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A mature pincer grasp is attained at ------ months | Grasp is best as..~ by offering a red cube to the ol.j)d. A 6-month-old infant reaches and holds the cul-e {b.rg? object) in a crude manner usincr the ulnar asf'C'l-'i: of r~ hand (Fig. 3_27). He can transfer ~bjects from one h.md t::i oth~ by 6-1 months. The child is able to grasp from the radial side of hand at 8-9 months (Fig. 328). B\* the ab'" ci 1 year, mature grasp (index finuer and thumb) is e,iJo.t (Fig. 3.29). 0 By offering pellets (smaller object), finer hand skills;.:~ assessed. By 9-10 months, the child approaches the pelletby an index finger and lifts it using finger thumb apposition, termed 'pincer' gras | 1,300 | medmcqa_train |
Hanging cuain sign seen in? | Pityriasis rosea REF: Dermatology. 1995; 190(3): 252. PubMed PMID: 7599393, Clinical Pediatric Dermatology - By Thappa page 104 PITYRIASIS ROSEA The primary eruption, herald patch (Mother spot) is a single oval or round patch with a central wrinkled salmon colored area and a darker peripheral zone separated by a "collarette of scales" (when stretched across the long axis, the scales tends to fold across the line of stretch, the so called Hanging cuain sign). | 1,301 | medmcqa_train |
Height of child acquire 100 cm in? | Ans. is 'c' i.e., 4.5 year | 1,302 | medmcqa_train |
Most common complication of tonsillectomy is- | Ans. is 'a' i.e., Hemorrhage "Post-tonsillectomy hemorrhage is the most common complication, occuring in approximately 2 to 5%, and should be taken seriously "._________Bellenger's otolaryngologyComplications of tonsillectomyo Complications of tonsillectomy may beImmediateDelayedImmediate complicationsPrimary haemorrhage : Occurs at the time of operation. It can be controlled by pressure, ligation or electrocoagulation of the bleeding vessels.Reactionary haemorrhage: Occurs within a period of 24 hours.Injury to tonsillar pillars, uvula, soft palate, tongue or superior constrictor muscle due to bad surgical technique.Injury to teeth.Aspiration of blood.Facial oedema : Some patients get oedema of the face particularly of the eyelids.Surgical emphysemaDalayed complicationsSecondary haemorrhage: Usually seen between the 5th to 10th post-operative day. It is the result of sepsis and premature separation of the membrane. Usually, it is heralded by bloodstained sputum but may be profuse.Infection : Infection of tonsillar fossa may lead to parapharyngeal abscess or otitis media.Lung complications : Aspiration of blood, mucus or tissue fragments may cause atelectasis or lung abscess.Scarring in soft palate and pillars.Tonsillar remnants : Tonsil tags or tissue, left due to inadequate surgery, may get repeatedly infected.Hypertrophy of lingual tonsil: This is a late complication and is compensatory to loss of palatine tonsils. | 1,303 | medmcqa_train |
Causes of epistaxis are all except | Causes of epistaxis Trauma Infections Foreign bodies Neoplasms of nose and paranasal sinus Atmospheric changes Deted nasal septum Hypeension Pregnancy Leukemia Liver disease Kidney disease Idiopathic Ref: Dhingra 7e pg 197. | 1,304 | medmcqa_train |
Which of the following drugs, is used for Smoking Cessation? | Answer is B (Bupropion): Bupropion (along with Varenicline and Nicotine replacement therapy) is a USFDA approved first line agent for pharmacotherapy in Smoking Cessation. USFDA Approved Agents for Smoking Cessation Nicotine Replacement Therapy (Transdermal Patch, gum, lozenges, oral inhaler, nasal spray) Bupropion (Atypical Antidepressant with dopaminergic and noradrenergic activity) Varenicline (Selective paial agonist at the Alpha4-Beta2 Nicotinic A-Choline receptor that is believed to mediate nicotine dependence) Clonidine and Noriptyline are two other medications that have efficacy but are NOT USFDA approved for this indication. These are classified as second line agents. | 1,305 | medmcqa_train |
LH surge occurs at | C. i.e. (24 - 36 hours before ovulation) (37-Shaw's 14th/64-Dutta 4th)* LH surge precedes ovulation by 24 to 36 hours (mean 30 hours) and minimum of 75 ng/ml is required for ovulation (37 - Shaw's 14th)* LH levels remains almost static throughout the cycle except at least 12 hours prior to vulation. When it attains its peak, called LH surge (64 - Dutta 4th)* The main function of LH is steroidogenic, but along with FSH. It is responsible for full maturation of the graffian follicle and oocyte and ovulation | 1,306 | medmcqa_train |
In abdominal surgery Lembe sutures refers to ? | Ans. is 'b' i.e., Sero muscular sutures | 1,307 | medmcqa_train |
Adrenal insufficiency in not associated with - | Ans. is 'd' i.e.. Metabolic alkalosis o Features of adrenal insufficiency (Addison's disease) are :-i) Hypoglycemiaii) Hyperpigmentationii) Hyperkalemiaiv) Hyponatremiav) Hypotensionvi) Metabolic acidosiso Associated features are nausea, vomiting, diarrhea and abdominal cramps. | 1,308 | medmcqa_train |
Barr body is absent in female having | Barr body is absent in those with genotype 45 XO . For a brr body to be present a minimum of 2 x chromosomes should be there . No of Barr body = no of x chromosomes - 1. Reference: GHAI Essential pediatrics, 8th edition | 1,309 | medmcqa_train |
Secondary amyloidosis occurs in ? | Ans. Three options are correct i.e., 'a, b & c' | 1,310 | medmcqa_train |
Splenectomy is most useful in : | Answer is B (Hereditary spherocytosis) Splenectomy is curative in hereditary spherocytosis. Splenectomy is carried out in all symptomatic patients Q because of the potential for gall stones and stones and episodes of bone marrow hyperplasia or hemolytic crisis Q It reliably corrects the anemia and RBC survival often becomes normal or nearly so. The operative risk is low. Remember Splenectomy is not carried out in young children e (preferably postponed until age 4) in order to minimize the risk of severe infections Q with gram positive encapsulated organisms. | 1,311 | medmcqa_train |
Epidemic hemorrhagic conjunctivitis is caused by - | Epidemic hemorrhagic conjunctivitis is caused by Coxsackie Virus A24 or Enterovirus 70 (members of the Family Picornaviridae). HSV (Herpes Simplex Virus)- causes oral herpes and genital herpes. HZV (Herpes Zoster Virus) -causes Shingles. HIV -cause AIDS. | 1,312 | medmcqa_train |
The industry, with the highest accidental death rate and long held to be the most dangerous occupation is – | Accidents are a common features in most industries.
In fact, some industries are known for accidents, eg: coal and other mining industries, quarrying, construction work. | 1,313 | medmcqa_train |
A 22-year-old African American male wants to know if he has sickle cell trait. He has no previous history of the signs or symptoms of sickle cell anemia. What laboratory method or test can be used to detect the presence of hemoglobin S? | The metabisulfite test is used to detect the presence of hemoglobin S, but it does not differentiate the heterozygous sickle cell trait from the homozygous sickle cell disease. The test is based on the fact that erythrocytes with a large propoion of hemoglobin S sickle in solutions of low oxygen content. Metabisulfite is a reducing substance that enhances the process of deoxygenation. The osmotic fragility test is a diagnostic test for hereditary spherocytosis. Spherocytes lyse at a higher concentration of salt than do normal cells, thus causing an increased osmotic fragility. The direct antiglobulin test (DAT), or Coombs' test, is used to differentiate autoimmune hemolytic anemia (AIHA) due to the presence of anti-red cell antibodies from other forms of hemolytic anemia. In this test, antibodies to human immunoglobulin cause the agglutination (clotting) of red cells if these anti-red cell antibodies are present on the surface of the red cells. In patients with paroxysmal nocturnal hemoglobinuria, the erythrocytes are excessively sensitive to complement-mediated lysis in low ionic environments (the basis for the sucrose hemolysis test) or in acidotic conditions, such as sleep, exercise, or the Ham's acid hemolysis test. The Schilling test, which measures intestinal absorption of vitamin B12 with and without intrinsic factor, is used to diagnose decreased vitamin B12 caused by pernicious anemia, which is characterized by a lack of intrinsic factor. Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition. | 1,314 | medmcqa_train |
Earliest clinical feature of Senile cataract | Earliest clinical feature of Senile cataract is Glare
Most common symptom at presentation is Frequent change of glasses | 1,315 | medmcqa_train |
Time taken for capacitation of sperms is | Capacitation is the process of reconditioning of the sperm, making it more suitable for penetration into the ovum.
