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Recommended anticopper drug for Wilson's disease in paediatric patients is: | Recommended Anticopper Drugs for Wilson's Disease: Disease status DOC Hepatitis/cirrhosis without decompensation Zinc Mild hepatic decompensation Trientine and Zinc Moderate hepatic decompensation Trientine and Zinc Severe hepatic decompensation Liver transplantation Pediatric Zinc Pregnant Zinc Reference: Harrisons Principles of Internal Medicine, 18th Edition, Page 3189 | 154,400 | medmcqa_train |
Which of the following structure is present over the mediastinal surface of right lung: | Ans. A Azygos veinRef: Gray's Anatomy 41st ed. P 955Mediastinal Surface of Right LungOn the mediastinal surface of the right lung, you find these structures:* Azygos vein and its arch (posterior and over the root of the lung).* Vagus nerve posterior to the root of the lung.* Esophagus posterior to the root.* Phrenic nerve anterior to the root of the lung.* Cardiac impression: Related to right atrium.* Below hilum and in front of pulmonary ligament: Groove for IVC. | 154,401 | medmcqa_train |
A 54 year old man is evaluated by a neurologist because of a gait disorder. When the physician passively moves the patient's right great toe upward or downward, the patient cannot accurately repo the direction of motion, although his perception of light touch and painful stimuli is unimpaired.This finding can best be explained by a lesion of which of the following structures? | The patient's inability to detect the position of his toe reflects a lack of conscious proprioception for this pa of his body. Conscious proprioception, discriminative touch, and vibration sense are all carried by the dorsal column/medial lemniscus system. The fact that he can still perceive light touch and painful stimuli indicates that his anterolateral system is unimpaired. In the dorsal column/medial lemniscus system, the primary neuron's cell body is located in the dorsal root ganglia and sends its projection to the cord through the dorsal roots. The fibers do not synapse in the cord, but rather ascend the cord in the dorsal columns. Fibers carrying information from the legs ascend in the fasciculus gracilis; those receiving input from the arms project in the fasciculus cuneatus. Both ascend to the caudal medulla, where they terminate in the nucleus gracilis and nucleus cuneatus, respectively. The secondary neurons originating from these nuclei cross as the internal arcuate fibers, ascend as the medial lemniscus, then synapse in the ventroposterolateral (VPL) nucleus of the thalamus. Teiary neurons from the VPL project to the ipsilateral somatosensory coex. Therefore, a lack of conscious proprioception from the right toe could result from lesions to the right fasciculus gracilis, the right nucleus gracilis, the left medial lemniscus, the left VPL, or left somatosensory coex. The right fasciculus cuneatus carries discriminative touch, proprioception, and vibration information from the upper extremities.The right lateral lemniscus , pa of the auditory system, receives input from the contralateral cochlear nuclei and from the superior olivary nuclei, and projects to the inferior colliculus.The right medial lemniscus carries discriminative touch, proprioception, and vibration information from the left side of the body. Ref: Waxman S.G. (2010). Chapter 5. The Spinal Cord. In S.G. Waxman (Ed),Clinical Neuroanatomy, 26e. | 154,402 | medmcqa_train |
Which among the following is the BEST parameter for estimation of fetal age by ultrasound in third trimester? | In the third trimester femur length is most accurate to estimate the gestational age. Gestational age in the first trimester is usually calculated by from fetal crown rump length. This is the longest demonstrable length of the embryo or fetus excluding the limbs and the yolk sac. Four fetal parameters routinely measured in the second and third trimester are BPD, head circumference, abdominal circumference and femoral length. In the second trimester, the best parameters for estimating gestational age are biparietal diameter and head circumference. When BPD is altered head circumference has the advantage of being shape independent and can be used as an alternative. Femoral length can also be used and is nearly as accurate as head measurements. Ref: Diagnostic Ultrasound By L. C. Gupta, page 175, Oxford Desk Reference: Obstetrics and Gynaecology edited by Sabaratnam Arulkumaran page 48. | 154,403 | medmcqa_train |
Which drug is not included in RNTCP regime for MDR TB - | Ans. is 'd' i.e., PAS Treatment of multidrug resistance (MDR) TBo MDR-TB is defined as resistance to at least both IIS H and rifampicin. Previously it was classified as Category IV under DOTS (DOTS-PLUS).o The treatment is given in two phases, the intestive phase (IP) and the continuation phase (CP). The total duration of treatment for regimen for MDR-TB is 24-27 months, depending on the IP duration,o Treatment regimen comprises :-Intensive phase (6-9 months) : Six drugs : Kanamycin (Km), levofloxacin (Lvx), ethionamide (Eto), pyrazinamide (Z), ethambutol (E), and cycloserine (Cs).Continuation phase (18 months) : Four drugs : Levofloxaxcin, ethionamide, ethambutol and cycloserine,o Total duration of treatment is 24-27 months.Treatment of extensive drug resistance (XDR) TBo XDR-TB is defined as resistance to any fluoroquinolone and at least one of the following three second-line drugs (capreomycin, kanamycin, amikacin), in addition to muitidrug resistance,o The Regimen for XDR-TB w'ould be of 24-30 months duration, with 6-12 months Intensive Phase (IP) and 18 months Continuation Phase (CP).o Regimen is :-Intensive phase (6-12 months) : Seven drugs : Capreomycin, PAS, moxifloxacin. high dose INH. clofazimine, Linezolid, amoxyclav.Continuation phase (18 months) : Six drugs : PAS, moxifloxacin, high dose INH, clofazimine, linezolid, amoxyclav. | 154,404 | medmcqa_train |
Two month old baby presented with non bilious vomiting and a palpable epigastric lump. which among the following will be investigation of choice | Ans) a (USG abdomen) Ref Nelson 18th ed pi555Above clinical scenario is about the classical presentation of hypertrophic pyloric stenosis.Ultrasound examination confirms the diagnosis in the majority of cases and allots an earlier diagnosis in infants with suspected disease but no pyloric mass on physical examination.Criteria for diagnosis include pyloric thickness >4 mm or an overall pyloric length >14 mm Ultrasonography has a sensitivity of ?95%When contrast studies are performed, they demonstrate an elon-gated pyloric channel, a bulge of the pyloric muscle into the antrum (shoul-der sign), and parallel streaks of barium seen in the narrowed channel, producing a "double tract sign"Hypertrophic pyloric stenosisHypertrophic pyloric stenosis occurs in 1 -3/1,000 infants in the United States. Males, (especially first-borns) are affected approximately four times as often as females. The offspring of a mother and. to a lesser extent, the father who had pyloric stenosis are at higher risk for pyloric stenosis. Pyloric stenosis develops in approximately 20% of the male and 10% of the female descendants of a mother who had pyloric stenosis. The inci-dence of pyloric stenosis is increased in infants with type B and O blood groups. Pyloric stenosis is associated with other congenital defects, in-cluding tracheoesophageal fistula and hypoplasia or agenesis of the infe-rior labial frenulum.ETIOLOGY.The cause of pyloric stenosis is unknown, but many factors have been implicated. Pyloric stenosis is usually not present at birth and is more concordant in monozygotic than dizygotic twins. Pyloric stenosis has been associated with eosinophilic gastroenteritis, Apert syndrome, Zellweger syndrome, trisomy 18, Smith-Lemli-Opitz syndrome, and Cornelia de Lange syndrome. A variable association has been found with the use of erythromycin in neonates when administered for pertussis postexposure prophy-laxis. Reduced