text
stringlengths 1
12.5k
| source
stringclasses 3
values |
|---|---|
As the volume of pancreatic secretion increases, its Cl- concentration falls and its HCO3- concentration increases.The magnitude of the exchange is inversely propoionate to the rate of flow.In cystic fibrosis where this exchange mechanism is lost, pancreatic secretions become dehydrated and thickenedREF: GANONG&;S REVIEW OF MEDICAL PHYSIOLOGY, TWENTY-THIRD EDITION, PAGE NO:435,436
|
openlifescienceai/medmcqa
|
Ans. is 'a' i.e., Vincristine Vincristine (Oncovin) Alkaloid derived from Vinca rosae. Vincristine belongs to the plant alkaloid group of anticancer. Rapidly acting anticancer This class of drugs are also known as spindle poison. These drugs bind to microtubular protein (tubulin) The drug-tubulin complex then attaches itself to microtubules and causes depolymerization of microtubules. Depolymerization of microtubule causes Mitotic arrest at metaphase Dissolution of mitotic spindle Interference with chromosome segregation Useful for inducing remission in childhood ALL (not useful in maintenance therapy) It can also be used for pediatric solid tumors (Wilm's tumor, neuroblastoma, rhabdomyosarcoma) and lymphomas. Prominent adverse effects? Peripheral neuropathy Alopecia SIADH Vincristine is a marrow sparing drug but some times it may cause myelosuppression which is very less than vinblastin. Indications of vincristine? Hodgkins disease Wilms's tumour Carcinoma lung Non hodgkin:s. disease Ewing's sarcoma Myeloma Vinblastine and vinorelbine are other vinca alkaloids. o Vinblastine's most impoant clinical use is the curative therapy of metastatic testicular tumor. o Vinblastine can cause bone marrow suppression (in contrast with vincristin), alopecia, and nausea & vomiting. o As they arrest mitosis, all vinca alkaloids act in M phase.
|
openlifescienceai/medmcqa
|
Genomics - Study of the entire genome of an organism. It enables the primary sequence of a protein to be identified easily from small amounts of sequence data.
Proteomics - Study of quantity & quality of all expressed protein.
Glycomics - Study of structure & function of chains of sugar.
Cytogenetics - It is a branch of genetics which deals with the structure & function of the cell, especially the chromosome.
Pharmacogenomics - Study of genetically determined variation in responses to drugs in human or in laboratory organisms.
|
openlifescienceai/medmcqa
|
Isoflurane is metabolized to trifluoroacetic acid. Although serum fluoride fluid levels may rise, nephrotoxicity is extremely unlikely, even in the presence of enzyme inducers. Prolonged sedation (>24 h at 0.1-0.6% isoflurane) of critically ill patients has resulted in elevated plasma fluoride levels (15-50 mmol/L) without evidence of kidney impairment. Similarly, up to 20 MAC-hours of isoflurane may lead to fluoride levels exceeding 50 mmol/L without detectable postoperative kidney dysfunction. Its limited oxidative metabolism also minimizes any possible risk of significant hepatic dysfunction. Total hepatic blood flow (hepatic aery and poal vein flow) may be reduced during isoflurane anesthesia. Hepatic oxygen supply is better-maintained with isoflurane than with halothane, however, because hepatic aery perfusion is preserved. Liver function tests are usually not affected. The major effect of acute inhalation of chloroform is central nervous system depression. At concentrations from 1,500-30,000 ppm, chloroform exposure can induce anesthesia; at concentrations exceeding 40,000 ppm, it can be fatal. Chronic inhalation of chloroform in humans results in hepatotoxicity and central nervous symptoms such as depression and irritability. Meanwhile, chronic oral exposure to chloroform in humans results in effects on the blood, livers, and kidneys. Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e
|
openlifescienceai/medmcqa
|
Complications of Recurrent chalazion are meibomian gland adenocarcinoma and sebaceous cell carcinoma.
|
openlifescienceai/medmcqa
|
MAMMARY GLAND:- Modified sweat gland in superficial fascia of pectoral region. Rudimentary in males. Located in superficial fascia. Extend: veically- 2nd to 6th rib Horizontally- lateral border of sternum to mid axillary line. LYMPHATIC DRAINAGE:- Lymph nodes:- 1. Axillary-anterior, posterior, central and lateral. 2. Internal mammary. 3. Supraclavicular. 4. Posterior intercostal 5. Cephalic. Lymphatics draining the breast:- 1. Superficial- drain skin of the breast except that of nipple and areola. 2. Deep-drain parenchyma of the breast , and skin of nipple and areola. 3. A plexus of lymph ceasefires deep to areola is called subareolar plexus of sappy.The subareolar plexus and most of the lymph from the breast drains into anterior group of axillary lymph nodes. Lymphatic drainage:- 1. Lateral quadrant of breast-drains into anterior axillary/ pectoral group of lymph nodes. 2. Medial quadrant- drains into Internal mammary 3. Lower and medial quadrant- communicates with subdiaphragmatic and subperitoneal lymph plexus. 4. Deep surface of breast-apical group . 5. A few lymph vessels from the breast follow the posterior intercostal aeries and drain into posterior intercostal nodes. About 75% -axillary 20%-internal mammary 5%-posterior intercostal lymph nodes. Among the axillary lymph nodes, most of lymph goes into anterior axillary and remaining into posterior and apical. The lymph from anterior and posterior groups first goes into central and lateral groups and then through them into supraclavicular nodes.Apical group of lymph nodes are terminal. Some lymph vessels from the inferomedial quadrant of breast communicates with the subperitoneal lymph plexus and carry cancer cells to it. From here cancer cells migrate transcoelomically and deposit over ovary- krukenberg&;s tumor. {Reference:vishram singh page no.48}
|
openlifescienceai/medmcqa
|
The paracentral lobule is on the medial surface of the hemisphere and is the continuation of the precentral and postcentral gyri. The leg and the foot areas are found on the medial surface of the hemisphere in the posterior pa of the paracentral lobule. The anal and genital regions are also found in this area.Ref: Clinical neuroanatomy By Richard S Snell, 2010, Page 292.
|
openlifescienceai/medmcqa
|
. Lung
|
openlifescienceai/medmcqa
|
Ans. is a, b and c i.e. Cesarean section; Vaccum extraction; Keilland forcep; and Manual rotation and forcep delivery In case of occipto posterior position if paial anterior rotation occurs the head is arrested with the sagittal suture in the transverse diameter at the level of the ischial spines, after full dilatation of the cervix in spite of good uterine contractions. This condition is called as Deep Transverse Arrest. It occurs more commonly in android pelvis. Note : In most centres now a days, either cesarean section or vaccum extraction is performed, due to lack of experience in forceps rotation and manual rotation. It is extremely impoant to remember that if vaccum or forceps fails, no attempt should be made to persist with vaginal delivery. The procedure should be abandoned and immediate cesarean section undeaken. In late and neglected cases if the fetus is dead. craniotomy is an option in experienced hands. However, now days most obstetricians would prefer to perform cesarean section in cases of obstructed labour, even when the fetus is dead.
