dataset
string | id
string | question
string | choices
list | rationale
string | answer
string | subject
string |
|---|---|---|---|---|---|---|
medmcqa
|
medmcqa_0
|
True about fungal corneal ulcer –a) Symptoms are severe b) Dry looking ulcerc) Satellite lesiond) Shifting hypopyone) Immunogenic ring
|
[
"bce",
"bc",
"acd",
"ace"
] |
Option d requires some explanation here (all other options have been explained).
Shifting Vs non- shifting hypopyon
The hypopyon, if fluid (as in sterile hypopyon of bacterial ulcer), will be seen to shift i.e., a change in fluid level with tilting or change in position of the head → Shifting hypopyon. On the other hand, larger hypopyons and those due to fungal infections are usually less fluid owing to the fibrinous network and direct invasion by fungal hyphae. Therefore, these hypopyon are immobile → non-shifting hypopyon.
|
A
| null |
medmcqa
|
medmcqa_1
|
Punched out edge is characteristic of which type of
ulcer:
|
[
"Tuberculosis",
"Rodent ulcer",
"Syphillitic",
"Non specific"
] | null |
C
| null |
medmcqa
|
medmcqa_2
|
A 11-year-old boy presents in the outpatient department with complaints of not developing secondary sexual characteristics. On examination, child is found to have tall stature, no secondary sexual characteristics. Testes are found to be small and firm and gynecomastia is noted. What is the most probable clinical diagnosis?
|
[
"Klinefelter's syndrome",
"Edwards syndrome",
"Patau syndrome",
"Turner syndrome"
] |
Ans. A. Klinefelter syndromeKlinefelter syndrome is a genetic condition that results when a boy is born with an extra copy of the X chromosome.Klinefelter syndrome is a common genetic condition affecting males, and it often isn't diagnosed until adulthood. It refers to a form of hypogonadism comprising small testis, failure of development of secondary sexual characteristics and increased gonadotropins. Affected males tend to be shy and sensitive and difficulty expressing thoughts and feelings.Chromosomal analysis reveals 47 XXY karyotype. As the number of X chromosomes increases beyond 2, the clinical manifestations increase correspondingly. Management includes behavioral and psychosocial rehabilitation.
|
A
| null |
medmcqa
|
medmcqa_3
|
The ideal material used for Femoro-Popliteal shunt is
|
[
"Polytetrafluoroethylene (PTFE)",
"Reverse Saphenous vein",
"Polypropylene",
"Dacron"
] |
(B) Reverse Saphenous veinInterventional Procedures: Lower extremitiesBypass graft:Synthetic: Polytetrafluoroethylene (PTFE), DacronAutogenous vein grafts:-Reversed; In situPercutaneous angioplasty (PTA)Stents Bypass Surgery:Some Bypass Options:Reverse the saphenous vein for femoro popliteal bypass.Synthetic prosthesis for - aortoiliac or ilio-femoral bypass.Others = iliac endarterectomy & thrombolysis.Current Cochrane review = not enough evidence for bypass >PCl.Percutaneous transluminal angioplasty (PTA) has proved very successful in dilating the iliac and femoro-popliteal segments; the results below the knee are less successful. Long occlusions may be treated by the technique of subintimal angioplasty where the guide wire crosses the lesion in the subintimal space (in the arterial wall) and a new lumen is created by inflation of the balloon. Complications occur in about 5 per cent of cases and include failure, haematoma, bleeding, thrombosis and distal embolisation.Autogenous saphenous vein gives the best results and can be used reversed or in situ after valve disruption.If the long saphenous vein is not available from either leg, short saphenous or arm veins may be used.If no vein is available, a prosthetic polytetrafluoroethylene (PTFE) graft may be employed, although patency rates are less; many surgeons construct the lower anastomosis using a small collar of vein (Miller cuff) between the PTFE and the recipient artery, which may improve patency.If no suitable vein is available, prosthetic material (usually PTFE) may be used, with or without a small vein collar (Miller cuff) at its distal end.A femoro-femoral crossover graft involves tunneling a prosthetic graft subcutaneously above the pubis between the groins.An axillo-femoral graft is tunneled subcutaneously between the axillary artery proximally, to reach one or both of the femoral arteries; the patency rates of an axillo-bifemoral bypass is better than an axillo (uni) femoral bypass.Results of operation:Long-term results of aortoiliac reconstructive surgery are good, usually marred only by progressive infrainguinal disease.Femoropopliteal surgery is less successful.Immediate postoperative success for vein bypass exceeds 90%, but the five-year patency is around 60%.PTFE-covered stents are engineered with a 30-100 micron pore size to allow for endothelial lining of the stent-graft and vessel healing. Only self-expanding covered nitinol stents should be used in femoropopliteal interventions.
|
B
| null |
medmcqa
|
medmcqa_4
|
Which of the following cardiac lesion is least likely to occur in Congenital Rubella syndrome?
|
[
"ASD",
"VSD",
"PDA",
"Pulmonary Stenosis"
] |
Most common cause of cardiac lesion in congenital Rubella syndrome is PDA > Pulmonary stenosis > VSD > ASD.
|
A
| null |
medmcqa
|
medmcqa_5
|
Which of the following is not a feature of rhinosporidiosis
|
[
"Bleeding polyp",
"Oral dapsone is useful in treatment",
"Excision with the knife is the treatment",
"Russel bodies are seen"
] |
Russel bodies are seen in rhinoscleroma.
|
D
| null |
medmcqa
|
medmcqa_6
|
The most potent topical corticosteroid is -
|
[
"Betamethasone valerate",
"Triamcinolone acetonide",
"Hydrocortisone acetate",
"Clobetasol propionate"
] |
Ans. is 'd' i.e., Clobetasol propionate Classification of topical steroids based on potencyClass 1(Super potent)Clobetasol propionate ointment and cream 0.5% Betamethasone dipropionate ointment 0.05% Halobetasol propionate ointment and cream 0.05%Class 2(Highly potent)Mometasone furoate ointment 0.1%Class 3(Potent)Betamethasone dipropionate cream 0.05% Fluticasone propionate ointment 0.05%Class 4(Moderately potent)Fluocinolone acetonide ointment 0.025% Fluticasone propionate cream 0.05% Mometasone furoate cream 0.1%Class 5(Moderately potent)Betamethasone valerate cream 0.1 % Hydrocortisone butyrate cream 0.1%Class 6(Mildly potent)Desonide cream 0.05% Fluocinolone acetonide solution 0.05%Class 7(Least potent)Dexamethasone cream 0.1% Hydrocortisone 1%
|
D
| null |
medmcqa
|
medmcqa_7
|
Insulin acts by which pathway-
|
[
"Tyrosin kinase",
"JAK-STAT-Kinase",
"Transcription factor",
"Intrinsic ion channel"
] |
Ans. is 'a' i.e., Tyrosin kinase
|
A
| null |
medmcqa
|
medmcqa_8
|
Rahul, 51-yrs-old who has chewed tobacco for more than 20 years presents with a slowly enlarging mass on the floor of his mouth. Examination finds the mass, 1.3 cm in greatest dimension, white in color and irregular in appearance. Biopsies from this lesion are most likely to reveals which one of the following malignancies?
|
[
"Acinic cell carcinoma",
"Adenocarcinoma",
"Basal cell carcinoma",
"Squamous cell carcinoma"
] |
Squamous cell carcinoma * Carcinoma of the oral cavity accounts for approximately 5% of all human malignancies. More than 90% of oral carcinomas are of the squamous cell type; precursor lesions include leukoplakia (dysplastic leukoplakia) and erythroplasia, with transformation rates of approximately 15 and 50%, respectively Oral carcinoma is more common in males. * Smoking, tobacco chewing, chronic irritation, heat exposure, and irradiation are all thought to contribute to carcinogenesis. * The lower lip is the most common site, followed by the floor of the mouth, the anterior tongue, the palate, and the posterior tongue. * Prognosis varies according to site but is best for lesions of the lip and worst for lesions in the floor of the mouth. * In contrast, acinic cell carcinoma is a type of malignancy of the salivary glands, while basal cell carcinoma is the most common malignancy of the skin, and small cell carcinoma is a type of primary lung carcinoma.
|
D
| null |
medmcqa
|
medmcqa_9
|
Drug capable of causing ocular hypotension with apnoea in infants is:-
|
[
"Acetazolamide",
"Latanoprost",
"Brimonidine",
"Apraclonidine"
] |
Brimonidine is contraindicated in infant <2 yo because it cause brain suppression leading to apnea. Apraclonidine and Brimonidine both are topical alpha adrenergic agonist which decrease aqueous humor production and increase aqeous outflow. Apraclonidine cause lid retraction. Latanoprost :- PGF2alpha P- Pigmentation of Iris G-Growth of eyelash (Hyperichosis) F2x-fluid in macula (Macular edema)
|
C
| null |
medmcqa
|
medmcqa_10
|
BCYE medium is used to culture -
|
[
"Mycoplasma",
"T. pallidum",
"H.pylori",
"Legionella"
] | null |
D
| null |
medmcqa
|
medmcqa_11
|
The flap technique procedure which does not increase the width of attached gingiva:
|
[
"Apically positioned flap",
"Undisplaced flap",
"Fenestration operation",
"Free gingival graft"
] | null |
B
| null |
medmcqa
|
medmcqa_12
|
All are involved in iron metabolism except:
|
[
"Hepcidin",
"Ferroportin",
"Transthyretin",
"Ceruloplasmin"
] |
Ans. C. TransthyretinHepcidin is the regulator of iron homeostasis. Ferroprotin is their on exporter protein into circulation from intestinal cells. Ceruloplasmin has ferroxidase which convert Fe2+ to Fe3+ so it can serve the purpose of hephaestin in iron metabolism. Transthyretin is a transport protein for Thyroxine and Retinol.