levels of pyloric nitric oxide synthase have been found with altered expression of the neuronal nitric oxide synthase (nNOS) exon lc regulatory region, which influences the expression of the nNOS gene. Reduced nitric oxide may contribute to the pathogenesis of pyloric stenosisCLINICAL MANIFESTATIONSNonbilious vomiting is the initial symptom of pyloric stenosis. The vomiting may or may not be projectile initially but is usually progressive, occurring immediately after a feeding. The vomiting usually starts after 3 wk of age, but symptoms may develop as early as the 1 st wk of life and as late as the 5th mo. As vomiting continues, a progressive loss of fluid, hydrogen ion, and chloride leads to hypochloremic metabolic alkalosis. Serum potassium levels are usually maintained, but there may be a total body potassium deficit. Jaundice associated with a decreased level of glucuronyl trans-ferase is seen in ?5% of affected infants. The indirect hyperbiliru- binemia usually resolves promptly after relief of the obstruction.The diagnosis has traditionally been established by palpating the pyloric mass. The mass is firm, movable, ?2 cm in length, olive shaped, hard, best palpated from the left side, and located above and to the right of the umbilicus in the mid epigastrium beneath the liver edge. In healthy infants, feeding can be an aid to the diagnosis. After feeding, there may be a visible gastric peristaltic wave that progresses across the abdomen. | 154,405 | medmcqa_train |
Hyperlipidemia is caused by intake of ? | Ans. is 'b' i.e., beta-Blocker Drugs causing hvperiglyceridemia ? o Estrogen o Furosemide o Bile acid - binding resin o HIV protease inhibitors. o beta-blockers o Glucocoicoids o Retinoic acid | 154,406 | medmcqa_train |
Criminal negligence is punishable under : | C i.e. 304 A | 154,407 | medmcqa_train |
After suxamethonium 50mg, apnea persists for one hour -- | Suxamethonium is a depolarising muscle relaxant used to rapidly gain optimal intubating conditions. It is normally metabolised within 5 minutes by plasma cholinesterase. Some patients lack this enzyme or have an altered enzyme that does not metabolise the suxamethonium as rapidly. These patients may remain paralysed for a prolonged period after a standard dose of suxamethonium and rely on renal elimination. This condition is often referred to as suxamethonium apnea | 154,408 | medmcqa_train |
Which is not included in millennium development goals? | Ans. is 'a' i.e., Number of oral pills intake in a community The indicators included in MDG are:? 1) Prevalence of underweight children (under five years of age). 2) Propoion (%) of population below minimum level of dietary energy consumption. 3) Under-five moality rate. 4) Infant moality rate. 5) Propoion (%) of 1 year old children immunized for measles. 6) Maternal moality ratio. 7) Propoion (%) of bihs attended by skilled health persons. 8) HIV preualence among young people. 9) Condom use in high-risk population. 10) Ratio of children orphaned/non-orphaed in schools. 11) Malaria death rate per 100,000 in children (0-4 years of age). 12) Malaria death rate per 100,000 in all age groups. 13) Malaria prevalence rate 100,000 population. 14) Propoion (%) of population under-age 5 in malaria risk areas using insecticide treated bed nets. 15) Propoion (%) of population under-age 5 with fever being treated with anti-malarial drug. 16) Tuberculosis death rate per 100,000. 17) Tuberculosis prevalence rate per 100,000. 18) Propoion (%) of smear-positive pulmonary tuberculosis cases detected and put under directly observed treatment sho-course (DOTS). 19) Propoion (%) of smear-positive pulmonary tuberculosis case detected cured under directly observed treatment sho-course (DOTS). 20) Propoion (%) of population using biomass fuel 21) Propoion (%) of population with sustainable accese to an improved water source, rural. 22) Propoion (%) of population with sustainable access to an improved water source, urban. 23) Propoion (%) of urban population with access to improved sanitation. 24) Propoion (%) of population with access to affordable essential drugs on a sustainable basis | 154,409 | medmcqa_train |
True about diabetes in pregnancy are all except: | Ans. is c, i.e. Insulin resistance improves with pregnancyRef. Dutta 7/e, p 282 for option a, b, 283 for option c and 285 for option d; Fernando Arias 3/e, p 440, 442, 443In pregnancy, the insulin sensitivity decreases i.e. insulin resistance increases as the gestation advances mainly due to anti insulin signals produced by placenta (mainly human placental lactogen).Congenital malformations in a diabetic mother occur within first 8 weeks of gestation when most women are just beginning prenatal care. Therefore preconceptional counselling is very essential in a diabetic motherScreening for diabetes during pregnancy is done by glucose challenges test at 24-28 weeks of pregnancy. | 154,410 | medmcqa_train |
Bone, which usually does not have a medullary cavity: | Clavicle is generally said to have no medullary cavity, but this is not always true Peculiarities of Clavicle:It has no medullary cavityIt is the first bone to ossify in the fetus (5th-6th week)It is the only long bone having 2 primary centers of ossification (others have only 1)It is the only long bone that ossifies in membrane and not in cailageIt is the only long bone lying horizontallyIt is the most common fractured long bone in the bodyIt is subcutaneous throughout | 154,411 | medmcqa_train |
An 18 year old man is evaluated for possible immunodeficiency disease because of a life-long history of chronic lung infections, recurrent otitis media, and multiple episodes of bacterial meningitis. While total IgG is normal, the patient is found to have a selective deficiency of IgG2. An associated deficiency of which of the following other substances may produce anaphylaxis when blood products are given to such individuals? | IgG subclass deficiency is one of the more minor forms of immunodeficiency disease, and most patients with this condition who are optimally managed can expect a normal life span. The typical presentation is as illustrated in the question stem. The deficiency may involve either or both IgG2 and IgG3 with or without IgG4 deficiency. (IgG1 is the major form, and its deficiency leads to a deficiency of total IgG, and so, by definition, it is not considered a "subclass" deficiency.) A potentially clinically impoant point is that some patients with IgG2 deficiency also have IgA deficiency and may develop anaphylaxis if given IgA-containing blood products. C3 deficiency tends to produce pyogenic infections. C4 deficiency tends to produce an SLE-like syndrome. IgE deficiency can be seen in some incomplete antibody deficiency syndromes, but is usually not clinically significant. Ref: Hellmann D.B., Imboden J.B. (2013). Chapter 20. Rheumatologic & Immunologic Disorders. In M.A. Papadakis, S.J. McPhee, M.W. Rabow, T.G. Berger (Eds), CURRENT Medical Diagnosis & Treatment 2014 | 154,412 | medmcqa_train |
A 23 year old female has abdominal lump that is movable and painless. On exploratory laparotomy, a cystic lump is found arising from mesentery which has no lymphatic supply but has independent blood supply. What is the probable diagnosis? | Mesenteric Cyst More common in females Usually seen in 2nd decade. CHYLOLYMPHATIC MESENTERIC CYST ENTEROGENOUS MESENTERIC CYST Congenitally misplaced lymphatics in ileum with Afferent lymphatics only. No efferent lymphatics | The chyle will collect | Progressive increase in size of cyst independent blood supply to cyst Treatment Enucleation Duplication cysts (walled off diveicula) Origin is from diveicula / duplication SI lined by columnar epithelium, which has goblet cells that produce mucin. Collected mucin leads to cyst | Enterogenous cysts Content is mucinous(shared wall & shared vascular supply) Treatment Resection + anastomosis | 154,413 | medmcqa_train |