|
openlifescienceai/medmcqa
|
Azathioprine and 6-mercaptopurine (6-MP) are purine analogues commonly employed in the management of glucocoicoid-dependent IBD. Azathioprine is rapidly absorbed and conveed to 6-MP, which is then metabolized to the active end product, thioinosinic acid, an inhibitor of purine ribonucleotide synthesis and cell proliferation. These agents also inhibit the immune response. Efficacy can be seen as early as 3-4 weeks but can take up to 4-6 months. Probiotics have shown to reduces disease activity in IBD Lactobacillus Bifidobacterium Taenia suis Saccharomyces boulardii
|
openlifescienceai/medmcqa
|
ICD ICD mentions International classification of mental and behavioural disorders this was given by WHO( World health Organisation) ICD is used all over the world except America latest edition of ICD is ICD11 ICD 11 was released in 2018 DSM DSM mentions Diagnostic and Statistical manual of mental disorders this was given by APA( American Psychiatric Assosiation) DSM is used in America latest edition of DSM is DSM 5 ICD 11 was released in 2018 categorisation ofmental disorders in ICD 10 is mentioned below F00-F09 Organic, including symptomatic, mental disorders F10-F19 Mental and behavioural disorders due to psychoactive substance use F20-F29 Schizophrenia, schizotypal and delusional disorders F30-F39 Mood disorders ICD-10 Classification of Mental and Behavioural Disorders, World Health Organization, Geneva, 1992
|
openlifescienceai/medmcqa
|
Refer robbins 9/e 511 Kawasaki disease (mucocutaneous lymph node syndrome) is an aeritis that often involve coronary aeries usually young children and infants ( majority of the cases are seen in less than 5 years of case) It is treated with intravenous immunoglobulin and aspirin
|
openlifescienceai/medmcqa
|
Ans. A Pulsatile tinnitus "The two most common presenting symptoms of paraganglioma of temporal bone (Glomus tumor) are conductive hearing losso and pulsatile tinnnus" Hearing loss is conductive and slowly progressive Tinnitus is pulsatile and of swishing character", synchronous with pulse", and can be temporarily stopped by carotid pressure", Thus, both pulsatile tinnitus and deafness are seen in glomus tumor.
|
openlifescienceai/medmcqa
|
Misoprostol (PGE1) and dinoprostone (PGE2) are two forms of prostaglandins are commonly used for cervical ripening before induction at term. RU-486 or mifepristone is an anti-progestin. It acts primarily as a competitive receptor antagonist for both progesterone receptors. Indications for its usage are, Termination of pregnancy Emergency contraception Prevention of conception Induction of labor For treatment of uterine leiomyomas, endometriosis, meningiomas, and breast cancer. Ref: Levin E.R., Hammes S.R. (2011). Chapter 40. Estrogens and Progestins. In L.L. Brunton, B.A. Chabner, B.C. Knollmann (Eds), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e.
|
openlifescienceai/medmcqa
|
Ans. is 'a' i.e., Centripetal o Rash of chicken pox : Superficial, unilocular, centripetal, pleomorphic, symmetrical, affects flexor surfaces and axilla, spares palms and sales, has inflammation around, rapid evolution and dew-drop on rose petal appeamace.o Has been explained in All India Dec-15
|
openlifescienceai/medmcqa
|
park's textbook of preventive and social medicine 23rd edition. *Oral contraceptive of combined type are almost 100 effective in preventing pregnancy.some women do not take it regularly so the actual rate is lower.mechanis of action:prevent the release of ovum from ovary.this is achieved by blocking pituitary secretion of gonadotrophin.progestogen only preparation render the cervical mucous thick and scanty and there by inhibit sperm penetration.
|
openlifescienceai/medmcqa
|
Ans. is C Nucleus of tractus solitarius o Baroreceptors are mechanoreceptors that are located in the adventia of carotid artery and aorta, at specialized locations called sinuses. Carotid sinus is a little bulge at the root of internal carotid artery, located just above the bifurcation of the common carotid artery. It is innerv ated by the sinus nerve, a branch of glossopharyngeal (IX cranial) nerve. Aortic arch (aortic sinus) also contains mechenoreceptors (stretch receptors) which are similar to carotid sinus receptors. However, their afferent nerve fibers travel in the aortic nerve, a branch of Vagus (X cranial) nerve. o The sinus nerve (from carotid sinus) and aortic nerve/vagal fibers (from aortic sinus) are together called 'Sino- aortic nerves'. They, together, are also refered to as 'Buffer nerves' because they are the afferents of cardiovascular reflexes that buffer abrupt changes in blood pressure. o Baroreceptors are highly sensitive to any change in mean blood pressure. Sinoaortic nerves (buffer nerves) normally discharge rhythmically, synchronous with the pressure fluctuation during systole and diastole. They respond to BP changes between 70 mm Hg and 150 mm Hg. When BP rises, baroreceptors are stimulated and their afferents (through sinoaortic nerves) stimulate nucleus of tractus solitarus (NTS) which inturn inhibits the pressor area of VMC, i.e., Rostral ventrolateral medula (RVLM). This results in decreased sympathetic outflow and therefore decreases in vasomotor tone and vasodilation. Vasodilation brings down the BP. Thereby helping hemostasis. Activated NTS also stimulates nucleus ambiguous (cardioinhibitory center) of medulla, which increases parasympathetic (vagal) output, through vagus, that decreases heart rate. Reduction in heart rate reduces the cardiac output, which also reduces BP. Baroreceptor stimulation also weekly inhibits respiration, o When BP falls, for instance while changing the posture from lying down to standing, reverse change takes place. When a person stands up, his blood is pooled in the veins of lowrer limbs by the effect of gravity. Central venous pressure and venous return decrease, which causes a fall in stroke volume. Hence the systolic BP falls. As a result, the discharge rate of baroreceptors decreases leading to a decrease in the inhibitory' influence on the pressor area of VMC. Hence vasomotor tone increases, leading to vasoconstriction, and consequently an increase in BP. Simultaneously, the nucleus ambiguous of the vagus is also inhibited, increasing the heart rate and consequently stroke volume and eventually BP. Thus fall in BP due to change of posture is very brief (Transient).
|
openlifescienceai/medmcqa
|
water soluble contrast enema releives obstruction in 75% of cases OPERATIVE INTERVENTION -paul mikulicz double barrel ileostomy koops distal chimney ileostomy santullis proximal chimney ileostomy
|
openlifescienceai/medmcqa
|
Basal cell cancer Aka Rodent ulcer Locally invasive Destruction of surrounding tissues - Aka Tear Cancer Seen in face above the line joining ear lobule to angle or corner of mouth - Arises from Basal layer of epidermis - Most common site - Nose > Inner canthus Types of BCC (based on pathology) - Nodular MC type Classical sign- Central depression with umbilication - Pigmented - Cystic - Superficial Diagnosis - IOC for Dx - Wedge Biopsy Management - Wide Local Excision- If tumor is non-aggressive involving trunk or extremities - MOH'S micrographic surgery- If tumor is aggressive involving vital areas, cosmetic areas and recurrent
|
openlifescienceai/medmcqa
|
Ans. C: Have conduction velocity of four times than that of the hea muscle Conduction rate is 4 m/s in purkinje fibers whereas it is 1 m/s in ventricular muscles, atrial pathways and Bundle of His. SA Node and AV Node has a conduction speed of 0.05 m/s
|
openlifescienceai/medmcqa
|
AIDS-related lymphomas can be divided into three group -
Systemic
Lymphomas involving lymph nodes as well as extranodal visceral sites constitute 80% of all lymphomas.