|
C
| null |
medmcqa
|
medmcqa_13
|
Ptosis with lid lag is seen in:
|
[
"Traumatic ptosis",
"Myogenic ptosis",
"Synkinesis",
"Congenital ptosis"
] |
Ans. Congenital ptosis
|
D
| null |
medmcqa
|
medmcqa_14
|
Which of the following aery is NOT ligated in a case of epistaxis?
|
[
"Anterior ethmoidal aery",
"Maxillary aery",
"Internal carotid aery",
"External carotid aery"
] |
Internal carotid aery shouldn't be ligated in epistaxis due to risk of development of collateral blood flow into pseudoaneurysm leading to recurrent epistaxis. Aeries which can be ligated in a case of epistaxis are: Anterior and posterior ethmoidal aery, sphenopalatine aery (SPA). More rarely the internal maxillary aery or the External Carotid Aery can be ligated.
|
C
| null |
medmcqa
|
medmcqa_15
|
Blowout injury refers to what
|
[
"Fracture of orbit",
"Fracture of maxillary antrum",
"Fracture of temporal bone",
"Open Fracture from inside out of a long bone"
] |
The floor of orbit is its weakest wall and in blunt trauma such as a blow from a fist ,it is often fractured without fractures of the other walls.This is called blow-out fracture Bailey & Love ,26th,627.
|
A
| null |
medmcqa
|
medmcqa_16
|
In intra-operative radiotherapy which of the following therapeutic mode is commonly employed?
|
[
"Electron",
"Photon",
"X-ray",
"Gamma rays"
] |
Ans. A. Electron.Intraoperative radiotherapy using electron beam has the potential to deliver higher doses of radiations to the tumor (pancreatic carcinoma mainly, carcinoma stomach, rectal cancers, head and neck cancers, retroperitoneal sarcomas and some genitourinary and gynecological cancers) while sparing neighboring tissues but does not give better results than external beam treatment and hence can be used as boost followed by photon beam therapy.
|
A
| null |
medmcqa
|
medmcqa_17
|
Red cells are caught as innocent bystanders in the reaction between drug and antibodies against that drug, and develops hemolysis. Which drug is responsible for such a reaction?
|
[
"Penicillin",
"Sulfonamide",
"Naphthalene",
"Primaquine"
] |
After exposure red cells can be caught as innocent bystanders during the reaction between penicillin and antipenicillin antibodies. Ref: Harrison's principles of internal medicine, 18th edition, Page 881.
|
A
| null |
medmcqa
|
medmcqa_18
|
Naloxone is not used during resuscitation of a childwhose mother is on :
|
[
">Methadone",
">Phenycyclidine",
">Amphetamine",
">Cocaine"
] |
Metandone "At the delivery of known opioid dependent women, naloxone should be avoided in resuscitation of the infant because it may precipitate seizures" Naloxone is used to reverse neonatal respiratory depression due to opioid use during labour. It should not be used in cases where mother is opioid dependent. It can result in withdraw! syndrome. When the mother is on opioids, fetus becomes opioid dependent in-utero and the use of naloxone in respiratory resuscitation may result in severe withdrawal symptoms. According to Goodman Gilman "In subjects who are dependent on morphine like opioids (methadone is pharmacologically similar to morphine) small subcutaneous doses of naloxone (5 mg) precipitate a moderate to severe withdraw! syndrome that is very similar to that seen after withdraw' of opioids, except that the syndrome appears within minutes after administration and subsides in about 2 hours."
|
A
| null |
medmcqa
|
medmcqa_19
|
A 30-year-old woman with family history of hearing loss from her mother's side developed hearing problem during pregnancy. Hearing loss is bilateral, slowly progressive, with bilateral tinnitus that bothers her at night. Pure tone audiometry shows conductive hearing loss with an apparent bone conduction hearing loss at 2000 Hz. What is the most likely diagnosis?
|
[
"Otosclerosis",
"Acoustic neuroma",
"Otitis media with effusion",
"Sigmoid sinus thrombosis"
] |
Otosclerosis mostly involves females, has a positive family history and causes slow progressive bilateral hearing loss. Audiogram is characterized by Carhart's notch--a dip in bone conduction at 2000 Hz.Carhart's notch is loss of bone conduction in audiogram. It is a feature of otosclerosis. Loss is5 dB in 500 Hz10 dB in 1000 Hz15 dB in 2000 Hz5 dB in 4000 HzCarhart's notch. Note dip at 2 kHz in bone conduction
|
A
| null |
medmcqa
|
medmcqa_20
|
All are anti-androgens except
|
[
"Finasteride",
"Flutamide",
"Cyproterone acetate",
"Dihydrotestosteron"
] |
Testosterone which is a natural androgen is conveed to more active dihydrotestosterone by the enzyme steroid 5alpha-reductase. All others are anti-androgens. Flutamide, nilutamide, bicalutamide are androgen receptor antagonists (Ref.Essential s of medical pharmacology TD Tripathi 7th edition page no.296)
|
D
| null |
medmcqa
|
medmcqa_21
|
A 28-year-old woman in the third trimester of pregnancy has experienced severe dizziness for several days and is admitted to the hospital. During physical examination her blood pressure is normal when standing or sitting. When the patient is supine, her blood pressure drops to 90/50 mm Hg. What is the most likely explanation for these findings?
|
[
"Compression of the inferior vena cava",
"Compression of the superior vena cava",
"Compression of the aorta",
"Compression of the common carotid artery"
] |
The inferior vena cava quite likely undergoes compression by the growing fetus when the mother is in the supine position. In this case the compression led to reduced blood flow through the heart, with a resultant drop in blood pressure. The other structures listed as answers are not likely to be compressed by the growing fetus.
|
A
| null |
medmcqa
|
medmcqa_22
|
In cold caloric stimulation test, the cold water, induces movement of the eye ball in the following direction -
|
[
"Towards the opposite side",
"Towards the same side",
"Upwards",
"Downwards"
] |
Ans. is 'a' i.e., Towards the opposite side o Cold water provokes nystagmus towards the opposite ear, while warm water provokes nystagmus towardssame ear (COWS Cold - oppsite, Warm-same).
|
A
| null |
medmcqa
|
medmcqa_23
|
Most common malignant intraorbital tumor in adult is -
|
[
"Lymphoma",
"Rhabdomyosarcoma",
"Dermoid cyst",
"Sarcoma"
] |
Malignant adult tumors are most commonly lymphoma, squamous cell carcinoma, and metastatic disease. Less commonly, thetumor is an adenoid cystic carcinoma of the lacrimal gland, which is an aggressive tumor. Lymphomas involving the orbit are typically B-cell and characteristically low grade Ref khurana 6/e
|
A
| null |
medmcqa
|
medmcqa_24
|
Patterns of Inter-relationships between persons in a society is -
|
[
"Social structure",
"Social psychology",
"Herd structure",
"Social science"
] |
Social structure refers to the patterns of Inter-relationships between persons in a society Social psychology is concerned with the psychology of individuals living in human society or groups Social sciences is applied to those disciplines which are committed to the scientific examiation of human behaviour Herd structure includes not only the hosts belonging to the herd species but also the presence and distribution of alternative animal host and possible insect vectors as well as those environmental and social factors that ours or inhibit the spread infection from host to host ref ;(page no;671)23rd edition of PARK&;s textbook of Preventive and Social medicine
|
A
| null |
medmcqa
|
medmcqa_25
|
Cloudy cornea is/are seen:
|
[
"Klinefelter syndrome",
"Turner syndrome",
"Megalocornea",
"Mucopolysaccharidosis"
] |
Answer- D. MucopolysaccharidosisS-SclerocorneaT-TraumaU-UlcerM- MucopolysaccharidosisP-Peter anomalyED- Congenital hereditary endothelial dystrophy
|
D
| null |
medmcqa
|
medmcqa_26
|
A pt of BPD on lithium for 6months after fasting for a day presents with seizure coarse tremors confusion and weakness of limbs Whats the most accurate to diagnosis her condition
|
[
"Serum Electrolyte",
"S Lithium",
"S creatinine",
"ECG"
] |
Lithium intoxication * Mild: Sleepy, Proximal muscle weaknes , Impaired memory, G-t: nausea, vomiting, diarrhea. * Moderate: !eurotoxic: Delirium, Convulsion, Coma, Incontinence, ivper- reflexia, Fasciculation, Parkinson-like : Ataxia. Un-coordination * Severe: Nenhrotoxic: Nocturia, Distal tubular acidosis, Impaired RFT. Cardiotoxic: ST-T change, QT prolong, Flat T Conduction delay, Hypotension. * Acute intoxication-- Less CNS depression. ref : kd tripathi pharmacology
|
B
| null |
medmcqa
|
medmcqa_27
|
aplastic anemia is the side effect of
|
[
"valproate",
"carbamezepine",
"lamotrigine",
"lithium"
] |
Carbamazepine - SIDE EFFECTS OF THE DRUG - APLASTIC ANEMIA - AGRANULOCYTOSIS - Hyponatremia - Steven Johnson's syndrome - Liver enzyme elevation - It has teratogenic potential Ref. Kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no.935
|
B
| null |
medmcqa
|
medmcqa_28
|
Dobutamine acts on which of the following receptors?