It takes about 6-8 hours and occurs in FGT chiefly in the tubes. | 1,316 | medmcqa_train |
Best method to remove confounding is | Method Utility to control confounding Randomization 2nd best method Restriction Limiting study to people who have paicular characteristics Matching Mostly useful in case control studies, MC used method Stratification Useful for larger studies Statistical modeling When many confounding variables exist simultaneously Stratified randomization Best method | 1,317 | medmcqa_train |
Nerve compressed by aneurysm of posterior communicating aery is | Occulomotor nerve Most unruptured intracranial aneurysms are completely asymptomatic. Symptoms are usually due to rupture and resultant subarachnoid hemorrhage. Occasionally neurological symptoms may arise due to mass effect of the aneurysm. Progressively enlarging unruptured aneurysm most commonly involves the occulomotor nerve. This usually occurs .from an expanding aneurysm at junction of post communicating aery and internal carotid aery. Other neuropathies due to intracranial aneurysms are Cavernous sinus aneurysm can produce sixth nerve palsy. Supraclinoid carotid or anterior cerebral aery aneurysm can produce visual field defects. Posterior inferior cerebellar aery or anterior inferior cerebellar aery aneurysm may present as occipital & posterior cervical pain. An expanding middle cerebral aery aneurysm can produce pain in or behind the eye & in the low temple. Ophthalmic aery aneurysm can cause visual loss by compressing optic nerve. | 1,318 | medmcqa_train |
Curschmann spirals are found in | (Asthma) (726- Robbins 7th) (485- 492- HM 5,h) (492- Basic pathology 8th)* Bronchial Asthma - Histologically the mucous plugs contain whorls of shed epithelium. Which give rise to the well known Curschmann spirals*, Numerous eosinophils and charcot Leyden crystals* are present* The other characteristic histologic findings of asthma collectively called "airway remodeling"* REID INDEX is the ratio between thickness of the submucosal mucous glands (i.e, hypertrophy and hyper plasia) in the cartilage containg large airway to that of the total bronchial wall seen in chronic bronchitis** | 1,319 | medmcqa_train |
All are TRUE about the relation of inguinal canal, EXCEPT: | Boundaries of Inguinal canal:Floor is formed by the grooved upper surface of the inguinal ligamentRoof is formed by the arching lower fibers of Internal oblique and transverse abdominal muscles.Anterior wall is formed by the external oblique aponeurosis all through it is extentreinforced laterally by the Internal oblique musclePosterior wall is formed by the transversalis fascia all through its extent, reinforced medially by the conjoint tendon also known as inguinal falx (Fused fibers of transversus abdominis and internal oblique muscles).Must know: Contents of the inguinal canal: In the males,Spermatic cordIlioinguinal nerveCremaster and its blood supplyGenital branch of genitofemoral nerveRemnants of processes vaginalsIn the femaleRound ligament of uterus, (remnant of Gubernaculum)Genital branch of genitofemoral nerveIlioinguinal nerveCremaster and its blood supplyRemnants of processes vaginalisRef: Snells, Clinical anatomy, 7th Edition, Page 173, 174. | 1,320 | medmcqa_train |
In emergency tracheostomy all of the following structures are damaged, EXCEPT: | Bleeding can occur immediately after a tracheostomy and in the late postoperative period. Sources of hemorrhage include granulation tissue in the stoma or trachea, and erosion of thyroid vessels or the thyroid itself, the tracheal wall (frequently from suction trauma), or the innominate aery. Inferior thyroid aery, a branch of the thyrocervical trunk of the subclan aery lies laterally away from midline, thus can escape injury. Ref: Moro-Sutherland D. (2011). Chapter 138. The Child with Special Health Care Needs. In J.E. Tintinalli, J.S. Stapczynski, D.M. Cline, O.J. Ma, R.K. Cydulka, G.D. Meckler (Eds), Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e. | 1,321 | medmcqa_train |
Platelets transfusion must be completed in how many hours after entering the bag | Answer- D. 4 hour Once the blood bag is opened hy puncturing one of the sealed pos, the platelets must be administered within 4 hours | 1,322 | medmcqa_train |
Rickets in infant present as all except - | Long bones of legs gets deformed when the child starts bearing weight. Therefore deformities of legs are unusual before the age of one year. | 1,323 | medmcqa_train |
The maxillary nerve arises from the trigeminal ganglion in the middle cranial fossa. It passes forward in the lateral wall of the cavernous sinus and leaves the skull through which of the following foramen to enter the pterygopalatine fossa? | It arises from the trigeminal ganglion, runs forwards in the lateral wall of the cavernous sinus below the ophthalmic nerve, and leaves the middle cranial fossa by passing through the foramen rotundum. Next, the nerve crosses the upper pa of the pterygopalatine fossa. In the pterygopalatine fossa, the nerve is intimately related to the pterygopalatine ganglion and gives off the zygomatic and posterior superior alveolar nerves. The posterior superior alveolar nerve enters the posterior surface of the body of the maxilla and supplies the three upper molar teeth and the adjoining pa of the gum.Ref: BD Chaurasia&;s HUMAN ANATOMY, Volume 3, 6th edition. | 1,324 | medmcqa_train |
What is seen in the X-ray of femur below | . | 1,325 | medmcqa_train |
Size of uterus in inches: | Ans. is c, i.e. 3x2x1 inchesRef: Jeffcoates Principle of Gynae 9/ed, pg 32Remember, best answer to this question is 3.25x2.5x1.5 inches. | 1,326 | medmcqa_train |
Hypocalcemia with hyperphosphatemia are seen in. | <p>Improved medical management of chronic kidney disease now allows many patients to survive for decades and hence time enough to develop features of renal osteodystrophy, which must be controlled to avoid additional morbidity. Impaired production of 1,25(OH) 2 D is now thought to be the principal factor that causes calcium deficiency, secondary hyperparathyroidism, and bone disease; hyperphosphatemia typically occurs only in the later stages of CKD. Low levels of 1,25(OH) 2 D due to increased FGF23 production in bone are critical in the development of hypocalcemia. The uremic state also causes impairment of intestinal absorption by mechanisms other than defects in vitamin D metabolism. Nonetheless, treatment with supraphysiologic amounts of vitamin D or calcitriol corrects the impaired calcium absorption. Since increased FGF23 levels are seen even in early stages of renal failure in some patients, and have been repoed to correlate with increased moality, there is current interest in methods (lowering phosphate absorption) to lower FGF23 levels and concern as to whether vitamin D supplementation (known physiologically to increase FGF23) increases FGF23 in CKD. Hyperphosphatemia in renal failure lowers blood calcium levels by several mechanisms, including extraosseous deposition of calcium and phosphate, impairment of the bone-resorbing action of PTH, and reduction in 1,25(OH) 2 D production by remaining renal tissue(harrison 18 pg 3116)</p> | 1,327 | medmcqa_train |
The specific name of the anomaly shown in the following radiograph is: | Dens in Dente
(Dens invaginatus, dilated composite odontome)
The ‘dens in dente’ is a developmental variation which is thought to arise as a result of an invagination in the surface of tooth crown before calcification has occurred. Several causes of this condition have been proposed. These include increased localized external pressure, focal growth retardation, and focal growth stimulation in certain areas of the tooth bud. The permanent maxillary lateral incisors are the teeth most frequently involved, and in the majority of cases the ‘dens in dente’ appears to represent simply an accentuation in the development of the lingual pit.