The most common extranodal site affected is CNS
Aggressive B cell tumours
Primary CNS lymphoma
CNS is the primary site of lymphomatous involvement in 20% AIDS patient (Note these primary CNS lymphomas are in addition to those involved by the systemic lymphomas).
Body cavity based lymphoma
Rare
Has an unusual distribution
It grows exclusively in body cavities in the form of pleural peritoneal and pericardial effusions
|
openlifescienceai/medmcqa
|
(Congenital dislocation of hip joint) (203-M)Congenital dislocation of hip(a) Plaster cast - A frog leg (Lorenz cast) or Bachelor cast(b) Splint - Von Rosen's splint
|
openlifescienceai/medmcqa
|
Ans. is 'b' i.e., Trochlear notch Inner surface of olecranon process forms trochlear notch for aiculation of trochlea of humerus. Radial notch is seen in lateral pa of upper end of shaft (not on olecronon). Olecranon fossa and coronoid fossa are pa of lower end of humerus.
|
openlifescienceai/medmcqa
|
Malathion has the least toxicity of all organophosphorus compounds. Yellow/clear brown liquid used in dose of 100-200 mg.per.sq.ft. every 3 months because of its low toxicity, malathion has been recommended as an alternative insecticide to DDT. as a low volume spray (ULV) spray it has been widely used to kill adult mosquitoes to prevent or interrupt dengue hemorrhagic fever and mosquitoes borne encephalitis epidemics. Park's Textbook of Preventive and Social Medicine, 25th Edition, Pg 844
|
openlifescienceai/medmcqa
|
Ans. is 'c' i.e., Wait & watch Laryngomalaciao The most common congenital laryngeal anomaly and the most frequent cause of stridor in infants and children.o Typically, stridor is inspiratory: low pitched, and exacerbated by any exertion (crying, agitation, feeding), supine position, and viral infections of the upper airway.o Stridor results from the collapse of supraglottic structures inward during inspiration.o Symptoms usually appear in the first 2 wk of life and increase in severity for up to 6 mo, although gradual improvement can begin at any time,o The diagnosis is confirmed by flexible laryngoscopyo Expectant observation is suitable for most infants because most symptoms resolve spontaneously.
|
openlifescienceai/medmcqa
|
Ans. is 'c' i.e., Black * Dead or moribund patients (color code black) have the lowest priority.* Triage has been explained in previous sessions
|
openlifescienceai/medmcqa
|
Y descent is due to passive movement of blood from atria to ventricles i.e. early diastolic filling
|
openlifescienceai/medmcqa
|
Ans. a. Paracentric inversion
|
openlifescienceai/medmcqa
|
Lymphoepithelioma occur chiefly in the nasopharynx of young or middle aged persons. It also seen in the oropharynx, tongue, tonsil, parotid, nasal chamber and paranasal sinus. Ref: Shafer'S Textbook of Oral Pathology By Rajendran, 6th Edition, Pages 119-120; Epstein-Barr Virus By Erle S. Robeson, Page 60
|
openlifescienceai/medmcqa
|
The most common location of acoustic nerve schwannoma is the internal auditory canal (Intracanalicular). It may then grow back to compress the facial nerve, and then progressively involve the cistern and cerebello-pontine angle.
|
openlifescienceai/medmcqa
|
APGAR score has no prognostic significance with regard to neurologic outcome.
|
openlifescienceai/medmcqa
|
The medical condition is Barrett's esophagus, in which the normally nonkeratinizing squamous epithelium of the esophagus undergoes metaplasia to gastric or intestinal-like epithelium composed of nonciliated columnar epithelial cells.
|
openlifescienceai/medmcqa
|
Central clearing: T. Corporis - KOH smear Central scarring: Lupus vulgaris - Biopsy Central crusting: Leishmaniasis - LT body demonstration
|
openlifescienceai/medmcqa
|
Ans. is 'b' i.e., Hydroxyurea Hydroxyurea* It blocks the conversion of ribonucleotides to the deoxyribonucleotides by inhibiting the enzyme ribonucleoside diphosphate reductase, which interferes with DNA synthesis.* It exerts S phase specific action.* Myelosuppression is a major toxicity* The most significant advance in the therapy of sickle cell anemia has been the introduction of hydroxyurea as a mainstay of therapy for patients with severe symptoms.* Hydroxyurea (10-30 mg/kg per day) increases fetal hemoglobin and may also exert beneficial affects on RBC hydration, vascular wall adherence, and suppression of the granulocyte and reticulocyte counts; dosage is titrated to maintain a white cell count between 5000 and 8000 per mL.* White cells and reticulocytes may play a major role in the pathogenesis of sickle cell crisis, and their suppression may be an important benefit of hydroxyurea therapy.* Hydroxyurea should be considered in patients experiencing repeated episodes of acute chest syndrome or with more than three crises per year requiring hospitalization. The utility of this agent for reducing the incidence of other complications (priapism, retinopathy) is under evaluation, as are the long-term side effects.* Hydroxyurea offers broad benefits to most patients whose disease is severe enough to impair their functional status, and it may improve survival. HbF levels increase in most patients within a few months.
|
openlifescienceai/medmcqa
|
Removal of Insect from ear canal Tilt the person's head so that the ear with the offending insect is upward. Try to float the insect out by pouring mineral oil, olive oil or baby oil into the ear. The oil should be warm but not hot. While pouring the oil, ease the entry of the oil by straightening the ear canal. Pull the earlobe gently backward and upward for an adult, backward and downward for a child. The insect should suffocate and may float out in the oil bath. Don't use oil to remove any object other than an insect. Do not use this method if there is any suspicion of a perforation in the eardrum -- pain, bleeding or discharge from the ear.
|
openlifescienceai/medmcqa
|
Refining decreases TFA
Vegetable oil refining and hydrogenation increase trans-fatty acid contents.
|
openlifescienceai/medmcqa
|
• Nephrotic syndrome is a clinical complex characterized by proteinuria (> 3.5 g/day), hypoalbuminemia, edema and hyperlipidemia.
• A hypercoagulable state frequently accompanies severe nephrotic syndrome due to urinary loss of AT-III, reduced serum levels of protein C and S, hyperfibrinogenimia and enhanced platelet aggregation.
• Due to increased coagulation state, predisposition to CAD is present in patients with nephrotic syndrome.
Potential future questions
Among hyperlipoproteinemias type II, III and IV are associated with increased risk of CAD whereas Type I and V are not associated with CAD.
|
openlifescienceai/medmcqa
|
Cyclosporine and tacrolimus acts by inhibiting calcineurin, which is involved in the activation of NFAT. Final result of this process is increased transcription of IL-2 gene.
