text
stringlengths 1
12.5k
| source
stringclasses 3
values |
|---|---|
Following are indications of thoracotomy in blunt chest trauma: Initial drainage of blood > 1000 ml, especially if fresh. Continued brisk bleeding > (100 ml/15 minutes) from the intercostal drain Continued bleeding of > 200 ml/hr for > 3 hrs Rupture of bronchus, aoa, esophagus or diaphragm Cardiac tamponade (if needle aspiration unsuccessful). Ref : Bailey & Love 24/e p872
|
openlifescienceai/medmcqa
|
Ans. (c) Infection seen when vaginal pH is < 4.5Ref Shaws 15th ed, pg: 308-310* After reading this question, usually we get this tendency to mark option D, which says bacterial vaginosis is NOT a STD, but this statement is true.* Bacterial vaginosis is a vaginal infection casued by Gardenella vaginalis.* Bacterial vaginosis is diagnosed on the basis of the following findings:# Vaginal secretions are gray and thinly coat the vaginal walls.# The pH of these secretions is higher than 4.5 (usually 4.7 to 5.7).# Microscopy of the vaginal secretions reveals an increased number of clue cells, and leukocytes are conspicuously absent.# The addition of KOH to the vaginal secretions (the "whiff" test) releases a fishy, amine-like odor.Also Know* Most common vaginal infectionscluringj pregnancy is candidiasis* Bacterial vaginosis (BV) is the most common vaginal infection in women of childbearing age I* Genital human papillomavirus the most common sexually transmitted infection.
|
openlifescienceai/medmcqa
|
There is increased sweating.
|
openlifescienceai/medmcqa
|
Pleomorphic adenomas, or benign mixed tumors, are the most common neoplasms of the salivary glands. They represent approximately 60-70% of all parotid tumors and 90% of submandibular benign tumors. The mixture of epithelial, myoepithelial, and stromal elements is represented by the name, benign mixed tumor. Any of these individual components may predominate in the histology, but all three must be present to confirm the diagnosis. Both immunohistochemical stains specific for myoepithelial cells and epithelial cells can help to distinguish pleomorphic adenoma. Complete surgical excision of the tumor with uninvolved margins is the recommended treatment. For example, a superficial parotidectomy with clear margins is the treatment of a pleomorphic adenoma located in the superficial lobe of the parotid gland. Ref: Butt F.Y. (2012). Chapter 18. Benign Diseases of the Salivary Glands. In A.K. Lalwani (Ed), CURRENT Diagnosis & Treatment in Otolaryngology--Head & Neck Surgery, 3e.
|
openlifescienceai/medmcqa
|
ICD CHAPTERS ICD is a text book for classification of psychiatric disorders. The below table comprises chapter numbers dealing with various psychiatric disorders. Ref.Kaplon and Sadock, synopsis of Psychiatry, 10th edition
|
openlifescienceai/medmcqa
|
“The first urge to void is felt at a bladder volume of about 150 ml, and a marked seme of fullness at about 400 ml”.
- Ganong
|
openlifescienceai/medmcqa
|
INDEX OF ORTHODONTIC TREATMENT NEED (IOTN):
The Index of Orthodontic Treatment Needs (IOTN) was described in 1989 by R H. Brook and W.C. Shaw to assess orthodontic treatment need from an anatomical and aesthetic perspective.
Essentials of preventive and community dentistry
Soben Peter
5th edition
|
openlifescienceai/medmcqa
|
Ans. is 'a' i.e., Lead * More idustrial workers are exposed to lead than any other toxic metal.
|
openlifescienceai/medmcqa
|
* The degree of displacement, in Garden's classification, is judged from change in the direction of medial trabecular stream of the neck, in relation to the bony trabeculae in the weight bearing pa of the head and in the corresponding pa of the acetabulum. 1) stage 1:There is an obtuse angle laterally at the trabecular stream. 2) stage 2: Trebeculae between head and neck are broken out they are in alignment with each other and with trabeculae in the acetabulum. 3) stage 3: All three trabeculae are out of alignment. 4) stage 4: Acetabular and head trabeculae are in alignment but head and neck trabeculae are not aligned. Ref: John Ebnezer's TB of ohopedics 4th/e p.657
|
openlifescienceai/medmcqa
|
Glycine
|
openlifescienceai/medmcqa
|
Ans. C. Glutamate dehydrogenase(Ref: HARRISON 19/E PG-1997, 18/E, P2530)Glutamate dehydrogenase is not elevated in obstructive jaundice.Liver diseases in which necrosis of hepatocytes is the predominant event, such as toxic liver damage or hypoxic liver disease, are characterized by high serum GLDH levels. GLDH is impoant for distinguishing between acute viral hepatitis and acute toxic liver necrosis or acute hypoxic liver disease, paicularly.Gamma glutamyl transpeptidase is impoant to differentiate between neonatal hepatitis and biliary atresia in infant with jaundice
|
openlifescienceai/medmcqa
|
Ans: d (Optically inactive) Ref: Vasudevan, 4th, ed, p. 5th ed, p. 173Glycine is the simplest amino acid.Optically inactive.It forms every third amino acid in collagen (and most abundant amino acid in collagen).Glycine is a glucogenic amino acid formed from serine.Guanido group is present in arginine.ESSENTIAL AMINO ACIDNON ESSENTIAL AMINO ACIDLeucineValine,AlanineGlutamic acidLysineThreonine,GlycineAspartic acidIsoleucineTiyptophan,ProlineTyrosinePhenylalanineMethionineCysteineSerineAsparagineGlutamineSEMI ESSENTIAL AMINO ACIDS:Arginine, histidine.