Disease imported in a country, which was not otherwise present? | Ans. c (Exotic) (Ref. Park PSM 22nd/pg. 90)Exotic diseaseDisease imported in a country, which was not otherwise present.Epizootic disease# Disease affecting a large number of population at the same time within a particular region or geographic area.# Epizootic disease has the potential for very serious and rapid spread.# Epizootic diseases cause serious socio-economic or public health consequences and are of major importance in the international trade of animals and animal products.Epornithic disease# An epidemic in a population of birds.# A disease affecting a large number of animals simultaneously, corresponding to "epidemic" in humans.Zoonotic disease# A disease of animals that may be transmitted to man under natural conditions (e.g., Brucellosis, Rabies, -Plague, Ringworm, Lyme disease, Tuberculosis, Cat scratch, Tick paralysis, Hanta virus, etc).# Thus these are the infectious diseases that can be transmitted between (or shared by) animals & humans. | 154,414 | medmcqa_train |
Repetitive stimulation increases pain sensation, the probable cause is | Repetitive stimulation causes release of chemical mediators such as histamine, bradykinin, prostaglandins etc, which increase the sensitivity of nociceptors. | 154,415 | medmcqa_train |
The outer covering of diatom is made of - | Ans. is 'b' i.e., Silicon o The extracellular coat of diatoms has silica.o Diatoms are unicellular algae, suspended in water.o They have silicaceous cell wall (i.e. cell wall contains silica) which resist acid digestion and putrefaction,o Only live body with a circulation can transport diatoms form lung to brain, bone marrow, muscles etc.o So, presence of diatoms in brain and bone marrow indicates death due to drowning.o For detection of diatoms, bone marrow of long bones, e.g. femur, tibia, humerus or sternum is highly suitable and reliable.o As diatoms resist acid digestion, to extract them acid digestion techinique is used.o Diatoms test is negative in dead bodies thrown in water and in dry drowning.o However, diatoms test is invalid, if deceased had drunk this water before submersion or species of diatoms do not match with specimen from the site of drowning. | 154,416 | medmcqa_train |
Study the following table of population in a district and the average population served per doctor. Calculate the harmonic mean: AREA POPULATION SERVED PER DOCTOR POPULATION NUMBER OF DOCTORS RURAL 1000 50000 50 URBAN 500 50000 100 TOTAL 100000 150 | Calculation of harmonic mean is as follows: (50000+50000)/(50000/100+50000/50)=667 Ref : Medical biostatistics, 1st edition pg: 118 | 154,417 | medmcqa_train |
The weight of the child at 3 years is usually_______ times the bih weight | <p> weight of new born Weight of child in nude or minimal clothing is measured accurately on a lever or electronic type of weighing scale. Spring balances are less accurate. The weighing scale should have a minimum unit of 100g. Child should be placed in middle of pan. Age Weight(kg) Bih. 3 6 months 6 (doubles) 1 yr. 9(triples) 2 yr. 12(quadruples) 3 yr. 15 4 yr. 16 At bih weight is 3 kg and at 3 years it is 15 kg ( 5 times bih weight). {Reference: GHAI essential Paediatrics}</p>. | 154,418 | medmcqa_train |
N Methyl Glycine is known as: | Sarcosine/ N-methylglycine = intermediate and by-product in Glycine synthesis and degradation * Ergothionine is a thiourea derivative of Histidine, containing a sulfur atom on the imidazole ring * Betaine is N,N,N-Trimethylglycine, present in beet sugar. * Carnosine (Beta-Alanyl-L-Histidine), has Imidazole ring like Histidine, is a dipeptide molecule, made up of Beta-Alanine and Histidine. It is present in muscle and brain tissues. | 154,419 | medmcqa_train |
40 yrs old diabetic patient presents with round lesions for 2 weeks on abdomen. HPE shows palisading granuloma. What is the diagnosis? | Ans. is 'a' i.e. Granuloma annulare Points in favour are:* Diabetic patient* Annular lesions* Palisading granuloma on HPE (most important)Palisading granulomas* They are a subtype of necrotizing granuloma in which the mononuclear phagocytes at the periphery have elongated or spindle-shaped nuclei that are palisaded and arranged roughly parallel to each other and roughly perpendicular to the edge of the central necrotic zone.* Classically they are found in granuloma annulare, necrobiosis lipoidica, and rheumatoid nodule.Other conditions associated with itNon-infectious causes InfectionsInfections* Suture granuloma* Non-tuberculous mycobacteriosis* Churg-strauss disease* Cat scratch disease* Foreign body granuloma* Phaeohyphomycosis* Cutaneous T-cell lymphoma* Sporotrichosis* Wegener's granulomatosis* Cryptococcosis* Steroids* Coccidioidomycosis* Actinic granuloma* Syphilis* Scleromyxedema * Eruptive xanthoma * Cutaneous langerhans histiocytosis * Epithelioid sarcoma | 154,420 | medmcqa_train |
Not a member of SAARC region | Members of SAARC region
Afghanistan
Bangladesh
India
Sri Lanka
Nepal
Bhutan
Maldives Islands
Pakistan | 154,421 | medmcqa_train |
For Dextroelevation of the eye, muscles acting are - | Dextroelevation: Right superior rectus and left inferior oblique Levoelevation: Left superior rectus and right Inferior oblique Dextroversion: Right lateral rectus and left medial rectus Levoversion: Left lateral rectus and right medial rectus Dextrodepression: Right inferior rectus and left superior oblique Levodepression: Left inferior rectus and right superior oblique Ref;A.K.Khurana;6th Edition;Page no: 339 | 154,422 | medmcqa_train |
Hemosiderin contains | Hemosiderin
It is hemoglobin derived, golden yellow to brown, granular or crystalline pigment in which form iron is stored in cells.
When there is local or systemic excess of iron, ferritin forms hemosiderin granules.
Thus hemosiderin pigment represents aggregrates of ferritin micelles.
Under normal conditions small amounts of hemosiderin can be seen in the mononuclear phagocytes of the bone marrow,
spleen and liver, all actively engaged in red cell breakdown | 154,423 | medmcqa_train |
HIV infects which of the following cells? | Ref: Textbook of Microbiology, 8th edition, .4 nanthna ray an and Paniker, Page 572Explanation:Infection is initiated by HIV after contact with a suitable host cell, namely the T-helper cell or CD4 lymphocyte.Receptor for HIV is - CD4 antigen borne primarily on CD4+ (helper/inducer) T lymphocyte, for which the cheinokine co-receptor involved is- CXCR4.HIV also infects Macrophages, the chemokines co-receptor involved is- CCR5.Rare hereditary conditions involving mutation of CCR5 (32 base pair deletion in the ORF-d32) -- Genetic resistance to acquiring HIV infection, delay AIDS onset or LTNPs (Long Term Non-Progressors).Cell Types Infected by HIV and Chemokine Co-receptorCD4+ T-helper cells - CXCR4.Macrophages - CCR5.Dendritic cells. | 154,424 | medmcqa_train |
If blindness is surveyed using schools as compared to population surveys, then estimation of prevalence of blindness will have ? | Blindness situation in India
Estimated prevalence of blindness in India (total) : 11.2 per 1000 population.
Estimated prevalence of blindness in India (0-14 years) : 0.1 per 1000 population.
Estimated prevalence of blindness in India (15-49 years) : 0.6 per 1000 population.
Estimated prevalence of blindness in India (50+ years) : 77.3 per 1000 population.
So if schools are used where only refractive errors generally constitute blindness (that too very few are actually blind i.e. <6 / 60) As compared to population (where age-related cataract constitute as major cause of blindness), it would lead to underestimation of prevalence of blindness in the country. | 154,425 | medmcqa_train |
Subacute sclerosing panencephalitis is a late neurological complication associated with infection due to: | a. Measles virus(Ref: Nelson's 20/e p 1542-1547', Ghai 8/e p 213-214)Subacute sclerosing panencephalitis (SSPE) is a chronic complication of measles with a delayed onset & fatal outcome. | 154,426 | medmcqa_train |
Ectopic rest of normal tissue is known as? | Ectopic rest of normal tissue is choristoma.