Sirolimus does not inhibit the transcription of IL-2 but interferes with its action. It inhibits the enzyme tyrosine kinase, known as mTOR (which is activated by IL-2).
|
openlifescienceai/medmcqa
|
Oswald Schmiedeberg is father of modern Pharmacology. Sir Ram Nath Chopra-father of Indian pharmacology, David Sackett is father of evidence-based medicine. Paul Ehrlich -father of chemotherapy
|
openlifescienceai/medmcqa
|
Ans. is 'a' i.e., Pemphigus Immunofluorescence in dermatologyDiseaseIgGIgMIgAC3FibrinIF patternAntigenPemphigus vulgaris++ ++ Intercellular- between epidermal cells.Network patternDesmoglein 3IgA pemphigus ++ Do Paraneoplastic pemphigus++++ DoDesmoplakinBullous pemphigoid++ ++ Linear deposits along BMZBP230 BPI80Epidermolysis bullosa acquisita++ ++ DoCollagen 7Dermatitis herpetiformis +++ Granular papillary tip deposits along BMZEpidermal transglutaminaseSLE++++ ++ Granular deposits along BMZ Lichen planus++++++Ovoid bodies with ragged fibrin band along BMZ Bullous SLE+++ Linear BMZ depositsCollagen 7Porphyria++\ +Perivascular and BMZ deposits Amyloid+++++-H- Globular deposits in tips of apillary dermis BMZ-Basement membrane zone
|
openlifescienceai/medmcqa
|
"William House was considered the father of Neurotology because of his pioneering development approaches for the removal of acoustic tumors and the management of patients with disabling veigo," said William House's nephew, John House, M.D., who is a House Clinic physician and House Research Institute president.
|
openlifescienceai/medmcqa
|
Ans. B: HypeensionFindings of atrial myxoma?Jugular venous pressure may be elevated, and a prominent a wave may be present.A loud S1 is caused by a delay in mitral valve closure due to the prolapse of the tumor into the mitral valve orifice (mimicking mitral stenosis).P2 may be delayed. Its intensity may be normal or increased, depending on the presence of pulmonary hypeension.In many cases, an early diastolic sound, called a tumor plop, is heard. This sound is produced by the impact of the tumor against the endocardial wall or when its excursion is halted.An S3 or S4 may be audible.A diastolic atrial rumble may be heard if the tumor is obstructing the mitral valve.If there is valve damage from the tumor, mitral regurgitation may cause a systolic murmur at the apex.A right atrial tumor may cause a diastolic rumble or holosystolic murmur due to tricuspid regurgitation.The major clinical manifestation are due to valvular "ball-valve" obstruction. Embolization, or a syndrome of constitutional symptoms such as fever, cyanosis, digital clubbing, rash, or petechiae. Sometimes fragmentation and systemic embolization calls attention to these lesion.Patients with familial myxoma may have a variety of features called syndrome myxoma or Carney syndrome, as follows:- Myxomas in breast, skin, thyroid gland, or neural tissue- Spotty pigmentation such as lentigines (i.e., flat brown discoloration of skin), pigmented nevi, or both- Endocrine hyperactivity such as Cushing syndrome- Multiple cerebral fusiform aneurysms may be seen in patients with Carney syndrome.Other described syndromes associated with atrial myxomas include the following:- NAME syndrome features nevi, atrial myxoma, myxoid neurofibroma and ephelides (i.e., freckles (tanned macules found on the skin)).- LAMB syndrome features lentigines, atrial myxoma, and blue nevi.
|
openlifescienceai/medmcqa
|
Answer is D (Thrombocytopenia, anemia, neurological abnormalities, progressive renal failure and fever) Thrombotic Thrombocytopenic Purpura (TTP) is characterized clinically by the Pentad of Microangiopathic Hemolytic Anemia, Thrombocytopenia. Decreased Renal Function. Disturbed Neurological function and Fever.
|
openlifescienceai/medmcqa
|
(A) Glucocerebrosidase# Gaucher disease refers to a duster of autosomal recessive disorders resulting from mutations in the gene encoding glucocerebrosidase. This disease is the most common lysosomal storage disorder.> This affected gene encodes glucocerebrosidase, an enzyme that normally cleaves glucose residue from ceramide> As a result, glucocerebroside accumulates principally in the phagocytic cells of the body but in some forms also in the central nervous system.> Glucocerebrosides derived mainly from the cell membranes of leukocytes and erythrocytes.
|
openlifescienceai/medmcqa
|
Ans. is 'b' i.e., Prostate Currently Intensity modulated radiotherapy is being used to treat cancers of:ProstateHead & NeckBreastThyroidLungGynecologic cancersLiverBrainLymphomasSarcomasIntensity modulated radiation therapy (IMRT) is an advanced mode of high precision radiotherapy that utilizes computer controlled X-ray accelerators to deliver precise radiation doses to a malignant tumour or specific areas within the tumour:The radiation dose is designed to conform to the three dimensional (3-D) shape of the tumour by modulating or controlling the intensity of the radiation beam to focus a higher radiation dose to the tumour while minimizing exposure to surrounding tissues.Note: IMRT can be used to treat lung cancers, but there are several technical reasons to delay the widespread use of IMRT for lung Ca at this time.
|
openlifescienceai/medmcqa
|
Ans. (b) Heberden's nodesRef: Harrison 18th ed. / ch. 332*"Heberderis nodes are hard or bony swellings that develop in the distal interphalangeal joints (DIP) in a case of osteoarthritis"Clinical Features of Rheumatoid Arthritis*The presenting symptoms of RA typically result from inflammation of the joints, tendons, and bursae.*Early morning joint stiffness lasting more than 1 hour and easing with physical activity. *The earliest involved joints are typically the small joints of the hands and feet. The initial pattern of joint involvement may be monoarticular, oligoarticular(<4 joints), or polyarticular (>5 joints), usually in a symmetric distribution* Wrists, metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints stand out as the most frequently involved joints.* The frequent hallmark of RA: Flexor tendon tenosynovitis.Deformities* Ulnar deviation of the hand.* Swan-neck deformity: Hyperextension of the PIP joint with flexion of the DIP* Boutonniere deformity: Flexion of the PIP joint with hyperextension of the DIP joint* Z-line deformity Subluxation of the first MCP joint with hyperextension of the first interphalangeal (IP) joint* Inflammation about the ulnar styloid and tenosynovitis of the extensor carpi ulnaris may cause subluxation of the distal ulna, resulting in a "piano-key movement" of the ulnar styloid* Metatarsophalangeal joint (MTP) involvement is a feature of early disease in the feet* Atlantoaxial involvement of the cervical spine can cause compressive myelopathy and neurologic dysfunction* Most frequent extraarticular manifestations: Subcutaneous nodules, secondary Sjogren's syndrome, pulmonary nodules, and anemia.
|
openlifescienceai/medmcqa
|
Ans. is 'b' i.e., Calcium Vitamin K plays an impoant role in blood coagulation for it is required for the post-translational processing of several clotting factors (factor II, VII, IX and X). Maturation of these clotting factors requires the conversion of glutamyl residues of precursor proteins into 'ycarboxyglutamate (Gla) residues by addition of carboxylate group. This carboxylation of glutamyl resdiue is vitamin K dependent. The y-carboxyglutamate (Gla) residues so formed serve as binding site for calcium ions. Each Gla contains two negative charges which chelate the positive calcium ion. After binding to Gla residue on activated clotting factor, calcium binds with negatively charged phospholipids present on the platelet cell membrane. In this way, bridging of the phospholipids the Gla residue of prothromin occurs calcium ion.