|
openlifescienceai/medmcqa
|
Conditions listed in the AIDS surveillance case definition. Candidiasis of bronchi, trachea, or lungs Candidiasis, esophageal Cervical cancer, invasivea Coccidioidomycosis, disseminated or extrapulmonary Cryptococcosis, extrapulmonary Cryptosporidiosis, chronic intestinal (>1 month's duration) Cytomegalovirus disease (other than liver, spleen, or nodes) Cytomegalovirus retinitis (with loss of vision) Encephalopathy, HIV-related Herpes simplex: chronic ulcer(s) (>1 month's duration); or bronchitis, pneumonia, or esophagitis Histoplasmosis, disseminated or extrapulmonary Isosporiasis, chronic intestinal (>1 month's duration) Kaposi's sarcoma Lymphoma, Burkitt's (or equivalent term) Lymphoma, primary, of brain Mycobacterium avium complex or M. kansasii, disseminated or extrapulmonary Mycobacterium tuberculosis, any site (pulmonarya or extrapulmonary) Mycobacterium, other species or unidentified species, disseminated or extrapulmonary Pneumocystis jiroveci pneumonia Pneumonia, recurrenta Progressive multifocal leukoencephalopathy Salmonella septicemia, recurrent Toxoplasmosis of brain Wasting syndrome due to HIV (Harrison's Principles of internal medicine, 20th edition, page 1507)
|
openlifescienceai/medmcqa
|
Ans. is 'a' i.e.. Amitryptiline Prophylaxis of migraineAatrhypertensivesAntidepressantsAnticonvulsantsBeta blockersCalciumACETricyclycicSerotonin/horepinephrineValproateTopiramateGabapentino Metoprolol channel inhibitorsantidepressantsreuptake inhibitor o Propranolol bolckers ARB's|| o Timololo Verapamil o Amitryptilineo Venaiafaxine o Nimodiptne o Nortriptiline o Doxepin o Protriptyline
|
openlifescienceai/medmcqa
|
Ans. is 'a' i.e., Fibroadenoma o Calcifications are common in fibroadenoma of breast, especially in postmenopausal women,o Most of the calcification are coarse and the so called popcorn calcifications are pathognomonic for fibroadenoma.
|
openlifescienceai/medmcqa
|
Ans. is 'b' i.e., Granulosa cell tumor Histologic Hallmarks of Ovarian TumorsOvarian TumorHistologic CharactersticSerious Epithelial tumorsPsammoma bodiesClear cell tumorsHobnail cellsBrenner tumorsWalthard cell restsDysgerminomaLarge polygonal cells, lymphocytic infiltration, and fibrous septaTeratomasSkin, teeth, bones, hair, cartilage, neural tissue, and thyroidEndodermal sinus tumorSchiller-Duval bodiesEmbryonal carcinomaEmbryoid bodiesGranulosa cell tumorsCell-Exner bodiesLey dig (hilus) cell tumorsRenke's crystalsKrukenberg tumorSignet ring cellsRadiological features of ovarian tumorsMalignantBenignGenerally BilateralGenerally unilateralMultiocularUnilocularThick septationsAbsent/thin septationsIntracapsular solid areas presentIntracapsular solid areas absent (clear)Papillary growth on capsule presentPapillary growth on capsule absentAscites presentAscites absentLymph nodes enlargedLymph nodes not enlargedOmental caking persentAbsentLow resistance, high flow (increased vascularity)High resistance, low flow
|
openlifescienceai/medmcqa
|
Divergence and convergence are two evolutionary processes by which organisms become adapted to their environments.
Convergence has been defined as the acquisition of morphologically similar traits between distinctly unrelated
organisms.
Convergence occurs at every level of biological organization.
Functional Convergence
This refers to molecules that serve the same function but have no sequence or structural similarity and carry out their function by entirely different mechanisms.
Mechanistic convergence
Mechanistic convergence occurs when the sequence and structure of molecules are very different but the mechanisms by which they act are similar.
Structural Convergence
This refers to molecules with very different amino acid sequences that can assume similar structural motifs, which may carry out similar functions.
Sequence Convergence
In sequence convergence, one or more critical amino acids or an amino acid sequence of two proteins come to resemble each other due to natural selection. (In protein evolution, sequence divergence, rather than sequence convergence is the rule.)
|
openlifescienceai/medmcqa
|
Ans. is 'b' i.e., Penicillin Drug induce SLEAppearance of SLE like symptoms in association with intake of certain drugs.Common symptoms are fever, malaise, arthritis or intense arthralgias/ myalgias, serositis and or rash.Some special points to note are -It is predominant in CaucasiansQIt has less female predilection than SLE.It rarely involves kidneys or brain Q.It is rarely associated with anti-Ds DNAQ.It is commonly associated with antibodies to histones Q.It usually resolves over several weeksQ after discontinuation of the offending medication.
|
openlifescienceai/medmcqa
|
Culture media for Neisseria gonorrhea - 1. Chocolate agar and Mueller-Hinton agar 2. Thayer: Main media 3. Modified New York city medium 4. Main: Lewis Media Bile Esculin (agar) hydrolysis test - Positive = Blackening of the medium Enterococcus Group D Streptococci Mannitol salt agar - Selective media for S. aureus Yellow colonies due to mannitol fermentation Blood agar - Prepared by adding 5-10% of sheep blood to the molten nutrient agar at 45degC. Enriched media and suppo growth of all types of non-fastidious bacteria.
|
openlifescienceai/medmcqa
|
ABPA is characterized by central bronchiectasis.
|
openlifescienceai/medmcqa
|
D. i.e. All
|
openlifescienceai/medmcqa
|
Corpulence index
|
openlifescienceai/medmcqa
|
Niemann-Pick disease (NPD) is a lipid storage disorder that results from the deficiency of a lysosomal enzyme, acid sphingomyelinase. The enzymatic defect results in pathologic accumulation of sphingomyelin (which is a ceramide phospholipid) and other lipids in the monocyte-macrophage system. Systemic involvement includes progressive lung disease, hepatosplenomegaly, sho stature, and pancytopenia. Ref: Clinical Studies in Medical Biochemistry Edited By Robe H. Glew, Miriam D. Rosenthal, 2006, Page 192; Lehninger Principles of Biochemistry, 4th Edition, Page 356
|
openlifescienceai/medmcqa
|
Preservation of semen :- The most common cryoprotectant used for semen is glycerol (10% in culture medium). Cryoprotectant media may be supplemented with either egg yolk or soy lecithin Liquid Nitrogen is the medium in which these 'Cassettes' containing' sperms and cryoprotectants' are stored in. Cryopreservation of sperms,ova and embryos is one big step in the field of infeility. It avoids repeated aspiration . It also permits donation of eggs as well as of sperms to couples whose husband is azoospermic or wife is in capable of ovulation.
