dataset string | id string | question string | choices list | rationale string | answer string | subject string |
|---|---|---|---|---|---|---|
medmcqa | medmcqa_22556 | What is ideal time for Preoxygenation? | [
"3-5 min",
"1- 3min",
"5-8 min",
"2-3 min"
] | Preoxygenation entails replacement of the nitrogen volume of the lung (as much as 95% of FRC) with oxygen in order to provide a reservoir for diffusion into the alveolar capillary blood after the onset of apnea. To provide effective preoxygenation, a methodical approach is necessary. The impoance of preoxygenation with a tight-fitting mask should be explained to the patient beforehand. Once preoxygenation is initiated, EtO2 and FIO2 values should be monitored closely. If the EtO2 value does not increase as expected, the anesthesia provider may have to hold the mask with both hands and/or replace the mask with a better-fitting one. Whenever possible, the induction should not sta until the EtO2 value approximates or exceeds 90%.. the ideal time period is 3 minutes. | A | null |
medmcqa | medmcqa_47100 | A patient presents with lower gastrointestinal bleed. Sigmoidoscopy shows ulcers in the sigmoid. Biopsy from this area shows flask-shaped ulcers. Which of the following is the most appropriate treatment? | [
"Intravenous ceftriaxone",
"Intravenous metronidazole",
"Intravenous steroids sulphasalazine",
"Hydrocoisone enemas"
] | Amoebic Colitis MC site of amoebic colitis : Cecum and ascending colon Flask shaped ulcers on colonoscopu confirms the diagnosis of amoebic colitis Drug Therapy for Amebiasis Asymptomatic carrier: Luminal agents (Iodoquinol, paromomycin) Acute colitis: Metronidazole and Luminal agents Amebic livet abscess: Metronidazole, tinidazole and Luminal agents Ref: Harrison&;s 19th edition Pgno : 1365 | B | null |
medmcqa | medmcqa_16510 | A 23-year-old male patient presented with a history of back pain, which is more in the morning and relieved by bathing in warm water. What is the likely additional finding present in this patient? | [
"Marrow fibrosis",
"Distal phalangeal joint involvement",
"Pleural nodules",
"Decreased chest wall expansion"
] | Ans. d. Decreased chest wall expansion (Ref: Harrison 19/e p2170, 18/e p2775)History of back pain, which is more in the morning and relieved by bathing in warm water is characteristic of spondylo arthropathy, like ankylosing spondylitis. Ankylosing spondylitis leads to extra-parenchymal restrictive lung disease, associated with decreased chest wall expansion."Ankylosing Spondylitis: The initial symptom is usually dull pain, insidious in onset, felt deep in the lower lumbar or gluteal region, accompanied by low-back morning stiffness of up to a few hours 'duration that improves with activity and returns following inactivity. "- Harrison 19/e p2170"Ankylosing Spondylitis: Initially; physical findings mirror the inflammatory process. The most specific findings involve loss of spinal mobility, with limitation of anterior and lateral flexion and extension of the lumbar spine and of chest expansion. Limitation of motion is usually out of proportion to the degree of bony ankylosis, reflecting muscle spasm secondary to pain and inflammation. Pain in the sacroiliac joints may be elicited either with direct pressure or with stress on the joints. In addition, there is commonly tenderness upon palpation at the sites of symptomatic bony tenderness and paraspinous muscle spasm. ''-- Harrison 19/e p2170A. Obstructive lung diseaseB. Restrictive lung disease* Asthma* Bronchiectasis* Bronchiolitis* Cystic fibrosis* COPD (Chronic bronchitis, Emphysema)Mnemonic- "ABCDE"ParenchymalExtra Parenchymal* Sarcoidosis* Pneumoconiosis* Idiopathic pulmonary fibrosis* Drug/Radiation induced interstitial lung disease* Neuromuscular diseases:- Diaphragmatic palsy- Guillain-Barre syndrome- Muscular dystrophy- Cervical spine injury* Chest wall diseases:- Kyphoscoliosis- Obesity- Ankylosing spondylitisAnkylosing Spondylitis/Marie-Strumpell or Bchtrew's diseaseEtiology & Pathogenesis:More than 90% patients of AS are HLA B27 positiveQ.The enthesis. the site of ligament attachment to bone is primary site of pathology in ASQ.Sacroilitis is the earliest manifestation with features of both enthesitis & synovitisQ.Clinical Presentation:Males are affected more frequently than females.Age of onset is 15-25 years (late adolescence & early adulthood )Q.The initial symptom is usually dull pain, insidious in onset, accompanied by low back morning stiffness of up to few hours duration that improves with activity and returns following period of inactivityQ.Arthritis in hips & shoulders (root joints) occur in 25-35%Q.Peripheral joints (usually shoulder, hips & knees) are involved in one third of patientsQ.Most serious complication of spinal disease is spinal fracture with even minor trauma.MC extra-articular manifestation is acute anterior uveitis (iridocyclitis)Q.Diagnosis:Radiological Examination(The following changes may be seen on an X-ray of the pelvis)* Haziness of sacro-iliac jointsQ* Irregular subchondral erosions in SI jointsQ* Sclerosis of the articulating surfaces of SI jointsQ* Widening of sacro-iliac joint spaceQ* Bony ankylosis of the sacro-iliac jointsQ* Calcification of the sacro-iliac ligaments and sacro- tuberous ligaments* Evidence of enthesopathy: Calcification at the attachment of the muscles, tendons and ligaments, particularly around the pelvis & heelQ.X-ray of Lumbar spine in Ankylosing Spondylitis* Squaring of vertebraQ: The normal anterior concavity of the vertebral body is lost because of calcification of the anterior tongitudinai ligament* Loss of lumbar lordosisQ* Bridging osteophytes (syndesmophytes)Q* Bamboo spine appearanceQ due to syndesmophytes & paravertebral ossificationTreatment:Phenylbutazone is the most effective drugQ (causes aplastic anemia).Indomethacin is most commonly used NSAIDQ. | D | null |
medmcqa | medmcqa_22304 | The most common tooth to get impacted (excluding the third molars) is | [
"Maxillary canine",
"Mandibular canine",
"Maxillary II premolar",
"Mandibular II premolar"
] | null | A | null |
medmcqa | medmcqa_45766 | Sequelae of Trachoma are all EXCEPT | [
"Ectropion",
"Entropion",
"Pinguecula",
"Corneal vascularization"
] | (Ectropion) (66-Khurana 4th) (168-Parson 20th)SEQUELAE OF TRACHOMA1. Sequelae in the lids - may be trichiasis, entropion** tylosis (thickening of lid margin) ptosis, maderosis and ankloblepharon2. Conjunctival sequelae - include concretions, pseudocyst xerosis and symblepharon3. Corneal sequelae - may be corneal opacity, ectasia, corneal xerosis and total corneal pannus blinding sequelae4. Other sequelae - may be chronic dacrocystitis, and chronic dacroadenitis* Trachoma causes superficial corneal vascularization* Pinguecula - degenerative condition formation of yellowish white patch on the bulbar conunctiva near the limbus, commonly in persons exposed to strong sunlight, dust and wind (same etiology of the Trachoma)* It affect the nasal side first & then the temporal side* ECTROPION - out rolling or outward turning of the lid margin is called ectropionTypes1. Senile ectropion - commonest variety2. Cicatricial ectropion - thermal bum, chemical bums lacerating injuries and skin ulcers3. Paralytic ectropion-paralysis of seventh nerve - Bell's palsy, head injury and infections of the middle ear4. Mechanical ectropion - tumours, as in proptoses and marked chemosis of the conjunctiva5. Spastic ectropion - spasm of the orbicularisFindings in TRACHOMA* Conjunctival follicles* (commonly on upper tarsals conjunctiva and fornix)* Papillary hyperplasia *** Conjunctival scaring* Herbert's pit*** Pannus*** Comeal ulcer, opacity & scarring* Vision 2020 - The five major eye conditions focusing are* Cataract** Trachoma** Onchocerciasis * * ** Childhood blindness* Refractive error and low vision* Arlt's line - fine linear scar in the sulcus subtarsalis in Trachoma*** The SAFE (Surgery, Antibiotics, Face washing, Environmental improvement) strategy for control of Trachoma*** Most common systemic association of scleritis is - Rheumatoid arthritis*** Lamina cribrosa (sieve like perforation in the posterior part of sclera) is absent in Morning glory syndrome** Sclera is thinnest at -posterior to attachment to superior rectus**** Telecanthus is - increase in intercanthal distance with normal interpupillary distance* Recurrent chalazion should be subjected to histopathologic evaluation to exclude the possibility of sebaceous cell carcinoma*** The comeal transparency is maintained by - Endothelium | A | null |
medmcqa | medmcqa_22377 | Investigation of choice for Interstitial Lung Disease? | [
"Plain chest X-ray",
"HRCT",
"MRI",
"Ultrasonography"