|
openlifescienceai/medmcqa
|
Eg for enzyme inducers- phenytoin, phenobarbitone, carbamazepine, rifampin An enzyme inhibitor is a molecule that binds to an enzyme and decreases its activity. Since blocking an enzyme's activity can kill a pathogen or correct a metabolic imbalance, many drugs are enzyme inhibitors. eg for enzyme inhibitors: ketoconazole, grapefruit juice, ciprofloxacin, chloramphenicol Refer cha Pg.no 26. KD TRIPATHI SEVENTH EDITION
|
openlifescienceai/medmcqa
|
FECUNDATION AB EXTRA: The conception of the female due to deposition of semen on the vulva, without penetration of the vagina - The insemination occurs due to the passage of spermatozoa from external genitalia to the uterus. Ref - Krishnan Vij 5th edition pg 395 , 404
|
openlifescienceai/medmcqa
|
Collagen * Collagen is the most abundant protein in the human body, have a triple helical structure * At least 28 distinct types of collagen made up of over 30 distinct polypeptide chains have been identified in human tissues * The main fibril forming collagens in skin and bone and in cailage, respectively, are types I and II. Ref:- Harper 30/e; pg num:- 628 , Lippincott 7/e; Pg Num:- 44
|
openlifescienceai/medmcqa
|
Tetanus never spreads through droplet infection. It usually spreads to local contact of spores with the wound. Ref: Parija Subhash Chandra (2009), Chapter 29, "Clostridium", In the book "Textbook of Microbiology and Immunology", Elsevier Publications, India, Page 247
|
openlifescienceai/medmcqa
|
Ans. is 'a' i.e., 95% oral bioavailability o Vancomycin is not absorbed orally (zero bioavailibility).
|
openlifescienceai/medmcqa
|
c. 500(Ref: Nelson 20/e 349; Pediatric Urology By John G. Gearhart pg 15-20)Premature infants have an even more limited capacity to concentrate their urine than those born at term, with a maximum urine osmolality of about 500mOsm/kgH2 O.
|
openlifescienceai/medmcqa
|
In acute exacerbations of COPD, noninvasive positive pressure ventilation (NIPPV) is initiated in patients with respiratory failure, which is defined as Paco2 > 45 mmHg, This results in a significant reduction in moality rate, need for intubation, complications of therapy, and hospital length of stay.Ref: Harrison 19e pg: 1707
|
openlifescienceai/medmcqa
|
Ans. is 'b' i.e. Median
|
openlifescienceai/medmcqa
|
Ans: D (Bladder and bowel involvement) Ref: Harrison's Principles of Internal Medicine. 18th edition. 2012. Chapter 385. (Table 385-3)Explanation:Guiilian-Barre SyndromeGBS manifests as a rapidly evolving areflexic motor paralysis with or without sensory- disturbance.The usual pattern is an ascending paralysis that may be first noticed as rubbery legs. Weakness typically evolves over hours to a few days and is frequently accompanied by tingling dysesthesias in the extremities.The legs are usually more affected than the arms, and facial di pares is is present in 50%' of affected individuals.The lower cranial nerves are also frequently- involved. causing bulbar weakness with difficulty handling secretions and maintaining an airway; the diagnosis in these patients may initially he mistaken for brainstem ischemia.Pain in the neck, shoulder, back, or diffusely over the spine is also common in the early stages of GBS, occurring in 50% of patients.Most patients require hospitalization, and in different series upto 30% require ventilatory assistance at some time during the illness.Fever and constitutional symptoms are absent at the onset.Deep tendon reflexes attenuate or disappear within the first few days of onset.Cutaneous sensory deficits (e.g., loss of pain and temperature sensation) are usually relatively mild, but functions subserved by large sensory fibers, such as deep tendon reflexes and proprioception, are more severely affected.Bladder dysfunction may occur in severe cases hut is usually transient.If bladder dysfunction is a prominent feature and comes early in the course, diagnostic possibilities other than GBS should he considered, particularly spinal cord disease.Once clinical worsening stops and the patient reaches a plateau (almost always within 4 weeks of onset), further progression is unlikely.Autonomic involvement is common and may occur even in patients whose GBS is otherwise mild.The usual manifestations are loss of vasomotor control with wide fluctuation in blood pressure, postural hypotension and cardiac dysrhythmias.Pain is another common feature of GBS; in addition to the acute pain described above, a deep aching pain may be present in w eakened muscles that patients like to having overexercised the previous day.Other pains in GBS include dysesthetic pain in the extremities as a manifestation of sensory nerve fiber involvement. These pains are selflimited and often respond to standard analgesics.
|
openlifescienceai/medmcqa
|
D i.e. Methadone
|
openlifescienceai/medmcqa
|
Ref-Park&;s textbook of Preventive and Social Medicine 24th edition. .
|
openlifescienceai/medmcqa
|
*Cotrimoxazole prophylaxis is recommended for all HIV exposed infants staing at 4-6 weeks of age and continued until infection can be excluded. *All children who begin cotrimoxazole prophylaxis should continue until the age of 5 yrs ,when can be reassessed. Reference : OP Ghai 9th edition pg:229
|
openlifescienceai/medmcqa
|
ANSWER: (B) LinezolidREF: Goodman and Gillman 11th edition page 780"Linezolid is a synthetic antimicrobial agent of the oxazolidinone class"The three classes of drugs which have beta lactam ring in its structure are:Penicillins consist of a thiazolidine ring connected to a b-lactam ring, to which is attached a side chainCephalosporins are produced from 7-aminocephalosporanic acid by the addition of different side chains. Modifications at position 7 of the b-Iactam ring alter antibacterial activity, while substitutions at position 3 of the dihydrothiazine ring alter the metabolism and pharmacokinetic properties.IILCarbapenems are b-lactams that have a broader spectrum of activity than most other fa- lactam antibiotics
|
openlifescienceai/medmcqa
|
Tibialis posterior is the deepest and most centrally located muscle in the deep posterior compament of the leg. It arises from the upper posterior aspect of tibia, fibula and interosseous membrane and passes medially deep to the flexor retinaculum. Its tendons flares and inses into the navicular, tarsal bones, and bases of the second, to fouh metatarsals. Flexor retinaculum is a thick band of deep fascia on the medial aspect of the ankle Medial calcaneal nerve and medial calcaneal aery pierce the retinaculum. Structures passing below it from above down are: Tibialis posterior tendon Flexor digitorum longus tendon Flexor hallucis longus tendon Posterior tibial aery Tibial nerve.
|
openlifescienceai/medmcqa
|
Cryoglobulinemia with renal involvement is associated with hypocomplementemia in the majority of cases. In addition it has been well recognized that hepatitis C is often associated with cryoglobulinemia. Diffuse proliferative lupus nephritis (WHO class IV) is the most aggressive form of the disease and is also associated with hypocomplementemia. Early in the course of postinfectious glomerulonephritis, immune complex deposition is in full force and serum complements are low. Henoch-Schonlein purpura, the systemic manifestation of IgA nephropathy, is not associated with hypocomplementemia. Other causes of hypocomplementemic glomerulonephritis are glomerulonephritis associated with bacterial endocarditis or other chronic infections as well as membranoproliferative glomerulonephritis.
