dataset string | id string | question string | choices list | rationale string | answer string | subject string |
|---|---|---|---|---|---|---|
medmcqa | medmcqa_39906 | A 5-year-old child suffering from nephrotic syndrome is responding well to steroid therapy. What would be the most likely finding on light microscopy – | [
"No finding",
"Basement membrabne thicking",
"Hypercellular glomeruli",
"Fusion of foot processes"
] | Minimal change disease
Minimal Change Disease is the most common cause of Nephrotic syndrome in children.
Oedema and Selective proteinuria are features of the nephrotic syndrome. Fever may be present on account of increased susceptibility to infection.
Minimal change disease presents with insidious onset of nephrotic syndrome in children below 6 years of age.
Hypertension is not a feature of nephrOtic syndrome and is rare in Minimal change disease. Hematuria (a finding of the nephritic syndrome) is also rare.
Pathological findings include
Light microscopy → No abnormality
Electron microscopy →Obliteration (loss) and fusion of foot processes of epithelial cells.
Immunofluorescence → No deposits of immune reactants
Serum complements → Normal levels
Minimal change disease has a very good prognosis with excellent response to steroids. | A | null |
medmcqa | medmcqa_2379 | Mutation in Hartnup's disease is | [
"SLC6A18",
"SLC6A17",
"SLC6A19",
"SLC6A20"
] | SLC6A19 gene encodes neutral amino acid transporter. Its mutation is seen in Hartnup's disease. | C | null |
medmcqa | medmcqa_10021 | Ifosfamide belongs to which class: | [
"Alkylating agent",
"Antimetabolite",
"Taxanes",
"Antibiotics"
] | Alkylating agent | A | null |
medmcqa | medmcqa_1546 | Inherited hyperammonemia is a result of deficiency of which enzyme of Krebs-Henseleit urea cycle? | [
"Malate dehydrogenase",
"Isocitrate dehydrogenase",
"N-acetyl glutamate synthetase",
"Succinate dehydrogenase"
] | Inherited hyperammonemias are a group of six diseases caused by inborn deficiencies of the enzymes of the Krebs-Henseleit urea cycle. The enzymes involved are: 1. N-acetyl glutamate synthetase 2. Arbamyl phosphate synthetase (CPS) 3. Ornithine transcarbamylase (OTC) 4. Argininosuccinic acid synthetase (citrullinemia) 5. Argininosuccinase deficiency 6. Arginase deficiency Most Severe Cases: In the most severe forms of the hyperammonemic disorders, the infants are asymptomatic at bih and during the first day or two of life, after which they refuse their feedings, vomit, and rapidly become inactive and lethargic, soon lapsing into an irreversible coma. Profuse sweating, focal or generalized seizures, rigidity with opisthotonos, hypothermia, and hyperventilation have been observed in the course of the illness. These symptoms constitute a medical emergency, but even with measures to reduce serum ammonia, the disease is usually fatal. Ref: Ropper A.H., Samuels M.A. (2009). Chapter 37. Inherited Metabolic Diseases of the Nervous System. In A.H. Ropper, M.A. Samuels (Eds), Adams and Victor's Principles of Neurology, 9e. | C | null |
medmcqa | medmcqa_53821 | For each of the following statements, select whether it is applicable to one of the following medications.Inhibition of angiotensin converting enzyme I (ACE I). | [
"losartan",
"enalapril",
"spironolactone",
"digoxin"
] | Enalapril exerts its effect by inhibiting formation of angiotensin II. This lowers systemic vascular resistance. In addition, ACE inhibitors have a natriuretic effect by inhibition of aldosterone secretion. | B | null |
medmcqa | medmcqa_40619 | Single gene disorder | [
"Duchenne muscle dystrophy",
"Down syndrome",
"Turner syndrome",
"Klinefelter syndrome"
] | (A) Duchenne muscle dystrophy MENDELIAN DISORDERS/SINGLE GENE DISORDERSAutosomal DominantAutosomal RecessiveX-linked RecessiveX-linked DominantFAP of colonAchondroplasiaAcute intermittent porphyriaHyperlipoproteinemia1.2,3,4HemorrhagicHSHuntington's dsMarfan's syndromeNeurofibromatosisOsteogenesis imperfectaPolydactylyvWDRetinoblastomaPeutz Zeghers syndromeOsteosclerosisMost inborn error of metabolism e.g.AlbinismAlkaptonuriaAgammaglobulinemia(Swiss type)Cystic fibrosisMaple Syrup Urine dsHemochromatosisWilson's dsPKULysosomal storage dsGlycogenesis, Gaucher's ds., PK deficiency21-Hydoxylase def,CAHb-thalessemiaSickle cell anemiaHirschsprung's diseaseHemophiliaColor blindnessG-6-PD def.(incompletely dominant (expression)DICGDAgammaglobulinemia (Bruton's)Duchenne's and Becker'sMuscle dystrophyRPHydrocephalusOrnithine transcarbamylase deficiencyVit-D resistant/ hypophosphatemicRicketsAlport syndromeFamilialHypophosphatemiaBlood group XgIncontinentia PigmentiFabry's DS | A | null |
medmcqa | medmcqa_30920 | Nail is involved in: | [
"Psoriasis",
"Lichen planus",
"Fungal infection",
"All"
] | A i.e., Psoriasis B Lichen planus C i.e., Fungal infection | D | null |
medmcqa | medmcqa_31404 | Diameter of fovea centralis is: | [
"0.5 mm",
"1.0 mm",
"1.5 mm",
"2.5 mm"
] | Ans. 1.5 mm | C | null |
medmcqa | medmcqa_34552 | Pulmonary tuberculosis is more common in following associated diseases except - | [
"Acquired Immune Deficiencies syndrome",
"Diabetes",
"Chronic renal failure",
"Mitral stenosis"
] | Risk factors for active tuberculosis among persons who have been infected with Tubercle bacilli include comorbidities like HIV infection(relative risk of 21-30),chronic renal failure(10-25),diabetes(2-4),silicosis(30),IV drug use(10-30),immunosuppressive treatment(10),gastrectomy(2-5),jejunoileal bypass(30-60),posttransplantation period(renal,cardiac:20-70). Ckd ,HIV/aids and diabetes are immune compromised conditions. Reference:Harrison's Medicine-18th edition,page no:1342. | D | null |
medmcqa | medmcqa_51793 | Which one of the following drugs does not have active metabolite? | [
"Diazepam",
"Propanolol",
"Allopurinol",
"Lisinopril"
] | Lisinopril is a lysine derivative of enalaprilat which is an active metabolite of enalapril. It is an oral prodrug that is conveed by hydrolysis to a conveing enzyme inhibitor, enalaprilat. Enalaprilat itself is available only for intravenous use, primarily for hypeensive emergencies. All other ACE inhibitors are prodrugs and are conveed to active metabolites by hydrolysis, primarily in the liver. Lisinopril doesn't require hydrolysis to become active metabolite. Its oral absorption is low and incomplete. Its half-life is about 12 hours. the active metabolite of diazepam-oxazepam Allopurinol is conveed to oxypurinol by xanthine oxidase propranolol undergoes hydrolysis to form active metabolite Pg no- 273 Basics and clinical Pharmacology G. Katzung 13th edition | D | null |
medmcqa | medmcqa_44694 | Acute SDH is seen on CT scan as: | [
"Lentiform-shaped hyperdense lesion",
"Crescent-shaped hypodense lesion",
"Crescent-shaped hyperdense lesion",
"Lentiform-shaped hypodense lesion"
] | Ans. c (Crescent-shaped hyperdense lesion). (Ref. Annie Osborn's Diagnostic Neuroradiology, 205).A Crescent-shaped or concavoconvex collection is SDH. Hyperdense on CT are fresh bleeds.Extradural hematoma verse subdural hematomaFeaturesEDHSDHIncidence1-4% overall10-20% overallAsso fractureAssociated in 85-95% cases.Underlying may not be presentEtiologyLacerated middle meningeal artery/ dural sinusStretching, tearing of bridging in 70 to 85% cases and venous "OOZE" or MMA cortical veins tear without in 15% cases onlyLocationBetween skull and dura.Between dura and arachnoid.Crosses dural attachments but not sutures.ImagingCT: Biconvex /LentiformAcute are hyperdense on CT.Chronic are hypodense on CT.CT: . Concavo-convex/ Crescentic.Acute are hyperdense on CT. Chronic are hypodense on CT. | C | null |
medmcqa | medmcqa_34623 | Which of the following casein predominates in cow milk: | [
"a casein",
"b casein",
"Equally present",
"None of the above"
] | a casein predominates in cow milk, whereas b casein predominates in human milk and the former may act as an allergen. Ref:Nutrition and Child Development, K.E. Elizabeth, 4th edition pg: 17 | A | null |
medmcqa | medmcqa_3612 | A patient with enlarged cervical lymph nodes has a malignant tumor of the cecum. Which of the following lymph nodes of the neck is most frequently associated with malignant tumors of the gastrointestinal tract? | [
"Left inferior deep cervical",
"Left supraclavicular",
"Right inferior deep cervical",
"Right supraclavicular"
] | The supraclavicular lymph node on the left side is associated with the thoracic duct. The thoracic duct receives lymph from below the diaphragm, including the gastrointestinal tract. Malignant cells that travel up the thoracic duct are known to involve the left supraclavicular lymph node. | B | null |
medmcqa | medmcqa_27348 | The sample taken below is sent for biochemical analysis in? | [
