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 |
|---|---|---|---|---|---|---|
Gastrointestinal stromal tumours arise form | [
"Paneth cells",
"Stave cells",
"Enterocytes",
"Interstitial cells of Cajal"
] | D | Gastrointestinal stromal tumours (GISTs) may arise in anypa of the gastrointestinal tract but 50% will be found inthe stomach.They are now known to be a distinct tumor derived from the interstitial cells of Cajal,The tumours are universally associated with a mutation in thetyrosine kinase c-kit oncogene (CD 117). These tumours are sensitive to the tyrosine kinase antagonist imatinibBailey and Love 27e pg: 1139 | train | med_mcqa | null |
Baby 20 year old female complains of sudden onset palpitation and apprehension. She is sweating for last 10 minutes and fears of impending death. Diagnosis is | [
"Hysteria",
"Generalized Anxiety Disorder",
"Cystic fibrosis",
"Pannic Attack"
] | D | D i.e. Pannic attack | train | med_mcqa | null |
A deficiency of substance Intrinsic factor can result in an anemia. Choose the type of anemia that would occur if the substance were deficient. | [
"Megaloblastic anemia",
"Hypochromic, microcytic anemia",
"Hemolytic anemia",
"Sickle cell anemia"
] | A | We will illustrate, in addition, how biochemical measurements can pinpoint a disorder and allow one to determine which enzyme is functioning improperly.a. Mouth(1). Salivary glands produce a-amylase, which cleaves a-1,4 bonds between glucose residues in dietary starch. (Pancreatic a-amylase catalyzes the same reaction.)b. Stomach(1). Chief cells produce the proteolytic enzyme pepsin, as its inactive precursor pepsinogen. Pepsin digests proteins.(2). Parietal cells produce hydrochloric acid (HCl) and intrinsic factor.(a). HCl causes pepsinogen (the precursor of pepsin) to cleave itself (autocatalysis), producing pepsin.(b). Intrinsic factor binds dietary vitamin B12 and aids in its absorption.(c). Vitamin B12 is the cofactor for the conversion of homocysteine to methionine and methyl malonyl-CoA to succinyl-CoAc. Gallbladder(1). Bile salts, synthesized in the liver from cholesterol, pass through the gallbladder into the intestine, where they aid in lipid digestion.(2). Bilirubin diglucuronide, produced in the liver from bilirubin (the excretory product of heme degradation), passes through the gallbladder into the intestine.d. Pancreas(1). The pancreas produces bicarbonate (HCO3- ), which neutralizes stomach acid as it enters the intestinal lumen. The subsequent increase in pH in the lumen allows more extensive ionization of bile salts (so they serve as better detergents) and increases the activity of digestive enzymes.(2). The pancreas produces digestive enzymes (e.g., trypsin, chymotrypsin, the carboxypeptidases, elastase, a-amylase, lipase).(3). The B (or b) cells of the endocrine pancreas produce insulin (the hormone that stimulates the storage of fuels in the fed state) and the A (or a) cells produce glucagon (the hormone that stimulates the release of stored fuels during fasting).e. Intestine(1). The enzymes from the exocrine pancreas digest food in the intestinal lumen.(2). The intestinal digestive enzymes are bound to the brush borders of intestinal epithelial cells (aminopeptidases, dipeptidases and tripeptidases, lactase, sucrase, maltases, and isomaltases).(3). The absorption of digestive products occurs through the intestinal epithelial cells.(4). The intestinal epithelial cells produce chylomicrons from the digestive products of dietary fat (fatty acids and 2-monoacylglycerols) and secrete the chylomicrons into the lymph.(5). Most bile salts are resorbed in the ileum and recycled by the liver. Only 5% are excreted in the feces. This excretion of bile salts, along with cholesterol secreted by the liver into the gut via the gallbladder, is the major means by which the body disposes of the cholesterol ring structure (sterol nucleus).f. Liver (the enzymic regulation of liver function is summarized in Tables below)(1). Functions of the liver include:(a). Storage of glycogen produced from dietary carbohydrate.(b). Synthesis of very low-density lipoprotein (VLDL), mainly from dietary carbohydrate.(c). Production of high-density lipoprotein, which transfers CII and E apolipoproteins to chylomicrons and VLDL, converts cholesterol to cholesterol esters (via the lecithin-cholesterol acyltransferase reaction), and reduces blood by which cholesterol and cholesterol esters are transported from tissues to the liver (reverse cholesterol transport).(d). Maintenance of blood glucose levels during fasting via glycogenolysis and gluconeogenesis.(e). Production of urea from nitrogen derived, in part, from amino acids because they are being converted to glucose (via gluconeogenesis) during fasting.(f). Production of ketone bodies from fatty acids derived from lipolysis of adipose triacylglycerols during fasting.(g). Synthesis of cholesterol (which is also made in other tissues).(h). Conversion of cholesterol to bile salts.(i). Production of many blood proteins (e.g., albumin, blood-clotting proteins).(j). Production of purines and pyrimidines, which are transported to other tissues via red blood cells.(k). Degradation of purines (to uric acid) and pyrimidines (to CO2 , H2 O, and ammonia).(l). Oxidation of drugs and other toxic compounds via the cytochrome P450 system.(m). Conjugation of bilirubin and excretion of bilirubin diglucuronide into the bile.(n). Oxidation of alcohol via alcohol and acetaldehyde dehydrogenases and the microsomal ethanol-oxidizing system (MEOS).(o). Synthesis of creatine (from guanidinoacetate), which is used to produce creatine phosphate, mainly in the muscle and brain.(p). Conversion of dietary fructose to glycolytic intermediates.(2). If liver cell function is compromised (e.g., in viral hepatitis or alcoholic cirrhosis):(a). NH4+ , which is toxic (particularly to the central nervous system), increases in the blood.(b). The BUN level decreases because the liver has a decreased capacity to produce urea.(c). Blood glucose decreases because of decreased glycogenolysis and gluconeogenesis.(d). Blood cholesterol levels decrease owing to an inability to produce and secrete VLDL.(e). The production of bile salts decreases.(f). Bilirubin levels increase in the body (causing jaundice) because of reduced conjugation with glucuronic acid.(g). Lysis of damaged liver cells allows enzymes to leak into the blood.1. Lactate dehydrogenase increases.2. Alanine aminotransferase increases.3. Aspartate aminotransferase increases.4. Alkaline phosphatase increases.(h). Chronic liver problems result in decreased protein synthesis.1. Serum proteins (e.g., albumin) decrease.2. VLDL production decreases because of decreased apolipoprotein B-100 and triacylglycerols accumulate in the liver. A fatty liver results.g. Brain(1). Glucose is the major fuel for the brain.(2). The brain can use ketone bodies, but only after 3 to 5 days of fasting when blood ketone body levels are elevated.(3). The brain needs energy to think (i.e., memory involves RNA synthesis), conduct nerve impulses, synthesize neurotransmitters, and so on.h. Red blood cells(1). Red blood cells lack mitochondria, so they have no TCA cycle, b-oxidation of fatty acids, electron transport chain, and other pathways that occur in the mitochondria.(2). Glucose is the major fuel for red blood cells.(a). Glucose is converted to pyruvate and lactate.(3). Red blood cells carry bases and nucleosides from the liver to other tissues.(4). The major function of red blood cells is to carry O2 from the lungs to the tissues and to aid in the return of CO2 from the tissues to the lungs.i. Adipose tissue(1). The major fuel of adipose tissue is glucose.(2). Insulin stimulates the transport of glucose into adipose cells.(3). The function of adipose tissue is to store triacylglycerol in the fed state and release it (via lipolysis) during fasting.(a). In the fed state, insulin stimulates the synthesis and secretion of lipoprotein lipase (LPL), which degrades the triacylglycerols of chylomicrons and VLDL in the capillaries. Fatty acids from these lipoproteins enter adipose cells and are converted to triacylglycerols and stored. Glucose provides the glycerol moiety. (Glycerol is not used because adipose cells lack glycerol kinase.)(b). During fasting, adipocyte triglyceride lipase and hormone-sensitive lipase (phosphorylated and activated via a cAMP-mediated mechanism) initiate lipolysis in adipose cells.j. Muscle(1). Muscle uses all fuels that are available (glycogen stores, and fatty acids, glucose, ketone bodies, lactate, and amino acids from the blood) to obtain energy for contraction.(2). During fasting, muscle protein is degraded to provide amino acids (particularly alanine) for gluconeogenesis.(3). Creatine phosphate transports high-energy phosphate from the mitochondria to actinomyosin fibers and provides ATP for muscle contraction.(4). Creatinine is produced nonenzymatically from creatine phosphate, and a constant amount (dependent on the body muscle mass) is released into the blood each day and excreted by the kidneys.(5). Muscle glycogen phosphorylase differs from liver phosphorylase but catalyzes the same reaction (glycogen+Pi-glucose-1-phosphate).(6). Insulin stimulates the transport of glucose into muscle cells.k. Heart(1). The heart is a specialized muscle that uses all fuels from the blood.(2). The muscle-brain (MB) isozyme of CK is found in heart muscle. Its release can be used to monitor a heart attackl. Kidney(1). The kidney excretes substances from the body via the urine, including urea (produced by the urea cycle in the liver), uric acid (from purine degradation), creatinine (from creatine phosphate), NH4+ (from glutamine via glutaminase), H2SO4 (produced from the sulfur of cysteine and methionine), and phosphoric acid.(2). Daily creatinine excretion is constant and depends on the body muscle mass. It is used as a measure of kidney function (the creatinine-clearance rate).