|
openlifescienceai/medmcqa
|
Spiramycin This macrolide antibiotic, though available for more than a decade, has been employed only sporadically. It resembles erythromycin in spectrum of activity and propeies. Distinctively, it has been fowtd to limit risk of transplacental transmission of Toxoplasma gondii infection. Its specific utility is for toxoplasmosis and recurrent aboion in pregnant women; 3 week courses of 3 MU 2-3 times a day are repeated after 2 week gaps till delivery. Other indications are similar to erythromycin for which 6 MU/day is given for 5 days. Side effects are gastric irritation, nausea, diarrhoea and rashes. ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:731
|
openlifescienceai/medmcqa
|
Ans. is 'a' i.e., HBsAg o HBsAg testing is widely used as a marker of HBV infection in epidemiological surveys.Serological markers for HBVo Serological markers for HBV infection areHBs Ag (surface antigen or Australia antigen) : It is the first marker which appears in the serum. It is the epidemiological marker for HBV infection.HBc Ag (core antigen) : It is not demonstrable in serum because it is enclosed by HBsAg coat.HBe Ag (envelope antigen) : It is marker of active replication and high infectivity. It is qualitative marker of replication. HBs Ag carrier mothers who are HBe Ag positive almost invariably (> 90%) transmit hepatitis B infection to their offspring, where as HBs Ag carrier mothers with anti HBe rarely (10 to 15%) infect their offspring.Anti-HBc Ag : It is the first antibody appears in serum. IgM anti-HBc Ag is a marker of acute or recent infection. IgG anti-HBc Ag indicates remote infection.Anti-HBs Ag : It is protective antibody. It is the only serological marker present after vaccination. After an infection, its presence indicates recovery and end of period of communicability.Anti-HBe Ag : Its presence indicate stopage of replication and tow infectivity.HBV DMA : It is quantitative marker of HBV replication.
|
openlifescienceai/medmcqa
|
C i.e. Brachycephaly
|
openlifescienceai/medmcqa
|
PTU is given in pregnant woman. Carbimazole is contraindicated.
|
openlifescienceai/medmcqa
|
Ans. (B). Arsenic(Ref: Parikh 6th/e p. 9.9-9.11; Reddy 30th/e p. 493-494; Essentials of forensic medicine-812)Bone, hair and nails are preserved in Heavy metals poisonings like arsenic, antimony, and thallium.Distribution of Arsenic in the body:Arsenic is present in almost all tissues, and found in the greatest quantity in the liverQ, followed by kidneys and spleen.In cases, where the patient survives, it is found in the muscles (for months), bones, hair, nails and skin (Sulfhydryl groups in keratin) for years.Hair: Arsenic > 75 mg% - Poisoning.Nails: Presence of > 100 mg% of arsenic - Poisoning.
|
openlifescienceai/medmcqa
|
B i.e. Retina laser photocoagulation
|
openlifescienceai/medmcqa
|
In pre-renal azotemiaBUN/creatinine ratio above 20, FeNa<1%, hyaline casts in urine sediment,urine specific gravity >1.018, urine osmolality >500 mOsm/kgPigmented "muddy brown" granular casts and tubular epithelial cell casts are seen in acute tubular necrosis.Ref: Harrison's 19e pg: 1805
|
openlifescienceai/medmcqa
|
Ans. (C) Function of the intestine is not affected(Ref: Katzung 11/e p542)Because of their direct action on the superficial neurons of the spinal cord dorsal horn, opioids can also be used as regional analgesics by administration into the epidural or subarachnoid spaces of the spinal column.It was initially assumed that the epidural application of opioids might selectively produce analgesia without impairment of motor, autonomic, or sensory functions other than pain. However, respiratory depression can occur after the drug is injected into the epidural space and may require reversal with naloxone.Effects such as pruritus and nausea and vomiting are common after epidural and subarachnoid administration of opioids and may also be reversed with naloxone if necessary.Currently, the epidural route is favored because systemic adverse effects are less common
|
openlifescienceai/medmcqa
|
The scleroderma spectrum of disorders are a group of connective tissue diseases inclusive of localized scleroderma (affects skin only), Raynaud's (vasospastic involvement of the fingers) and systemic sclerosis which is itself divided into diffuse cutaneous systemic sclerosis (DCSS) and limited cutaneous systemic sclerosis (also known as CREST syndrome). The two conditions vary in their symptom pattern and onset, but both involve the internal organ systems, including the renal tract and lungs (causing failure and pulmonary fibrosis). Skin involvement in DCSS is severe and widespread, but organ involvement is maximal at around 3 years and then typically improves. In CREST skin involvement is confined to the face and extremities; however, organ involvement tends to be progressive and more severe. CREST syndrome is typified by the following features: Calcinosis, Raynaud's, esophageal disorders, sclerodactyly and telangiectasia. Diagnosis is clinical and backed by identification of ceain auto-antibodies. Anti-nuclear antibodies are usually present, anti-Scl-70 is positive in 40% of scleroderma, the presence of anti-centromere antibody occurs in 80%-90% of CREST and is suggestive of the diagnosis. However, auto-antibody testing is non-specific, and either antibody or both antibodies may occur in both conditions.
|
openlifescienceai/medmcqa
|
A Small Amount of free fluid may be undetectable on an erect PA chest radiograph as it tends initially to collect under the lower lobes. As the amount of effusion increases, the posterior and then the lateral costophrenic angles become blunted, by which time a 200 to 500-mL effusion is present
|
openlifescienceai/medmcqa
|
Culture is defined as learned behaviours which have been socially acquired. it is transmitted from one generation to another. It is liable for change through acculturation.Behaviour is the total reactions (of an individual) accessible to external observation.Opinions are views held by people on a point of dispute. Opinions by definition are temporary, provisional.Beliefs, on the other hand, are permanent, stable, almost unchanging.Park 23e pg: 674
|
openlifescienceai/medmcqa
|
Answer- D. FamciclovirTopical antivirals used are - Acyclovir, Ganciclovir, triflurothymidine, Vidarabine, Idoxuridine.
|
openlifescienceai/medmcqa
|
Ans. B: Lymphocyte Radiosensitivity is the relative susceptibility of cells, tissues, organs, organisms, or other substances to the injurious action of radiation. In general, it has been found that cell radiosensitivity is directly propoional to the rate of cell division and inversely propoional to the degree of cell differentiation. In sho, this means that actively dividing cells or those not fully mature are most at risk from radiation. The most radio-sensitive cells are those which: Have a high division rate Have a high metabolic rate Are of a non-specialized type Are well nourished. - Highly sensitive-Lymphoid organs, bone marrow, blood, testes, ovaries, intestines - Low sensitivity-Muscle, brain, spinal cord Lymphocytes are most radiosensitive and platelets are more radioresistant.
