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Drug of choice for pregnant female suspected of having a baby with congenital adrenal hyperplasia | Refer Goodman Gilman 12/e p 123 To suppress fetal androgen production effectively band consequent virilization Dexamethasone must be initiated before 10 weeks of gestation To treat congenital adrenal hyperplasia is baby hydrocoisone is used. | 1,000 | medmcqa_train |
The drug that inhibits uterine contractility and cause pulmonary edema is : | Ans. is a i.e. Ritodrine Pulmonary edema is a serious complication of beta-adrenergic therapy (ritodrine) and MgSO4. This complication occurs in patients receiving oral or (more common) intravenous treatment. It occurs more frequently in patients who have excessive plasma volume expansion, such as those with twins or those who have received generous amounts of intravenous fluids and in patients with chorioamnionitis. Patient presents with respiratory distress, bilateral rales on auscultation of the lungs, pink frothy sputum, and typical X-ray picture. Patients receiving IV beta-adrenergic drugs should be monitored continuously with pulse oxymeter to anticipate the development of pulmonary edema. | 1,001 | medmcqa_train |
A patient presents with diarrhoea. analysis of stool on wet mount shows mobile protozoa without RBCs and pus cells. The diagnosis is - | Ans. is 'b' i.e., Giardiasis . Mobile protozoa with absence of RBC's and pus cells in stools in a patient with diarrhoea suggests giardiasis. . In balantidum cob and entomoeba histolytica infections, pus cells and RBC's will be present in stools. Trichomonas hominis is considered as non-pathogenic | 1,002 | medmcqa_train |
A clinical study involves patients diagnosed with carcinoma whose tumor stage is T4N1M1. The patients' survival rate 5 years from the time of diagnosis is less than 50%, regardless of therapy. Which of the following clinical findings is most likely to be characteristic of this group of patients? | Cachexia is a common finding in advanced cancers, and weight loss without dieting in an adult is a "red flag" for malignancy. The exact cause for this is unknown, but increases in circulating factors such as tumor necrosis factor (TNF) may play a role. Cardiac murmurs may occur in the development of nonbacterial thrombotic endocarditis, a feature of a hypercoagulable state that may occur with advanced malignancies. Icterus is most likely to occur when there is obstruction of the biliary tract by a mass (e.g., as in pancreatic cancer), but metastases are unlikely to cause such an obstruction. Neurologic abnormalities may occur in local tumor growth impinging on nerves, but dull constant pain is the most likely abnormality in malignant neoplasms that invade nerves. Metastases to the spleen are uncommon. Tympany is uncommon in cancer because obstruction by a mass tends to be incomplete and to develop over a long time. (Hint: an empty beer keg is tympanitic when percussed.) | 1,003 | medmcqa_train |
Thiopentone is absolutely contraindicated in | (Porphyria): (381 -- KDT 7th edition; 536- Goodman 12th7or variegate)Thiopentone can precipitate acut intermittent or variegate porphyria in susceptible individuals therefore contraindicated. The abnormal synthesis of protoporphyrin (important in hemoglobin production) results in excess porphobilinogen. Barbiturates induce amino levulinic acid synthase, an enzyme responsible for phosphobilinogen synthesis, This leads to excessive porphobilinogen levels and can precipitate acute porphyric crises, that are manifested by severe abdominal pain, nausea, vomiting, psychiatric disorders and neurologic abnormalities | 1,004 | medmcqa_train |
True regarding the rubens valve is | Rubens valve is a non – rebreathing valve used in self inflating resuscitation bags. It jams in inspiratory position occasionally. It allows spontaneous breathing . | 1,005 | medmcqa_train |
Loeffler's medium is- | Enriched media The media containing ingredients which enhance their growth-promoting qualities E.g. Blood agar, Chocolate agar and Loeffler medium. The usual media employed for cultivation of the diphtheria bacillus are Loeffler's serum slope and tellurite blood agar. Diphtheria bacilli grow on Loeffler's serum slope very rapidly and colonies can be seen in 6-8 hours, long before the other bacteria grow. Best Selective media for Corynebaterium is Potassium tellurite agar. | 1,006 | medmcqa_train |
All are true about halothane except - | Ans. is 'a' i.e., Tachycardia o Halothane causes bradycardia.Halothaneo It is a volatile liquid with sweet odour, nonirritating and noninflammable.o It is a potent anaesthetic with poor analgesic and muscle relaxant properties,o Halothane causes direct depression of myocardial contractility by reducing intracellular Ca+2.o It causes fall in BP and CO.o Heart rate decreases due to vagal stimulation.o It tends to sensitize the heart to arrhythmogenic action of adrenaline - contraindicated in pheochromocytoma.o It causes greater depression of respiration and ventilation perfusion mismatch.o It dilates the bronchi -inhalation agent of choice in asthmatics (intravaneous anaesthetic of choice in asthmatics is ketamine).o It is a hepatotoxic drug and can also cause malignant hyperthermia (Succinylcholine accentuate it),o Recovery is smooth and reasonably quick,o It causes postanaesthetic shivering and chills.o It inhibits intestinal and uterine contractions - agent of choice for assisting external or internal version during late pregnancy.o Because its uterine relaxant action it is contraindicated during labour.o It is particularly suitable for induction and maintenance in children and as maintenance anaesthetic in adults. | 1,007 | medmcqa_train |
A man coming from a mountain whose wife died 6 months prior says that his wife appeared to him and asked him to join her. The diagnosis is | B i.e. Grief psychosis Bereavement, Grief, or Mourning is a psychological reaction of those who survive a significant loss. Differences between normal & abnormal grief:Identifying with a deceased person such as taking on ceain admired traits or treasuring ceain possessions is normal; believing that one is the deceased person or is dying of exactly what the deceased person died of (if in fact, this is untrue) is not normal.- Hearing the fleeting, transient voice of a deceased person may be normal; persistent, intrusive, complex auditory hallucinations are not normal.Denial of ceain aspects of the death is normal; denial that includes the belief that the dead person is still alive is not normal.GriefIs a normal response of an individual to the loss of a loved object which presents with:- Various physical & mental symptoms like sighing, crying, choking, breathing difficulty, weakness, etc. - Preoccupation with the memory of deceased- Sense of presence of deceased & misinterpretation of voices & faces of others as that of lost. - Seeing a person in dreams & fleeting hallucinations.Abnormal Grief Exaggeration of one or more normal symptoms of grief- Duration > 6 months. Pathological/Morbid GriefComplicated Grief1Associated with psychotic orneurotic illness* Chronic Grief* Delayed Grief* Inhibited Grief =* Anniversary Reaction=Duration > 6 monthsOnset after 2 weeks of lost (death)Denial of lossGrief reaction on the death anniversary Over idealization of the deceased. | 1,008 | medmcqa_train |