|
openlifescienceai/medmcqa
|
Answer: b) InfliximabTREATMENT OF INFLAMMATORY BOWEL DISEASEAminosalicylates* 5-aminosalicylic acid (formulations known as mesalamine): acts topically in the colon.* Sulfasalazine (5-ASA + sulphapyridine), olsalazine (5-ASA+5-ASA) and balsalazide (5-ASA+ amino benzoyl Alanine) are effective for the treatment of ulcerative colitis.* 5-ASA is the first line treatment for mild ulcerative colitis.Glucocorticoids* Prednisone, hydrocortisone, prednisolone and budesonide: in moderate to severe ulcerative colitis and Crohn's disease.Purine analogs* Azathioprine and 6-MP: maintenance for remission of ulcerative colitis and Crohn's disease.Methotrexate: induction and maintenance of remission of Crohn's disease but not ulcerative colitis.Anti TNFa therapy: Infliximab, adalimumab and certolizumab are useful in Crohn's disease.Natalizumab: targeted against a-4 subunit of integrins. Should not be used with other immunosuppressants due to the risk of progressive multifocal leukoencephalopathy.* Infliximab therapy is associated with | incidence of respiratory infections; potential reactivation of tuberculosis or other granulomatous infections with subsequent dissemination.* Candidates for infliximab therapy should be tested for latent tuberculosis with purified protein derivative and chest radiographs, and patients who test positive should be treated prophylactically with isoniozid.* Infliximab also is contraindicated in patients with severe congestive heart failure.
|
openlifescienceai/medmcqa
|
Rectosigmoid endometriosis: - The endometrial deposit on rectum causes proliferation of muscularis propria and the surrounding tissues which is seen as "mushroom cap sign" in T2 weighted MRI.
|
openlifescienceai/medmcqa
|
Ans. is 'a' i.e., I.V. Mannitol Treatment of angle closure glaucoma Definitive treatment (treatment of choice) is surgery. However, intially drugs are used to decrease KW during an acute attack. Approach of treatment is as follows:- Sta i.v. mannitol or i.v. acetazolamide When IOT stas falling, sta topical pilocarpine or b-blocker (timolol). Apraclonidine/latanoprost may be added. Once IOT is reduced, surgery is done. Topical pilocarpine 2% is the preferred antiglaucomatous drug. After control of IOP, Laser (Nd : YAG) peripheral irodotomy is the definitive management of choice. If laser is not available surgical peripheral iridectomy is the procedure of choice. Other surgical procedures used are filteration surgeries (like trabeculectomy, deep sclerotomy, Viscoanulostomy). Symptomatic treatment during an attack also includes analgesics, antiemetic and topical coicosteroids to reduce inflammation. Mydriatics (e.g. atropine) are contraindicated as they precipitate glaucoma. PACG is a bilateral disease, the fellow eye is at risk of developing an acute attack in 50% cases in future. Therefore a prophylactic peripheral laser iridotomy should be performed in the fellow eye.
|
openlifescienceai/medmcqa
|
The 585-nm pulsed dye laser is an effective treatment for: Molluscum contagiosum. Keloidal scars. Vascular lesions Treatment of Icthyosis: Topical emmolients Systemic steroids
|
openlifescienceai/medmcqa
|
Polymorphonuclear leucocytosis in C.S.F. suggests meningeal involvement Spread of infection and immune response in lyme disease Lyme disease is caused by Borrelia Burgdorferi. Borrelia burgdorferi is transmitted to humans the bite of ixodes tick vector. Borrelia burgdorferi is inoculated in the skin, where local replication takes place locally and outward migration in the dermis occurs. - Days to week after the tick bite, hematogenous dissemination to secondary sites (like joints, hea eye, nervous system) takes place. If untreated, the bacteria may persist in the body for months or even years, despite the production of anti-Borrelia burgodorferi antibodies by the immune system. The following mechanisms have been described - i) Tick saliva, which accompanies the spirochete into the skin during the feeding process, contains substances that disrupt the immune response at the site of the bite. - This provides a protective environment where the spirochete can establish the infect on. ii) Once inside the body, Borrelia burgdorferi become; a stealth invader i.e., it changes shape. - In the tick and mice which host the bacterium through most of its life cycle, the bacterium has a thick cell wall and spiral shape. If it maintains its thick cell wall and its spiral shape, immune system can control infection. However, in the human body, it can shed its cell wall and can take a different shape. When under attack from immune system, it simply changes shape so it is not recognized. iii) Borrelia burgdorferi produces antigenic variation in a "cell surface lipoprotein VIsE", during the course of infection - The VIsE system presents a challenge to immune system because after an immune response is generated to one version of VISE protein, a different version is quickly produced. By using this type of antigenic variation, B. burgdorferi can escape the adaptive immune system. Lyme meningitis Meningitis (meningeal involvement) is the most common neurological event that occurs in the setting of early lyme dissemination. - In this clinical setting CSF is always abnormal and shows: 1) Pleocytosis with predominantly lymphocytosisQ (not polymorphonuclear leukocytosis). 2) Increased protein 3) Glucose content is usually normal, but it .falls below the serum concentration in 20% of patients. Immunoglobulin abnormalities are common in the CSF of patients with lyme meningitis. - Specific IgM, IgG or IgA antibody against B. burgdorferi appears in CSF and indicates intrathecal antibody synthesis.
|
openlifescienceai/medmcqa
|
(D) Neurocysticercosis > Neurocysticercosis is a predominant manifestation of T. solium Infection
|
openlifescienceai/medmcqa
|
Clinical features
Occurs in young adults of age 25 years or less.
Most frequently involved area is anterior surface of tibia.
In jaws, occurs in mandible, in molar and bicuspid region.