|
[
"D1",
"Alpha/Beta",
"D2",
"All of the above"
] |
Ans. B. Alpha/Beta. (Ref. KDT 6th/pg. 126, 129; 507)# Dobutamine is not a D1 or D2 receptor agonist. It acts on both a and b adrenergic receptors, but as such considered to be a relatively selective b1 agonist.Difference between b1: ,b2 andb3 recptors; b1b2b31.LocationHeart, JG cells in kidneyBronchi, blood vessels, uterus, g.i.t., urinary tract, eyeAdipose tissue2.Selective agonistDobutamineSalbutamol, terbutalinBRL 373443.Selective antagonistMetoprolol, AtenololICI 118551a-methyl propranololCGP 20712A (also b1)ICI 118551 (also b2)4.Potency of NA as agonistStrongWeakStrongDobutamine:# A derivative of DA, but not a D1 or D2 receptor agonist.# Though it acts on both a and b adrenergic receptors, the only prominent action of clinically employed doses (2.5-10 mg/kg/ min i.v. infusion) is increase in force of cardiac contraction and output, without significant change in heart rate, peripheral resistance and BR# As such it has been considered to be a relatively selective b, agonist.# It is used as an inotropic agent in pump failure accompanying myocardial infarction, cardiac surgery, and for short- term management of severe congestive heart failure.# It is less arrhythmogenic than Adr.Dopamine (DA):# It is a dopamine (D1 and D2) as well as adrenergic a and bl (but not b2) agonist.Q# The D1 receptors in renal and mesenteric blood vessels are the most sensitive: i.v. infusion of low dose of DA dilates these vessels (by raising intracellular cAMP) increasing GFR and Na+ excretion.# Moderately high doses produce a positive inotropic (direct bl action + that due to NA release), but little chronotropic effect on heart.# Vasoconstriction (al action) occurs only when large doses are infused.# At doses normally employed, it raises cardiac output and systolic BP with little effect on diastolic BP.# It has practically no effect on nonvascular a and b receptors; does not penetrate blood brain barrier - no CNS effects.- Dopamine is used in patients of cardiogenic or septic shock and severe CHF wherein it increases BP and urine outflow.- It is administered by i.v. infusion (0.2-1 mg/min) which is regulated by monitoring BP and rate of urine formation.DrugReceptor SelectivityClinical UseCommentsEpinephrineb = b2>al* = a2*Anaphylactic shock; cardiogenic shock; cardiac arrestLow doses produce cardiac stimulation and vasodilation, which turns to vasoconstriction at high doses.*At high plasma concentrations, a = b selectivity.Norepinephrineb1 = a1>b2 = a2Severe hypotension; septic shockReflex bradycardia masks direct stimulatory effects on sinoatrial node.Dopamineb1 = b2>a1Acute heart failure, cardiogenic shock and acute renal failureBiosynthetic precursor of norepinephrine; stimulates norepinephrine release.*At low doses, it stimulates the heart and decreases systemic vascular resistance; at high doses, vasodilation becomes vasoconstriction as lower affinity ?- receptors bind to the dopamine; also binds to D1 receptors in kidney, producing vasodilation.Dobutamineb1 > b2 > a1Acute heart failure; cardiogenic shock; refractory heart failureNet effect is cardiac stimulation with modest vasodilation.Isoproterenolb1 = b2Bradycardia and atrioventricular blockNet effect is cardiac stimulation and vasodilation with little change in pressure.Additional Educational points:ADRENERGIC DRUGS(Sympathomimetics)Direct sympathomimetics -They act directly as agonists on a and / or b adrenoceptors - Adr, NA, isoprenaline (Iso), phenylephrine, methoxamine, xylometazoline, salbutamol and many others.Indirect sympathomimetics -They act on adrenergic neurone to release NA which then acts on adrenoceptors - tyramine. Mixed action sympathomimetics - act directly as well as indirectly - ephedrine, amphetamine, and mephentermine.ACTIONSAdr: a1+a2 + b1 + b2 and weak b3NA: a1 + a2 + b1+ b3 but no b2 actionIso: b1 + b2 + b3 but no a action Step/siteActionDrugResponse1.Synthesis of NAInhibitionUtilization of same synthetic pathwaya-methyl-p-tyrosine a-methyl dopaDepletion of NAReplacement of NA by a methyl NA (false transmitter)2.Axonal uptakeBlockadeCocaine, desipramine, guanethidine, antihistaminics, ephedrinePotentiation of NA (endo-and exogenous), inhibition of tyramine3.Granular uptakeBlockadeReserpineDepletion of NA (degraded by MAO)4.Nerve impulse coupled release of NAInhibitionGuanethidine, bretyliumLoss of transmission5.Granular NADisplacementGuanethidineInitially sympathomimetic, depletion later.6.Membrane NA poolExchange diffusionTyramine,ephedrineIndirect sympathomimetic7.MetabolismMAO inhibitionCOMT inhibitionNialamid tranylcypromineTolcapone, entacaponePotentiation of NA (slight),-of tyramine (marked)Potentiation of NA (slight)8.ReceptorsMimickingPhenylephrineClonidinea1 sympathomimetic a2-inhibition of NA release, | sympathetic outflow Isoprenalineb1 + b2 - sympathomimetic Salbutamolb2-sympathomimetic BlockadePhenoxybenzaminePrazosinYohimbinePropranololMetoprolola1+ a2 - blockadea1- blockadea2 - blockadeb1 + b2 - blockadeb1 - blockade
|
B
| null |
medmcqa
|
medmcqa_29
|
All are ototoxic drugs except -
|
[
"Streptomycin",
"Vancomycin",
"Furosamide",
"Atropine"
] |
Ans. is 'd' i.e.. Atropine Important ototoxic drugso Aminglycoside antibiotics:Streptomycin, gentamycin, tobramycin, neomycin, fcanamycin, amikacin, sisomycino Other antibiotics: Erythromycin, vancomycin, polymixin B, colistin, Ampicillino Loop diuretics: Furosemide, Ethacrynic acido Antineoplastics : Cisplatin, carboplatin, nitrogen mustardo Antimalaria!s: Quinineo Analgesics: Salicylateso Other drugs : Propranolol, propylthiouracil
|
D
| null |
medmcqa
|
medmcqa_30
|
The following statements are ture regarding the SA node except -
|
[
"Is located at the right border of the ascending aorta",
"In contains specialized nodal cardiac muscle",
"It is supplied by the atrial branche of the right coronary artery",
"It initiates cardiac conduction"
] |
SA node is supplied mostly by right coronary artery and beats at a rate of 70-80/min. It is situated at upper end of crista terminalis in the right atrium.
|
A
| null |
medmcqa
|
medmcqa_31
|
True about enzyme specificity:
|
[
"Amount of enzyme required per second, per mole or product formation",
"Number of sites per substrate",
"Amount of enzyme binding with various substrates",
"Amount of enzyme causing transformation of 1 mol of substrate per minute under standard condition"
] |
The specific activity of enzyme is usually expressed as p mol of substrate transformed to product per minute per milligram of enzymes under optimal condition of measurement.1 international unit (IU) =1 micromole / minuteModern unit of enzyme activity, 1 katals (kat) =1 mole/second (i.e. conservation of 1 moles of substrate per second)Enzymes are highly specific, interacting with one or few specific substrates & catalyzing only one type of chemical reaction Rate of metabolic processes may thus be regulated by changes in the catalytic efficiency of specific enzymes.
|
D
| null |
medmcqa
|
medmcqa_32
|
Anterior ethmoidal nerve suplies all except:
|
[
"Maxillary sinus",
"Interior of nasal cavity",
"Dural sheath of anterior cranial fossa",
"Ethmoidal air cells"
] |
Maxillary sinus Maxillary sinus is not supplied by ant. ethmoidal nerve.Anterior ethmoidal nerve is the branch of the nasociliary nerve; a branch of ophthalmic division of trigeminal nerve.Ant. ethmoidal nerve supplies- Dura mater of ant. cranial fossa- Ethmoidal sinuses- Roof of the nasal cavity- Anterior pa of the lateral wall of nasal cavity- Anterior and upper pas of the nasal septum- Skin of the external nose to the nasal tip.
|
A
| null |
medmcqa
|
medmcqa_33
|
True about pKa is:-
|
[
"pH at which ionized fraction of drug equals to unionized fraction",
"pH at which ionized fraction of drug is more than unionized fraction",
"pH at which ionized fraction of drug is less than unionized fraction",
"pH at which ionized fraction of drug is twice unionized fraction"
] |
* pKa is the pH at which ionized fraction(50%) of drug equals to unionized fraction(50%). * i.e. 50% is lipid soluble and 50% is water soluble. * It is the pH at which 50% of drug can cross the membrane and 50% of drug cannot cross the membrane.
|
A
| null |
medmcqa
|
medmcqa_34
|
What is the basic minimum illumination required for satisfactory vision?-
|
[
"10-15 foot candles",
"15-20 foot candles",
"20-25 foot candles",
"25-30 foot candles"
] |
(PARK TB 23rd edtn pg 739) The lighting should be sufficient to enable eye to discern the details of an object as well as the surroundings without eye strain. An illumination of 15 to 20 candles is accepted as the basic minimum for satisfactory vision.
|
B
| null |
medmcqa
|
medmcqa_35
|
Fournier's gangrene occurs in the
|
[
"Toes",
"Scrotum",
"Fingers",
"Muscles"
] |
See Idiopathic scrotal gangrene.
