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The incubation period of mumps is- | Incubation period of mumps is 2-3 wks Ref Harrison20th edition pg 897 | 1,200 | medmcqa_train |
During a hysterectomy and an oophorectomy, the uterine and ovarian vessels must be ligated. These vessels can be found in which ligaments? | The uterine vessels are found in the inferior poion of the broad ligament, while the ovarian vessels are found in the suspensory ligaments of the ovaries. The suspensory ligaments of the ovaries are peritoneal folds covering ovarian aeries , veins, nerves, and lymphatics as the structures pass over the pelvic brim to reach the ovary. The ovarian ligament proper is a round cord which attaches the ovary to the uterus, just below the entrance of the uterine tube into the uterus. The round ligament of the uterus is a connective tissue band that attaches the uterus to the inner aspect of the labium majus,it traverses the inguinal canal and it is found in the broad ligament. Ref: Hoffman B.L., Schorge J.O., Schaffer J.I., Halvorson L.M., Bradshaw K.D., Cunningham F.G., Calver L.E. (2012). Chapter 38. Anatomy. In B.L. Hoffman, J.O. Schorge, J.I. Schaffer, L.M. Halvorson, K.D. Bradshaw, F.G. Cunningham, L.E. Calver (Eds), Williams Gynecology, 2e. | 1,201 | medmcqa_train |
A 10-year-old male child with sho stature presented to the pediatric OPD with complaints of frequent headaches over the past 6 months along with slowly progressive loss of vision of the right eye. Lately the child has also staed having trouble in walking along with frequent mood changes and excessive thirst. MRI brain showed a tumour in the sellar region which was resected. HPE examination showed reticular epithelial cells that have appearances reminiscent of the enamel pulp of developing teeth along with calcifications and wet keratin nodules. The gene involved in causing the above condition is also involved in causing which other condition: - | This is a case of Craniopharyngioma. Benign tumour Arise in sellar/suprasellar region Arise from vestigial remnants of Rathke's pouch Bimodal age distribution Presents with headache and visual disturbance May present with sho stature due to GH deficiency (Pituitary hypofunction). Most commonly due to abnormalities in WNT signaling pathway including the activating mutations of the beta-catenin. MRI image shows a mass in the suprasellar region- likely craniopharyngioma OTHER CANCERS DUE TO WNT PATHWAY Mutations in b-catenin are present in: - 50% of hepatoblastomas. 20% of Hepatocellular carcinomas GENES INVOLVED IN: - Melanoma- NRAS, FGF3, HST1 Neuroblastoma- N-MYC, ALK CML- ABL | 1,202 | medmcqa_train |
Fatty acid present in breast milk which is important for growth and CNS development is: | Ans. A. Docosahexaenoic acidDocosahexaenoic acid (DHA) is a long-chain polyunsaturated fatty acid found in breast milk that plays a role in neurodevelopment. Breast milk DHA concentration is influenced by DHA in the mother's diet. | 1,203 | medmcqa_train |
The commonest cause of limp in a child of seven years is - | The most common cause of limp in a child between 3-10 years is transient synovitis of hip.
However, among the given options Perthe's disease is the best answer as Perthes disease is the second most common cause of limp in a child between 5-10 years. | 1,204 | medmcqa_train |
A 64-year-old lady Kamla complains of severe unilateral headache on the right side and blindness for 2 days. On examination, there is a thick cord-like structure on the lateral side of the head. The ESR is 80 mm / hr. in the first hour. The most likely diagnosis is : | Ans. is 'a' i.e.,. Temporal Arteritis The symptom and the laboratory examination of the patients almost confirm the diagnosis of temporal arteritis.This question has been asked too frequently in various PGME examination you are required to be well versed with the differential diagnosis of a headache.Let's see the diagnostic features of various headaches.A migraineAge - Females after pubertySex - Females > malePresentationLateralised*usually frontotemporalPain preceded by Aura*Builds up gradually*May lasts for several hoursUsually throbbing but may be dull*Onset is after awakening & quietened by Sleep*.* Associated symptoms includeNausea, vomiting, Diarrhoea, photophobia* & Visual disturbance*Paresthesia with tingling and numbness*Other focal neurological symptoms such as clumsiness & weakness *.Cluster HeadacheMen in 20 - 50*Male>F (7 to 8 times)*Lateralised*Periorbital*Pain(periodic attacks 1-2/days)*Begins without warning. Reach crescendo within 5 min last for 45 minutes*Excruciating deep, explosive but only rarely pulsatile*.Commonly awakens the patients from sleep*.Associated SymptomsHomolateral lacrimation*Reddening of eye*Nasal stuffiness*Ptosis*Nausea*Trigeminal Neuralgia> 40 YearsOccurs along the distribution of Maxillary nerve*Electric in character*Episodic each episode lasts 2-4 min.The typical course is relapsing-remitting over several years.Temporal ArteritisMedian age 75 yrs*Female (Account for 65% cases)*Unilateral or Bilateral located temporarily in 50% patients*Usually appear graduallyOccasionally it is explosive.Dull and boring in character,Seldom throbbing.Scalp tenderness*Patients also complains of pain in jaw*Headache is usually worse at night.Associated symptomsHeadache, fever, weight lossJaw claudication*Polymyalgia Rheumatica*ESR Increase*Anemia*Blindness d/t ophthalmic artery involvement*.A tension HeadacheAt all agesFemalesBilateral Frontal area *Builds up slowlyFluctuates in severityPersists continuously for many days.A headache may be episodic or chronic.A tight band like discomfort*Associated symptomsNot prominentSometimes post neck muscles are tight*May be associated with anxiety & depression*. | 1,205 | medmcqa_train |
An 85 years old man underwent transurethral resection of prostate. A histological examination of his specimen showed T1a stage of adenocarcinoma: management will be: | Management of CA prostate- T1a- observation+ Follow up (DRE+ PSA)- T1b, T1c, T2* > 70 years - Observation + follow up* < 70 years - Radical prostectomy Or RadiotherapyT3, T4 * Hormone therapy > Palliative radiotherapy* Bilateral Orchidectomy + Flutamide* LHRH Agonist (Goserelin, Leuperolide) + Flutamide- Goserelin -Recently FDA approved for advanced and metastatic CA prostate | 1,206 | medmcqa_train |
Ulnar nerve supplies all except- | Ans. is 'd' i.e., 1st & 2nd lumbricals Nerve supply of intrinsic muscles of HandThenar muscleso Abductor pollicis brevis. Flexor pollicis brevis, opponens pollicis - Median nerveo Adductor pollicis - Deep branch of ulnar nerveHypothenar muscleso Abductor digiti minimi, Flexor digiti minimi, opponens digiti minimi - Deep branch of ulner nerveo Palmaris brevis - Superficial branch of ulnar nerveInterosseio Palmar interossei - Deep branch of ulnar nerveo Dorsal interossei - Superficial branch of ulnar nerveLumbricalso 1st & 2nd (lateral two) lumbricals - Median nerveo 3rd & 4th (medial two) lumbricals - Deep branch of ulnar nerve | 1,207 | medmcqa_train |
Which of the gene is most often implicated in congenital cataract and alpha crystallin mutation? | CRYAA is implicated in congenital cataract and alpha crystallin mutation. | 1,208 | medmcqa_train |
According to WHO guideline, all are indications for hospital admission in Pneumonia except | Child with chest indrawing ⇒ Pneumonia ⇒ Oral Amoxycillin
Rest are danger signs ⇒ Severe Pneumonia ⇒ Referal to hospital. | 1,209 | medmcqa_train |