Abnormally arranged tissue present at normal site is hamartoma. | 154,427 | medmcqa_train |
True about use of NSAIDs in Abnormal uterine bleeding is all except | NSAIDs are taken only during menstruation. | 154,428 | medmcqa_train |
The influenza virus has - | Influenza virus
Belong to orthomyxoviridae → Envelope, RNA virus
Contain single stranded RNA which is segmented → 8 pieces
There are three viral subtypes
1. Type A → Causes all pandemics and most of the epidemics
2 Type B → Can cause epidemics
3. Type C → Causes endemic infection
Three types of influenza viruses are circulating in world →A(H1N1), A(H3N2) and B
A new type has been recognized →A (H5N1)
Source of infection → Case or subclinical case
Mode of transmission → Droplet infection by respiratory route
Incubation period → 18-72 hours
Clinical manifestations
Most infections are subclinical
Fever, headache and myalgia
Respiratory → coughing
There is no viremia
Complications
Pneumonia → M.C. by str. pneumoniae
Worsening of COPD
Encephalitis
Reye’s Syndrome→ with type B virus
GB. Syndrome
GI Symptoms (gastric flu)→ Type B virus
Laboratory diagnosis
Most commonly, the diagnosis is established by the use of rapid viral tests that detect viral nucleoprotein or neuraminidase. | 154,429 | medmcqa_train |
A 26yr old female presented with complaints of coloured
halos, matted and sticky eyelids since 3 days. On examination,
visual acuity was normal. Most common organism causing
this condition is | The Clinical scenario gives the diagnosis of Acute mucoopurulent conjunctivitis which is most commonly caused by Staphylococcus aureus. | 154,430 | medmcqa_train |
The following antibiotic accentuates the neuromu-scular blockade produced by pancuronium: | (Ref: KDT 6e p721, 722) Aminoglycosides (like streptomycin and gentamicin) can accentuate the neuromuscular blockade produced by competitive blockers (like pancuronium). Mechanism of neuromuscular blockade produced by aminoglycosides is the inhibition of presynaptic release of ACh. | 154,431 | medmcqa_train |
Chemical name for estasy is - | Ecstasy is a designer drug used in rave paies Drugs Street names MDMA(3,4-methylenedioxymethamphetamine) Ecstasy, X, M,rolls GHB (gamma-hydroxybutyrate) G, liquidecstasy, soap Flunitrazepam (Rohypnol) Mexicanvalium, circles Ketamine (Ketalar) K, Special K,jet Ref: Rave drugs, Wikipedia. | 154,432 | medmcqa_train |
Which is NOT used in treatment of heroin dependence | SYMPTOMATIC DETOXIFICATION Patients withdrawal symptoms is treated with suppoive care Anti-spasmodic for abdominal cramps Anti-diarrheal for diarrheas Anti-emetics for vomiting Sedatives for reduction of anxiety Clonidine 0.1mg four times a day Antispasmodic Sedatives AGONIST ASSOSIATED DETOXIFICATION Methadone====== it's a long acting opioid thus it has less abuse potential, as it acts on the mu receptor and results in respiratory depression as it has risk of abuse and respiratory depression it is used only by the practioner who has a license to prescribe methadone Bupenorphine (suboxone) It has paial agonist in mu receptor; thus, it has high affinity, less efficacy, slow dissociation. Thus, they have ceiling effect and hence there is no risk of respiratory depression and less chance of abuse ANTAGONIST ASSOSIATED DETOXIFICATION If we use suppoive measures or agonist associated detoxification it results in 14 days and by the time to move from an opioid state to non-opioid state, during which the patient may lapse again. To overcome that there is a method rapid detoxification where the patient is given naltrexone to drive away the opioid and to make the patient unaware of the withdrawal symptoms the patient is placed under anesthesia. This method of naltrexone+ anesthesia used detoxification is called ultra-rapid detoxification Ref.Kaplon and Sadock, synopsis of psychiatry, 11 th edition, pg no.681 | 154,433 | medmcqa_train |
Best source of vitamin D - | Ans. is 'a' i.e., Fish liver* Though vitamin D is synthesised when UV B photons strike 7 dehydrocholesterol of malphigian layer of skin epidermis, vitamin D is still considered as an essential micronutrient because Vitamin D produced from sunlight is not sufficient. Hence we are dependent on vitamin D supplementation in the diet.* Natural dietary sources of vitamin D include:1. Fish cod liver - 2200IU/200Calorie2. Herring fish - 2000 IU/200C3. Salmon Fish - 900 IU/200C4. Fortified milk -300 IU/200C5. Unfortified milk - 100 IU/200C6. Egg Yolk-68IU/200 C | 154,434 | medmcqa_train |
Which of the following beta blocker doesn't cause bradycardia? | Ans. A. PindololPindolol is beta blocker with intrinsic sympathomimetic activity. These drugs themselves activate beta 1/2 sub maximally. | 154,435 | medmcqa_train |
All are true of tinea Versicolor except - | Ans-ATinea VersicolorCausative agent: Pitryrosporuni orbiculare (Malassezia furfur)It is a superficial fungal infection of the skin caused by Malassezia furfur and related fungiThe yeast phase was known as Pityrosporum orbiculare (round); Pityrosporum ovale (oval)Now the genus Pityrosporum is considered invalidM. sympodialis - most common on normal skinM.globosa-most commonly associated with tinea versicolorPredisposing factors:Warm and humidClimate of tropicsPregnancySerious underlying disease,Immunocompromised hostBoth hyper and hypopigmented lesions are seenFine branny powdery scales are seen (Candle grease sign or coup doggie sign)Diagnosis:KGH mount; Spaghetti and meatball appearanceCultureWood's lamp examination: Gold to orange fluorescenceTherapyTopical; 2.5% Selenium sulphideSystemic; Ketoconazole, Itraconazole, Flucanozole - Single oral doseOther fungal infectionsDermatophytes I ringworm - superficial fungal infections by three genera- all affect the skin: Microsporum affects hair while epidermophvton affects nailsTrichophyton - affects skin, hairs, nails (remember as tri-all three structures affected)Most common cause of dermatophyte infectionTrichophyton rubrumMicrosporum - affects skin and hairEpidermophvton - affects skin and nailsCandidiasis - most common causative agent is Candida albicansOther species- C.glabrata, C.parapsilosis. C.tropicalis- rarely pathogenic | 154,436 | medmcqa_train |
The antibody iso-type associated with the mucosal immune system | (A) IgA # Mucosa-associated lymphoid tissues lining the gut are known as gut-associated lymphoid tissue or GALT. The tonsils and adenoids form a ring, known as Waldeyer's ring, at the back of the mouth at the entrance of the gut and airways.> The mucosal immune system contains a distinctive repertoire of lymphocytes> Secretory IgA is the antibody isotype associated with the mucosal immune system> Most antigens presented to the mucosal immune system induce tolerance.> The mucosal immune system can mount an immune response to the normal bacterial flora of the gut> Polymeric IgA and IgM are synthesized throughout the gut by plasma cells located in the lamina propria and are transported into the gut by immature epithelial cells located at the base of the intestinal crypts.> Secreted IgA and IgM bind to the mucus layer overlying the gut epithelium where they can bind to and neutralize gut pathogens and their toxic products | 154,437 | medmcqa_train |
Associated with objective tinnitus? | Ans. is `d' i.e., Glomus tumor Tinnitus Tinnitus is ringing sound or noise in the ear. The characteristic feature is that the origin of this sound is within the patient. Two types of tinnitus have been described : ? a. Subjective I. Otologic II . Non-otologic Impacted wax Disease of CNS Fluid in the middle ear Anaemia Acute and chronic otitis media Aeriosclerosis Abnormally patent eustachian tube Hypeension Meniere's disease Hypotension Otosclerosis Hypoglycaemia | 154,438 | medmcqa_train |
A baby is born with a flat facial profile, prominent epicanthal folds, and simian crease. She vomits when fed, and upper GI studies demonstrate gas in the stomach and duodenal bulb. Which of the following cardiovascular abnormalities might this child also have? | The disease is Downs syndrome (trisomy 21). In addition to mental retardation and the characteristic physical findings described in the question stem, duodenal atresia is fairly common, as evidenced by the "double bubble" sign (gas in the stomach and duodenal bulb) on x-ray. These children are also likely to have various cardiac anomalies; endocardial cushion defect is the most common.Note:Atrial septal defect is one of the most common genetic defects in the general population, but is less common than endocardial cushion defect in patients with Down syndrome.Berry aneurysms, also known as saccular aneurysms, are typically located in the circle of Willis on the ventral surface of the brain. They occur more frequently in patients with adult polycystic disease. Rupture can produce subarachnoid hemorrhage.Coarctation of the aoa occurs more commonly in females with a 45, XO genotype (Turner syndrome). Ref: Brown D.W., Fulton D.R. (2011). Chapter 83. Congenital Hea Disease in Children and Adolescents. In V. Fuster, R.A. Walsh, R.A. Harrington (Eds), Hurst's The Hea, 13e. | 154,439 | medmcqa_train |