Radiographic picture—Classical onion skin appearance due to cortical layer duplication.
|
openlifescienceai/medmcqa
|
Alpha 1 anti trypsin deficiency is associated with panacinar emphysema Emphysema is a type of COPD involving damage to the air sacs (alveoli) in the lungs. As a result, your body does not get the oxygen it needs. Emphysema makes it hard to catch your breath. You may also have a chronic cough and have trouble breathing during exercise. The most common cause is cigarette smoking. Refer robbins 9/e p466
|
openlifescienceai/medmcqa
|
Ans. a (Thalidomide). (Ref. Harrison, Internal Medicine, 15th ed., 1038)Treatment of Type I Lepra reactionTreatment of Type II Lepra reaction# Best with corticosteroids.# Thalidomide ineffective in Typel reaction and clofazimine questionable.# In mild reaction give antipyretics# Then glucocorticoids# Thalidomide causes dramatic improvement probably attributable to its reduction of TNF levels and IgM synthesis and slowing of PMN migration.
|
openlifescienceai/medmcqa
|
Precocious pubey:The term is reserved for girls who exhibit any secondary sexual charecters before the age of 8 or menstruate before the age of 10 Causes GnRH Dependent: 80% Constitutional : Activation of HPO axis Juvenile Primary Hypothyroidism Intracranial Lesions GnRH Independent Ovary Adrenal Liver Iatrogenic Granulosa cell tumour Theca cell tumor Leydig cell tumor Androblastoma McCune Albright syndrome Hyperplasia Tumor Hepatoblastoma Exogenous Estrogen or Androgen intake Ref: D.C.DUTTA&;S TEXTBOOK OF GYNAECOLOGY; 6th edition; Pg no:51
|
openlifescienceai/medmcqa
|
THREE COMMON TOPICAL MEDICATIONS USED Silver sulfadiazine Mafenide acetate 0.5% Silver nitrate Painless on application Fair to poor eschar penetration No metabolic side effects Broad antibacterial spectrum Painful on application Excellent eschar penetration Carbonic anhydrase inhibitor Broad-spectrum antibacterial Painless on application Poor eschar penetration Broad-spectrum antibacterial and antifungal
|
openlifescienceai/medmcqa
|
Ans. 2 DD
|
openlifescienceai/medmcqa
|
Ans. is d, i.e. NOVO-TRef. Fernando Arias 4/e, p 393For fluid resuscitation after PPH following are used:Colloids and crystalloidsBloodFresh frozen plasma-to correct clotting factor deficiency given, if 4U of blood has been given or, if PT>1.5CryoprecipitatePlatelets (if platelet count < 50,000 or, if 4 units of blood have been transfused).NOVO-T is activated factor 7. Its role is well, established in hemophilia. Activated factor VII (NOVOT) acts by binding with tissue factor to augment intrinsic clotting pathway by activating factor IX and X. However its role is obstetrical haemorrhage is uncertain and moreover it is not used in these cases due to risk of thromboembolic events like MI.
|
openlifescienceai/medmcqa
|
Ans. is 'c' i.e., 2 years o The Vi polysacchiride vaccine is licensed for individuals aged 2 years because it does not elicit immune response in children less than 2 years.
|
openlifescienceai/medmcqa
|
.
|
openlifescienceai/medmcqa
|
Ans. A. PseudoseizuresIn conversion disorder Pseudoseizure can occur.The most frequent conversion disorder symptoms are-* Blindness* Mutism* Paralysis.The most widespread sensory symptoms particularly of the -extremities are-* Anaesthesia* ParesthesiaOther sensory symptoms consist of-* Deafness* Tunnel vision and blindness.Motor symptoms related with it includes-* Abnormal movements* Gait disturbance* Paralysis and weakness.One gait disturbance observed in this is ataxia abasia, which is a wildly ataxic, staggering gait accompanied by gross, irregular, jerky truncal movements as well as thrashing and waving arm movements.
|
openlifescienceai/medmcqa
|
(b) Bulb of the internal jugular vein(Ref. Cummings, 6th ed., 1983)The floor of middle ear cavity is a thin plate of bone separating the middle ear from jugular bulb below.Internal carotid artery is in relation to the anterior wall of middle ear.Sigmoid sinus is not related directly with middle ear cavity. It lies posterior to the mastoid antrum.Round window lies postero-inferiorly on the medial wall of middle ear.
|
openlifescienceai/medmcqa
|
Ans. is 'a' i.e., Uterine infection {Ref: Dutta's Obs 7th/e p. 432]Puerperal sepsiso An infection of genital tract as a complication of delivery is termed puerperal sepsis.o Puerperal sepsis is commonly due toI. EndometritisII EndomyometritisIII. Endopvometritiso Combination of all these is called pelvic cellulitis
|
openlifescienceai/medmcqa
|
Management of Pyonephrosis Immediate institution of antibiotics therapy and drainage of the infected collecting system. Antibiotics should be staed before manipulation of the urinary tract. In the ill patient, drainage of the collecting system with a percutaneous nephrostomy tube. Nephrectomy in destroyed or non-functioning kidney.
|
openlifescienceai/medmcqa
|
Use of phenytoin in pregnancy can result in fetal hydantoin syndrome. It is charecterized by the presence of hypoplastic phalanges, cleft lip, cleft palate and microcephaly. Ref: Essentials of Medical Pharmacology By KD Tripathi, 5th Edition, Page 372, 374, 672; Management of Genetic Syndromes By Suzanne B. Cassidy, Judith E. Allanson.
|
openlifescienceai/medmcqa
|
Ans. is 'a' i.e., HCV
|
openlifescienceai/medmcqa
|
Ans. is d i.e. 120 hours The standard recommendation is to sta emergency contraceptive not later than 72 hours. The greatest protection is offered if it is taken within 12 hours, as postponing the dose by 12 hours raises the chances of pregnancy by almost 50% For this reason, the treatment should be initiated as soon as possible after sexual exposure. Note : But here the question says - till how / long are ECs effective or till how long can they be adminsitered. "The tables can be offered upto 120 hours, but its efficacy decreases with the longer coital - drug interval." According to current concepts in contraceptions and women health also -Emergency contraception can be given upto 5 days. This is becasue "Emergency contraception is not an aboifacient i.e. it will not act after implantation has occured. This is also the basis for the window period of 5 days for use effectiveness of EC ,as the whole proocess from deposition of sperms to implantation takes about 5 days."