|
openlifescienceai/medmcqa
|
III A REF: See APPENDIX-60 for details of "FIGO staging of Carcinoma ovary"
|
openlifescienceai/medmcqa
|
Ans. is 'b' i.e., Most infections are subclinical Influenza Influenza virus a RNA virus, belongs to ohomyxovirus. There are three viral subtypes : i) Type A (causes all pandemics and most epidemics); type B; and type C (not circulating currently). Currently the influenza viruses circulating in the world are : 111 N, of type A (causes swine flu); H2 N2 of type A; H3 N2 of type A ; H5 NI of type A (causes birdflu or an influenza); H7 N9 of type A (caused epidemic of an influenza in China in 2013); and type B. Influenza shows cyclic trend with epidemic occuring every 2-3 years in case of influenza - A and every 4-7 years in case of influenza-B. Pandemics are caused by only influenza - A every 10-15 years. Influenza affects all ages and both sexes. Source of infection of influenza is a clinical case or subclinical case. Major reservoir of influenza virus exists in animal and birds. Incubation period is 18-72 hours. Most of the infections are subclinical. Clinical cases present with cough, fever, myalgia and headache.
|
openlifescienceai/medmcqa
|
C i.e. Wait & Watch
|
openlifescienceai/medmcqa
|
(D) Bile in vomitus # Clinical features of Hypertrophic pyloric stenosis:> Classical presentation is of non-bilious vomiting beginning usually at 3-6 weeks age.> Vomiting gradually increases in frequency and severity to become projectile.> Gradually dehydration and failure to thrive manifest.> Persistent vomiting leads to malnutrition, dehydration & Constipation is usual.> Stomach muscles contract forcibly to overcome the obstruction.> Vigorous peristaltic waves moving from the left hypochondrium to umbilicus are visible.> Small mass due to pyloric thickening might be palpable in the transpyloric plane on the right side.
|
openlifescienceai/medmcqa
|
Ref Robbins 8/p209 T cells (thymus cells) and B cells (bone marrow- or bursa-derived cells) are the majorcellular components of the adaptive immune response. T cells are involved in cell-mediated immunity, whereas B cells are primarily responsible for humoral immunity (relating to antibodies). And the positive selection during development
|
openlifescienceai/medmcqa
|
Ans: a (Lymphoma) Ref: Robbins, 7th ed, p. 1046Lymphomas account for 5% of testicular tumours and constitute the most common form of testicular neoplasm in men over the age of 60."The histologic type in most cases is the diffuse large cell lymphoma"Prognosis is extremely poor.Testicular tumoursSeminoma - 40%Teratoma - 32%Combined - 14%Lymphoma - 7%Interstitial - 1.5%Others - 5.5%"Pulmonary mets suggest that tumour is a teratoma" (Bailey, p. 1411)
|
openlifescienceai/medmcqa
|
Ans. (d) NifedipineRef: Bailey and Love 27th edition, Page 813Preoperative preparation of Thyrotoxic patient:* Aim of thyrotoxic patient is to make the patient euthyroid:# Carbimazole 30-40mg per day is the drug of choice for preparation# For pregnant patients and patient's with leucopenia we prefer propyl thiouracil# Last dose of carbimazole is given on the day before surgery in evening# Propranolol 40mg, three times daily or Nadolol 160mgOD is added for fast preparation for surgery# Propranolol is given on day of surgery and continued for 7 days postoperative.# Lugol's Iodine (Iodide) is given last 10 days to make gland firmer and reduce the vascularity of gland
|
openlifescienceai/medmcqa
|
Hepatic siderosis is seen in patients with reduced levels of serum ceruloplasmin and non-ceruloplasmin bound copper. Overeatment with penicillamine lead to reversible sideroblastic anemia and hemosiderosis. Ref: Journal of Hepatology 2012 vol. 56 / 671-685.
|
openlifescienceai/medmcqa
|
- This would be a cross-sectional study, which will provide information about prevalence of diseases in that hospital at that time only. - Cross sectional study: Aka Snapshot study/ Prevalence study . Done at point of time . Based on primary data. Can't calculate strength of association.
|
openlifescienceai/medmcqa
|
Ans. a (Facial nerve). (Ref. Harrison-medicine, 18th/Chapter 376.)Bell's palsy# The most common form of facial paralysis is Bells palsy. Bell's palsy is idiopathic palsy of facial nerve.Clinical Manifestations# The onset of Bell's palsy is fairly abrupt, maximal weakness being attained by 48 h as a general rule.# Pain behind the ear may precede the paralysis for a day or two.# Taste sensation may be lost unilaterally, and hyperacusis may be present.# In some cases there is mild cerebrospinal fluid lymphocytosis.# MRI may reveal swelling and uniform enhancement of the geniculate ganglion and facial nerve, and, in some cases, entrapment of the swollen nerve in the temporal bone.# Approximately 80% of patients recover within a few weeks or months.# The presence of incomplete paralysis in the first week is the most favorable prognostic sign.Pathophysiology# Bell's palsy is associated with the presence of herpes simplex virus type 1 DNA in endoneurial fluid and posterior auricular muscle, suggesting that a reactivation of this virus in the geniculate ganglion may be responsible. However, a causal role for herpes simplex virus in Bell's palsy is unproven.Differential Diagnosis# Tumors that invade the temporal bone (carotid body, cholesteatoma, dermoid).# The Ramsay Hunt syndrome, presumably due to herpes zoster of the geniculate ganglion, consists of a severe facial palsy associated with a vesicular eruption in the pharynx, external auditory canal, and other parts of the cranial integument; often the eighth cranial nerve is affected as well.# Acoustic neuromas frequently involve the facial nerve by local compression.# Infarcts, demyelinating lesions of multiple sclerosis, and tumors are the common pontine lesions that interrupt the facial nerve fibers; other signs of brainstem involvement are usually present.# Bilateral facial paralysis (facial diplegia) occurs in Guillain-Barre' syndrome and also in a form of sarcoidosis known as uveoparotid fever (Heerfordt syndrome).# Lyme disease is a frequent cause of facial palsies in endemic areas.# The rare Melkersson-Rosenthal syndrome consists of a triad of recurrent facial paralysis, recurrent--and eventually permanent--facial (particularly labial) edema, and less constantly, plication of the tongue;# Leprosy frequently involves the facial nerve, and facial neuropathy may also occur in diabetes mellitus.# All these forms of nuclear or peripheral facial palsy must be distinguished from the supranuclear type.# In the latter, the frontalis and orbicularis oculi muscles are involved less than those of the lower part of the face, since the upper facial muscles are innervated by corticobulbar pathways from both motor cortices, whereas the lower facial muscles are innervated only by the opposite hemisphere.Treatment# Symptomatic measures include use of paper tape to depress the upper eyelid during sleep and prevent corneal drying, and Massage of the weakened muscles.# A course of glucocorticoids, given as prednisone 60 to 80 mg daily during the first 5 days and then tapered over the next 5 days, appears to shorten the recovery period and modestly improve the functional outcome.# In one double-blind study, patients treated within 3 days of onset with both prednisone and acyclovir (400 mg five times daily for 10 days) had a better outcome than patients treated with prednisone alone.
|
openlifescienceai/medmcqa
|
• In most cases, lesions regress spontaneously after stopping alcohol or tobacco consumption or correction of underlying cause.