In colour perimetry the smallest field of vision is with: | Ans. Green object | 154,440 | medmcqa_train |
Hyperkalemia is not caused by: | Hyperkalemia is caused by angiotensin-conveing enzyme inhibitors, angiotensin-II receptor blockers, direct renin inhibitors, nonsteroidal anti-inflammatory drugs, calcineurin inhibitors, heparin, aldosterone antagonists, potassium-sparing diuretics. salbutamol causes hypokalemia ESSENTIALS of medical PHARMACOLOGY SIXTH EDITION-KD TRIPATHI Page:757,758 | 154,441 | medmcqa_train |
A 32-year-old woman is confirmed as being 6 weeks pregnant. She feels well, and has no past medical history. This is her second pregnancy; the first pregnancy was uncomplicated and she delivered at term, but the baby was anemic due to beta-thalassemia. She is now worried that the current pregnancy may also be affected. Which of the following methods is most likely to establish an accurate prenatal diagnosis? | Chorionic villus sampling in the first trimester with deoxyribonucleic acid (DNA)-based diagnosis has a high degree of accuracy. Cord blood electrophoresis is suitable for screening high-risk infants at birth. | 154,442 | medmcqa_train |
Which of the following features is shared in common between lymphocyte - rich and lymphocyte predominant types of Hodgkin&;s lymphoma - | Classical RS cells are difficult to find in lymphocyte predominance type but it is frequently present in lymphocyte rich type. About 40% of lymphocyte rich type is associated with EBV.But lymphocyte predominance is not associated with EBV RS cells in lymphocyte predominance is CD20 positive. But RS cells in lymphocyte rich type isCD2O negetive. Both type have very good prognosis. Reference : Robbins and Cotran Pathologic basis of disease.South Asia Edition volume 1.page no. 609 | 154,443 | medmcqa_train |
This patient was a former smoker and was being treated for essential hypertension, hypercholesterolemia, and hyperuricemia. Oral examination during the three follow up visits are being shown What is the most likely diagnosis of the tongue involvement? | Ans. A. Geographic tongue* Geographic tongue, also known as benign migratory glossitis and migratory stomatitis, is the correct answer.* The changing lesions are suggestive of a geographic map (hence geographic tongue) with pink continents surrounded by whiter oceans.* It is a recurrent, benign, usually asymptomatic, inflammatory condition, of unknown etiology, of the tongue, affecting nearly 2% of the general population.* Geographic tongue typically presents with migratory red lingual patches, which are irregularly shaped erythematous patches bordered by a white keratotic band. Tongue lesions exhibit central erythema because of atrophy of the filiform papillae of tongue epithelium.* Lesions may last days, months, or years. THE LESIONS DO NOT SCAR.* It being a benign asymptomatic condition, therefore requires no treatment. | 154,444 | medmcqa_train |
Death sentence can be awarded by | The sessions cou is usually located at district headquaers. It can only try cases which have been committed by a Magistrate S.193, Cr.P.C. It can pass any sentence authorised by law, but a Death sentence passed by it must be confirmed by the High cou.S.28.(2) and S.366, Cr.P.C. District Cou deals with civil cases REF: The Synopsis of Forensic Medicine and Toxicology 28th edition page no: 4. | 154,445 | medmcqa_train |
35 year old mother of two children is suffering from amenorrhea from last 12 month. She has a history of failure lactation following second delivery but remained asymptomatic thereafter. Skull X-ray shows empty sella diagnosis is : | Ans. is c i.e. Sheehan's Syndrome Friends, here before arriving to any diagnosis lets first see the causes of : Empty Sella : Congenital incompleteness of the sellar diaphragm. Presentation : Women present with : * Galactorrheadeg Features of hypogonadism : Men present with : * Impotence Loss of libido Infeility. In both sexes they can cause : Cavernous sinus syndrome consisting Raised serum prolactin levels X-Ray sella shows space occupying lesion. Investigations : In all cases of hyperprolactinemia : - MRI should be performed - TSH levels should be measured. Management : Microadenoma with no desire of feility : Asymptomatic patients with microadenomas rarely progress to macroadenomas managed conservatinely. If patient has osteopenia. (due to hypoestrogenemia caused by TProlactin levels) estrogen replacement or OCP's. Monitor patients with regular serial prolactin levels and MRI (every 12 months). 216 * Secondary to Surgery / Radiotherapy or infarction of pituitary tumor. * Secondary to Infarction and Necrosisof pituitary gland. Now from the given causes : either pituitary tumor or Sheehans syndrome can cause an empty sells on x Ray. Pituitary Tumours (Micro / Macro adenoma) cause galactorrhoea (not lactationat failure) with amenorrhea and are so, ruled out. - So, the ObVious answer me by exclusion is Sheehan's Syndrome. Sheehan's syndro: It is the syndrome which results from ischaemic necrosis of most of the Anterior Pituitarydeg due to spasm in its aerioles occurring at the time of severe hemorrhage or shock complicatingchildbih. Only the anterior pituitary is affected because in paurient woman, blood supply to the pituitary gland is modified to the advantage of the posterior lobe and disadvantage of the anterior lobe so, when spasm occurs, posterior lobe is protected. When 75% of Anterior pituitary is destroyed, manifestations of Sheehan's syndrome appear and when 95% is destroyed -- fully developed Simmonds syndrome is seen. Hormones of Anterior Pituitary are affected in order of frequency = GH, FSH and LH, TSH and ACTH. Clinical Features : SymptomsQ Failure of lactation after deliverydeg Secondary amenorrhoeadeg Loss of libidodeg Increased sensitivity to cold (hypothydroidism)deg Signs : Absence of axillary sweatingdeg 1 Loss of axillary and pubic hairdeg Signs of adrenal coical failure Decrease in skin pigmentationdeg I Anemia due to lack of pituitary erythropoeitic factor Weakness, lethargydeg Hypothermiadeg Hypoglycemiadeg (due to decreased insulin tolerance)deg Hypothyroidismdeg All genital organs show atrophy, uterus is smaller than in postmenopausal womendeg as there is decrease in FSH, LH $ estrogen Although dormant ovaries retain their ova till menopausedeg Lab investigation : FSH LH TSH ACTH 1deg Oestrogens J.deg Urinary 17 keto steroids ,1,deg Management : The treatment of Sheehan's syndrome includes : Life long hormone substitute including estrogen, | 154,446 | medmcqa_train |
Post Traumatic stress syndrome is due to | D i.e. Major life threatening events | 154,447 | medmcqa_train |
March fracture is ? | Ans. is 'a' i.e., Neck of 2nd metatarsal Metatarsal stress fractures are common in distance runners and ballet dancers. The second metatarsal neck is the most likely site for stress fracture, but all metatarsals are susceptible. March fracture, also known as fatigue fracture or stress fracture of metatarsal bone, is the fracture of the distal third of one of the metatarsals occurring because of recurrent stress. It is more common in soldiers, but also occurs in hikers, organists, and even those, like hospital doctors, whose duties entail much standing. March fractures most commonly occur in the second and third metatarsal bones of the foot. | 154,448 | medmcqa_train |
Raynolds-Braude phenomenon is shown by: | Ans. a (Candida albicans). (Ref. Ananthanarayan, Microbiology/ 6th/pg.576)RAYNOLDS-BRAUDE PHENOMENON (Germ tube formation) is a rapid method of identifying Candida albicans based on ability to form germ tubes within 2 hours on incubation in human serum at 37degC.CANDIDA ALBICANS# Yeast like fungus# Pseudomycelia# Diabetes is the most common predisposing factor# Normal inhabitants of skin and mucosa# Produces creamy-white, smooth colonies with yeast odour on Sabouraud's media# Forms Chlamydospores on com meal agar at 20degC# Treatment:- Local-nystatin,- Disseminated - Amphotericin, 5-Flurocytocin, clotrimazole.Opportunistic systemic mycotic infections include:SR. NO.FUNGUSMICROBIOLOGICAL FEATURESCLINICAL MANIFESTATIONS1AspergillusSeptate hyphae & sterigmataOtomycosis is most common.Rhinocerbral aspergillosis is particularly seen in diabetics.ABPA2MucorBroad non-septate mycelia without rhizoids, branched sporangiophoresNasal & PNS mucormycosis3PenicilliumBrush like conidia, chain of sporesIn HIV infected patients4RhizopusNon-septate mycelia with rhizoids-5AbsidiaiInvasive disease | 154,449 | medmcqa_train |