|
openlifescienceai/medmcqa
|
Ans: C (Guilt) Ref: Synopsis of psychiatry-, Kaplan & Sadock, 10th editionExplanationDepressionIt is a common psychiatric syndrome characterized by persistent & pervasive sad mood,Because of such sad mood, the person might feel guilty, which in turn gives rise to thoughts like worthlessness, hopelessness & helplessness (Cognitive triad of Beck), which in turn put him/her at risk of ending life (ie., suicide).The other symptoms mentioned in the question do occur in any psychiatric disorder.So, the best answer would be "'Guilt" which is pathognomonic of depression.
|
openlifescienceai/medmcqa
|
Ans. is 'b' i.e., Co-Polymer of glycolide and lectide
|
openlifescienceai/medmcqa
|
Superficial branch of ulnar nerve supplies the palmaris brevis muscle and divides into 2 digital branches for the medial 1 1/2 digits . Adductor pollicis, opponens digiti minimi and abductor digiti minimi is supplied by the deep branch of ulnar nerve. Ref - BD Chaurasia 7th edition Page no: 124
|
openlifescienceai/medmcqa
|
LOW-DENSITY LIPOPROTEINS (LDL) LDL transpos cholesterol from liver to peripheral tissues. The only apoprotein present in LDL is apo B100 . Most of the LDL paicles are derived from VLDL, but a small pa is directly released from liver. The half-life of LDL in blood is about 2 days. Metabolism of LDL and LDL Receptors LDL is taken up by peripheral tissues by receptor-mediated endocytosis. LDL receptors are present on all cells but most abundant in hepatic cells. LDL receptors are located in specialised regions called clathrin-coated pitsBinding of LDL to the receptor is by apo-B-100 and uptake of cholesterol from LDL is a highly regulated process. When the apo-B-100 binds to the apo-B-100 receptor, the receptor-LDL complex is internalised by endocytosis. The endosome vesicle thus formed fuses with lysosomes. The receptor is recycled and returns to the cell surface. The LDL paicle, along with apoproteins and cholesterol ester are hydrolysed by lysosomal hydrolases, forming amino acids and free cholesterol. The free receptors can now return to the membrane surface to bind fuher LDL molecules . Approximately 70% of LDL is degraded in the liver, and the rest in extra-hepatic tissues. For their work on LDL receptors, Michael Brown and Joseph Goldstein were awarded Nobel prize in 1985. Function of LDL About 75% of the plasma cholesterol is incorporated into the LDL paicles. LDL transpos cholesterol from liver to the peripheral tissues. The cholesterol thus liberated in the cell has three major fates: i. It is used for the synthesis of other steroids like steroid hormones. ii. Cholesterol may be incorporated into the membranes. iii. Cholesterol may be esterified to a MUFA by acyl cholesterol acyltransferase (ACAT) for storage. The cellular content of cholesterol regulates fuher endogenous synthesis of cholesterol by regulating HMG CoA reductase.LDL and Clinical Applications LDL concentration in blood has positive correlation with incidence of cardiovascular diseases. A fraction of cholesterol is taken up by macrophages, this is not a regulated pathway. Increased levels of LDL or modification of LDL by glycation (as seen in diabetes mellitus) or oxidation increases the fraction of cholesterol taken up by macrophages. LDL infiltrates through aerial walls, and is taken up by macrophages or scavenger cells. This is the staing event of atherosclerosis leading to myocardial infarction . When these cells become engorged with cholesterol, foam cells are formed, that get deposited in the subendothelial space triggering formation of atheromatous plaque . Procoagulant changes are induced in the endothelium resulting in increased chances of thrombosis and coronary aery disease. Since LDL-cholesterol is thus deposited in tissues, the LDL (low-density lipoprotein) variety is called "bad cholesterol" and LDL as "Lethally Dangerous Lipoprotein" in common parlanceRef: DM Vasudevan - Textbook of Biochemistry, 6th edition, page no: 153 - 154
|
openlifescienceai/medmcqa
|
Coccidiodes immitis-pulmonary system severely affected Fatal if untreated It is dimorphic fungus present in yeast and in mycelial form Ref: Baveja 5th ed pg: 555
|
openlifescienceai/medmcqa
|
Lithium
|
openlifescienceai/medmcqa
|
Decreased size of paracoical areas of lymph nodes is expected as this child has DiGeorge Syndrome. DiGeorge Syndrome: Deficient CMI is seen due to aplasia of thymus and hence deficiency of T cells. This leads to paracoical areas of lymph nodes and periaeriolar sheaths of the spleen being reduced in size. B cells are usually not affected. Clinical Features of DiGeorge Syndrome - DiGeorge syndrome is a cellular immunodeficiency disorder caused by the deletion of a small segment of chromosome 22 (22q11) leading to a developmental defect involving the endodermal derivatives of the third and fouh pharyngeal pouches. (Thymus and parathyroid glands) The clinical features can be remembered with the mnemonic - CATCH C - Cardiac defects A - Abnormal facies T - Thymic aplasia C - Cleft palate H - Hypocalcemia Reference: Ananthanarayan and Paniker&;s Textbook of Microbiology Tenth edition
|
openlifescienceai/medmcqa
|
Ref Robbins 9/e p261 Spleen. Amyloidosis of the spleen often causes moderate or even marked enlargement (200 to 800 gm). For obscure reasons, either of two patterns may develop. The deposits may be viually limited to the splenic follicles, producing tapioca-like granules on gross examination ("sago spleen"), or the amyloidosis may principally involve the splenic sinuses, eventually extending to the splenic pulp, with formation of large, sheetlike deposits ("lardaceous spleen"). In both pat- terns, the spleen is firm in consistency. The presence of blood in splenic sinuses usually impas a reddish color to the waxy, friable deposits.