] | Ans. b (HRCT) (Ref. Harrison 18th/ p 1554)High Resolution Computerized Tomography # BASIC PRINCIPLE:- "Bone algorithm" (Basic Principle)0- Narrow beam collmation- 1 mm sections- Small field of view- Large matrix size# INDICATIONS (Investigation of choice for):- LUNGS:* Interstitial Lung Disease (ILD)* Bronchiectasis ("Signet-ring" sign)* Emphysema- PETROUS TEMPORAL BONE:* Cholesteatoma* Mastoiditis & Petrositis* Ossicular chain disruption* Congenital ear malformations* Facial canal fracture# Some Patterns of ILDs on HRCT:- "Groundglass" haziness is the earliest sign of almost all ILDs.0- "Honeycombing" correlates with end-stage disease.- "Tree in bud" apperance is seen in atypical mycobacterial infection/endobronchial TB.deg- "Crazy paving" is seen in several ILDs but is a distinct feature of Pulmonary Alveolar Proteiniosis.- Multiple discrete "lung cysts" and chylous pleural effusion in a postmenopausal women is chracteristic of lymphangioleomyomatosis.- "Mosaic perfusion" is also a feature of ILD.Also KnowDiseases with Predeliction for Upper Lung ZonesDiseases with Predeliction for Lower Lung ZonesExtrinsic allergic alveolitis (chronic hypersensitivity pneumonitis)Fibrosing alveolitisCWPAsbestosisLCHInterstitial pulmonary edemaAnkylosing spondylitisLymphangitis carcinomatosaSilicosis Sarcoidosis | B | null |
medmcqa | medmcqa_2487 | Which of the following fuel gases used for soldering, has the highest heat content | [
"Hydrogen",
"Natural gas",
"Acetylene",
"Propane"
] | null | D | null |
medmcqa | medmcqa_44954 | An increased dose of spinal anaesthetic is indicated in a patient who has/is | [
"Ascites",
"Increased height of the patient",
"Pregnant",
"Obese"
] | All others are reasons for decreasing the dosage | B | null |
medmcqa | medmcqa_39763 | Maximum radiation exposure is by | [
"Radiography",
"CT abdomen",
"Radionuclide scan",
"X-ray Abdomen"
] | Examination Effective total dose (mSv) Chest radiograph 0.06 Skull radiograph 0.2 Pelvis radiograph 0.65 Lumbar spine radiograph 1.3 Upper GI series (Barium) 2.45 Abdomen radiograph 0.55 Barium enema 2.8 to 4 IVP/IVU 1.6 Extremities 0.01 Enteroclysis 1.5 CT chest 8 CT abdomen 10 CT head 3.5 RNI 4.8 | B | null |
medmcqa | medmcqa_9590 | Sho acting anesthetic agent used for day care surgery is: September 2005, 2010 | [
"Diazepam",
"Ketamine",
"Propofol",
"Sevoflurane"
] | Ans.: C: Propofol Propofol is a sho-acting, intravenously administered hypnotic agent. Its uses include the induction and maintenance of general anaesthesia, sedation for mechanically ventilated adults, and procedural sedation. Propofol is unrelated to barbiturates, and has largely replaced sodium thiopental (Pentothal) for induction of anaesthesia because recovery from propofol is more rapid and "clear" when compared with thiopental. Propofol is not considered an analgesic, so opioids such as fentanyl may be combined with propofol to allete pain and it is the agent of choice for total intravenous anaesthesia (TIVA). It is used to produce sedation in ICU. It is the agent of choice for induction in susceptible individuals for malignant hypehermia. Due to its amnestic effects and appearance as a white liquid, propofol has been humorously dubbed "milk of amnesia". | C | null |
medmcqa | medmcqa_21413 | Which pa of the intrahepatic bile duct is involved in Type 2 cholangiocarcinoma ? | [
"Division of both ducts and not extending outside",
"Common hepatic duct only",
"Secondary hepatic ducts",
"Extends beyond hilum"
] | Cancers of the hepatic duct bifurcation have also been classified according to their anatomic location (BISMUTH'S CLASSIFICATION). In this system, Type I tumors are confined to the common hepatic duct. Type II tumors involve the bifurcation without involvement of secondary intrahepatic ducts. Type IIIa involves right secondary intrahepatic duct, Type IIIb involves left secondary hepatic duct. Type IV tumors involve the secondary intrahepatic ducts on both sides. | A | null |
medmcqa | medmcqa_39133 | Major current for depolarization in Purkinje fiber is of: | [
"Na+",
"Ca++",
"K+",
"Cl-"
] | Purkinje fiber is a fast-response type or rapidly depolarizing fiber. The rapid depolarization is due a rapid influx of Na+ through the fast Na+ channels. Major current for depolarization in pacemaker cells is due to Ca++ | A | null |
medmcqa | medmcqa_46633 | Which of the following is related to floor of middle ear? | [
"Round window",
"Internal carotid aery",
"Internal jugular vein",
"Tegmen tympani"
] | The floor or Jugular Wall of the middle ear is formed by a thin plate of bone which separates the middle ear from the superior bulb of the internal jugular vein. This plate is a pa of the temporal bone, Near the medial wall, the floor presents the tympanic canaliculus which transmits the tympanic branch of the glossopharyngeal nerve to the medial wall of the middle ear. Ref: BD Chaurasia's HUMAN ANATOMY, Volume 3, 4th edition. | C | null |
medmcqa | medmcqa_37245 | Which of the following is the most common functioning pancreatic islet cell tumour ? | [
"Gastrinoma",
"Glucagonoma",
"Insulinoma",
"Vipoma"
] | null | C | null |
medmcqa | medmcqa_29142 | In Anterior dislocation of the shoulder the nerve involved is: | [
"Radial nerve",
"Circumflex nerve",
"Ulnar nerve",
"Median nerve"
] | B i.e. Circumflex nerve - Most common early complication of anterior dislocation of shoulder is nerve injuryQ- Most commonly injured nerve in anterior dislocation of shoulder is circumflex branch of axillary nerveQ.- The higher frequency of circumflex nerve injury is accounted for by the sho fixed course of the nerve round the humerus which makes it difficult to escape traction when the humerus is displaced forwards.- Loss of axillary nerve function results in denervation of deltoid muscle (extension lag sign) & teres minorQ, and loss of sensation over proximal lateral aspect of arm (regimental batch area)Q. | B | null |
medmcqa | medmcqa_10434 | only epithelium in the body in which type4 collagen is absent in basal lamina: | [
"Oral epithelium",
"Sulcular epithelium",
"Gingival epithelium",
"Junctional epithelium"
] | null | D | null |
medmcqa | medmcqa_7793 | The most common finding associated With fibromyalgia syndrome is- | [
"High ESR",
"Musculoskeletal pain without local tenderness",
"Spontaneous resolution of symptoms",
"Tiredness and insomnia"
] | The defining symptoms of fibromyalgia are chronic widespread pain, fatigue, sleep disturbance, and heightened pain in response to tactile pressure (allodynia). Other symptoms may include tingling of the skin (paresthesias),prolonged muscle spasms without muscle tenderness weaknessin the limbs, nerve pain, muscle twitching, palpitations,and functional bowel disturbances. Ref Davidson 23rd edition pg 629 | B | null |
medmcqa | medmcqa_48582 | Which of the following does not go into chromic hepatitis stage - | [
"HBV",
"HCV",
"HDV",
"HEV"
] | Hepatitis E infection is mild&self limited&there is no carrier state. it does not lleadto chronic hepatitis REF:<\p> MICROBIOLOGY ANANTHA NARAYANAN NINTH EDITION PAGE.550 | D | null |
medmcqa | medmcqa_46714 | True about methicillin-resistant staphylococcus aureus (MRSA) -a) Isoxazolyl penicillin is highly effectiveb) All MRSA are multidrug resistantc) Vancomyin is effectived) MRSA are more virulent than sensitive strainse) Resistance develop due to altered binding protein | [
"bcde",
"abd",
"abcd",
"acde"
] | Methicillin resistance staphyloccus aureus (MRSA)
MRSA is a bacterium responsible for several difficult to treat infections in humans.
It may also be referred to as multidrug resistant staphyloccus aureus or oxacillin resistant staphylococcus aureus (ORSA)
MRSA is by definition any strain of staphyloccus aureus that is resistant to a β-lactams (including penicillin, methicillin, cloxacillin, nafcillin and oxacillin, cephalosporin).
Resistance develops due to alteration in transpeptidase (penicillin binding protein) on which all β-lactam antibiotic act → So, MRSA is resistant to all β-lactam antibiotics.
MRSA (especially community acquired MRSA; CA-MRSA) display enhanced virulence, spreading more rapidly and causing disease much more severe than traditional staphylocccus aureus.
Vancomycin is the DOC for MRSA. | A | null |
medmcqa | medmcqa_26621 | All are measures of dispersion around central value except- | [
"Mode",
"Variance",
"Standard deviation",
"Standard error of mean"
] | Mode is a measure of central tendency not dispersion around central tendency.
Measure of dispersion (variation)
The measures of central tendency (mean, median, mode) serve to locate the center of distribution, but they do not reveal how the items are spread out on either side of the center.
This characteristic of a frequency distribution is commonly referred to as dispersion.
There are measures to obtain this dispersion, commonly known as measures of dispersion or measures of variation.
There are two kinds of measures of dispersion -
i) Absolute measures of dispersion
Indicates the amount of dispersion (variation) in terms of unit.
For example, when rainfall on different days are available in mm (unit of rainfall), any absolute measure of dispersion gives the variation in rainfall in mm.
In simple words, absolute measure of dispersion has a unit.
ii) Relative measures of dispersion
In contrast to absolute measures, relative measures are free from the units.
They are pure numbers.
They are used to compare variation in two or more sets, which are having different units of measurements of observations.
Absolute measure
Range
Quartile deviation
Mean deviation
Standard deviation
Relative measure
Co-efficient of range
Co-efficient of quartile deviation
Co-efficient of mean deviation
Co-efficient of variation
Measures of dispersion used
To compare variation in two or more sets, which have same units → Absolute measures.