Naltrexone is used to maintain abstinence following opioid withdrawal in addicts. It blocks all of the following featues of opioid use, except - | Ans. is 'b' i.e., Craving for opioids o Naltrexone can reverse all effects of opioids like sedation, analgesia, constipation, respiratory depression and miosis, but it does not reduce craving. "Craving for opioids may continue during naltrexone treatment" Principles of addiction medicine o It is interesting to know that naltrexone does not reduce craving for opioid, but it reduces craving for alcohol in chronic alcoholism | 1,210 | medmcqa_train |
Causing hu by means of poison, etc with an intent to commit an offence is punishable under | - Sec. 328 IPC - Causing hu by means of poison, etc with an intent to commit an offence shall be Punishment is imprisonment upto 10 years and also fine. - Sec.326 A IPC - voluntarily causing grievous hu by means of acid - Sec.327 IPC - voluntarily causing hu to exto propey - Sec. 329 IPC - voluntarily causing grievous hu to exto propey | 1,211 | medmcqa_train |
All of the following are precipitating factor for hepatic encephalopathy in patients with chronic liver disease except | Answer is D (Metabolic acidosis): Hepatic encephalopathy is precipitated by metabolic alkalosis and not by metabolic acidosis. Electrolyte and Metabolic imbalances that precipitate Hepatic Encephalopathy Hypokalemia Alkaosis (Metabolic Alkalosis) Hypoxia Hyponatremia | 1,212 | medmcqa_train |
DIC is seen most commonly seen in which ANIL type? | Answer is option 2 M3 DIC is common, especially in M3, with prolonged prothrombin time, low levels of fibrinogen and fibrin degradation products (FDPs) present. myeloid luekemia. | 1,213 | medmcqa_train |
Aspirin is contraindicated in? | Ans. is 'b' i.e., Peptic ulcer Contraindications of Aspirin Peptic ulcer Prostaglandin has cytoprotective function for gastric mucosa by inhibiting acid secretion and promoting secretion of mucus. Aspirin inhibits synthesis of cytoprotective PG -3 bleeding & perforation may occur. Children with chicken pox & influenza Aspirin can cause Reye's syndrome (hepatic encephalopathy). Acknowledging this aspirin should not be given to children < 12 years, e.g. in JRA. Bleeding tendencies By its antiplatelet action, aspirin can exacerbate bleeding. Chronic liver disease Long-term therapy with high dose aspirin can cause insidious onset hepatic injury. | 1,214 | medmcqa_train |
In the international death ceificate, one of the following is not true- | ref: Park&;s 23rd edition pg 56 International Death Ceificate: Recommended by WHO for international use. 2 pas: PA 1: deals with immediate cause, and the underlying cause which staed the whole trend of events leading to death. The underlying cause of death is reccorded on line (c). PA 2: any significant associated diseases that contributed to the death but did not directly lead to it. | 1,215 | medmcqa_train |
Semicircular canals are stimulated by: | Semicircular canals contain cristae which sense angular or rotational acceleration | 1,216 | medmcqa_train |
Which is true regarding ovary: | Ans. is b i.e. Ovarian ligament connects ovar ovaries to uterus.REMEMBERMesovarium connects ovary posteriorly to the broad ligament.Ovarian ligament connects ovary to uterus (option b)Suspensory ligament or infundibulopelvic ligament connects ovary to lateral pelvic wall.Ovarian vessels and nerves are present in suspensory ligament.Ovarian fossa is related posteriorly to obturator nerve, not ilioinguinal nerve. | 1,217 | medmcqa_train |
Vitamin K dependent coagulation factors include | Vitamin K is an essential factor to a liver carboxylase that adds a carboxyl group to glutamic acid residues on five of the impoant clotting factors: prothrombin, Factor VII, Factor IX, Factor X, and protein C.Ref: Guyton and Hall textbook of medical physiology 13th edition. Page: 490 | 1,218 | medmcqa_train |
Cells are most radio-resistant in | Cell cycle Correct sequence: G0-G1-S-G2-M Most impoant checkpoint: G1-S Cellular content doubled in: S phase Cyclins D,E,A,B appears sequentially Cyclin D - first to increase in cell cycle Cyclin D - controls G1-S transition P16 (CDKN2A), P53& RB - Induce cell cycle arrest at G1-S Cyclin B - controls G2-M transition Fixed time is required for: S & M phase Most radio-resistant phase: S Most radio-sensitive phase: M | 1,219 | medmcqa_train |
Useful diagnostic studies in the evaluation of upper-extremity pain include all of the following, EXCEPT? | Pain in the upper extremity may be of musculoskeletal or neurologic origin. Compression of the nerves supplying the upper extremity can occur at various levels from the spinal cord all the way down to the fingers. Cervical spine x-ray is helpful for detecting bony abnormalities, which may cause nerve compression. Pancoast's tumor, which can be demonstrated on chest x-ray, may be responsible for pain. Neural conduction studies of the median nerve may disclose the presence of carpal tunnel syndrome as the cause of pain. Finkelstein's test produces pain in patients with de Quervain's disease. The test is performed by asking the patient to grab his own thumb with the other fingers of the same hand and then move the wrist in the ulnar direction. If pain is elicited, then the test is positive. Adson's test is very helpful in detecting the presence or absence of collateral circulation between the radial and ulnar aeries and is not diagnostic for pain. | 1,220 | medmcqa_train |
Which of following is the feature of Y chromosome? | A normal chromosome appear constricted at the centromere, this divides each chromosome into two arms. The sho arm is designated as p arm and the long arm is designated as q. Ref: Primate Anatomy: An Introduction By Friderun Ankel-Simon, 3rd Edition, Page 552 ; Clinical Laboratory Medicine By Kenneth D. McClatchey 2nd Edition, Page 568 ; Folia Biologica 2001, Page 146 | 1,221 | medmcqa_train |
Calcification of interveebral disc is seen in - | Interveebral disc calcification seen in : Ochronosis /Alkaptonuria Ankylosing spondylitis Pseudogout Hemochromatosis Hypervitaminosis D Transient interveebral disc calcification Juvenile chronic ahritis Hyperparathyroidism Amyloidosis Poliomyelitis Acromegaly | 1,222 | medmcqa_train |
A 70 - year old male presents with a C/O fatigue & jaundice. There is no H/O alcohol or liver disease. The liver and spleen are nonpalpable. He has a normocytic, normochromic anemia. The first step in evaluation of this patient is | The first step in evaluating patient with asymptomatic jaundice is to determine whether the increased bilirubin, as evidenced by scleral icterus, is conjugated or unconjugated hyperbilirubinemia. Patients with unconjugated hyperbilirubinemia do not have bilirubin in their urine because unconjugated bilirubin (bound to albumin) is not excreted in the urine; these patients usually have either hemolysis or an enzyme deficiency in the path way for excretion of bilirubin. Conjugated hyperbilirubinemia suggests liver dysfunction and requires fuher assessment | 1,223 | medmcqa_train |
Normal turnover rate of epidermis: | Epidermal turnover time - skin doubling time -Time taken by keratinocytes to move from Stratum Basale to environment. -Around 14 days are required to move from Stratum Basale to reach lowermost layer of Stratum Corneum & 14 days to cross Stratum Corneum. -Sloughing off requires 28 days So total ETT =56 days (8 weeks) The turnover time in psoriasis = 4 days. | 1,224 | medmcqa_train |
Which one of the following describes the flavouring substance asafoetida (Fling)? | Ans. is 'b' i.e., Exudate from chopped roots | 1,225 | medmcqa_train |
Anion gap is increased in all except: September 2009 | Ans. A: Ureterostomy | 1,226 | medmcqa_train |
Hypopituitarism in the adult is usually due to infarction of the pituitary called as: | Hypopituitarism in the adult is usually due to an infarction of the pituitary called Simmonds’ disease.
