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Drug of choice for night shift workers insomnia is | . | 154,300 | medmcqa_train |
Polyhydramnios not seen in - | Ans. is 'b' i.e., Renal agenesis Etiology of Poivhvdrammoso Fetal anomaliesy Anencephalyy Open spina bifiday Esophageal or duodenal atresiay Facial clefts and neck massesy Hydropsfetalisy Aneuploidyo Placentay Chorioangioma of placentao Multiple pregnancyy Maternal diabetes: cardiac or renal disease. | 154,301 | medmcqa_train |
Treatment of choice of thoracic actinomycosis is: | Ans. is 'c' Penicillin Actinomycosis occur at different sites such as oro cervicofacial, thoracic, abdominal and pelvic.The drug of choice for all types of actinomycosis is penicillin. | 154,302 | medmcqa_train |
28 yr old man presented with headache. CT head shows a low attenuation mass in left temporoparietal region which has similar density to CSF and shows no enhancement following contrast administration. Diffusion weighted MRI shows high signal. Which of the following is most probable diagnosis? | When there is Diffusion Restriction, DW-MRI gives a bright signal and has low apparent Diffusion Coefficient(ADC value). Lesions showing Diffusion Restriction Infarct(Acute Infarct)- IOC Abscess Medulloblastoma & Other Cellularity Tumours Epidermoid Cyst There is free diffusion of water within arachnoid cysts therefore DW-MRI is useful to differentiate b/w arachnoid and epidermoid cyst. Clinical history not suppoive of Migraine. Option D: Multiple sclerosis shows Dawson's fingers. | 154,303 | medmcqa_train |
Treatment of lepromatous leprosy is | Ans. c (Rifampicin + Dapsone + Clofazimine); (Ref. Park PSM 22nd/pg. 296)Recommended regimens of chemotherapy for Leprosy in adultsFORM OF LEPROSYMORE INTENSIVE REGIMENWHO RECOMMENDED REGIMENLepromatous(multibacillary)Rifampin (600 mg/d) for 3 years plus dapsone (100 mg/d) indefinitelyDapsone (100 mg/d self-administered) plus clofazimine (300 mg once monthly for 1-2 yrs supervised; and 50 mg/d self-adm); and rifampin (600 mg once monthly undersupervision). Note: Clofazimine is unacceptable owing to discoloration of the skin, its replacement by 250-375 mg self-adm daily ethionamide or propionamide has been suggested.Tuberculoid (paucibacillary)Dapsone (100 mg/d) for 5 years Dapsone (100 mg/d, unsupervised) plus rifampin(600 mg/month, supervised) for 6 months.# ******** Duration of Rx for Multibacillary leprosy = MB blisterpacks for 12 months, within 18 months.# ******* Duration of Rx for Paucibacillary leprosy = PB blisterpacks for 6 months, within 9 months# ******Rifampin is considered the most active agent for the treatment of leprosy.# *****Dapsone inhibits bacterial folic acid synthesis & is now considered the second most active drug (after rifampin) in the treatment of leprosy.# ****Clofazimine is useful in treating dapsone-resistant leprosy and may lessen the severity of ENL.# ***Thalidomide is now approved by the FDA for treatment of ENL. This drug is sedating and extremely teratogenic and should never be taken by anyone who is or may become pregnant.# **Ethionamide with rifampin (600 mg/d) is used to treat dapsone-resistant leprosy for who cannot accept the skin- pigmentation of clofazimine.# The newer macrolide antibiotics (particularly clarithromycin), minocycline (a long-acting tetracycline), and a number of fluoroquinolones (including ofloxacin, sparfloxacin, and pefloxacin) have shown promising bactericidal activity against M. leprae. Ofloxacin and minocycline are being investigated with rifampin in short-course regimens for lepromatous disease. | 154,304 | medmcqa_train |
Commonest hemorrhage following head injury: KCET 13 | Ans. Subdural hemorrhage | 154,305 | medmcqa_train |
All of the following are associated with Atrioventricular block, except: | Adrenal insufficiency is associated with Atrioventricular Block (Not cushing&;s syndrome). Metabolic/Endocrine Causes of AV Block: Hyperkalemia Hypermagnesemia Hypothyroidism Adrenal Insufficiency Ref: Harrison 19th edition Pg no: 1471 | 154,306 | medmcqa_train |
Mantle cell lymphoma are positive for all of the following except: | Parameter CLL MCL SMZL/SL VL HCL FL PLL CD5 + + - - - - CD10 - -/+ - - + -/+ CD11c -/+ -/+ + + - + CD19 + + + + + + CD20 +(dim) +(bright) +(bright) +(bright) +(bright) +(bright) CD23 + -/+ -/+ - -/+ - CD79b - + - -/+ + + FMC7 - + + + + + Smlg +(dim) +(bright) +(bright) +(bright) +(bright) +(bright) CLL: Chronic lymphocytic leukemia ; MCL: Mantle cell lymphoma; SMZL/SL VL: Splenic marginal zone lymphoma/splenic lymphoma with villous lymphocytes; HCL: Hairy cell leukaemia; FL: Folliculsr lymphoma; | 154,307 | medmcqa_train |
All are indicators of malignancy in a mammography except - | Answer (a) Nodular calcification | 154,308 | medmcqa_train |
Methimazole differ from propylthiouracil in all except- | Ans. is 'c' i.e., More protein bound | 154,309 | medmcqa_train |
The pathological feature in wegener's granulomatosis on renal biopsy is | Robins..... 'The renal lesions range from a mild/early disease, where glomeruli show acute focal neorosis with thrombosis of isolated glomerulas capillary loops (focal and segmental necrotising glomerulonephritis) where as advanced glomerular lesions are characterized by diffuse necrosis and partial cell proliferation to form crescents.
Direct quote from harrison......