To compare variation in two or more sets, which have different units → relative measures. | A | null |
medmcqa | medmcqa_29100 | Gonococci have affinity for - | [
"Vaginal mucosa",
"Epithelium of urethra",
"Testis",
"All of the above"
] | Ans. is 'b' i.e., Epithelium of urethra "The pili of gonococcus has affinity for the columnar epithelium of urethra". -- Richard M Hyde"Virulent gonococci have affinity to adhere to urethral epithelial cells even in the presence of the violent flushing of urine".* N. gonorrhoeae is exclusively (obligate) a human pathogen although chimpanzees have been infected artificially.It is never found as a normal commensal although a proportion of those infected, particularly women, may remain asymptomatic. The asymptomatic carrier is the major reservoir.* Incubation period is 2-8 days.* The important infections caused by gonococci are:-1) Males# Acute urethritis is the most common manifestation. Prostate, seminal vesical and epididymis may also be involved.* Testis is usually spared.2) Females# Cervicitis is the most common manifestation, which primarily infects cervical os. Infection may spread to cause salpingitis, urethritis, endometritis, peritonitis and perihepatitis (fitz-hugh-curtis syndrome).# The vaginal mucosa of healthy women is lined by stratified squamous epithelium and is usually not infected by N. gonorrhoeae however, gonococcal vaginitis can occur in anestrogenic women (eg. prepubertal girls and postmenopeusal women) in whom the vaginal stratified epithelial layers are often thinned down to basilar layer, which can be infected by N. gonorrhoea.3) Other infections# These are anorectal gonorrhea (proctitis), pharyngeal gonorrhea, ocular gonorrhea and in children vulvovaginitis.4) Gonorrhea in neonates# The most common form of gonorrhea in neonates is ophthalmia neonatorum which results from exposure to infected cervical secretions during parturition.# Ocular neonatal instillation of a prophylactic agent is a cost effective measure for the prevention of ophthalmia neonatorum.# Septic arthritis is the most common manifestation of systemic infection.5) Disseminated gonococcal infection (DGI) or Gonococcal arthritis# It is produced by strains of Pori A serotype of gonococci. It has two stages:-i) Stage I (Bacteremic stage): There is bacteremia with polyarthralgia and skin lesions (papule, pustules).ii) Stage II (Suppurative arthritis): There is pyogenic arthritis which may cause complications (endocarditis, meningitis). | B | null |
medmcqa | medmcqa_11082 | For resuscitation in burn shock the following transfusion is advised | [
"Plasma",
"Packed cell volume",
"Whole blood volume",
"Crystalloids & Colloids"
] | (D) Crystalloids & Colloids # Both crystalloid and colloid solutions are equally effective in restoring cardiac output and intravascular volume.> PARKLANDS formula for total fluid requirement in 24 hrs; 4 ml *TBSA%* body weight in kgs: 50% give in first 8 hrs | D | null |
medmcqa | medmcqa_19540 | Hypophosphatemia is a caused by | [
"Primary hypothyroidism",
"Primary hyperparathyroidism",
"Primary hyperthyroidism",
"Hypoparathyroidism"
] | null | B | null |
medmcqa | medmcqa_36529 | Which of the following mucopolysaccharidosis present with clear cornea? | [
"Hurler disease",
"Hunter disease",
"Scheie disease",
"Morquio disease"
] | Hunter's disease and sanfilippo disease present with clear cornea. | B | null |
medmcqa | medmcqa_12573 | SLE like reaction is caused by? | [
"Hydralazine",
"Rifampicin",
"Paracetamol",
"Furosemide"
] | ANSWER: (A) HydralazineREF: Harrison's Internal Medicine 17th ed chapter 113The list of substances that can induce lupus-like disease is long. Among the most frequent are;Antiarrhythmic: procainamide, disopyramide, and propafenoneAntihypertensive: hydralazine; several angiotensin-converting enzyme inhibitors and beta blockersAntithyroid: propylthiouracilAntipsychotics: chlorpromazine and lithiumAnticonvulsants: carbamazepine and phenytoinAntibiotics: isoniazid, minocycline, and macrodantinAntirheumatic: sulfasalazineDiuretic: hydrochlorothiazideAntihyperlipidemics: lovastatin and simvastatinInterferons and TNF inhibitors | A | null |
medmcqa | medmcqa_32056 | The staging system for thymoma was developed by: | [
"Masaoka",
"Yokohama",
"Todani",
"Kluive"
] | The staging system for thymoma was developed by Masaoka The stage is increased on the basis of the degree of invasiveness. The 5-year survival in stage I, 96%; stage II, 86%; stage III, 69%; stage IV, 50%. The French Study Group on Thymic Tumors (GETT) has modified the Masaoka scheme based on the degree of surgical removal. Ref: Harrison, E-18, chapter e-20. | A | null |
medmcqa | medmcqa_27480 | Which of the following represents the indication for In-situ DNA nick end labeling technique? | [
"To detect fraction of cells in apoptotic pathways",
"To detect fraction of cells in S phase",
"To detect p53 gene product",
"To detect bcr/abl gene"
] | It is an in-situ method for detecting areas of DNA which are nicked during apoptosis.In-situ methods for labeling apoptotic cells are used to demonstrate the DNA fragments produced by endonucleolytic cleavage directly within tissue sections. The in-situ methods makes use of enzymes that label 3'-OH ends that results from endonucleolytic cleavage, the terminal deoxynucleotidal transferase mediated UTP nick end labeling (TUNEL) reaction employs terminal deoxynucleotidal transferase TdT. Ref: Molecular Genetic Testing in Surgical Pathology By John D. Pfeifer, Page 116; The Journal of Histochemistry and Cytochemistry, Volume 47(5), Pages 711- 717 | A | null |
medmcqa | medmcqa_10767 | Not a cause of Gynaecomastia: | [
"INH",
"Cimetidine",
"Digitalis",
"Pyrazinamide"
] | Pyrazinamide | D | null |
medmcqa | medmcqa_47697 | In a rape indence occurred in child of 5yrs the hymen is | [
"Ruptured because it is thin",
"Ruptured because it is situated superficially",
"Don't rupture because it is thick and elastic",
"Dont rupture because it is situated deeply"
] | ref : narayana reddy | D | null |
medmcqa | medmcqa_14476 | Double blind study means: | [
"Observer is blind about the study",
"Person or group being observed is blind about the study",
"Both observer and person or group being observed is blind about the study",
"Interpreters and analyzer are blind about the study"
] | Blinding:
Blinding can be done in three ways:
(a) Single blind trial: The trial is to planned that the participant is not aware whether he belongs to the study group or control group.
(b) Double blind trial: The trial is to planned that neither the investigator nor the participant is aware of the group allocation and the treatment received.
(c) Triple blind trial: The participant, the investigator and the person analyzing the data are all "blind'.
Ideally, of course, triple blinding should be used, but double blinding is the most frequently used method.
Reference: Essentials of Preventive and Community Dentisitry, Soben Peter , 4th ed page no 73 | C | null |
medmcqa | medmcqa_25062 | Which does not requires BIOTIN? | [
"Acetyl CoA to Malonyl CoA",
"Pyruvate to Oxaloacetate",
"Glutamate to GABA",
"Propionyl CoA to Methyl Malonyl CoA"
] | Biotin (Vitamin B7) is required mainly in carboxylation reactions- Acetyl CoA to Malonyl CoA is done by enzyme Acetyl CoA carboxylase. Pyruvate to Oxaloacetate is done by enzyme Pyruvate carboxylase. Propionyl CoA to Methyl Malonyl CoA is done by enzyme Propionyl CoA carboxylase. =Glutamate to GABA conversion is a simple decarboxylation reaction, which requires vitamin B6 i.e. Pyridoxine. ADDITIONAL INFORMATION ON BIOTIN: Biotin is a prosthetic group for all carboxylases. But there are few carboxylation reactions which do not require Biotin.They are : CPS-I and II (Carbamoyl Phosphate Synthetase ). CO2 addition in C6 of purines. Pyruvate (3C) to Malate (4C) conversion by Malic enzyme Gamma Carboxylation of Glutamate (Vitamin K required, not Biotin). | C | null |
medmcqa | medmcqa_47669 | All are true regarding Jarisch-Hexiemer's reaction, except | [
"Occurs in late syphilis",
"Acute febrile reaction",
"Ophthalmic involvement worsens",
"Prednisolone for 3 days given in treatment"
] | (C) Ophthalmic involvement worsens # Jarisch-Herxheimer reaction:> The Herxheimer reaction (also known as or Herx) occurs when large quantities of toxins are released into the body as bacteria (typically Spirochete bacteria) die, due to antibiotic treatment or rapid detoxification.> Typically the death of these bacteria and the associated release of endotoxins occur faster than the body can remove the toxins via the natural detoxification process performed by the kidneys and liver.> It is manifested by fever, chills, headache, myalgia (muscle pain), and exacerbation of skin lesions.> Duration in syphilis is normally only a few hours but can be much longer, up to months or years, for other diseases.> The intensity of the reaction reflects the intensity of inflammation present.> The Herxheimer reaction has shown an increase in inflammatory cytokines during the period of exacerbation, including tumor necrosis factor alpha, interleukin-6 and interleukin-8.> The reaction is also seen in other diseases, such as borreliosis (Lyme disease and tick-borne relapsing fever, bartonellosis, brucellosis, typhoid fever, and trichinellosis and Q fever). | C | null |
medmcqa | medmcqa_39201 | ‘A’ wave in Electro Retinogram corresponds to the activity | [
"Rods and cones",
"Pigment epithelium",
"Ganglion cell layer",
"Nerve fibre layer"
] | The electroretinogram (ERG) is a diagnostic test that measures the electrical activity generated by neural and non-neuronal cells in the retina in response to a light stimulus. The electrical response is a result of a retinal potential generated by light-induced changes in the flux of trans retinal ions, primarily sodium and potassium.