(3). Glutaminase action increases during acidosis and produces NH3 , which enters the urine and reacts with H+ to form NH4+ . NH4+ buffers the urine and removes acid (H+) from the body.(4). Uric acid excretion is inhibited by lead (Pb) and metabolic acids (ketone bodies and lactic acid). High blood uric acid can result in gout. Gout can be caused either by increased production or by decreased excretion of uric acid. Deficiency of the base salvage enzyme hypoxanthine guanine phosphoribosyl transferase in Lesch-Nyhan syndrome results in increased production of uric acid.(5). Kidney dysfunction can lead to increased BUN, creatinine, and uric acid in the blood and decreased levels of these compounds in the urine.(6). During ketoacidosis, ketone bodies are excreted by the kidney, and during lactic acidosis, lactic acid is excreted.(7). Elevated blood glucose levels (over 180 mg/dL) in DM results in the excretion of glucose in the urine.Intrinsic factor is required for the absorption of dietary vitamin B12 . Lack of B12 (or folate) results in a megaloblastic anemia. In a B12 deficiency, irreversible neurologic problems (due to demyelination) also occur. When decreased intrinsic factor causes a B12 deficiency, the condition is called pernicious anemia. An iron-deficiency anemia is characterized by small, pale RBCs. The lack of iron reduces the synthesis of heme, so the red cells cannot carry as much oxygen (which gives them the pale color). The cells are small in order to maximize the concentration of hemoglobin present in the cells. Hemolytic anemia occurs when the red cell membrane fragments, which can occur with pyruvate kinase deficiencies or a lack of glucose-6-phosphate dehydrogenase activity (which results in reduced NADPH levels). Sickle cell anemia is caused by a point mutation in the b-globin gene, substituting a valine for a glutamic acid.When Blood Sugar Increases:When Blood Sugar Decreases:Insulin is released, which leads to the dephosphorylation of:Glucagon is released, which leads to the phosphorylation of:PFK-2 (kinase activity now active)PFK-2 (phosphatase activity now active)Pyruvate kinase (now active)Pyruvate kinase (now inactive)Glycogen synthase (now active)Glycogen synthase (now inactive)Phosphorylase kinase (now inactive)Phosphorylase kinase (now active)Glycogen phosphorylase (now inactive)Glycogen phosphorylase (now active)Pyruvate dehydrogenase (now active)Pyruvate dehydrogenase (now inactive)Acetyl-CoA carboxylase (now active)Acetyl-CoA carboxylase (now inactive)Which leads to activeGlycolysis GlycogenolysisFatty acid synthesisFatty acid oxidationGlycogen synthesisGluconeogenesis Liver Enzymes Regulated by Activation/InhibitionEnzymeActivated byState in Which ActivePhosphofructokinase 1Fructose 2,6-bisP, AMPFedPyruvate carboxylaseAcetyl-CoAFed and fastingAcetyl-CoA carboxylaseCitrateFedCarnitine palmitoyltransferase ILoss of inhibitor (malonyl-CoA)FastingLiver Enzymes Regulated by Phosphorylation/DephosphorylationEnzymeActive formState in Which ActiveGlycogen synthaseDephosphorylatedFedPhosphorylase kinasePhosphorylatedFastingGlycogen phosphorylasePhosphorylatedFastingPhosphofructokinase- 2/fructose 2,6-bisphosphatase (acts as a kinase, increasing fructose2,6-bisP levels)DephosphorylatedFedPhosphofructokinase-2/fructose 2,6-bisphosphatase (acts as aphosphatase, decreasing fructose 2,6-bisP levels)PhosphorylatedFastingPyruvate kinaseDephosphorylatedFedPyruvate dehydrogenaseDephosphorylatedFed | train | med_mcqa | null |
The amount of blood loss during each menstrual period is about : | [
"10 cc",
"35 cc",
"50 cc",
"100 cc"
] | B | Ans. is b i.e. 35 cc Normal Menstrual Cycle : Average amount of blood loss = 35 ml / cycledeg Normal duration of flow < 7 daysdeg Mean duration = 4.7 daysdeg Cycle length = 21 - 35 daysdeg Abnormal menses terminology Term Interval Duration Amount Menorrhagia Regular Prolonged Excessive Metrorrhagia Irregular Prolonged Normal Menometrorrhagia Irregular Prolonged Excessive Hypermenorrhea Regular Normal Excessive Hypomenorrhea Regular Normal or less Less Oligomenorrhea Infrequent or irregular Variable Scanty Amenorrhea Absent No menses for 90 days Absent Also know : Recurrent bleeding in excess of 80 ml/cycle causes anemia. | train | med_mcqa | null |
A 50 year old male presents with a 3 year history of irritability, low mood, lack of interest in Surroundings and general dissatisfaction with everything. There is no significant disruption in his sleep or appetite. He is likely to be suffering from: | [
"Major depression",
"No psychiatric disorder",
"Dysthymia",
"Chronic fatigue syndrome"
] | C | C i.e. DysthymiaLong standing atleast for 2 years (1 year in children & adolescents) of low grade subthreshold depressive symptoms (not severe enough to be called major depression) exclusive of indicators of severity (such as suicidality and psychomotor disturbance and featuring symptoms more than signs (i.e. more subjective than objective)Q indicate diagnosis of dysthymic disorder. Absence of psychomotor agitation or retardation and uncharacteristic (very very rare) presence of marked disturbances in libido & appetite differentiate it from major depression in which these features are relatively more commonQ.Dysthymia (Meaning bad mood/ill humored) DisorderClinical PinctureLong standing insidious onset sub threshold depression of fluctuating or persistent nature dating back to late childhood or the teens, preceding any major depressive episodes by years, even decades.A return to low grade depressive pattern is the rule following recovery from superimposed major depressive episodes, if any, hence the name double depression.Low grade chronic depressive profile marked by fluctuating complaint consisting of gloominess, pessimism, lethargy (low drive), self doubt, lack of joie de vivre (i.e. low enjoyment of life), yet endowed with self critical attitudes & suffering for others.Typically work hard (back bone of society), devoting their lives to jobs that require dependability & great attention to detail, but do not enjoy their work. At their best, they invest what ever energy they have in work, leaving none for leisure or social activities.They are satisfied with nothing, complain of everything and brood about their usefullness of existence. Their entire existence is a burden for them.Often complain of having been depressed since bih. They view themselves as belonging to an aristocracy of suffering. These hyperbolic descriptions of suffering in absence of more objective signs of depression label them characterological depression.Both ICD-10 & DSM-IV stipulate a 2 year duration of low grade depressive symptoms (not severe enough to be called major depression) exclusive of such indicators of severity as suicidality and psychomotor disturbanceDiffers from major depression in that symptoms tend to outnumber signs (more subjective than objective depression)Q. So marked disturbances in libido and appetite are uncharacteristic, and psychomotor agitation or retardation is not observedQ.Other differential diagnosis, chronic fatigue syndrome present with disabling fatigue & typically deny depressive symptoms; patients with fibromyalgia complain of pain; by contrast typical dysthymic patient cannot stop relating to physician their titany of depressive symptoms. Polysomnography may differentiate fibromyalgia from dysthymia | train | med_mcqa | null |
Trans-tubular potassium gradient (T.T.K.G) in hypokalemia is? | [
"<3-4",
">6-7",
">9-10",
">10-15"
] | A | The expected values of the Trans-tubular potassium gradient (T.T.K.G) are <3-4 in the presence of hypokalemia and >6-7 in the presence of hyperkalemia. TTKG is measured as follows: | train | med_mcqa | null |
Rhinoscleromatis is caused by - | [
"Klebseilla",
"Autoimmune",
"Spirochetes",
"Rhinosporidium."
] | A | Rhinoscleroma is caused by Klebsiella rhinoscleromatis or Frisch bacillus. | train | med_mcqa | null |
Aniacinosis results in | [
"Perleche",
"Bed ben",
"Pellagra",
"Nyctalopia"
] | C | null | train | med_mcqa | null |
Gluconeogenesis from lactate needs all except | [
"Transpo of lactate from muscle to liver",
"Conversion of lactate to pyruvate",
"Transamination of pyruvate to alanine",
"None of the above"
] | C | The lactate formed in the muscle is transpoed to the liver. In the liver cell lactate dehydrogenase conves lactate to pyruvate (Fig. 9.28). The pyruvate enters the gluconeogenic pathway to form glucose.Ref: DM Vasudevan, 7th edition, page no: 119 | train | med_mcqa | null |
159,35 yr old lady presents with a lump in the upper outer quadrant of breast Histopathology shows cells in pools of mucin and faint nuclei | [
"Adenocarcinoma",
"colloidal carcinoma",
"Medullary carcinoma",
"Lobular carcinoma"
] | B | *colloidal/ Mucinous carcinoma breast *The histopathology feature of cells in pools of mucin is suggestive of colloidal carcinoma ref : robbins 10th ed | train | med_mcqa | null |
The epitheliod cell and multinucleated giant cells of granulomatous inflammation are derived from | [
"Basophils",
"Eosinophil",
"CD4T lymphocytes",
"Monocytes marcophages"
] | D | Ref Robbins 9/e p97 Delayed type of hypersensitivity results from accumulation of mononucleated cells around small veins and venules producing a perivascular cuffing .mono cytes transform into macrophages which undergo morphological changes to produce epitheliod cell | train | med_mcqa | null |
Not true about amoebic liver abscess | [
"Adult forms are seen",
"Conservative treatment is generally seen",
"Larvae are seen",
"USG can diagnose it"
] | C | Larval forms of E.histolytica are not seen in the abscess | train | med_mcqa | null |
Palpation of muscles of mastication is best accomplished bilaterally and | [
"Simultaneously",
"Alternately",
"Intermittently",
"None of the above"
] | A | null | train | med_mcqa | null |
Which one is not converted to an active metabolite? | [
"Quinapril",
"Fosinopril",
"Benzopril",
"Lisinopril"
] | D | Lisinopril: It is the lysine derivative of enalaprilat; does not require hydrolysis to become active ACE inhibitor.