|
B
| null |
medmcqa
|
medmcqa_36
|
The most common complication of vagotomy is:
|
[
"Diarrhoea",
"Dryness of mouth",
"Tachycardia",
"Bleaching"
] |
Postvagotomy diarrhea- most commonly observed after truncal vagotomy Due to a motility disorder from interruption of the vagal fibers supplying the luminal gut. Other factors may include decreased absorption of nutrients, increased excretion of bile acids, release of luminal factors that promote secretion. Diphenoxylate or loperamide is often useful in symptom control.
|
A
| null |
medmcqa
|
medmcqa_37
|
Single gene defect ca using multiple unrelated problems -
|
[
"Pleiotropism",
"Pseudodominance",
"Penetrance",
"Anticipation"
] |
Ans. is 'a' i.e. Pleiotropy o Pleiotropy occurs when a mutation in a single gene produces effects on more than one characteristic, that is causes multiple mutant phenotypes. o In humans this phenomenon is most obvious when mutations in single genes causes diseases with seemingly unrelated symptoms. Some examles of this phenomenon are : Transcription factor TBx5 mutations that cause the cardiac and limb defects of Holt-Oram syndrome. Glycosylation enzyme MPI mutations that produce the severe mental retardation and blood coagulation abnormalities of type Ib congenital disorders of glycosylation. o DNA damage repair protein NBSI mutations that lead to microcephaly, immunodeficiency and cancer predisposition in Nijmegen breakage syndrome.
|
A
| null |
medmcqa
|
medmcqa_38
|
Maple syrup urine disease is characterised by all except -
|
[
"Hypotonia",
"Hypertonia",
"Pancreatitis",
"Hypopigmentation"
] |
Ans. is 'd' i.e., Hypopigmentation* Maple syrup urine disease is caused by a defect of branched chain keto acid dehydrogenase (BCKADH), the enzyme which is involved in the catabolism of branched chain amino acids - valine, leucine and isoleucine* The disorder is so called because of the classic sweet odour observed in urine. This classic odour is found to be because of the presence of sotolone (a metabolite of branched chain keto acids) in urine* The enzyme BCKADH has three subunits - Branched chain keto acid dehydrogenase, Dihydrolipoyl transacetylase, Dihydrolipoyl dehydrogenase. It uses 5 coenzymes - thiamine pyrophosphate,, lipoamide, CoA, FAD and NAD* Mutation of any of the genes of any of the subunits involved in the complex can result in maple syrup urine disease.* It presents as either an early onset acute illness or as late onset chronic disorder.* Early onset acute illness# The infant is normal at birth but slowly neurodegenerative features are observed and it progresses rapidly and the infant dies close to 6 months* Late onset chronic illness# In late onset type, the person is normal and features appear during metabolic crisis states like during starvation or catabolic states. As during starvation or during catabolic states, the person presents with# Weight loss# Hypoglycemia# Ketoacidosis# Diorrhea, vomiting, dehydration# Neurological manifestations like alternating hypotonia and hypertonia, ataxia, seizures, coma# Pancreatitis* Diagnosis can be done using dried blood spot analysed using HPLC and Tandem mass spectrometry* Screening tests includes DNPH test (Dinitrophenylhydrazine test). DNPH reacts with the carbonyl groups of aldehydes and ketone to give a red or yellow complex.* Treatment involves diet (restriction of valine, leucine and isoleucine with formula foods) and supplementation of vitamins, minerals and omega 3 fatty acid)* To avoid RBCs of the sample utilising glucose of the plasma, fluride is added in the tube (Grey topped tube). Fluride inhibits glycolysis in RBCs. Hence it avoids false low values of glucose.* Pyruvate dehydrogenase is an enzyme complex made up of three subunits - pyruvate dehydrogenase, dihydrolipoyl transacetylase. Dihydrolipoyl dehydrogenase. Lipoamide is one of the coenzymes required for this enzyme complex. During the process of conversion of pyruvate to acetyl CoA, lipoamide gets reduced to form dihydrolipoamide. Regeneration of lipoamide is not possible in the presence of arsenite
|
D
| null |
medmcqa
|
medmcqa_39
|
Bacterial endocarditis is most commonly caused by?
|
[
"a -Hemolytic streptococci",
"b -Hemolytic streptococci",
"Staphylococcus aureus",
"Cardiobacterium"
] |
Ans. is 'c' i.e., Staphylococcus aureusEndocarditis is an inflammation of the inner layer of the hea, i.e. endocardium.o It usually involve the hea valves (native or prosthetic).o Other structures which may be involved are interventricular septum, chordae tendinae, the mural endocardium, and intracardiac devices.Endocarditis can be classified into -1.Infective endocarditis In this, infection is the source of inflammation.Most common causes of infective end ocarditisIn native wall --> Staphylococcus aureus.In early prosthetic valve (up to 12 months after valve surgery) Staphylococcus epidermidis (coagulase negative staphylococcus).In late prosthetic valve (more than 12 months after valve surgery) --> streptococcus viridans.In IV drug abusers --> Staphylococcus aureus.In patients with intravenous catheter --> coagulase negative staphylococci.o After dental procedure (tooth extraction) --> streptococcus mutans.Infective endocarditis can be fuher divided intoA. Acute infective endocarditiso Occurs on a previously normal hea valve.o Caused by an organism with high virulence, e.g. staphylococcus aureus.o Involvement and progression is more severe.B. Subacute infective endocarditiso Occurs on previously damaged or abnormal valve.o Caused by organism with low virulence, e.g. streptococci.o Disease is insidious in onset with less severe involvement and slow progression.2.Non-infective endocarditis o Source is other than infection, eg. non-infective thrombotic endocarditis, rheumatic carditis, Libmansack's endocarditis.
|
C
| null |
medmcqa
|
medmcqa_40
|
Killing of a 6 months old child by parents is known as ?
|
[
"Genocide",
"Infanticide",
"Neonatal homicide",
"Aboion"
] |
Ans. is 'b' i.e., Infanticide Infanticide refers to killing a child after delivery, to till 1 year after bih. Infanticide in India is considered equivalent tomurder and is tried under section 302 IPC. Law considers every child as born dead and therefore in a case of infanticide,it has to be proved that the child was born alive and was then killed. Thus the first question in the investigation of a case of infanticide is, whether the child was still born or dead born or whether it was born live.
|
B
| null |
medmcqa
|
medmcqa_41
|
Most common viral disease affecting parotid glands-
|
[
"Mumps",
"Measles",
"Rubella",
"Varicella"
] | null |
A
| null |
medmcqa
|
medmcqa_42
|
Na+ uptake at basolateral surface of apical cells is by
|
[
"Active transpo",
"Passive transpo",
"Diffusion",
"Osmosis"
] |
Ans. is 'a' i.e., Active transpo
|
A
| null |
medmcqa
|
medmcqa_43
|
True about nerve fiber C is
|
[
"Most susceptible to hypoxia",
"Unmyelinated",
"Preganglionic autonomic",
"Not for temperature and pain senses"
] |
SPECIAL FEATURES
1) Susceptibility to
A) Hypoxia B > A > C
B) Pressure A > B > C
C) Local Anasthesia C > B > A
2) Diameter
A alpha > A beta > A gamma > A delta > B > C
3) Velocity
A alpha > A beta > A gamma > A delta > B > C
4) a)Large axons are associated with
Proprioception
Somatic motor
Touch
Pressure
b) Small axons are associated with
Pain
Temperature
Autonomic function
5) a) Velocity is directly dependent on
Myelination, Diameter and capacitance
b) Velocity is inversely dependent on
Resistance
|
B
| null |
medmcqa
|
medmcqa_44
|
Inheritance pattern of ABO blood group system is
|
[
"Pseudodominance",
"Autosomal dominant",
"Autosomal recessive",
"Codominance"
] |
harshmohan textbook of pathology 7th edition ABO blood grouping shows codominance as both alleles of a gene pair are expressed in heterozygous state
|
D
| null |
medmcqa
|
medmcqa_45
|
Facial colliculus is seen in -
|
[
"Midbrain",
"Pons",
"Medulla",
"Interpeduncular fossa"
] | null |
B
| null |
medmcqa
|
medmcqa_46
|
Platelets are derived from which of the following cell types?
|
[
"Megakaryocytes",
"Lymphocytes",
"Neutrophils",
"Plasma cells"
] |
Megakaryocytes are giant cells found in the bone marrow and are the source of circulating platelets. The megakaryocyte undergoes many rounds of DNA replication without undergoing cell division. Once DNA synthesis has stopped, the cytoplasm of the cell matures. Platelets bud from the main cell body of the megakaryocyte. Platelets lack nuclei and function in hemostasis, coagulation, and inflammation. Ref: Kaushansky K. (2010). Chapter 113. Megakaryopoiesis and Thrombopoiesis. In J.T. Prchal, K. Kaushansky, M.A. Lichtman, T.J. Kipps, U. Seligsohn (Eds),Williams Hematology, 8e.
|
A
| null |
medmcqa
|
medmcqa_47
|
Which of the following is not a usual feature of right middle cerebral aery territory infarct :
|
[
"Aphasia.",
"Hemiparesis",
"Facial weakness",
"Dysahria"
] |
Answer is A (Aphasia): Aphasia is a manifestation of dominant parietal lobe involvement. Dominant hemisphere is right handed person is left hemisphere and thus a right middle cerebral aery infarct indicates 'Non Dominant Paial Lobe' involvement. Apahsia will not be a manifestation because an infarction in middle cerebral aery distribution on the right side affect the non dominant parietal lobe (kit parietal lobe).
|
A
| null |
medmcqa
|
medmcqa_48
|
In 3 year child with polio paralysis, the tendon transfer operation is done at -
|
[
"2 months after the disease",
"2 years after the disease",
"6-12 months after the disease",
"After skeleton maturation"
] |
Tendon transfers : are done to equalize an unbalanced paralysis or to use the motor power of working muscles for more useful functions. It is not done before 5 yrs of age as the child has to be manageable enough to be taught proper exercises.