Ocular manifestation in giant cell arteritis? | Ans. a. Arteritic AIONAION occurs due to interference of blood supply to anterior part of optic nerve (posterior ciliary artery)AION can be clinically differentiated into:Arteritic AIONNonarteritic AION*. Due to giant cell arteritis*. Due to occlusion of short posterior ciliary artery*. Sudden, severe visual loss (6/60)*. Sudden, moderate visual loss (>60/60 non-progressive)*. Most common in females, 7-8th decade*. Most common males, 5th-6th decade*. Premonitory symptoms like pain, Amaurosis Fugax present*. Premonitory symptoms like pain, Amaurosis Fugax absent*. Usually Bilateral-fellow eye affected within days to weeks*. Usually Unilateral (>70%)*. Pale optic disc*. Hyperemic optic with small cup*. Poor prognosis*. Good prognosis | 1,009 | medmcqa_train |
A 43-year-old man suddenly develops odynophagia. Which organism is most likely to be isolated on throat culture? | Odynophagia is a sensation of sharp retrosternal pain on swallowing. It is usually caused by severe erosive conditions such as Candida, herpes virus, and corrosive injury following caustic ingestion. | 1,010 | medmcqa_train |
Which disease is associated with the Father of Public Health? | Dr. John Snow was the first to associate Cholera to a sewage-affected drinking water pump in London Ref: 25th edition Park&;s Textbook of Preventive and Social Medicine, Page no. 25 | 1,011 | medmcqa_train |
Caloric test is done for | Ans. (a) Semicircular canalRef. Dhingra's ENT 5th ed. / 48* Caloric test is used to assess vestibular function. The basis of this test is to induce nystagmus by thermal stimulation of the vestibular system.* Done by taking water of 2 temperatures, cold (30degC) and hot (44degC).* Position of the test: Supine then lift head at 30deg forward or patient sitting with bending backwards 60*.* This position is used in order to make lateral/ horizontal SCC in vertical position.* Cold water elicits nystagmus in opposite eye and warm water elicit nystagmus in same eye (Mn: COWS).* Interpretation:# Normal: Time taken from start of irrigation to end point of Nystagmus is taken and it is 80 seconds --120 seconds.# Canal paresis: Duration of Nystagmus shortened i.e. < 80 sec.* Indicates depressed function of ipsilateral Labyrinth, vestibular nerve and vestibular nuclei.* It is seen in:# Meniere's disease# Acoustic neuroma# Vestibular neuritis# Vestibular nerve section# Postural vertigo | 1,012 | medmcqa_train |
In humans, effective renal blood flow is ? | C i.e., 625 ml | 1,013 | medmcqa_train |
Typhoid carriers are detected by following except ? | Ans. is 'd' i.e., Widal test | 1,014 | medmcqa_train |
Which of the following statements regarding live vaccines is false? | When the administration of two live vaccines is mandatory, it can be given simultaneously but either: ? at different sites of injection or ? at an interval of at least 3 weeks Ref: Park's Textbook of Preventive and Social Medicine By K. Park, 19th Edition, Page 97; Immunology for The Health Sciences By Nicholas J. Vardaxis, Pages 101-4 | 1,015 | medmcqa_train |
Magnan's symptom is seen in: | Altered tactile sensation: the person feel that some insects are crawling on his skin. This is known asMagnan's symptomorcocaine bugs(formication). Cocaine is an alkaloid derived from plantErythroxylon coca. | 1,016 | medmcqa_train |
The earliest manifestation of increased intrcranial pressure following head injury is | In general, symptoms and signs that suggest a rise in ICP include altered level of consciousness, headache, vomitingwithout nausea, ocular palcies, back pain and papilledema. If papilledema is protracted, it may lead to visual disturbances, optic atrophy, and eventually blindness. The headache is classically a morning headache which may wake them from sleep. The brain is relatively poorly supplied by oxygen as a result of mild hypoventilation during the sleeping hours and also cerebral edema may worsen during the night due to the lying position. ref-Graham, D. I.; Gennarelli, T. A. (2000). "Pathology of Brain Damage After Head Injury". In Cooper, Paul Richard; Golfinos, John (eds.). Head Injury (4th ed.). McGraw-Hill. pp. 133-54 | 1,017 | medmcqa_train |
True about Bochdalek hernia is - | Ans. is 'c' i.e., Differential diagnosis for pleuropericardial cyst Differential diagnosis of CDH o Pulmonary sequestration o Cystic adenomatoid malformation o Pleuropericardial cysts | 1,018 | medmcqa_train |
Which bone do not contributes to the medial wall of the orbit? | ANSWER: (D) ZygomaREF: Grays anatomy 39th edition, page 688-690 style="font-size: 1.04761904761905em; color: rgba(0, 0, 0, 1); font-family: Times New Roman, Times, serif">part_8/chapter_45.htmlIndirect repeat in December 2010WALLS OF THE ORBIT:The orbit possesses four walls; a roof, lateral wall, floor, and medial wall.* The roof (frontal and sphenoid bones) presents the fossa for the lacrimal gland anterolaterally and the trochlear pit for the cartilaginous or bony pulley of the superior oblique muscle anteromedially. The optic canal lies in the posterior part of the roof, between the roots of the lesser wing of the sphenoid bone. It transmits the optic nerve and ophthalmic artery from the middle cranial fossa.The posterior aspect of the lateral wall (zygomatic and sphenoid bones) is demarcated by the superior and inferior orbital fissures, The superior orbital fissure lies between the greater and lesser wings of the sphenoid bone. It communicates with the middle cranial fossa and transmits cranial nerves III, IV, and VI, the three branches of the ophthalmic nerve, and the ophthalmic veins. The inferior orbital fissure communicates with the infratemporal and pterygopalatine fossae and transmits the zygomatic nerve. The lateral walls of the two orbits are set at approximately a right angle from one another, whereas the medial walls are nearly parallel to each otherThe floor (maxilla, zygomatic, and palatine bones) presents the infraorbital groove and canal for the nerve and artery of the same name. The inferior oblique muscle arises anteromedially, immediately lateral to the nasolacrimal canal.The medial wall (ethmoid, lacrimal, and frontal bones) is very thin. Its main component (the orbital plate of the ethmoid) is papyraceous (paper-thin). At the junction of the medial wall with the roof, the anterior and posterior ethmoidal foramina transmit the nerves and arteries of the same name. | 1,019 | medmcqa_train |
Swan neck deformity - | Ans. is 'd' i.e., Extention at PIP and Flexion at DIP joint * Boutonniere deformity: Flexion contracture of PIP joint and extension of DIP joint.* Swan neck deformity: Hyperextension of PIP joint and flexion at DIP joint. | 1,020 | medmcqa_train |
A 55-year-old man with recent onset of atrial fibrillation presents with a cold, pulseless left lower extremity. He complains of left leg paresthesia and is unable to dorsiflex his toes. Following a successful popliteal embolectomy, with restoration of palpable pedal pulses, the patient is still unable to dorsi- flex his toes. The next step in management should be | This case illustrates two (among many) conditions that lead to the anterior compartment syndrome, namely, acute arterial occlusion without collateral inflow and rapid reperfusion of ischemic muscle. Treatment for a compartment syndrome is prompt fasciotomy Assessing a compartment syndrome and proceeding with fasciotomy are generally based on clinical judgment. Inability to dorsiflex the toes is a grave sign of anterior compartment ischemia. EMG studies and compartment pressure measurements would probably be abnormal but are unnecessary in view of the known findings and would delay treatment. Mere elevation of the leg would be an ineffective means of relieving compartment pressure, although elevation should accompany fasciotomy. Application of a splint has no role in the acute management of this problem. | 1,021 | medmcqa_train |
Which of the following is not a CT feature ofAdrenal adenoma – | Adrenal adenoma on contrast-enhanced CT/MRI shows rapid uptake and relatively rapid washout of contrast material than do non adenomasQ.