KEY CONCEPT:-
All ACE inhibitors are prodrugs except captopril and lisinopril. Other drugs like enalapril are converted to its active metabolite (enalaprilat) and thus are slow acting.
Reference: Essentials of Medical Pharmacology Eighth Edition KD TRIPATHI page no 532 | train | med_mcqa | null |
Which of the following assays are used to estimate amount of glycated Hemoglobin? | [
"HPLC",
"Immunoassay",
"Affinity chromatography",
"All of the above"
] | D | All the 3 assays can be used to estimate amount of glycated hemoglobin.
Normal level of HbA1C is < 5.5%.
High performance liquid chromatography employs cation exchange chromatography. | train | med_mcqa | null |
Treatment of Acute Hyperkalemia -a) Ca gluconate givenb) Insulin & Glucose reduces hyperkaJemia within 4 hrsc) Dialysis not usefuld) Resin shows the response within minutese) IV NaHCO3 given | [
"a",
"b",
"ae",
"ad"
] | C | Resins show response within → 1-2 hr
Insulin + Glucose shows response within → 15-30 minutes
Ca gluconate shows response within → minutes (less than 5 minutes)
B2 adrenergic shows response within → 30 minutes
NaHCO3 shows response within → 30 minutes
Hemodialysis is the most effective and rapid nlav of lowerine plasma potassiumQ | train | med_mcqa | null |
Internal anal sphincter is pa of | [
"Internal longitudinal fibres of rectum",
"Puborectalis muscle",
"Deep perineal muscles",
"Internal circular muscle fibres of rectum"
] | D | The internal anal sphincter, IAS, (or sphincter ani internus) is a muscular ring that surrounds about 2.5-4.0 cm of the anal canal; its inferior border is in contact with, but quite separate from, the external anal sphincter. It is about 5 mm thick and is formed by an aggregation of the involuntary circular fibers of the rectum. Its lower border is about 6 mm from the orifice of the anus. Ref - BDC 6e vol2 pg413-416 | train | med_mcqa | null |
Indicator solution in Horrock’s Apparatus contains | [
"Ortho-toulidine",
"Bromocresol purple",
"Ortho-toulidine arsenite",
"Starch iodide"
] | D | Indicator in Horrock’s apparatus: Starch iodide.
Indicator in Presumptive coliform test (MPN Multiple Tube Method): Bromocresol purple. | train | med_mcqa | null |
HIV virus was discovered in? | [
"1976",
"1983",
"1996",
"1988"
] | B | Ans. (b) 1983 History of HIV In 1981 AIDS was first recognized when US centre for disease control and prevention repoed the unexplain occurrences of P. jiroveci infection in five previously health homosexual male. They appear to have lost their immunocompetence. So the condition was given the name "Acquired immune deficiency syndrome" (AIDS). In 1983 Lue montognier and colleagues from pasteur institute, Paris isolated a retro virus from a West African patient with persistent generalized lymphadenopathy and called it lymphadenopathy associated virus (LAV). In 1984 Ader Gallo repoed isolation of a retrovirus from AIDS patient and called it human T-cell lymphotrophic virus III. To reduce the nomenclature confusion, the intervational committee on virus nomenclature in 1886 decided a generic name human immuno deficiency virus to the virus isolated from AIDS cases. | train | med_mcqa | null |
Vocal cords are supplied by? | [
"External laryngeal nerve",
"Internal laryngeal nerve",
"Recurrent laryngeal nerve",
"Vagus nerve"
] | C | Ans. c (Recurrent laryngeal nerve). (Ref. BD Chaurasia, Anatomy, 3rd vol., 3rd ed., 61)# The internal laryngeal nerve supplies the mucous membrane of larynx above the level of vocal folds.# The recurrent laryngeal nerve supplies below the level of vocal cords.# When both recurrent laryngeal nerves are interrupted, vocal folds lie in cadaveric position and phonation is lost completely.# When only recurrent laryngeal is paralysed, opposite vocal cord compensates and phonation is possible. | train | med_mcqa | null |
Gardener&;s syndrome is a rare hereditary disorder involving the colon. It is characterized by | [
"Polyposis colon, Cancer thyroid, skin tumours",
"Polyposis is jejunum, pituaitary adenoma and skin tumours",
"Polyposis colon, osteomas, epidermal inclusion cysts and fibrous tumours in the skin",
"Polyposis of gastrointestinal tract, cholangiocarcinoma and skin tumours"
] | C | .GARDNER'S SYNDROME * It is commonly associated with FAP - 10%. * Presents with bone, skin, soft tissue and dental abnormalities. Jaw osteomas are very common. Other features are epidermoid cysts (50%), exostoses, fibromas, lipomas. * Associated with desmoid tumours seen in the scar, abdomen, intraabdominal region and mesenteric fibromatosis. * Congenital hyperophy of pigment layer of retina (seen as pigment spots)--commonly seen. * Often associated with MEN IIb syndrome. ref:SRB&;s manual of surgery,ed 3,pg no 834 | train | med_mcqa | null |
A cut injury on wrist causes the inability of thumb to touch the tip of little finger, the nerve likely to be damaged is - | [
"Ulnar",
"Radial",
"Median",
"Deep branch of ulnar nerve"
] | C | Patient is unable to do opposition (i.e., inability of thumb to touch the tip of little finger).
Loss of opposition is seen in median nerve injury. | train | med_mcqa | null |
Which of the following is used in gene therapy? | [
"Electroporation",
"Electrofocusing",
"Selectively targeted recombination",
"Intracytoplasmic injection"
] | A | Electroporation is used in gene therapy. Gene therapy is a technique that uses genes to treat or prevent disease. Delivery of DNA into patient&;s cells by using recombinant viruses/naked DNA/DNA complexes. Methods used include intranuclear injection, electroporation, gene-gun, sonoporation, and magnetofection Gene therapy was first used for severe combined immunodeficiency disorder (SCID), which is due to adenosine deaminase enzyme deficiency. FDA-approved gene therapy is used for SCID, Leber&;s congenital amaurosis, multiple myeloma and adrenoleukodystrophy Ref: Nelson textbook of pediatrics 21st edition Pgno: 584-586 | train | med_mcqa | null |
Vitamin associated with one carbon transfer is: | [
"Niacin",
"Thiamine",
"Ascorbic acid",
"Folic acid"
] | D | null | train | med_mcqa | null |
Most radio resistant phase in cell cycle: | [
"G1",
"Early S",
"Late S",
"G2"
] | C | Radiation energy is absorbed by tissue causing ionization or excitation, which are responsible for various biological effects. Susceptibility of various phases of cell cycle of radiation: G2M>M>G1> early S> late S phase Phase of cell cycle Comment G2M>G2 * Most sensitive to radiation End of S phase * Most resistant to radiation G1 * Radiation exposure leads to chromosomal aberration G2 * Radiation exposure leads to chromatid aberration | train | med_mcqa | null |
Following are used in treatment of digitalis toxity except - | [
"Potassium",
"Lignocaine",
"Fab particles",
"Hemodialysis"
] | D | null | train | med_mcqa | null |
25 hydroxylation of vitamin D occurs | [
"Skin",
"Liver",
"Kidney",
"Spleen"
] | B | Synthesis of 25-OH-D3 in Liver (Calcidiol)Vitamin D2 and/or D3 binds to specific D binding protein and is transpoed to liver.It undergoes hydroxylation at 25 position, by the enzyme 25-hydroxylase, in the endoplasmic reticulum of the mitochondria of liver cells.Coenzyme/cofactors required are: *Mg++NADPH, and *Molecular O2 A cytoplasmic factor is also required, the exact nature not known. Two enzymes, an NADPH-dependant cytochrome P450 reductase and a cytochrome P450 are involved also.25-OH-D3 (calcidiol) is the major storage form of vitamin D in liver and found in appreciable amount in circulation. The blood level of 25-OH-D3 exes feedback inhibition on the enzyme 25-hydroxylase. Reference: Chatterjea Textbook of Biochemistry pg no. 168 | train | med_mcqa | null |
The following statement regarding ganglion blocking agents are true except: | [
"They block the transmission of impulse in the sympathetic and parasympathetic autonomic ganglia.",
"They reduce the amount of noradrenaline released from the postganglionic sympathetic nerve endings.",
"Incidence of postural hypertension is less with their use.",
"Neostigmine can counteract the paralytic il... | C | Ganglion blocking agents occupy the receptors on the ganglion cells and block the transmission of impulses in the autonomic ganglia. They produce sympathetic and parasympathetic ganglion blockade. This results in a decrease in the amount of noradrenaline at the postganglionic sympathetic nerve ending, a decrease in the peripheral sympathetic tone and a fall in the blood pressure. The normal protective vasometer reflexes that are mediated by baroreceptors and sympathetic nervous system is also blocked thus there is marked postural hypotension. Paralytic ileus and urinary retention can result due to parasympathetic bloackade, which can be countered by neostigmine, an anticholinesterase. | train | med_mcqa | null |
Which of the following is the commonest location of hypertensive haemorrhage - | [
"Pons",
"Thalamus",
"Putamen/external capsule",
"Cerebellum"
] | C | null | train | med_mcqa | null |
In Acne rosacea, the main pathogenesis is: | [
"Unknown",
"Increased sebum production",
"Increased reactivity of cutaneous blood vessels to vasodilators",
"Telangiectasia is present over whole face along with the exposed part of back where papules & pustules are also present"