As the child is 3 years old, tendon transfer should be done after 2 years (at 5 years of age).
|
B
| null |
medmcqa
|
medmcqa_49
|
Prophylactic intracranial irradiations are given in –
|
[
"Small cell Ca of lung",
"Testicular Ca",
"Ca breast",
"Ca stomach"
] |
Prophylactic craniospinal irradiation is given in:- medulloblastoma, SCC lung, Glioblastoma, Germinoma, ALL, Non-Hodgkin's lymphoma (NHL), Leptomeningeal rhabdomyosarcoma
|
A
| null |
medmcqa
|
medmcqa_50
|
Local anaesthesia causing methemoglobinemia ?
|
[
"Procaine",
"Prilocaine",
"Etodicaine",
"Ropivacaine"
] |
Ans. is 'b' i.e., Prilocaine Prilocaine and benzocaine can cause methemoglobinemia. Impoant facts Chlorprocaine is the shoest acting LA. Dibucaine is the longest acting, most potent and most toxic LA. Bupivacaine is the most cardiotoxic LA (Ropivacaine is a newer bupivacaine congener with less cardiotoxicity). o Levobupivacaine (The S (-) enantiomer of bupivacaine) is less cardiotoxic and less prone to cause seizure. o Prilocaine can cause Met haemoglobinemia. Lignocaine is the most commonly used LA. Bupivacaine has the highest local tissue irritancy. Chlorprocaine is contraindicated in spinal anaesthesia as it can cause paraplegia due to presence of neurotoxic preservative sodium metabisulphite. Procaine is the LA of choice in malignant hypehermia
|
B
| null |
medmcqa
|
medmcqa_51
|
Millennium development goal targets to reduce MMR in 2015 by:-
|
[
"0.25",
"0.75",
"0.5",
"1"
] |
- Target 6 of Goal-5 of MDG aims to reduce Maternal Moality ratio by 3/4th or 0.75. GOALS OF MDG: However, now 17 Sustainable Development Goals or SDGs have been introduced from 2016 - 2030.
|
B
| null |
medmcqa
|
medmcqa_52
|
Hypopigmentation, gray streaks of hair, degranulation defect of neutrophils and neuropathy are seen in
|
[
"aleukemic Leukemia",
"chronic granulocytic leukemia",
"Lazy leukocyte syndrome",
"Chediak higashi syndrome"
] | null |
D
| null |
medmcqa
|
medmcqa_53
|
Which of the follow ing deficiency does not cause dilated cardiomyopathy -
|
[
"Calcium",
"Selenium",
"Manganese",
"Carnitine"
] |
Ans. is 'c' i.e., Manganese Major causes of dilated cardiomyopathy (with common examples)Inflammatory myocarditisMatabolicInfectiveViral (Coxsackie. adenovirus, HIV, hepatitis C)Parasitic (T. cruzi- Chagas1 disease, toxoplasmosis)Bacterial (diphtheria)Spirochetal (Borellia burgdorferi-Lyme disease)Rickettsial- (Q fever)Fungal (with systemic infection)NoninfectiveGranulomatous inflammatoiy diseaseSarcoidosisGiant cell myocarditisHypersensitivity myocarditisPolymyositis, dennaiomyositisCollagen vascular diseasePeripartum cardiomyopathyTransplant rejectionNutritional deficiencies: thiamine, selenium, carnitineElectrolyte deficiencies: calcium, phosphate, magnesiumEndocrinopathy:Thyroid diseasePheochromocytomaDiabetesObesityHemochromatosisInherited Metabolic Pathway DefectsFamilial*Skeletal and cardiac myopathyDystrophin-related dystrophy (Duchenne's, Becker's)Mitochondrial myopathies (e.g. Kearns-Sayre syndrome)Arrhythmogenic ventricular dysplasiaHemochromatosisAssociated with other systemic diseases ToxicSusceptibility to immune-mediated myocarditisAlcoholCatecholamines: amphetamines, cocaineChemotherapeutic agents: (anthracyclines, trastuzumab)InterferonOther therapeutic agents (hydroxychloroquine, chloroquine)Drugs of misuse (emetine, anabolic steroids)Heavy metals: lead, mercuryOccupational exposure: hydrocarbons, arsenicalsOverlap with restrictive cardiomyopathy"Minimally dilated cardiomyopathy"HemochromatosisAmyloidosisHypertrophic cardiomyopathy ("burned-out") ''Idiopathic"Miscellaneous (Shared elements of above etiologies)Arrythmogenic right ventricular dysplasia (may also affect left ventricle)*Left ventricular noncompaction*Peripartum cardiomyopathy
|
C
| null |
medmcqa
|
medmcqa_54
|
Best skin disinfectant for central line inseion is:
|
[
"Povione iodine",
"Alcohol",
"Cetrimide",
"Chlorhexidine"
] |
Ans is 'd' i.e. Chlorhexidine "Chlorhexidine is now the disinfectant recommended for all catheter placement procedures and for routine site cleansing during dressing changes."- Comprehensive Hospital Medicine: An Evidence-Based And Systems Approach By Mark V. Williams, Scott A. Flanders, p320 "Use of antiseptic solution for skin disinfection at the catheter inseion site helps prevent catheter-related infection. Chlorhexidine-based solutions appear to be superior to both aqueous and alcohol-based povidone-iodine in reducing the risk for catheter colonization and catheter-related bloodstream infection. If there is a contraindication to chlorhexidine, tincture of iodine, an iodophor or 70 percent alcohol can be used as alternatives"-uptodate.com
|
D
| null |
medmcqa
|
medmcqa_55
|
A child can Count 4 pennies accurately by the age of ?
|
[
"30 months",
"36 months",
"48 months",
"60 months"
] |
Emerging patterns for language behaviour from 1-5years of age 15months Jargon Follows simple commands May name a familiar object (e.g., ball) Responds to his/her name 18months 10 words (average) Names pictures Identifies 1 or more pas of the body 24months Puts 3 words together (subject, verb, object) 30months Refers to self by the pronoun "I" Knows full name 36months Knows age and sex Counts 3 objects correctly Repeats 3 numbers or a sentence of 6 syllables Most of the speech intelligible to strangers 48months Counts 4 pennies accurately Tells story 60months Names 4 colours Repeats sentence of 10 syllables Counts 10 pennies correctly Ref: Nelson paediatrics; Table 11-1
|
C
| null |
medmcqa
|
medmcqa_56
|
An angiographic study of the distal pa of the circle of Willis requires access to the veebral aery. Access to this aery can be obtained the:
|
[
"Anterior triangle of the neck",
"Muscular triangle of the neck",
"Posterior triangle of the neck",
"Suboccipital triangle"
] |
The suboccipital triangle lies in the neck at the base of the skull. The suboccipital triangle is bounded by the inferior oblique, rectus major, and superior oblique muscles. The veebral aery can be found within the suboccipital triangle, lying on the posterior arch of the atlas, lateral to the midline, typically at about the level of the lower poion of the ear lobe. Care should be taken in accessing the vessel, since the first cervical nerve lies between the veebral aery and the posterior arch of the atlas.The anterior triangle of the neck is in the anterior neck, and is bounded by the neck midline, the mandible, and the sternocleidomastoid muscle. The anterior triangle of the neck is subdivided into the muscular, carotid, submandibular, and submental triangles.The small muscular triangle lies between the superior belly of the omohyoid and the sternohyoid muscle. The posterior triangle of the neck is on the side of the neck, and is bounded by the sternocleidomastoid muscle, trapezius, and the middle third of the clavicle. Ref: Waxman S.G. (2010). Chapter 12. Vascular Supply of the Brain. In S.G. Waxman (Ed), Clinical Neuroanatomy, 26e.