Adenoma: CT features
Well defined/sharply defined
<5 cm in size
Low attenuation (<10 HU) due to lipid content
Mild homogenous enhancement
Relatively rapid washout of contrast material (due to lack of large interstitial spaces
Relatively rapid washout is characteristic of adenoma | 1,022 | medmcqa_train |
Most common cause of death in primary amyloidosis is? | ANSWER: (B) Cardiac failureREF: Harrison's Internal Medicine 17th edition chapter 324. AmyloidosisThe kidneys are the most frequently affected organ (80%), Renal amyloidosis is usually manifested by proteinuria, which is often in the nephrotic range and associated with significant hypoalbuminemia and edema or anasarca; rarely, tubular rather than glomerular deposition of amyloid can produce azotemia without significant proteinuria. Cardiac symptoms are the second most common presentation (40%), but cardiac dysfunction is associated with death in 75% of patients. | 1,023 | medmcqa_train |
Which of the following is false about mucocele of gallbladder | Mucocele(Hydrops) Mucocele results from Prolonged obstruction of the cystic duct, usually by a large solitary calculus Obstructed GB lumen is progressively distented by mucus (mucocele) or by clear transudate(hydrops) produced by mucosal epithelial cells Clinical features A visible, easily palpable, non tender gallbladder sometimes extending from the RUQ into the right iliac fossa may be found on physical examination The patient with hydrops of the gallbladder frequently remains asymptomatic, although chronic RUQ pain may also occur. Treatment Early cholecystectomy, because empyema, Perforation or gangrene may complicate the condition Ref: Bailey and love 27th edition Pgno :1199 Harrison's 19th edition Pg no :2081 | 1,024 | medmcqa_train |
Most Common Tumour of Eyelid is: | BCC | 1,025 | medmcqa_train |
Intolerance to loud sound, nerve affected is | Clinical features of the 7th nerve palsy: Eyeball turns up and out Saliva dribbles Tears flow down Pain in the ear Noise intolerance Loss of taste Ref: Dhingra 7e pg 104. | 1,026 | medmcqa_train |
Thyroid hormone formation involves many steps. Which of the following amino acid is the precursor for thyroxine? | Tyrosine: Tyrosine is the precursor of triiodothyronine and thyroxine. Neural cells conve tyrosine to epinephrine and norepinephrine. While dopa is also an intermediate in the formation of melanin, different enzymes hydroxylate tyrosine in melanocytes. Dopa decarboxylase, a pyridoxal phosphate-dependent enzyme, forms dopamine. Subsequent hydroxylation by dopamine -oxidase then forms norepinephrine. In the adrenal medulla, phenylethanolamine-N-methyltransferase utilizes S-adenosylmethionine to methylate the primary amine of norepinephrine, forming epinephrine. Ref: Rodwell V.W. (2011). Chapter 30. Conversion of Amino Acids to Specialized Products. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K. Murray, V.W. Rodwell (Eds), Harper's Illustrated Biochemistry, 29e. | 1,027 | medmcqa_train |
Sputum positive patient who should be quarantined: | Ans. (d) Children below 6 yearsRef: K. Park 23rd ed. /182-84* About national TB program, if a person is smear positive for TB:# All the family who is in close contact with the patient is given prophylaxis# Children under age 6 is given prophylaxisNote: India's Revised National Tuberculosis Control Programme (RNTCP) recommends screening of all household contacts of smear-positive pulmonary tuberculosis (PTB) cases for tuberculosis (TB) disease, and 6-month isoniazid preventive therapy (IPT) for asymptomatic children aged <6 years. | 1,028 | medmcqa_train |
Which of these pathologies is the most common benign tumour of the parotid gland? | Mumps causes the classic bilateral parotitis, but it can present as a unilateral enlargement in rare cases. Heerfordt syndrome includes sarcoidosis.
Tuberculosis historically was associated with ‘cold abscess’. It is caused by Mycobacterium tuberculosis, an acid-fast bacterium that does not stain with Gram stain. It requires Ziehl–Neelsen staining. | 1,029 | medmcqa_train |
A patient has ecchymosis and petechiae all over the body with no hepato-splenomegaly. All are true except | Ans. is 'b' i.e., Bleeding into the joints Features of Acute and Chronic Idiopathic Thrombocytopenic Purpura Feature Acute ITP Chronic ITP Peak age of incidence Children 2-6 year Adults, 20-40 year Sex predilection None 3:1 female to male Antecedent infection Common 1-2 week Unusual Onset of bleeding Before Abrupt Insidious Hemorrhagic bullae in mouth Present in severe cases Usually absent Platelet count < 20000/4 3000-80000/8L Eosinophilia and yphocytosis Common Rare Spontaneous remission Occurs in 80% cases Months or years Uncommon | 1,030 | medmcqa_train |
Which body pa is represented superiorly and medially within the postcentral gyrus? | In the postcentral gyrus (somatosensory area) of each hemisphere, the sensory information from the opposite side of the body is received. The lower limb representation is found in the superior and medial poion of the postcentral gyrus (see the figure below). The lateral poion of the postcentral gyrus receives somatic sensory information from the facial and neck region. | 1,031 | medmcqa_train |
A 62 year old man has a 25 year history of alcoholism and liver disease. He visits his physician complaining of pain and swelling of his legs. A decrease in which of the following is the most likely cause of the peripheral edema? | The plasma colloid osmotic pressure is often low in alcoholics with chronic liver disease (cirrhosis). The diseased liver cannot produce adequate amounts of albumin, which leads to a decrease in the concentration of albumin in the plasma, i.e., hypoalbuminemia. Because about 75% of the plasma colloid osmotic pressure can be attributed to the presence of albumin in the plasma, the decrease in plasma albumin concentration that occurs in the latter stages of cirrhosis often leads to peripheral edema. Cirrhosis also causes excess fluid to accumulate in the peritoneal cavity as ascites. In the case of ascites, the edema results not only from hypoalbuminemia, but also from poal vein obstruction (which increases capillary hydrostatic pressure) as well as the obstruction of lymphatic drainage of the liver. In fact, ascites is observed more often than peripheral edema in liver disease. A decrease in capillary hydrostatic pressure would tend to decrease fluid loss from the capillaries, and thereby oppose the development of edema. A decrease in the colloid osmotic pressure of the interstitial fluid would decrease fluid loss from the capillaries, thereby opposing the development of edema. A decrease in interstitial hydrostatic pressure would tend to increase fluid loss from the capillaries, but this cannot be considered a primary cause of edema because the interstitial hydrostatic pressure actually increases when a tissue becomes edematous. Ref: Barrett K.E., Barman S.M., Boitano S., Brooks H.L. (2012). Chapter 31. Blood as a Circulatory Fluid & the Dynamics of Blood & Lymph Flow. In K.E. Barrett, S.M. Barman, S. Boitano, H.L. Brooks (Eds), Ganong's Review of Medical Physiology, 24e. | 1,032 | medmcqa_train |
Most common cause of dissecting hematoma is | Aoic dissection occurs when blood splays apa the laminar planes of the media to form a blood-filled channel within the aoic wall.Aoic dissection occurs mainly in two age groups: (1)men aged 40 to 60 with antecedent hypeension (more than 90% of cases); and (2) younger patients with connective tissue abnormalities that affect the aoa.Robbins Basic pathology, 9th edition, pg no.346 | 1,033 | medmcqa_train |
Charcot's triad include | Charcot's triad is a feature of ascending cholangitis secondary to CBD stones.Intermittent symotoms are produced as the stone moves proximally & floats with relieving of obstruction and subsiding of symotoms.The triad includes fever,jaundice and pain(maybe colicky). SRB's manual of surgery,5th edition,page no:651. | 1,034 | medmcqa_train |
Die is commonly seen in - | Acute promyelocytic leukaemia (M3) may be associated with a serious coagulation abnormality ,disseminated intravascular coagulation.Reference :Davidson's principles & practices of medicine 22nd edition pg no 383. | 1,035 | medmcqa_train |
Humans become infected by M.tuberculosis commonly by | M.tuberculosis is mainly transmitted by direct inhalation of aerosolised bacilli contained in the droplet nuclei of expectorated sputum. Generated while coughing. sneezing,or speaking of infected patients. There may be as many as 3000 infectious nuclei per cough. The tiny droplets may remain suspended in the air for several hours and are easily inhaled. Ref: Textbook of microbiology; Ananthanarayan and paniker's; 10th edition; Pg: 355 | 1,036 | medmcqa_train |
Umbilical cord usually separates in newborns on: | Ans. C. Day 7-10Umbilical cord is the connection between the mother and the fetus in the intrauterine stage and includes two arteries and one vein. It usually separates in children between day 7-10, either by dry gangrene or a residual moist base. | 1,037 | medmcqa_train |
Delayed pubey is when primary amenorrhea is seen without development of secondary sexual characters beyond the age of? | Delayed pubey: Girls: Absence of secondary sexual characters by 13 yrs of age / Absence of menarche by 16 years of age / within 5 yrs of onset of pubey Boys: Lack of pubeal changes by 14 yrs of age | 1,038 | medmcqa_train |
Most common cause of central precocious pubey in girls: | - MCC of central precocious pubey in girls is Idiopathic. - Organic causes are more common in boys. - OTHER CAUSES: Infections - TB, meningitis Injuries - Trauma, neurosurgery, Radiotherapy Tumors - Hypothalamic hamaoma (Gelastic seizures)- MCC of organic central precocious pubey CNS malformations like arachnoid cyst ,hydrocephalus, septo-optic dysplasia | 1,039 | medmcqa_train |
Which test is used to compare kapian-meier survival curve- | Ans. is 'C' i.e., Log rank test o The Kaplan-Meier estimator is an estimater for estimating the survival function from life time data. o A plot of the Kaplan-Meier estimate of the survival function is a series of horizontal steps of declining magnitude which, wrhen a large enough sample is taken, approaches the true survial function of that population. The value of the survival function between successive distinct sampled observations is assumed to be constant, o Different Kaplan-Meier curves can be compared by - The log rank test The cox proportional hazards test | 1,040 | medmcqa_train |