] | A | Ans. A. UnknownAcne rosacea - Disease of unknown etiology, Papules & pustules over central face (but never over any other part of body); Telangiectasia of nose & cheeks; Facial erythema.a. Flushing reaction to hot, spicy foods & alcohol but no increased reactivity of cutaneous blood vessels to vasodilators.b. Sebum production is normal.Tit-Topical & oral antibiotics; topical metronidazole; avoidance of hot, spicy foods & alcohol. | train | med_mcqa | null |
Pyogenic infection and brain infarction are associated with: | [
"Coagulative necrosis",
"Liquefactive necrosis",
"Caseous necrosis",
"Fat necrosis"
] | B | Liquefactive necrosis, is characterized by digestion of the dead cells, resulting in transformation of the tissue into a liquid viscous mass. It is seen in focal bacterial or occasionally, fungal infections because microbes stimulate the accumulation of leukocytes and the liberation of enzymes from these cells. The necrotic material is frequently creamy yellow because of the presence of dead leukocytes and is called pus. For unknown reasons, hypoxic death of cells within the central nervous system often manifests as liquefactive necrosis. | train | med_mcqa | null |
Which vitamin is associated with glycogen phosphorylase? | [
"Pyridoxin",
"Niacin",
"Riboflavin",
"Thiamine"
] | A | Pyridoxin Pyridoxal phosphate is an essential cofactor for glycogen phosphorylase | train | med_mcqa | null |
Which of the following is seen in the ovulatory phase | [
"Inhibin A is increased",
"FSH increases steroid synthesis in granulosa cells",
"Stimulation of continuation of reduction division of oocytes",
"Activin causes FSH to act on granulosa cells"
] | C | Ovulation
The combined LH/FSH midcycle surge is responsible for the final stage of maturation of the follicle,
completion of the first meiotic division of oocyte with extrusion of first polar body and expulsion of oocyte | train | med_mcqa | null |
Collecting tubules of kidney develop from : | [
"Uretric bud",
"Mesonephric duct",
"Paramesonephric duct",
"Wolffian duct"
] | A | A. i.e. Ureteric bud | train | med_mcqa | null |
Initial treatment of buphthalmos is - | [
"Laser trabeculolasty",
"Goniotomy",
"Topical pilocarpine",
"Carbonic anhydrase inhibitors"
] | B | In Buphthalmos medications are not effective and so treatment is primarily surgical. Incisional angle surgery by goniotomy or trabeculectomy Ref:Comprehensive ophthalmology-AK Khurana 6th edition chapter-10 page no:227 | train | med_mcqa | null |
Which of the following is true regarding PROPOFOL | [
"It is used in day care anesthesia",
"It is contraindicated in porphyria",
"IT is contraindicated in person allergic to egg",
"It is HIGHLY cardiostable"
] | A | Only contraindication of propofol is shock being cardiounstable. Intravenous induction agent of choice for day care anesthesia is propofol. It has rapid onset of action and a faster recovery. It also reduces postoperative nausea and vomiting which provide yet another reason for it to be a preferred drug for outpatient anesthesia. Inhalational agent of choice for day care anesthesia issevoflurane. Muscle relaxant of choice for day care anesthesia isrocuronium. | train | med_mcqa | null |
Which of the following anti-arrhythmic drugs is useful in AV block resulting from digoxin overdose? | [
"Adrenaline",
"Noradrenaline",
"Atropine",
"Adenosine"
] | C | Treatment of digoxin toxicity: Mild digitalis toxicity Decreased with K+ (It decreases binding of the drug to Na+K+ATPase) but in severe digitalis toxicity, K+ is C/I Ventricular arrhythmias Lignocaine Atrial tachyarrhythmia b blockers Bradyarrhythmias and AV block Atropine Very severe toxicity Digibind | train | med_mcqa | null |
Neologism is characteristically seen in: Gujarat 07 | [
"Depression",
"Mania",
"Schizophrenia",
"Delirium"
] | C | Ans. Schizophrenia | train | med_mcqa | null |
Mitral valve vegetations do not usually embolise to | [
"Lung",
"Liver",
"Spleen",
"Brain"
] | A | Ref Harrison 19 th ed pg 820 Mitral valve vegetation would obviously not go to the lung, as that would involve a backward flow | train | med_mcqa | null |
All are true about salivary gland tumor except: | [
"Parotid gland is most common site of involvement",
"Warthin tumour almost always found in the parotid gland",
"Minor gland tumours are mostly malignant",
"Parotid tumours are mostly malignant"
] | D | Ans: D (Parotid tumours...) Tumours of minor salivary glands are histologically similar to those of major glands; however, up to 90 per cent of minor salivary gland tumours are malignant"- L&B 26th/722'Warthin tumour (papillary cystadenoma Lymphomatosum): It arise almost alwaysQ in the parotid gland (the only tumour virtually restricted to the parotid & occur more commonly in male'1 than in female (other tumour more common in female). Oncocytese that are epithelial cell stuffed with mitochondria are found in warthin tumour. (Robbins 7th/792-93)"The parotid gland is the most common site for salivary tumours. Most tumours arise in the superficial lobe and present as slow growing,, painless swellings below the ear, in front of the ear or in the upper aspect of the neck"- L& B 26th/732"Tumours involving the sublingual gland are extremely rare and are usually (85 percent) malignantTreatment requires wide excision involving the overlying mucosa and simultaneous neck dissection"- L & B 26th/725"Tumours of the submandibular gland are uncommon and usually present as a slow-growing, painless swelling within the submandibular triangle.Only 50 per cent of submandibular gland tumours are benign, in contrast to 80-90 per cent of parotid gland tumours"- L & B 26th/728TablefL & B 26th/728): Salivary gland tumours - frequency and distribution.TypeLocationFrequencyMalignant (%)MajorParotidSubmandibularSublingualCommonUncommonVery rate10-205085MinorUpper aerodigestive tractRare90PLEOMORPHIC ADENOMA (MIXED TUMOUR)This is the commonest tumour0 of the major salivary glandsThis tumour most commonly(r) occur in the parotid & about 90% isseen in thisgland\7% is seen in submandibulargland. In the parotid the commonest location is the tail of parotid.Age : It is more frequent around 40 years of age, but it is also seen in childrenSex : Slightly higher incidence in woman(r) has been noticedSymptom : The patients complains of a painless swelling of the side of the face which has been present for months or years. It is a slow growing turnout^ & gradually increases in size.This tumour is radioresistant(r), so excision is the treatment of choice.Superficial parotidectomy(r) is the treatment of choice(r). This operation is also known as patey's operation (S. Das 5th/609)In case of submandibular gland neoplasms, the whole gland is excised with particular care to preserve the lingual & hypoglossal nerve. | train | med_mcqa | null |
Iron supplementation in a healthy term breast fed baby should be staed at the age of - | [
"2 weeks",
"4 weeks",
"8 weeks",
"None"
] | D | Ans. is NoneCorrect answer is 6 months. | train | med_mcqa | null |
Which of the following is used in the treatment of well differentiated thyroid cancer? | [
"32 P",
"131 I",
"99mTc",
"131I-MIBG"
] | B | I 131 is used in the treatment of well differentiated thyroid cancer and hypehyroidism. I 131 has a half life of 8 days and emits beta paicles as well as gamma rays. Radiation dose to thyroid is mainly due to the emitted beta paicles (90%) rather than gamma radiation. Ref: Oncology for Health-Care Professionals By V. Pervan, Page 262; Radiation in Medicine: A Need for Regulatory Reform By U.S. Nuclear Regulatory Commission, Page 74 | train | med_mcqa | null |
A 56-year-old man is brought to the emergency department by his wife because of memory loss and difficulty walking. She has noticed personality changes, truancy from work, and lack of personal care over the past 1 year. On examination, he appears unkempt, smells of urine, and is uncooperative. He cannot recall the date or season, and gets angry when asked questions. His answers are often fabricated when checked with his wife.The blood pressure is 150/90 mmHg, pulse 100/min, and he is diaphoretic and tremulous. His gait is wide based, and motor strength and reflexes are normal. His ocular movements are normal but there is nystagmus on lateral gaze. In the past, he has had multiple admissions for alcohol withdrawal. Which of the following is the most appropriate next step in management? | [
"prophylactic phenytoin administration",
"prophylactic diazepam administration",
"prophylactic carbamazepine administration",
"calcium administration"
] | B | Prophylactic administration of diazepam in a withdrawing alcoholic can prevent or reduce severe syndromes such as delirium tremens (DTs). Prophylactic phenytoin, however, is not helpful. A calm, quiet environment with close observation and frequent reassurance is very important. Vitamin administration (especially thiamine) is important, but frequently, severe magnesium depletion slows improvement. | train | med_mcqa | null |
Which is SsRNA unenveloped virus: | [
"HBV",
"HEV",
"HCV",
"None"
] | B | Ans. b. HEV | train | med_mcqa | null |