It is characterized by loss of weight and diminished sexual function. The basal metabolic rate is markedly lowered, and since Simmonds’ disease represents a panhypopituitarism, there is a decrease in the activity of the many hormones of the pituitary gland and of those glands that are under pituitary regulation. In this disease, the skin shows atrophic alterations. Changes in the head include thin eyebrows, loss of eyelashes, sharp features, thin lips, and an immobile expression. There will be a decreased salivary flow due to hyperfunctioning of salivary glands which leads to increased caries activity and periodontal disease. | 1,227 | medmcqa_train |
Vesicular lesions, indistinguishable from primary infection, which arise in other pas of the body of an allergic individual infected with Trichophyton are referred to as | Dermatiphytids - Hypersensitivity to dermatophyte antigen may occur which leads to appearence of secondary eruption in sensitized patients because of circulation of allergic products. These lesions are indistinguishable , but these lesions are distinct from the primary ringworm lesion as they occur distal to primary site and fungal culture often turns negative. | 1,228 | medmcqa_train |
In which of the following condition serum ascites-to-albumin gradient is > 1.1 | The development of the serum ascites-to-albumin gradient (SAAG) has replaced the description of exudative or transudative fluid. When the gradient between the serum albumin level and the ascitic fluid albumin level is >1.1 g/dL, the cause of the ascites is most likely due to poal hypeension; this is usually in the setting of cirrhosis. When the gradient is <1.1 g/dL, infectious or malignant causes of ascites should be consideredIn Budd Chiari syndrome SAAG is >1.1 i.e poal hypeensionReference: Harrison&;s Principles of Internal medicine; 19th edition; Chapter 35; Cirrhosis and its complications | 1,229 | medmcqa_train |
Regarding autoimmune hemolytic anemia in pregnancy all are true except | During pregnancy, autoimmune hemolytic anaemia usually responds to prednisolone. | 1,230 | medmcqa_train |
AIDS day is: September 2004 | Ans. D i.e. 1 December | 1,231 | medmcqa_train |
The strength attained by amalgam within 8 hours is | The strength attained by amalgam within 8 hours is 70%.
Reference: Phillip’s Science of Dental Materials, Pg-353 | 1,232 | medmcqa_train |
All are cause of Respiratory distress in newborn and Ipsilateral shift of mediastinum | No mediastinal shift in hyaline membrane disease. | 1,233 | medmcqa_train |
A non diabetic, non hypertensive patient has some extra beats in pulse. Doctor informed that is benign and no intervention required. But patient is worried that it is a serious cardiac disorder and is still going for repeated investigation & going from doctor to doctor. This is a type of: | Interpretation of benign symptom (extra beats) as a serious illness (cardiac disorder) is suggestive of Hypochondriosis. | 1,234 | medmcqa_train |
Ascorbic acid is a potent enhancer of iron absorption because it: | Ans. C. Is a reducing agent, thereby helping to keep iron in the ferrous stateAscorbic acid enhances iron absorption mostly by its reducing capacity, keeping iron in the ferrous state. Ascorbic acid does not enhance heme iron absorption, nor does it affect heme oxygenase activity or the production of ferritin or transferrin. | 1,235 | medmcqa_train |
Most common cause of unilateral proptosis is | A i.e. Thyrotoxicosis Grave's ophthalmopathy is most common cause of U/L or B/L proptosis in adults Q between age of 25-50 yrsQ | 1,236 | medmcqa_train |
Macrophage is - | Ans. is 'a'i.e., Monocytes o The monocytes migrate to tissues and become part of the tissue (fixed) macrophages.o Blood macrophages - Monocyteso Tissue macrophages - HistiocytesTissue macrophages (histiocytes) in different tissue are mentioned below -o Lung: 'Alveolar macrophages' or 'Dust' cellso Placenta: Hoffbauer cellso Brain: Microgliao Kidney : Mesangial cellso Liver : Kupffer cellso Spleen : Littoral cellso Bone: Osteoclastso Synovium: Type-A lining cellso Skin: Langerhans cellso Spleen: Red pulp sinusoidal lining cellso Connective tissue: Histiocytes (tissue macrophages)o Life span of monocytes in circulation is 1-3 days whereas tissue macrophages have life span of 3 months to years | 1,237 | medmcqa_train |
The medicolegal impoance of postmoem lividity is all except - (UP 07) | The postmoem hypostasis helps to estimate time since death with its extent, is a sign of death, posture and moving of body at death by its fixation. Cause of death can be determined from its colour. Dr.Narayana Reddys Synopsis of Forensic Medicine and Toxicology 27th edition pg. 78. | 1,238 | medmcqa_train |
Asherman syndrome is due to : | Postaboion curettage | 1,239 | medmcqa_train |
A three years old boy presents with poor urinary stream. Most likely cause is - | Ans is 'd' i.e. Posterior urethral valve Poor urinary stream in 3 years old boy suggests urinary tract obstruction (usually infravesical) and the most common cause of obstructive uropathy in a male child is posterial urethral valve. Posterior urethral valve These are symmetrical folds of urothelium extending distally from prostatic urethra to external urinary sphincter. It most commonly lies just distal to the verumontanum or at the verumontanum* It occurs only in males. It behaves as flap valves so, although urine does not flow normally a urethral catheter can be passed without difficulty. Sometimes, the valves are incomplete and the patient remains without symptoms until adolescence or adulthood. Approximately 30% of patients experience end stage renal disease Vesicoureteral reflux occurs in 50% of patients. Diagnosis is made by (a) voiding cystourethrogram* & (b) endoscopy Both of these investigations clearly depict the site of obstruction. The diagnosis can be established prenatally by ultrasound.* Management First a small polyethylene feeding tube is inseed in the bladder and left for several days. Then fuher management is done according to serum creatinine level. (a) with normal serum creatinine --> transurethral ablation of the valve leaflets. * (b) With increased serum creatinine and the worsening of condition --> vesicostomy to bypass the obstruction and when normal creatinine levels are achieved, transurethral ablation is done. | 1,240 | medmcqa_train |