"Hydrochloric acid",
"Phenol",
"Formalin",
"Fluoride"
] | The sample taken in image is Vitreous sample . A preservative Potassium/sodium fluoride 0.5-2%w/v is used for Collecting vitreous humour sample for ethanol analysis in postmoem toxicology cases. | D | null |
medmcqa | medmcqa_47232 | Parachute reflex disappear at – | [
"3 months",
"6 months",
"9 months",
"Never"
] | null | D | null |
medmcqa | medmcqa_41381 | All are complications of hydatid cyst in the liver except- | [
"Jaundice",
"Suppuration",
"Cirrhosis",
"Rupture"
] | null | C | null |
medmcqa | medmcqa_13216 | A female patient w ith signs of meningitis and CSF showing gram positive cocobacilli, which isshowing characteristic tumbling motility.Diagnosis is - | [
"Listeria",
"Meningococcus",
"H.influenzae",
"Pneumococcus"
] | Ans. is 'a' i.e., Listeria o Information in this question areGram positiveCocobacilliTumbling motilityo Listeria is gram positive coccobacilli and shows characteristic tumbiling motility when grown at 25degC.o Other options can easily be excludes as no one has tumbling motility (charactristic of Listeria) and no one is gram- positive coccobacillusi)Meningococci: Gram-negative cocciii) H. influenza: Gram-negative bacilliiii) Pneumococcus: Gram-positive cocci | A | null |
medmcqa | medmcqa_41863 | Drug used in AV Block a) Isoprenaline b) Dopamine c) Astropine d) Disopyramide e) Propranolol | [
"ac",
"ad",
"bd",
"cd"
] | null | A | null |
medmcqa | medmcqa_14489 | When a person moves from a supine position to a standing position, which of the following compensatory changes occurs? | [
"Decreased hea rate",
"Increased contractility",
"Decreased total peripheral resistance (TPR)",
"Decreased cardiac output"
] | When a person moves to a standing position, blood pools in the leg veins, causing decreased venous return to the hea, decreased cardiac output, and decreased aerial pressure. The baroreceptors detect the decrease in aerial pressure, and the vasomotor center is activated to increase sympathetic outflow and decrease parasympathetic outflow. There is an increase in hea rate (resulting in a decreased PR interval), contractility, and total peripheral resistance (TPR). Because both hea rate and contractility are increased, cardiac output will increase toward normal | B | null |
medmcqa | medmcqa_36597 | Munson's sign is seen in: | [
"Keratoconus",
"Keratoglobus",
"Microcornea",
"All"
] | Ans. Keratoconus | A | null |
medmcqa | medmcqa_32201 | Mild hemolytic anaemia is associated with vitamin deficiency- | [
"B6",
"E",
"A",
"C"
] | Vitamin E acts as antioxidants that serve to scavenge free radicals formed in redox reactions throughout the body.
Vitamin-E deficient erythrocytes are more susceptible to oxidative stress and have a shorter half-life in the circulating blood. | B | null |
medmcqa | medmcqa_44483 | A child draws circle at – | [
"12 months",
"24 months",
"30 months",
"36 months"
] | null | D | null |
medmcqa | medmcqa_45562 | Cardinal feature of antisocial personality | [
"Violation of rules of society",
"Attention - seeking behavior",
"Unstable interpersonal relationship",
"Grandiose behavior"
] | These traits include callous unconcern for the feelings of others, gross and persistent attitude of irresponsibility and disregard for social norms, rules and obligations, incapacity to maintain enduring relationships, very low tolerance to frustration and a low threshold for discharge of aggression, incapacity to experience guilt and to profit from experience, paicularly punishment, and marked proneness to blame others. Eliminationg other options: option B: it is seen in Histrionic personality disorder. option C: it is seen in Boderline personality disorder.option D: not seen in personality disorder but could be seen as delusions of grandiosity in Mania. Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no. 115 | A | null |
medmcqa | medmcqa_31832 | In relation to Ethylene glycol poisoning | [
"It may present with an acute ascending motor and sensory neuropathy",
"A normal anion gap acidosis is usually seen",
"Alcohol dehydrogenase catabolises the metabolism of EG into metabolites including oxalate and glycolic acid",
"Haemodialysis is not effective"
] | Ethylene Glycol poisoning presents in three phases depending on timing: initially (30-60 minutes) after ingestion acute intoxication occurs. This may also result in excitatory symptoms, cerebral oedema, convulsions and coma. The second phase occurs at 12-18 hours with predominantly cardiovascular effects including dysrhythmias and cardiac failure. Profound metabolic acidosis often causes death during this phase. Phase three occurs at 2-3 days with predominantly renal failure and acute tubular necrosis due to calcium deposition. Finally, a delayed neurologic phase can occur 5-20 days post-ingestion, presenting with neurological effects including profound limb weakness, cranial nerve palsies and sensory disturbance. EG causes an increased anion gap acidosis. Other causes of a raised anion gap acidosis include lactate, toxins (ethanol, ethylene glycol, methanol, paraldehyde, aspirin, cyanide, iron, isoniazid), and ketoacidosis (diabetes, alcohol). Causes of a normal anion gap acidosis include gastrointestinal losses (diarrhea), renal loss of bicarbonate (proximal renal tubular acidosis), renal failure and hyperchloraemic acidosis. Renal replacement therapy is a very effective treatment for EG poisoning, as it corrects acid-base status and eliminates EG and some of the harmful metabolites. Fomepizole is a potent inhibitor of alcohol dehydrogenase preventing the production of toxic metabolites of EG. It is given as a loading dose 15mg/kg and then 10mg/kg every 12 hours for the next 48 hours. After which, the dose is increased to 15mg/kg 12hourly. It is continued until plasma EG levels are less than 20mg/dL.Reference: Glossop AJ, Bryden DC. Case repo: an unusual presentation of ethylene glycol poisoning. J Intensive Care Soc 2009; 10(2): 118-21 | A | null |
medmcqa | medmcqa_29825 | Pulmonary Plethora is seen in - | [
"TOF",
"TAPVC",
"CoA",
"Tricuspid Atresia"
] | Pulmonary plethora It is a term used to describe the appearances of increased pulmonary perfusion on chest radiographs. It may occur in several situations : Total anomalous pulmonary venous return (TAPVC) Left-to-right cardiac shunts (e.g. ASD, VSD, PDA) Truncus Aeriosus Vein of Galen Malformation Transposition of the Great Aeries It may also been seen in pregnancy due to increased cardiac output. | B | null |
medmcqa | medmcqa_45576 | Autoantigen is - | [
"Blood group antigen",
"Forssman antigen",
"Both",
"None"
] | Sequesterd antigen that are not normally found free in ciculation or tissue fluids such as eye lens protien Ref: Ananthanarayan & Panikers textbook of microbiology 9th edition pg:89 | D | null |
medmcqa | medmcqa_43178 | Which of the following methods for assessment of female infertility during a menstrual cycle can best predict timing of ovulation: | [
"BBT",
"Fern Test",
"Spinnbarkeit Phenomenon",
"Hormonal Study"
] | Ans. is d, i.e. Hormonal studyRef: Leon Speroff 8th/ed, pi 161-4; Dutta Gynae 5th/ed, p228LH Surge"Evaluation of ovulation is an important part of any female fertility investigation. All of the different methods are useful and no one method is necessarily best. When circumstances require accurate prediction of ovulation as in couples having infrequent intercourse or those who require timely insemination, monitoring urinary LH excretion generally is the most cost-effective and appropriate choice" - Ref: Leon speroff 7th/ed, p1036"Ovulation predictor kits (LH kits) are noninvasive and widely available, require relatively little time and effort. Their greatest advantage over other methods is the ability to accurately predict when ovulation will occur""LH ovulation predictor kits are probably the most convenient home monitoring methods of predicting ovulation" - Ref: Cambridge Guide to Infertility management and Assisted reproduction/68Note: Ovulation occurs because of LH surgeOnset of LH surge to ovulation = 36 hoursOnset of LH peak to ovulation = 12 hoursSerum Progesterone levels* It is the simplest method to assess ovulation in a female with regular menstruationTest - Should be performed 1 week after LH surge, i.e. on Day 21 if menstrual cycle is of 28 days.If serum progesterone levels on day 21 are >3ng/ml, it indicates ovulation has occurred. | D | null |
medmcqa | medmcqa_54529 | Ethmoidal sinus opens into which of the following | [
"Hiatus semilunaris",
"Middle meatus",
"Superior meatus",
"All of the above"