"Necrotising vasculitis of small arteries and veins with gramuloma formation is seen in pulmonary tissue where as granuloma formation is rarely seen on renal bipsy'. | 154,310 | medmcqa_train |
Dermatitis herpetifomis is associated with:- | Dermatitis herpetiformis occurs d/t gluten. HLA associated are: HLA B8 HLA A1HLA DQ2,DQ8, DR3 Psoriasis is associated with HLA CW6 | 154,311 | medmcqa_train |
Most frequent site of metastasis in a case of Choriocarcinoma is: | Lungs | 154,312 | medmcqa_train |
Mechanism of action of Tubocurarine is | Tubocurarine is a non depolarizing muscle relaxant that competitively blocks action of Acetylcholine on its receptors. | 154,313 | medmcqa_train |
All are true regarding Menetrier's disease, EXCEPT: | Answer is B (Exophytic growth) Menetrier's disease is characterized hr hyperophy of gastric mucosa and not hr exoph;'tic growth. Menetrier's disease Menetrier's disease is a relatively rare disorder of the stomach characterized by lar e touous mucosal folds Etiology * Etiology is unknown * Over expression of growth factors such as TGF are suggested Pathology Gross * Marked Hyperophy of gastric folds/Rugaee * Hyperophy results from hyperplasia of mucus producing cells (mucosa)Q * Hyperophy is most prominent in the body and fundus deg Histological/microscopic * Massive foveolar hyperplasia (Hyperplasia of surface and glandular mucosal cells). * Pits of gastric glands elongate and may become touous * Lamina propria may contain a mild chronic inflammatory infiltrate (Note: Although lamina propria may contain an inflammatory infiltrates, Menetrier's disease is not considered a form of gastritis Clinical picture * Protein losing enteropathy is characteristic Excessive protein is lost from the thickened mucosa into the gut which results in hypoprotenemia and edema * Gastric acid secretion is usually reduced or absent This happens because mucosal cell hyperplasia replaces most of the parietal cells. * Epigastric pain accompanied by nausea, vomiting anorexia and weight loss Ove bleeding is unusual but occult gastrointestinal bleeding may occur Differential Diagnosis DD includes conditions that may present with large gastric folds: ZES Malignancy Infiltrative disorders eg sarcoidosis Infectious etiology (CMV, Histoplasmosis, syphilis) Prognosis These is an increased risk of adenocarcinoma of stomach in adults with menetrier's disease (CSDT) | 154,314 | medmcqa_train |
All of the following are true about Raynaud's disease except | Raynaud's disease is a rare disorder of the blood vessels, usually in the fingers and toes. It causes the blood vessels to narrow when you are cold or feeling stressed. When this happens, blood can't get to the surface of the skin and the affected areas turn white and blue. When the blood flow returns, the skin turns red and throbs or tingles. In severe cases, loss of blood flow can cause sores or tissue death. Primary Raynaud's happens on its own. The cause is not known. There is also secondary Raynaud's, which is caused by injuries, other diseases, or ceain medicines. People in colder climates are more likely to develop Raynaud's. It is also more common in women, people with a family history, and those over age 30 . It also shows antinuclear antibodies in blood which can be recognised by an ANA test . Ref - Davidson's medicine 23e p1035 <a href=" | 154,315 | medmcqa_train |
A patient is suspected to have vestibular shwanomma the investigation of choice for its diagnosis is - | MRI – MRI with gadolinium contrast is the gold standard for the diagnosis or exclusion of vestibular Schwannoma | 154,316 | medmcqa_train |
Ovulation is associated with sudden rise in | Ovulation is associated with LH surge Ref: guyton and hall textbook of medical physiology 12 edition page number:641,642,643 | 154,317 | medmcqa_train |
All of the following changes are seen in pregnancy except : | CARDIAC OUTPUT: Increases from 5th week of pregnancy, reaches its peak 40-50% at about 30-34 weeks. Thereafter the CO remains static till term. CO is lowest in the sitting or supine position and highest in the right or left lateral or knee chest position. Cardiac output increases fuher during labor (+50%) and immediately following delivery (+70%) over the pre-labor values. MAP also rises. There is squeezing out of blood from the uterus into the maternal circulation (auto transfusion) during labor and in the immediate postpaum. CO returns to pre-labor values by one hour following delivery and to the pre-pregnant level by another 4 weeks time. The increase in CO is caused by: (1) Increased blood volume (2) To meet the additional O2 required due to increased metabolic activity during pregnancy. The increase in CO is chiefly affected by increase in stroke volume and increase in pulse rate to about 15 per minute. BLOOD PRESSURE: Systemic vascular resistance(SVR) decreases (-21%) due to the smooth muscle relaxing effect of progesterone, NO, prostaglandins or ANP. Reference: Dutta's Textbook of Obstetrics 7th edition page 53 | 154,318 | medmcqa_train |
The structure found in a cross-section of the thorax at T4 veebra is : | C i.e. Arch of aoa | 154,319 | medmcqa_train |
Three point relationship is reversed in all of the following conditions, EXCEPT: | The structures forming the three bony point around the elbow are medial epicondyle, lateral epicondyle and tip of olecranon. Normally in an elbow flexed at 90 degree these three points forms a near isosceles triangle. Base is formed by the line joining the two epicondyles. The three points lies in a straight line when the elbow is extended. The three point relation is maintained in supracondylar fracture of humerus. Three point relation is disturbed in: Elbow dislocation Fracture medial epicondyle and condyle Fracture lateral epicondyle and condyle Fracture intercondylar humerus Ref: Best Aid to Ohopedics By Pramod T. K., Pramod TK page 120. | 154,320 | medmcqa_train |
A 3-month-old infant is diagnosed with a membranous ventricular septal defect. A cardiac operation is performed, and the septal defect is patched inferior to the noncoronary cusp of the aorta. Two days postoperatively the infant develops severe arrhythmias affecting both ventricles. Which part of the conduction tissue was most likely injured during the procedure? | The bundle of His is a collection of specialized cardiac muscle cells that carry electrical activity to the right and left bundle branches. Because both ventricles are affected, this is the logical site of injury, for this bundle leads to the bundle branches supplying both ventricles. An injury either to the right or left bundle branch would affect only one ventricle. Terminal Purkinje fibers transmit the electrical activity to the greater sections of the ventricles, yet dysfunction in the terminal part of the conduction system would affect only a small section of one ventricle, not both. The atrioventricular node is a group of specialized cardiac muscle cells that serve to decrease the rate of conduction to the ventricles and is located in the region deep to the septal wall of the right atrium. The posterior internodal pathway is in the roof of the right atrium and is not involved here. | 154,321 | medmcqa_train |
The drug NOT used in psoriasis is | (B) Chloroquine # TREATMENT OF PSORIASIS: Locally by Topical coaltar.> Wide spread Psoriasis: by Ultraviolet fi-spectrum alone or along with coaltar (Geockerman regimen) or Anthranil (Ingram regimen)> Methotrexate Therapy: Methotrexate is drug of choice in Very Severe form of Psoriatic arthritis & Methotrexate is indicated in Psoriatic erythroderma, Generalized pustular psoriasis, Intractable & Crippling psoriasis.> Psoralens & Ultraviolet-A phototherapy (PUVA): is successful in clearing & delaying recurrence of Chronic Psoriasis.> Etritinate, & its metabolite Acitretin, are Retinoids (Vitamin A derivatives): useful for Severe Resistant Psoriasis.> Systemic drugs useful in Psoriasis: Hydroxyurea, Razoxane & Azathioprine; Cyclosporin A and Topical Vitamin-D3 | 154,322 | medmcqa_train |
A 35 year old sailor from a merchant ship that has been cruising the Caribbean presents to a clinician because of painful, flocculent masses in his groin. Physical examination demonstrates multiple enlarged, abscessed lymph nodes draining through the skin indolent sinuses. The sailor describes previously having a small papular lesion on his penis that spontaneously resolved. Which of the following is the most likely diagnosis? | This is lymphogranuloma venereum. The only other commonly discussed sexually transmitted disease in which they can occur is chancroid. Histologically, the buboes of lymphogranuloma venereum are enlarged lymph nodes with stellate abscesses. The primary lesion is usually a self-healing papule or shallow ulcer. The causative organism is Chlamydia trachomatis. Condyloma acuminatum causes a papillary lesion and does not cause buboes. Granuloma inguinale causes a spreading ulcer and does not cause buboes. Herpes virus infection causes tiny vesicles and ulcers and does not cause buboes. Ref: Brooks G.F., Carroll K.C., Butel J.S., Morse S.A., Mietzner T.A. (2013). Chapter 27. Chlamydia Spp.. In G.F. Brooks, K.C. Carroll, J.S. Butel, S.A. Morse, T.A. Mietzner (Eds), Jawetz, Melnick, & Adelberg's Medical Microbiology, 26e. | 154,323 | medmcqa_train |