Which one of the following drug may be used for prevention of relapse of P. vivax infection : | [
"Chloroquine",
"Primaquine",
"Atovaquone",
"Tetracycline"
] | B | null | train | med_mcqa | null |
Trendelenberg test is positive due to injury to: | [
"Sup gluteal nerve",
"Inf gluteal nerve",
"Obturator nerve",
"Tibial nerve"
] | A | A.i.e. Superior gluteal nerve | train | med_mcqa | null |
The Burrows in scabies is in the – | [
"Stratum basale",
"Stratum granulosum",
"Stratum corneum",
"Dennis"
] | C | Mite burrows into stratum corneum. These burrow is visible clinically as an irregular gray - brown line. | train | med_mcqa | null |
Which of the following is seen in eosinophil granules? | [
"Cathepsin",
"Major basic protein",
"Transferrin",
"All of the above"
] | B | Eosinophils are abundant in immune reactions mediated by IgE and in parasitic infections. A chemokine that is especially impoant for eosinophil recruitment is eotaxin. Eosinophils have granules that contain major basic protein, a highly cationic protein that is toxic to parasites but also causes lysis of mammalian epithelial cells. Ref: Robbins 8th edition, Chapter 2. | train | med_mcqa | null |
A patient is brought to the casualty in the state of altered sensorium. He was on lithium for affective disorder and has suffered through an attack of epileptic fits. On examination he has tremors increased DTRs and incontinence of urine. He has also undergone an episode of severe gastroenteritis 2 days ago. The serum lithium was found to be 1.95 m moles/L. What is the MOST likely cause of her condition? | [
"Lithium toxicity",
"Dehydration",
"Manic episode",
"Depressive stupor"
] | A | The clinical manifestations in this patient along with elevated levels of serum lithium more than 1.5mE/l indicates that he is suffering from lithium toxicity.Features of acute lithium intoxication includes vomiting, profuse diarrhea, coarse tremor, ataxia, coma, and convulsions. Nervous system is involved in serious cases of intoxication and its manifestations includes mental confusion, hyperreflexia, gross tremor, dysahria, seizures, and cranial nerve and focal neurological signs, progressing to coma and death.Serum levels of Lithium more than 1.5mE/L is considered to be toxic. Dialysis is the most effective means of removing Lithium in patients exhibiting symptoms of toxicity or patients with serum Li+ concentrations >/= 3 mEq/L in acute overdoses. Ref: Meyer J.M. (2011). Chapter 16. Pharmacotherapy of Psychosis and Mania. In B.C. Knollmann (Ed), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e. | train | med_mcqa | null |
Paralysis of 3rd, 4th, 6th nerves with involvement of ophthalmic division of 5th nerve, localizes the lesion | [
"Cavernous sinus.",
"Apex of orbit.",
"Brainstem",
"Base of skull."
] | A | A i.e. Cavernous sinus Abrupt (sudden/ very rapid) onset of marked systemic features (high grade fever) with proptosis, chemosis especially with prostration, sequential ophthalmoplegia (i.e. initial lateal gaze involvement), bilateral involvement and mastoid edemaQ strongly suggest the diagnosis of cavernous sinus thrombosis. - In cavernous sinus, the ophthmic division of trigeminal (Vi)nerve picks up sympathetic fibers from cavernous plexus. These are for dilator papillae muscle. Vi divides just posterior to superior orbital fissure into 3 branches (lacrimal nerve, frontal nerve, nasociliary nerve), which pass through superior orbital fissureQ - Lesions of cavernous sinus e.g. thrombosis, rupture of aneurysm of internal carotid aery at may lead to paralysis of 3rd 4th, 5th and 6th nerve Q Feature Cavernous Sinus Thrombosis Orbital Cellultis Orbital Apex Syndrome Arise from - Most septic CST arise from - Exension of inflammation - < 1% of orbital cellulitis result in sphenoid or ethmoid sinuses >> from neighbouring tissues esp OAS; howeve, >50% of these dental, facial & ear infection by gram positive bacteria sinuses (mc ethmoid); eyelid, eyeball, face etc or occur in patient with diabetes meltitus and most frequently - Aseptic thrombosis (rare) is penetrating injuries & d/t rhinocerebral caused by conditions that 1/t surgeries mucormycosis. venous thrombosis eg - Bacterial OC is more common - Ketoacidosis is most impoant polycythemia, sickle cell anemia, in children whereas, fungal risk factor b/o lack of inhibitory (vasculidities), trauma, neurosurgery, pregnancy & oral condraceptive use. (mucor or Aspergillus) affect diabetic (ketoacidosis) & immune compromised activity against Rhizopus in serum. Involve Cavernous sinus i.e. - All orbital contents may be - Superior orbital fissure - 6th CN & carotid plexus of involved and may evolve into transmitting 3rd,4th, 6th and Vi sympathetic nerves run through the substance orbital abscess cranial nerves - Optic canal transmitting optic - 3rd,4th,ophthalmic (Vi) and maxillary (V2) division of 5th (2nd) cranial nerve CN and trigeminal ganglion lie in lateral wall Onset & progression Abrupt / violent /Very RapidQ Slower (relatively) Slower (relatively) Systemic Features MarkedQ (fever, headache, nausea, vomiting) Mild (less prominent) Mild (less prominent) Mastoid edema DiagnosticQ (Present) Absent Absent Laterality Bilateral (in >50%), although initially unilateral Unilateral Unilateral Proptosis & Chemosis Marked (with eye pain) Marked (with severe eye pain) Mild to moderate (do not always complain of pain) Vision Not affected in early stagesQ May lost early if retrobulbar Lost in early stages d/t optic (2" CN) optic neuritis or compression develop nerve involvement (RAPD) present Ophthalmoplegia Sequential (beginning with 6th Concurrent & complete Concurrent & complete external (3,4,6 CN) nerve) and completeQ. Initial external ophthalmoplegia ophthalmoplegia involving 3rd,4th lateral rectus (gaze) palsyQ is d/ t early involvement of 6th nerve in substance of CS. involving 3rd,4th & 6th nerve & 6th nerve Irigeminal (V) nerve Opthalmic (V1) and maxillary - Opthalmic (V1) division involved (5 CN) (V2) division involved (= decreased corneal sensation) Clinical Features Abrupt onset marked periorbital Signs of anterior eye Visual loss (2" CN) and edema, orbital congestion (chemosis), proptosis, adnexal involvement (chemosis, edema) are usually out of ophthalmoplegia are out of propoion and often precede edema, eye pain, ptosis and ophthalmoplegia (involving 3rd, 4th, 6th cm CN) with involvement of VI & Vz. propoion to ophthalmoplegia at least initially signs of anterior eye involvement, such as proptosis periorbital (adnexel) edema, and orbital congestion | train | med_mcqa | null |
Ketone body formation without glycosuria seen in: | [
"DM",
"DI",
"Prolonged starvation",
"Obesity"
] | C | C i.e. Prolonged StarvationHexokinase has low Km value i.e. high affinity for glucoseQ and it is present in all tissue including brain0; where as glucokinase has high Km value i.e. low affinity for glucoseQ and it is present in liver and BcellsQ. That's why brain can utilize glucose in starvation but the liver can not. The glucokinase functions only when intracellular concentration of glucose in hepatocytes is elevated as in post absorptive state. | train | med_mcqa | null |
All are false except one in case of hypertrophic pyloric stenosis - | [
"Symptomatic within one week",
"Lump is always clinically palpable",
"T/t of choice is Finney's pyloroplasty",
"Ultrasonography is diagnostic test"
] | D | Hypertrophic Pyloric Stenosis (HPS)
The musculature of the pylorus and adjacent antrum is grossly hypertrophied, the hypertrophy being maximum in the pylorus itself.
It occurs in approximately 3 in 1000 live birth and is the most common surgical cause of vomiting in infancy.
M> F (4 : 1)*
Characteristically the first born male child is affected.
The condition is most commonly seen at 4 wks after birth ranging from the 3rd wk to on rare occasion, the 7th. However, 20% of infants are symptomatic from birth, and most are symptomatic within the first 2 months after birth.
Non-bilious vomiting, becoming increasingly projectile, occurs over several days to weeks. Eventually the infant will develop a nearly complete obstruction by the second to fourth week of life and will not be able to hold down even clear liquids. This invariably proceeds to severe dehydration if not t/t.
These infants develop a metabolic alkalosis with severe depletion of potassium and chloride ions.
" The diagnosis of pyloric stenosis usually can be made on physical examination by palpation of the typical 'olive' in the right upper quadrant and the presence of visible gastric waves on the abdomen.
When the olive cannot be palpated, ultrasound in experienced hands will diagnose the condition accurately in 95 percent of pts." - Schwartz.
Treatment
Pyloric stenosis is never a surgical emergency although dehydration and electrolyte abnormalities may present a medical emergency
Fluid resuscitation and correction of electrolyte, abnormalities and metabolic alkalosis is essential before surgery.
- Surgery : Fredet-Ramstedtpy/oromyotomy. (In it the pyloric mass is split without cutting the mucosa)
Also know
Administration of erythromycin in early infancy has been linked to the subsequent development of HPS.