Pulled elbow means - | Ans. is 'b' i.e., Subluxation of head of radius Pulled elbowo If a young child is lifted by the wrist, the head of the radius may be pulled partly out of the annular ligament, i.e., subluxation of the head of the radius.o Ir occurs when forearm is pronated, elbow is extended and longitudinal traction is applied to the hand or wrist, e.g., lifting, spinning or swinging a child with wrist or hand. Pulled elbow most commonly occurs between the age of 2-5 years.Clinical features of pulled elbowo History of sudden axial pull on extended elbow.o Immediately child starts crying and is unable to move the affected elbow.o The forearm is held in pronation and extension and any attempt to supinate is resisted,o Child does not allow to touch the affected limb,o X-ray seems to be normal.Treatment of pulled elbowo Treatment is simple. The child's attention is diverted, the elbow is quickly supinated and then slightly flexed.o This reduces the subluxation or dislocation and the radial head is relocated with a snap. | 1,241 | medmcqa_train |
Recommended level of fluoride in drinking water- | Ans, is 'b' i.e., 0[?]5 - 0[?]8 mg/L o The recommended level of fluoride in drinking water in the country is accepted as 0-5 to 0-8 mg.; Liter. -Park o The maximum permissible limit is T5 mg/L it. | 1,242 | medmcqa_train |
A 95-year-old woman touches a pot of boiling water. Within 2 hours, she has marked erythema of the skin of the fingers of her hand, and small blisters appear on the finger pads. This has led to which one of the following inflammatory responses? | Serous inflammation is the mildest form of acute inflammation. A blister is a good example of serous inflammation. It is associated primarily with exudation of fluid into the sub-corneal or subepidermal space. Because the injury is mild, the fluid is relatively protein-poor. A protein-rich exudate results in fibrin accumulation. Granulomatous inflammation is characterized by collections of transformed macrophages called epithelioid cells. Acute inflammatory cells, mainly neutrophils, exuded into a body cavity or space form a purulent (suppurative) exudate, typically associated with liquefactive necrosis. Loss of the epithelium leads to ulceration. | 1,243 | medmcqa_train |
A 35 years old man presented with dry cough and rusty coloured sputum; He has history of eating in chinese restraunt very often with consumption of crabs often; What is the probable causative agent in this condition? | from above mentioned clinical scenerion Paragonimus westermani (lung fluke) is moste likely to be causitive organism:- Paragonimus westermani first intermediate host- snail 2nd intermediate host - crab in crab metacercarie larva which is cyst like stage is seen. It causes Red Brown sputum or endemic hemoptysis. | 1,244 | medmcqa_train |
Hobnail pattern is seen in which type of RCC | Renal cell carcinoma *Renal cancers are mostly sporadic, except for a 4% cases which appear familial *Familial renal cancers are due to mutation of VHL and MET genes*98% of all renal cancers (sporadic and familial) are due to VHL mutation encoded in chr3p*Most common cause of familial papillary renal cell carcinoma (rare disease) is MET protooncogene*Most common risk factor for all renal cancers- Tobacco*Most common type of renal cell carcinoma is clear cell carcinoma , which is followed by papillary carcinoma, chromophobe carcinoma and collecting duct carcinoma*Most common type of renal cancer in patients who develop dialysis associated cystic disease - Papillary carcinoma*VHL is a tumour suppressor gene. Mutation of both the VHL genes causes angiogenesis (by increasing expression of hypoxia inducible factor-1) and cell growth (by increasing expression of insulin like growth factor -1)*Renal cell carcinoma mostly affects the poles Microscopic findings:*Classic clinical features of renal cell carcinoma - Costoveebral pain, palpable mass and hematuria*Clear cell carcinoma -Cells with clear cytoplasm containing glycogen and lipids, delicate capillaries*Papillary carcinoma - Papillary formations, foam cells in interstitium, psammoma bodies*Collecting duct carcinoma - irregular channels lined by atypical cells and show hobnail pattern*Chromophobe cell carcinoma - cells with abundant cytoplasm impaing blue colour in Hale's colloidal iron stain (Ref: Robbins 8/e p964) | 1,245 | medmcqa_train |
Treatable causes of dementia are -a) Alzheimer's ds.b) Hypothyroidismc) Multi-infarct dementia d) SDH (subdural h'ge) e) Hydrocephalus | Perhaps the use of word “treatable” is inappropriate here since all the types of dementia can be “treated”. The examiner most likely wants to ask the types which can be “reversed” or “cured” | 1,246 | medmcqa_train |
Normal axial length of the eye - | Ans. is 'c' i.e., 24 mm o The length of the eyeball is approximately 24 mm, So the distances from the cornea / crystalline lens to the retina and the focal length of optical rays focused by the comea/crystalline lens propagating in the vitreous humor and imaging on the retina, are also about 24 mm.Dimensiosn of an adult eyeAnteroposterior diameter (Length)24 mmHorizontal diameter23-5mmVertical diameter23 mmCircumference75 mmVolume6-5 mlWeight7 gm | 1,247 | medmcqa_train |
The dose of radiation for point A for early and locally advancing cervical cancer during brachytherapy according to ABS guidelines is: | (Refer: John Hopkins’ Manual of Obstetrics & Gynecology, 4th edition, pg no: 554)
Brachytherapy of CA Cervix | 1,248 | medmcqa_train |
All are tumor markers of HCC except | Tumor markers PIVKA Glypican-3 AFP fractions (AFP-L3) Neurotensin Ref:Sabiston 20th edition Pgno : 1458-1463 | 1,249 | medmcqa_train |
The posterior cord of the Brachial plexus contains all except: | Ans: A (Long thoracic nerve of Bell) Ref: Gray's Anatomy, 40th edition, pg.820 Explanation: Lateral cord Lateral pectoral C5, 6. 7 Museulocu taneous C5, 6. 7 Lateral root of median C(5), 6, 7 Medial cord (M4U) Medial pectoral C8. T1 Medial cutaneous of forearm C8. Tl Medial cutaneous of arm C8. T1 Ulnar C(7), 8. T1 Medial root of median C8, T1 Posterior cord (ULTAR) Upper subscapular C5, 6 Thoracodorsal C6, 7.8 Lower subscapular C5.6 Axillary C5, 6 Radial C5.6.7X (T1) Root Dorsal scapular nerve Long thoracic nerve of bell C5 C5,6,7 Trunk Nerve to subclavius Suprascapular nerve C5.6 C5,6 | 1,250 | medmcqa_train |
Mad Cow Disease has been highly publicized in Great Britain. This disease, which is similar to scrapie, is caused by | Mad Cow Disease is related to both scrapie in sheep and bovine spongiform encephalopathy virus. The fear in Great Britain is the potential for acquiring Creutzfeldt-Jakob disease, which is a slowly progressive neurodegenerative disease. Theoretically, such acquisition could be through ingestion of beef from infected cows. A prion consists of protein material without nucleic acid. While related to a virus, a prion is a proteinaceous infectious particle that replicates within cells. | 1,251 | medmcqa_train |
True about Bater&;s syndrome are all except | Bater syndrome is an autosomal recessive disorder characterized by hypokalemia and metabolic alkosis , resulting from excessive chloride, potassium and sodium wasting in thick ascending loop of Henle . Reference : Ghai pediatrics eighth edition pg no 501 | 1,252 | medmcqa_train |