] | The anterior ethmoidal air sinus is opened into the anterior pa of the hiatus semilunaris The middle ethmoidal air sinus is opened into the middle meatus of the nose The posterior ethmoidal air sinus is opened into the superior meatus of the nose <img src=" /> Ref BDC volume 3,6th edition pg 246 | D | null |
medmcqa | medmcqa_23453 | Which of the following is a secondary cutaneous diseases? | [
"Ichthyosis",
"Psoriasis",
"Lichen planus",
"Reiter's disease"
] | The skin involvement is secondary in Reiter's disease which is primarily characterised by ahritis, urethritis and uveitis. While psoriasis, lichen planus and icthyosis exhibit dermatological manifestations as their primary clinical features. Ref: Harrison's Textbook of Internal Medicine, 17th Edition, Page 2174; Inherited Metabolic Diseases: A Clinical Approach By Georg F. Hoffmann, Johannes Zschocke, William L. Nyhan, Pages 204-205; Psoriasis and Psoriatic Ahritis: An Integrated Approach By Kenneth B. Gordon, Eric M. Ruderman, Pages 23-26, 67-72 | D | null |
medmcqa | medmcqa_26395 | Trisomy 13 is: | [
"Patau syndrome",
"Edward syndrome",
"Down syndrome",
"Di George syndrome"
] | a. Patau syndrome(Ref: Nelson's 20/e p 590, Ghai 8/e p 641)Important features of Trisomy 13 (Patau Syndrome)"CMC DOCTOR OPD"C: Cutis aplasiaD: DeafnessO: Others (Renal abnormalities)M: Microphthalmia, MicrocephalyO: Ocular hypotelorismP: PolydactylyC: Congenital Heart diseasesC: Cleft lip & cleft palateD: Developmental delayT: Trisomy 13O: hOLOprosencephalyR: Rib abnormalities | A | null |
medmcqa | medmcqa_50482 | Maximum potassium ions secretion is seen in which of the following secretion? | [
"Saliva",
"Gastric secretions",
"Jejunal secretions",
"Colonic secretions"
] | Saliva contains large quantity of potassium and bicarbonate ions. The concentration of potassium ion is about 30 mEq/L, seven times as great as in plasma. The concentration of potassium is gastric secretions is relatively low. Colon secretes only a small amount of potassium. Ref: Guyton, 11th Ed Page 794 | A | null |
medmcqa | medmcqa_21709 | GABA transmission is facilitated by | [
"Vigabatrin",
"Carbazepine",
"Phenytoin",
"Buspirone"
] | GABAergic transmission refers to activation ofGABA receptors and release of GABA by endogenous or pharmacological modulators. g-Aminobutyric acid (GABA) is the most prevalent inhibitory neurotransmitter in the mammalian central nervous system. Ref: KD Tripathi 8th ed. | A | null |
medmcqa | medmcqa_13206 | Which of the following inhibits the activity of acetyl-CoA carboxylase? | [
"Citrate",
"Glucagon",
"High-carbohydrate, low-fat diet",
"Insulin"
] | The key thing to remember here is that acetyl-CoA carboxylase catalyzes the first and rate-limiting step of fatty acid synthesis. If you got that far, you could have figured out which of the choices would inhibit the synthesis of fatty acids. Ceainly glucagon, a catabolic hormone released in response to low blood glucose, would be a likely candidate to inhibit the synthesis of fatty acids. In fact, glucagon inhibits fatty acid synthesis by a cAMP-dependent phosphorylation of acetyl-CoA carboxylase. Conversely, glucagon stimulates fatty acid oxidation. Citrate is a key player in fatty acid synthesis (citrate shuttle). Therefore, the presence of citrate would stimulate, not inhibit, acetyl-CoA carboxylase. A high-carbohydrate, low-fat diet (would stimulate, not inhibit, the synthesis of fatty acids. In contrast to glucagon, insulin is an anabolic hormone that promotes fatty acid synthesis and therefore would stimulate acetyl-CoA carboxylase. It does so by dephosphorylating the enzyme. Ref: Botham K.M., Mayes P.A. (2011). Chapter 23. Biosynthesis of Fatty Acids & Eicosanoids. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K. Murray, V.W. Rodwell (Eds), Harper's Illustrated Biochemistry, 29e. | B | null |
medmcqa | medmcqa_36036 | Lung Carcinoma is most commonly associated with: March 2005 | [
"Silicosis",
"Asbestosis",
"Coal dust",
"Beryllium"
] | Ans. B: Asbestosis Cigarette smoking is the most impoant cause of lung cancer. About 90% of lung cancers arise due to tobacco use. Other causes of lung cancer include the following: Passive smoking, or secondhand smoke, presents another risk for lung cancer. Air pollution from motor vehicles, factories, and other sources probably increase the risk for lung cancer. Asbestos exposure increases the risk of lung cancer nine times. A combination of asbestos exposure and cigarette smoking raises the risk to as much as 50 times. Another cancer known as mesothelioma (a type of cancer of the lining of the chest cavity called the pleura or of the lining of the abdominal cavity called the peritoneum) is also strongly associated with exposure to asbestos. Lung diseases, such as chronic obstructive pulmonary disease (COPD), also create a risk for lung cancer. A person with COPD has a four to six times greater risk of lung cancer even when the effect of cigarette smoking is excluded. Radon exposure poses another risk. Radon is a by-product of naturally occurring radium, which is a product of uranium. Silicosis is associated with pulmonary fibrosis. X-ray of chest shows rounded opacities in the upper lobes after 15-20 years (simple silicosis). Calcification of hilar nodes may produce 'eggshell' pattern. Beryllium may produce acute pneumonitis, but it is more commonly associated with a chronic granulomatous disease similar to sarcoidosis. | B | null |
medmcqa | medmcqa_23649 | Which of these statements is false for Erytherma marginatum : | [
"Lesions are serpiginous",
"Characteristically it is an evanescent",
"Rash worsens on application of hea",
"Rash is itchy"
] | D i.e. Rash is itchy These rashes in Erythema marginatum are transient, migrating from place to place, non-pruritic, not indurated and blanch on pressure. Q Erythema Marginaturn It is one of the major criteria for diagnosis of rheumatic fever - Extermely rare in Indians It is an evanescent macualar eruption with rounded or serpiginous borders.Q These are erythematous pink rashes with a clear center and round or serpiginous margin.Q - Not raised above the skin. They are brought on by application of heat Q. Most commonly seen on the trunk and proximal pas of extremities, but never on face. | D | null |
medmcqa | medmcqa_50104 | Which of the following is not a pneumatic bone: | [
"Ethmoid",
"Sphenoid",
"Maxillary",
"Mandible"
] | Pneumatic bones are those bones which contain an air filled cavity within them which make them light in weight. In humans, they are seen in relation to nasal cavity & enclose paranasal sinuses. Besides making the skull light in weight they also help in resonance of sound & act as air conditioning chambers for inspired air. Pneumatic bones are - maxilla, frontal bone, sphenoid, ethmoid and Mastoid | D | null |
medmcqa | medmcqa_47299 | Ketamine contraindicated in all except? | [
"Head injury",
"Hypeension",
"Asthma",
"Glaucoma"
] | Ans. is `c' i.e., Asthma Ketamine increases cerebral blood flow, metabolism, oxygen consumption and intracranial tension, unlike thiopentone, propofol&etomidate, which have cerebroprotectiveeffect, therefore ketamine is contraindicated in head injury, intracranial space occupying lesions and for neuroanaesthesia. Cerebrovascular responsiveness to CO2 is preserved, and reducing the aerial CO2 tension by hyperventilation attenuates the ketamine induced rise in ICT. Ketamine has direct myocardial depressant (negative ionotropic) & vasodilator effect. However, ketamine also has indirect sympathomimetic effect. Indirect sympathomimetic effect predominates over direct myocardial depressant &vasodilator effect; usual response is increased BP, cardiac output and hea rate-Cardiac 02 demand is increased. Ketamine is contraindicated in aoic aneurysm, hypeensive and ischemic hea disease. Ketamine also sensitizes the hea to adrenaline - arrhythmias may occur. As ketamine cause sympathetic stimulation, it is the intravenous anaesthetic of choice in patients with shock and hypovolemia. Ketamine increases intra-ocular tension - Contraindicated in glaucoma & open eye surgery. It is a potent bronchodilator and relieves bronchospasm - Intravenous anesthetic agent of choice in asthmatic (inhalational anaesthetic agent of choice in asthmatics is halothane) It increases uterine tone and intensity of uterine contraction - agent of choice in patients with obstetric haemorrhage and flaccid uterus. Injection of ketamine is not painful (all other i.v. inducing agents cause pain on injection). | C | null |
medmcqa | medmcqa_38008 | Inhalational agent of choice for induction in children is | [
"Desflurane",
"Sevoflurane",
"Isoflurane",
"Halothane"
] | Desflurane has the lowest blood partition co-efficient and hence it is the fastest inducing agent. But it can lead to coughing & bronchospasm on inhalation.