|
openlifescienceai/medmcqa
|
Ans. (b) LeadRef Parikh 6/e, p 9.22
|
openlifescienceai/medmcqa
|
Ans: b (Ventricular fold) Ref: Dhingra, 3rd ed, p. 379 & 4th ed, p. 289In dysphonia plica ventricularis (ventricular dysphonia) voice is produced by ventricular fold which take over the function of true vocal cords. Voice is rough, low pitched and unpleasant.Aetiology:1. Functional2. Secondary to impaired function of vocal cord (paralysis, fixation, surgical excision.tumour)Diagnosis:On direct laryngoscopy false cords are seen to approximate partially or completely and obscure the view of true cords on phonationTreatment:1. VD secondary to laryngeal disorders -- difficult to treat2. Functional VD -- voice therapy & psychological counselling
|
openlifescienceai/medmcqa
|
A i.e. IV diazepam Status epilepticus is said to occur when seizures lasts beyond 30 minutes or seizures are repetitive, prolonged & the patient remains unconscious in between the seizures. The drug of choice is /V Lorazepam (Benzodiazipine)Q 0.1 mg/kg at rate of 2 mg/min. Pharmacologic treatment of generalized tonic-clonic status epilepticus in adults. IV, intravenous, PE, phenytoin equivalents. The horizontal bars indicate the approximate duration of drug infusion.
|
openlifescienceai/medmcqa
|
Pudendal nerve, its course through the lesser sciatic foramen, and branches, including inferior anal at bottom right. The superficial branches of the internal pudendal aery. The perineal nerve is a nerve arising from the pudendal nerve that supplies the perineum. Ref - BDC 6e vol2 pg363
|
openlifescienceai/medmcqa
|
This woman has onychomycosis, which often affects the toenails in an asymmetric pattern. Onychomycosis does not usually resolve spontaneously and is more difficult to eradicate than is tinea pedis (athlete's foot). The etiologic agents include several species of yeast, mold, and dermatophytes, therefore, direct microscopy and/or fungal culture may be necessary for definitive therapy. The condition is often asymptomatic and may not require treatment. Topical therapies are effective but require daily application for many months. They have the advantage of safety. Oral treatment with terbinafine or itraconazole is more effective than topical treatment but must also be continued up to 6 months; oral antifungals carry the risk of hepatotoxicity. Yellow nail syndrome should be considered in the differential for widespread yellow nail changes and is associated with pulmonary disease and cancers. Yellow nail syndrome affects all 20 nails; a workup for systemic disease is unnecessary in the usual patient with onychomycosis.
|
openlifescienceai/medmcqa
|
Causes of Erythema nodosum
Idiopathic
Bacterial: - Streptococci, TB, Leprosy (ENL), LGV, yersinia, mycoplasma, Rickettsia, Cat scratch disease.
Fungal: - Coccidioidomycosis, Histoplasmosis, Trichophyton.
Viral : - HBV, HIV
Drugs : - Sulfonamides, iodides, oral contraceptives.
Systemic diseases : - IBD (Ulcerative colitis, Crohn's disease), Sarcoidosis, Bechet's disease, SLF
Malignancy : - Hodgkin's disease, other malignancies
Other : - Pregnancy
|
openlifescienceai/medmcqa
|
Ans. is 'a' i.e., Adrenal medulla * Pheochromacytomas arise in adrenal medulla (not in adrenal cortex) and at extra-adrenal sites along sympathetic chain.* Most pheochromocytomas arise in adrenal medulla* Pheochromocytomas are catecholamine secreting tumors arising from chromaffin cells.* About 10% of these tumors arise at extra-adrenal sites, where they are called paragangliomas. These extra- adrenal sites area) Along the para-aortic sympathetic chain.b) Organ of Zuckerkandl (paravertebral ganglion).c) Along the sympathetic chain in neck and mediastinum.d) In the wall of urinary bladder.
|
openlifescienceai/medmcqa
|
Ans. D. Maxillary process & Lateral Nasal ProcessOblique facial clefts are produced by failure of the maxillary prominence to merge with its corresponding lateral nasal prominence. When this occurs, the nasolacrimal duct is usually exposed to the surface
|
openlifescienceai/medmcqa
|
Balanced occlusion cannot be attained on mean value articulator. It requires an adjustable articulator to establish proper balanced contacts.
|
openlifescienceai/medmcqa
|
Ans. is 'd' i.e., Herpes virus o Human B-cell lymphotropic virus is HHV type 6-o RK virus is Human herpes virus-7Classification of Human Herpes VirusesSpeciesSubfamilyCytopathologyState of latent infectionOfficial NameCommon NameHuman herpesvirus type 1Human herpesvirus type 2Human herpesvirus type 3Herpes simplex virus type 1Herpes simplex virus type 2Varicella zoster virusalphaalphaalphacytolyticcytolyticcytolyticneuronsneuronsneuronsHuman herpesvirus type 4Epstein-Barr virusgammalymphoproliferativelymphoid tissuesHuman herpesvirus type 5Cytomegalovirusbetacytomegalicsecretory glandsKidneys, other organs and tissuesHuman herpesvirus type 6Human B cell lymphotropic virusbetalymphoproliferativelymphoid tissuesHuman herpesvirus type 7R K virusbbetalymphoproliferativelymphoid tissuesHuman herpesvirus type 8 gamma
|
openlifescienceai/medmcqa
|
Esophagitis is the most common complication
|
openlifescienceai/medmcqa
|
In psychoanalysis (classical psychoanalysis) the therapist remains passive, whereas in psychoanalytic psychotherapy therapist talks quite a lot.
|
openlifescienceai/medmcqa
|
Treatment of chalazion
Treatment of chalazion includes :-
Conservative :- For small, soft and recent chalazion hot fomentation, topical antibiotics eye drops and oral antiinflammatory drugs can be tried.
Intralesional injection of steroid.
Drainage by transconjunctival incision and curettage.
Diathermy for marginal chalazion.
Systemic tetracycline is required in recurrent chalazion especially if associated with acne rosacea or seborrheic dermatitis.
|
openlifescienceai/medmcqa
|
Simple / typical Febrile seizures
Single episode of generalised seizures
It lasts < 15 min
Seizure within 24 hours of fever onset
No recurrence within 24 hours period.
|
openlifescienceai/medmcqa
|
Ans-B
|
openlifescienceai/medmcqa
|
Owing to the outpouring of fluid, there is remarkable concentration of blood. Thus, there is an immediate apparent increase in the number of red cells and the hemoglobin level (Hb level may rise to 150% in severe burns).
|
openlifescienceai/medmcqa
|
Ans. D: All of the above About 65% of the filtered electrolytes are absorbed in PCT actively Thin ascending loop of Henle: Passive diffusion of sodium Thick ascending loop of Henle: Active transpoation of sodium Early distal tubule: Similar propeies as that of thick ascending loop of Henle
|
openlifescienceai/medmcqa
|
Amongst given options, fluid-fluid levels are seen in GCT and ABC.