Both hyperplasia and hyperophy are seen in | Ref,Robbins 9/e p36 The massive physiological growth of the uterus during pregnancy is a good example of hormone induced increase in size of an organ that results from both hyperophy and hyperplasia | 154,324 | medmcqa_train |
The drug of choice for the treatment of Thyrotoxicosis during pregnancy is: | Ans. is 'c' i.e. propylthiouracilRef.: K.D. T. 5th/e p 232, 4th/e p 259, 260This question has been repeated several times before, remember these important pointsAll antithyroid drugs can cross placenta so risk of fetal hypothyroidism and goitre is always thereBoth carbimazole and propylthiouracil can be used during pregnancy, but propylthiouracil is the drug of choice because its greater protein binding allows low doses of propylthiouracil to be transferred across the placenta and therefore less chance of hypothyroidism.The lowest effective dose of propyl thiouracil should be given and it is often possible to stop treatment in the last trimester since TSH Receptor antibodies tend to decline in pregnancy.Radioactive iodine is C/I during pregnancyIt can destroy the fetal thyroid tissue resulting in cretinismCarbimazole and methimazole have been associated with rare cases of foetal aplasia cutis. | 154,325 | medmcqa_train |
Which of the following is false regarding Multiple Sclerosis (MS)? | Multiple sclerosis is an auto immune disease of central neural system with a relapsing and remitting or progressive course. The pathologic hallmark of disease is demyelination. Myelin specific antibodies are present on degenerating myelin sheaths. Surviving oligodendrocytes paially remyelinate surviving axons, which are called as shadow plaques. Reference: Harrison's Principles of Internal Medicine, 21st edition, p2661 | 154,326 | medmcqa_train |
All except one leads to delayed puberty | Mc Cune - Albright syndrome is characterised by precocious puberty. | 154,327 | medmcqa_train |
Calculi is most commonly seen in: | Sialolithiasis is accumulation of obstructive calcifications within the glandular ductal system, more common in submandibular gland (90%) than the parotid gland (10%). | 154,328 | medmcqa_train |
Centrally acting sympatholytic agent used as antihypeensive agent is | Refer kDT 6/e p540 Clonidine, sold as the brand name Catapresamong others, is a medication used to treat high blood pressure, attention deficit hyperactivity disorder, drug withdrawal(alcohol, opioids, or smoking), menopausal flushing, diarrhea, and ceain pain conditions. It is used by mouth, by injection, or as a skin patch. Onset of action is typically within an hour with the effects on blood pressure lasting for up to eight hours | 154,329 | medmcqa_train |
All of the following intraocular foreign bodies produce suppurative reaction except | INTRAOCULAR FOREIGN BODIES Reactions of the foreign body Depending upon its chemical nature following 4 types of reactions are noted in the ocular tissues: 1. No reaction is produced by the ine substances which include glass, plastic, porcelain, gold silver and platinum. 2. Local irritative reaction leading to encapsulation of the foreign body occurs with lead and aluminium paicles. 3. Suppurative reaction is excited by pure copper, zinc, nickel and mercury paicles. 4. Specific reactions are produced by iron (Siderosis bulbi) and copper alloys (Chalcosis). Ref:- A K KHURANA; pg num:-409 | 154,330 | medmcqa_train |
Neonate with blotchy rash on the abdomen. Diagnosis is: | Ans. (c) Erythema toxicum neonatorum.* Erythema toxicum neonatorum presents in neonates with blotchy maculopapular rash with pustules. These pustules are sterile and contain eosinophils and the rash usually settles by day 10 of life.* Cutis marmorata presents with mottling which disappears when the skin becomes warmer. The mottling is likely to disappear beyond neonatal period. Persistence beyond neonatal period may be associated with hypothyroidism, trisomy 21 and Cornelia de Lange syndrome. | 154,331 | medmcqa_train |
Sabin fleldman dye test is used for - | Ans. is 'a1 i.e., Toxoplasmosis Sabin-Feldman dye testo A Sabin-Feldman dye test is a serologic test to diagnose for toxoplasmosis.o The test is based on the presence of certain antibodies that prevent methylene blue dye from entering the cytoplasm of Toxoplasma organisms.o Patient serum is treated with Toxoplasma trophozoites and complements as activator, and then incubated. After incubation, methylene blue is added.o If anti-Toxo antibodies are present in the serum, because these antibodies are activated by complements and lyse the parasite membrane, Toxoplasma trophozoites are not stained (positive result); if there are no antibodies, trophozoites with intact membrane are stained and appear blue under microscope (negative result). | 154,332 | medmcqa_train |
Common site of regional enteritis is – | Crohn disease (Terminal ileitis or regional enteritis)
Crohn disease (CD) is an inflammatory bowel disease (IBD) which is characterized by -
Sharply delimited and typically transmural involvement of the bowel by an inflammatory process with mucosal damage.
The presence of non-caseating granulomas.
Fissuring with the formation of a fistula.
Any portion of intestine can be involved but most commonly small intestine is involved.
Small intestine → 40%
Small intestine + colon → 30%
Colon → 30% | 154,333 | medmcqa_train |
A person was on chemotherapy for 2 week for some mediastinal tumour. Now he develops high frequency hearing loss. Most probable cause of this condition is use of: | Ans: A (Cisplatin) OTOTOXIC DRUGS P.LDhingra 6th/33-34Various drugs & chemical can damage the in ner ear & cause sensorineural hearing loss, tinnitus & sometimes vertigoCytotoxic drugs causing hearing loss are- nitrogen mustardfmechlorethamine), cisplatin & carboplatin"Cisplatin: Important toxicities are- renal impairment & emetogenic potential.Tinnitus, deafness, sensory neuropathy & byperuricaemia are other problem"- K.D.T 7th/861'Carboplatin: Nephrotoxicity, ototoxicity & neurotoxicity are low as compared to cisplatin"- K.D.T 7th/861Table Dhingra Ototoxic drugsA. Aminoglycoside antibiotisE. AnalgesicsStreptomycinDihydrostreptomvcinGentamicinTobramycinNeomycinKanamycinAmikacinNetilmycinSisomycinSalicylatesIndomethacinPhenylbutazoneIbuprofenF. ChemicalsAlcoholTobaccoMarijuanaCarbon monoxidePoisoningB. DiureticsFurosemideEthacrynic acidBumetanideG. MiscellaneousErythromycinAmpicillinPropranololPropylthiouracilDeferoxamineC. AntimalarialsQuinineChlonoquineHydroxychloroquineD, Cytotoxic drugsNitrogen mustard (Mechlorethamine)CisplatinCarboplatin | 154,334 | medmcqa_train |
Product of pentose phosphate pathway: | Pentose phosphate pathway/Phosphogluconate pathway/Hexose monophosphate shuntIt is a process that generates NADPH and pentoses (5-carbon sugars).There are two distinct phases in the pathway.- The first is the oxidative phase, in which NADPH is generated, and the- Second is the non-oxidative synthesis of 5-carbon sugars.This pathway is an alternative to glycolysis.While it does involve oxidation of glucose, its primary role is anabolic rather than catabolic.For most organisms, it takes place in the cytosol | 154,335 | medmcqa_train |
Most common cause of rubeosis iridis | it develops following retinal ischemia which is a common feature of:
●proliferative diabetic retinopathy
●central retinal vein occlusion
●sickle cell retinopathy
●Eale's disease | 154,336 | medmcqa_train |
Most common cause of ptosis | *Congenital myogenic ptosis is the most common type of ptosis and is often bilateral. Ref: Clinical ophthalmology p.786 | 154,337 | medmcqa_train |
Least chances of cord prolapse are seen with | Maximum chances of cord prolapse seen in breech are in footling where as min chances in frank frank breech | 154,338 | medmcqa_train |
In which organelle (s) of hepatocyte, the elongation of long chain fatty acid takes placea) Endoplasmic reticulum (ER)b) Golgi bodyc) Mitochondriad) Lysosomese) Ribosome | Endoplasmic reticulum (E ) & i.e., Mitochondria
Elongation takes place in microsomal system (endoplasmic reticulum) and mitochondrial system. | 154,339 | medmcqa_train |
The term erythroderma is applied when any inflammatory skin disease affects more than ___ of body surface area | Erythroderma is involvement of more than 90% of skin in any disorder. | 154,340 | medmcqa_train |
An intrauterine pregnancy of approximately 10 weeks gestation is confirmed in a 30 year old, gravida 5, para 4 woman with an IUD in place. The patient expresses a strong desire for the pregnancy to be continued. On examination, the string of the IUD is noted to be protruding from the cervical os. The most appropriate course of action is to: | A woman with an IUCD in place, with amenorrhea should have a pregnancy test and pelvic examination.