Radiological signs
Dens in dente represent a tooth-shaped, enamel-covered mass within the crown and/or root of the tooth but which may traverse the length of the tooth. Dilated odontome represents the most extreme form of this anomaly and exhibits a grossly altered morphology that is internally outlined by a dense linear radiopacity. In both cases, the apical region may or may not display an open apex and there may be associated adjacent apical rarefaction. | 1,328 | medmcqa_train |
An upper motor neuron (UMN) lesion involving cranial nerve VII would most likely produce | The physical finding of facial asymmetry is suggestive of an abnormality involving the facial nerve (CN VII). The facial nucleus, which is located within the pons, is divided in half, the upper neurons innervate the upper muscles of the face, while the lower neurons innervate the lower poion of the face. It is impoant to realize that each half receives input from the contralateral motor coex, while only the upper half receives input from the ipsilateral motor coex. Therefore an upper motor neuron (UMN) lesion will produce a defect involving only the contralateral lower half of the face. Causes of UMN lesions involving the facial nerve includes strokes that involve the coex or the internal capsule. In contrast, lesions that affect the facial nerve from the facial nucleus to the remaining length of the nerve result in LMN lesions. Patients present with facial asymmetry involving the ipsilateral upper and lower quadrants. Lesions to the facial nerve within the facial canal (frequently due to cold weather) cause Bell's palsy. Patients present with paralysis of all muscles of facial expression. Bell's phenomenon refers to the finding of the affected eye looking up and out when patients try to close their eyes. Because the lacrimal punctum in the lower eyelid moves away from the surface of the eye, lacrimal fluid does not drain into the nasolacrimal duct. This produces "crocodile tears." ref - pubmed.com | 1,329 | medmcqa_train |
Dry skin seen due to excess dosage of datura is due to | One of the anticholinergic effects is dry skin due to absence of sweating due to blockade of m3 receptors on sweat glands Datura is nothing but atropine-anticholinergic drug Ref: KDT 6th ed pg 114-116 | 1,330 | medmcqa_train |
Perception of uterine contraction is known as: | Ans: c (Palmer sign) Ref: Dutta, 6th ed, p. 66Perception of rhythmic uterine contraction on bimanual examination in pregnancy is Palmer sign. It is done as early as 4-8 weeks. This is one of the signs used to diagnose pregnancy. There are various signs and symptoms to detect early pregnancy. These are listed below:Diagnosis of pregnancy1st trimester - Amenorrhoea- Morning sickness- Freq. of micturition- Breast discomfortPlacental signBleeding at the time of next periodHartman signImplantation bleedingJacquemiersign(Chadwick sign)Blue hue of vestibule and anterior vaginal wallOsiandersignIncreased pulsation in the lateral fornixGoodell signCervix becomes softPiskacek signDuring lateral implantation one half of the uterus becomes more firm than other halfHegars signOn bimanual palpation upper uterus and cervix are felt separately, due to the softening of lower part of body of uterus.(6-10 weeks)Palmer signRhythmic uterine contraction during bimanual examination.2nd trimester- Quickening (16-18 wks)- Chloasma (20 wks)- Breast changes - Secondary areola- Montgomery tubercles -Colostrum - 12 wks- Linea nigra- Striae gravidarum- Ext. ballotment- Int. ballotment | 1,331 | medmcqa_train |
The most common site of puerperal infection is: | Ans. (a) Placental siteRef. Dutta's Obstetrics, 7th ed. 1433PUERPERAL SEPSIS* An infection of the genital tract which occurs as a complication of delivery is termed puerperal sepsis.* Sources of infection may be endogenous where organisms are present in the genital tract before delivery.Mode of infection* Puerperal sepsis is generally a wound infection.* Placental site being a raw surface in the endometrium is the most common site for infection.* Other causes of puerperal sepsis may be laceration of the genital tract or may be CS section wound infection by organisms like anaerobic strep, E. Coli, staph etc.* Anaerobic streptococcus is the most common cause of Puerperal sepsis.* The primary sites of infections are: Uterus, Perineum, Vagina, Cervix. | 1,332 | medmcqa_train |
Gas causing global warming but is not a greenhouse gas? | Greenhouse gases are CO2 Methane CFC 12 HCFC 22 Nitrous oxide Tetrafluoromethane SO2 is not a Greenhouse gas but it causes global warming Park's Textbook of Preventive and Social Medicine, 25th Edition, Pg 794 | 1,333 | medmcqa_train |
Lahsal classification is used for: | Any classification for such a diverse and varied condition as cleft lip and palate needs to be simple, concise, flexible and exact but graphic. It must be suitable for computerisation but descriptive and morphological. An example of such a classification is the LAHSHAL system. | 1,334 | medmcqa_train |
Features of vernal keratoconjunctivitis are – a) Papillary hypertrophyb) Follicular hypertrophyc) Herbert's pitsd) Tantra\'s Spote) Ciliary congestion | Papillary hypertrophy into polygonal papilla is arranged in cobblestone or pavement stone fashion. | 1,335 | medmcqa_train |
Dawn phenomenon refers to: March 2013 | Ans. A i.e. Early morning hyperglycemia Impoant terms Dawn phenomenon: Glucose level rise in early morning Somogyi effect: Rebound hyperglycemia may appear after 1-24 hours after moderate to severe hypoglycemia | 1,336 | medmcqa_train |
Women with PCOS and Hirsutism, management is : | Drugs used for Hirusitism: 1.Ovarian Suppression agents a.Oral Contraceptives b.Cyproterone acetate. c.GnRH agonist and antagonist. 2.Adrenal suppresion agents a.Glucocoicoids. 3.Androgen receptor blocking agents a.Spironolactone b.Flutamide. c.Cyproterone acetate. 5. 5 alpha reductase inhibitor a.Finasteride. Shaw's textbook of Gynecology 16th edition page no 152 | 1,337 | medmcqa_train |
Gaucher's disease is inherited as? | Gaucher disease results from mutation in the gene that encodes glucocerebrosidase. There are three autosomal recessive variants of Gaucher disease resulting from distinct allelic mutations. Common to all is variably deficient activity of a glucocerebrosidase that normally cleaves the glucose residue from ceramide. This deficit leads to an accumulation of glucocerebroside, an intermediate in glycolipid metabolism, in the mononuclear phagocytic cells and their transformation into so-called Gaucher cells. (Robbins Basic Pathology,9th edition,pg no. 231) | 1,338 | medmcqa_train |
Gamma Rays Are used in which Diagnostic Modality ? | Gamma Rays are used in Radioisotope studies/scintigraphy studies Bone scan is a radioisotope study done using Tc99m -MDP to detect skeletal metastasis Fluoroscopy and CT scan uses Xrays Radiowaves are used in MRI | 1,339 | medmcqa_train |
Fomepizole acts as antidote for - | Ans. is 'a' i.e., Methanol poisoning Methyl alcohol (methanol)o Methanol is highly toxic alcohol. It is metabolized to formaldehyde (by alcohol dehydrogenas) and formic acid (by acetaldehyde dehydrogenase).o It is the accumulation of formic acid which causes toxic effects in methanol poisoning. Accumulation of formic acid results in lactic acidosis/high anion gap metabolic acidosis with low plasma bicarbonates, blindness due to retinal damage, papilledema.o Methanol poisoning can be treated by supportive measures, gastric lavage and sodium bicarbonate (to treat acidosis). Ethanol is useful because it competitively inhibits the conversion of methanol to formic acid. Fomepizole can also be used as it is a specific inhibitor of alcohol dehydrogenase. Folic acid or folinic acid. Enhance the metabolism formic acid to CO2. Hemodialysis may also be used. | 1,340 | medmcqa_train |