All are feature(s) of Beckwidth-Wide man syndrome except: | Answer- C. HyperglycemiaBeckwidth- Wiedemann syndrome is an overgrowth syndrome that is characterized by visceromegaly, macroglossia, macrosomia,mphalocele and hyperinsulinemic hypoglycemia. | 1,253 | medmcqa_train |
Which of the following has to be present for diagnosis of major depressive disorder | In typical depressive episodes of all three varieties described below (mild, moderate, and severe), the individual usually suffers from depressed mood, loss of interest and enjoyment, and reduced energy leading to increased fatigability and diminished activity. Reference: International classification of diseases 10, page 119. | 1,254 | medmcqa_train |
Which of the following is/are true of blunt renal trauma? | Renal trauma general management - Only those who have gross hematuria need undergo contrast studies. Microscopic hematuria is no longer an indication for contrast evaluation. Patients who have blunt renal trauma need to undergo exploration only if they are hemodynamically unstable. Conservative management in the absence of hemodynamic instability is the current trend. All penetrating injuries should undergo exploration. | 1,255 | medmcqa_train |
All of the following can lead to increased Intra cranial pressure accept - | Answer-D. MigraineCommon causes include-Aneurysm rupture and subarachnoid hemorrhageBrain tumorEncephalitisHead injuryHydrocephalus (increased fluid around the brain)Hypeensive brain hemorrhageIntraventricularhemorrhageMeningitisSubdural hematomaStatus epilepticusStroke | 1,256 | medmcqa_train |
All of the following are features of Hemophagocytic Lymphohistiocytosis (HLH), except: | Hemophagocytic lymphohistiocytosis (HLH) is a reactive condition marked by cytopenias and signs and symptoms of systemic inflammation related to macrophage activation. For this reason, it is also sometimes referred to as macrophage activation syndrome. Some forms are familial and may appear early in life, even in infants, while other forms are sporadic and may affect people of any age. The common feature of all forms of HLH is systemic activation of macrophages and CD8+ cytotoxic T cells. Primary HLH (Mendelian inherited conditions leading to HLH) Defects in the cytolytic function of cytotoxic T cells and/or NK cells Defects in inflammasome regulation Secondary HLH (apparently non-Mendelian HLH) Infections (mainly viruses, such as EBV, HIV, and CMV, but also bacteria, parasites, and fungi) Malignancies (mainly malignant lymphoma) Macrophage activation syndrome in autoinflammatory or autoimmune disorders Other causes (organ or stem cell transplantation; metabolic,traumatic, iatrogenic causes; and, rarely, pregnancy) | 1,257 | medmcqa_train |
All are Narcotic drug as per NDPS (National Drug Psychotropic Substances Act) EXCEPT: | ANSWER:(B)KetamineREF: Textbook Of Forensic Medicine And Toxicology: Principles And Practice By Vij 4th ed page 566, style="font-size: 1.04761904761905em; font-family: Times New Roman, Times, serif; margin: 0 0 0 8px; text-indent: 0; text-align: left">The Narcotic Drugs and Psychotropic Substances (NDPS) Act, 1985 was framed taking into account India's obligations under the three UN drug Conventions as well as Article 47 of the Constitution which mandates that the 'State shall endeavour to bring about prohibition of the consumption except for medicinal purposes of intoxicating drinks and of drugs which are injurious to health'NARCOTIC DRUGSCoca Leaf & derivatives(a) Crude cocaine(b) Ecgonine and derivatives(c) Cocaine, that is, methyl ester of benzoyl-ecgonine and its salts(d) All preparations containing more than 0.1 per cent, of cocaineCanabis (Hemp): (AKA - Cannabis indica/ Indian hemp/Hashish in Egypt/Marijuana in America/Dagga in Africa)(a) Charas/Hashish- resinous exudates of leaves & stem- 25 to 40% THC(b) Ganja - flowering top- 25% THC(c) Any mixture, with or without any neutral material, of any of the above forms of cannabis or cannabisOpium and derivatives(a) Poppy seed: Seeds of Papaver sominiferum are called the poppy seeds while the latex which oozes out and dries is called the opium gum(b) Poppy straw: As per the NDPS Act, poppy straiv means 'all parts of the plant of opium poppy except seeds'(c) Opium derivative means: medicinal opium, phenanthrene alkaloids namely, morphine, codeine, thebaine and their salts, diacetylmorphine (Heroin), that is, the alkaloid also known as diamorphine or heroin and its salts, all preparations containing more than 0.2 per cent, of morphine or containing any diacetylmorphine and their salts, preparations, admixtures, extracts and other substances containing any of these drugs.(II) Psychotropic substances: "psychotropic substance" means any substance, natural or synthetic, or any natural material or any salt or preparation of such substance or material included in the list of psychotropic substances specified in the Schedule. E.g. Amphetamines, LSD, Barbiturates, Alprazolam, Benzodiadepines, Ergotamine, Ephedrine, Methyl ethyl ketone (MEK) etc.Note:* Essential narcotic drug means a narcotic drug notified by the Central Government for medical and scientific use (Morphine, Fentanyi and Methadone)* Bhang is a preparation made from cannabis leaves consumed in parts of India on some festivals. As it is not made from cannabis resin or from flowering tops, it is not covered under the NDPSAct, 1985. | 1,258 | medmcqa_train |
Halban's disease is due to | Halban's disease: Rare, self-limiting process. Also called Irregular shedding endometrium Due to persistent corpus luteum due to incomplete withdrawal of LH even on 26 in day of cycle. The corpus luteum continues to secret progesterones Menstruation comes on time, is prolonged but not heavy. Slight bleeding continues intermittently for several days after proper flow. On D& C done on 5-6th of cycle - endometrial tissue shows presence of proliferative endometrium along with secretory endometrium | 1,259 | medmcqa_train |
The RPR test uses VDRL antigen containing fine | The rapid plasma reagin (RPR) test is a macroscopic, nontreponemal flocculation card test used to screen for syphilis. RPR antigen is prepared from a modified VDR antigen suspension containing choline chloride to eliminate the need to heat inactivate serum, ethylenediaminetetraacetic acid (EDTA) to enhance the stability of the suspension, and finely divided charcoal paicles as a visualizing agent. Ref: Ananthanarayana textbook of Microbiology 9th edition Pgno : 374 | 1,260 | medmcqa_train |
Human metapneumovirus is structurally similar to: | Ans. b. Respiratory syncytial virus | 1,261 | medmcqa_train |
What is the mechanism of action of Fluconazole? | Ref. KDT. Page. 793
Fluconazole
They inhibit the fungal cytochrome P450 enzyme ‘lanosterol 14-demethylase’ and thus impair ergosterol synthesis leading to a cascade of membrane abnormalities in the fungus.