An intrauterine pregnancy can occur and continue successfully to term with an IUCD in place.
A. If an intrauterine pregnancy is diagnosed and IUCD strings are visible:
IUCD should be removed as soon as possible in order to prevent septic abortion, premature rupture of membranes, and premature birth. Also do an USG to know whether it is intrauterine or ectopic pregnancy.
B. If an intrauterine pregnancy is diagnosed and IUCD strings are not visible:
An ultrasound examination should be performed to localize the IUCD and determine whether expulsion has occured.
If the IUCD is present there are 3 options for management.
i. Therapeutic abortion
ii. If IUCD is not fundal in location: ultrasound guided intrauterine removal of IUCD.
iii. If IUCD is present in fundus of uterus: it should be left in place and pregnancy continued with the device left in place.
If pregnancy continues with the device in place, the patient should be warned of the symptoms of intrauterine infection like fever or flue like symptoms, abdominal cramping or bleeding.
At the earliest sign of infection, high dose intravenous antibiotic therapy should be given and the pregnancy evacuated promptly.
Note: Fetal malformations have not been reported to be increased with a device in place. | 154,341 | medmcqa_train |
First extensor compament of wrist have which of the following structures | Tendon of extensor carpi radialis longus and extensor carpi radialis brevis pass through the second compament of extensor retinaculum.Tendon of extensor digiti minimi passes through the sixth compament.B D Chaurasia 7th edition Page no: 137 | 154,342 | medmcqa_train |
A 25 year old pregnant female with gestational diabetes came to OPD at 30 weeks of gestation for routine antenatal checkup. Her sugars are uncontrolled. Her fundal height was found to be 36 cm and abdominal skin appears excessively stretched and shiny. Her previous antenatal USG repos were normal. What could be the most probable diagnosis? | Fundal height normally correlates (in cms) with gestational age in weeks (from 16 to 36 weeks). The possible reason for increased fundal height could be : Polyhyramnios, Fibroids, Twin pregnancy, H. Mole, Big baby (Fetal macrosomia) Normal previous USGs rules out fibroid, twin pregnancy and H. Mole. According the above given case scenario the most probable cause is polyhydramnios (as the patient is a known case of gestational diabetes which is a risk factor for polyhydramnios). | 154,343 | medmcqa_train |
All of the following are criteria for irritable bowel syndrome except - | <p>Davidson&;s principles and practice of medicine 22nd edition. *Romelll criteria. * abdominal pain or discomfo associated with 2 or more of the following # improvement with defecation #change in frequency of stool. #change in appearance of stool </p> | 154,344 | medmcqa_train |
Bosniak classification is for? | The Bosniak classification system of renal cystic masses divides renal cystic masses into five categories based on imaging characteristics on contrast-enhanced CT. It is helpful in predicting a risk of malignancy and suggesting either follow up or treatment. Classification: Bosniak I -Simple cyst , imperceptible wall; Work up:nil; Percentage malignant: ~0% Bosniak 2 - Minimally complex, a few thin <1 mm septa or thin calcifications (thickness not measurable); non-enhancing high-attenuation (due to proteinaceous or haemorrhagic contents) renal lesions of less than 3 cm are also included in this category; these lesions are generally well marginated; Work-up: nil; Percentage malignant: ~0% Bosniak 2F - Minimally complex, increased number of septa, minimally thickened with nodular or thick calcifications there may be perceived (but not measurable) enhancement of a hairline-thin smooth septa hyperdense cyst >3 cm diameter, mostly intrarenal (less than 25% of wall visible); no enhancement; Requiring follow-up: needs ultrasound/CT follow up - no strict rules on the time frame but reasonable at 6 months; Percentage malignant: ~ 5% Bosniak 3 - Indeterminate thick, nodular multiple septa or wall with measurable enhancement, hyperdense on CT; Work-up: paial nephrectomy or radiofrequency ablation in elderly or poor surgical candidates; Percentage malignant: ~55% Bosniak 4 - Clearly malignant solid mass with a large cystic or a necrotic component; Treatment: paial or total nephrectomy; Percentage malignant: ~100%. | 154,345 | medmcqa_train |
Most powerful cloning vector ? | Most powerful cloning vector is cosmid as largest DNA can be incorporated in cosmid.Overall, most powerful cloning vector is YAC (Yeast aificial chromosome). | 154,346 | medmcqa_train |
Bacterial species seen in skin ? | Ans. is 'd' i.e., Propionobacterium | 154,347 | medmcqa_train |
End-Product of the action of salivary amylase is | Salivary alpha-amylase hydrolyse the alpha-1,4-glycosidic linkage, so as to produce smaller subunits like maltose, isomaltose, dextrins and oligosaccharides.Ref: DM Vasudevan, page no: 39 | 154,348 | medmcqa_train |
The oesophgus commences at the following level? | A. i.e. Lower end of Cricoid | 154,349 | medmcqa_train |
33-years-old alcoholicon ATT presents with increased serum iron & increased transferrin saturation. Diagnosis? | Ans. (b) Sideroblastic anemia(Ref: Wintrobe's 12th/pg 847-848)This is an Alcoholic patient on Anti TB drugs (isoniazid, pyrazinamide) who presents with features of iron overload on iron studies (increased serum iron & increased transferrin saturation). These features are suggestive of sideroblastic anemia. | 154,350 | medmcqa_train |
Endogenous chemoattractants are all except - | Endogenous Chemoattractants include LTB4, complement system C5, chemokines, but not integrins. Integrins are cell matrix adhesion molecules. Integrins are proteins that function mechanically, by attaching the cell cytoskeleton to the extracellular matrix (ECM), and biochemically, by sensing whether adhesion has occurred. The integrin family of proteins consists of alpha and beta subtypes, which form transmembrane heterodimers. Basic Pathology, Robbins. Page no.:36 | 154,351 | medmcqa_train |
Nodular regenerating hyperplasia is associated with - | Nodular regenerative hyperplasia of the liver This is the most common cause of non-cirrhotic poal hypeension in developed countries; it is characterised by small hepatocyte nodules throughout the liver without fibrosis, which can result in sinusoidal compression. It is believed to be due to damage to small hepatic aerioles and poal venules. It occurs in older people and is associated with many conditions, including connective tissue disease, haematological diseases and immunosuppressive drugs, such as azathioprine. The condition is usually asymptomatic but occasionally presents with poal hypeension or with an abdominal mass. The diagnosis is made by liver biopsy, which, in contrast to cirrhosis, shows nodule formation in the absence of fibrous septa. Liver function is good and the prognosis is very ourable. Management is based on treatment of the poal hypeension. Ref Davidson edition23rd pg899 | 154,352 | medmcqa_train |
In an emergency room an alcoholic patient enters with hematemesis. On examination he has ascites with splenomegaly and gynecomastia. Etiology is | Ans. (b) Portal hypertension due to alcholic cirrhosisRef: Sabiston 20th edition Page 1437* Clinical features and findings suggest that the patient is a known case of Alcoholic cirrhosis with portal hypertension.* So most common cause in him is Varices bleeding | 154,353 | medmcqa_train |
All are true about chronic SDH except: | Chronic SDH Caused bysignificant trauma, can present weeks after tril injury. Most patients are symptomatic but patient can be completely asymptomatic. Treated by burr hole/craniotomy, twist drill craniostomy with subdural drains. Clinical improvement occurs when subdural pressure is close to zero, which usually occurs after almost 20 percent of the collection has been removed. Residual subdural fluid collections are common and may take upto 6 months for complete resolution. Use of a subdural drain is associated with a decreased need for repeat surgery | 154,354 | medmcqa_train |