A-wave: initial corneal-negative deflection, derived from the cones and rods of the outer photoreceptor layers.
This wave reflects the hyperpolarization of the photoreceptors due to the closure of sodium ion channels in the outer segment membrane. Absorption of light triggers the rhodopsin to activate transducin, a G-protein. This leads to the activation of cyclic guanosine monophosphate phosphodiesterase (cGMP PDE) eventually leading to a reduction in the level of cGMP within the photoreceptor. This leads to closure of the sodium ion channels resulting in a decrease of inwardly directed sodium ions, or a hyperpolarization of the cell. The a-wave amplitude is measured from the baseline to the trough of the A-wave. | A | null |
medmcqa | medmcqa_36565 | True about anaphylactoid reaction caused by NSAIDs- | [
"Caused by all NSAIDs",
"COX-2 inhibitors are safe",
"Related to hypersensitivity reaction",
"Not related to inhibition of COX"
] | Ans. is 'b' i.e., COX-2 inhibitors are safe | B | null |
medmcqa | medmcqa_2926 | A 38 year old female presents to the physician with complaints of excessive thirst and urination for the past 4 weeks. Her appetite has been normal and she has not had diarrhea. Blood chemistry showed mildly elevated glucose and glucagon. Physical examination reveals tenderness in the left upper quadrant and an erythematous necrotizing skin eruption on her legs. Radiographic studies show a tumor in the pancreas. Which of the following cells is responsible for this lesion? | [
"Acinar cell",
"Alpha cell",
"Beta cell",
"Delta cell"
] | The symptoms described are typical for a patient with glucagon excess. Glucagon is secreted by alpha cells of the pancreatic islets of Langerhans. Increased levels are rare, usually due to carcinoma (70%) or adenoma (30%) of the islets. Two-thirds of patients with carcinoma have liver metastasis at the time of diagnosis. Increased glucagon causes a syndrome similar to diabetes mellitus, due to antagonism of insulin effects. Patients also have migratory skin rashes, alopecia, hyperpigmentation of the skin, and glossitis. Diagnosis is made by measuring glucagon. The acinar cell , the main exocrine cell of the pancreas, contains digestive enzymes. Increases in the release of these enzymes (especially amylase and lipase) occur with pancreatitis. Acute pancreatitis is considered an emergent medical condition. Chronic pancreatitis is associated with fibrosis and atrophy of the acinar structures. Beta cells are responsible for insulin release. An adenoma of beta cells (insulinoma) would cause hyperinsulinism. 70% are solitary and 10% are multiple. Insulinomas cause hypoglycemia, dizziness, confusion, and excessive sweating. Glucose needs to be given promptly to avoid coma and death. Diagnosis is made by finding increased insulin and hypoglycemia. Delta cells are islet cells that secrete somatostatin. Tumors producing increased somatostatin are usually malignant. Clinically, a diabetes mellitus-like syndrome occurs along with diarrhea. Diagnosis is made from elevated serum somatostatin levels, but can be difficult because of the hormone's sho half-life. Ref: German M.S. (2011). Chapter 17. Pancreatic Hormones and Diabetes Mellitus. In D.G. Gardner, D. Shoback (Eds), Greenspan's Basic & Clinical Endocrinology, 9e. | B | null |
medmcqa | medmcqa_10518 | Ground glass cells of Hadziyannis are seen in | [
"Bone",
"Liver",
"Thyroid",
"Prostate"
] | Ans. is 'b' i.e., Liver | B | null |
medmcqa | medmcqa_7612 | Local anaesthetic usually used for retrobulbar block - | [
"Bupivacaine",
"Procaine",
"Tetracaine",
"Prilocaine"
] | Ans. is 'a' i.e., BupivacaineRetrobulbar anaesthesiao In this technique local anaesthetic is injected behind the eye into the cone formed by extraocular muscles.o Retrobulbar injection is given with a special needle which is having a rounded tip. This needle penetrates the lower lid at the junction of the middle and lateral one third of the orbit (usually. 5 cm medial to the lateral canthus).o Choice of local anaesthetic varies, but lidocaine 2% and bupivacaine 0.75% are most common,o To enhance the retrobulbar spread of local anaesthetic Hyaluronidase, a hydrolyzer of connective tissue polysaccharide is frequently added.o A properly placed retrobulbar injection is effective within second and blocks all extraocular muscles except the superior oblique muscle, affects the ciliary ganglion (resulting in pupillary dilatation) and anesthetizes the entire globe. | A | null |
medmcqa | medmcqa_3894 | Drug contraindicated in pregnancy is : | [
"Enalapril",
"Hydralazine",
"Frusemide",
"Aldactone"
] | Frusemide | C | null |
medmcqa | medmcqa_29502 | A boy presented in the OPD with minimal pleural effusion on the right side. The best method to detect this would be : | [
"Left side chest X-ray",
"Right side chest X-ray",
"Right lateral decubitus chest X-ray",
"Left lateral decubitus chest X-ray"
] | Ans. is 'c' is Right lateral decubitus chest X-ray Most dependent recess of the pleura is the posterior costophrenic angle*.So in pleural effusion this recess would be filled earliest. But at least 100-200 ml of fluid would be required to fill this recess before it can be detected on a PA view.Therefore in cases of minimal pleural effusion the best method to detect it would be- Decubitus view with a horizontal beam. | C | null |
medmcqa | medmcqa_10354 | Subacute sclerosing panencephalitis is associated with - | [
"Mumps",
"Measles",
"Exanthema subitum",
"Erythema infectiosum"
] | Subacute sclerosing panencephalitis This is a rare, chronic, progressive and eventually fatal complication of measles, presumably a result of an inability of the nervous system to eradicate the virus. It occurs in children and adolescents, usually many years after the primary virus infection. There is generalised neurological deterioration and onset is insidious, with intellectual deterioration, apathy and clumsiness, followed by myoclonic jerks, rigidity and dementia. The CSF may show a mild lymphocytic pleocytosis and the EEG demonstrates characteristic periodic bursts of triphasic waves. Although there is persistent measles-specific IgG in serum and CSF, antiviral therapy is ineffective and death ensues within a few years. Ref Harrison 20th edition pg 1011 | B | null |
medmcqa | medmcqa_15639 | Main cause of congestive splenomegaly. | [
"CCF",
"Malaria",
"DIC",
"Banti syndrome"
] | Ans. (d) Banti syndromeRef: Internet sourcesBanti syndrome:* Congestive splenomegaly caused by obstruction of Portal veins, Splenic Veins, Hepatic veins resulting in Portal hypertension, Ascites, Thrombocytopenia, Leukopenia and Upper GI haemorrhage. | D | null |
medmcqa | medmcqa_31285 | atural family planning method ? | [
"Abstinence",
"Coitus interruptus",
"BBT",
"Safe peroid"
] | Ans. is 'c' i.e., BBT Miscellaneous methods of contraceptions o These are (i) Abstinence, (ii) Coitus interruptus, (iii) Safe period (rhyth method), and (iv) Natural family planning methods. Abstinence o There is complete abstinence from sexual intercourse. It is not used and can hardly be considered as a method of contraception to be advocated to the masses. Coitus interruptus o It is the oldest method of voluntary feility control. The male withdraws before ejaculation, and thereby tries to prevent deposition of semen into vagina. Failure rate is very high 25%. Natural family planning methods o These are :- i) Basal body temperature (BBT) method : It is based on the principle that there is rise BBT at or just before ovulation. ii) Cervical mucus method (Billings method or ovulation method) : It is based on the observation that at the time of ovulation cervical mucus becomes watery clear resembling raw egg white, smooth, slippery and profuse. iii) Symptothermic method : This method combines temperature, cervical mucus and safe period (calender method) methods. | C | null |
medmcqa | medmcqa_36479 | The Electron Microscopy is viually diagnostic in renal biopsy study of: | [
"Goodpasture's syndrome",
"Churg-Strauss syndrome",
"Alpo syndrome",
"Wegner's granulomatosis"
] | For Alpo syndrome, the most diagnostic morphologic lesion is seen only by electron microscopy as an irregularly thickened GBM, with splitting of the lamina densa into interlacing lamellae that surround electron-lucent areas. | C | null |
medmcqa | medmcqa_22055 | An infant can regard his parent's face, follow to midline, lift his head from the examining table, smile spontaneously, and respond to a bell. He does not yet regard his own hand, follow past midline, nor lift his head to a 45deg angle off the examining table. Which of the following is the most likely age of the infant? | [
"1 month",
"3 months",
"6 months",
"9 months"
] | At one month, infants typically regard face, follow items to the midline, begin to vocalize, respond to a bell, and lift their head from the examining table. An 8-week-old child normally should be able to smile and coo when smiled at or talked to. Not until about 3 months of age would an infant be expected to follow a moving toy from side to side and also in the vertical plane. | A | null |
medmcqa | medmcqa_34390 | Which of the following is indicated by the pedigree given below? | [
"Adopted into family",
"Adopted out of family",
"Identical twins",
"Nonidentical twins"
] | null | C | null |
medmcqa | medmcqa_4296 | Which of the following drugs is most useful for acute depression and has good side effect profile? | [
"RIMA",
"SSRIs",
"Tricyclic Antidepressants",
"Non selective MAO-inhibitors"