lower affinity for mammalian CYP450 enzymes and lesser propensity to inhibit mammalian sterol synthesis – causes less side effects
It is a water-soluble triazole having a wider range of activity
Indications include cryptococcal meningitis, systemic and mucosal candidiasis in both normal and immunocompromised patients, coccidioidal meningitis and histoplasmosis | 1,262 | medmcqa_train |
Which of the following is the most common benign neoplasm of liver | Most common benign neoplasm is cavernous hemangioma
Most common hepatic neoplasm is metastasis
Most common primary malignant tumor is Hepatocellular carcinoma. | 1,263 | medmcqa_train |
A patient presents with Hb of 8 gm%, WBC count of 2000/mm3 and platlet count of 60000/mm3. What is your likely diagnosis ? | Answer- C. Aplastic anemiaThe patient in question is having Pancytopenia (anemia, leukopenia and thrombocytopenia) - Feature of Aplastic anemia. | 1,264 | medmcqa_train |
Why fetal cells continue to divide but terminally differentiated adult cells do not divide - | A cyclin-dependent kinase inhibitor protein is a protein which inhibits cyclin-dependent kinase. Several function as tumor suppressor genes. Cell cycle progression is negatively controlled by cyclin-dependent kinases inhibitors (called CDIs, CKIs or CDKIs). CDIs are involved in cell cycle arrest at the G1 phase. | 1,265 | medmcqa_train |
Which aery does not contribute to little's area: | Little's area-Anteroinferior pa of nasal septum- formed by- anterior ethmoidal aery,septal branch of superior labial aery,septal brach of sphenopalatine aery,greater palatine aery. Ref.Dhingra 6/e,p 176. | 1,266 | medmcqa_train |
HSV 2 causes: | Ans: a (Genital herpes) Ref: Shaw, 13th ed, p. 113Heipes genitalis is caused by HSV type 2. It is the most common DNA viral infection encountered in vulval disease.Symptoms: Tingling, itching, paraesthesia - vesicles - painful ulcers.Treatment: AcyclovirNote:Genital warts (condyloma accuminata) caused by HPV 6,11.Heipes zoster is caused by varicella virus. | 1,267 | medmcqa_train |
All of the following are anthropozoonosis except | Ans. is 'd' i.e., Schistosomiasis Zoonoses Zoonoses are diseases and infections which are naturally transmitted between veebrate animal and man. The zoonoses may be classified according to the direction of transmission of disease : ? l. Anthropozoonoses Infection is transmitted to man from lower veebrate animals. Examples -4 Rabies, plague, hydatid disease, anthrax, trichinosis. 2. Zoonthroponoses Infection is transmitted from man to lower veebrate animals Examples - Human tuberculosis in cattle 3. Amphixenoses Infection is maintained in both man and lower veebrate animals that may be transmitted in either direction. Examples T cruzi, S. japonicum. | 1,268 | medmcqa_train |
A child with jaundice being given food intravenously. Which of the following can occur out of it – | Complications of parentral nutrition in children
Infections
Liver dysfunction
Hyperglycemia
Metabolic acidosis
Hyperlipidemia
Electrolyte imbalance | 1,269 | medmcqa_train |
The commonest site of surgical uretero-vaginal fistula is: | B. i.e. Below uterine aery in Mackenrodt's ligament Maximum chances of ureteric injury is in hysterectomy while ligating uterine vessels in mackenrodt's ligament Ureter is also vulnerable to injury when ovarian vessels are being ligated during ovariectomy. | 1,270 | medmcqa_train |
Chronic lymphoedema of the limb is predisposed to all of the following except - | Morjolin's ulcer: - Refers to the development of malignant ulcers over chronic scars most commonly those from burns. Malignancy is usually a squamous cell carcinoma and has not been mentioned as a complication of lymphoedema.
Features of chronic lymphoedema of limb
Initially, the lymphoedema is soft and pits on the pressure but with time the skin becomes thickened & non-pitting due to fibrosis, dermal thickening and hyperkeratosis.
Frequent episodes of lymphangitis and cellulitis may occur. this is believed to be due to loss of local immune defence mechanism.
Chronic eczema, a fungal infection of the skin (dermatophytosis) and nails (onychomycosis), fissuring, verrucae and papillae (warts) are frequently seen in advanced disease.