Bilateral consonants are ? | Ans. is 'b' i.e., PbMW Pronounced or aiculated with both lips, as the consonants b, p, m, and w. Baby stas producing bilabial words by 4th month of age. | 154,355 | medmcqa_train |
Which of the following are antigen-presenting cells? | Neutrophils are one of the primary defense cells of the innate immune system. T-lymphocytes are important activators of the specific (adaptive) immune system. Macrophages are antigen presenting cells. Plasma cells produce antibodies. | 154,356 | medmcqa_train |
A 32-years old male with suspected neurofibroma, tosis was found to have a blood pressure of 178/110 mm Hg at a recent health fair. He complained of palpitations and excessive sweating. Today he presents to the clinic for a checkup because he has developed abdominal discomfo. His blood pressure is now recorded to be 130/80 mm Hg. Physical examination reveals multiple tumors of the oral mucosa and skin. Laboratory investigations reveal: Serum K+ : 3.8 mEq/L (N : 3.5-5.0 mEq/L) Serum Ca2+: 136 mEq/L (N : 135-145 mEq/I,) Serum Ca2+ : 9.4 mg/dL (N : 8.4-10.2 mg/dL) d 14) Genetic studies in this patient will most likely show - | The RET proto-oncogene encodes a receptor tyrosine kinase for members of the glial cell line-derived neurotrophic factor (GDNF) family of extracellular signalling molecules.RET loss of function mutations are associated with the development of Hirschsprung's disease, while gain of function mutations are associated with the development of various types of human cancer, including medullary thyroid carcinoma, multiple endocrine neoplasias type 2A and 2B, pheochromocytoma and parathyroid hyperplasia Ref Davidson 23rd edition pg 1057 | 154,357 | medmcqa_train |
The gross specimen section of kidney depicts: | The specimen shows an enlarged kidney with cysts of varying sizes in both coex and medulla. Minimal normal kidney tissue is present and there is a complete loss of coicomedullary gradient. Choice B is ruled out as it has small shrunken kidneys. The gross specimen section of kidney depicts : Polycystic kidney Gross specimen differentiating features Very large kidneys, mass of cysts of varying sizes with no intervening parenchyma. Cysts are filled with fluid, which may be clear, turbid, or hemorrhagic | 154,358 | medmcqa_train |
Indications of FESS | INDICATIONS : 1. Chronic bacterial sinusitis unresponsive to adequate medical treatment. 2. Recurrent acute bacterial sinusitis. 3. Polypoid rhinosinusitis (diffuse nasal polyposis). 4. Fungal sinusitis with fungal ball or nasal polypi. 5. Antrochoanal polyp. 6. Mucocele of frontoethmoid or sphenoid sinus. 7. Control of epistaxis by endoscopic cautery. 8. Removal of foreign body from the nose or sinus. 9. Endoscopic septoplasty. Ref: Dhingra 7e pg 477 | 154,359 | medmcqa_train |
As compared to unfractionated heparin, low molecular weight heparins | Low molecular weight heparin has higher subcutaneous bioavailability. Lab monitoring is not required unlike heparin. LMWH has lower risk of osteoporosis and lower incidence of thrombocytopenia. From medical pharmacology padmaja 4th edition Page no 337, 339 | 154,360 | medmcqa_train |
Which of the following tendons has attachments on sustentaculum tali? | SUSTENTACULUM TALI:- Medial surface of calcaneum bone is concave from above downwards.The concavity is attenuated by the presence of a shelf like projection of bone, called the sustentaculum tali.The groove on the lower surface of sustentaculum tali is occupied by tendon of FHL.Medial margin is related to tendon of flexor digitorum longus. Attachments:-1. Spring ligament.2. Tibialis posterior 3. Superficial fibres of deltoid ligament.4. Medial talocalcanean ligament. Origin to medial head of flexor digitorum accessorius. {Reference: BDC 6E pg no.33} | 154,361 | medmcqa_train |
Quaernary ammonium compound disinfectants are ? | Quaternary ammonium compounds are cationic detergents. They have microcidal and viricidal activities. They can be used for instrument disinfection and skin antisepsis. | 154,362 | medmcqa_train |
In exhaled air, normal pCO2 pressure is: | (Refer: Ganong’s Review of Medical Physiology, 24th edition, pg no: 635) | 154,363 | medmcqa_train |
True about fluorescent antibody detection test in the diagnosis of Plasmodium falciparum are all except? | The diagnosis of malaria involves identification of malarial parasite or its antigens/products in the blood -
The diagnosis of malaria is confirmed by blood tests and can be divided into microscopic and nonmicroscopic tests.
1) Microscopic test
For nearly a hundred years, the direct microscopic visualisation of the parasite on the thick and/or thin blood smears has been the accepted method for diagnosis.
The careful examination of a well prepared and well-stained blood film currently remains the "gold standard" for malaria diagnosis.
2) Non-Microscopic tests
Although the peripheral blood smear examination that provides the most comprehensive information on a single test format has been the "gold standard" for the diagnosis of malaria, the immunochromatographic tests for the detection of malarial antigens developed in the past decade have opened a new and exciting avenue in the malaria diagnosis.
Immunochromatographic test for malaria antigens -
Immunochromatographic tests are based on the detection of the parasite antigens from the peripheral blood using either monoclonal or polyclonal antibodies against the parasite antigen targets.
Currently, immunochromatographic tests can target the:-
Histidine-rich protein 2 of Plasmodium falciparum
Pan malarial Plasmodium aldolase
Parasite-specific lactate dehydrogenase.
Histidine-rich protein 2 of Plasmodium falciparum (PFHRP2)
It is a water-soluble protein that is produced by the asexual stages and gametocytes of Plasmodium falciparum, expressed on the red cell membrane surface and shown to remain in the blood for at least 28 days after the initiation of antimalarial therapy.
Plasmodium aldolase
It is an enzyme of the parasitic glycolytic pathway expressed by the blood stages of P. falciparum as well as non falciparum malarial parasites.
Monoclonal antibodies against plasmodium aldolase are panspecific in their reaction and have been used in a combined Rfalciparum/P.vivax immunochromatographic tests that targets the pan malarial antigen along with PFHRP2.
Parasite lactate dehydrogenase -
The first rapid diagnostic tests were using P.falciparum glutamate dehydrogenase as antigen P.falciparum gutamate dehydrogenase were soon replaced by P. falciparum lactate dehydrogenase.
It is a soluble glycolytic enzyme produced by the asexual and sexual stages of the live parasite and it is present in and released from the parasite infected.
It has been found in all four human malarial species and different isomers of pLDH for each of the four species exist.
Other tests for malaria parasites -
Polymerase chain reaction -
Polymerase amplification can also be used to detect malarial parasites.
In travellers returning to developed countries studies based on PCR have been found to be highly sensitive and specific for detecting all species of malaria particularly in cases of low-level parasitemia and mixed infections.
The PCR test is reportedly tenfold more sensitive than microscopy.
Detection of antimalarial antibodies -
Antibodies to the asexual blood stages appear a few days after malarial infection, increase in titre over the next few weeks and persists for months or years in semi-immune patients in endemic areas where re-infection is frequent.
In non-immune patients, antibodies fall more rapidly after treatment for a single infection and are undetectable in 3-6 months.
Reinfection/relapse induces a secondary response with a rapidly increasing antibody titre.
Malarial antibodies can be detected by immunofluorescence or enzyme immunoassay. It is useful in epidemiological surveys for screening potential blood donors and occasionally for providing evidence of recent infection in non-immunes.
Intraleucocyte malarial pigment -
Intraleucocyte malaria pigment has been suggested as a measure of disease severity in malaria.