Apoptotic bodies are | In H&E-stained tissue sections, the nuclei of apoptotic cells show various stages of chromatin condensation and aggregation and, ultimately, karyorrhexis; at the molecular level, this is reflected in fragmentation of DNA into nucleosome-sized pieces. The cells rapidly shrink, form cytoplasmic buds, and fragment into apoptotic bodies composed of membrane-bound vesicles of cytosol and organelles.( Robbins Basic Pathology, 9th edition, page 18 ) | 1,041 | medmcqa_train |
According to Hellin's law chances of twins in pregnancy are: | According to Hellin’s rule
The mathematical frequency of multiple pregnancy is:
Twins 1 in 80
Triplets 1 in (80)2
Quadruplets 1 in (80)3 and so on | 1,042 | medmcqa_train |
All of the following are true about OPSI (Overwhelming Postsplenectomy Infection), Except: | Ans is A (Maximum risk is within 1 year of splenectomy) Overwhelming Postsplenectomy Infection (OPSI) Splenectomised patients are likely to suffer from severe infections. This syndrome is called overwhelming postsplenectomy infection (OPSI). OPSI is among the more devastating sequelae of asplenia and is the most common fatal late complication of splenectomy. The loss of the spleen's ability to filter and phagocytose bacteria and parasitized blood cells predisposes the patient to infection by encapsulated bacteria or parasites. Splenectomy also results in the loss of a significant source of antibody production. Infection may occur at any time after splenectomy; in one recent series, most infections occurred more than 2 years after splenectomy, and 42% occurred more than 5 years after splenectomy."- Sabiston I8/e The risk for OPSI is greater after splenectomy for malignancy or hematologic disease than for trauma. The risk also appears to be greater in young children (<4 years of age). OPSI may begin with a relatively mild-appearing prodrome, including fever, malaise, myalgias, headache, vomiting, diarrhea, and abdominal pain. These symptoms may then progress rapidly to fulminant bacteremic septic shock, with accompanying hypotension, anuria, disseminated intravascular coagulation, coma, and death within hours of presentation. The moality rate is between 50% and 70% for fully developed OPSI despite antibiotics and intensive care. Survivors often have a long and complicated hospital course with severe sequelae, such as peripheral gangrene requiring amputation, deafness from meningitis, mastoid osteomyelitis, bacterial endocarditis, and cardiac valvular destruction. S. pneumoniae is the most frequently involved organism in OPSI and is estimated to be responsible for between 50% and 90% of cases. Other organisms involved in OPSI include Haemophilus influenzae, Neisseria meningitidis, Streptococcus species and other pneumococcal species, Salmonella species, and Capnocytophaga canimorsus (implicated in OPSI as a sequela of dog bites). Currently, the standard of care for postsplenectomy patients includes immunization within 2 weeks of splenectomy with: - polyvalent pneumococcal vaccine (PPV23), - H. influenzae type b conjugate, and - meningococcal polysaccharide vaccine Antibiotic prophylaxis--usually a single daily dose of penicillin or amoxicillin--is recommended for asplenic children. (Antibiotic prophylaxis is controversia. Schwaz 9/e and Sabiston 18/e advise chemoprophylaxis; but Harrison 17/e does not recommend it) | 1,043 | medmcqa_train |
"La-facies sympathique" is a condition seen in cases of | * La facies sympathique occurs in hanging* On postmortem examination, in hanging, usually the eyes are closed or partly open and the pupils are usually dilated.Sometimes, when the ligature knot presses on the cervical sympathetic, the eye on the same side may remain open and its pupil dilated (La, facies sympathiaue). This indicates antemortem hanging. | 1,044 | medmcqa_train |
In acute inflammation the tissue response consists of all except | Ref Robbins9/e p97 Granulomatous inflammation is a distinctive pattern of chronic inflammation characterized by aggregates of acti- vated macrophages with scattered lymphocytes. Granulo- mas are characteristic of ceain specific pathologic states; consequently, recognition of the granulomatous pattern is impoant because of the limited number of conditions (some life-threatening) that cause it (Table 2-8). Granulo- mas can form under three settings: * With persistent T-cell responses to ceain microbes (such as Mycobacterium tuberculosis, T. pallidum, or fungi), in which T cell-derived cytokines are responsible for chronic macrophage activation. Tuberculosis is the proto- type of a granulomatous disease caused by infection and should always be excluded as the cause when granulomas are identified. * Granulomas may also develop in some immune- mediated inflammatory diseases, notably Crohn disease, which is one type of inflammatory bowel disease and an impoant cause of granulomatous inflammation in the United States. * They are also seen in a disease of unknown etiology called sarcoidosis, and they develop in response to rela- tively ine foreign bodies (e.g., suture or splinter), forming so-called foreign body granulomas. | 1,045 | medmcqa_train |
This condition is best treated by: | Ans. (a) Intra-keloidal injection of triamcinolone.Diagnosis based on the image is Keloid scar* Characterized by overgrowth of scar tissue beyond the margins of original wound* Occur more commonly in females over sternum, shoulder and face, Black people are more prone for it* Treatment is with intralesional injections of triamcinolone. However best is surgery combined with postoperative interstitial radiotherapyImage Source- style="font-family: Times New Roman, Times, serif"> | 1,046 | medmcqa_train |
Which joint is commonly involved in osteochondritis dissecans? | Kness is the most commonly affected joint. Other joints such as hip, ankle , elbow and shoulder can also be involved. Definition : * Localized condition affecting the aicular surface of a joint with separation of a segment of cailage and subchondral bone * Knee by far the most common joint involved (75% of all OCD lesions) with the ankle, elbow, wrist and other joints accounting for the remaining 25% * Most common: Lateral aspect of medial femoral condyle * Weightbearing surfaces of medial and lateral femoral condyles also affected . ref : maheswari 9th ed | 1,047 | medmcqa_train |
renal papillary necrosis is caused by ? | Etiology # Pyelonephritis # Obstruction of the urinary tract # Sickle cell hemoglobinopathies, including sickle cell trait # Tuberculosis # Cinhosis of the liver, chronic alcoholism # Analgesic abuse # Renal transplant rejection, Radiation, Renal vein thrombosis # Diabetes mellitus # Systemic vasculitis Renal papillary necrosis # Renal papillary necrosis (RPN) is characterized by coagulative necrosis of the renal medullary pyramids and papillae # Renal papillary necrosis generally affects individuals who are in the middle decades of life or older # It is more common in women than in men # 60% of the patients have DM, 30% Urinary tract obsruction, 15% have both. # Renal papillary necrosis is primarily a bilateral process ref : harrisons 21st ed | 1,048 | medmcqa_train |
Bilateral spider leg sign on IVP is suggestive of: | Ans. Polycystic kidney | 1,049 | medmcqa_train |
Which is the only living pa of Hydatid cyst? | Hydatid cyst is caused by Echinococcus granulosus. It has a thick opaque white outer cuticle / laminated layer and an inner thin germinal layer containing nucleated cells. The germinal layer is the site of asexual reproduction. It also secretes the hydatid fluid which fills the cavity. The fluid is clear, colourless / pale yellow with a pH of 6.7 containing salts and protein. It is a good antigen which sensitises the host. The fluid was used as the antigen for Casoni's intradermal test and other diagnostic serological tests. From the germinal layer, small knob like excrescences / gemmules protrude into the lumen of the cyst. These enlarge and become vacuolated and filled with fluid. These are called brood capsules. They are initially attached to the germinal layer by a stalk, but later escapes free into the fluid filled cyst cavity. From the inner wall of brood capsule, protoscolices develop, which represent head of adult worm, complete with invaginated scolex, bearing suckers and hooklets. Each of these are potential tapeworm. Many of the scolices float free in the cyst fluid. These with free brood capsules are called hydatid sand. Ref: Paniker's Textbook of parasitology, 6th Ed page 151. | 1,050 | medmcqa_train |
Von Langenbeck repair is used for treatment of: | Von Langenbeck Repair: Two-stage palate repairs were originally described as a means of treating wide clefts; soft palate repair was done at the same time as lip repair, with the hard palate repaired later after the cleft width had diminished. In a way, this is analogous to lip adhesion; the surgeon is committed to a second operation and has additional scar to confront at the time of the second procedure. The use of two-stage palate repair has consistently been shown to produce poorer speech results when compared with most single-stage techniques, but is still used by some surgeons. | 1,051 | medmcqa_train |
Which of the following is not recommended in the treatment of Chronic Low Back Pain: | B. i.e. Bed rest for 3 months In low back ache (lumbago) bed rest should not exceed 2 (to 4) daysQ, because bed rest for longer period may lead to debilitating muscle atrophy and increased stiffness. Therefore bed rest > 2 days (Harrison)/>4 days (CDTF) is not recommended. | 1,052 | medmcqa_train |
Fatty acid synthase complex contain the following enzymes except: | Ans. C. Acetyl: CoA carboxylase(Ref: Harper 31/e page 217)Six enzyme activities of fatty acid synthase complex are:Ketoacyl SynthaseMalonyl-acetyl transacylaseHydrataseEnoyl reductaseKetoacyl reductaseThioesterase (Deacylase) | 1,053 | medmcqa_train |
Which is false regarding Gram positive cocci ? | Unlike streptococci enterococci are not reliably killed by penicillin or ampicillin alone at concentration acheived clinically in the blood or tissues.