Therefore Sevoflurane is the inhalational agent of choice for induction in children. | B | null |
medmcqa | medmcqa_38372 | To be defined as a ganglioside, a lipid substance isolated from nervous tissue must contain in its structure | [
"N-Acetylneuraminic acid (NANA), hexoses, sphingosine, long chain fatty acid",
"NANA, a hexoses, a fatty acid, sphingosine, phosphorylcholine",
"NANA, Phingosine, ethanolamine",
"NANA, hexoses, fatty acid, glycerol"
] | Gangliosides They are formed when ceramide oligo-saccharides have at least one molecule of NANA (N-acetyl neuraminic acid) (sialic acid) attached to them. Ceramide--Glucose--galactose--NANA; this is designated as GM3 (ganglioside M3). Gangliosides contribute to the stability of paranodal junctions and ion channel clusters in myelinated nerve fibers. Autoantibodies to GM1 disrupt lipid rafts, paranodal or nodal structures, and ion channel clusters in peripheral motor nerves.Ref: DM Vasudevan - Textbook of Biochemistry, 8th edition, page no: 82 | A | null |
medmcqa | medmcqa_38574 | Arrange the following drugs according to increasing volume of distribution. 1. Haloperidol 2. Gentamicin 3. Heparin 4. Chloroquine | [
"3-2-4-1",
"3-2-1-4",
"2-3-4-1",
"2-1-3-4"
] | * Chloroquine has highest volume of distribution. It is concentrated in liver and retina. * Heparin is high molecular weight compound and thus not able to cross most membranes. It has low Vd. * Gentamicin again cannot cross many membranes because of polar nature and thus has low Vd. * Haloperidol is a drug working in CNS. So, it must be able to cross other membranes also resulting in high Vd. Thus the sequence is Chloroquine > Haloperidol > Gentamicin > Heparin | B | null |
medmcqa | medmcqa_16012 | A 40 year old farmer with a history of recurrent attacks of porphyria complains of itching when exposes to the sun and maculopapular rash on sun exposed areas, his symptoms are exaggerated in the summer. The diagnosis is – | [
"Seborrheic dermatitis",
"Contact dermatitis",
"Psoriasis",
"Porphyria cutanea tarda"
] | This farmer has :-
Porphyria
Skin manifestations (Photosensitivity)
No neuropsychiatric manifestations
Porphyrias with only skin manifestations are porphyria cutanea tarda, erythropoietic protoporphyria, congenital erythropoietic porphyria. | D | null |
medmcqa | medmcqa_28124 | Implantation occurs after: | [
"5-6 days",
"7-8 days",
"8-10 days",
"10-12 days"
] | Ans. (a) 5-6 daysRef: D.C. Dutta 8th ed. / 25, 8th ed. 25* Dutta in 8th ed. states that Implantation occurs in the endometrium of the anterior or posterior wall of the body near the funduson 6th day, which corresponds to 20th day of a regular normal cycle.* Implantation occurs through 4 stages: Apposition, Adhesion, Penetration, Invasion.* Most students got confused here and marked the answer as 7- 8 days. But if you read the question again, it is cleverly asking that implantation occurs AFTER. 5-6 days is the single best answer here. | A | null |
medmcqa | medmcqa_6385 | Sudden withdrawal of which of the following drugs could result in serious adverse cardiovascular changes in a patient taking the drug over a long time: | [
"Phenelzine (MAO inhibitor)",
"Enalapril (ACE inhibitor)",
"Clonidine (α2 agonist)",
"Fluoxetine (serotonin reuptake inhibitor)"
] | null | C | null |
medmcqa | medmcqa_22091 | Verapamil is contraindicated in | [
"Hypertension",
"Complete heart block",
"Paroxysmal supraventricular tachycardia",
"Angina pectoris"
] | Ans. b (Complete heart block). (Ref. KDT, Pharmacology, 4th ed., 530)# VERAPAMIL can accentuate conduction defects, hence contraindicated in II and III degree AV blocks and precipitates congestive heart failure in patients with pre-existing disease.# Cardiac arrest can occur in patients with sick sinus syndrome.CALCIUM CHANNEL ANTAGONISTSDrugIndicationContraindications/CautionsFrequent or peculiar side EffectsDihydropyridines:# Nifedipine XL# Amlodipine# Felodipine XL# Isradipine# NicardipineMild to moderate hypertensionHeart failure, 2nd or 3rd degree heart blockTachycardia, flushing, gastro- intestinal disturbances, hyperkalemia, edema,headache.Benzothiazepines:DeltiazemMild to moderate HypertensionHeart failure, 2nd or 3rd degree heart blockSame as amlodipine, except no tachycardia or edema, but can cause heart block, constipation, and liver dysfunction.Phenylalkylamine: VerapamilMild to moderate HypertensionHeart failure, 2nd or 3rd degree heart block.Nausea, Constipation and Bradycardia | B | null |
medmcqa | medmcqa_19813 | Randomized controlled trials are all except: | [
"Clinical trials.",
"Preventive trials.",
"Before and after comparison studies.",
"Evaluation of health services."