|
D
| null |
medmcqa
|
medmcqa_57
|
Disc edema is not seen in:
|
[
"Retro bulbar neuritis",
"Papillitis",
"Papilledema",
"Optic nerve glioma"
] |
Retro bulbar neuritis REF: Neuro-ophthalmology: the practical guide, By Leonard A. Levin page 101 Optic Disc Edema: Possible diagnostic consideration of appearance of optic disc edema is to determine whether the disc edema is pathological or just the disc itself is congenitally elevated (Pseudopapilledema). A reliable indicator of Pseudopapilledema is the presence of anomalous vessels on the disc. Now if disc is truly swollen then its turn to decide, it is due to increased ICT (papilledema) or any other cause of disc edema. Unilateral Visual Increased Anomalous Broad category Examples or Bilateral function ICT vessels Generally bilateral Normal No Yes Pseudopapilledema Pseudopapilledema (aka-Optic Disc Drusen- congenital & asymptomatic) Bilateral Normal Yes No Papilledema Papilledema Either Normal No No Disc edema with preserved vision Diabetic papillopathy Aerial hypeension Papillophlebitis Either Abnormal No No Disc edema with abnormal vision Optic neuritis (Papillitis) Neuroretinitis Optic nerve tumors Optic nerve glioma Optic nerve sheath meningioma Anterior ischemic optic neuropathy
|
A
| null |
medmcqa
|
medmcqa_58
|
The record of the position of the patients maxillary ridge in relation to the condyles is the
|
[
"Jaw relation",
"Articulator",
"Face bow record",
"Centric jaw relation"
] | null |
C
| null |
medmcqa
|
medmcqa_59
|
Which of the following can be given orally aEUR'
|
[
"Cytosine ara",
"Actinomycin D",
"Doxorubicin",
"Mesna"
] |
Mesna MESNA is given alongwith alkylating agents to prevent nephrotoxicity due to cyclophosphanzide. Cyclophosphamide and Ifosfamide are alkylating agents that release a nephrotoxic and urotoxic metabolite -> Acrolein. Acrolein causes severe hemorrhagic cystitis. MESNA is administered to prevent hemorrhagic cystitis. MESNA conjugates with Acrolein and forms a nontoxic compound. It can be administered intravenously or orally. Mesnex injection is given as intravenous bolus injection in a dosage equal to 20% of the ifosfamide dosage at the time of ifosfamide administration whereas Mesnex tablets are given orally in a dose equal to 40% of the Ifosfamide dose 2 and 6 hours after each dose of Ifosfamide. The total daily dose of mesna is 100% of the ifosfamide dose. Cytarabine Cytarabine (Ara C) is degraded by the enzyme cytidine deaminase. Cytidine deaminase is present in high concentrations in g.i. tract therefore only about 20% of the drug reaches the circulation after oral Ara-C administration. Thus the drug must be given intravenously. Dactinomycin or Actinomycin D It is administered by intravenous route. Doxorubicin It is administered intravenously and are cleared by complex pattern of hepatic metabolism and biliary excretion.
|
D
| null |
medmcqa
|
medmcqa_60
|
Myd88 L265p mutation is seen in:
|
[
"Multiple myeloma",
"Waldenstrom's macroglobulinemia",
"ALL",
"Chronic myeloid leukemia"
] |
B i.e. Waldenstrom's macroglobulinemiaRef: Robbins 9th edition, page 538Explanation:Waldenstrom MacroglobulinemiaIndolent neoplasm.Also known as lymphoplasmacytic lymphoma.Involves bone marrow (100%), liver, spleen, lymph nodes (15 - 20%).Rare sites of involvement lung and testis (PGIMER exam options).IgM secretion.MYD88 mutation - virtually in all cases.Associated with cold agglutinin AIHA and Hyperviscosity syndrome in 15%.
|
B
| null |
medmcqa
|
medmcqa_61
|
Diagnosis of folic acid deficiency is done by all except
|
[
"FIGLU estimation",
"Peripheral blood smears",
"AICAR estimation",
"transketolase activity"
] |
Blood Level: Normal folic acid level in serum is about 20 nanograms/ml and about 200 microgram/ml of packed cells. The level is measured by radioimmunoassay. Histidine load test or FIGLU excretion test: Histidine is normally metabolised to formimino glutamic acid (FIGLU) from which formimino group is removed by THFA. Therefore in folate deficiency, FIGLU is excreted in the urine. AICAR excretion: In the purine nucleotide synthesis, the last step is the addition of C2 with the help of N10-formyl THFA, the precursor, aminoimidazole carboxamide ribosyl-5-phosphate (AICAR) accumulates and is excreted in the urine. Peripheral blood picture. Ref: DM Vasudevan - Textbook of Biochemistry, 8th edition, page no: 475, 297
|
D
| null |
medmcqa
|
medmcqa_62
|
Tumor suppressor genes are all, except:-
|
[
"APC",
"p53",
"Rb",
"C-myc"
] |
C-myc is a proto-oncogene of transcriptional activator category and is associated with Burkitt's lymphoma.
|
D
| null |
medmcqa
|
medmcqa_63
|
Best local anaesthetic for ophthalmic surgery is-
|
[
"Tetracaine",
"Prilocaine",
"Procaine",
"Bupivacaine"
] |
Ans. is 'd' i.e., Bupivacaine o The choice of local anaesthetic for ocular surgery varies,o But lidocaine (2%) and bupivacaine (0.5-0.75%) are used most commonly.o Generally the use of 1:1 mixture of 2% lidocaine (xylocaine) and 0.50% bupivacaine along with adrenaline and hyaluronidase in facial, retrobulbar and peribulbar blocks is common.
|
D
| null |
medmcqa
|
medmcqa_64
|
True regarding presentation of Primary TB is:
|
[
"Bilateral pleural effusion with negative tuberculin test",
"Unilateral hilar lymphadenopathy",
"Sustained chronic pyrexia",
"B/L pleural effusion with positive tuberculin test"
] |
TB in young children is almost invariably accompanied by hilar or paratracheal lymphadenopathy due to the spread of bacilli from the lung parenchyma through lymphatic vessels.
|
B
| null |
medmcqa
|
medmcqa_65
|
Superior rectal vein drains into-
|
[
"Inferior mesenteric vein",
"External iliac vein",
"Internal iliac vein",
"Internal pudendal vein"
] |
Ans. is 'a' i.e., Inferior mesenteric vein o Superior rectal vein drains into inferior mesenteric vein,o Inferior rectal vein drains into internal pudendal vein.
|
A
| null |
medmcqa
|
medmcqa_66
|
Bedsore is an example of:
|
[
"Tropical ulcer",
"Trophic ulcer",
"Venous ulcer",
"Post thrombotic ulcer"
] |
Ans. (b) Trophic ulcer* Bedsore is a pressure ulcer. Most common in sacrum site due to persistent pressure in the back.* This is a type of trophic ulcer.* This can be prevented by frequent change of positioning of the bedridden patient and using Water/Aqua bed.* Once bedsore is formed it is difficult to treat.* Treatment extends from local wound debridement to flap procedures.
|
B
| null |
medmcqa
|
medmcqa_67
|
A 8 year old boy presented with swelling in the left eye of 3 months, examination revealed proptosis of left eye with preserved vision. Right eye is normal. CT scan revealed intraorbital extraconal mass lesion. Biopsy revealed embryonal rhabdomyosarcoma. Metastatic work up was normal. The standard line of treatment is -
|
[
"Chemotherapy only",
"Wide local excision",
"Enucleation",
"Chemotherapy and Radiaton therapy"
] |
Treatment of choice for rhabdomyosarcoma is Radiotherapy followed by chemotherapy.
|
D
| null |
medmcqa
|
medmcqa_68
|
Rinne test is negative in:
|
[
"Sensorineural deafness",
"Acoustic neuroma",
"Tympanosclerosis",
"Meniere's disease"
] |
(c) Tympanosclerosis(Ref Cummings, 6th ed., 2203)Tympanosclerosis being a conductive pathology so BC > AC so Rinne will be negative.All the other options being SN deafness so AC > BC so Rinne will be positive.
|
C
| null |
medmcqa
|
medmcqa_69
|
Which among the following is used in deflouridation of water?
|
[
"Alum and lime",
"Potassium permanganate",
"Ozonisation",
"Bromides"
] |
Ans: a (Alum and Lime) Ref: Park, 19th ed, p. 511,582The addition of lime and alum in sequence followed by flocculation, sedimentation and filtration for defluridation of water is Nalgonda technique.The recommended level of fluorides in drinking water in India accepted as 0.5 to 0.8 mg/ltr.Endemic fluorosis.It has been observed in areas where the drinking water contains excessive amount of fluorine (3-5 mg/L).Intervention:i) Changing of water source - running surface water contains lower quantities of fluorides than ground water.ii) Chemical treatment - Nalgonda technique of deflouridation of waters It involves the addition of lime and alum in sequence followed by flocculation, sedimentation and filtration.BRIDGEStabilising bleaching powder by adding lime is called Clarke's methodNalgonda technique - developed by The National EnvironmentalEngineering Research Institute, Nagpur.
|
A
| null |
medmcqa
|
medmcqa_70
|
Which of the following liver tumor has a propensity to invade the poal or hepatic vein?
|
[
"Cavernous hemangioma",
"Hepatocellular carcinoma",
"Focal nodular hyperplasia",
"Hepatic adenoma"
] |
Hepatocellular carcinoma Characteristic of HCC; Propensity to invade the poal vein Causing "Multicentric & Bi-lobar" spread (in 75%-80%) . This happens because POAL VEINS are valveless .