Lymphoid tissues reach their maximum size: | The thymus matures at pubey, thus attaining the maximum size Ref: guyton and hall textbook of medical physiology 12 edition | 1,341 | medmcqa_train |
Incubation period of gonorrhoea is - | Ans. is 'c' i.e., 2 to 15 days Incubation period of gonorrhea is 2 - 8 days. | 1,342 | medmcqa_train |
Which of the following are causes for cholecystitis wxcept? | acalculous cholecystitis is not an uncommon entity, but can be commonly missed.* It is common in patients who have undergone major surgeries, trauma, burns, or any other stress or in cases of cholecystoses. * Common in ICU patients. ACUTE CHOLECYSTITIS * Commonly it occurs in a patient with pre-existing chronic cholecystitis but often also can occur as a first presentation. * Usual cause is impacted gallstone in the Hamann's pouch, obstructing cystic duct. ref : SRB&;s manual of surgery,3 rd ed,pg no 576 | 1,343 | medmcqa_train |
NADPH actions in RBC are a/e | ATP is not produced by NADPH. ATP is produced by reducing equivalents like NADH, FADH2. W When NADH and other reducing equivalents transfer their electrons through Electron transpo chain in the Mitochondrial inner membrane and generate proton motive force which brings about the ATP synthesis by the ATP synthase complex. Both nicotinamide adenine dinucleotide (NAD+) or nicotinamide adenine dinucleotide phosphate (NADP+) are co-factors of vitamin niacin used by dehydrogenases. However NAD-linked dehydrogenases catalyse oxido-reduction reactions in the oxidative pathways of metabolism, paicularly in glycolysis, in the citric acid cycle and in the respiratory chain of mitochondria. | 1,344 | medmcqa_train |
Which is called nerve of Wrisberg | Facial nerve runs from pons to parotid. It is a mixed nerve having motor and a sensory root. The latter is also called the nerve of Wrisberg and carries secretomotor fibres to lacrimal gland and salivary glands, and brings fibres of taste and general sensation. Nerve of Wrisberg (Nervus intermedius receives fibres from Nucleus tractussolitarious and Nucleus salivatorius superioris Motor fibres take origin from the nucleus of VIIth nerve, hook round the nucleus of VIth nerve and are joined by the sensory root (nerve of Wrisberg). | 1,345 | medmcqa_train |
A patient repoed with a history of fall on an outstretched hand, complains of pain in the anatomical snuffbox and clinically no deformities visible. The diagnosis is: | D i.e. Scaphoid | 1,346 | medmcqa_train |
High spinal anaesthesia is characterized by: | Ans. (d) Hypotension, bradycardiaRef : KDT 6th ed. / 360Systemic Effects (Physiological Alterations) of Central Neu- ralxial BlocksCARDIOVASCULAR SYSTEMThe most prominent effect is hypotension which is because of the following factors:* Venodilatation which is because of sympathetic block which maintains the venous tone.* Dilatation of post arteriolar capillaries which is again because of loss of sympathetic tone.* Decreased cardiac output which is because of:# Decreased venous return: Due to blood pooling in veins of lower limb and lower abdomen.# Bradycardia: Bradycardia can occur as a result of: Decreased atrial pressure because of decrease venous return (Bainbridge reflex) and Direct inhibition of cardioaccelerator fibres (T1 to T4).* Paralysis of nerve supply to adrenal glands with consequently decreased catecholamine release.* Direct absorption of drug into systemic circulation.* Compression of inferior vena cava and aorta by pregnant uterus, abdominal tumors (supine hypotension syndrome).NERVOUS SYSTEM* Autonomic fibres (mediated by C fibres) are most sensitive and they are blocked earliest followed by sensory and then motor fibres. So, sequence of block is Autonomic - Sensory - Motor. The recovery occurs in reverse order although number of studies have suggested return of autonomic activity before sensory. | 1,347 | medmcqa_train |
Iron absorption is inhibited by all except: | Ans. A. Vitamin C(Ref: Harper 31/e page 533-540)Iron absorption is enhanced by:Vitamin C, Fructose, Alcohol iron absorption is inhibited byPhytates, Oxalates, Caffeine, Calcium | 1,348 | medmcqa_train |
Most common nerve involved in supracondylar fracture of humerus is: | D i.e. Supracondylar fracture | 1,349 | medmcqa_train |
Fistula formation due to the below etiology occurs within | Vesicovaginal fistula: In obstructed labor, the bladder becomes an abdominal organ and due to compression of urethra between presenting part and pubic symphysis, patient fails to empty bladder. The bladder wall gets traumatized which may lead to bloodstained urine, a common finding in obstructed labor. The bases of the bladder and urethra which are nipped in between presenting part and pubic symphysis may undergo pressure necrosis. The devitalized tissue becomes infected and later on may slough off around the 3rd to 5th day of puerperium resulting in genitourinary fistula which is a remote complication (does not present on the day of injury as in perineal tear).
Causes:
Obstetric cause—97% obstructed labor is the prime cause, and bladder neck is the most common site;
Gynecological operations—anterior colporrhaphy, total hysterectomy, or Wertheim’s operation, sling operation. | 1,350 | medmcqa_train |
Botulism is a disease of ? | Ans. is 'c' i.e., Neuromuscular transmission caused by the toxin of the bacterium clostridium botulinum Botulinum Toxin Cl. botulinum produces a powerful exotoxin that is responsible for its pathogenicity. The toxin differs from other exotoxins in that it is not released during the life of organism. It is produced intracellularly and appears in the medium only on the death and autolysis of the cell. It is the most toxic substance known. Toxin is heat labile, but spores are highly heat resistant. It acts by blocking the release of acetylcholine at synapses and neuromuscular junction. It acts presynaptically. Toxin of all types (A, B, C, D, E, F, G) are neurotoxin except C2 which is a cytotoxin (enterotoxin). | 1,351 | medmcqa_train |
Retinoscopy is done for: | Retinoscopy is an objective method of finding out the error of refraction by the method of neutralization.The end point of neutralization is either no movement or just reversal of the movement of the pupillaryshadow. Depending upon the movement of the red reflexvis-a-vis movement of the plane mirror, Following infrences are drawan No movement of the red reflex indicates myopia of 1D.With movement - emmetropia or hypermetropia or myopia of lessthan 1D.Against movement -myopia of more than 1D. | 1,352 | medmcqa_train |
The commonest location for the carcinoid tumor is which of the following? | Carcinoid tumor:- Neuroendocrine tumor, most common site being GIT and Lungs being 2nd most common In GIT, most common site is small intestine Composed of cells that contains dense-core neurosecretory granules in their cytoplasm. | 1,353 | medmcqa_train |
Persistent and inappropriate repetition of response beyond the point of relevance is called | The patient repeats same response beyond the point of relevance.
Example :
What is your name? – Darshan
What you ate in the morning? – Darshan
Where do you live? – Darshan | 1,354 | medmcqa_train |
If the prevalene is very low as compared to the incidence for a disease, it implies - | Prevalence is less than incidence
1) Disease is very fatal
Most of the cases die, so at the time of calculating prevalence the number is usually less than the incidence.
2) Disease is very well curable either by rapid recovery or by treatment
Most of the cases recover, so at the time of calculating prevalence the number is usually less than incidence.