Flowcytometry
Flowcytometry and automated hematology analyzers have been found to be useful in indicating a diagnosis of malaria. In cases of malaria, abnormal cell clusters and small particles with DNA fluorescence probably free malarial parasites have been seen on automated hematology analyzers and it is suggested that malaria can be suspected based on the scatter plots produced on the analyzer.
Mass spectrometry
A novel method for the in vitro detection of the malaria parasite at a sensitivity of 10 parasites/ 1 of blood has been recently reported. | 154,364 | medmcqa_train |
A 21-year-old medical student suffered a needle stick injury. The patient has a history of illicit intravenous drugs abuse. One month later, the medical student develops jaundice. Which of the following findings would implicate hepatitis B as the etiology? | The presence of hepatitis B surface antigen means actively replicating virus, and in the context of the history of recent needle-stick injury, this likely represents a hepatitis B infection. During the acute episode of disease, when there is active viral replication, large amounts of HBsAg and hepatitis B virus DNA can be detected in the serum, as can fully developed virions and high levels of DNA polymerase and HBeAg. Upon resolution of acute hepatitis B, HBsAg and HBeAg disappear from serum with the development of antibodies (anti-HBs and anti-HBe) against them. The development of anti-HBs is associated with elimination of infection and protection against reinfection. Anti-HBc is detected early in the course of disease and persists in serum for years. It is an excellent epidemiologic marker of infection, but is not protective. In patients with chronic hepatitis B, evidence of viral persistence can be found in serum. HBsAg can be detected throughout the active disease process, and anti-HBs does not develop, which probably accounts for the chronicity of the disease. However, anti-HBc is detected. Ref: Ray C.G., Ryan K.J. (2010). Chapter 13. Hepatitis Viruses. In C.G. Ray, K.J. Ryan (Eds), Sherris Medical Microbiology, 5e. | 154,365 | medmcqa_train |
MRI can detect | (All of the above) (6, 11-S. Bhadury 2nd essentials of radiology and imaging) (133-35-B & L 25th) Disadvantage of MRI * Very high cost of imaging * Inability to image bone and calcium * It is unsuitable for patients with cardiac pacemakers and other ferromagnetic implants. * Imaging time is long, hence movement or motion artifacts are quite likely. * Highly operator-dependent, hence requires technical expertise Fluoroscopy is particularly valuable in (a) The selection of the optimum tangential projection in encysted pleural effusion. (b) In suspected obstructive emphysema especially following inhalation of a foreign body. (c) In the assessment of diaphragmatic function (d) In the assessment of the proximity of a peripheral pulmonary lesion to the thoracic cage and pleura | 154,366 | medmcqa_train |
Characteristic lab findings of hemophilia A are –a) ↑ PTb) ↑ aPTTc) X–linked recessived) Presence of 30% of factor level express the diseasee) Increased bleeding time | Hemophilia A
Hemophilia A is due to deficiency offactor VIII.
Hemophilia 'A' is inherited as an X-linked recessive trait.
Factor VIII is an intrinsic pathway component required for activation of factor X.
Clinical manifestations are due to defect in coagulation system -
Large post-traumatic ecchymoses or hematoma
Prolonged bleeding after a laceration or any form of surgical procedure.
Bleeding into weight bearing joints.
Petechiae are characteristically absent (in contrast to platelet dysfunction where bleeding occurs from small vessels of the skin and mucous membrane, e.g. petechiae).
Laboratory findings
PIT
Normal PT
Normal BT
Normal platelet counts
Remember
Hemophilia B (Christmas disease) is due to deficiency of factor IX
Hemophilia B has clinical features and laboratory findings similar to haemophilia A. | 154,367 | medmcqa_train |
Complication of trauma to danger area of face - | Ans. is 'a' i.e., Cavernous sinus infection o The area of upper lip and the lowrer part of nose is the danger area of face. It is due to that this area is the common site of infection.o This area is drained by facial vein wrhich communicates with the cavernous sinus through the superior ophthalmic vein and pterygoid venous plexus through the emissary vein,o In case of any infection of this area it may spread to the cavernous sinus causing infection and/or thrombosis. | 154,368 | medmcqa_train |
The drugs not used for treatment of osteoporosis are - | A.General 1.Bedrest 2.Local heat 3.Analgesics 4.Exercise: Regular walking or other weight bearing exercise for 1 hour 3 times a week protects bone mass 5.Prevention of injury (most hip and wrist fractures are caused by falls). 6.Excessive thyroid hormone replacement therapy should be avoided. B.Antiresorptive agents 1.Oestrogen: Oestrogen 0.625 mg + Medroxyprogesterone (cyclic progestin) 5-10 mg per day 10-14 days/month. Progesterone to be added to prevent endometrial carcinoma. Transdermal oestrogen patches are used to avoid deep vein thrombosis and pulmonary embolism. Oestrogen therapy is impoant in women with premature or surgical menopause. Contraindications of oestrogen therapy are carcinoma breast or endometrial cancer, recurrent thromboembolic disease, acute liver disease and unexplained vaginal bleeding. 2.Calcium: The recommended daily calcium intake for postmenopausal women is 1,500 mg, and 1,000 mg for premenopausal women. 3.Calcitonin: Salmon calcitonin for 1-2 years increases veebral bone density and decreases the risk of veebral fracture. The usual dose is 50 IU SC per day 3 times a week. (salmon calcitonin 200 units/day as nasal spray). The side effects are nausea, flushing, and rarely allergic reactions. 4.Bisphosphonates: They specifically impair osteoclast function and reduce osteoclast number paly by induction of apoptosis. a.Alendronate 5-10 mg/day b.Risedronate 5 mg/day The prominent adverse effect is esophageal irritation and hence both should be taken with a full glass of water and the patient should remain upright for 30 min after taking the drug. c.Etidronate is given as an intermittent cyclical regimen, 400 mg orally for 2 weeks, has some efficacy against veebral fractures. 5.Selective oestrogen receptor modulators (SERMS) a.Raloxifene 60 mg/day b.Tamoxifen Both reduce bone turnover and bone loss in postmenopausal women. In addition Tamoxifen is beneficial in women at increased risk of breast cancer and Raloxifene reduces serum total and LDL cholesterol, Lp (a), and fibrinogen. C.Bone forming agents a.Fluoride--75 mg/day b.Anabolic steroids: Testosterone is used in the treatment of osteoporotic man with gonadal deficiency. D.Supplementation of Vitamin D metabolites and thiazide diuretics. R ALAGAPPAN MANUAL OF PRACTICAL MEDICINE FOUH EDITION PAGE NO-691,692 | 154,369 | medmcqa_train |
Which type of pelvis is associated with increased incidence of ‘face to pubis’ delivery? | As discussed in the text in Table 1.1 face-to-pubis delivery is common in anthropoid pelvis. | 154,370 | medmcqa_train |
In a survey, many children are examined and were found to have urogenital abnormalities. Which congenital anomaly is associated with increased risk of bladder carcinoma. | Ans is b ie Bladder exstrophy Congenital anomalies associated with increased risk of bladder cancer are: - patent urachus - exstrophy bladder - Both increase the risk for adenocarcinoma. | 154,371 | medmcqa_train |
Renal osteodystrophy is due to:- | Renal rickets/ renal osteodystrophy - This is seen in patients with chronic renal failure. Renal rickets is mainly due to decreased synthesis of calcitriol in kidney. lt can be treated by administration of calcitriol.