|
B
| null |
medmcqa
|
medmcqa_71
|
Most sensitive test for carpal tunnel syndrome -
|
[
"Phalen's test",
"Tinel's sign",
"Tourniquet test",
"None"
] |
*Phalen&;s test / wrist flexion : the patient is asked to actively place the wrist in complete but unforced flexion . If tingling & numbness are produced in median nerve distribution of the hand within 60 seconds , the test is positive . it is the most sensitive provocative test , has a specificity of 80%. *Tinel &;s sign - to record the rate of regeneration of nerve clinically . * Tourniquet test : a pneumatic BP cuff is applied proximal to elbow & inflated higher than the patient&;s systolic BP .The test is positive if there is parasthesia or numbness in region of median nerve distribution of the hand . Is less reliable & is specific in 65% cases. * median nerve percussion test : tap the median nerve at the wrist gently ,test is positive if there is tingling sensation .seen in 45% cases only * median nerve compression test : direct pressure over both wrist by examiner .first phase of test is time taken for symptoms to appear (15 sec- 2min) .the second phase is the time taken for symptoms to disappear after the release. REF:textbook of ohopedics, John Ebenezer, 4th edition , pg.no.394
|
A
| null |
medmcqa
|
medmcqa_72
|
T. pallidum was discovered by
|
[
"Schaudin and Hoffman",
"Ellerman and Bang",
"Twort",
"Robert Koch"
] |
Ans. a (Schaudin and Hoffman) (Ref. Anantanarayan, Microbiology, 8th/ p. 5; 377)Treponema pallidum, the causative agent of syphilis, was discovered by Schaudinn and Hoffmann (1905) in the chancres and ingunal nodes of syphilitic pts. Pallidum refers to pale staining.Important discoveries in MicrobiologySr. no.ScientistDiscovery/invention1ANTONY VAN LEEUWENHOEKMicroscope2AUGUSTINO BASSIEarliest discovery of a pathogenic microrganism2OLIVER WENDELL HOLMESHand washing for anti-sepsis.Concluded that puerperal sepsis is contagious.3LOUIS PASTEURMicrobial theory of fermentation.Coined the term vaccineAnthrax, cholera, Rabies vaccine.Principle of sterilization. Streptococci.Father of modern microbiology.4JENNERSmallpox vaccine5OGSTONDiscovered Staphylococci6NICOLAI ERTetanus bacillus7FRENKELPneumococcus8RUSKAElectron microscope9LISTER JOSEPHLaudable pus; Physical sterilization10METCHNIKOFFPhagocytosis (MH'05)11WRIGHTOpsonization12BURNETImmunosurviellance13LANDSTEINERBlood group antigen14FLEMINGPenicilium against Staph15JOHN HUNTERFather of experimental surgery16PRUISSNER (1997)Prion Proteins17JERNEIdiotypic network18BRUCEIdentified causative agent of Malta fever19LOEFFLERIsolated diphtheria bacillus20Schaudinn & Hoffmann (1905)Discovered spirochete of syphilis21BEIJERINCKCoined the term Virius22THE FIRST HUMAN PROVED TO HAVE VIRAL CAUSEYelow Fever23RuskaIntroduction of electron microscope24Ellerman and BangPossibilty that virus infection can lead to malignancy was first put forth25Twort and d'HerelleIndependently discovered a lytic phenomenon in bacterial cultures26Richet and PortierAnaphylaxis27NUTTALLObserved that fibrinated blood has bactericidal effect28BUCHNERObserved that Bactericidal effect of fibrinated blood can be abolished by heating the sera for 1 hr at 55degC29Von BEHRING AND KITASATOAntibody
|
A
| null |
medmcqa
|
medmcqa_73
|
In an adult male, on per rectal examination, the following structures can be felt anteriorly except:
|
[
"Internal iliac lymph nodes",
"Bulb of the penis",
"Prostate",
"Seminal vesicle when enlarged"
] |
Internal iliac lymph nodes can be palpated laterally when they are enlarged & not anteriorly Ref: Anatomy Workbook By Colin Hinrichsen, Peter Lisowski, 2007, Page 103
|
A
| null |
medmcqa
|
medmcqa_74
|
Baclofen is:
|
[
"Centrally acting muscle relaxant",
"Peripherally acting muscle relaxant",
"Both centrally and peripherally acting muscle relaxant",
"Direct acting muscle relaxant"
] |
Baclofen is a centrally acting muscle relaxant . Baclofen is primarily used for the treatment of spastic movement disorders, especially in instances of spinal cord injury, cerebral palsy, and multiple sclerosis. Its use in people with stroke or Parkinson's disease is not recommended From padmaja 4th edition Page no 83
|
A
| null |
medmcqa
|
medmcqa_75
|
A 55-year-old postmenopausal lady with simple endometrial hyperplasia with atypia. What is the management?
|
[
"Hysterectomy",
"Mirena",
"Progestin",
"Estrogens"
] |
Ans. is a i.e. Hysterectomy* Women with atypical hyperplasia should undergo a total hysterectomy because of the risk of underlying malignancy or progression to cancer.* A laparoscopic approach to total hysterectomy is preferable to an abdominal approach as it is associated with a shorter hospital stay, less postoperative pain and quicker recovery.* Postmenopausal women with atypical hyperplasia should be offered bilateral salpingo oophorectomy together with the total hysterectomy.
|
A
| null |
medmcqa
|
medmcqa_76
|
All among the following are characteristics of postmoem abrasions except
|
[
"Exudation is more and scab is slightly raised",
"Yellowish, translucent, Parchment like color",
"Usually over bony prominences",
"No intra-vital reaction is seen"
] |
Source Ante moem wounds Post-moem wounds Site Anywhere on the body Usually over bony prominences Colour Bright reddish brown Yellowish, translucent, Parchment like Exudation More; scab slightly raised Less; scab often lies slightly below the level of skin Microscopic Intravital reaction and congestion seen No intravital reaction No congestion
|
A
| null |
medmcqa
|
medmcqa_77
|
Poal vein begins at the level of which veebra?
|
[
"L2",
"L4",
"L5",
"None of the above"
] |
The poal vein begins at the level of the second lumbar veebra and is formed from the convergence of the superior mesenteric and splenic veins. It is 8 cm long and lies anterior to the inferior vena cava and posterior to the neck of the pancreasRef: Gray's anatomy 40th edition, Chapter 85.
|
A
| null |
medmcqa
|
medmcqa_78
|
The cardiac jelly formed around the hea tube during early development, contributes to the formation of?
|
[
"Pericardium",
"Mesocardium",
"Myocardium",
"Endocardial cushion valves"
] |
Prior to looping, the acellular space between the myocardium and endocardium in the hea is filled with a deformable extracellular matrix, the cardiac jelly, secreted by the myocardium. Radioactive labeling demonstrates that proteins produced in the myocardium flow toward the endocardium and are incorporated into the basal lamina. The cardiac jelly has a variety of functions related to hemodynamic performance, cardiac looping, and cell migration in cardiac septation and formation of the endocardial cushion valves at the atrioventricular (AV) junction and outflow tract of the hea.
|
D
| null |
medmcqa
|
medmcqa_79
|
A 68-year-old man with prostate cancer and bone metastases presents with shaking chills and fever. The peripheral WBC count is 1,000/mL (normal = 4,000 to 11,000/mL). Which of the following terms best describes this hematologic finding?
|
[
"Leukocytosis",
"Leukopenia",
"Neutrophilia",
"Leukemoid reaction"
] |
Leukopenia=Absolute decrease in the circulating WBC count. It is occasionally encountered under conditions of chronic inflammation, especially in patients who are malnourished or who suffer from a chronic debilitating disease. Other cause can be typhoid fever and ceain viral and Rickettsial infections. -Leukocytosis is defined as an absolute increase in the circulating WBC count. -Neutrophilia is defined as an absolute increase in the circulating neutrophil count. -Pancytopenia refers to decreased circulating levels of all formed elements in the blood.
|
B
| null |
medmcqa
|
medmcqa_80
|
Both aeriolar and venodilator drug is: September 2007
|
[
"Hydralazine",
"Sodium nitroprusside",
"Minoxidil",
"Captopril"
] |
Ans. B: Sodium Nitroprusside
|
B
| null |
medmcqa
|
medmcqa_81
|
To supress lactation in mother with rheumatic fever, Rx of choice is -
|
[
"D-Norgesterol",
"Pyridoxine",
"Bromocriptine",
"DMPA"
] |
Ans. is 'b' Pyridoxine All of the drugs given in the question are used to suppress lactation.But we have to keep in mind that lady is suffering from heart disease and steroidal drugs are contraindicated in patients with heart disease due to fear of thromboembolic phenomenon.It is not specifically mentioned that bromocriptine in contraindicated in patients with heart disease, but postural hypotension is an important adverse effect of bromocriptine. Therefore I have ruled it out.Now we are left with pyridoxine has no effect on CVS and it suppresses lactation by potentiating dopamine (Page, 886, 4/e, KDT).
|
B
| null |
medmcqa
|
medmcqa_82
|
During the first week of infection, Dengue can be best detected by:
|
[
"NS1 antigen detection",
"MACELISA",
"ICT test to detect IgM",
"None of the above"
] |
Dengue: - Caused by Group-B Arbovirus - D1, D2, D3, D4 - Vector - Aedes aegypti - Reservoir - Man, Aedes - Incubation period - 3 to 10 days - Diagnosis: Clinically - Torniquet test - >= 10 spots - Dengue fever ; >= 20 spots - Dengue hemorrhagic fever. Serologically - NS-1 Antigen Test comes positive even in 1st week. - Presentation: Dengue fever Dengue hemorrhagic fever Dengue shock syndrome - Backbone fever - Fever - Hemorrhagic features - Thrombocytopenia - Hemo-concentration - DHF +ve - Shock - Vaccine : DENGAVARIA , Strain: CYD - TDV ; recommended in age groups 9-45yrs
|
A
| null |
medmcqa
|
medmcqa_83
|
Deep flexors of forearm are supplied by
|
[
"Median nerve",
"Ulnar nerve",
"Radial nerve",
"Musculocutaneous nerve"
] |
Deep flexors of forearm are Flexor digitorum profundus, Flexor pollicis longus, and Pronator quadratus. Flexor digitorum medial half is supplied by Ulnar nerve and lateral half is supplied by the anterior interosseous nerve. Flexor pollicis longus and pronator quadratus are supplied by anterior interosseous nerve. REF:B D Chaurasia edition 7th page no:110.