Rarely malignancy (lymphangiosarcoma or angiosarcoma) may occur in chronic lymphoedema. This neoplastic transformation of blood vessels and lymphatics is called Stewart - Treves syndrome. | 1,271 | medmcqa_train |
What is normal range of glycosylated haemoglobin (HbA1c) for adequate glycaemic control in diabetic patient- | normal Range in glycosylated haemoglobin 7% to 9 % for < 5 yrs 6 % to 8 % for > 5 yrs | 1,272 | medmcqa_train |
Nephrotic range of proteinuria is | Nephrotic range of proteinuria is > 40 mg/m2/hr or > 1 gm/m2/24hrs. | 1,273 | medmcqa_train |
Thyroxine is synthesized from which amino acid- | Ans. is 'd' i.e., TVrosine Thyroid hormones (Important facts)o Thyroid hormones are T4 (throxine) and T3 (Triiodothyroxine)o Thyroid hormones are synthesised from amino acid tyrosine.o Their synthesis is regulated by TSH, a hormone secreted by anterior pituitary.o T3 is the active form and T4 is converted to T, in liver and kidney. Thus T4 mainly serves as transport form,o Circulating thyroid hormones are bound to thyroxine binding globulin fmain binding protein), throxine binding albumin and throxine binding prealbumin.o Thyroid hormone has two main function.i) Morphogenesis: - Growth & differentiation.ii) Calorigensis : - It increases all metabolism producing energy. | 1,274 | medmcqa_train |
The normal time required to culture mycobacterium TB is : | M. tuberculosis 4-8 weeks is required before growth is detected. New methods have decreased the time required for bacteriologic confirmation of TB to 2-3 weeks. Reference: Harrisons Principles of Internal Medicine, 18th Edition, Page 1350 | 1,275 | medmcqa_train |
True about Hematological change in Pregnancy | Hemoglobin concentration and Hematocrit decrease slightly during pregnancy. | 1,276 | medmcqa_train |
Which of the following means of contraception is the best method to achieve Net Reproductive Rate (NRR)=1? | NRR is the most significant indicator of feility. Sterilization accounts for 80% of effective couple protection and hence is the best method among the above choices. | 1,277 | medmcqa_train |
Boundary of the Koch's triangle is not formed by? | Koch's Triangle is a triangle enclosed by the septal leaflet of the tricuspid valve, the coronary sinus, and the membranous pa of the interatrial septum.Koch's triangle: Walter Karl Koch (1880-1962) was a distinguished German surgeon who discovered a triangular-shaped area in the right atrium of the hea that marks the atrioventricular node (known as Koch's triangle).The three sides of the triangle are defined by the following structures within the right atrium: The ostium of the coronary sinus, posteriorly; The anterior poion of the tricuspid valve annulus; and The tendon of Todaro (a tendinous structure connecting the valve of the inferior vena cava ostium to the central fibrous body), posteriorly.Impoance:Used as an anatomical landmark for location of the atrioventricular node during electrophysiology procedures such as pacing or ablation. | 1,278 | medmcqa_train |
Prostaglandin was discovered from | Prostaglandins were believed to be pa of the prostatic secretions, and eventually were discovered to be produced by the seminal vesicles. ... The biochemists Sune K. Bergstrom, Bengt I. Samuelsson and John R. Vane jointly received the 1982 Nobel Prize in Physiology or Medicine for their research on prostaglandins. Ref: guyton and hall textbook of medical physiology 12 edition | 1,279 | medmcqa_train |
Which of the following is not a proinflammatory cytokine - | Cytokines
Proinflammatory Anti-inflammatory
o Major:- IL-1, o IL-4, IL-10, IL-13
TNF-alpha, IL-6
o Other:- IL-2, IL-4,
IL-5, IL-6, IL-8, IL-11,
IL-12, IL-15, IL-21,
IL-23, IFN- gamma, GM-CSF
o Here, you can consider IL-4 as pro-inflammatory cytokine ( as more than one options can be correct in PGIchandigarh). | 1,280 | medmcqa_train |
Mrs A is hesitant about having children because her two sisters had sons who had died from kinky hair disease. Her mother's brother also died of the same condition. What is the mode of inheritance of kinky hair disease which is running in this family? | Menkes syndrome is an X linked recessive disorder characterized by a mutation in ATP7a or MNK gene encoding copper binding ATPase leading to deficient copper transpo and metabolism with subsequently low serum copper. Pili tori is the most common hair manifestation, showing flattening and twisting at 180 degree angles. Children show progressive neurologic degeneration with mental retardation, failure to thrive and hypotonia. X-linked Recessive disease is seen only in males because males have only one X chromosome. There is no male to male transmission. Heterozygous females are clinically normal but may be detected by subtle clinical features. Ref: Embryology By Ronald W. Dudek, 3rd Edition, Page 229 ; The Busy Physician's Guide to Genetics, Genomics and Personalized Medicine By Kevin M. Sweet, Page 41; Clinical Genetics In Nursing Practice By Felissa R. Lashley 3rd Edition ; Dermatology Terminology By Herbe B. Allen, Page 100 | 1,281 | medmcqa_train |
Which is the principal virulence factor in Clostridium tetani | C.tetani produces two distinct toxins- a hemolysin(tetanolysin), and neurotoxin(tetanospasmin). Tetanospasmin: This is the toxin responsible for tetanus. This toxin acts pre-synaptically. The abolition of spinal inhibition causes an uncontrolled spread of impulses initiated anywhere in the central nervous system. This results in muscle rigidity and spasms. Tetanolysin: it is not relevant in the pathogenesis of tetanus. Ref: Textbook of microbiology; Ananthanarayan and paniker's; 10th Edition; Pg: 265 | 1,282 | medmcqa_train |
Most common radiation induced cancer: | Leukemia is most common radiation induced cancer.
Others: Thyroid, Breast Carcinoma | 1,283 | medmcqa_train |
Exposure to noise above--causes permanent loss of hearing: | 160 dB | 1,284 | medmcqa_train |
Drug that may induce nail pigmentation - melanonychia: | Anthracyclines, taxanes, fluorouracil, psoralens, and zidovudine may induce nail pigmentation through melanocyte stimulation in nail matrix resulting in melanonychia. It appears to be reversible and dose-dependent and appears 3-8 weeks after drug intake. | 1,285 | medmcqa_train |
Inferior angle of scapula is at the level of? | ANSWER: (D) T7REF: Gray's Anatomy 30th edition page 819, Instant Anatomy by Robert H. Whitaker, Neil R. Borley 4th edition Page 199See APPENDIX- 9 below for "VERTEBRAL LEVELS"The scapula is a large, flat, triangular bone which lies on the posterolateral aspect of the chest wall, covering parts of the second to seventh ribs (also T7). It has costal and dorsal surfaces, superior, lateral and medial borders, inferior, superior and lateral angles, and three processes, the spine, its continuation the acromion and the coracoid process. APPENDIX - 9Vertebral Levels (Mnemonic: All Bifurcations (B 14-cation) are at The Level of 4)C4Hyoid bone; Bifurcation of common carotid artery.C5Thyroid cartilageC6Cricoid cartilageTrachea beginsOesophagus begins Pharynx and larynx endsC7Thoracic duct reaches its greatest height; Isthmus of thyroid glandT1Sternoclavicular joint; Highest point of apex of lung.T2Sternal notchJugular notchT4Sternal angle (of Louis)Junction of superior and inferior mediastinumAscending aorta endsArch of aorta begins and ends.Bifurcation of tracheaTSIVC hiatusT9Xiphisternal jointT10Oesophageal hiatusT12Aortic hiatusThoracic duct through diaphragmAzygos vein through diaphragmLIEnd of spinal cord in adults Transpyloric plane Pylorus of stomach Superior mesenteric artery originHilum of kidneys (renal artery-left is above and right is below)Celiac artery originates just above and renal arteries originate just below this line.L2Thoracic duct begins; Azygos and hemiazygos beginL3UmbilicusEnd of spinal cord in newborns Inferior mesenteric arteryL4Iliac crestAorta bifurcates into common iliac arteries.Inferior vena cava formed from common iliac veins.S1Sacral promontoryS2Posterior superior iliac spineEnd of dural sac (Dura, arachnoid, subarachnoid space, CSF)Middle of sacroiliac jointS3Posterior inferior iliac spineEnd of sigmoid colonRectum begins (important landmark in surgery of recto sigmoid carcinoma). | 1,286 | medmcqa_train |