Jaundice may be seen in HPS, although cause is not clear. | train | med_mcqa | null |
Beta blocker that can be used in renal failure is all except- | [
"Propranolol",
"Pindolol",
"Sotalol",
"Oxyprenolol"
] | C | Ans. is 'c' i.e., Sotalol "Sotalol is not metabolized in liver, excretion is predominantly by the kidney in the unchanged form". - Katzung 101Ve p. 229 Since it is primarly excreted in urine, it should not be used in renal failure. 0-blockers which are primarily excreted by kidney and should not be given in renal failure --> Atenolol, Sotalol, nodolol About other options Approximately 50% of pindolol is metabolized in liver, the remainder of the drug is excreted unchanged in urine - - Goodman Gillman o Propranolol and oxprenolol are mainly metabolized in liver. | train | med_mcqa | null |
Replacing alanine by which amino acid will increase UV absorbances of protein at 280 nm wavelength | [
"Leucine",
"Proline",
"Arginine",
"Tryptophan"
] | D | Aromatic amino acids absorb UV light, which has absorption maxima between 275 nm-285 nm.
Tryptophan has greater absorption in this region than other two aromatic amino acids (tyrosine, phenylalanine).
Since nearly all proteins contain aromatic amino acids, the amount of light absorbed at 280 nm by protein is used as an indirect measure of protein concentration. | train | med_mcqa | null |
Torsade-de- pointes is caused by- | [
"Hypermagnesemia",
"Metabolic acidosis",
"Hypomagnesemia",
"Metabolic alkalosis"
] | C | Torsades-de-pointes is a form of VT seen as a complication of prolonged ventricular repolarisation. It is seeen in hypomagnesemia. It is not seen in hypermagnesemia,metabolic acidosis,metabolic alkalosis Ref Harrison 20th ed pg 1436 | train | med_mcqa | null |
The elastomer having the longest curing time is | [
"Polysulfide",
"Poly ether",
"Addition silicone",
"Condensation silicone"
] | A | null | train | med_mcqa | null |
Pasteur effect is: | [
"Inhibition of glycolysis",
"Oxygen is involved",
"Inhibition of enzyme phosphofructokinase",
"All of these"
] | D | Ans. D. All of theseThe inhibition of glycolysis by oxygen is referred to as Pasteur effect. This is due to inhibition of the enzyme phosphofructokinase by ATP and citrate (formed in the presence of 02). | train | med_mcqa | null |
After meiotic division, the primary oocyte remains arrested in | [
"Diplotene stage",
"Pachytene stage",
"Metaphase",
"Telophase"
] | A | At the time of bih all primary oocyte are in the prophase of meiotic division The primary oocyte remain in prophase and complete their first meiotic divison until they mature and ready to ovulate Human embryology Tenth edition Inderbier Singh Page 24 | train | med_mcqa | null |
The protection against small pox by previous infection with cowpox represents: | [
"Antigenic cross-reactivity",
"Antigenic specificity",
"Passive immunity",
"Innate immunity"
] | A | Ans. is 'a' i.e., Antigenic cross-reactivity(Ref: Ananthanarayan, 7th/e, p. 81, 82)* Antigenic cross reactivity - Sometimes single antigen stimulates production of variety of antibodies that more or less resemble the correct fit for the antigen. Each of these antibodies may attack different antigens that more or less resemble one another. | train | med_mcqa | null |
Superficial perineal muscles include- | [
"Iliococcygeus",
"Ischiococcygeus",
"Bulbospongiosus",
"Levator ani"
] | C | Muscles in superficial perineal space.
- Ischiocavernosus
- Bulbospongiosus
- Superficial transverse perinei | train | med_mcqa | null |
Shoest acting muscle relaxant - | [
"Pancuronium",
"Atracurium",
"Mivacurium",
"Vecuronium"
] | C | Ans. is 'c' i.e., Mivacurium o Mivacurium is the shoest acting competitive blockers. | train | med_mcqa | null |
Laboratory evaluation for the differential diagnosis of chronic myeloproliferative disorders includes all the following evcepr : | [
"Chromosomal evaluation",
"Bone marrow aspiration",
"Flow-cytometric analysis",
"Determination of red blood cell mass"
] | C | Answer is C (Flow cytometry) respective myeloproliferative disorde Myeloproliferative disorder Useful tests Polycythemia vera Elevated Red cell mass / with normal erythropoetin levels Chronic myeloid leukemia Chromosomal demonstration of Philadelphia chromosome or bcr /abl translocation Chronic idiopathic Myelofibrosis Dry tap on bone marrow aspiration alongwith characteristic peripheral blood picture Essential thrombocytosis Elevated Platelet count with cytogenetic evaluation to rule out CML or other myelodysplastic disorder | train | med_mcqa | null |
Which of the following is the least likely presentation of multiple sclerosis? | [
"Sensory loss",
"Optic neuritis",
"Veigo",
"Transverse myelitis"
] | D | Multiple sclerosis is a demyelinating disorder of the brain and rarely involve spinal cord, Hence answer is D. If Spinal cord involved, it is called Devic's Disease. Devic's disease -Characterized by presentation of Transverse myelitis and Optic neuritis. MC presentation of MS is sensory loss followed by optic neuritis. Symptom % of cases Sensory loss 37 Optic neuritis 36 Weakness 35 Paresthesias 24 Diplopia 15 Ataxia 11 Veigo 6 Paroxysmal attacks 4 Bladder 4 | train | med_mcqa | null |
All except one is required for the diagnosis of obesity hypoventilation syndrome | [
"Hypeension",
"Sleep disorder breathing",
"BMI more than or equal to 30 kg/m2",
"PaCO2 more than or eqal to 45 mmHg"
] | A | Repeated | train | med_mcqa | null |
Which of the following statements is true regarding Rett syndrome? | [
"Seen only in boys",
"Does not involve motor abnormalities",
"Associated with normal intelligence",
"None of the above"
] | D | Ans. D. None of the aboveRett syndrome is a progressive condition that develops after 6 months of apparently normal development after birth. Head circumference at birth is normal, and early developmental milestones, including social interactions, are unremarkable. Between 6 and 48 months, most commonly between 6 and 12 months, a progressive encephalopathy develops. Head growth begins to decelerate, with resultant microcephaly. Motor abnormalities occur; purposeful hand movements are lost, and characteristic midline hand movements, such as hand wringing, emerge.Gait and truncal apraxia, ataxia, and poor coordination develop in the preschool years. Expressive and receptive language skills deteriorate and are associated with marked mental retardation (not normal intelligence). A loss of social interactional skills is observed during the preschool years. The etiology of the disease is unknown. A genetic basis for the condition is likely; Rett syndrome occurs only in girls, and case reports indicate complete concordance in monozygotic twins.Associated features include seizures (occurring in up to 75% of affected patients) and irregular respiration with episodes of hyperventilation, apnea, and breath holding. | train | med_mcqa | null |
Calcium does not bind to | [
"Tropomyosin",
"Calmodulin",
"Troponin",
"None"
] | A | Tropomyosin-A protein that binds to and stabilizes actin filaments in cells. In skeletal and cardiac muscle cells, tropomyosin is released after interacting with troponin and calcium, facilitating the binding of actin to myosin that causes muscle contraction.Calmodulin- a calcium-binding protein present in all nucleated cells, thought to be an essential mediator of most calcium-sensitive cellular processes.Troponin- a complex of muscle proteins which, when combined with Ca++, influence tropomyosin to initiate contraction.Ref: Ganong&;s review of medical physiology; 24th edition; page no:-378 | train | med_mcqa | null |
Indicators of impending uterine rupture during labour include all of the following except : | [
"Fetal distress",
"Hematuria",
"Fresh bleeding per vaginum",
"Passage of meconium"
] | D | Ans. is d i.e. Passage of meconium Impending rupture : Abdominal pain Slight vaginal bleeding Fetal distress as evidenced by abnormal FHR, bradycardia and variable and late declerations. Tenderness in uterine palpation Complete rupture : Sense of something giving away Collapse, shock, dehydration Absent FHS Palpation of superficial pas Shoening of cord immediately following a difficult vaginal delivery is pathognomonic of uterine rupture. So it is clear that fetal distress and vaginal bleeding may be seen in impending uterine rupture. Now we are left with 2 options: Hematuria and passage of meconium "There are no reliable signs of impending uterine rupture that occurs before labor, although the sudden appearance of gross hematuria is suggestive" ...COGDT 10/e p 340. Thus, hematuria can be seen in impending rupture. Though some of you may argue that passage of meconium is a sign of fetal distress, it should not be ruled out but here I would like to say--lets think as a clinician if we have a patient with previous LSCS in whom there is passage of meconium, obviously it will not mean that patient is going to have impending rupture, it means the fetus is in distress which can be due to any reason. Also remember: Spontaneous rupture of uterus during pregnancy occurs in upper segment. Spontaneous non obstructive rupture during labour occurs in upper segment - Fundus. Spontaneous obstructive rupture during labour occurs in lower segment. Most common sign of uterine rupture is non reassuring FHR pattern with variable hea rate decelerations that may evolve into late decelerations. | train | med_mcqa | null |
Drug of choice for West syndrome in children is? | [
"Vigabatrin",
"Valproate",
"ACTH",
"Lamotrigene"
] | C | - Drug of choice for West syndrome in children is either ACTH or steroids. (ACTH > Steroids) - In children with Tuberous sclerosis - Vigabatrin is preferred. - West syndrome is characterized by triad of Infantile spasms (SALAAM ATTACKS) Developmental delay Hypsarrhythmia (on EEG) | train | med_mcqa | null |