] | null | C | null |
medmcqa | medmcqa_12616 | Which muscle is responsible for abduction of vocal cord, in the given diagram | [
"A",
"B",
"C",
"D"
] | A - Lateral cricoarytenoid muscle. B - Inter arytenoid muscle C - Posterior cricoarytenoid muscle D - Cricothyroid muscle | C | null |
medmcqa | medmcqa_27015 | Male breast cancer wrong statement- | [
"Brca2 seen in 6% cases",
"Lobular carcinoma is common",
"DUCTAL carcimoma is most common subtype",
"Colloid carcinoma can be seen"
] | Ans. (b) Lobular carcinoma is common(Ref: Robbins 9th/pg 1054)From 4% to 14% of cases in males are attributed to germline BRCA2 mutations -OPTION A IS TRUEStructure of the male breast does not have lobules and acini, lobular carcinoma cases are seen infrequently- OPTION B IS FALSEMost common breast cancer in male is ductal carcimnoma NOSColloid carcinoma can be seen. | B | null |
medmcqa | medmcqa_8563 | Chromosomes are formed during which phase of cell cycle | [
"G1",
"S",
"G2",
"M"
] | Though the DNA is synthesized during the S phase of cell cycle, but the condensation of chromatin fibers into Chromosomes happens during metaphase of Mitosis phase (M) of cell cycle. Hence, if question ask about which phase of cell cycle for DNA synthesis, the answer is S phase. If asked about the chromosome formation, answer is M phase. | D | null |
medmcqa | medmcqa_46942 | Osteomas, adenomatous polyps of intestine & periampullary carcinomas are seen in ? | [
"Cowden syndrome",
"Peutz Jegers syndrome",
"FAP",
"Gardener syndrome"
] | Ans. is 'd' i.e., Gardener syndromeGardner syndrome includes adenomatous polyps of the gastrointestinal tract, desmoid tumours, osteomas, epidermoid cysts, lipomas, dental abnormalities and periampullary carcinomaso It is an autosomal dominant form of polyposis characterized by the presence of multiple polyps in the colon . | D | null |
medmcqa | medmcqa_14620 | Hypercalcemia in sarcoidosis all are true except? | [
"Parathormone level is increased",
"PTHrP level is increased",
"Calcitriol level is increased",
"Oral steroids are useful"
] | Ans. is 'a' i.e., Parathormone level is increased Calcium metabolism in sarcoidosis* Extrarenal synthesis ofcalcitriol is central to the pathogenesis of abnormal calcium metabolism in sarcoidosis.* Sarcoidosis causes an increase in 1, 25-dihydroxy vitamin D, the active metabolite of vitamin D, which is usually hydroxylated within the kidney, but in sarcoidosis patients hydroxylation of vitamin D can occur outside the kidneys, mainly inside the immune cells found in the granulomas and produces 1 alpha, 25(OH)2D3, which is the main cause for hypercalcemia in sarcoidosis.* Gamma-interferon produced by activated lymphocytes and macrophages, also plays a major role in the synthesis of 1 alpha, 25(OH)2D3.* Above 1-ahydroxylation is controlled by PTH and calcitriol. PTH is stimulated by circulating vitamin D metabolites and low levels of ionized calcium to form a bioregulatory loop 8c PTH release is inhibited by hypercalcaemia and high levels ofcalcitriol, which explains why the PTH level is suppressed in sarcoidosis.* PTHrP has similar properties to PTH, stimulating 1 -a hydroxylation of 25(OH)2D3 and affecting bone turnover but unlike PTH, PTHrP gene expression is not regulated by calcium and vitamin D metabolites, but rather by TNFa and IL-6, two cytokines that are up-regulated in sarcoidosis. They are produced by macrophages and have autocrine actions, up-regulating PTHrP expression and therefore increasing calcitriol synthesis* To date corticosteroids have been the first-line therapy in hypercalcaemic sarcoidosis because of their effectiveness in rapidly restoring normocalcaemia and the lack of a recognized alternative therapy.* It is generally accepted that a corrected serum calcium concentration of >3.0 mmol/1 or evidence of renal complications in the presence of a lesser degree of hypercalcaemia is an indication for therapy. | A | null |
medmcqa | medmcqa_32530 | A patient of glaucoma with bronchial asthma presents to the emergency with status asthmaticus, causative agent might have been – | [
"Pilocarpine eye drop",
"Timolol eye drop",
"Betaxolol eye drop",
"Levobunolol eye drop"
] | Pilocarpine and timolol (β - blockers) can cause bronchospasm. However, β-blockers are the most commonly used drugs for POAG and pilocarpine is used very rarely these days. So, best answer here is timolol. | B | null |
medmcqa | medmcqa_18004 | Hydatid cyst is commonly found in: September 2005 | [
"Lungs",
"Liver",
"Kidney",
"Brain"
] | Ans. B: LiverHydatid disease is a parasitic infestation by a tapeworm of the genus Echinococcus.Human echinococcosis is a zoonotic infection caused by the tapeworm of the genus Echinococcus. Of the 4 known species of Echinococcus, 3 are of medical impoance in humans. These are Echinococcus granulosus, causing cystic echinococcosis (CE); Echinococcus multilocularis, causing alveolar echinococcosis (AE); and Echinococcus vogeli.E. granulosus is the most common of the threeEchinococcosis can involve any organ. The liver is the most common organ involved, followed by the lungs. These 2 organs account for 90% of cases of echinococcosis | B | null |
medmcqa | medmcqa_45743 | Agranular endoplasmic reticulum is involved in the synthesis of | [
"Protien",
"Lipid",
"Carbohydrate",
"Vitamin D"
] | Agranular Endoplasmic reticulum is also called smooth Endoplasmic reticulum. It is the site of steroid synthesis and detoxification. Granular is involved in protein synthesis.(REF: Ganong&;s Review of medical physiology) | B | null |
medmcqa | medmcqa_49974 | Drainage of venous blood from testes following division of testicular vein for treatment of varicocele is by: March 2009 | [
"Cremasteric vein",
"Dorsal vein of penis",
"Internal pudendal vein",
"Pampiniform plexus"
] | Ans. A: Cremasteric veinVaricocelectomy, the surgical correction of a varicocele, is performed on an outpatient basis.The three most common approaches are inguinal (groin), retroperitoneal (abdominal), and infrainguinal/subinguinal (below the groin).Possible complications of this procedure include hematoma (bleeding into tissues), infection, or injury to the scrotal tissue or structures.In addition, injury to the aery that supplies the testicle may occur.An alternative to surgery is embolization, a non-invasive treatment for varicocele.Embolization is an effective treatment for post-surgical varicoceles. | A | null |
medmcqa | medmcqa_50779 | Sister Mary Joseph nodule is most commonly seen with: March 2011 | [
"Ovarian cancer",
"Stomach cancer",
"Colon cancer",
"Pancreatic cancer"
] | Ans. B: Stomach cancer Gastric tumour may spread the abdominal cavity to the umbilicus (Sister Joseph's nodule) Sister May Joseph's nodule: Periumbilical nodule/ hard mass Represents metastatin involvement of the paraumbilical nodes from intrapelvic or intraabdominal malignancies Seen with: - Stomach - Large bowel - Ovary - Pancreatic tumour Indicates poor prognosis | B | null |
medmcqa | medmcqa_4004 | The incidence of breech at term is NOT RELATED-GYN | [
"1%",
"3%",
"99.50%",
"0.50%"
] | Researchers generally site a breech presentation frequency at term of 3-4%. at the onset of labour though some claim a frequency as high as 7%.). the incidence is about 20 % at 28 wks which drops to 3-4% at term. | B | null |
medmcqa | medmcqa_33156 | Cirrhosis of liver with poal hypeension occurs in all except: | [
"Cystic fibrosis",
"Alpha 1 anti-trypsin deficiency",
"Wilson's disease",
"Schistosomiasis"
] | Schistosomiasis can lead to Poal HTN but not cirrhosis. Wilson's disease is an inherited disorder of copper homeostasis with failure to excrete excess amounts of copper, leading to its accumulation in the liver and resultant cirrhosis. Alpha 1 antitrypsin deficiency results from an inherited disorder that causes abnormal folding of the alpha-1- AT protein, resulting in failure of secretion of that protein from the liver and these patients are at greatest risk for developing chronic liver disease. Cystic fibrosis is an uncommon inherited disorder & Secondary biliary-type cirrhosis occurs in it. | D | null |
medmcqa | medmcqa_21052 | The difference between gram +ve and gram -ye organism is the gram -ve organism contains: | [
"Teichoic acid",
"Muramic acid",
"N-acetyl neuraminic acid",
"Aromatic amino acids"
] | Ans. (d) Aromatic amino acids Ref. Ananthanarayan Cell Wall Features Gram positive Gram negative bacteria Plasmolysis Thickness (Peptidoglycan) Variety of amino acids Aromatic and sulphur containing amino acids Lipids Teichoic acid Late Thicker Few Absent Absent or scant Present Early Thinner Several Present Present Absent | D | null |
medmcqa | medmcqa_28872 | Asbsestosis is associated with which cancer: | [
"Lung cancer",
"Liver cancer",
"Colon cancer",
"Stomach cancer"
] | Ans. (a) Lung cancerRef: K. Park 23rd ed. / 807* Asbestosis occurs due to long duration (>10 years) exposure to asbestos.* This may lead to pulmonary fibrosis, carcinoma of bronchus, mesothelioma of pleura/peritoneum and GIT cancer.Other Important Occupational CancerAgentAssociated CancerAsbestosisArsenicBenzeneBenzidineSilicaWood dustMesotheliomaSkin, lung, liver CALeukemiaBladder CALung CANasal sinus* Most common occupational cancer: skin CA (75%), mainly squamous cell CA. | A | null |
medmcqa | medmcqa_11752 | In DNA, adenine always pairs with - | [
"Guanine",
"Cytosine",
"Thymine",
"Uracil"
] | Ans. is 'c' i.e., Thymineo DNA is the repository of genetic information,o DNA is located in nucleus.o DNA is also present in mitochondria (but less than 0.1% of the total DNA).o Most accepted model for DNA structure is "Watson and Crick" modelQ,o Which was proposed by W atson and Crick in 1953Q.o DNA is a double-stranded molecule.o Each strand is a polymer of nucleotides (deoxyribonucleotides).o Each strand possesses a palority.o It has a 31 end and a 51 end.o The two strands are antiparallelQ, i.e. they are parallel but run in opposite directions,o The sugar of DNA is deoxyribose.o The purine bases in DNA are adenine (A) and Guanine (G) Q, and pyrimidine bases are thymine (T) and cytosine (C) Q.o Uracil (U), a pyrimidine, is not found in DNAQo Between two strands of DNA : The two chains (strands) are held together by hydrogen bondsQ between complementary pairs of bases.o Adenine is alw ays paired w ith thymine by formation of tw o hydrogen bonds and Guanine is alw ays paired with cytosine by formation of three hydrogen bondsQ | C | null |
medmcqa | medmcqa_46093 | Which of the following drug increase activity, of warfarin- | [
"OCP",
"Erythromycin",
"Griseofulvin",
"Phenytoin"
] | Ans. is 'b' i.e., Erythromycin | B | null |
medmcqa | medmcqa_45801 | Which of the following clotting factors are common in both extrinsic and intrinsic pathway: | [
"Factor 5,9,10.",
"Factor 5,10.",
"Factor 5,9,10,11.",
"None."