Antimicrobial susceptibility testing should be performed routinely on enterococcal isolates.
Other options
Option ‘a’ • Staph. saprophyiticus specially causes UTI in sexually active young women.
Option ‘b’ • Micrococci are catalase and oxidase positive Gr (+ve) cocci. They are strict aerobes and are non pathogenic.
Micrococci are differentiated from Staphylococci by Hugh and deifson oxidation fermentation test in which micrococci shows oxidative pattern while staphylococci show fermentive pattern. | 1,054 | medmcqa_train |
Brugada syndrome is characterized by | Brugada syndrome is a rare syndrome characterized by >0.2 mV of ST-segment elevation with a coved ST segment and negative T wave in more than one anterior precordial lead (V1-V3) and episodes of syncope or cardiac arrest due to polymorphic VT in the absence of structural hea disease.Harrison 19e pg: 1497 | 1,055 | medmcqa_train |
Malaria causing nephrotic syndrome - | It would appear that quaan malaria causes an immune complex nephritis in some individuals that, once established, is sustained by mechanisms not yet fully explained but which may involve an autoimmune process. Evidence to suppo an immunologic pathogenesis of the renal lesions is provided by the presence of immunoglobulin, complement (C3) and quaan malarial antigen in biopsy specimens studied by immunofluorescence microscopy | 1,056 | medmcqa_train |
Drug of choice for acute severe asthma is: September 2006 | Ans. A: Sho acting beta 2 agonists Severe asthma (Continuous symptoms; activity limitation; frequent exacerbations/hospitalization) requires: Regular high dose of inhaled steroid (800-2000 microgram/ day) through a large volume spacer device and inhaled long acting beta2 agonist (Salmeterol). Additional treatment with one or more of the following: Leukotriene antagonist/Sustained release oral theophylline/ oral beta2 agonist/ inhaled ipratropium bromide. Rescue treatment with sho acting inhaled beta2 agonist In patients not adequately controlled or those needing frequent emergency care-institute oral steroid therapy. | 1,057 | medmcqa_train |
False statement regarding myocardial infarction and depression is: | The first three options are correct. Depression and myocardial infarction are risk factors for each other. The treatment of depression after MI involves both medications and CBT. | 1,058 | medmcqa_train |
Regarding Fanconi anemia, the wrong statement is: | Fanconi's anemia is an autosomal recessive disease Characterized:- Progressive pancytopenia Increased risk of malignancy (solid tumors and AML) Congenital developmental anomalies like sho stature, cafe au lait spots, abnormalities affecting thumb, radius and genitourinary tract. Fanconi's anemia is associated with BRCA gene. | 1,059 | medmcqa_train |
According to WHO, what is given to prevent PPH by active management of third stage of labour? | WHO recommendations for prevention of PPH by active management of third stage of labour Components of Active Management of the Third Stage of Labour (WHO)Administration of uterotonic soon after bih of baby.Delayed cord clamping and cutting.Controlled cord traction for delivery of the placenta (Brandt Andrew&;sMethod).Uterine massage.Uterotonic Agents Used in AMTSLInjectable oxytocin is the first line agent as it is effective after 2-3 minutes and has minimal side effects. Recommended dose by WHO is 10 units IM.Injectable methylergometrine (methergine) 0.2 mg IM/IV delivery of anterior shoulder or immediately after DELIVERY OF BABY.Syntometrine or Oxymatrine (ERGOMETRINE 0.5 MG +OXYTOCIN 5 UNITS) IM after delivery of the baby.Misoprostol 600 microgram tablet orally or rectally (in home delivery). Oral administration of misoprostol should be reversed for situations when the safe administration and/or appropriate storageconditions for injectable oxytocin and ergot alkaloids are not possible.Cord ClampingEarly cord clamping which was included originally in AMTSL not recommended now.Delayed cord clamping is now recommended and not immediate cord clamping.Current evidence shows that delayed cord clamping is beneficial for the baby.Immediate cord clamping has been shown to increase the incidence of iron deficiency and anemia.For premature and low bih weight babies immediate cord clamping can also increase the risk of intraventricular hemorrhage and late-onset sepsis.Controlled Cord TractionRecommended intervention for delivery of the placenta and a well-documented intervention in the active management of third stage of labour.(Refer: Mudaliar and Menon&;s Clinical Obstetrics, 11th edition, pg no: 121) | 1,060 | medmcqa_train |
A multipara with 34 weeks pregnancy tachycardia, fever, hepatospleenomegaly, pallor has : | Malaria | 1,061 | medmcqa_train |
Osmotic fragility is increased in ? | Ans. is 'c' i.e., Hereditary spherocytosis Osmotic fragility of Red blood cells. Red blood cell osmotic fragility is the resistance of RBC hemolysis to osmotic changes. o Normally RBC maintains osmotic equilibrium with the surrounding medium i.e., with serum that has 0.9% NaCl. o As the surrounding medium becomes hypotonic fluid will enter into the cell along osmotic gradiant, eventually under very hypotonic conditions the cell will enlarge to capacity and rupture -4 Osmotic lysis. Osmotic fragility is determined by measuring the degree of hemolysis in hypotonic saline. o Normal red cell begins to lyse at 0.5% NaC1 and the hemolysis is complete at 0.3 NaCl. o Red blood cells osmotic fragility is considered to be increased if hemolysis occur in a NaC1 concentration > 0.5%. o Osmotic fragility is considered to be decreased if the hemolysis is not complete in a 0.3% of NaCl. Increased osmotic fragility o Hereditary spherocytosis o Hemolytic anemia (acquired immune) o Malaria o Severe pyruvate kinase dificiency o Hemolytic disease of newborn Decreased osmotic fragility o Iron deficiency anemia Thalassemia Liver disease Reticulocytosis o Hemoglobinopathies, MS, HbC. | 1,062 | medmcqa_train |
Which drug is not used to prevent contrast nephropathy - | Ans. is 'a' i.e., Fenoldopam Summary And Recommendations for prevention of contrast induced nephropathy (uptodate recommendation )o Optimal therapy to prevent contrast-induced acute renal failure remains uncertain. Patients with near-normal renal function are at little risk and few precautions are necessary other than avoidance of volume depletion.o We recommend the following preventive measures for patients at increased risk of contrast nephropathy, which is defined a serum creatinine >1.5 mg/dL (132 micromol/L) or an estimated glomerular filtration rate <60 ml/l 73 m2, particularly in those with diabetes.o Use, if possible, ultrasonography, MRI without gadolinium contrast, or CT scanning without radiocontrast agents.o We recommend NOT using high osmolal agents is not recommendedo We recommend the use of iodixanol or nonionic low osmolal agems such as iopamidol or ioversol rather than iohexol.o Use lower doses of contrast and avoid repetitive, closely spaced studies.o Avoid volume depletion and nonsteroidal anti-inflammatory drugs.o If there are no contra indications to volume expansion, we recommend isotonic intravenous fluids prior to and continued for several hours after contrast administration. The optimal type offluid and timing of administration are not well established. We suggest isotonic bicarbonate rather than isotonic saline.o Despite conflicting data, we suggest that acetylcysteine be administered the day before and the day of the procedure, based upon its potentialfor benefit and low toxicity and cost. If acetylcysteine is administered, we suggest giving 1200 mg orally twice daily rather than 600 mg twice daily the day before and the day of the procedure.o Based upon the lack of convincing evidence of benefit and ihe potential risk of anaphylactoid reactions, we suggest not using intravenous acetylcysteine for the prevention of contrast nephropathy. (Note: Oral acetylcysteine is used)o We recommend NOT using mannitol or other diuretics prophytactically.o Among patients with stage 3 and 4 CKD, we recommend NOTperforming prophylactic hemofiltration or hemodialysis after contrast exposure.o Among patients with stage 5 CKD, we suggest prophylactic hemodialysis after contrast exposure if there is already a functioning hemodialysis access. | 1,063 | medmcqa_train |