Which type of abnormality in sexual development has best prognosis? | Ans. a. Congenital adrenal hyperplasia (Ref: Navak's 15/e p1029. 14/e p1023-1026)Congenital adrenal hyperplasia is a type of abnormality in sexual development, which has best prognosis.'Congenital adrenal hyperplasia can be managed by supplying enough glucocorticoids to suppress excess androgen production. The deformity in genitalia (enlarged clitoris, fusion of labia minora) can be corrected surgically. Newborn screening methods to detect CAH and efforts to treat CAH in utero have improved the prognosis. Women with CAH can get pregnant and have healthy infants.'21-Hydroxylase Deficiency (Congenital Adrenal Hyperplasia)The classic form of 21 -hydroxylase deficiency (21-OHD) is the most common cause of CAH.It has an incidence between 1 in 10.000 and 1 in 15,000 and is the most common cause of androgenization in chromosomal 46,XX females.Affected individuals are homozygous or compound heterozygous for severe mutations in the enzyme 21-hydroxylase (CYP21A2).This mutation causes a block in adrenal glucocorticoid and mineralocorticoid synthesis, increasing 17-hydroxyprogesterone and shunting steroid precursors into the androgen synthesis pathwayQ.Increased androgen synthesis in utero causes androgenization of the female fetus in the first trimesterQ.Ambiguous genitalia are seen at birth, with varying degrees of clitoral enlargement and labial fusionQ.Excess androgen production causes gonadotropin-independent precocious puberty in males with 21-OHDQ.Presymptomatic diagnosis of classic 21-OHD is now made by neonatal screening tests forincreased 17-hydroxy progesteroneQ in many centers.Treatment: Congenital Adrenal Hyperplasia:Acute salt-wasting crises require fluid resuscitation, IV hydrocortisone, and correction of hypoglycemia.Once the patient is stabilized, glucocorticoids must be given to correct the cortisol insufficiency and suppress ACTH stimulation, thereby preventing further virilization, rapid skeletal maturation, and the development of polycystic ovariesQ.Girls with significant genital androgenization due to classic 21-OHD usually undergo vaginal reconstruction and clitoral reductionQ (maintaining the glans and nerve supply).Androgen insensitivity syndrome (AIS):A condition that results in the partial or complete inability of the cell to respond to androgensQ.The unresponsiveness of the cell to the presence of androgenic hormones can impair or prevent the masculinization of male genitalia in the developing fetus, as well as the development of male secondary sexual characteristics at puberty, but does not significantly impair female genital or sexual developmentQ.As such, the insensitivity to androgens is clinically significant only when it occurs in genetic malesQ (i.e. individuals with a Y-chromosome, or more specifically, an SRY gene).Clinical phenotypes in these individuals range from a normal male habitus with mild spermatogenic defect or reduced secondary- terminal hair, to a full female habitus, despite the presence of a Y-chromosome.Androgen insensitivity syndrome is the largest single entity that leads to 46, XY undermasculinized genitaliaQ.Management of AIS is currently limited to symptomatic management; no method is currently available to correct the malfunctioning androgen receptor proteins produced by AR gene mutationsQ.Areas of management include sex assignment, genitoplasty, gonadectomy in relation to tumor risk, hormone replacement therapy, genetic counseling, and psychological counseling.Mixed Gonadal Dysgenesis:A condition of unusual and asymmetrical gonadal development leading to an unassigned sex differentiation.A number of differences have been reported in the karyotype, most commonly a mosaicism 45, X/ 46, XY.The phenotypical expression may be ambiguous, intersex, or male, or female pending the extent of the mosaicism.It has been pointed out that the gonads may not be symmetrical, thus the development of the Mullerian duct and Wolffian duct may be asymmetrical, too.Because of the presence of dysgenetic gonadal tissue and Y chromosome material, there is a high risk of the development of a gonadoblastoma, thus removal of the gonads is usually indicated.True hermaphroditism:A medical term for an intersex condition in which an individual is born with ovarian and testicular tissue.There may be an ovary underneath one testicle or the other, but more commonly one or both gonads is an ovotestis containing both types of tissue.There are no documented cases in which both types of gonadal tissue function.Encountered karyotypes are 47XXY, 46XX/46XY, or 46XX/47XXY, and various degrees of mosaicism.There has yet to be a documented case where both gonadal tissues function (Bad reproductive potential); contrary to rumors of hermaphrodites being able to impregnate themselves. | 154,450 | medmcqa_train |
Mangled Extremity Severity Score (MESS) includes all of the following, EXCEPT: | The mangled extremity severity score (MESS) is a scoring system that can be applied to mangled extremities and help to determine which mangled limbs will eventually go for amputation and which can be salvaged. This system grades the injury on the basis of 4 categories: skeletal or soft tissue injury, limb ischemia, shock and the patient's age. | 154,451 | medmcqa_train |
hich of the following is not true about Neisseria gonorrhoea - | Ans. is. 'd'i.e., All the strains are highly sensitive to penicillin . Penicillin is ineffective in treatment of gonorrhoea as most of the strains are resistant to penicillin because penicillnase producing N. gonorrhoeae (PPNG) have spread widely. . Ceftriaxone is the drug of choice for gonococcal infections. . All other options have been explained earlier. | 154,452 | medmcqa_train |
Toxigenicity of C. diphtheria is determined by- | Ans. is 'a' i.e., Elek's gel ppt test | 154,453 | medmcqa_train |
WHO regime for paucibacillary leprosy: | A i.e. 100 mg Dapsone daily + Rifampcin 600 mg monthly | 154,454 | medmcqa_train |
For cardiopulmonary resuscitation in neonates ratio of chest compression to ventilation is | Ans: b (3:1) Ref: Nelson, 18th ed,p. 389; 17th ed,p. 280Chest compression-ventilation relationship Neonate1-8 years> 8 yearsCompression rate120At least 100100Compression to ventilation ratio3:15:115:2Pulse checkUmbilical arteryBrachialcarotidQuestion is a direct pick from the above Table in Nelson. | 154,455 | medmcqa_train |
In a programme, results analyzed in comparison to cost is known is - | - cost effective analysis express the benefits in terms of results achieved rather than monetary terms. - more promising tool for application in the health field. Reference : Park&;s textbook of preventive and social medicine, 23rd edition, pg no:871 <\p> | 154,456 | medmcqa_train |
Medullary chemoreceptors are sensitive to ? | Ans. is 'a' i.e., H+ in CSFThe primary direct stimulus for central chemoreceptors is increased H+ concentration in the CSF and brain interstitial fluid.Central chemoreceptors These receptors are located in a chemosensitive area on the ventral surface of the medulla near the exit of the ninth and tenth cranial nerves. The primary stimulus for the central chemoreceptors is an increase in the hydrogen ion concentration. Stimulation of central chemoreceptors by increased hydrogen ion concentration leads to excitation of the respiratory neurons, thereby producing an increase in the rate and depth of respiration.Although the primary stimulus for central chemoreceptors is an increase in hydrogen ion concentration, in actual practice the physiological stimulus is an increase in PCO2. The reason is that hydrogen ions cannot cross blood - brain barrier. Therefore, a change in the blood hydrogen ion concentration does not change the hydrogen ion concentration in the immediate vicinity of the chemosensitive neurons (i.e., in CSF and brain interstitial fluid). On the other hand, CO2 being lipid soluble can easily cross blood brain barrier. It enters the brain, where it is hydrated to give rise to fr and HCO2- ions. Now these H' directly stimulate the central chemoreceptors.Thus, central chemoreceptors are directly stimulated by an increase in H+ concentration in CSF and brain inerstitial tissue, which is brought about by change in aerial PCO2 (PaCO2). | 154,457 | medmcqa_train |
ELISA is performed on a population with low prevalence. What would be the result of performing double screening ELISA tests - | The specificity of ELISA can be increased by carrying out ELISA in a row (series) using different HIV markers.