] | null | B | null |
medmcqa | medmcqa_11096 | Dubin Johnson syndrome characteristically makes the liver: | [
"Black",
"Blue",
"Red",
"White"
] | This rare autosomal recessive condition, characterized by conjugated hyperbilirubinemia, with normal liver transaminases, a unique pattern of urinary excretion of heme metabolites (coproporphyrin) and the deposition of a pigment, that gives liver a characteristic black color. | A | null |
medmcqa | medmcqa_16950 | Variable portion of antibody molecule is - | [
"C-Terminal",
"N-Terminal",
"CHO moiety",
"None"
] | null | B | null |
medmcqa | medmcqa_32708 | Anterior uveitis in hypeensive patient, Drug of choice is to decrease the 10P | [
"Lanatoprost",
"Pilocarpine",
"Epinephrine",
"Timolol"
] | D i.e. TimololIn inflammatory glaucomas (e.g. hypeensive uveitis as Fuchs uveitis syndrome & Posner-Schlossman syndrome also k/a glaucomatocyclitic crisis) the following drugs should be avoided.1. Prostaglandin analogues e.g. latanoprost Q breakdown the blood aqueous barrier and may exacerbate cystoid macular oedema2. Miotic (e.g. physostigmine & Pilocarpine is also contraindicated Q) as it will promote the development of posterior synechiae. | D | null |
medmcqa | medmcqa_15822 | A child is presenting with erythmatous follicular papules on trunk. There are areas of normal skin within the lesions. There is thickening of Palms & soles. This child is suffering from – | [
"Pityriasis rosea",
"Pityriasis rubra pilaris",
"Psoriasis",
"Seborrheic dermatitis"
] | Clues are :-
Erythmatous follicular papules
Involvement of trunk
Thickening of Palm and soles (Palmo-Planter keratoderma)
The most important one is presence of normal skin within the lesions
Diagnosis is nothing other than pityriasis rubra pylaris. | B | null |
medmcqa | medmcqa_45872 | Females have low RBC count compared to males of same age group due to? | [
"Menstrual blood loss",
"Testosterone promotes erythropoiesis",
"Both of the above",
"Low thyroxine levels"
] | ANSWER: (C) Both of the aboveREF: With textRepeat from December 2010Repeat (**)"In prepubertal humans no major differences can be found between the sexes in RBC count and hemoglobin or serum ferritin concentrations. Only after the onset of menstruation does a difference emerges due to loss of blood in menstruation" (REF: BMJ: British medical journal: Volume 322, Issues 7295-7302 page 1355 page 1355)After puberty, values for the hematocrit, blood hemoglobin concentration, and red cell count average approximately 10 to 13% higher in men than in women. In castrated men, these values fall to within the normal female range. This is almost certainly due to a difference in erythropoietin production, although the relationship between hemoglobin and erythropoietin concentration does not differ between the sexes. After the sixth decade, male hemoglobin values fall back toward those observed in women. The anemia in these patients is corrected by androgen replacement. The differences in red cell parameters between the sexes are accounted for chiefly by the stimulating effect of androgens on erythropoiesis. In addition, some observers suggest that estrogens exert a suppressive effect. (REF: Wintrobe's Clinical Hematology, 11th Ed chapter 47) | C | null |
medmcqa | medmcqa_33808 | True about oral polio vaccine - | [
"Poliomyelitis in recipients",
"Poliomyelitis not seen in contact of recipient",
"Guillein Bare syndrome",
"Vomiting and fever"
] | <p>OPV/ Sabin vaccine Live attenuated . Contains type 1,2 and 3 viruses grown in primary monkey kidney/human diploid cell culture. Administration:- WHO programme on immunisation (EPI) and the national immunisation program in India recommend a primary course of 3 doses of vaccine with 1 month interval commencing at 6 weeks. It is recommended that a dose of OPV is required to be given to all children delivered in the hospital before discharge. Very impoant to complete vaccination before 6 months before most cases occur between 6 months- 3 years. Dose -2 drops Immunity:- prevents paralysis and intestinal reinfection. Thus limits virus transmission in community . The vaccine progeny excreted in faeces and secondary spread occurs to household contacts and susceptible contacts in community. Non immunised persons may therefore become immunised. This propey of OPV has been exploited in controlling epidemic . Advantages:- Antibodies quickly produced and therefore helps to control epidemic. Induces both humoral and intestinal immunity. Easy to administer. Complication:- Vaccine associated paralytic polio in recipients of vaccine and their contacts . Contraindications:- Immunocompromised. Malignancy . Leukemia. Storage-Requires to be stored and transpoed at sub zero temperature,unless stabilized. Problems with OPV:- 1. Instability of vaccine at high temperatures. 2. Frequent vaccine failures. 3. Small residual neurovirulence. OPV bicalent vaccine: Contains strains types 1 and 3. {Reference: park&;s textbook of preventive and social medicine, 23rd edition, pg no.207}</p> | A | null |
medmcqa | medmcqa_4199 | French in Foley's Catheter refers to | [
"Outer circumference measurement",
"Inner circumference measurement",
"Diameter of catheter",
"Lumen size"
] | Ans. (c) Diameter of catheterRef Internet Sources, Wikipedia* The French scale or French gauge system (most correctly abbreviated as Fr, but also often abbreviated as FR or F) is commonly used to measure the size (diameter) of a catheter.* 1Fr=0.33mm, and therefore, the diameter of the catheter in millimeters can be determined by dividing the French size by 3:# D(mm)=Fr/3 or# Fr = D (mm) x3For example, if the French size is 9, the diameter is 3mm.Note that the French scale is a measurement of the diameter, not the circumference (diameter xp).* An increasing French size corresponds to a larger diameter catheter. This is contrary to needle-gauge size, where the diameter is 1/gauge, and where the larger the gauge the narrower the bore of the needle. | C | null |
medmcqa | medmcqa_39156 | The hypothalamus produces several releasing peptides. Which releasing peptide is responsible for the release of adrenocoicotropin (ACTH) from the pituitary? | [
"CRF (coicotropin releasing factor)",
"ACF (ACTH releasing factor)",
"Coicosterone",
"Coisol"
] | Coicotropin releasing factor (CRF) released from the hypothalamic paraventricular nucleus is responsible for release of ACTH. The cell type within the paraventricular nucleus is termed the parvicellular or small neurons. These neurons project their axons into the tuberohypophyseal tract to be released into the hypothalamo hypophyseal poal system to act on the pituitary. Ref: Javorsky B.R., Aron D.C., Findling J.W., Tyrrell J.B. (2011). Chapter 4. Hypothalamus and Pituitary Gland. In D.G. Gardner, D. Shoback (Eds),Greenspan's Basic & Clinical Endocrinology, 9e. | A | null |
medmcqa | medmcqa_35495 | Lesions of lateral cerebellum causes all of the following, EXCEPT | [
"Incoordination",
"Ataxia",
"Intention tremor",
"None of the above"
] | null | D | null |
medmcqa | medmcqa_39328 | A 50 year old male patient complains of pain in back and legs. On routine investigations, it is found that he is anemic and his ESR is also raised. Which of the following is the most probable diagnosis for this patient? | [
"Sickle cell anemia",
"Polycythemia",
"Waldenstrom macroglobulinemia",
"Multiple myeloma"
] | Clinical findings stem mainly from:
The effects of plasma cells on the skeleton.
The production of excessive immunoglobulins, which often have abnormal physicochemical properties.
The suppression of humoral immunity.
Bone resorption often leads to pathologic fractures and chronic pain. The attendant hypercalcemia can give rise to neurologic manifestations, such as confusion, weakness, and lethargy, and contributes to renal dysfunction. Decreased production of normal immunoglobulins sets the stage for recurrent bacterial infections. Of great significance is renal insufficiency, which trails only infections as a cause of death. | D | null |
medmcqa | medmcqa_8996 | Which of the following statement on microalbuminuria is not true? | [
"Cannot be detected by routine lab tests",
"Urine protein less than 30-299 pg/day is called microalbuminuria",
"Microalbuminuria is an independent risk factor for cardiovascular risk in diabetic patients",
"Microalbuminuria is the earliest marker of diabetic nephropathy."