|
B
| null |
medmcqa
|
medmcqa_84
|
Globi is -
|
[
"Histiocyte containing acid fast bacillus",
"Lymphocyte containing acid-fast bacillus",
"Neutrophile containing acid-fast bacillus",
"Large lymphocyte containing acid fast bacillus"
] |
Ans. is 'a' i.e., Histiocyte containing acid-fast bacillus
|
A
| null |
medmcqa
|
medmcqa_85
|
Selective reduction of multi chorionic multifetal gestation is performed around
|
[
"4 to 6 weeks",
"8 to 10 weeks",
"10 to 13 weeks",
"16 to 20 weeks"
] |
Selective Reduction Reduction of a selected fetus or fetuses in a multi chorionic multifetal gestation may be chosen as a therapeutic intervention to enhance survival of the remaining fetuses (ACOG, 2013a).Transabdominal fetal reductions are typically performed between 10 and 13 weeks. This gestational age is chosen because most spontaneous aboions have already occurred, the remaining fetuses are large enough to be evaluated sonographically, the amount of devitalized fetal tissue remaining after the procedure is small, and the risk of aboing the entire pregnancy as a result of the procedure is low. The smallest fetuses and any anomalous fetuses are chosen for reduction. Potassium chloride is then injected under sonographic guidance into the hea or thorax of each selected fetus(Ref: William's Obstetrics; 25th edition)
|
C
| null |
medmcqa
|
medmcqa_86
|
Right axis deviation is seen in all except –a) VSDb) Tricuspid atresiac) Pulmonary atresiad) ASD
|
[
"a",
"c",
"bc",
"ad"
] |
Normally, the QRS axis ranges from -30° to + 100°.
An axis more negative than -30° is referred to as left axis deviation.
An axis more positive than + 100° is referred to as right axis deviation.
Causes of left axis deviation (LAD)
Left ventricular hypertrophy
Left anterior fascicular block or hemiblock.
Inferior wall MI.
Causes of Right axis deviation (RAD)
Right ventricle overload (right ventricular hypertrophy
Left posterior fascicular block.
Lateral wall MI
Dextrocardia
Left pneumothorax
Now see the explanations of the previous question and you can easily solve this question.
Left ventricular hypertrophy causes LAD, and CHDs causing LVH are : -
1) VSD iii) Endocardial cushion ASD v) Truncus arteriosus
ii) PDA iv) COA (in older children) vi) Tricuspid atresia
vii) Pulmonary atresia
Right ventricular hypertrophy causes RAD, and CHD's causing RVH are : -
TGA
TAPVR
TOF
ASD
Eisenmenger's syndrome
COA (in infants)
About option 'a'
All patients with VSD are born with right ventricular hypertrophy, as the pulmonary vascular resistance decreases, RVH regresses and there is LVH. Hemodynamics of VSD will be explained in the respective question.
So, at birth VSD may show right axis deviation.
|
C
| null |
medmcqa
|
medmcqa_87
|
Which of the following medication is used to directly relax the lower esophageal sphincter?
|
[
"Diphenoxylate",
"Famotidine",
"Granisetron",
"Isosorbide dinitrate"
] |
Commonly used medications to relax the lower esophageal sphincter in patients with achalasia include nitrates such as isosorbide dinitrate (remember that nitric oxide physiologically inhibits the lower esophageal sphincter) and calcium channel blockers such as nifedipine (which inhibit calcium flow into the smooth muscle of the lower esophageal sphincter, thereby inhibiting contraction.) For patients in whom medical therapy fails, other options include paralysis of the lower esophageal sphincter with intrasphincteric injection of botulinum toxin, pneumatic dilatation, and a Heller myotomy (which interrupts the muscles of the lower esophageal sphincter). Also know: Diphenoxylate is an opiate antidiarrheal, and would not be useful for achalasia. Famotidine is an H2 antagonist that would be useful in reducing stomach acidity, but would not directly affect lower esophageal pressure. Other drugs in this class include cimetidine, ranitidine, and nizatidine. Granisetron is a 5HT3 antagonist and is used to prevent nausea and vomiting in patients who receive chemotherapy, and after general anesthesia. Other members of this drug class include ondansetron and dolasetron. Ref: Michel T., Hoffman B.B. (2011). Chapter 27. Treatment of Myocardial Ischemia and Hypeension. In L.L. Brunton, B.A. Chabner, B.C. Knollmann (Eds), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e.
|
D
| null |
medmcqa
|
medmcqa_88
|
Sucking releases which of the following from the anterior pituitary
|
[
"Prolactin",
"Oxytocin",
"Somatostatins",
"Somatomedins"
] |
Oxytocin a hypothalamic hormone stored in and released from the posterior pituitary; it may also be prepared synthetically or obtained from the posterior pituitary of domestic animals. It acts as a powerful stimulant to the pregnant uterus, especially toward the end of gestation, and also causes milk to be expressed from the alveoli into the lactiferous ducts during breastfeeding. Injection of oxytocin may be used to induce labor or strengthen uterine contractions during labor, to contract uterine muscle after delivery of the placenta, and to control postpaum hemorrhage.Ref: Ganong&;s review of medical physiology; 24th edition; page no:-311
|
B
| null |
medmcqa
|
medmcqa_89
|
Muscle supplied by glossopharyngeal nerve:
|
[
"Platysma",
"Stylopharyngeus",
"Styloglossus",
"Genioglossus"
] |
Stylopharyngeus is the only muscle in the pharynx innervated by the glossopharyngeal nerve (CN IX) and is done by its motor branch, which supplies special visceral efferent (SVE) fibers to it.
|
B
| null |
medmcqa
|
medmcqa_90
|
Which of the following anticancer drugs can cause a hypercoagulable state
|
[
"5–FU",
"L–asparginase",
"Melphalan",
"Carmustine"
] |
L-asparginase causes the breakdown of aspargine and thus interferes with protein synthesis. It can inhibit the production of clotting factors (responsible for cerebral hemorrhage) as well as anti-clotting proteins (can lead to cortical vein thrombosis and other hypercoagulable states).
|
B
| null |
medmcqa
|
medmcqa_91
|
The most metabolically active pa in bone is
|
[
"Coical bone",
"Cancellous bone",
"Periosteal surface",
"Endosteal surface"
] |
Endosteum is the most metabolically active pa in bone
|
D
| null |
medmcqa
|
medmcqa_92
|
Selenocysteine is derivative of which aminoacid -
|
[
"Serine",
"Alanine",
"Arginine",
"Glycine"
] |
Ans. is 'a' i.e., Serine o Selenocysteine is considered as 21" standard amino acid. o It is present at the active site of some enzymes that catalyze redox reactions, e.g. thioredoxin reductase, glutathione peroxidase, and the deiodinase (converts thyroxin to triiothyronine). o Biosynthesis of selenocysteine requires cysteine, serine, ATP and a specific t-RNA o Serine provides the carbon skeleton of selenocysteine. o Selenocysteine has a structure similar to cysteine, but containing the trace element selenium in place of sulfur atom of cysteine.
|
A
| null |
medmcqa
|
medmcqa_93
|
A patient presents to the emergency depament with uniocular diplopia. Examination with oblique illumination shows shining golden crescent while examination with co-axial illumination show a black dark crescent line. Which of the following is the most likely diagnosis.
|
[
"Ectopia lentis",
"Lenticonus",
"Coloboma",
"Microspherophakia"
] |
A i.e. Ectopia lentis
|
A
| null |
medmcqa
|
medmcqa_94
|
Characteristics of benign tumor of lung in X-ray is:
|
[
"Size > 5 cm diameter",
"Cavitation",
"Peripheral location",
"Concentric dense calcification"
] |
Ans. Concentric dense calcification
|
D
| null |
medmcqa
|
medmcqa_95
|
Color of postmoem lividity in hypothermic deaths: NEET 13
|
[
"Purple",
"Deep red",
"Cherry red",
"Bright pink"
] |
Ans. Bright pink
|
D
| null |
medmcqa
|
medmcqa_96
|
A 29-year-old woman with a ruptured ectopic pregnancy is admitted to a hospital for culdocentesis. A long needle on the syringe is most efficiently inseed through which of the following structures?
|
[
"Anterior fornix of the vagina",
"Posterior fornix of the vagina",
"Anterior wall of the rectum",
"Posterior wall of the uterine body"
] |
A needle should be inseed through the posterior fornix, just below the posterior lip of cervix while the patient is in supine position, to aspirate abnormal fluid in the cul-de-sac of Douglas (rectouterine pouch). Rectouterine excavation is not most efficiently aspirated by puncture of other structures.
|
B
| null |
medmcqa
|
medmcqa_97
|
When a person changes position from standing to lying down position , following occurs
|
[
"Venous return to heart rises rapidly",
"Decrease in blood flow to the lung apex",
"Heart rate increases and settles at a higher level",
"Cerebral blood flow becomes more than that in standing position and settles at a higher level"
] | null |
A
| null |
medmcqa
|
medmcqa_98
|
In amyloidosis Beta pleated sheet will be seen in-
|
[
"X-ray crystallography",
"Electron microscope",
"Spiral electron microscope",
"Congo red stain"
] |
Beta pleated sheets in amyloidosis is seen by X- ray crystallography. Basic Pathology, Robbins. Page no.:156
|
A
| null |
medmcqa
|
medmcqa_99
|
Which hormone does not act through cAMP ?
|
[
"TSH",
"Adrenaline",
"Insulin",
"ACTH"
] |
Ans. is 'c' i.e., Insulin
|
C
| null |
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