When screening test is used in a series mode : -
↑ Specificity
↑ PPV
↓ Sensitivity | 154,458 | medmcqa_train |
A most common complication of lateral condyle humerus fracture - | Amongst the given options, nonunion is the most common complication. | 154,459 | medmcqa_train |
CT scan of the head should be performed before lumbar puncture in all of the following conditions except? | Neuroimaging should be done prior to LP in the following patients: 1. Altered level of consciousness 2. Focal neurological deficit 3. New onset seizure 4. Papilledema 5. Immunocompromised state These patients are at increased risk of potentially fatal cerebellar or tentorial herniation following lumbar puncture. | 154,460 | medmcqa_train |
Which of the following is a vector for Dengue fever? | Aedes aegypti:Principle vector of Dengue virusesAlso an efficient vector of the Yellow fever and Chikungunya virusesBreeds near human habitation, using relatively fresh waterUsually inhabits dwellings and bites during the dayRef: Harrison's 17/e p1230 | 154,461 | medmcqa_train |
Post-transplant cytomegalovirus infection may cause | Overall, 30% of all infections contracted in the posttransplant period are viral. The most common viral infections are DNA viruses of the herpesvirus family and include cytomegalovirus (CMV), Epstein-Barr virus, herpes simplex virus, and varicella zoster virus. CMV infections may occur as either primary or reactive infections and have a peak incidence at about 6-week post-transplant. The classic signs include fever, malaise, myalgia, arthralgia, and leukopenia. CMV infection can affect several organ systems and result in pneumonitis; ulceration and hemorrhage in the stomach, duodenum, or colon; hepatitis; esophagitis; retinitis; encephalitis; or pancreatitis. The risk of developing posttransplant CMV depends on donor-recipient serology, with the greatest risk in seronegative patients who receive organs from seropositive donors. Pyelonephritis, cholecystitis, intraabdominal abscesses, and parotitis are caused by bacterial infections or GI perforation and not primarily by CMV infection. | 154,462 | medmcqa_train |
SIte of bleeding after cataract surgery is | After cataract surgery, posterior ciliary vessels are the common sites of bleeding. Ref AK khurana 6/e p 215 | 154,463 | medmcqa_train |
Rain drop pigmentation is caused by ? | Ans. is 'd' i.e., ArsenicHomosexual | 154,464 | medmcqa_train |
Most common genetic play in Neisseria infection is | Ans. is 'c' i.e., Complement deficiency Complement deficiency and neisserial infections The complement system is an essential component of the innate immune defence against infection by Neisseria (N. Meningitidis and N. gonorrhoeae). People who lack or have a deficiency in complement mediated bactericidal activity are most susceptible to neisserial diseases. Terminal complement component (C5 through C9) deficiencies and deficiencies of the alternative pathway (Properdin, C3,Factor D) have a strong effect on susceptibility to, as well as severity of, neisserial infections. Deficiency of terminal complement (C, - C9) component :- Deficiency of one of the terminal components that compose membrane attack complex (MAC) predisposes patients to infection with Neisseria meningitidis or Neisseria gonorrhoeae. However, N. meningitidis infection is more common. Deficiencies of terminal pathway :- Deficiencies in components of alternative pathway, namely properdin, C3 and factor D, have been associated with increased susceptibility, almost exclusively, to meningococcal infection (amongst Neisseria). | 154,465 | medmcqa_train |
Disease usually not seen in a country but brought from abroad is: | Exotic: Disease usually not seen in a country but brought from abroad. OTHER OPTIONS Zoonotic: A disease which is transmitted to man from animals e.g. Rabies, plague. Epidemic: when disease has exceeded it's normal expectancy. Endemic: Constant or continuous presence of a disease in a population. | 154,466 | medmcqa_train |
Kinky hair desease is disorder where an affected child has peculiar white stubby hair, does not grow, brain degeneration is seen and dies by age of two years. Mrs A is hesitant about having children because her two sisters had sons who had died form kinky hair disease. Her mother's brother also died of the same condition. Which of the following is the possible mode of inheritence in her family - | Ans. is 'a' i.e., X-linked Recessive o The clues in this question are ? Only males are manifesting disease. Females are acting as carriers -3 sisters sons had suffered from the disease. o Both these are features of X-linked recessive disorders. X-linked disorders o Except for a few conditions, all X-linked disorders are X-linked recessive. o As male has only one X-chromosome, the male with affected gene on X-chromosome will always manifest the disease. o On the other hand, female has 2 X-chromosomes, heterozyogous female will be carrier because of expression of normal allel on the other X-chromosome. o Note ---> Female with Turner syndrome (only one 'X' chromosome) can manifest X-linked recessive disorders. o 50% boys of the carrier mother will be affected. o All daughters of affected father will become carrier, i.e. affected father will transmitt the defective X chromosome to all the daughters. o Father will not transmitt the disease to son as boys do not inherit X-chromosome from father. About other options o In X-linked dominant disorder the females will also manifest the disease. o In autosomal dominant and autosomal recessive disorders, both males and females are affected. | 154,467 | medmcqa_train |
Quarantine is related to> | Ans. is 'b' i.e. Maximum incubation period Quarantine - has been defined as The limitation of freedom of movement of such well person or domestic animals exposed to communicable disease for a period of time no longer than the longest usual incubation period of the disease in such a manner to prevent effective contact with those not so exposed. "Also KnowIsolation -- It is the oldest communicable disease control measure.- It is defined as "separation for the period of communicability of infected persons or animals from others, as to prevent or limit the direct or indirect transmissions of the infectious agent from those injected to those who are susceptible, or who may spread the agent to others"In contrast to isolation, quarantine applies to restriction on the healthy contacts of an infectious disease. * | 154,468 | medmcqa_train |
Insulin resistance in liver disease is due to | Refer Robbins page no Insulin resistance is defined as the failure of target tissues to respond normally to insulin. It leads to decreased uptake of glucose ik muscle reduced glycolysis and fatty acid oxidation I'm the liver and inability to suppress hepatic gluconeogenesis | 154,469 | medmcqa_train |
Gastrospleenic ligament is due to peritoneal reflection of which aery ? | Ans. is 'b' i.e., Sho gastric aery | 154,470 | medmcqa_train |
Which of the following antifungal is used in cancer chemotherapy? | Flucytosine is used as a pyrimidine antagonist which is a prodrug and is conveed to 5 FU.Ref: KD Tripathi 7th ed; Pg: 791 | 154,471 | medmcqa_train |
Herbe's pit is seen in: September 2006 March 2013 (c) | Ans. D: Chlamydial conjunctivitis Later structural changes of trachoma are referred to as "cicatricial trachoma". These include scarring in the eye lid (tarsal conjunctiva) that leads to distoion of the eye lid with buckling of the lid (tarsus) so the lashes rub on the eye (trichiasis). These lashes will lead to corneal opacities and scarring and then to blindness. Linear scar present in the sulcus subtarsalis is called Arles line (named after Carl Ferdinand von Arlt). In addition, blood vessels and scar tissue can invade the upper cornea (pannus). Resolved limbal follicles may leave small gaps in pannus (Herbe's Pits). | 154,472 | medmcqa_train |
Blow out fracture of orbit involves | Ans. (c) Inferior wallRef; Kanski 7/e, p. 873Blow out fracture is typically of the orbital floor, it may also involve the medial wall but always as a secondary involvement. | 154,473 | medmcqa_train |
Spring catarrh may be associated with: | Ans. Keratoconus | 154,474 | medmcqa_train |
Drug used in Benign Prostatic Hypertrophy is? | ANSWER: (B) a, antagonistsREF: KDT 7th ed p-135, Goodman and Gillman's 11th ed page 172,173,183 | 154,475 | medmcqa_train |
Ratio of O2 : N2O in Entonox is – | Entonox contain equal amount (50/50) of N2O and O2. | 154,476 | medmcqa_train |
Treatment of Asherman's syndrome is : | D + C with IUCD inseion | 154,477 | medmcqa_train |
All of the following statements regarding disposal of biomedical waste are true, except | Blue bag contents are disposed by autoclaving/microwaving/chemical treatment and destruction shedding.