] | The significance of microalbuminuria: Microalbuminuria is the finding of albumin in the urine not detectable by the urine dipstick which is sensitive to protein concentration > 1gm%. It precedes the decline in GFR and indicates the presence of renal and cardiovascular complications. Annual screening for microalbuminuria will allow the identification of patients with nephropathy at a point very early in its course. Definition of abnormalities in albumin excretion Category 24-hr-urine albumin (mg/24h) Dipstick analysis Spot collection (ug/mg creatinine) Normal Microalbuminuria Clinical albuminuria <30 30-299 >300 Negative Negative, trace, 1+ 1+ to 3+ <30 30-299 >300 | B | null |
medmcqa | medmcqa_42716 | In pseudocholinesterase deficiency, a drug to be used cautiously is - | [
"Barbiturate",
"Succinylcholine",
"Halothane",
"Galiamine"
] | Ans: B | B | null |
medmcqa | medmcqa_7013 | None Not seen in alpha helix ? | [
"Alanine",
"Leucine",
"Proline",
"Isoleucine"
] | Ans. is 'c' i.e., Proline Proline is never found in a-helix as it has imino group (-NH) not amino (-N112).Thus it cannot provide hydrogen for hydrogen bonding, the major stabilizing force of a-helix.Glycine also tends to disrupt a-helix; because of its high flexibility and small size it often induces bends in a-helix. | C | null |
medmcqa | medmcqa_7772 | Which of the following is a mode of primary prevention? | [
"Administration of vit A in children",
"Treating a sputum + ive case of TB",
"Splinting a fractured leg",
"Providing wheel chair for the limbless"
] | Here the vitamin A administration removes the risk factor. Hence it is a primary prevension strategy. | A | null |
medmcqa | medmcqa_15360 | Structure superficial to mylohyoid in anterior digastric triangle are all EXCEPT: | [
"Deep pa of submandibular gland",
"Hypoglossal nerve",
"Pa of parotid gland",
"Mylohyoid aery & nerve"
] | Deep pa of submandibular gland & hypoglossal neve are deep to mylohyoid muscle. Structures passing superficial to mylohyoid in anterior pa of digastric triangle are submandibular gland (superficial pa), facial vein, facial aery, mylohyoid nerve & vessels, hypoglossal nerve & submandibular nodes. | D | null |
medmcqa | medmcqa_5607 | Scalds are produced by | [
"Dry heat",
"Moist heat",
"Severe burns",
"All"
] | 118. Ans. b (Moist heat) (Ref. Parikh, FMT, 5th ed. 343)SCALD# A scald is an injury resulting from moist heat or from application of liquid at or near boiling point.# Only superficial layers of skin are affected.# Skin becomes swollen and bleached.# Blister formation may be a important feature.ELECTRIC BURNS# Low voltage (<1000 V) such as from a domestic supply (240 V, 50 Hz) causes significant contact wounds and may induce cardiac arrest, but no deep tissue damage.# Hlghvoltage burns (>1000 V) cause damage by two mechanisms: flash and current transmission. | B | null |
medmcqa | medmcqa_30127 | Karyotyping of the foetus may be done from all of the following except - | [
"Lymphocyte",
"Monocyte",
"Amniocyte",
"Fibroblast"
] | Although human chromosome may be visualized (karyotyping) in any growing tissue such as bone marrow, skin, fibroblast, amniotic fluid cells or chorionic villus; they are most conveniently studied in peripheral blood lymphocytes. | B | null |
medmcqa | medmcqa_35053 | HLA allele associated with Graves disease is | [
"DR4",
"B27",
"B8",
"DQ8"
] | Disease HLA Allele Rheumatoid ahritis DR4 Insulin-dependent diabetes mellitus DR3/DR4` Multiple sclerosis, Goodpasture's DR2 Systemic lupus erythematosus DR2/DR3 Ankylosing spondylitis, psoriasis,inflammatory bowel disease, reactiveahritis B27 Celiac disease DQ2 or DQ8 Graves disease B8 Ref : Ananthanarayana textbook of Microbiology 9th edition Pgno : 180 | C | null |
medmcqa | medmcqa_30821 | In myasthenia gravis, antibodies are present against: September 2012 | [
"Muscarinic receptor proteins",
"Nicotinic receptor proteins",
"Protein actin",
"Protein myosin"
] | Ans. B i.e. Nicotinic receptor proteins Myasthenia gravis It is an autoimmune neuromuscular disease leading to fluctuating muscle weakness and fatigability. It is an autoimmune disorder, in which weakness is caused by circulating antibodies that block acetylcholine receptors at the postsynaptic neuromuscular junction, inhibiting the excitatory effects of the neurotransmitter acetylcholine on nicotinic receptors throughout neuromuscular junctions. Myasthenia is treated medically with acetylcholinesterase inhibitors or immunosuppressants, and, in selected cases,thymectomy. | B | null |
medmcqa | medmcqa_18072 | Which of the following is pruritic: | [
"Lichen planus",
"Psoriasis",
"Icthyosis",
"Secondary syphilis"
] | A. i.e. Lichen planus | A | null |
medmcqa | medmcqa_30808 | Dengue hemorrhagic fever is caused by: | [
"Type 1 dengue virus",
"Reinfection with same serotype of dengue virus",
"Reinfection with a different serotype of dengue virus",
"Infection in an immunocompromised host"
] | Ans. is 'c' i.e., Reinfection with a different serotype of dengue virusDengue hemorrhagic fever is a most severe manifestation of the disease. The initial classic phase of dengue hemorrhagic fever is similar to that of dengue fever and other febrile viral illnesses. But, subsequently, the condition of the patient suddenly worsens with shock and hemorrhage, especially into the gastrointestinal tract and skin. The hemorrhagic manifestations include bleeding from nose, melena and hematemesis. This condition shows a high fatality rate as high as 10%. It occurs in children with passively acquired maternal antibodies. It may also occur in a person previously infected with a different serotype of the virus, showing non-neutralizing heterologous antibodies in the serum. | C | null |
medmcqa | medmcqa_46089 | Genital warts are most commonly caused by which of the following serotypes of V ? | [
"HPV 6",
"HPV 16",
"HPV 18",
"HPV 33"
] | Genital warts (anogenital warts or condyloma acuminata) is most commonly caused by low risk HPV i.e. HPV-6, 11. Other HPV causing genital warts are high risk HPV, i.e. HPV-16,18, 31, 33, 45. | A | null |
medmcqa | medmcqa_33332 | Which cerebellar component would be abnormal in a degenerative disease that affected spinal sensory neurons? | [
"Purkinje cells",
"Mossy fibers",
"Parallel fibers",
"Climbing fibers"
] | Ans. B. Mossy fibersSpinal input, such as from the spinocerebellar tracts, enters the cerebellum on the mossy fibers. The climbing fibers originate from the inferior olivary nucleus of the medulla (the olivo-cerebellar tract). The other components are intrinsic to the cerebellum.Diagram of neural connections in the cerebellum. Plus (+) and minus (-) signs indicate whether endings are excitatory or inhibitory. BC, basket cell; GC, Golgi cell; GR, granule cell; NC, cell in deep nucleus; PC, Purkinje cell. | B | null |
medmcqa | medmcqa_15000 | Ilio-Pectineal line is used to determine difference in ? | [
"Sex",
"Race",
"Age",
"None of the above"
] | Ans. is 'a' i.e., Sex Ilio-Pectineal line is helpful in differentiating the sex of pelvis. In males it is rough, well marked and less veical while in females it is smooth, rounded and more veical. | A | null |
medmcqa | medmcqa_21122 | The most commonly practiced operative procedure for a perforated duodenal ulcer is - | [
"Vagotomy and pyloroplasty",
"Vagotomy and antrectomy",
"Vagotomy and perforation closure",
"Graham's omentum patch repair"
] | Ans. is 'd' i.e., Graham's omentum patch repair | D | null |
medmcqa | medmcqa_18170 | A surgeon entering the abdominal cavity through the abdominal wall will take care to avoid injury to the vessels and nerves within the wall. The main poion of these vessels and nerves will be found immediately deep to which of the following | [
"Skin",
"External abdominal oblique muscle",
"Superficial fascia",
"Internal abdominal oblique muscle"
] | The main course of the intercostal vessels and nerves is deep to the internal abdominal oblique muscle in the neurovascular plane. The anterior abdominal wall is composed of three paired flat muscles that, in general, arise from bony structures posteriorly and whose fibrous aponeuroses form the rectus sheath and meet to form the linea alba.These muscles are from superficial to deep: the external abdominal oblique, internal abdominal oblique, and transversus abdominis. These muscles are supplied by segmental branches of the thoracic and abdominal aoa: the 10th, 11th, and 12th (subcostal) intercostal aeries and the 1st or 2nd lumbar aeries. These aeries, their companion veins, and the nerves supplying the muscles are all found in the interval between the internal abdominal oblique and the transversus abdominis muscles, known as the neurovascular plane. Ref:- BD Chaurasia | D | null |
