Mark the cartilage incisions while retaining a 3 mm wide posterior strip.* Out with a saginal saw* Use a headlight* Incise the perichondrium along the superior border of the thyroid ala. Incise across the petiole of the spiglotis. This will provide panoramic view of the larynx.* Incise the cricothyroid membrane along the superior aspect of the circoid cartilage.* Using a no. 15 blade, cut down to the true vocal cord and examine and cut through the one vocal cord either in the midline or in lesions that cross the anterior commissure. 2 to 3 mm behind the visible tumor.* Using hooks, open the thyroid alae like a book.* STOP. Carefully evaluate the lesion and determine the ares to be excised.* Excise the tumor by incising along the apex of the aryepiglotic fold down around the arytenoid or through the vocal process of the arytenoid, depending on the posterior extent of the tumor.* Orient and examing the surgical specimen and select sites for frozen section examination of the margins* Obtain hemostasis* Suture the contralateral cord to the anterior end of the remaining cartilage or to the external perichondrium* An epiglotopex must be performed in cases of extended vertical partial laryngectomy.* Insert a nasogastric tube for feeding* Close the perichondrium with probable suture* Inferiorly based or pedicled muscle flaps may be used reconstrict the glottis but are probably not necessary* A cricopharyngeal myotomy is not required* Close the wound in layers over a chain* Apply a neck dressing | train | med_mcqa | null |
Sunder Lal, 28 year old farmer is found convulsing in the farm. Heart rate is 100/min and blood pressure is 180/110 mm Hg. Diarrhea, sweating and urination are apparent. Pupils are pin point. Drug poisoning is suspected. Most probable cause is: | [
"Acetaminophen overdose",
"Amphetamine toxicity",
"Organophosphate poisoning",
"Atropine poisoning"
] | C | All the given symptoms are due to anticholinesterase action. | train | med_mcqa | null |
Type of schizophrenia with mental retardation | [
"Von-Gosh syndrome",
"Paranoid schizophrenia",
"Catatonic schizophrenia",
"Pfropf schizophrenia"
] | D | Pfropf schizophrenia occurring in the presence of mental retardation .it differs from schizophrenia in only that there is often a povey of ideation and delusions are not usually very well systematised.therefore behavioural disturbances are more prominent than delusions and hallucinations Ref: A sho textbook of Psychiatry. Nihal Ahuja. Edition 7. Pg no:61 | train | med_mcqa | null |
Peripheral nerves can withstand ischemia upto ? | [
"30 minutes",
"1 hour",
"2 hours",
"None"
] | D | Ans. is 'None' | train | med_mcqa | null |
Which drug is contraindicated in a glaucoma patient suffering from bronchial asthma: | [
"Timolol maleate",
"Latanoprost",
"Betaxolol",
"Brimonidine"
] | A | null | train | med_mcqa | null |
Which of the following is more prone to osteomyelitis | [
"Maxilla",
"zygorna",
"palatine bone",
"mandible"
] | D | null | train | med_mcqa | null |
On consumption of which aminoacid, requirement of methionine is reduced because of sparing effect? | [
"Homocysteine",
"Cysteine",
"Lysine",
"Arginine"
] | B | Ans. is 'b' i.e., Cysteine"Adequate dietary source of cysteine 'spares' methionine".* Methionine is an essential amino acid.* Methionine is required for synthesis of cysteine (thus cysteine is non-essential amino acid)* Thus, cysteine can spare the requirment of methionine in diet. | train | med_mcqa | null |
Which of the following is a feature of hibernating myocardium? | [
"Elevated cardiac troponins",
"Depressed ST segment",
"Elevated ST segment",
"Left bundle branch block"
] | B | Hibernating myocardium/chronic stable angina Depressed ST segment seen in chronic stable angina Option A: Elevated cardiac Troponins is seen in stunned myocardium/MI Option C: Elevated ST seen in MI Option D: LBBB-Complication of MI | train | med_mcqa | null |
Last ocular muscle to be involved in Grave's disease? | [
"Inferior rectus",
"Lateral rectus",
"Superior rectus",
"Inferior oblique"
] | D | Ans. is 'd' i.e., Inferior oblique Order of involvement (Mnemonic : IM SLO(W)) :- Inferior rectus > medial rectus > superior rectus > Lateral rectus > obliques. | train | med_mcqa | null |
The "Crude death rate" is defined as "the number of deaths (from all causes) per 1000 estimated". | [
"Total population",
"Total births",
"Mid year population",
"Live births"
] | C | (C) Mid year population # Crude death rates lack comparability for communities with populations that differ by age, sex, race etc.> Crude Death Rate: Number of deaths /1000 population/year in a given community deglt indicates the rate at which people are dying The usefulness of Crude death rate is restricted because it is influenced by the age-sex composition of the population | train | med_mcqa | null |
Superior thyroid artery is related to - | [
"Recurrent laryngeal nerve",
"External laryngeal nerve",
"Internal laryngeal nerve",
"Chorda-tympani nerve"
] | B | Ans. is 'b' i.e., External laryngeal nerve Blood supply of thyroidArteryBranch ofRelated toRemarkSuperior thyroidExternal carotidExternal laryngeal N.During thyroidectomy superior thyroid artery is ligated close to upper pole ofgland to avoid injury to external laryngeal nerve.Inferior thyroidThyrocervical trunkRecurrent laryngeal N.During thyroidectomy inferior thyroid artery is ligated away from the lower pole to avoid injury to recurrent laryngeal nerveLowest thyroid A. (thyroid ima)Brachiocephalic trunk or Aorta Accessory thyroidTracheal & esophageal arteries | train | med_mcqa | null |
Which among the following is the abductor of vocal cord? | [
"Posterior cricoarytenoid",
"Cricothyroid",
"Interarytenoid",
"Lateral cricoaretynoid"
] | A | The posterior cricoarytenoid is the only abductor of the vocal cords. The major abductors of the vocal cords are the lateral cricoarytenoid, thyroarytenoid, and arytenoideus muscles. | train | med_mcqa | null |
Not true about carcinoma Nasopharynx | [
"Epstein barr virus",
"Nickel if found to be associated",
"Bimodel age distribution",
"Samter's Triad"
] | D | null | train | med_mcqa | null |
Culture mediam for corynebacterium diphtheria? | [
"Loefflers serum slope",
"McConkey",
"Saburauds agar",
"Lowenstein Jensen medium"
] | A | Ans. is 'a' i.e., Loefflers serum slope | train | med_mcqa | null |
Canon 'a' wave is seen in | [
"Junctional rhythm",
"Atrial fibrillation",
"Atrial flutter",
"Ventricular fibrillation"
] | A | Ans. is 'a' i.e., Junctional rhythm | train | med_mcqa | null |
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