Aminoacyl t-RNA is not require for - | Ans. is 'c' i.e., Hydroxylysine o The initial step in protein synthesis is the activation of amino acid in which each of the 20 amino-acids is covalently attached to their respective t-RNA, forming specific amino acyl t-RNA.o The reaction is catalyzed by ami noacyl t-RNA synthase.o Hydroxyproline and hydroxylysine are not represented into genetic code, i.e. they to not have t-RNA capable of accepting them and inserting them into polypeptide chain. Therefore, they have to be synthesized post-translational ly from proline and lysine residues in the polypeptides. | 1,064 | medmcqa_train |
Intermediate host for hydatid disease: | Man | 1,065 | medmcqa_train |
Episodes of depression in major depressive disorder tend to: | Episodes of major depression tend to increase in both length and frequency with age. When treated, episodes of major depression last for about 3 months. If untreated, depression lasts from 6 to 12 months. Episodes of major depression often have a gradual onset and occur an average of 5 to 6 times over a 20-year period. | 1,066 | medmcqa_train |
Which of the following does cause epidemic kerato conjuctivitis - | adeno virus cause epidemic keratoconjuctivitis REF:<\p> MICROBIOLOGY ANANTHA NARAYANAN NINTH EDITION PAGE.482 | 1,067 | medmcqa_train |
Sacrococcygeal teratoma is associated with: | Ans: A (Menigocele) Ref: Robbins and Cotran Pathologic Basis of Disease: 8th editionExplanation:Sacrococcygeal TeratomasMost common teratomas of childhoodAccounts for 40% or more of casesFour times more common in girlsApproximately 10% of sacrococcygeal teratomas are associated with congenital anomaliesPrimarily defects of the hindgut and cloacal regionMid line defectsMeningocele and spina bifidaApproximately 75% of these tumors are mature teratomas, and about 12% are unequivocally malignant and lethal. The remainder is immature teratomas.Most of the benign teratomas are encountered in younger infants (<4 months), whereas children with malignant lesions tend to be older.Other sites for teratomas in childhood include:TestisOvariesMediastinumRetroperitoneumHead and neck. | 1,068 | medmcqa_train |
Which poisoning causes 'pink disease'? | Ans. is 'b' i.e. Mercury Pink disease or Acrodvniao It is thought to be an idiosyncratic hypersensitivity reaction particularly seen in children. This can be caused by chronic mercury exposure in any form usually in children. The onset is insidious with anorexia, insomnia, sweating, skin rash and photophobia. Hands and feet become puffy, pinkish, painful, paraesthetic with peeling of skin (5Ps). Teeth may be shed. | 1,069 | medmcqa_train |
What is the treatment of threshold ROP? | Ans is 'a' i.e. Laser Photocoagulation Threshold disease in ROP is defined as stage 3+ ROP in Zones 1 or 2 occupying at least five contiguous clock-hours or eight noncontiguous clock-hours of retina.Treatment of threshold disease is Laser Photocoagulation.'Laser therapy has largely replaced cryotherapy because visual and anatomical outcomes are superior and laser induces less myopia. " -Kanski 6/e p610Other options:Antioxidants like vit E and slow reduction in 02 has no role in established ROP (threshold disease in our patient); although both are mentioned in few texts for prevention of ROP and even that is not well proven.Retinal reattachment is required when retina is detached like in stage 4 and 5 while Threshold disease is Stage 3 + disease.Also know:"Low birth weight and decreased gestational age are now considered the primary causative factors for ROP. Supplemental oxygen administration which was for a long time considered as the important causative factor is now considered only a risk factor. " - Khuran Ophthalmology 4/e p264 "ROP is confined to those with a birth weight of under 1.5 kg and/or a gestational age of under 32 wks. "- Parson 21/e P310 The hallmark of retinopathy of prematurity (ROP) is abnormal retinal vasculature. Ophthalmologists diagnose and make decisions about the initial treatment of ROP based on the appearance of the retinal blood vessels. Dilatation and tortuosity of the retinal vessels at the posterior pole is termed 'plus' disease. It is a sign of rapidly progressive ROP and is an indication for early laser ablation of the peripheral avascular retina.Retinopathy of prematurity (ROP)ROP is a bilateral proliferative retinopathy that develops in premature infants due to incomplete vasculogenesis of retina at the time of birth.During normal retinal development, vessels migrate from the optic disc to the ora serrata beginning at 16weeks of gestation. Capillary network is formed differentiating into mature vessels which extend to nasal ora by 36 wks and tangential ora by 39-41 wks.The pathogenesis of ROP begins with premature birth. Exposure of extrauterine environment causes phases of hyperoxia-vasocessation (obliteration of retinal vessels) and hypoxia-Vaso proliferation (neovascularization). VEGF is thought to be the most important molecule involved in the neovascularization.Neovascularization leads to retinal and vitreous changes which ultimately lead to retinal detachment.Classification of ROP:ROP is described using a number of parameters. These are location of the disease into zones (1, 2, and 3), the circumferential extent of the disease based on the clock hours (1-12), the severity of the disease (stage 1-5) and the presence or absence of "Plus Disease".Classification on the basis of severity, ROP is divided into 5 stages:-Stage I- the first sign of ROP (stage 1) is the appearance of a thin, fiat, white structure (termed a demarcation line) at the junction of vascularized retina posteriorly and avascular retina anteriorly.Stage II- the demarcation line develops into a pink or white elevation (ridge) of thickened tissueStage III- proliferation of vessels over the ridge and into vitreous (extra vitreal fibrovascular proliferation)Stage IV- partial retinal detachmentIVa- partial detachment with macular sparing IVb- partial detachment with macula involvedStage V- total retinal detachmentClassification on basis of anatomical location:-Since there is a direct correlation between severity of disease and amount of avascular retina, the location of the border between vascularized and avascular retina is an important prognostic sign.3 zones are divided to describe the location of ROP. Location of the border in zone 1 is the most severe disease and in zone 3 least.Zone 1 is defined as a circle, the center of which is the disc, and the radius of which is twice the distance of the disc to the fovea.Zone 2 is a doughnut-shaped region that extends from the anterior border of Zone 1 to within one disc-diameter of the ora serrata nasally and to the anatomic equator temporally.Zone 3 encompasses the residual temporal retina.Plus disease:- As ROP progresses, more and more shunting occurs in the neovascular tissue at the retinal vascular- avascular junction. This increased retinal vascular blood flow results in dilation and tortuosity of the major retinal arteries and veins in the posterior pole - described as "plus disease". Plus disease is the hallmark of rapidly progressive ROP and is notated by adding a plus sign after the number of the ROP stage.Management:Most of the cases (approx. 80%) of ROP resolve spontaneously, hence intervention is chosen according to the below given protocol.ROP is divided into Threshold and Pre threshold disease.Threshold disease: It is defined as stage 3+ ROP in Zones 1 or 2 occupying at least five contiguous clock-hours or eight noncontiguous clock-hours of retina.Treatment of Threshold disease is - Laser photocoagulation.Pre threshold disease is divided into 2 types:High risk or Type I - treatment is Laser photocoagulationLow risk or Type II - treatment is Weekly or Twice weekly observationType 1 Pre thresholdType 2 Pre thresholdZone I ROP (any stage) + Zone I, Stage 3 Zone II, Stage 2/3 +Zone I, Stage 1/2 - Zone II, Stage 3 -Laser PhotocoagulationWeekly or Twice weekly observationROP diseases less severe than Pre threshold are followed up.In this question, the child with zone 1, stage II 'plus' ROP falls into Pre threshold disease- Type 1 or high risk type, hence Laser Photocoagulation would be the management of choice. | 1,070 | medmcqa_train |