] | Most effective drug for acute depression is SSRI i.e. Selective serotonin reuptake inhibitors. They are drug of choice for the same. They have very less side effects as compared to tricyclic antidepressants. | B | null |
medmcqa | medmcqa_28089 | A 53-year-old woman presents with a 1-cm invasive carcinoma of the breast, detected on mammography. She feels well and has no other symptoms. On examination the lump is palpable, and there are no axillary lymph nodes. Which of the following is the most appropriate local therapy for her tumor? | [
"simple mastectomy with axillary dissection",
"radiation therapy to breast and axilla",
"local excision plus radiation therapy",
"local excision and axillary dissection followed by radiation therapy"
] | Breast-conserving surgery is now recommended for small tumors. Radiation therapy will decrease local recurrence rates. For tumors < 1 cm, adjuvant therapy is indicated only if axillary nodes are positive. Therefore, in this case, an axillary dissection will provide important therapeutic information. However, this is an area of rapidly changing knowledge and practice. | D | null |
medmcqa | medmcqa_22922 | Most common location of carcinoid in GI tract is | [
"Stomach",
"Small bowel",
"Appendix",
"Colon"
] | Relative distribution of neuroendocrine tumours in different organs.Appendix40%Small bowel25%Rectum15%Lung10%Colon6%Stomach5%Duodenum2%Ref: Bailey and Love 27e pg: 853 | C | null |
medmcqa | medmcqa_30883 | A 24-year-old female graduate student repos increasing shoness of breath with exercise and has recently noticed dyspnea on mild activity. One day before presenting at the office, she experienced sudden loss of consciousness while shopping at a grocery store. On physical examination, vital signs are: pulse 88 bpm; temperature 97.8degF; respirations 18/min; blood pressure 100/70 mm Hg. BMI is 34. ABGs on RA: pH 7.43; PCO2 36 mm Hg; PO2 87 mm Hg. Chest x-rays are shown in.The clinical and chest radiographic diagnosis may be commonly associated with | [
"A loud A2 on cardiac auscultation",
"Right arm swelling",
"Rib notching",
"A loud P2 on cardiac auscultation"
] | The lateral view shows that the anterior clear space behind the sternum is occupied above a poion of the lower one-third of the cardiac shadow. The truncus of the right pulmonary aery seen in front of the trachea is very large and the left main pulmonary aery coursing over the left upper lobe bronchus is greater than 16 mm. These findings are consistent with pulmonary aerial hypeension. The chest x-ray shows large pulmonary aeries, and this, coupled with the clinical scenario, is consistent with primary pulmonary hypeension (PPH). As mentioned in the general discussion, this entity is due to an unknown cause. The physical sign most likely to be present would be a loud P2, and right hea catheterization would confirm the high pulmonary aery (PA) pressures. Patients with PPH may give a history of syncopal episodes. A loud A2 is heard in systemic hypeension, and rib notching is classically seen on the x-ray in coarctation of the aoa. Right arm swelling is seen with either a localized vascular or lymphatic obstruction such as postradiation, malignancy, or superior vena cava syndrome. This patient does not exhibit any of these signs. Since the hilar shadows are of vascular nature, mediastinoscopy or bronchoscopy would not be indicated and in fact may be dangerous if PA pressures are very high. | A | null |
medmcqa | medmcqa_27732 | Armoured Endotracheal tube is used in: | [
"Pediatric surgery",
"Neurosurgery",
"Cardiac surgery",
"Thoraxic surgery"
] | Neurosurgery | B | null |
medmcqa | medmcqa_3296 | According to International Health Regulations, there is no risk of spread of yellow Fever if the Aedes aegypti index remains below | [
"5%",
"1%",
"10%",
"8%"
] | International Health Regulations (IHRs) of WHO covers 7 diseases:
– Cholera
– Plague
– Yellow Fever
– Smallpox
– Wild Polio Virus
– Human Influenza
– SARS
International measures to restrict the spread of Yellow Fever (IHRs):
– Travellers:
- Must possess a valid International certificate of vaccination (validity 10days – 10yrs) against YF before they enter ‘YF receptive areas’
- If no such certificate available: Quarantine for 6 days (Max I.P of YF) from date of leaving an infected area
- If traveller arrives before certificate becomes valid (10 days after vaccination): Isolate till it becomes valid
Mosquitoes:
- Aircrafts/ships arriving from endemic areas: Aerosol spray to kill insect vectors
- Airports/ seaports kept free from vector breeding: at least 400 meters around boundary
- Aedes aegypti index: kept below 1% | B | null |
medmcqa | medmcqa_41496 | A 30 year old man had a road traffic accident and sustained fracture of femur. Two days later he developed sudden breathlessness. The most probable cause can be: | [
"Pneumonia",
"Congestive heart failure",
"Bronchial asthma",
"Fat Embolism"
] | Ans. D. Fat EmbolismThe fat globules released from the bone marrow (due to trauma/orthopedic procedures) are deposited in the pulmonary capillary bed. This causes ischemia and inflammation. The symptoms appear 12-72 hours after the trauma. Initial symptoms are tachycardia and tachypnea. There may be high spiking fever and non-palpable petechiae, especially over upper body.Neurological symptoms like agitation, delirium, stupor and coma can occur. (The fat globules may cross the pulmonary circulation via arteriovenous connections). | D | null |
medmcqa | medmcqa_37806 | Alvarado score is used for | [
"Acute cholecystitis",
"Acute appendicitis",
"Acute apncreatitis",
"Acute epidydimitis"
] | Answer- B. Acute appendicitisScoring system for Acute Appendicitis: Alvarado Score:The diagnosis of appendicitis is based primarily on clinical history and physical examination assisted by blood counts. A number of clinical and laboratory based scoring systems have been devised to assist diagnosis.The most widely used scoring system is Alvarado score. | B | null |
medmcqa | medmcqa_32489 | A 58-year-old woman presents with a 2-month history of abdominal discomfort and dark stools. Physical examination shows pallor but no evidence of jaundice. Laboratory studies disclose a microcytic, hypochromic anemia, with a hemoglobin level of 6.7 g/dL. A barium swallow radiograph reveals a "leather bottle" appearance of the stomach. Microscopic examination shows diffusely infiltrating malignant cells, many of which are "signet ring" cells, in the stomach wall. Which of the following is the most likely diagnosis? | [
"Fungating adenocarcinoma",
"Gastric leiomyosarcoma",
"Gastric lymphoma",
"Linitis plastica"
] | Diffuse adenocarcinoma constitutes10% of all stomach cancers. No true tumor mass is seen macroscopically. Instead, the wall of the stomach is conspicuously thickened and firm, accounting for the radiologic "leather bottle" appearance. When the entire stomach is involved, the term linitis plastica is applied. The invading tumor cells induce extensive fibrosis in the submucosa and muscularis of the stomach wall. Gastric carcinomas typically metastasize to regional lymph nodes and the liver. Signet ring cells are so named because intracellular mucin displaces the nuclei to the periphery of the tumor cells. Gastric carcinomas and linitis plastica, in particular, have a poor prognosis. The other choices do not show the characteristic morphologic appearance of linitis plastica and generally do not exhibit signet ring cells.Diagnosis: Gastric adenocarcinoma | D | null |
medmcqa | medmcqa_1571 | The incidence of mental illness is the maximum if the causal factors affect a paicular period - | [
"Perinatal period",
"First five years of life",
"School age",
"Adolescence"
] | The incidence of mental illness is the maximum if the causal factors affect a paicular period of first five years of life crucial points in the life cycle of human being which are impoant from the view of mental health are prenatal period, first five years of life, school child , adolescence, old age. ref ;(page no;832)23rd edition of PARK&;s textbook of Preventive and Social medicine | B | null |
medmcqa | medmcqa_35273 | Neurological complications following rabies vaccine are common with | [
"Duck egg vaccine",
"Chick embryo vaccine",
"Semple vaccine",
"HDCS vaccine"
] | (B) Chick embryo vaccine # Egg vaccines:> Duck egg vaccine prepared from a fixed virus adapted for growth in duck eggs and inactivated with beta propiolactone was used, but was discontinued because of its poor immunogenicity. A purified, more potent duck egg vaccine was developed, but was supplanted by tissue culture vaccines which became available then,> Live attenuated chick embryo vaccines: two types of vaccines were developed with the Flury strain-the Low Egg Passage (LEP) vaccine at 40-50 egg passage level for immunisation of dogs and the High Egg Passage (HEP) vaccine at 180 passage level for cattle and cats, these are not in use now because of their high neurological complications. | B | null |
medmcqa | medmcqa_22320 | Treatment of choice in nasopharyngeal carcinoma. | [
"Chemotherapy",
"Radiotherapy",
"Chemo given with radiation",
"Surgery"
] | Radiotherapy: It is the treatment of choice for nasopharyngeal cancer. Stage I and II are treated by radiotherapy alone while Stage III and IV require concomitant radiation and chemotherapy or radiation followed by chemotherapy. | B | null |
medmcqa | medmcqa_3222 | The highest frequency of palpable metastasis in neck on presentation is - | [
"Carcinoma tongue",
"Buccal mucosa",
"Alveolus",
"Lip"
] | "Among oral cavity cancers, cancers of the mobile tongue have a high incidence of occult and clinical cervical lymph node metastasis".