Prevalence is more than incidence
1) Disease is not fatal but very chronic
Due to increased duration, prevalence increases
2) Treatment prevent death but does not cure
Due to increased duration, prevalence increases. | 1,355 | medmcqa_train |
Which of the following does not predispose to leukemia? | Ans. is 'b' i.e., Alcohol Leukemia risk factors1) Generala) Gender: Men are more likely to develop CML, CLL and AML than women.b) Age: The risk of most leukemias, with the exception of ALL, typically increases with age.2) Geneticsa) Family history: First degree relatives of CLL patients, or having an identical twin who has or had AML or ALL, increases the risk for developing the disease.b) Genetic diseases: AML has been associated with Down syndrome, Klinefelter syndrome, Patau syndrome, Fanconi anemia, Bloom syndrome, Ataxia telangiectasia, and Kostman syndrome, may play a role in the development of leukemia.3) Smoking: Smoking cigarettes does increase the risk of developing AML.4) Exposuresa) Radiation: Exposure to high-energy radiation (e.g., atomic bomb explosions) and intense exposure to low- energy radiation from electromagnetic fields (e.g., power lines).b) Chemical exposure: Long-term exposure to chemicals like benzene & ethylene oxide is considered to be a risk for leukemia.c) Drugs - alkylating agents & topoisomerase II inhibitors increase the risk of AML.5) Previous Cancer Treatment: Certain types of chemotherapy and radiation therapy for other cancers are considered leukemia risk factors. | 1,356 | medmcqa_train |
Stroma of cornea is developed from | Stroma of cornea develops from neural crest cells derived (secondary) mesenchyme. The adult cornea has developmentally three layers: Outer epithelium layer (surface ectoderm) Middle stromal layer of collagen-rich extracellular matrix between stromal keratocytes (neural crest) Inner layer of endothelial cells (neural crest). Ref - medscape.com | 1,357 | medmcqa_train |
Distribution of functional renal tissue is seen by – | Static renal scintigraphy (Tc-99 DMSA) can be used to locate functional renal mass. | 1,358 | medmcqa_train |
Coical representation of body in the cerebrum is | The various pas of the body are represented in the precentral gyrus, with the feet at the top of the gyrus and the face at the bottom. The facial area is represented bilaterally, but the rest of the representation is generally unilateral, with the coical motor area controlling the musculature on the opposite side of the body. The coical representation of each body pa is propoionate in size to the skill with which the pa is used in fine, voluntary movement. The areas involved in speech and hand movements are especially large in the coex; use of the pharynx, lips, and tongue to form words and of the fingers and apposable thumbs to manipulate the environment are activities in which humans are especially skilled.Ref: Ganong's Review of Medical Physiology, Twenty-Third Edition | 1,359 | medmcqa_train |
Most common site of histiocytosis is - | Langerhan's cell histiocytosis are malignant proliferation of dendritic cells or macrophages. These proliferating cells are actually Langerhan's cells of marrow origin.Reference :Harsh Mohan textbook of pathology 6th edition pg no 385. | 1,360 | medmcqa_train |
Tick born relapsing fever is/are caused by - | Ans. is 'b' i.e., Borrelia duttonii | 1,361 | medmcqa_train |
Spatial relationship of every atom in a molecule is known as: | The terms configuration and conformation are often confused:
Configuration refers to the geometric relationship between a given set of atoms, for example, those that distinguish l- from d-amino acids. Interconversion of configurational alternatives requires breaking (and reforming) covalent bonds.
Conformation refers to the spatial relationship of every atom in a molecule.
Ref: Harper’s illustrated biochemistry. 30th edition page no: 36 | 1,362 | medmcqa_train |
Mac Callum plaques in rheumatic hea disease are | Mac Callum's plaques is a condition featuring the thickening of left atrium's wall and its endocardial wall above the mitral valve due to fibrosis. It is one complication of chronic rheumatic hea disease. Other complications of chronic rheumatic hea disease are valvular effect (stenosis, insufficiency or can be both), valvular leaflets become thickened by fibrosis, frequent valvular calcification, cordae tendinae become thickened, shoened and fused. Robbins 9 th edition page 393 | 1,363 | medmcqa_train |
Same amino acid is coded by multiple codons d/t following : | Ans. is 'a' i.e. Degeneracy There are 20 amino acids, to be coded by 61 codons, so every amino acid except methionine and tryptophan are represented by more than one codon. This is k/a degeneracy or redundancy.The genetic code is made up of codons. Codons consist of a sequence of three nucleotides i.e. it is a triplet code. Since there are 4 different nucleotides, their various combination leads to 64 codons (43). Three of these codons do not code for any specific amino acid (known as nonsense codons) and are used as termination signals (hence also known as termination or stop codons. When one of these termination codons appear in an mRNA sequence, it signals that polymerization of amino acids into a protein molecule is complete.Characteristics of the Genetic CodeSpecific or UnambiguousA given codon designates only one single specific amino acid.Degenerate or RedundantAlthough each codon corresponds to a single amino acid, a given amino acid may have more than one triplet coding for it.Exceptions are Methionine & Tryptophan, which have a single codon.Codons that represent same amino acids are called as synonymsIn general, the third nucleotide in a codon is less important than the first two in determining the specific amino acid. This is k/a third base degeneracy or wobbling phenomenon.UniversalIn all living organisms the genetic code is the same, this is k/a universality of the codeException is found in mitochondrial genome where AUA codes for methionine and UGA for tryptophan instead of isoleucine and termination respectively.Non-overlappingThere is no overlapping i.e. no base functions as a common member of two consecutive codons.CommalessThere is no punctuation between the codons. The codons are arranged as a continuous structure. The last nucleotide of the preceding codon is immediately followed by the first nucleotide of succeeding codon. | 1,364 | medmcqa_train |
Features of histocytosis are all except - | Answee is option 3,CD127 marker The tumor cells of malignant histiocytosis generally expressed the monocyte markers CD11b, CD11c, CD14, and CD45, especially after induction with phorbol ester. In contrast, the tumor cells of true histiocytic lymphoma exhibited a marker expression very similar to that of Reed-Sternberg cells in Hodgkin's disease. These cells expressed markers CD30, 2H9, and 1A2, but rarely expressed CD11b, CD11c, CD14, or CD45. | 1,365 | medmcqa_train |
SAFE strategy use in | SAFE strategy - for prophylaxis against trachoma and prevention of blindness S - Surgery for trichiasis - Teiary prevention A - Antibiotic - AZITHROMYCIN (D/O/C) - secondary prevention F - Facial hygiene - primary prevention E - Environmental changes - primordial prevention | 1,366 | medmcqa_train |
In carcinoma cheek what is the best drug for single drug chemotherapy | Single-agent chemotherapy is used as palliative therapy in head and neck cancers with the recurrent or metastatic form of cancer. The drugs which are used are - Cisplatin Methotrexate 5 Fu Paclitaxel Docetaxel Sometimes combinations of these drugs are used . a) Treatment of localized head and neck cancers - These tumors are treated with curative intent either with surgery or radiotherapy. The choice of modality differs according to anatomic location and institutional expeise. In early laryngeal cancer generally, radiotherapy is done to preserve voice while in early oral cavity cancers, surgery is preferred to avoid the long-term complication of radiation such as xerostomia and dental decay. b) Locally or advanced regional disease - Combined modality therapy including surgery, radiation therapy, and chemotherapy is used. Concomitant chemotherapy and radiotherapy appear to be most effective. c) Recurrent or metastatic disease - chemotherapy is used. Management of neck lymph nodes The neck lymph nodes should be treated when there are clinically positive nodes or the risk for occult disease is high based on the location and stage of the primary lesion. The decision to perform neck dissection or irradiate the neck is related to the treatment of the primary lesion. If the primary tumor is being treated with radiation and the neck is N0 or N1, the nodes are usually treated with irradiation. For surgically treated primary lesions, N0 or N1 neck disease may be treated surgically as well (Radical neck dissection/Modified neck dissection/Selective neck dissection). Negative prognostic factors such as extracapsular spread of tumor, perineural invasion, vascular invasion, fixation to surrounding structures, and multiple positive nodes are indicators for postoperative adjuvant radiation therapy. For N2 or N3 neck disease, neck dissection with planned postoperative radiation therapy is performed. | 1,367 | medmcqa_train |