Diplopia is usually seen in ? | Ans. is 'a' i.e., Paralytic squint | 1,071 | medmcqa_train |
Which is the most common lymphoma in adults? | DLBCL - Most common lymphoma in adults Follicular lymphoma - Most common indolent lymphoma in adults Chronic lymphocytic leukemia - Most common leukemia in adults | 1,072 | medmcqa_train |
Mooning is a form of | Flashing: The act of momentarily exposing or revealing sexual body pa by quickly moving the clothing. Streaking: The act of running naked through a public place. Mooning: The act of displaying one's bare buttocks, by lowering the pants and bending over | 1,073 | medmcqa_train |
All are seen in vitamin C deficiency except: | Vitamin C/Ascorbic acid deficiency leads toScurvy Clinical manifestation of scurvy: Swollen and bleeding gums Subcutaneous bleeding and brushing into skin/joints Delayed wound healing Anemia Weakness. | 1,074 | medmcqa_train |
A person had injury to right upper limb he is not able to extend fingers but able to extend wrist and elbow. Nerve injured is - | Posterior interosseous emerges from the supinator on the back of the forearm .Here it lies between the superficial and deep muscles.At the lower border of the extensor pollicis brevis, it passes deep to extensor pollicis longus.it then runs on the posterior surface of the interosseous membrane up to the wrist where it enlarges into pseudoganglion and ends by supplying the wrist and intercarpal joints. | 1,075 | medmcqa_train |
The patient with least risk of pulmonary aspiration of gastric contents during induction of anesthesia is:- | NPO is same for obese and normal. NPO guidelines - 6hrs for liquid and semisolid, 2 hours NPO for clear fluids. Subset of patients who are at high risk for aspiration - pregnant women, morbidly obese (rapid sequence induction), full fatty meal - 8 hours NPO. | 1,076 | medmcqa_train |
Which of the following enzyme uses citrate in fatty acid synthesis? | Reference: Harpers illustrated biochemistry 30th edition | 1,077 | medmcqa_train |
Which of the following changes does not occur in malignant hypeension : | Answer is D (Hyaline Aeriosclerosis) : Hyaline aeriosclerosis is a feature of Benign Nephrosclerosis associated with benign phase of Hypeension. It is not a ,feature of Malignant Hypeension. | 1,078 | medmcqa_train |
Which of the following nerves has the best prognosis for repair after injury - | Ans. is 'b' i.e., Radial nerveRecovery potential after nerve repairExcellent :- Radial, Musculocutaneous, femoral, digital nervesModerate :- Median, Ulnar, TibialPoor :- Common peroneal (lateral popliteal) | 1,079 | medmcqa_train |
Treatment in post operative shivering? | Ans. is 'a' i.e., Pethidine Post-anaesthesia shivering (PAS) Post anaesthesia (post operative) shivering occurs in 40% of patients recovering from general anaesthesia. Some time it is preceded by central hypothermia and peripheral vasoconstriction, indicating that it is a thermoregulatory mechanism Pethidine is most effective drug for treatment of PAS. Other drugs used are --clonidine, doxapram, ketanserin, alfentonil, butorphanol, chlorpromazine. | 1,080 | medmcqa_train |
Birbeck’s granules in the cytoplasm are seen in: | Birbeck granules are rod Shaped/Tennis-racket shaped cytoplasmic organelles with a central linear density and a striated appearance.
They are diagnostic microscopic feature in Langerhans cell histiocytosis (Histiocytosis X) | 1,081 | medmcqa_train |
Crural index is: | Ans. Length of tibia/femur x 100 | 1,082 | medmcqa_train |
Primordial prevention is done to prevent development of ? | Ans. is 'b' i.e., Risk factors LEVELS OF PREVENTION There are four levels of prevention :? Primordial prevention Primary prevention Secondary prevention Teiary prevention Primordial Level of Prevention: Is primary prevention (see below) in purest sense It is the prevention of the emergence or development of risk factors in countries or population groups in which they have not yet appeared Modes of Intervention: Individual Education Mass Education Primordial Level is Best level of prevention for Non-communicable diseases | 1,083 | medmcqa_train |
Anakinra is a - | Ans. is 'a' i.e., IL-1 antagonisto Anakinra is an IL-1 antagonist.o It is used for some rare syndromes dependent on IL-1 production :Neonatal - onset inflammatory diseaseMuckle - Wells syndromeFamilial cold urticariaSystemic juvenile - onset inflammatory arthritisRA | 1,084 | medmcqa_train |
The gold standard for the definitive diagnosis of the extrahepatic biliary atresia is | Biliary atresia Evaluation of biliary anatomy begins with ultrasound Other imaging modalities such as HIDA scintigraphy, MRCP and ERCP have been used with varying success Although these are useful adjuncts, liver biopsy is gold standard for the diagnosis of biliary atresia and can safely be done percutaneously under local anaesthesia Ref: Sabiston 20th edition Pgno : 639 | 1,085 | medmcqa_train |
All of the following passes through lesser sciatic foramen, except ? | The lesser sciatic foramen is formed by the lesser sciatic notch of the pelvic bone, the ischial, the sacrospinous ligament and the sacrotuberous ligament. It transmits the following structures: The tendon of the Obturator internus Internal pudendal vessels Pudendal nerve Nerve to the obturator internus | 1,086 | medmcqa_train |
Increased osmotic fragility is characteristic of:September 2009 | Ans. A: Hereditary spherocytosisThe normal red blood cell is a relatively impermeable biconcave disc which maintains osmotic equilibrium with the surrounding medium. As the surrounding medium becomes hypotonic, fluid will be taken into the cell to maintain stability. Eventually under very hypotonic conditions the cell will fill to capacity and rupture. Spherocytic red blood cells have a decreased capacity to expand, and will rupture in mildly hypotonic conditions that fail to lyse normal red cells. They thus exhibit increased osmotic fragility.Osmotic fragility is determined by measuring the degree of hemolysis in hypotonic saline solution. With the unincubated test, red cell osmotic fragility is considered to be increased if hemolysis occurs in a sodium chloride concentration > 0.5%. Although increased osmotic fragility is characteristically associated with hereditary spherocytosis, it may also be increased in other types of hemolytic anemia associated with the presence of spherocytes, paicularly auto-immune hemolytic anemia, and in hypernatermia (Na > 155 meq/L).Often the increased osmotic fragility in spherocytosis is limited to a small fraction of cells that are unusually susceptible to lysis. After incubation, the defect is magnified, and a striking increase in fragility will be seen in hereditary spherocytosis. Osmotic fragility is considered to be decreased if hemolysis is not complete in a 0.30% NaC1 solution. Decreased osmotic fragility is associated with chronic liver disease, iron deficiency anemia, thalassemia, hyponatremia (Na < 130 meq/ L), polycythemia vera, and sickle cell anemia after splenectomy. | 1,087 | medmcqa_train |