Lesion in question is metaphyseal:-
ABC → Metaphyseal
GCT → Epiphyseal
Age of the patient is early adolescent:-
ABC → Before the age of 20 years
GCT → 20 - 40 years
So, the answer to the question is ABC.
|
openlifescienceai/medmcqa
|
If a stone is detected, the T tube should be left in place for 6 weeks to allow the tract to mature. At this time, the T tube can be removed, and the stone can be extracted by using a Dormia basket under fluoroscopy. This approach is indicated only when a T-tube larger than 16 has been inserted. If this approach is not feasible, the stone can be extracted by retrograde endoscopic techniques or CBD exploration.
|
openlifescienceai/medmcqa
|
Howarth's retractor: Howarth's elevator can be used for retracting the lingual flap because of close proximity of the lingual nerve in relation to the impacted third molar.
|
openlifescienceai/medmcqa
|
IgA antibody is involved in local immunity at the level of the mucous membrane. It also arises early in disease, is short lived, and will disappear similarly as IgM.
|
openlifescienceai/medmcqa
|
IgG anti HBC is the only serological marker detectable during window period.
|
openlifescienceai/medmcqa
|
(B) Microglia # Microglia are tissue macrophages that populate the mammalian central nervous system (CNS) very early in embryonic development. By adulthood, microglia are found in all regions of the brain and spinal cord and comprise 10-15% of the total cells in the CNS.
|
openlifescienceai/medmcqa
|
At rest,At least 50% of the circulating blood volume is in the systemic veins, 12% is in the hea cavities, and18% is in the low-pressure pulmonary circulation.Only 2% is in the aoa, 8% in the aeries,1% in the aerioles, and5% in the capillariesRef: Ganong's Review of Medical Physiology Twenty-Third Edition Page No:543
|
openlifescienceai/medmcqa
|
Xenon Advantages of Xenon Anesthesia 1. Ine (probably nontoxic to liver and kidney with no metabolism) 2. Minimal effect on CVS function 3. Lowest blood solubility (Lowest blood gas paition coefficient) therefore rapid induction and recovery. 4. Does not trigger malignant hypehermia 5. Environmental friendly 6. Non-explosive Disadvantages of Xenon Anesthesia 1. High cost 2. Low potency (MAC = 70%) 3. No commercially available anaesthesia equipment.
|
openlifescienceai/medmcqa
|
b-Estradiol; 17b-estradiol; the most potent naturally occurring estrogen in mammals, formed by the ovary, placenta, testis, and possibly the adrenal coex; therapeutic indications for estradiol are those typical of an estrogen. a-Estradiol (17a-estradiol), exhibits considerably less biologic activity.Ref: Ganong&;s review of medical physiology; 24th edition; page no: 406
|
openlifescienceai/medmcqa
|
Ans. D: Both subcutaneous and intramuscular route A depot injection is an injection, usually subcutaneous or intramuscular, of a pharmacological agent which releases its active compound in a consistent way over a long period of time. Depot injections are usually either solid or oil-based. Depot injections may be available as ceain forms of a drug, such as decanoate salts or esters. Examples of depot injections include Depo Provera and haloperidol decanoate. The advantages of using a long-acting depot injection include increased medication compliance due to reduction in the frequency of dosing, as well as more consistent serum concentrations. A significant disadvantage is that the drug is not immediately reversible, since it is slowly released.
|
openlifescienceai/medmcqa
|
(A) Competes with estrogen receptor in breast # Tamoxifen is a hormone treatment developed over twenty years ago. It lowers the risk of breast cancer coming back (recurring) or developing in the other breast.> Tamoxifen prevents oestrogen from going into breast cancer cells> Oestrogen can stimulate breast cancer cells to divide and grow.> The oestrogen receptor is a part of the cell that oestrogen can lock into and encourage the cell to multiply to make more breast cancer cells.> Tamoxifen locks into the oestrogen receptor and stops the oestrogen from getting to the cell. Progesterone receptors are similar 'locks' on the cell surface for progesterone, the other female sex hormone.> Breast cancers are divided into oestrogen receptor and progesterone receptor positive and Tamoxifen is given to oestrogen receptor positive patients
|
openlifescienceai/medmcqa
|
Answer is D (Hemodialysis) Hemodialysis has no role in treatment of digoxin overdose. Management of digitalis overdose includes: Withdrawl of drug e Potassiume: administer cautiously and by oral route whenever possible if hypokalemia is present. Potassium must not be employed in the presence of A-V block or hyperkalemia Phenyloin//3 blocker or Lidocaine e : Lidocaine is effective in treatment of digitalis induced ventricular tachyarrhythmias. Cardiac pacemaker : may be required in digitalis induced A-V block Electrical conversion : may be life saving in digitalis induced ventricular fibrillation FAB fragments/digitalis antibodies e :are potentially life saving in severe intoxication. Hemodialysis is not useful in poisonings due to: Digoxin Q Kerosene Q Benzodiazepines Q Organophosphates Q
|
openlifescienceai/medmcqa
|
Metabolites of progesterone may be classified into 3 groups based on degree of reduction. Pregnanediones: the C4-5 double bond is reduced producing 2 pregnanediones and allopregnanediones Pregnanolones: the keto group at C3 is reduced producing a hydroxyl groups in alpha and beta orientation. Urinary pregnanolones exit in alpha orientation Pregnanediols: keto group at c20 is reduced and compounds with c20 hydroxyl groups in alpha orientation are quantitatively more impoant. Hence urinary measurement of pregnanediols can be used as an index of endogenous production of progesterone and also its concentration correlates well with many clinical conditions Ref: Katzung 12 th ed.