Other than cataract, which one among the following is the highest prevalent cause of blindness in the world - | Cataract 39% Glaucoma 10% tracoma3% diabeticretinopathy 4% Ref-Park&;s textbook of Preventive and social medicine 23rd edition. . | 1,287 | medmcqa_train |
Best prognostic factor for head injury is | The severity of head injury is classified according to glassglow coma scale(GCS) as it is the best predictor of neurological outcome. Mode of injury and age of the patient help in initial evaluation and management, CT helps in confirmation of the diagnosis. Their prognostic value is less when compared to GCS. Reference: Bailey and Love's Sho Practice of Surgery, 26th edition, Pg no:313 | 1,288 | medmcqa_train |
Granular deposit of IgA at dermoepidermal junction is seen in - | Ans. is 'c' i.e., Dermatitis herpatiformis Immunopathological appearance of vesicobullous disorderso Bullous pemphigoid-Linear band of IgG or C3 in epidermal basement membraneo Pemphigus vulgaris-Cell surface deposits of IgG on keratinocyteso Pemphigus foliaceous-Cell surface deposits of IgG on keratinocyteso Pemphigoid gestationis-Linear band of C3 in epidermal basement membrane zoneo Dermatitis herpeteformis-Granular deposits of IgA in dermal papillaeo Chronic bullous disease of childhood-IgA deposits along the dermoepidermal junctiono Linear IgA dermatosis of adults-Linear deposits of IgA at dermoepidermal junction | 1,289 | medmcqa_train |
True statement regarding Prevalence: | (Refer: K. Park’s Textbook of Preventive and Social medicine, 24th edition, pg no: 66, 67)
Incidence = New cases
Prevalence = New + Old cases
Prevalence = Incidence X Duration | 1,290 | medmcqa_train |
The type of receptors present on T cells is- | T cell receptor for antigen: The TCR is the recognition molecule for T cells. The TCR is a transmembrane heterodimeric protein containing two disulfide-linked chains. It is composed of two different classes of TCR called: alpha-beta (a and b) and gamma-delta (g and d). The majority of the T cells contain the ab TCR phenotype. However, a smaller percentage of T cells express the g d TCR. The ab T cells are subdivided by their surface markers: CD4 or CD8. They recognize peptide antigens presented by MHC molecules on the surfaces of APC's (antigen-presenting cells) The g d T cells are primarily located in the epithelial linings of the reproductive and GI tracts.(aiims nov. 2020). Theyrecognize different type of antigenswithout the requirement of MHC Prostglandins( eicosanoids) are the lipid compounds acting as mediators of pain and inflamation .they have diverse action such as bronchodilation ,vasodilataion etc.. IgG AND IgD are immunoglobolins involved in defence mechanism | 1,291 | medmcqa_train |
All are hepatotoxic except | 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 | 1,292 | medmcqa_train |
Pathological feature of pyogenic granuloma | Pyogenic granulomas) are pedunculated masses usually found on the gingiva of children, young adults, and pregnant women. These lesions are richly vascular and typically are ulcerated, which gives them a red to purple color. In some cases, growth can be rapid and raise fear of a malignant neoplasm. However, histologic examination demonstrates a dense proliferation of immature vessels similar to that seen in granulation tissue. Pyogenic granulomas can regress, mature into dense fibrous masses, or develop into a peripheral ossifying fibroma. Complete surgical excision is definitive treatment. (Robbins basic pathology,9th edition,pg no.553) | 1,293 | medmcqa_train |
Baby born prematurely at 29 wks, on examination at 42 weeks with ROP, both eyes shows stage 2 zone 1 `plus' disease, how will you manage the patient ? | 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. | 1,294 | medmcqa_train |
Treatment of Non-union of # shaft femur - | Treatment of choice is open the fracture site for bone grafting and internal fixation.
Internal fixation technique may be : -
Intramedullary interlock nailing (Preferred)
Intramedullary 'K' nailing
Plating (compression plaiting). | 1,295 | medmcqa_train |
Cardiac anomaly associted with TOF False is - | Ans. is 'c' i.e., ASD Tetralogy of falloto Cyanotic heart disease (MC).o Defect in infundibular septum leads to :Pulmonary stenosisVSD (Not ASD)Dextroposition and overriding of aorta.Right ventricular hypertrophy (NOT LVH).o Pink TOF (Acyanotic TOF) when PS is mild to moderate balanced shunt tnt across the VSD, pt not have cyanosis. | 1,296 | medmcqa_train |
‘Accompanied MDT’ in NLEP implies | Accompanied MDT: If patient is unable to come to collect his/her MDT from clinic, any responsible person from family or village can collect it
Designed to help patients who have to interrupt their treatment due to any avoidable reason
Especially useful for irregular patients
Gives patients a choice: Patients can collect entire MDT course when diagnosed after proper counseling. | 1,297 | medmcqa_train |
Which of the following is most characteristic of the brain in patients with Alzheimer’s disease | Most prominent feature of alzheimer’s disease is neuronal loss, fibrillary tangles, loss of synapses and amyloid plaque formation. | 1,298 | medmcqa_train |
True statement regarding sarcoma botryoides:a) Involvement of vaginab) Grape like growth seenc) Common in old aged) Malignant | Embryonal Rhabdomyosarcoma is the most common malignancy of the vagina in infants and children.
Most common subtype of embryonal rhabdomyosarcoma is sarcoma botyroides
Seen in infants and children less than 5 years of age.
"This rare tumor develops almost exclusively in girls younger than 5 years, although vaginal and cervical sarcoma botryoides have been reported in females aged 15 to 20 years." - William Gynae 1st /ed p 683
"Sarcoma botryoides are usually seen in patients who are younger than 5 years of age." - COGDT 10th ed p 831
In infants and children, sarcoma botyroides is usually found in vagina, in reproductive age females rhabdomyosarcoma is seen within the cervix and after menopause within the uterus.
The gross appearance of the tumor resembles pinkish bunch of grapes —it can be in the form of multiple polyp like structures or can be a solitary growth with pedunculated appearance.
Histologically-its characteristic finding is "rhabdomyoblast."
Clinical features
The presenting features are:
Blood stained vaginal discharge
Anaemia and cachexia
Management
Chemotherapy — vincristine actinomycin D and cyclophasphamide followed by conservative surgery to excise residual tumor is the treatment of choice. Newer studies have revealed that primary chemotherapy without surgery is adequate for most patients. | 1,299 | medmcqa_train |
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