─ Head & Neck surgery : otolaryngology | A | null |
medmcqa | medmcqa_8506 | Which group of streptococcus grow at > 60degC - | [
"A",
"B",
"C",
"D"
] | Option 1, 2, 3 Heat tolerance test (60oC) is negative for Group A, B, C Streptococci. Option 4 Enterococcus is heat resistant. Enterococcus grows in presence of 6.5% NaCl, pH 9.6 and temperature >55oC which differentiate it from Group D streptococci. | D | null |
medmcqa | medmcqa_54736 | Which of the following is NOT a content of medial wall of middle ear: | [
"Oval window",
"Round window",
"Processus cochleariformis",
"Aditus ad antrum"
] | Ans. (d) Aditus ad antrumReft Dhingra's ENT 6th edj 5-6* Aditus ad antrum is located on posterior wall. It is a doorway to antrum of mastoid.* Antrum is largest mastoid air cell. | D | null |
medmcqa | medmcqa_12123 | Which of the following drugs cause relaxation of LES? 1. Nitrates 2. Histamine blockers 3. Morphine 4. Atropine 5. Calcium channel blockers | [
"1,2 & 3",
"1,4 & 5",
"1,2 & 5",
"All"
] | Factor causing relaxation of LES Factor increasing LES pressure Pharmacological agents:nitrates, anticholinergics, barbiturates, calcium channel blockers, caffeine, theophylline, diazepam, dopamine, prostaglandin E1 and E2 and meperidine Pepperdine Chocolate Coffee Alcohol Smoking Fat Antacids Cholinergics Domperidone Metoclopramide Prostaglandin F2 Also know: LES pressure is higher in the supine position than in the upright position. Ref: Schwarz 9/e, Page 812; Harrison 17/e, Page 1741. | B | null |
medmcqa | medmcqa_12219 | Centroacinar cells are present in ? | [
"Pancreas",
"Parotid gland",
"Prostate",
"None"
] | Ans. is 'a' i.e., Pancreas Pancreas It is a mixed exocrine and endocrine gland. A . Exocrine pa The exocrine poion is a compound acinar gland, consists of pancreatic acini. The acini of pancreas consist of a group of pyramid-shaped acinar cells' (pancreatic parenchymal cells) arranged around a small lumen. The centroacinar-cells are seen at the centre of acini where the duct system begins. These cells are an extension of the intercalated duct cells into the acinus. They add bicarbonate ions to pancreatic juce. Individual acini are drained by intercalated ducts (interalobular ducts), which drain into larger interlobular ducts, found in connective tissue septa. B. Endocrine pa Islets of Langerhans constitute the endocrine pa and are scattered throughout the exocrine pa, most abundandly in tail region. | A | null |
medmcqa | medmcqa_11936 | Lathyrism results due to: | [
"Aflatoxin",
"BOAA",
"Pyruvic acid",
"Sanguinarine"
] | BOAA | B | null |
medmcqa | medmcqa_7966 | Earliest symptom of Congenital Glaucoma | [
"Lacrimation",
"Blepharospasm",
"photophobia",
"Diminision of vision"
] | Earliest but nonspecific symptom of Congenital Glaucoma is photophobia | C | null |
medmcqa | medmcqa_32694 | A 36 month old girl shows frontal bossing and wrist enlargement. Diagnosis is - | [
"Rickets",
"Scurvy",
"Beri Beri",
"Osteomalacia"
] | Ans. is 'a' i.e., RicketsClinical features of ricketso Clinical manifestations of rickets are usually manifested by 6 months of age. Rickets is unusual below the age of 3 months.Clinical features of rickets are :o Skull: Craniotabes (earliest manifestation), frontal and parietal bossing; widened sutures; delayed closure of anterior fontanel; Caput quadratum or hot cross-bun skull; soft skull with ping-pong ball like feelo Chest: Rachitic rosary (prominent costochondral junction); pectus craniatum (pigeon breast); Harrison's groove (horizontal depression along lower border of chest corresponding to insertion of diaphragm)o TeathDelayederuption;enamelhypoplasia;dentalcaries.o Limbs and joints : Bone pain & tenderness (most common manifestation); coxa vara; genu valgus) or genu varus; bowing of legs (tibia), femur, radus & ulna; widening of wrist, elbow, knee & ankle; windswept deformity; string-of-pearls deformity (Saucage-like enlargement of ends of phalanges and metacarpals with constrictions at joints); double malleoli sign (two medial malleoli are palpable instead of one). | A | null |
medmcqa | medmcqa_26739 | True about endotracheal intubation (during the process) is all except: | [
"Hypeension & tachycardia",
"Raised IOT",
"Raised ICT",
"Increased esophageal peristalsis"
] | D i.e. Increased esophageal peristalsis | D | null |
medmcqa | medmcqa_28087 | Varicella zoster virus belongs to which family of DNA viruses - | [
"Poxviridae",
"Herpesviridae",
"Adenoviridae",
"Papovaviridae"
] | Ans. is 'b' i.e., Herpesviridae DNA virusesPoxviridae :-Variola, vaccinia, cowpox, monkeypox, tanapox, mofluscum contagiosumHerpesviridae :- HSV-1, HSV-2, varicella-zoster, EBV, CMV. HTLV-1, RK-virusAdenoviride :- AdenovirusParvoviridae :-Parvovirus, Adenosatello virus, DensovirusPapovaviridae :-Papilloma virus (HPV), PotyomavirusHepadnaviridae :-Hepatitis-B vims | B | null |
medmcqa | medmcqa_22202 | All are true regarding METHANOL poisoning except: | [
"Hemodialysis should be done when serum methanol cencentration is above 50 mg/dl",
"Fomepizole acts by inhibiting aldehyde dehydrogenase",
"High anion gap metabolic acidosis is seen in severe cases",
"Visual disturbances are commonly seen"
] | Ref: Katzung 12/e p398 Fomepizole inhibits alcohol dehydrogenase and not aldehyde dehydrogenase *Serum methanol concentration above 20 mg/dl is an indication to sta treatment and above 50 mg/dl is for Hemodialysis. *Metabolic product formaldehyde and fornic acid is responsible for blindness and high anion gap metabolic acidosis. | B | null |
medmcqa | medmcqa_53442 | Hereditary pancreatitis is characterised by all of the following except | [
"Autosomal recessive inheritance",
"Increased risk of pancreatic cancer",
"80% penetrance",
"Increased risk of chronic pancreatitis"
] | Hereditary pancreatitis: Is a autosomal dominant condition. Hereditary factors are increasingly being recognized as a significant cause of pancreatitis. Hereditary pancreatitis is characterized by recurrent attacks of severe acute pancreatitis often beginning in childhood and ultimately leading to chronic pancreatitis. The disorder is genetically diverse, but the shared feature of most forms is a defect that increases or sustains the activity of trypsin. Three genes implicated in hereditary pancreatitis deserve special note: PRSS1, SPINK1, and CFTR. Of note, patients with hereditary pancreatitis have a 40% lifetime risk of developing pancreatic cancer. Autosomal dominant condition have high degree of penetrance. | A | null |
medmcqa | medmcqa_53905 | Essential amino acid amongst the following ? | [
"Arginine",
"Lysine",
"Threonine",
"All"
] | Ans. is 'd' i.e., All | D | null |
medmcqa | medmcqa_22728 | Cicatrising alopecia with perifollicular blue–gray patches is most commonly associated with – | [
"Pitting of nails",
"Whitish lesions in the buccal mucosa",
"Arthritis",
"Discoid plaques in the face"
] | Cicatricial alopecia with perifollicular blue-grey patches indicates in favour of lichen planus.
Whitish lesion in buccal mucosa (Lacey pathern) is characteristic of lichen planus | B | null |
medmcqa | medmcqa_11585 | Palmaris Brevis is supplied by: | [
"Median nerve",
"Ulnar Nerve",
"Radial Nerve",
"Musculocutaneous nerve"
] | Ans. B. Ulnar Nervea. In the proximal forearm, ulnar nerve gives muscular branches to: (a) flexor carpi ulnaris, and (b) medial half of flexor digitorum profundus.b. In the mid-forearm, it gives off palmar cutaneous branch, which provide sensory innervation to the skin over the hypothenar eminence.c. About 5 cm proximal to the wrist, it gives off dorsal cutaneous branch which provides sensory innervation to the skin over the medial third of the dorsum of the hand and medial 11/2 finger.d. The superficial terminal branch supplies palmaris brevis provides sensory innervation to the skin on the palmar surface of medial 11/2 fingers.e. The deep branch of ulnar nerve is purely motor and supplies all the intrinsic muscles of the hand including adductor pollicis except other muscles of thenar eminence and first two lumbricals. | B | null |
medmcqa | medmcqa_1064 | Combined oral pill reduces the risk of: | [
"Breast cancer",
"Ovarian cancer",
"Cervical cancer",
"Vaginal cancer"
] | null | B | null |
medmcqa | medmcqa_13858 | which of the following is a SSRI | [
"clomipramine",
"fluoxetine",
"milnacipran",
"trazadone"
] | SSRI * IMPOANCE Most widely prescribed antidepressant * MECHANISM Specifically acts on serotonin transpoers and increases serotonin in synapse. DRUGS FLUOXETINE FLUVOXAMINE DAPOXETINE CITALOPRAM ESCITALOPRAM ESCITALOPRAM SERALINE PAROXETINE USE FLUOXETINE=============CHILDHOOD DEPRESSION FLUVOXAMINE===========OCD DAPOXETINE==============PME ESCITALOPRAM===========HEA SAFE, PATHOLOGICAL EMOTIONS PAROXETINE=========SEDATING, PANIC DISORDER IMPULSE CONTROL DISORDERS PME PARAPHILIA Ref., kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no. 955 | B | null |
medmcqa | medmcqa_8692 | Most common side effect of IUDs | [
"Pain abdomen",
"Increased vaginal bleed",
"Abortion",
"Pelvic Infleammatiom"
] | Most common side effect : Increased vaginal bleed.