|
openlifescienceai/medmcqa
|
Ans is d, i.e. <95gm/dL;HbA/c<6.5(Wiliams Obs 25/e pg 1111)Metabolic goals in gestational diabetesFasting glucose <95mg/dL2 hr PP <120mg/dLHbA1c: <6.5%
|
openlifescienceai/medmcqa
|
Ans. is 'd' i.e., Imipenem + Amikacin Extended spectrum b lactamases are now responsible for majority of multidrug resistance in Gram negative bacteria.Outbreaks due to strains possessing ESBL have been associated with extensive institutional use of 3rd generation cephalosporins.Extended spectrum b lactamases are resistant to :Third generation cephalosporinsAztreonamAminoglycosidesTetracyclinesTrimethoprim - sulphamethoxazoleFluoroquinolonesDrug effective against expended spectrum b lactamase inhibitors.* CarbapenemAlso knowCarbapenems of ESBL resistance occurs via transferrable plasmids.
|
openlifescienceai/medmcqa
|
ACE inhibitor (captopril) and AT1 antagonists(losaan) First Choice antihypeensive drugs for diabetic patients Calcium channel blockers like amlodipine and Alpha blockers like Prisoner also safe in diabetics Thiazidess and diuretics should be avoided in diabetics
|
openlifescienceai/medmcqa
|
Investigations for Obstructive Jaundice 1. Serum bilirubin. A normal value is less than 1.0 mg%. Both direct and indirect bilirubin are assessed. Direct is increased in obstructive jaundice, i.e. conjugated hyperbilirubinaemia. van den Bergh's test is done. 2. Serum albumin, globulin and A: G ratio. Normal S. albumin is more than 3.5 gm%. 3. Prothrombin time. A normal value is 12-16 seconds. It is significant if it is more than 4 from the control or more than one and half times the control. It is corrected by injection vitamin K, 10 mg IM OD for 5 days or by FFP--5-10 units. 4. Serum alkaline phosphatase, SGPT, SGOT, 5' nucleotidase. 5. U/S abdomen. 6. ERCP to visualise the site of obstruction, brush biopsy, bile sample for analysis. 7. MRCP--Non-invasive diagnostic tool. Ref: SRB&;s manual of surgery,3 rd ed, pg no 588
|
openlifescienceai/medmcqa
|
Tetracycline or azithromycin are the drugs of choice for trachoma. Other drugs used are erythromycin, clarithromycin, rifamipicin and sulfonamide. Ref: Parson's 22nd/e p.175 & 21st/e p. 174
|
openlifescienceai/medmcqa
|
(C) Lack of tolerance for alcohol # Diagnosis of Alcohol Dependence includes the following, such as the: Impaired occupational and social functioning The need for daily drinking to function adequately Inability to cut down or stop drinking
|
openlifescienceai/medmcqa
|
All Correct
|
openlifescienceai/medmcqa
|
C i.e. Distal colonThere are two types of defecation reflex.Intrinsic reflex mediated by local enteric nervous systemParasympathetic defecation reflex mediated by sacral segment of the spinal cord.In both these types, the reflex is initiated by distention of the rectum by the feces and causes increased peristalsis in the descending colon, sigmoid colon and rectum. This forces the feces toward the anus.In a similar way, when the rectum is inflated with gas (CO2) in sigmoidoscopy, nerves are stimulated and causes increased peristalsis in the descending colon, sigmoid (distal colon)Q and rectum.
|
openlifescienceai/medmcqa
|
B i.e. 6 O'clock
|
openlifescienceai/medmcqa
|
Silver impregnation: cells and structure too thin to be seen under the ordinary microscope may be rendered visible if they are thickened by impregnation of silver on the surface. Such a method is used for the demonstration of spirochetes and bacterial flagella REF:Ananthanarayan & Panicker's Textbook of Microbiology 9th edition pg no:13
|
openlifescienceai/medmcqa
|
Answer is A (Small ASD) Endocarditis is unusual in sites with a small pressure gradient as in - ASD - Harrison
|
openlifescienceai/medmcqa
|
Answer is C (Microscopic polyangitis): Henoch Schonlein Nephritis and Lupus Nephritis are examples of Immune complex mediated crescenteric nephritis (Type II RPGN) Nephritis in Alpos syndrome is not associated with crescenteric glomerulonephritis or RPGN Pauci - Immune Crescenteric Glomerulonephritis : Type III RPGN Pauci - Immune crescenteric glomerulonephrits represents those cases of RPGN in which glomerular immunoglobulin deposits, either linear or granular are absent (Immunoflorescence and electron microscopy in these cases charachteristically show absence of Anti GBM antibodies and immune complexes) Most patients with Pauci - immune crescenteric G.N are positive for ANCA (upto 90% of patients), and hence this group is often called ANCA associated RPGN Pauci -- Immune crescenteric Glomerulonephritis includes Idiopathic RPGN Wegener's Granulomatosis Microscopic polyangitis
|
openlifescienceai/medmcqa
|
A cirrhotic patient with abnormal coagulation who needs cholecystectomy should be given FFP FRESH FROZEN PLASMA Transfusions with FFP are given to replenish clotting factors The effectiveness of the transfusion in maintaining hemostasis is dependent on the quantity of each factor delivered and its half life The half-life on the most stable clotting factor, FACTOR-VII, is 4 to 6 hours A reasonable transfusion scheme would be to give FFP on call to the operating room. This way the transfusion is complete prior to the incision, with circulating factors to cover the operative and immediate post-op period Ref: Sabiston 20th edition Pgno :1496
|
openlifescienceai/medmcqa
|
Ans. is 'c' i.e., MicrogliaMicroglia are the major phagocytic cells in the brain.Phagocvtosis Phagocytosis and release of enzymes by neutrophils and macrophages are responsible for eliminating injurious agents.o Phagocytosis involves the following three steps.1. Recognition and attachmentPhagocytosis of microbes and dead cells is initiated by recognition of paicles by receptors expressed on leukocyte surface.These receptors are Mannose receptors and scavenger receptors.These receptors bind a variety of microbes.2. EnglulfmentBinding of a paicle to phagocytic leukocyte receptors initiates the process of active phagocytosis of the paicles.During engulment, extension of the cytoplasm, i.e., pseudopods flow around the paicle to be engulfed. Eventually, this results in complete enclosure of the paicle within a phagosome created by the plasma membrane.Membrane of this phagocytic vacuole (Phagosome) fuses with the membrane of lysosome to form phagolysosome resulting in discharge of lysosomal granule's content into phagosome.During this process neutrophils and macrophages become progressively degranulated.Phagocytosis is dependent on polymerization of actin (similar to chemotoxis that is also dependent on polymerisation of actin).3. Killing and degradationKillingMicrobial killing is accomplished largely by oxygen-depending mechanism, i.e., due to generation of reactive oxygen species.The generation of reactive oxygen species is due to rapid activation on an oxidase - NADPH oxidase. Reactive oxygen species cause membrane damage, cytoskeletal damage and DNA damage.Bacterial killing can also occur by oxygen-independent mechanisms, through action of substances in leukocyte granules -3 Bacterial permeability increasign protein (BPI), lysozyme, lactoferrin, major basic protein and defensin.DegradationAfter killing, acid hydrolases, which are normally stored in lysosomes, degrade the microbes within phagolysosome.
|
openlifescienceai/medmcqa
|
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.