Reference: Satyanarayana- Biochemistry, 3rd edition, pg-128 | 154,372 | medmcqa_train |
A 35 year old athlete has height 184 cm., arm span 194 cm., pulse rate 64/min., BP 148/64 mm Hg. Chest auscultation reveals long diastolic murmur over right 2nd intercostal space on routine examination. The probable diagnosis is : | Answer is A (A.R.): Arm span greater than height is suggestive of Marfan's syndrome. Aoic regurgitation (A.R.) is a feature associated with Marfans as well as consistent with a diastolic murmur is second right intercostal space. | 154,373 | medmcqa_train |
Active metabolite form in synthesis of fatty acid is:- | Staing material in FA synthesis is Acetyl CoA Acetyl CoA (2C) - Malonyl CoA -Used for FA Synthesis Malonyl CoA is the Main active metabolite used. Each time during elongation of fatty acid chain the addition of 2C carbons taking place are derived from malonyl CoA. So, it the active metabolite of fatty acid synthesis. | 154,374 | medmcqa_train |
Which of the following drug needs no dose modification in TB with CRF? | In CRF we can give full dose of rifampicin because this drug is completely metabolize in liver | 154,375 | medmcqa_train |
A 35 years old mother of two children is suffering from amenorrhea for last 12 months. She has history of failure of lactation following 2nd delivery but remained asymptomatic thereafter. Skull X-ray shows "Empty sella". Most likely diagnosis is: | Amenorrhea, failure of lactation and "Empty sella" in skull X-ray give the diagnosis of Sheehan's syndrome. Ref: Current Obs and Gynae Diagnosis and Treatment 8th Edition, Page 446 ;Internal Medicine: An Illustrated Radiological Guide By Jarrah Ali Al-Tubaikh, 2010, Page 247 | 154,376 | medmcqa_train |
15-year-old girl presented with primary amenorrhea with orderly appearance of secondary sexual characteristics like breast and pubic hair. What is the next best step for this patient: | In the question the girl is 15 yrs with normal secondary sexual characteristics, she is a case of primary amenorrhea and needs evaluation (reassurance could have been given had the patient been younger than 15 years) The next impoant step would be an USG to check whether she has normal mullerian structures (uterus and tubes) and ovaries or not Hormonal studies and karyotyping are done subsequently to find out the cause. | 154,377 | medmcqa_train |
Optic cup give rise to ? | Ans. is `b' i.e., RetinaThe inner layer of optic cup forms the main structure of the retina. From its anterior border develop pas of ciliary body and iris. | 154,378 | medmcqa_train |
A 6-year-old child with recurrent UI with mouth breath ing and failure to grow with high arched palate and impaired hearing should be managed by | The child is having recurrent UI with high arched palate and failure to grow which indicates child is having adenoids and since there is impaired hearing it means child has developed otitis media as a complication. Hence logically the child should be treated with adenoidectomy with grommet inseion. Ref:- Scott Brown; pg num:- 896-906 | 154,379 | medmcqa_train |
Transamination reaction requires which vitamin? | Pyridoxal phosphate (active form of vitamin B6) is the coenzyme for transamination reactions. | 154,380 | medmcqa_train |
Osgood schlatters disease involves? | Ans. (a) Tibial tuberosityRef.-.Apley's system of orthopaedics and fractures edited by Louis Solomon, dividwarwicky selvadurainayagam 9/e, p 575-576y 887) | 154,381 | medmcqa_train |
A 28 years old male presented with diarrhea for 6 months. On examination the causative agent was found to be acid fast with 12 micrometer diameter. What is the MOST likely causative agent? | Cyclospora oocysts take days or weeks to become infectious, and because of this, direct person to person transmission through fecal exposure is unlikely to occur. Cyclosporiasis has been linked to waterborne and foodborne infections. Altered mucosal architecture with shoening of intestinal villi due to diffuse edema and infiltration of inflammatory cells leads to diarrhea, anorexia, fatigue, and weight loss. The duration of symptoms among untreated, non immune persons is often prolonged but ultimately self-limited, with remitting-relapsing symptoms lasting up to several weeks or months. The incubation period for Cyclospora infections is about 1 week, similar to infections with Cryptosporidium. The diagnosis can be made by detection of spherical 8- to 10-m oocysts in the stool, although routine stool ova and parasite (O+P) examinations are not sufficient. Specific fecal examinations must be requested to detect the oocysts, which are variably acid-fast and are fluorescent when viewed with ultraviolet light microscopy. All the parasites mentioned in the question cause chronic diarrhea (mostly in immunocompromised patients). All of them reveal oocyst on stool examination. In Giardiasis, parasite is also seen along with oocyst stool examination. Oocyst of all the organisms except giardia are acid fast. The diagnosis rests on the size of the oocyst. Ref: Brooks G.F., Carroll K.C., Butel J.S., Morse S.A., Mietzneron T.A. (2010). Chapter 46. Medical Parasitology. In G.F. Brooks, K.C. Carroll, J.S. Butel, S.A. Morse, T.A. Mietzneron (Eds), Jawetz, Melnick, & Adelberg's Medical Microbiology, 25e. | 154,382 | medmcqa_train |
Ecthyma gangrenosum in a neutropenic patient is caused by which of the following organism? | Ecthyma gangrenosum is a localized cellulitis with necrotizing and ulcerative evolution occurring in immunocompromised or neutropenic patients, mainly caused by Pseudomonas aeruginosa. Two pathogenic mechanisms are recognized; one occurring as the result of the presence of P. aeruginosa during bacteriemia, and the second as a primary lesion. Treatment is systemic antibiotics. | 154,383 | medmcqa_train |
which of the following mumurs will increase with valsalva ? | HOCM REF: harrisons 21st ed | 154,384 | medmcqa_train |
Complement level is reduced in: | Ans. D. Membrane proliferative GNMembranoproliferative GlomerulonephritisCauses of Membranoproliferative Glomerulonephritis1. Type I Disease (Most Common)a. Idiopathicb. SLEc. Endocarditisd. Hepatitis Ce. Hepatitis Bf. Mixed cryoglobulinemiag. Cancer: Lung, breast, and ovary (germinal)2. Type II Disease (Dense Deposit Disease)a. Idiopathicb. C3 nephritic factor-associatedc. Partial lipodystrophy3. Type III Diseasea. Idiopathicb. Complement receptor deficiencyClinical Featurea. They present with microscopic to gross hematuria and selective or non - selective proteinuria depending on the severity of the disease.b. They have a poor prognosis, developing renal failure 5-10 years after diagnosis.c. Complement level is reduced | 154,385 | medmcqa_train |
The 23 valent pneumococci vaccine is recommended in all except - | Ans. is 'c' i.e., Children less then 2 years Pneumacoccal vaccine . There are two types of pneumococcal vaccines available : ? 1) Polyvalent (23 type) polysaccharide vaccine This polysaccharide vaccine represents the capsular antigen of 23 most prevalent serotypes. - It gives 80-90% protection which is long lasting (5 years). - It is not meant for general use, but only in persons at enhanced risk of pneumococcal infection such as those with absent or dysfunctional spleen; sickle cell disease, coeliac disease; Chronic liver or renal or lung or cardiac disease, DM, CSF leaks (meningeal disruption: dural tear) and; immunodeficiency including HIV infection. - It is not recommended in children under two years of age and those with lymphoreticular malignancies and immunosupprassive therapy. 2)Conjugate vaccine - A different pneumococcal vaccine containing pneumococcal polysaccharide coupled (conjugated) to a carrier protein (diphtheria toxoid) has been developed. - The vaccine contains the capsular polysaccharide of seven most common pneumococcal serotypes. - It can be given to children under the age of 2 years (but more than 6 weeks old). | 154,386 | medmcqa_train |
The drug of choice for schistosomiasis is: | This novel anthelmintic has wide ranging activity against Schistosomes, other trematodes, cestodes and their larval forms but not nematodes ESSENTIALS OF PHARMACOLOGY page no. 855 | 154,387 | medmcqa_train |
Most common cause of epidural abscess | Harrison's principles of internal medicine. * Staphylococci or gram negative organisms are the usual cause of an epidural abscess | 154,388 | medmcqa_train |