Tularemia belongs to which category of bioterrorism agents - | [
"A",
"B",
"C",
"D"
] | A | Ans. is 'a' i.e., A * Bioterrorism agents can be separated into three categories, depending on how easily they can be spread and the severity of illness or death they cause. Category A agents are considered the highest risk and Category C agents are those that are considered emerging threats for disease.* Important organisms in different categories are1) Category A: Small pox, Anthrax, Botulism, Plague, tularemia, viral hemorrhagic fever (yellow fever, KFD, Ebola, Marburg, Lassa).2) Category B: Brucella, C. perfringens (epsilon toxin), Salmonella, Shigella, E. coli 157: H7, Staphylococcus (enterotoxin-B), V. cholerae, Q. fever. Typhus fever, psittacossis, glanders, Malioidosis.3) Category C: Emerging infections like Nipah, Hantavirus, SARS corona virus. | train | med_mcqa | null |
A 47-year-old man presents to his physician because he has noticed that his right breast is noticeably larger than his left breast. Breast examination demonstrates that the right breast is diffusely enlarged. The breast tissue is freely mobile and without distinct masses. The patient repos that the breast has been slowly enlarging over a period of several years. Which of the following is the MOST likely mechanism causing a relative excess of hormone leading to the breast enlargement in this patient? | [
"Decreased production of testosterone secondary to primary hypogonadism",
"Drug that inhibits testosterone synthesis",
"Drug with estrogen-like activity",
"Increased peripheral conversion of androgens to estrogens"
] | D | Peripheral conversion of androgens (testosterone and androstenedione) to estrogens occurs mainly in adipose tissue, muscle, and skin. In patients with chronic liver disease, malnutrition, and hypehyroidism, this peripheral conversion is increased, and may be associated with feminization (seen as changes in hair distribution, body fat distribution, and breast size). Conditions that cause primary or secondary hypogonadism can cause gynecomastia by the mechanisms of decreased production and/or action of testosterone. These conditions can include Klinefelter syndrome, congenital anorchia, testicular trauma or torsion, viral orchitis (e.g., mumps), pituitary tumors, and renal failure. Drugs that can cause gynecomastia by inhibiting testosterone synthesis or action include ketoconazole, metronidazole, cisplatin, spironolactone, and cimetidine. Drugs that can cause gynecomastia because of their estrogen-like activity include diethylstilbestrol, digitalis, and estrogen-containing foods and cosmetics. Ref: Bhasin S., Jameson J.L. (2012). Chapter 346. Disorders of the Testes and Male Reproductive System. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e. | train | med_mcqa | null |
Gout is a disorder of - | [
"Purine metabolism",
"Pyrimidine metabolism",
"Ketone metabolism",
"Protein metabolism"
] | A | null | train | med_mcqa | null |
Cranial nerve not carrying parasympathetic fibers | [
"Fourth",
"Seventh",
"Third",
"Ninth"
] | A | Ans. is 'a' i.e. Fourth Four cranial nerves CN III, CN VII, CNIX & CN X carry presynaptic parasympathetic (visceral motor) axons as they emerge from brain stem.Parasympathetic fibres carrying cranial nervesAssociated GanglionOcculomotor (III)Ciliary ganglionFacial (VII)Pterygopalatine & Submandibular ganglionGlossopharyngeal (IX)Otic ganglionVagus (X)Visceral ganglionsAlso know:Pure motorPure sensory (unique/special sensation carrying)MixedOcculomtor (III)Trochlear (IV)Abducent (VI)Spinal accessory (XI)Hypoglossal (XII)Olfactory (I)Optic (II)Vestibulocochlear VIII)Trigeminal (V)Facial (VII)Glossopharyngeal (IX)Vagus (X)Olfactory nerve (CNI) is the only sensory cranial nerve that projects directly to the cerebral cortexOptic nerve terminates in the thalamus while the other ten pairs of C.N. are attached to brain stem.Except the vagus N., all the cranial nerves are confined to head & neck.Trochlear N. is the only cranial nerve to emerge from the dorsal surface of the brain stem.Trochlear N. is the smallest cranial nerve in terms of axons it contains. It supplies only one muscle - the superior oblique.Trochlear N. has the longest intracranial course. | train | med_mcqa | null |
In methyl alcohol poisoning there is CNS depression, cardiac depression and optic nerve atrophy. These effects are produced due to - | [
"Formaldehyde and formic acid",
"Acetaldehyde",
"Pyridine",
"Acetic acid"
] | A | Methanol itself is not toxic but two metabolites formed -- formaldehyde and formic acid are highly toxic. These compounds are responsible for causing profound metabolic acidosis and visual defect and blindness REF;THE SYNOPSIS OF FORENSIC MEDICINE:KS NARAYANA REDDY;28th EDITION;PAGE NO 332 | train | med_mcqa | null |
Slow IPSP in autonomic is generated by: | [
"Nicotinic cholinergic",
"Muscarinic cholinergic",
"Dopamine",
"GnRH"
] | C | C i.e. Dopamine | train | med_mcqa | null |
A 52-year-old male presents to the emergency department complaining of persistent severe right upper quadrant pain for the past 2 hours. During that period of time he felt nauseated, was sweating profusely, and also experienced pain in the posterior aspect of his right shoulder. The pain began shortly after a lunch consisting of "fast food." Ultrasound examination reveals multiple stones in an inflamed gallbladder with a normal bile duct. Which of the following spinal nerve segments are involved in the shoulder pain, associated with cholecystitis? | [
"C3 to C5",
"C5 to C8",
"T1 to T4",
"T5 to T9"
] | D | Referred pain from cholecystitis is generally referred to the region of the inferior angle of the right scapula. These fibers are generally from T5 to T9. These sensory fibers for pain are stimulated by the gallbladder inflammation because of the proximity of the adjacent structures. C3 to C5 sensory fibers innervate the shoulder area. The distribution of C5 to C8 is primarily to the upper limb, to the level of the hand; T1 to T4 distribution is to the upper thoracic wall and medial upper arm; T10 and T11 distribution is to the thoracic and abdominal wall, T1 to T4 visceral fibers for pain are generally associated with referred pain from the heart. | train | med_mcqa | null |
Pick the odd one out: | [
"Lactose",
"Maltose",
"Sucrose",
"Cellulose"
] | D | null | train | med_mcqa | null |
Mantoux test is based on which hypersensitivity- | [
"Typel",
"Type 2",
"Type 3",
"Type 4"
] | D | Ans. is 'd' i.e.. Type 4 Following are the examples of type 4 hypersensitivity reactionsType 1 diabetes mellitusHashimoto thyroiditisCrohn's diseaseMultiple sclerosisContact dermatitisMantoux test | train | med_mcqa | null |
Most common benign tumor of heart in children | [
"Rhabdomyoma",
"Myxoma",
"Fibroma",
"Lipoma"
] | A | Most common benign tumor of heart is Rhabdomyoma in children myxoma in adults. | train | med_mcqa | null |
Maximum pressure in right ventricle seen is | [
"2mmHg",
"25mmHg",
"80mmHg",
"120mmHg"
] | B | Peak pressures in the left and right ventricles are about 120 and 25 mm Hg, respectively.Reference: Ganong's Review of Medical Physiology; 25th edition; Page no: 538 | train | med_mcqa | null |
Ischemia/reperfusion (I/R) injury is considered to be a MAJOR mechanism for organ transplant failure. Allopurinol is used in organ preservation as: | [
"Antioxidant",
"Preservative",
"Free radical scavenger",
"Precursor for energy metabolism"
] | C | The most commonly used solution for organ storage and flushing is the University of Wisconsin solution that contains lactobionate, raffinose, adenosine (a precursor for ATP generation), magnesium sulfate (to retard calcium influx), glutathione (as an antioxidant), and allopurinol (to inhibit xanthine oxidase induced reactive oxygen species (ROS) formation). Ref: Immunobiology of Organ Transplantation edited by David S. Wilkes, William J. Burlingham, 2004, Page 548, 560. | train | med_mcqa | null |
Which vasculitis is seen most commonly in childhood? | [
"Kawasaki",
"HSP",
"Susac syndrome",
"Giant cell"
] | B | Disease in choice Age of presentation and findings Kawasaki Occurs predominantly in young children; 80% of patients are <5 yr, and, only occasionally, are teenagers or, more rarely, adults affected. HSP Usually seen in children; most patients range in age from 4 to 7 years; however, the disease may also be seen in infants and adults. Susac's Syndrome Consists of the triad of encephalopathy, branch retinal aery occlusions (BRAO), and hearing loss. It usually affects women aged 20 to 40, but men are also affected, and the age range extends from 9 to 72 years Giant Cell Aeritis Occurs almost exclusively in individuals >50 year | train | med_mcqa | null |
EAC rosette formation is the propey of one of the following type of immune cells ? | [
"T-cells",
"B-cells",
"Macrophages",
"All of the above"
] | A | Ans. is 'a' | train | med_mcqa | null |
True about right atrium is : | [
"Auricle lies superolaterally",
"Related to central tendon of diaphragm at Tio level",
"Coronary sinus lies between fossa ovalis and IVC",
"SVC opening is gaurded by endocardial valve"
] | C | Coronary sinus lies between fossa ovalis and IVC | train | med_mcqa | null |
Eruption of Mandibular 1st premolar occur at | [
"8-9 years",
"6 years",
"4 years",
"10-12 year"
] | D | null | train | med_mcqa | null |
Which of the following conditions does not have a National Screening / Control Programme? | [
"Diabetes Mellitus",
"Dental caries",
"Refractive errors",
"Carcinoma cervix"