Zinc phosphide is - | Rodenticides They are 2 groups: 1) Single dose /acute(Zinc phosphide and Barium carbonate), 2) multiple doses/cumulative(warfarin, diphacinone, coumafuril, pindone). Zinc phosphide is an efficient single dose rodenticide. Rats are killed by about 3 hours. Due to the good safety record, low cost, and reasonably high effectiveness zinc phosphide is recommended for large scale use against rats. Park's Textbook of Preventive and Social Medicine, 25th Edition, Pg 847 | 1,368 | medmcqa_train |
The content of base pair A in the DNA is 15%, what could be the amount of G in DNA according to Chargaff's base pair rule? | Chargaff's rules state that DNA from any cell of all organisms should have a 1:1 ratio (base Pair Rule) of pyrimidine and purine bases and, more specifically, that the amount of guanine is equal to cytosine and the amount of adenine is equal to thymine. This pattern is found in both strands of the DNA. %A = %T and %G = %C and A + T + G + C = 100% In the question, A is 15%. According to Chargaff's rule, T will also be 15%. A+T=30 Therefore G+C=100-30=70 According to Chargaff's rule C=G, Therefore, C=70/2=35, Hence G=35% | 1,369 | medmcqa_train |
Most common type of breast carcinoma is: September 2010 | Ans. C: Ductal Ductal carcinoma in situ (DCIS): DCIS, the most common type of non-invasive breast cancer, is confined to the ducts of the breast. DCIS is often first detected on mammogram as microcalcifications (tiny calcium deposits). With early detection, the five-year survival rate for DCIS is nearly 100%, provided that the cancer has not spread past the milk ducts to the fatty breast tissue or any other regions of the body. There are several different types of DCIS. For example, ductal comedocarcinoma refers to DCIS with necrosis (areas of dead or degenerating cancer cells). Infiltrating ductal carcinoma (IDC): IDC is also known as invasive ductal carcinoma. IDC begins in the milk ducts of the breast and penetrates the wall of the duct, invading the fatty tissue of the breast and possibly other regions of the body. IDC is the most common type of breast cancer, accounting for 80% of breast cancer diagnoses. | 1,370 | medmcqa_train |
The braggs peak is found in: | Ref: Internet source: Medscape RadiologyExplanation:Bragg peak is a concept utilized in giving focused radiotherapy using ionizing radiation to a tumor without affecting the normal healthy surrounding tissuesOptions B.C and D are examples of non-ionizing radiation.Bragg's peakThe Bragg peak is a peak on the Bragg curve which plots the energy loss of ionizing radiation during its travel through matter.For protons, a-rays and other ion rays, the peak occurs immediately before the particles come to rest. This is called Bragg peak.When a fast charged particle moves through matter, it ionizes atoms of the material and deposits a dose along its path.A peak occurs because the interaction cross section increases as the charged particle's energy decreases.Absorption of a beam of energetic photons (X- ravs) which is entirely different in nature; the curve is mainly exponential.The phenomenon is exploited in particle therapy of cancer, to concentrate the effect of light ion beams on the tumor being treated while minimizing the effect on the surrounding healthy tissue.Monenergistic proton beam with the sharp peak is widened by increasing the range of energies, so that a larger tumor volume can be treated.This can be achieved by using variable thickness attenuators like spinning wedges. | 1,371 | medmcqa_train |
A 43-year-old man presents with signs and symptoms of peritonitis in the right lower quadrant. The clinical impression and supportive data suggest acute appendicitis. At exploration, however, a tumor is found; frozen section suggests carcinoid features. For each tumor described, choose the most appropriate surgical procedure. A 2. 5-cm tumor at the base of the appendix (SELECT 1 PROCEDURE) | Carcinoid tumors are most commonly found in the appendix and small bowel, where they may be multiple. They have a tendency to metastasize, which varies with the size of the tumor. Tumors <1 cm uncommonly metastasize. Tumors >2.0 cm are more often found to be metastatic. Metastasis to the liver and beyond may give rise to the carcinoid syndrome. The tumors cause an intense desmoplastic reaction. Spread into the serosal lymphatics does not imply metastatic disease; local resection is potentially curative. When metastatic lesions are found in the liver, they should be resected when technically feasible to limit the symptoms of the carcinoid syndrome. When extensive hepatic metastases are found, the disease is not curable. Resection of the appendix and cecum may be performed to prevent an early intestinal obstruction by locally encroaching tumor. | 1,372 | medmcqa_train |
Gillette's space is: | The retropharyngeal space is divided by a midline fibrous raphe into two spaces known as space of Gillette. Peritonsillar space is the space between the capsule of tonsil and the circular muscles of the pharynx. This contains a loose areolar tissue. Infection of this space is known as quinsy. | 1,373 | medmcqa_train |
Demography deals with all except- | Demography is the scientific study of human population. It focuses its attention on three readily observable human phenomena :-
Change in the population size (growth or decline).
The composition of population.
The distribution of population.
It deals with five "demographic processes", namely fertility, mortality, marriage, migration and social mobility. These five processes are continuously at work within a population determining size, composition and distribution. | 1,374 | medmcqa_train |
Disulfiram-like reaction is caused by: Kerala 11 | Ans. Metronidazole | 1,375 | medmcqa_train |
CVS change in pregnancy - | Ans. is 'b' i.e., Slight left axis deviation in ECG Cardiovascular systemo Anatomical changes heart is pushed upwards & outward. Apex beat is shifted in 4th intercostals space. A systolic murmur can be heard in apical or pulmonary area. Mammary' murmur is a continuous hissing murmur audible over tricuspid area in left 2nd & 3rd intercostals space. ECG shows left axis deviation. S3 and rarely S4 can be heard.o Cardiac output starts to increase from 5th week of pregnancy, reaches its peak 40-50% at about 30-34 weeks. It is lowest in sitting or supine position & highest is the right or left lateral or knee chest position. CO further increases by 50% during labour and immediately following delivery. CO returns to pre labour values by one hour following delivery and to the pre-pregnant level by another 4 weeks,o Blood pressure systemic vascular resistance (SVR) decreases. Maternal BP is decreased,o Venous pressure femoral venous pressure is raised,o Supine hypotension syndrome (postural hypotension)o Regional distribution of blood flow uterine blood flow is increased from 50 ml per minute in non-pregnant state to 750ml near term. Pulmonary blood flow is increased by 2500 ml /minrenal blood flow increases by 400ml/min. The blood flow through skin and mucous membrane increases by 500ml/min. | 1,376 | medmcqa_train |
Most cases of paraneoplastic syndrome are associated with which type of lung carcinoma? | Ref: Robbins Pathologic Basis of Disease, 8th edition, Pg: 677Explanation:"Paraneoplastic syndromes are common in patients with lung cancer, especially those with SCLC. and may be the presenting finding or the first sign of recurrence " (Ref: Harrison)"'Any one of the histologic types of tumors may occasionally produce any one of the hormones, but tumors that produce ACTH and ADH are predominantly small cell carcinomas, whereas those that produce hypercalcemia are mostly squamous cell tumors <& Small cell lung cancer type is most commonly associated with ectopic hormone production. " (Ref: Robbins)Paraneoplastic syndromes: Symptom complexes in cancer-bearing individuals that cannot readily be explained, either by the local or distant spread of the tumor or by the elaboration of hormones indigenous to the tissue from which the tumor arose. Paraneoplastic Syndromes associated with lung carcinomasLung carcinoma can be associated with several paraneoplastic syndromes . some of which may- antedate the development of a detectable pulmonary lesion.The hormones or hormone-like factors elaborated include:Small cell CaAntidiuretic hormone (ADH), inducing hyponatremia due to inappropriate ADH secretionSmall cell CaA drenocorticotropic hormone (ACTH). producing Cushing syndromeSqamous cell CaParathormone, parathyroid hormone-related peptide, prostaglandin E. and some cytokines, ail implicated in the hypercalcemia Calcitonin, causing hypocalcemia Gonadotropins, causing gynecomastiaLung carcinoid syndromeSerotonin and bradykininThe incidence - 1% to 10% of all lung cancer patients.Tumors that produce ACTH and ADH are predominantly small cell carcinomas. whereas those that produce hypercalcemia are mostly squamous cell tumors.Lambert-Eaton myasthenic syndrome, in w hich muscle weakness is caused by auto-antibodies (possibly elicited by tumor ionic channels) directed to the neuronal calcium channel peripheral neuropathy, usually purely sensory; dermatologic abnormalities, including acanthosis nigricans: hematologic abnormalities, such as leukemoid reactions; and abnormality of connective tissue called hypertrophic pulmonary osteoarthropathy, associated with clubbing of the fingers.Apical lung cancers in the superior pulmonary sulcus tend to invade the neural structures around the trachea, including the cervical sympathetic plexus, and produce a group of clinical findings that includes severe pain in the distribution of the ulnar nerve and Horner syndrome (enophthalmos. ptosis, miosis, and anhidrosis) on the same side as the lesion. Such tumors are also referred to as Pancoast tumors.Paraneoplastic Syndromes(See table in the next question) | 1,377 | medmcqa_train |