2nd most common side effect : Pain. | B | null |
medmcqa | medmcqa_26020 | In a patient with wide-complex tachycardia, the presence of all of the following in the ECG indicates ventricular tachycardia except- | [
"Atrioventricular dissociation",
"Fusion beats",
"Typical right bundle branch block",
"Capture beats"
] | Absence of a "RS complex," Concordance of QRS simply means "all up" or "all down. right bundle branch block (RBBB) is a hea block in the right bundle branch of the electrical conduction system During a right bundle branch block, the right ventricle is not directly activated by impulses travelling through the right bundle branch. The left ventricle however, is still normally activated by the left bundle branch. These impulses are then able to travel through the myocardium of the left ventricle to the right ventricle and depolarize the right ventricle this way. As conduction through the myocardium is slower than conduction through the Bundle of His-Purkinje fibres, the QRS complex is seen to be widened. The QRS complex often shows an extra deflection that reflects the rapid depolarisation of the left ventricle followed by the slower depolarisation of the right ventricle. The criteria to diagnose a right bundle branch block on the electrocardiogram: The hea rhythm must originate above the ventricles (i.e., sinoatrial node, atria or atrioventricular node) to activate the conduction system at the correct point. The QRS duration must be more than 100 ms (incomplete block) or more than 120 ms (complete block). There should be a terminal R wave in lead V1 (often called "R prime," and denoted by R, rR', rsR', rSR', or qR). There must be a prolonged S wave in leads I and V6 (sometimes referred to as a "slurred" S wave). The T wave should be deflected opposite the terminal deflection of the QRS complex. This is known as appropriate T wave discordance with bundle branch block. A concordant T wave may suggest ischemia or myocardial infarction Ref Harrison 20th edition pg 1456 | C | null |
medmcqa | medmcqa_12022 | A neonate was found to have periventricular calcifications on CT brain. The best method for the diagnosis of this etiological agent is ______ | [
"Urine examination",
"Liver Biopsy",
"Blood examination",
"CSF examination"
] | Urine examination is one of the best methods to diagnose congenital cytomegalovirus infection, in which periventricular calcification is seen For diagnosis of congenital CMV infection, urine and saliva are the best specimens for culture and saliva and cord blood are the best specimens for polymerase chain reaction (PCR). Among the given options, the best option would be urine. Congenital CMV infection: Clinical features: Characteristics signs and symptoms of clinically manifested infections: Intrauterine growth retardation(IUGR), prematurity, hepatosplenomegaly, jaundice, blue-berry muffin-like rash, thrombocytopenia, purpura, microcephaly and intracranial calcification, Other nuerological problems: Chorioretinitis, Sensineural hearing loss (SNHL), and mild increases in cerebrospinal fluid (CSF) protein. Asymptomatic congenital CMV infection is possibly a leading cause of SNHL, which occurs in 7-10% of all infants with congenital CMV infection, whether symptomatic at bih or not. Diagnosis: Definitive diagnosis: By virus isolation or demonstration of CMV DNA by PCR (performed first 2 weeks of life) Treatment: Ganciclovir treatment can limit hearing loss and improve the developmental outcome in symptomatically infected infants. Ref: Nelson 21st edition Pgno: 1721 | A | null |
medmcqa | medmcqa_22737 | Which one of the following diseases characteristically causes fatty change in liver? | [
"Hepatitis B virus infection",
"Wilson s disease",
"Hepatitis C virus infection",
"Chronic alcoholism"
] | Fatty liver is also known as hepatic steatosis. It happens when fat builds up in the liver. Having small amounts of fat in your liver is normal, but too much can become a health problem When fatty liver develops in someone who drinks a lot of alcohol, it's known as (AFLD) Refer robbins 9/e | D | null |
medmcqa | medmcqa_18244 | Which of the following vessel is injured in Hemothorax patient? | [
"Pulmonary aery",
"Pulmonary vein",
"Bronchial aery",
"Intercostal aeries"
] | "The most common cause of massive Hemothorax in blunt injury is continuing bleeding from torn intercostal vessels or occasionally from the internal mammary aery secondary to the fracture of ribs" | D | null |
medmcqa | medmcqa_48409 | A child Mahesh has been diagnosed to be having vitamin D dependent rickets. The most appropriate vitamin D preparation for him is: | [
"Calciferol",
"Cholecalciferol",
"Calcifediol",
"Calcitriol"
] | (Ref: KDT 6/e p390) Most active vitamin D preparation is calcitriol. | D | null |
medmcqa | medmcqa_22605 | Vasopressin is synthesized in the: | [
"Anterior pituitary",
"Hypothalamus",
"Juxtaglomerular apparatus",
"Vasomotor centre"
] | Vasopressin.
Vasopressin, also called antidiuretic hormone, is even more powerful than angiotensin II as a vasoconstrictor, thus making it one of the body’s most potent vascular constrictor substances. It is formed in nerve cells in the hypothalamus of the brain but is then transported downward by nerve axons to the posterior pituitary gland, where it is finally secreted into the blood.
Reference: GUYTON AND HALL TEXTBOOK OF MEDICAL PHYSIOLOGY, THIRTEENTH EDITION(INTERNATIONAL EDITION ) page no 1014 | B | null |
medmcqa | medmcqa_14207 | widening of the the cailaginous pa of the external auditory canal ? | [
"otoplasty",
"myringoplasty",
"tympanoplasty",
"meatoplasty"
] | Z memamtoplasty conchal incision incision extend to superior ear canal | D | null |
medmcqa | medmcqa_46212 | Kleptomania means | [
"Irresistible desire to set fire",
"Irresistible desire to steal things",
"Compulsive hair pulling",
"Pathological gambling"
] | Disruptive, Impulse-Control & Conduct Disorder: include intermittent explosive disorder, pyromania, kleptomania, conduct disorder*, antisocial personality disorder* , oppositional defiant disorder*. (* - usually described as a type of personality disorders) Feature Of Impulse-Control Disorders failure to resist an impulse /drive temptation to perform the act of tension or arousal before the act Pleasure/relief after the act Regret/guilt following the act compulsive drive to reduce dysphoria Intermittent Explosive Disorder (1) repeated aggressive acts resulting in the destruction of propey, (2) the dispropoionate response to the stimulus that preceded the aggression. Kleptomania - the Pathological compulsion to steal Pyromania -a pattern of behavior, with more than one occasion of purposeful fire setting. it is not done for monetary or other gains. Pathological Gambling- Gambling with increasing amounts of money needed to achieve the same level of excitement (tolerance) and restlessness and irritability when attempting to stop or cut back on gambling (withdrawal) Impulse control disorders and obsessive compulsive disorders involves doing repeated motor acts. In impulse control disorders, there is an urge and the person is not able to control the temptation and he does the act and finally by finishing the act there is a pleasure that is experienced. in obsessive compulsive disorder there is a obsession that is denoted by recurrent, irrelevant, intrusive thought and this thought is stressful To overcome that thought the person has to do some motor acts that are called as compulsions by doing these compulsions there is no pleasure but, there is a sense of releif of tension. b Reference: Page No.925 chap 7.3 Signs and Symptoms in Psychiatry(Kaplan & Sadock's Comprehensive Textbook of Psychiatry, 9th Edition) DSM-5 section II Disruptive, Impulse-Control & Conduct Disorder P-461 | B | null |
medmcqa | medmcqa_33887 | In which of the following a 'Coeur en Sabot' shape of the hea is seen: | [
"Tricuspid atresia",
"Ventricular septal defect",
"Transposition of great aeries",
"Tetralogy of Fallot"
] | Coeur en Sabot' or boot shaped hea is seen in Tetralogy of Fallot. The cardiac silhouette resembles that of a 'boot' or wooden shoe in 'Coeur en Sabot'. Ref: O P Ghai Essential Pediatrics, 6th Edition, Page 406 | D | null |
medmcqa | medmcqa_38911 | Jurisdiction of land assessment comes under - | [
"Supreme court",
"Sessions court",
"District court",
"None of above"
] | o Boundry disputes (Jurisdiction of land assessment) is handled by executive magistrate, e.g. collector, deputy collector or Tahsildar (district magistrate).
o It does not pertain to supreme, sessions or district court. | D | null |
medmcqa | medmcqa_7111 | Massive splenomegaly with pancytopenia- | [
"CLL",
"Pure red cell aplasia",
"CML",
"Myelofibrosis"
] | Chronic idiopathic myelofibrosis shows symptoms like anaemia, leukocytopenia, thrombocytopenia ,with massive splenomegaly ,hepatomegaly is present in half the cases. petechial and other bleeding problems are found in about 20% cases reference: textbook of Pathology 7th edition author Harsha Mohan page number 340 | D | null |
medmcqa | medmcqa_16745 | Which of the following inducing agent produces cardiac stability? | [
"Etomidate",
"Ketamine",
"Halothane",
"Thiopentone"
] | Etomidate
It is another induction anaesthetic (0.2- 0.5 mg/kg) which has a briefer duration of action (4-8 min).
than thiopentone; produces little cardiovascular and respiratory depression, but motor restlessness and rigidity is more prominent as are pain on injection or nausea and vomiting on recovery. It is a poor analgesic and has not found much favour ,except for patients with compromised cardiovascular status.