] | B | The National Health Programmes have been launched by the Central Government for the control/eradication of communicable diseases, improvement of environmental sanitation, raising the standard of nutrition, control of population and improving rural health. Several programmes are currently under operation. However, currently there is no programme concerning dental caries. Ref: Preventive and Social Medicine, By K.Park, 19th edition, Page 346, 360-362, 373, 374 | train | med_mcqa | null |
The most common viral cause of Acute liver failure worldwide is: | [
"Hepatitis A",
"Hepatitis B",
"Hepatitis C",
"Hepatitis E"
] | B | Answer is B (Hepatitis B) Hepatitis B remains the most common viral agent responsible for Acute Liver Failure Worldwide Fulminant Viral Hepatitis leading to acute liver failure is typically seen with Hepatitis B infection (Increased by co-infection or super-infection with Hepatitis D) and Hepatitis E infection. The most common hepatitis virus responsible for fulminant disease and acute liver failure varies from one geographic region to the other. Hepatitis B is the most common cause of Acute Liver Failure in USA, Europe and Japan and accounts fbr a significant percentage of cases in the rest of the world thereby being the single most impoant virus implicated in Acute Liver Failure (Liver failure occurs in approximately 1 percent of patients with Acute Hepatitis B). Note: Hepatitis E is the most common cause of Acute Liver Failure in India 'In India, over 95% of acute liver failure is due to viruses, with 40% secondary to hepatitis E and 25-30% to hepatitis B. Hepatitis E is the most common cause of Acute Liver Failure in India - Sherlock's Diseases of the Liver and Biliary System | train | med_mcqa | null |
Chromosomal translocation wen in CMS? | [
"2:08",
"8:14",
"9:22",
"15:17"
] | C | A translocation is a type of abnormal change in the structure of a chromosomethat occurs when a pa of one chromosomebreaks off and sticks to anotherchromosome. These "mutations" are an impoant cause of many types of lymphomas and leukemias | train | med_mcqa | null |
Which of the following is the source of hepatic stem cells | [
"Limbus cells",
"ITO cells",
"Oval cells",
"Paneth cells"
] | C | ref , Robbins 8/e p83;7/e p91;9/e p28 Hepatic oval cells (HOC) are a small subpopulation of cells found in the liver when hepatocyte proliferation is inhibited and followed by some type of hepatic injury. ... These cells are believed to be bipotential, i.e., able to differentiate into hepatocytes or bile ductular cells It is source of hepatic stem cells | train | med_mcqa | null |
Which of the following is true regarding non specific interstitial pneumonia | [
"A. Honey combing on CT",
"B. Predominant in males",
"C. Affects elderly age grpup",
"D. Good prognosis"
] | D | It is idiopathic or associated with consecutive tissue damage clinical features patient present with cough and pneumonia of several duration Mostly female non smoker present in 6th decade of life High resolution CT scan- B/l,symmetric,predominatly lower lobe opacities, (honey comb pattern) Have better prognosis than the usual interstitial pneumonia. | train | med_mcqa | null |
Most common cause of amoebic lung abscess is : | [
"Aspiration",
"Direct spread from liver",
"Hematogenous spread from liver",
"Hematogenous spread from gut"
] | B | Answer is B (Direct spread from liver): An amoebic lung abscess is almost always secondary to spread from the liver. Extraintestinal infection by E. histolytica most often involves the liver. Fuher involvement most commonly leads to Amoebic lung abscess. Infact pleuropulmonary involvement (Lung): is the most frequent complication of Amoebic liver abscess. Remember: Most common cause of a lung abscess is - 'Aspiration'. However this holds true for pyogenic (bacterial lung abscess) | train | med_mcqa | null |
In a ceain population, there were 4050 bihs in the last one year. There were 50 still bihs, 50 infants died within 7 days whereas 150 died within the first 28 days. What is the neonatal moality rate | [
"50",
"62.5",
"12.5",
"49.4"
] | A | Ans. a. 50 | train | med_mcqa | null |
Articular disc of TMJ receives insertion from which muscle: | [
"Medial pterygoid",
"Lateral pterygoid",
"Massetor",
"Temporalis"
] | B | null | train | med_mcqa | null |
The earliest sign of syncope is | [
"Pallor",
"Constriction of pupil",
"Dilation of pupil",
"Bradycardia"
] | A | null | train | med_mcqa | null |
A major step in the pathogenesis of listeriosis is - | [
"The formation of antigen-antibody complexes with resultant complement activation and tissue damage",
"The release of hyaluronidase by L. monocytogenes, which contributes to its dissemination from local sites",
"The antiphagocytic activity of the L. monocytogenes capsule",
"The survival and multiplication of ... | D | null | train | med_mcqa | null |
Dissociative sensory loss is not seen in | [
"Syringomelia",
"Cauda equine syndrome",
"Diabetes mellitus",
"Damage to spino-thalamic pathway"
] | B | Dissociated sensory loss is a pattern of neurological damage caused by a lesion to a single tract in the spinal cord which involves preservation of fine touch and proprioception with selective loss of pain and temperature. Understanding the mechanisms behind these selective lesions requires a brief discussion of the anatomy involved. Loss of pain and temperature are due to damage to the lateral spinothalamic tracts, which cross the central pa of the cord close to the level where they enter it and travel up the spinal column on the opposite side to the one they innervate (i.e. they ascend contralaterally). Note that a lesion of the lateral spinothalamic tract at a given level will not result in sensory loss for the dermatome of the same level; this is due to the fibers of the tract of Lissauer which transmit the neuron one or two levels above the affected segment (thus bypassing the segmental lesion on the contralateral side). Loss of fine touch and proprioception are due to damage to the dorsal columns, which do not cross the cord until the brainstem, and so travel up the column on the same side to the one they innervate (i.e. they ascend ipsilaterally). This means that a lesion of the dorsal columns will cause loss of touch and proprioception below the lesion and on the same side as it, while a lesion of the spinothalamic tracts will cause loss of pain and temperature below the lesion and on the opposite side to it. Dissociated sensory loss always suggests a focal lesion within the spinal cord or brainstem. The location of cord lesions affects presentation--for instance, a central lesion (such as that of syringomyelia) will knock out second order neurons of the spinothalamic tract as they cross the centre of the cord, and will cause loss of pain and temperature without loss of fine touch or proprioception. Other causes of dissociated sensory loss include: Diabetes mellitus Syringomyelia Brown-Sequard syndrome Lateral medullary syndrome aka Wallenberg's syndrome Anterior spinal aery thrombosis Tangier disease Subacute combined degeneration Multiple sclerosis Tabes dorsalis Friedreich's ataxia (or other spinocerebellar degeneration) Ref Harrison20th edition pg 2756 | train | med_mcqa | null |
Which of the following is indicated by the pedigree given below? | [
"Adopted into family",
"Adopted out of family",
"Identical twins",
"Nonidentical twins"
] | C | null | train | med_mcqa | null |
A 70 year old male has a pathologic fracture of femur. The lesion appears lytic on X-ray with a circumscribed punched out appearance. The curetting from fracture site is most likely to show which of the following? | [
"Diminished and thinned trabecular bone fragments secondary to osteopenia",
"Sheets of atypical plasma cells",
"Metastatic prostatic adenocarcinoma",
"Malignant cells forming osteoid bone"
] | B | Malignant cells forming osteoid bone | train | med_mcqa | null |
Which of the following structure forms the medial border of Hesselbach's triangle? | [
"Linea alba",
"Linea semilunaris",
"Inferior epigastric aery",
"Conjoint tendon"
] | B | Boundaries of Hasselbach's triangle:Medial border: Lateral margin the rectus sheath, also called linea semilunaris.Superolateral border: Inferior epigastric aery.Inferior border: Inguinal ligament, sometimes Referred to as Poupa's ligament. | train | med_mcqa | null |
In a outbreak of cholera in village of 2,000 population, 20 cases have occured and 5 died, Case fatality rate is- | [
"1%",
"0.25%",
"5%",
"25%"
] | D | .here it is 5 divided by 20 expressed in percentage that is 25% .case fatality rate represents the killing power of a disease.it is simply the ratio of deaths to cases.the time interval is not specified.it is usually used in the case of acute infections such as food poisoning,cholera,measles etc.its usefulness to chronic diseases is limited.because the period from onset to death is long and variable.the case fatality rate for the same disease may very in epidemics.it is closely related to VIRULENCE. REF:park&;s textbook ,ed22,pg no 55 | train | med_mcqa | null |
A patient presents to the emergency depament with self harm and indicates suicidal intent. Which of the following conditions does not warrant an immediate specialist assessment? | [
"Formal thought disorder",
"Acute alcohol intoxication",
"Chronic severe physical illness",
"Social isolation"
] | B | The suicidal intent in a person with formal thought disorder (most likely a patient with Schizophrenia), chronic severe physical illness and social isolation, should be taken very seriously and immediate measures taken must include assessment by a specialist. If patient has expressed suicidal intent in an inebriated state, it must still be ensured that he doesn't harm himself however a specialist assessment can be deferred till he is sober. | train | med_mcqa | null |
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