A 7-year-old boy has severe microcytic anemia due to beta-thalassemia major (homozygous). He requires frequent blood transfusions (once every 6 weeks) to prevent the skeletal and developmental complications of thalassemia. Which of the following medications is also indicated in the treatment of patients requiring frequent blood transfusions? | Iron chelation with desferrioxamine will reduce the toxicity from iron overload if given regularly in high doses. The most lethal toxicity of iron overload is iron infiltration of the myocardium, with resultant dysfunction and death. Penicillamine has no role in the treatment of thalassemia patients requiring frequent transfusions. As well FFP, and cryoprecipitate are not indicated in the management of patients with thalassemia as there are no defects in thrombosis or coagulation. | 1,378 | medmcqa_train |
Botulinum toxin is used for the treatment of: DNB 08 | Ans. All | 1,379 | medmcqa_train |
HHH syndrome is due to defect in ? | Ans. is 'd' i.e., Ornithine transpoer Hyperornithinaemia, hyperammonaemia, homocitrullinuria (HHH) syndrome is an autosomal recessive disorder of ornithine transpo caused by mutations in gene SLC 25A15 encoding the ornithine transoer protein (ORNT1).There is defective activity of the ornithine transpoer across the mitochondrial membrane, which causes a functional deficiency of two mitochondrial enzymes:Ornithine transcarbomylase : Which catalyses the condensation of ornithine and carbamoylphosphate to citrulline.Ornithine-8-aminotransferase (OAT) : Which metabolizes the ornithine to .'-pyrroline-5-carboxylate and ultimately glutamate and proline.Ornithine accumulates in the cytoplasm and its deficiency in mitochondria causes a secondary urea cycle disorder and hyperammonemia.Carbamoylphosphate accumulates and undergoes allternate metabolism to form :Homocitrulline - Excreted in urineOrotic acidPlasma | 1,380 | medmcqa_train |
Main action of superior rectus - | Ans. is 'c' i.e., Elevation There are six extraocular muscles in each eye.MusclePrimary ActionSecondary ActionSuperior rectusElevationAdduction and intorsionInferior rectusDepressionAdduction and extorsionMedial rectusAdduction Lateral rectusAbduction Superior obliqueIntorsionAbduction and depressionInferior obliqueExtorsionAbduction and elevationo All the extra ocular muscles are supplied by the occulomotor nerve except for the superior oblique which is supplied by the trochlear nerve and the lateral rectus which is supplied by the abducens nerve.o The occulomotor nerve also supplies the levator palpebrae superioris, sphincter papillae and the ciliary muscle. | 1,381 | medmcqa_train |
The major regulator of platelet production is the hormone thrombopoietin (THPO), which is produced by | Thrombopoietin (THPO) also known as megakaryocyte growth and development factor (MGDF) is a protein that in humans is encoded by the THPO gene.Thrombopoietin is a glycoprotein hormone produced by the liver and kidney which regulates the production of platelets. It stimulates the production and differentiation of megakaryocytes, the bone marrow cells that bud off large numbers of platelets.Ref: Ganong&;s review of medical physiology;24th edition; page no-80 | 1,382 | medmcqa_train |
Not characteristic feature of granuloma ? | Ans. is 'd' i.e., PMN's with fibrinoid necrosis with cellular infiltrates Polymorphonuclear leucocytes or neutrophils have a major role in acute inflammatory response. They are typically seen in acute inflammation. While granuloma formation is seen during chronic inflammatory response. The cells predominating during chronic inflammatory response are lymphocytes, plasma cells, monocytes etc. PMN's or neutrophils are typically absent during chronic inflammation. Granuloma contains Activated macrophages, i.e., epitheloid cells. Monocytes Lymphocytes Plasma cells Giant cells There are two types of giant cells 1. Langhans Giant cells Contains 3-5 nuclei Nuclei arranged peripherally (horse shoe) in the cytoplasm. 2. Foreign body cells Contains 3-5 nuclei Nuclei are arranged haphazardly in the cytoplasm. Langhans cells are the precursors of foreign body giant cells, as the numbers of nuclei increase langhans cells are conveed to foreign body giant cells So in early stage Langhans giant cells are predominant, while later on foreign body giant cells predominate. Foreign body giant cells can be arise directly from the fusion of macrophages also. So, Foreign body giant cells arise from ? 1. Langhans giant cells 2. Fusion of macrophages. | 1,383 | medmcqa_train |
Highest cholesterol content is seen in - | Ans. is 'a' i.e., LDL o Maximum triglyceride contento Maximum exogenous triglyceride o Maximum endogenous triglycerideo Maximum cholesterol content----ChylomicronsChylomicronsVLDLLDL | 1,384 | medmcqa_train |
A 70 year old male chronic smoker is diagnosed of having cancer of the urinary bladder. It is confined to the trigone and extention is upto the submucosa. The management would be - | Ans. is 'b' i.e., Complete Transurethral resection with intravesical chemotherapy Management of bladder cancero Cystoscopy and transurethral resection or biopsy# initially, any pt. with hematuria is examined by cystoscopy and any tumor seen is removed by transurethral resection (if possible) or biopsied.o Further treatment decisions are made after tumor staging on histology. Such decisions are based on tumor stage (TNM), grade, size, multiplicity, and recurrence patterno First see the staging (TNM)o The primary bladder cancer is staged according to the depth of invasion into the bladder wall or beyond The urothelial basement membrane separates superficial bladder cancers into Ta (noninvasive) and T1 (invasive) tumors. The muscularis propria separates superficial disease from deeply (muscularis propria) invasive disease. Stage T2 and higher T stage tumors invade the muscularis propria, the true muscle of the bladder wall. If the tumor extends through the muscle to involve the full thickness of the bladder and into the serosa, it is classified as T3. If the tumor involves contiguous structures such as the prostate, the vagina, the uterus, or the pelvic sidewall, the tumor is classified as stage T4.# Tis Ca in situ# Ta Ca confined to mucosa# T1 Ca confined to submucosa# T2 Muscle invasion# T3 perivescical fat invasion# T4 invasion of adjacent structures (prostate, uterus, vagina, pelvic wall, abd. wall)o Now the histological grading.# There are 3 histological gradeso Grade I, II & IIIo There is a strong correlation between tumor grading and tumor recurrence progression and survival.Treatment options for bladder cancersCancer stageInitial treatment optionsTisComplete TUR followed by intravesical BCGTa (single, low-to- moderate grade, not recurrent)Complete TURTa (large, multiple, high grade, or recurrent)Complete TUR followed by intravesical chemo-or immunologyT1Complete TUR followed by intravesical chemo- or immunotherapy or radical cystectomyT2-T4Radical cystectomyNeoadjuvant chemotherapy followed by radical cytectomy followed by adjuvant chemotherapyConcomitant chemotherapy and irradiationAny T, N+, M+Systemic chemotherapy followed by selective surgery orirradiationo Intravesical therapy : Common agents used for intravesical therapy are# Mitomycin C# Thiotepa# BCGo Among these agents, BCG is the most effective.o The patient in question has T1 stage (Tumor upto submucosa) | 1,385 | medmcqa_train |
True about leimyosarcoma breast | .LEIOMYOSARCOMA * It arises from smooth muscle. Cut section shows whorled appearance. * It is undetermined grade. * It is common in retroperitoneum and viscera, but can occur in limbs and skin. * Recurrence is common. It has got poor prognosis. * It can occur in the piloerector muscle of skin; inferior vena cava; pulmonary aery. * Desmin and actin are the most common immunohistochemical stains.leiomyosarcoma of breast is a well encapsulated tumour. ref:SRB&;s manual of surgery,ed 3,pg no 268 | 1,386 | medmcqa_train |
Which of the following is not a component of APACHE score | Acute Physiology And Chronic Health Evaluation (APACHE) II scoring system It incorporates 12 physiological and laboratory parameters as well as age and comorbid conditions to estimate severity of any disease process The 12 physiologic variables are BT| HR at CWG SHOP - 2 Mean aerial blood pressure Temperature Hea rate. Respiratory rate. Creatinine WBC count Glasgow Coma Scale Sodium Hematocrit Oxygenation Aerial pH Serum potassium Ref: Sabiston 20th edition Pgno :1527 | 1,387 | medmcqa_train |