|
openlifescienceai/medmcqa
|
Oliguria <400ml/day Anuria <100 ml/ day
|
openlifescienceai/medmcqa
|
Patients suffering from shock, sepsis, massive burns, severe trauma, or head injury develop acute erosive gastric mucosal changes or frank ulceration with bleeding. It is classified as stress-induced gastritis or ulcers. fThe injury is most commonly observed in the acid-producing (fundus and body) poions of the stomach. The most common presentation is GI bleeding, which is usually minimal but can occasionally be life threatening. Stress injury does not cause inflammation or H. pylori. Although elevated gastric acid secretion may be noted in patients with stress ulceration after head trauma (Cushing's ulcer) and severe burns (Curling's ulcer), mucosal ischemia and breakdown of the normal protective barriers of the stomach also play an impoant role in the pathogenesis. Ref: Valle J.D. (2012). Chapter 293. Peptic Ulcer Disease and Related Disorders. 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.
|
openlifescienceai/medmcqa
|
Ans. is d, i.e. Visual symptomsRemember: For clomiphene* M/C side effect of clomiphene- Menopausal symptom-hot flashes- Ovarian cyst formation* Side effect for which its use should be immediately stopped -- visual symptoms* Most dreaded side effect- OHSS* Chances of OHSS =<1%* Chances of multiple pregnancy -* <10%(5-8%)* Maximum dose =100mg* Maximum duration of use = 12 months.
|
openlifescienceai/medmcqa
|
The epiblast is capable of forming all three germ layers (ectoderm, mesoderm, and endoderm) during gastrulation week 3 of development .
|
openlifescienceai/medmcqa
|
Acceleromyography (AMG) and kinemyography (KMG) provide increasingly objective measures of neuromuscular function. Kinemyography employs a piezoelectric transducer and consists of a moulded plastic device which mirrors the contour of the outstretched thumb and index finger. Acceleromyography measures acceleration of a given end-organ, e.g., the thumb when moved by the AP. It is related to the actual force by the formula: force = mass x acceleration Also Know: At present, the most versatile technique to monitor neuromuscular function is AMG, since it can be applied at different muscles. Ref:
|
openlifescienceai/medmcqa
|
Ref: Parks 23rd edition pg 850 The standard detion of means is a measure of sampling error It is given by the formula SD/ROOT OF RANDOM SAMPLE.
|
openlifescienceai/medmcqa
|
The side effect postural hypotension AkA ''First Dose Hypotension" is observed with drug ending with zosin Prazosin, Terazosin, Doxazosin (d) Acarbose - Inhibition of intestinal absorption of carbohydrate. S/E - flatulence, abdominal discomfo, loose stool. These drugs cause blocking of a1receptors, leading tovasodilation, that can Cause Postural Hypotension. (a)Metformin -Antidiabetic drug which comes under the category of Biguanide. S/E - Abdominal Pain, Anorexia, bloating, nausea, metallic taste mild diarrhea & tiredness. Nor - adrenaline(Press or agent)- stimulates a1 and a2 adrenergic receptors to cause blood vessel contraction, thus increases peripheral vascular resistance and result in increase BP. It acts on b1 adrenergic receptors, causing increase In hea rate and cardiac output. S/E = Transient restlessness, headache, palpitations, Anxiety,tremor. Marked rise in BP leading to cerebral hemorrhage, ventricular tachycardia, angina, MI.
|
openlifescienceai/medmcqa
|
Ans. is 'b' i.e., alpha-thalassemia o Out of the given 4 types of hemolytic anemias only alpha thalassemia is able to give rise to such severe presentation at bih. In all other conditions the newborn is either normal or has mild jaundice.
|
openlifescienceai/medmcqa
|
(Ref: KDT 6/e p604) Patients of chronic atrial fibrillation are at high risk of developing thromboembolism. Oral anticoagulants are most frequently advised drugs in these patients to decrease the risk of this adverse effect.
|
openlifescienceai/medmcqa
|
Ans. B RicketsClassical WideningQ FrayingQ and CuppingQ of metaphysis with widened epiphyseal plate of cartilage - suggests Rickets. Appearance of band of metaphyseal calcificationQ - is earliest radiological sign of healing rickets.
|
openlifescienceai/medmcqa
|
Ans. is 'c' i.e., Grey hepatization
|
openlifescienceai/medmcqa
|
For AF, digoxin can be used- it decreases ventricular rate in AF Verapamil decreases conduction velocity and increases the refractory period of the AV node and so used in PSVT. REF.Essentials of Pharmacology KD Tripathi 8th ed.
|
openlifescienceai/medmcqa
|
Acinetobacter Boumani The acromym HACEK refers to a group of fastidious slow growing bacteria normally resident in the mouth which can sometimes cause severe infections paicularly endocarditis. The group inludes:- H aemophilus species (parainfluenzal, aprophilus, paraphrophilus) A ctinobacillus actinomycetemcomitans C ardiobacterium hominis E ikenella corrodens and K ingella kingae Also k low Blood cultures from HACEK patients take 7 to 30 days to become positive Antibiotic sensitivity tests are essential for effective therapy as drug resistance is very common.
|
openlifescienceai/medmcqa
|
Ans is 'a' i.e. Inhibiting IL-1 "In monocytes, IL-4 inhibits IL-1, TNF-alpha and IL-6." - Principles of Cancer Biotherapy p. 173
|
openlifescienceai/medmcqa
|
Immersion Syndrome (Hydrocution): Death in immersion syndrome is due to cardiac arrest as a result of vagal inhibition. It is produced by (i) Cold water stimulatung the nerve endings of the surface of the body (!!) Cold water striking the epigastrium and (!!!) Cold water entering the ear drums, mucosa of pharynx or Larynx Reff: The synopsis of forensic medicine&Toxicology 28th edition pg:191
|
openlifescienceai/medmcqa
|
Pyuria is the presence of more than 5 WBCs / high power field, both for boys and girls. —CPDT
Pyuria suggests infection, but infection can, occur in the absence of pyuria. —Nelson
Pyuria can present without UTI. — Nelson
So, Isolated pyuria is neither confirmatory nor diagnostic for UTI.
|
openlifescienceai/medmcqa
|
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.