Which one of the following is the description used for the term allodynia during pain management ? | Allodynia refers to perception of an ordinarily non-noxious stimulus as pain. | 154,389 | medmcqa_train |
Quinsy refers to ? | Ans. is 'b' i.e., Peritonsillar abscess Ouinsy (Peritonsillar abscess) Quinsy consists of suppuration outside the capsule in the area around the capsule. There is collection of pus between the capsule of tonsil and the superior constrictor muscle, i.e. in the peritonsillar area. Peritonsillar abscess is a complication of tonsillitis and is most commonly caused by group A beta - hemolytic streptococcus. Clinical features of Quinsy Clinical features are divided into :? 1) General : They are due to septicaemia and resemble any acute infection. They include fever (up to 104degF), chills and rigors, general malaise, body aches, headache, nausea and constipation. 2) Local : Severe pain in throat. Usually unilateral. Odynophagia. It is so marked that the patient cannot even swallow his own saliva which dribbles from the angle of his mouth. Patient is usually dehydrated. Muffled and thick speech, often called "Hot potato voice". Foul breath due to sepsis in the oral cavity and poor hygiene. Ipsilateral earache. This is referred pain CN IX which supplies both the tonsil and the ear. Trismus due to spasm of pterygoid muscles which are in close proximity to the superior constrictor. Examination findings The tonsil, pillars and soft palate on the involved side are congested and swollen. Tonsil itself may not appear enlarged as it gets buried in the oedematous pillars. Uvula is swollen and oedematous and pushed to the opposite side. Bulging of the soft palate and anterior pillar above the tonsil. Mucopus may be seen covering the tonsillar region. Cervical lymphadenopathy is commonly seen. This involves jugulodigastric lymph nodes. Toicollis : Patient keeps the neck tilted to the side of abscess. Treatment of peritonsillar abscess IV fluids Antibiotics : High dose penicllin. (iv benzipenicillin) is the DOC. In patients allergic to penicillin erythromycin is the DOC. Incision and drainage per orally, if the abscess does not resolve depite high dose of iv antibiotics. Tonsillectomy is done 6 weeks following an attack of quinsy (interval tonsillectomy). | 154,390 | medmcqa_train |
In Colle's fracture, distal fragment is: March 2003 | Ans. D i.e. All of the above | 154,391 | medmcqa_train |
X Ray view of fracture of nasal bone includes all except | .X-RAYS FOR NASAL FRACTURES 1. Lateral view of nasal bones : Both right and left lateral views should be taken. Fracture line and depression or elevation of the fractured segment is seen. Lower pa of nasal bones is thin and fractured more frequently. Groove for ethmoidal nerve and vessels can be seen running downwards and forwards and may look like fracture line. 2. Occlusal view of nasal bone. In this the X-ray film is held between the teeth, and central beam is projected perpendicular to the film. Both sides of the nasal pyramid are seen. Fracture line and lateral displacement of the nasal pyramid is seen clearly. 3. Waters' view. It gives end-on view of nasal arch. Fractures of right and left nasal bones and their lateral displacement can be seen. Ref: Dhingra 7e pg 494. | 154,392 | medmcqa_train |
The most common organism causing food poisoning in canned food is | Clostridium botulinum: strict anaerobic, cause botulism. Source of foodborne botulism is preserved food, meat and meat products, canned foods. Proteolytic varieties can digest food, which appears spoiled. The cans are often inflated and show bubbles on opening. Non-proteolytic varieties have food unchanged. Reference: Textbook of Microbiology; Anathanarayan and paniker's; 10th edition; Page no: 269 | 154,393 | medmcqa_train |
A 40 year old male patient has a large, foul smelling ulcer with bright red granulation tissue over the glans penis. There was no lymphadenopathy. The most likely diagnosis is: | Ulcer with red granulation tissue (beafy red) and absence of lymph nodes suggests the diagnosis of granuloma inguinale or Donovanosis. | 154,394 | medmcqa_train |
Staph aureus causes - | Option 1 Erythrasma Cause :Corynebacterium minutissimum Appears in the folds of the skin In warm or humid climates Option 2 Chancroid/soft sore Cause : H. Ducreyi Painful lymph node, tender non-indurated and bleeding genital ulcer. Option 3 S. aureus doesn't cause acne vulgaris. Option 4 lmpetigo- 2 types :- i) Non-bullous impetigo (Impetigo contagiosum):- Caused by staphylococcus aureus ,streptococcus pyogenes. ii) Bullous impetigo:- Caused by staphylococcus aureus. | 154,395 | medmcqa_train |
Loud S1 in Mitral stenosis is caused by: | Answer is A (Prolonged flow through mitral valve) Loud SI in mitral stenosis results from prolonged AV flow through the mitral vain `S1 is louder i fAV flow is prolonged because of mitral stenosis' -- Harrison Reduced mobility of valve (Immobility, calcification), and Prolonged PR interval (1st degree block) are all causes of soft S1. Note: First degree block is characterized by prolonged PR interval. | 154,396 | medmcqa_train |
Fournier's gangrene affects | Ref:Bailey and love 27th edition Pg no :419 | 154,397 | medmcqa_train |
In 1st trimester, all of the following can be well appreciated, except | Crown rump length- Ideal time to measures CRL is 7 - 10 weeks Anencephaly - Earliest anomaly to be detected on USG , can be defected earliest by 10 weeks. Nuchal translucency - sonographic marker of down syndrome / aneuploidy in 1st trimester (seen at 10-12 weeks). Hydrocephalus can be seen around 20 - 24 weeks or beyond when fetal cranium and brain stas growing and the CSF stas establishing | 154,398 | medmcqa_train |
Diastolic hea failure is impairment in the filling of the left ventricle. Which of the following is LEAST likely to occur? | Diastolic dysfunction is an impairment in the filling of the left ventricle ("stiff ventricle") caused by decreased compliance at a normal left atrial pressure. Systolic hea failure, which is an impairment in contractility, has a better response to positive inotropic agents. Most patients have a combination of both systolic and diastolic dysfunction.In diastolic hea failure, filling of the left ventricle is slow or incomplete (i.e., decreased compliance) unless left atrial pressures increase to maintain the ejection fraction at the expense of increasing pulmonary and systemic venous congestion. Clinical findings include dyspnea, which is the most common symptom, resulting from interstitial and pulmonary edema. Pathophysiologically, there is left atrial hypeension and pulmonary venous hypeension, leading to pulmonary congestion. Therapy is aimed at slowing the hea rate, which promotes filling of the left ventricle at low pressures. -Adrenergic blockers and calcium channel blockers are effective. Patients with diastolic dysfunction have a better survival rate than those with systolic dysfunction, because the ejection fraction is normal to slightly decreased, albeit at the expense of increased left atrial pressures.Systolic dysfunction is an impairment in contractility of the left ventricle or a defect in the ability ofmyofibrils to shoen against a load. The left ventricle loses its ability to eject blood into the aoa, so the ejection fraction (i.e., stroke volume/left ventricular end-diastolic volume) is decreased (usually < 40%); the normal ejection fraction is 80/120, or 66%, with a range of 55% to 75%. The ejection fraction is measured by echocardiography or radionuclide ventriculography. Signs of isolated systolic dysfunction include fatigue, prerenal azotemia, cool skin, and mental obtundation. The left ventricular chamber eventually dilates and patients develop fatigue, dyspnea, and peripheral edema, which are signs of right-sided hea failure. Examples of systolic dysfunction include post-myocardial infarction, ischemic injury (e.g., acute myocardial infarction), and congestive cardiomyopathy. Therapy is aimed at improving the performance of the left ventricle with the administration of positive inotropic agents and peripheral vasodilators to decrease peripheral resistance. | 154,399 | medmcqa_train |
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