False about Immunoglobulins is | Any antibody contains one type of light chain and one type of heavy chain. | 1,388 | medmcqa_train |
What is the pathology of edema in nephrotic syndrome | Ans. b. Sodium and water retention Sodium and water retention is the pathology of edema in nephrotic syndrome. The nephrotic syndrome is characterized by proteinuria, edema, and hypoalbuminemia. Renal sodium retention and changes in variables of the Starling equation are fundamental to the pathophysiology of nephrotic edema. There is evidence for both intravascular volume expansion (overfilling) and intravascular volume depletion (under filling) in patients with nephrosis. Microvascular fluid exchange is described using a formulation of the Starling driving forces (DP and Dp) and it is through this equation that nephrotic edema is conceptualized. Previous theories have focused on abnormalities in DP and Dp to explain nephrotic edema. Studies have shown that hypoalbuminemia (and thus Dp) is not a likely cause of edema formation in most nephrotic patients owing to a parallel decrease in interstitial fluid albumin and an increase in interstitial fluid pressure, both of which serve to maintain edema driving forces constant. There is limited evidence suggesting that abnormalities in vascular permeability (Kf and s) may contribute to edema formation. A major advance in our understanding of the pathophysiologic basis of edema formation in the nephrotic syndrome is the discovery that proteinuria can cause primary renal sodium retention through ENaC activation. This mechanism is likely active in all patients with nephrotic syndrome, regardless of their intravascular volume status. Other causes of primary renal sodium retention include increased renal efferent sympathetic nerve activity, ANPase, and in the expression and activity of the Ne--le in the collecting duct in animal models. Fuhermore, excess serum vasopressin levels have been found to contribute to free water retention in some patients with the nephrotic syndrome."- Eric Siddall and Jai Radhakrishnan. The pathophysiology of edema formation in the nephrotic syndrome Nephrotic Syndrome Manifestations of Nephrotic Syndrome 1. Massive proteinuria, with the daily loss of 3.5 gm or more of proteinQ 2. Hypoalbuminemia, with plasma albumin levelsQ 3. Generalized edemaQ 4. Hyperlipidemia and lipiduriaQ Pathophysiology: Renal sodium retention and changes in variables of the Starling equation are fundamental to the pathophysiology of nephrotic edema. There is evidence for both intravascular volume expansion (overfilling) and intravascular volume depletion (under filling) in patients with nephrosis. Nephrotic Syndrome Mechanisms of Sodium Retention in the Nephrotic Syndrome Increased angiotensin 11-independent afferent and efferent aeriolar tone because of increased efferent sympathetic nerve activity. Tubular resistance to atrial natriuretic peptide (ANP). Increased number of open epithelial sodium channel (ENaC) channels in the coical collecting duct due to proteolytic activation of ENaC by plasmin. Increased number and activity of coical collecting duct Na/K ATPase channels Most impoant facts about Nephrotic syndrome The lipid appears in the urine either as free fat or as oval fat bodies, representing lipoprotein resorbed by tubular epithelial cells and then shed along with the degenerated cells. Most proteins are decreased in nephrotic syndrome except Fibrinogen and lipoproteins, due to increased synthesis. Proteins decreased Consequence Albumin Edema due to hypoalbuminemiaQ Transferrin Iron resistant microcytic anemiaQ Cholecalciferol binding proteins HypocalcemiaQ Thyroxin binding globulin Decreased thyroxin (Hypothyroid state)Q IgG Increased susceptibility of infectionsQ Renal vein thrombosis is paicularly common (up to 40%) in patients with nephrotic syndrome due to membranous glomerulopathy, memranoproliferative glomerulonephritis, and AmyloidosisQ. As a consequence of hypercoagulability and changes in proteins, patients can develop spontaneous peripheral aerial or venous thrombosis, renal vein thrombosis, and pulmonary embolismQ | 1,389 | medmcqa_train |
What percentage of Lente Insulin is amorphous? | Insulin Lente is 70% crystalline (ultra lente) and 30% amorphous (semi lente). It is an insulin - zinc suspension | 1,390 | medmcqa_train |
Lobar pneumonia is caused predominantly by: | Most cases of lobar pneumonia are caused by S. pneumoniae (reclassification of the pneumococcus). Streptococcal or pneumococcal pneumonia involves one or more lobes and is often seen in alcoholics or debilitated persons. | 1,391 | medmcqa_train |
Caudate lobe of liver is ? | Ans. is 'a' i.e., I | 1,392 | medmcqa_train |
Nucleosomes are | Nucleosomes : The double stranded DNA wraps twice around a histone octamer formed by H2A, H2B, H3 and H4. This super - twisted helix forms a spherical paicle of 10nm diameter ; called Nucleosome. The function of the Nucleosomes is to condense DNA ; this arrangement also stabilises the DNA. REF : DM.VASUDEVAN.TEXTBOOK; SEVENTH EDITION ; PAGE NO :577 | 1,393 | medmcqa_train |
Bilirubin is the degradation product of - | Bilirubin metabolism
Bilirubin is the end product of heme degradation.
The heme is derived from -
Senescent erythrocytes by the mononuclear phagocytic system in the spleen, liver and bone marrow (major source).
Turnover of hemoproteins (e.g. cytochrome p.450).
Heme is oxidized to biliverdin by heme oxygenase.
Biliverdin is then reduced to bilirubin by biliverdin reductase.
Bilirubin is transported to the liver in bound form with albumin.
There is the carrier-mediated uptake of bilirubin in the liver.
This bilirubin is conjugated with glucuronic acid by UDP glucuronosyl transferase (UGT1A1) to from conjugated bilirubin (bilirubin glucuronides).
Conjugated bilirubin is excreted into bile.
Most of the conjugated bilirubin is deconjugated and degraded to urobilinogen.
The most of the urobilinogen is excreted in the faeces.
Approximately 20% of the urobilinogen is reabsorbed in the ileum and colon and is returned to the liver, and promptly excreted into bile → Enterohepatic circulation.
The small amount that escapes this enterohepatic circulation is excreted in urine. | 1,394 | medmcqa_train |
Which is not Glucogenic ? | Ans. is 'd' i.e., Lysine | 1,395 | medmcqa_train |
Linear enamel caries is called as: | In odontoclasia Gross destruction of labial surface of anterior maxillary teeth occurs. | 1,396 | medmcqa_train |
A 3-day-old newborn was born with ectopia cordis. Despite the efforts of doctors at the pediatric intensive care unit the infant died from cardiac failure and hypoxemia. Which of the following embryologic events is most likely responsible for the development of such conditions? | Ectopia cordis is a condition in which the heart is located abnormally outside the thoracic cavity, commonly resulting from a failure of fusion of the lateral folds in forming the thoracic wall. This is incompatible with life because of the occurrence of infection, cardiac failure, or hypoxemia. Faulty development of the sinus venosus is related to atrial septal defects that result from deficient absorption of the sinus venosus into the right atrium and/or unusual development of the septum secundum. | 1,397 | medmcqa_train |
All of the following predominantly involve the white matter EXCEPT? | Gray matter diseases White matter diseases Clinical features Seizures, impaired vision, dementia Motor problems Examples Neuronal ceroid lipofuscinosis Biotinidase deficiency Pyridoxine deficiency Mitochondrial disorders Alexander disease Canavan disease Adrenoleukodystrophy Metachromatic leukodystrophy Krabbe disease | 1,398 | medmcqa_train |
What is not true regarding venous ulcer? | Ans: c. (It is found in elderly males)Ref: Cuschieri, 4th ed. pg. 903, 904Characteristic features of venous ulcer: It is seen at the gaiter area- on the medial side. Edges will be sloping Base of the venous ulcer is fixed to the deeper tissues Surrounding tissues show signs of chronic venous hypertension - eczema, pigmentation, lipodermatosclerosis Presence of obvious varicose veins.Option c), unlike arterial ulceration in which patients areusually > 60 years, patients with venous ulcers usuallypresents at 40-60 years of age.Management of venous ulcer bleed - Bisgard regimeElevation of limbElastic bandageExerciseEducationlf the ulcer is non healing, biopsy of the ulcer has to be done.There is no role for topical antibiotics in a case of venous ulcers.Option a) Role of surgerySurgery for the superficial venous system incompetence is done. It can be performed before the ulcer has healed. This leads to rapid ulcer healing. In patients with deep venous insufficiency, surgery may not be effective.Option b) Klippel Trenaunay syndromeit consists of varicose veins, haemangiomata, excess growth of bone and soft tissues and other congenital abnormalities.Referral may be due to pain, bleeding, ulceration, phlebitisor thromboembolism. | 1,399 | medmcqa_train |
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