A three year old child is brought to the emergency depament having just ingested a large overdose of an antihistaminic drug. This drug is a weak base capable of entering most tissues including the brain. On physical examination the hea rate is 100/ minute, blood pressure is 110/60 mm Hg and the respiratory rate is 20/ minute. In this case of poisoning: | This question can be solved by the knowledge that basic drugs are ionized in the acidic medium and vice-a-versa. This antihistaminic drug is a weak base and will be highly ionized in the acidic urine. As ionized drugs cannot be reabsorbed in the nephron, urinary acidifying agents like NH4Cl will accelerate the excretion of this agent. On the other hand, NaHCO3 will decrease its excretion by increasing the unionized form. Blood pH is slightly alkaline (7.4) whereas gastric pH is highly acidic. Basic drugs are ionized more in the acidic pH, therefore option (c) is false. Only unionized molecules can cross the membranes, therefore more drug will be absorbed by the small intestine (alkaline pH). | 1,088 | medmcqa_train |
A patient on t/t for psychiatric disorder takes overdose of a drug, develops bradycardia, hypotension, decreased sweating and salivation. The likely drug is | A i.e. Amitryptilline | 1,089 | medmcqa_train |
Which of the following is an absolute indication for surgery in cases of benign prostatic hyperplasia - | Absolute indications for surgical treatment of BPH 1) Refractory urine retention (failing at least one attempt at catheter removal 2) Recurrent UTI from BPH 3) Bladder stones d/t BPH 4) Renal insufficiency d/t BPH 5) Large bladder diveicula secondary to BPH 6) Recurrent gross hematuria from BPH Ref : Cambell's Urology 8/e p1340 | 1,090 | medmcqa_train |
Phenylketonuria caused by deficiency of | (C) Phenyalanine hydroxylase # Phenylketonuria is a genetic disorder inherited from a person's parents.> It is due to mutations in the PAH gene which results in low levels of the enzyme phenylalanine hydroxylase.> This results in the build up of dietary phenylalanine to potentially toxic levels. It is autosomal recessive meaning that both copies of the gene must be mutated for the condition to develop.> There are two main types, classic PKU and variant PKU, depending on if any enzyme function remains.> Those with one copy of a mutated gene typically do not have symptoms. | 1,091 | medmcqa_train |
Telefono is: | Simultaneous beating of both ears with the palms of the hands is known as TELEFONO. This may lead to rupture of the tympanic membrane causing pain, bleeding and hearing loss. It is difficult to detect this. The external ear may also get torn during pulling of the ears. | 1,092 | medmcqa_train |
All of the following are direct causes of maternal moality except: | Ans. is c i.e. Hea disease | 1,093 | medmcqa_train |
who introduced ECT | HISTORY * Medunna ====IM injection of camphor to induce seizures * Ugo cerletti and lucio bini==== ECT in a catatonic patient INDICATIONS * DEPRESSION SUICIDAL IDEAS-------------- first choice * CATATONIC SCHIZOPHRENIA * SCHIZOPHRENIA * MANIA * ELECTRODE PLACEMENT * Most commonly used=== bi fronto temporal * More cognitive side effects==bi fronto temporal * Less cognitive side effect======bi frontal * SIDE EFFECTS * RETROGRADE AMNESIA * BODY ACHE * MEDICATIONS USED IN THE PROCEDURE * ANAESTHETIC======Thiopentone / ethosuximide * MUSCLE RELAXANT====Succynyl choline CURARE IN PSEUDOCHOLINEESTERASE DEFICIENCY * ANTICHOLINERGIC=====Atropine CONTRA INDICATIONS * NO ABSOLUTE Contra indication * RELATIVE -----------------Brain tumour / arrythmia Ref. kaplon and saock, synopsis of psychiatry, 11 th edition, 1055 | 1,094 | medmcqa_train |
MELD score includes all except | Serum albumin is not a part of MELD SCORE.
It is a part of child - pugh classification. | 1,095 | medmcqa_train |
All are hypercoagulable states, except ? | Ans. is 'None' o All are hypercoagulable states. | 1,096 | medmcqa_train |
Which of the following is the most common cause of meningoencephalitis in children: | Answer is D (Enterovirus): Enteroviruses are the most common cause of viral meningoencephalitis. Arboviruses, HSV and Mumps virus are all impoant agents associated with viral meningoencephalitis, but Enteroviruses are the most commonly associated agents and the answer of choice. 'Enteroviruses are the most common cause of viral meningoencephalitis' - | 1,097 | medmcqa_train |
Pneumocystic carnii infects: | Ans. c. Rat | 1,098 | medmcqa_train |
All of the following are true about Roll back malaria except:(AIIMS November 2013, Nov 2012) | Ans. c. Development of newer insecticide (Ref; Harrison 19/e p14,18/e p14 WHO Roll Back Malaria Document] HTM_ MAL 2005. 1101.pdf (Roll Back Malaria)Roll Back Malaria:Messages on malaria case management, intermittent preventive treatment during pregnancy and insecticide- treated netsQ (ITNs) were promoted using volunteers, social marketing of unit-dose, prepackaged antimalarial medicines and trainingQ of patent medicine dealers (BASICS II, 2004).The key to the success of this programme was the shift from supply to demand creation for health servicesQ, increased access to medicines, and community ownershipRoll Back Malaria* In Nigeria, a communication strategy for behavioural change was initiated using both the public and private sectors.* Messages on malaria case management, intermittent preventive treatment during pregnancy and insecticide-treated nets (ITNs) wrere promoted using volunteers, social marketing of unit-dose, prepackaged antimalarial medicines and training of patent medicinedealers (BASICS II. 2004).* The channels used included interpersonal communication, traditional communication channels such as 'town criers' and local festivals, and social marketing through medicine packaging, radio spots and distribution of booklets to patent medicine dealers.* The strategy resulted in an increased knowledge of the role and benefits of ITNs in malaria prevention and an increased awareness of the danger signs of malaria and of the importance of seeking early treatment for febrile children through antimalarial medicines.* The key to the success of this programme was the shift from supply to demand creation for health services, increased access to medicines, and community ownership* The experience gained from such training programmes has demonstrated the need for training to address the following gaps in skills and knowledge, depending on the specific roles undertaken:- Knowledge and skills to recognize uncomplicated malaria, danger signs and when to refer the patient Knowledge and skills to manage malaria appropriately (recommended medications/dosages)- Awareness of the need for prompt and early treatment, and completion of the dose- Communication skills to counsel and offer health education on other aspects (e.g. ITNs. intermittent preventive treatment during pregnancy)- Recording/reporting tasks- Drug storage* The highest level of political commitment by the national government is required to ensure that the cross-ministerial activities beyond the purview of the ministry of health required for the implementation of HMM are facilitated at the policy level.Central and regulatory factors:* Regulatory status of recommended antimaiarial medicines.* Quality assurance mechanisms for medicine manufacture and Distribution, and their application.* Regulatory status of potential provider groups.* Current curricula for pre-service and in-service training for* Health providers and other stakeholders in the HMM programme (e.g. teachers) and for schools. | 1,099 | medmcqa_train |
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