Reference: Essentials of Medical Pharmacology Eighth Edition KD TRIPATHI page no 410 | A | null |
medmcqa | medmcqa_36224 | Epilepsy is defined as: | [
"One or more unprovoked seizures",
"Two or more unprovoked seizures",
"Three or more unprovoked seizures",
"Four or more unprovoked seizures"
] | Epilepsy is a condition where the patient has 2 or more episodes of unprovoked seizures. | B | null |
medmcqa | medmcqa_26424 | Radiological feature of sarcoidosis - | [
"Hilar lymphadenopathy",
"Hilar lymphadenopathy with parenchymal lung changes",
"No Hilar lymphadenopathy with parenchymal lung changes",
"All of the above"
] | Ans. is 'd' i.e., All of the above o The chest radiographic manifestations of sarcoidosis have been divided into five stages# Stage 0-Normal chest radiograph# Stage 1-Bilateral hilar lymphadenopathy# Stage 2-Bilateral hilar lymphadenopathy writh parenchymal disease.# Stage 3-Only parenchymal disease (no hilar lymphadenopathy)# Stage 4-Pulmonary fibrosis | D | null |
medmcqa | medmcqa_41618 | Most common cause of small intestinal obstruction in adults is | [
"Malignancy",
"Crohn's disease",
"Hernia",
"Adhesions"
] | Adhesions account for more than 50% of small intestine obstruction. They follow appendicitis or other pelvic operations. | D | null |
medmcqa | medmcqa_5301 | Rosette cataract is seen in - | [
"Blunt trauma",
"Diabetes",
"Galactosemia",
"Congenital Rubella"
] | Ans. is 'a' i.e., Blunt trauma o Repeat from previous sessions. | A | null |
medmcqa | medmcqa_38563 | A patient presents with diplopia with limitation of adduction in the left eye and abducting saccades in right eye. Convergence is preserved. Most likely etiology is: | [
"Paial 3rd nerve palsy",
"Internuclear ophthalmoplegia",
"Duane's reactionary syndrome",
"Absence of medial rectus muscle"
] | Internuclear ophthalmoplegia (INO) results from damage to the medial longitudinal fasciculus ascending from the abducens nucleus in the pons to the oculomotor nucleus in the midbrain. Damage to fibers carrying the conjugate signal from abducens interneurons to the contralateral medial rectus motoneurons results in a failure of adduction on attempted lateral gaze. For example, a patient with a left INO will have slowed or absent adducting movements of the left eye. Nystagmus is usually present in the abducted eye. Convergence is usually preserved unless the responsible lesion is high in the midbrain. A patient with bilateral injury to the medial longitudinal fasciculus will have bilateral INO. Multiple sclerosis is the most common cause, although tumor, stroke, trauma, or any brainstem process may be responsible. Ref: Hoon J.C. (2012). Chapter 28. Disorders of the Eye. 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. | B | null |
medmcqa | medmcqa_17074 | The intensity of sound that does not cause ear damage- | [
"80",
"100",
"120",
"150"
] | Ans. is 'a' Le., 80 o Intensity is the strength of sound which determines its loudness. It is usually measured in decibels (dB). o Following are intensities when a person is at a distance of one meter from a sound source. Whisper 30 dB Normal conversation 60 dB Shout 90 dB Discomfort of ear 120 dB Pain in ear 130 dB o A daily exposure up to 85 dB is the about the limit people can tolerate without substantial damage to their hearing. | A | null |
medmcqa | medmcqa_43586 | Ifosfamide belongs to which group of anticancer drugs- | [
"Alkylating agents",
"Antiimetobolites",
"Mitotic inhibitors",
"Topoisomerase inhibitors"
] | Ans. is 'a' i.e., Alkylating agents Ifosfamide belongs to alkylating agentIt is an analogue of cyclophosphamide.It is used in combination for germ cell testicular cancer and is widely used to treat pediatric and adult sarcomas. Adverse effect of If sodamide:-Ifosfamide has virtually the same toxicity profile as cyclophosphamide although it causes greater platelet suppression, neurotoxicity, nephrotoxicity and in the absence of mesna, urothelial damage.When it is used in high doses (myeloablative doses) it causes severe neurological toxicity.When it is used in non myeloablative or low doses it causes severe urinary tract abnormalities. Intravenous mesna is given together with ifosfamide to prevent urinary tract adverse effects. | A | null |
medmcqa | medmcqa_7568 | Fracture shaft of humerus causes damage to? | [
"Median nerve",
"Ulnar nerve",
"Axillary nerve",
"Radial nerve"
] | ANSWER: (D) Radial nerveREF: Keith and Moore's anatomy 4th ed p. 761Radial nerve injury is commonly associated with:Fracture shaft of humerusSaturday night palsyInjection palsy | D | null |
medmcqa | medmcqa_32764 | Which of the following is not always a true odontogenic infection | [
"Periapical abscess",
"Periodontal abscess",
"Maxillary sinusitis",
"None of the above"
] | → Orofacial infections may be odontogenic or non-odontogenic in nature.
→ Majory of odontogenic infections are caused by the endogenous bacteria present in the oral cavity. Eg: Periapical and periodontal infections.
→ Most of non-odontogenic infections are associated with an underlying medical condition Eg: Non-odontogenic infections of the skin, tonsils, or maxillary sinuses.
→ Occasionally, infections could develop following an anesthetic injection or a surgical procedure. | C | null |
medmcqa | medmcqa_11676 | True about blood pressure measurement is all/except: | [
"Cuff width should be 40% of arm circumference",
"Diastolic blood pressure is indicated by fouh Korotkoff sound",
"Small cuff measures spuriously elevated Diastolic blood pressure",
"Monkenberg sclerosis causes pseudohypeension"
] | Answer is B (Diastolic BP is indicated by 4th Kovotkoffs sound) Diastolic blood pressure is indicated by the 5th fbuh Korotkoff sound (not by fouh Korotkoff sound). Diastolic blood pressure is best indicated by fifth Korotkoff sound Korotkoff sounds are produced by turbulent flow in aery 1. Faint, clear, tapping sounds It indicates systolic Be 2. Murmur / swishing sounds 3. More intense, crisper sounds 4. Distinct abrupt muffled f sounds Indicates diastolic BP in children. 5. No sound Best correlates with diastolic BP in normal adultsdeg. | B | null |
medmcqa | medmcqa_7942 | Which enzy me is irreversibly inhibited by aspirin? | [
"Lipooxygenase",
"Cyclooxygenase",
"Thromboxane synthase",
"Phospholipase"
] | Ans. is 'b' i.e., Cyclooxygenase o Aspirin, indomethacin and diclofenac are NSAIDs.o All NSAIDs inhibit cvcloxvgenase.NON STEROlPOL ANTIINFL.AMM ATORY PRI GS (NSAIDS)o Also called "nonnarcotic, nonopioid or aspirin tike analgesicso Important drugs are1. Nonselective Cox inhibitors (traditional NSAIDs)o Aspirino Diclofenaco Indomethacino Ketorolaco Ibuprofeno Piroxicamo Phenylbutazono Naproxen2 Preferential COX-2 inhibitors (COX 2 > COX 1)o Nimesulideo Meloxicamo Nabumetone3 Selective COX-2 inhibitorso Celecoxibo Parecoxibo Rofecoxibo Etoricoxibo Lumiracoxibo Valdecoxib4 nAnalgesic-antipyretics without antiinflammatory actiono Paracetamolo Metamizolo NefopamMechanism of actiono All NSAIDs inhibit cyclooxygenase inhibit synthesis of prosaglandins.o Aspirin inhibits COX irreversibly by acetylating one of its serine residues, return of COX activity depends on synthesis of fresh enzyme.o Other NSAIDs are competitive and reversible inhibitors of COX, return of activity depends on their dissociation from the enzyme which in turn is governed by the pharmacokinetic characteristics of the compound. | B | null |
medmcqa | medmcqa_38383 | Which of the following is/ are the side effect/ s of using argon laser ? | [
"Hypopigmentation",
"Crusting",
"Keloid formation",
"All the above"
] | Ans. is 'd' i.e., All the above Argon Laser Wavelength 488 - 514 nm Penetration depth of 1 mm, which can be increased by cooling Side effects: crusting and possible blistering of skin, irreversible hypopigmentation, transient hyperpigmentation, punctate atrophic or hyperophic scars, keloid formation. | D | null |
medmcqa | medmcqa_28110 | Treatment of choice for the chronic dacrocystitis: | [
"Syringing",
"Dacrocystectomy",
"Conjunctivo-dacryocystorhinostomy",
"Dacrocystorhinostomy"
] | Ans. (d) DacrocystorhinostomyRef.: A.K. Khurana 6th ed. /395-96Dacrocystits is inflammation of the lacrimal sac# CHRONIC PACROCYSTITIS* Chronic dacryocystitis is more common than the acute dacrocystitis.* Cause: Vicious cycle of stasis and mild infection of long duration.* Factors responsible for stasis of tears in lacrimal sac:# Anatomical factors: Narrow bony canal# Foreign bodies in the sac may block opening of NLD.# Excessive lacrimation# Mild grade inflammation: May block the NLD# Obstruction of lower end of the NLD by nasal diseses such as polyps, hypertrophied inferior concha, severe deviated nasal septum.* Source of infection: It may get infected from the conjunctiva, nasal cavity (retrograde spread), or paranasal sinuses by: Staphylococci, pneumococci, streptococci and pseudomonas pyocyanea.* Clinical Feature# Stage of chronic catarrhal dacryocystitis:Characterised by mild inflammation of the lacrimal sac associated with blockage of NLD.# Stage of lacrimal mucocoele: Characterized by constant epiphora associated with a swelling just below the inner canthus.# Stage of chronic suppurative dacryocystitis:Characterized by epiphora, associated recurrent conjunctivitis and swelling at the inner canthus with mild erythema.# Stage of chronic fibrotic sac: repeated infections may result in a small fibrotic sac due to thickening of mucosa, which is associated with epiphora and discharge.* Treatment# Conservative treatment by repeated lacrimal syringing.# Dacryocystorhinostomy (DCR). It is considered as surgery of choice as it re-establishes the lacrimal drainage.# Dacryocystectomy (DCT). It should be performed only when DCR is contraindicated.# Conjunctivodacryocystorhinostomy (CDCR). It is performed in the presence of blocked canaliculi. | D | null |
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