medmcqa | medmcqa_7660 | The most common pulmonary manifestation of SLE is: | [
"Pleuritis",
"Pleural effusion",
"Pulmonary hypeension",
"ILD"
] | SLE The most common pulmonary manifestation is pleuritis with or without pleural effusion. Pulmonary infiltrates also occur as a manifestation of active SLE Serious manifestations are: Interstitial inflammation leading to fibrosis Shrinking lung syndrome Intra-alveolar hemorrhage Ref: Harrison, E-18, P-2731. | A | null |
medmcqa | medmcqa_16340 | Most common glial tumor - | [
"EpendYmomas",
"Astrocytoma",
"Meningioma",
"Neurofibroma"
] | Ans. is 'b' i.e., Astrocytoma o Most common glial tumor Astrocytoma o Most common meningeal tumor Meningioma | B | null |
medmcqa | medmcqa_7984 | Carbamoyl phosphate is used in- | [
"Urea",
"Uric acid",
"Pyruvic acid",
"Stearic acid"
] | Ans. is 'a' i.e., Urea o Carbamoyl phosphate is used in the synthesis of urea (urea cycle).Aspartate - NH. (or NH4+) + CO, + H,0 + 3 ATP - Fumarate + Urea + 2 ADP + 2Pi + AMP + PPio Kidney and intestine contribute to most of body arginine because they posses all the urea cycle enzymes except arginase.o Brain can synthesize urea from citrulline (AMU 93,AMC 90) but lacks enzyme for formation of citrulline from orthithine, i.e., ornithine transcarbamylase.o Thus neither brain nor kidney can form urea in significant amount. | A | null |
medmcqa | medmcqa_28888 | Which of the following is the investigation of choice in cholestasis of pregnancy? | [
"Serum bilirubin levels",
"Serum bile acids levels",
"Serum alkaline phosphatase levels",
"Serum glutathiones transferase levels"
] | In patients with cholestasis of pregnancy the levels of serum bile acids are elevated 30-100 times the upper limit of normal. Levels of AST, ALT and alkaline phosphatase are only mildly elevated. Intrahepatic cholestasis of pregnancy: The major risk factors for IHCP include multiparity, advanced maternal age, family history of IHCP, and pruritus while on oral contraceptive medicines. Patients often presents in the third trimester of pregnancy with pruritus beginning centrally and spreading peripherally. 20% develop pruritus and jaundice. Ursodiol and cholestyramine are the first agents of choice in the treatment of pruritus. Ref: Ukomadu C. (2012). Chapter 8. Hepatic Complications of Pregnancy. In N.J. Greenberger, R.S. Blumberg, R. Burakoff (Eds), CURRENT Diagnosis & Treatment: Gastroenterology, Hepatology, & Endoscopy, 2e | B | null |
medmcqa | medmcqa_39973 | Posterior wall of axilla is formed by | [
"Pectoralis major",
"Pectoralis major",
"Subscapularis",
"Intercostal muscles"
] | Axilla (armpit)The axilla is apyramidal space situated between the upper pa of the arm and the chest wall. It resembles afour sided pyramid, and has following : (i) an apex (ii) a base (iii) four walls (anterior, posterior, medial and lateral).Anterior (pectoral) wall :- Formed by (i) Pectoralis major, (ii) Pectoralis minor, and (iii) Subclavius. The latter two muscles enclosed by clavipectoral fascia.Posterior (subscapular) wall :- Formed by (i) Subcapularis, (ii) Teres major, and (iii) Latissimus dorsi.Medial (thoracic) wall :- Formed by (i) Upper four ribs (with their intercostal muscles), and (ii) Upper pa of serratus anterior.Lateral (humeral) wall :- Formed by (i) Upper pa of humerus with bicipital groove lodging the tendon of long head of biceps, and (ii) Corachobrachialis and sho head of biceps ?Base :- Formed by Skin, superficial fascia and deep (axillary) fascia. It is directed downwards.Apex :- It is directed upwards and medially towards the root of neck. It communicates with supraclavicular triangle of neck, hence referred to as Cervicoaxillary canal. It is triangular in shape and is bounded anteriorly by clavicle, posteriorly by upper pa of scapula and medially by outer border of first rib. The axillary aery and brachial plaxus enter the axilla through this canal. | C | null |
medmcqa | medmcqa_54775 | Strabismic amblyopia is more common in patients with: | [
"Intermittent squint",
"Alternate squint",
"Constant squint",
"Latent squint"
] | Paralytic Squint (Incomitant): * Due to complete or paial palsy of one of the nerves t at supp y * . * Here, the angle of direction of gaze, being maximal in the direction of action of the weak muscle. Eg.: - Oculomotor Palsy -> - Abducens Palsy - Trochlear Palsy Latent Strabismus / tga.Ua o It is a condition in which the tendency of the eyes to dete is kept latent by fusion. Therefore, when the influence of fusion is removed the visual axis of one eye detes away. L Types L 1. Esophoria- It is a tendency to converge. L 2. Exophoria- It is a tendency to diverge. L 3. Hyperphoria- It is a tendency to dete upwards, while hypophoria is a tendency to dete downwards. L 4. Cyclophoria- It is a tendency to rotate around the anteroposterior axis. When the 12 O&;clock meridian of cornea rotates nasally, it is called incyclophoria and when it rotates temporally it is called excyclophoria. Constant squint Least common - alternate squint. Ref: AK khurana 7th ed. | C | null |
medmcqa | medmcqa_29248 | Gemfibrozil/produces hypolipidemic action by? | [
"Increasing activity of lipoprotein lipase",
"Decreased production of VLDL",
"Increase LDL receptors on hepatocytes",
"Increased conversion of cholesterol to bile acids"
] | Ans. is 'a' i.e., Increasing activity of lipoprotein lipase | A | null |
medmcqa | medmcqa_21212 | Prostaglandin inhibiting action of aspirin is useful in the treatment of all of the following conditions, EXCEPT : | [
"Analgesia and antipyresis",
"Closure of ductus arteriosus",
"Uricosuria",
"Antiinflammatory and anti platelet aggregation"
] | null | C | null |
medmcqa | medmcqa_38521 | All of the following muscles are supplied by accessory nerve except | [
"Palatopharyngeus",
"Stylopharyngeus",
"Palatoglossus",
"Musculus uvulae"
] | null | B | null |
medmcqa | medmcqa_20545 | Z track technique is used for | [
"Monitoring of lithium therapy",
"Monitoring of carbamazepine therapy",
"Administration of long acting depot antipsychotics",
"Administration of nicotine patches"
] | Ans. (C) Administration of long acting depot antipsychotics(Ref: Kaplan and Sadock's Concise Text book of Clinical Psychiatry 11th Ed; Page No- 873)Guidelines for Administration of Long Acting Antipsychotic Depot Injections (LAAI)LAAIs are given to patient with psychosis or mania who have poor compliance to oral treatment.A test dose is given for all drugs except olanzapine, risperidone, paliperidone and aripiprazole.Route of administration is by intramuscular route with maximum permissible volume as given below.Deltoid2 mlDorsogluteal4 mlVentrogluteal (Safest site)4 mlRectus femoris5 mlVastus lateralis5 mlZ track technique is used for injection into all sites, except deltoid. The skin is stretched laterally from the intended site of injection and then insert the needle at 90deg angle. After 10 seconds of injecting the drug, skin is released to allow the displaced tissue to cover the needle track. It is done to maximize absorption in to muscles by preventing the drug from moving back to subcutaneous tissue.Z track technique is also used to inject iron. | C | null |
medmcqa | medmcqa_14627 | If amphotericin B is administered, the patient should be premedicated with : | [
"Diphenhydramine",
"Ibuprofen",
"Prednisone",
"Any of the above"
] | null | D | null |
medmcqa | medmcqa_22971 | In corrosive acid case is opened along: | [
"Lesser curvature",
"Greater curvature",
"Veical",
"Pylorus"
] | In corrosive acid poisoning, it is open along the greater curvature. Toxic substances may be held in high concentrations in the rugae and crypts of the mucosa in the actual stomach wall. The pathway of acids and alkalis in food-filled stomach stas along the lesser curvature of the stomach and leads to the pylorus, which explains the location of greatest damage in stomach. | B | null |
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