Yellow bag contains category No. 1, 2, 3, & 6 wastes. Category No 1 contains human anatomical waste (option a is correct)
Red bags are used for disposal of microbiology waste from laboratory cultures, stocks of microorganisms etc (Cat -3) and hence may be a source of contamination.
Black bag contains category No 5, 9 and 10 wastes. Category 9 contains incineration ash which is disposed in multiple landfill (option c is correct.) | 154,478 | medmcqa_train |
Peusis toxin acts by all of the following mechanisms except ? | Ans. is 'c' i.e., Increased calcium release from saroplasmic reticulum Peusis toxin . Peussis toxin is an exotoxin that has A and B subunits. . B subunit binds to the target cells whereas A subunit acts on the target. . First, the peussis toxin itself gets activated by glutathione and ATP. . Once the toxin gets activated it activates cell membrane bound G proteins. . Peussis toxin catalyzes the ADP ribosylation of the G proteins and activates them. . The activated G protein in turn activates adenylate cyclase, this results in an outpouring of cAMP which activates protein kinase and other intracellular messangers. | 154,479 | medmcqa_train |
Drug producing dissociative anesthesia: | Ans: (c) KetamineRef: katzung 9th ed. 1604; KDT 6th ed./376* Ketamine is the only intravenous anesthetic that possesses analgesic properties and produces cardiovascular stimulation.* It causes "dissociative anesthesia" which is characterized by profound analgesia, immobility, amnesia and feeling of dissociation from ones own body and the surrounding.* In addition it also causes:# Hallucination# Delusion and illusion.# Profound analgesia* Ketamine increases all pressures like:# BP (hypertension)# Intracranial tension (ICT)# Intraocular pressure (IOP)* It is contraindicated in intracerebral mass/hemorrhage.About Ketamine: (Remembered as:)KKids: can be given to kidsEEmergence reaction: s/e occurring during recoveryTThalamo-cortical junction affected: Dissociative AnesthesiaAAnalgesia strongestMMeal: can be given with full stomachIIncrease: BP/IOP/ICTNNMDA receptor blockerEExcellent bronchodilator: inducing agent of choice in asthma patient.Also Kno* PROPOFOL causes myocardial depression and fall in BP. | 154,480 | medmcqa_train |
All is true about pseudocyesis except: | Patient is not pregnant is pseudocyesis. Though she falsely believes that and there are also associated changes suggestive of pregnancy. Pseudocyesis False pregnancy There is development of classical symptoms of pregnancy like: Abdominal enlargement Amenorrhea Subjective sense of fetal movements Breast engorgement Labour pains at expected date of delivery Extra edge: Couvade Syndrome In this syndrome, the paner of the pregnant woman repos that he is experiencing some of the symptoms of pregnancy, complaining of nausea, morning sickness, and often of toothache. These complaints generally resolve after a fewweeks. | 154,481 | medmcqa_train |
Injury that comes under sec 320 IPC | B i.e. Nasal bone fracture | 154,482 | medmcqa_train |
Massive bleeding per rectum in a 70 yr old patient is due to : | Answer is A (Diveiculosis) Although anorectal disease is the most commonm cause of bleeding per rectum in the elderly, these lesions usually cause small amount of 'bright red' blood on the surface of stool and toilet tissue (small bleeds). Diveiculosis may give rise to massive colonic bleed. The usual presentation of diveicular hemorrhage is that of brisk painless passage of a maroon coloured stool. It is the most common cause of massive bleeding per rectum in those above 55 years of aze and hence the answer here. Angiodysplasias and diveiculosis were the most common reasons for LGIB Common causes of Acute Lower G.I. bleeding over 55 years of age are : Anorectal disease : Haemorrhoids and fissures Diveiculosis Angiodysplasia Polyps and Cancer Enterocolitis | 154,483 | medmcqa_train |
Main recommendation of Jungalwalla committe? | Ans. is 'd' i.e., Integration of health services Health Planning in India The guide lines for national health planning were provided by a number of committees. These committees were appointed by the Government of India from time to time to review the existing health situation and recommend measures for fuher action. | 154,484 | medmcqa_train |
Which of the following drugs is not used for the therapy of congenital adrenal hyperplasia? | Ans. C. AntibioticsPatients with congenital adrenal hyperplasia require lifelong treatment. Patients with salt wasting and virilizing forms should be treated with hydrocortisone and fludrocortisone. After completion of growth, synthetic glucocorticoid preparations (dexamethasone, prednisolone) can be used. | 154,485 | medmcqa_train |
The treatment of congenital glaucoma is- | Ans. is 'c' i.e. Trabeculectomy with trabeculectomy Treatment of congenital glaucoma:Treatment of congenital glaucoma is primarily surgical. However I.O.P. must be lowered by the following agents till surgery is doneHyper osmotic agentsAcetazolamideb Blockers Surgical procedures: -GoniotomyTrabeculectomyCombined trabeculectomy and trabeculectomy - It is now the preferred surgery with better resultsCongenital glaucoma has been discussed in detail in earlier papers. | 154,486 | medmcqa_train |
The commonest site for extragonadal germ cell tumor | Reference Robbins page no 475 Extragonadal germ cell tumors form from developing sperm or egg cells that travel from the gonads to other pas of the body. ... These are more common than malignantextragonadal germ cell tumors and often are very large. Malignant extragonadal germ cell tumors are divided into two types, nonseminoma and seminoma In adults, the mediastinum is the most common extragonadal site for the development of germ cell tumors.229-233 The most common tumor in this site is mature teratoma.234 This diagnosis can be suggested by the presence of a large circumscribed anterior mediastinal mass with normal serum HCG and a-fetoprotein. Management of mature teratoma is surgical, and there is no role for chemotherapy or radiotherapy. Although these tumors histologically are benign, removal is often difficult. The tumors are commonly adherent to adjacent structures, such as the pericardium, lung, and great vessels. | 154,487 | medmcqa_train |
Drug which is useful for the diagnosis of myasthenia gravis is? | The two types of weakness require opposite treatments. They can be differentiated by edrophonium test. | 154,488 | medmcqa_train |
The transition from G2 to M phase is controlled by | The cell cycle is regulated by activators and inhibitors. Cell cycle progression is driven by proteins called cyclins. cyclin D-CDK4, cyclin D-CDK6, and cyclin E-CDK2 regulate the G1-to-S transition by phosphorylating the Rb protein (pRb). Cyclin A-CDK2 and cyclin A-CDK1 are active in the S phase. Cyclin B-CDK1 is essential for the G2-to-M transition.Reference: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Chapter 1; The Cell as a Unit of Health and Disease | 154,489 | medmcqa_train |
Which feature is MOST helpful in distinguishing dementia from severe depression? | Somatic complaints such as anorexia, weight loss and headache are features of both conditions, though more prominent in patients with depression. The behavioural and cognitive functions are affected in both conditions. Poor concentration, poor attention span, poor memory and social withdrawal are encountered in both. Grasp reflex and other primitive reflexes indicate neuronal loss in the frontal lobe, which does not occur in depression. A positive response to antidepressant treatment is a reliable sign in our of depression | 154,490 | medmcqa_train |
Middle ear effusion with intact eardrum gives rise to which type of tympanogram? | Type B tympanogram is flat in appearance, indicating lack of compliance. The volume measurement that is simultaneously performed with tympanometry helps to differentiate between a flat tympanogram suggesting an intact eardrum with middle ear effusion and a perforated eardrum or patent ventilating tube. | 154,491 | medmcqa_train |
Modified Kastenbaum surgery is done for | Modified Kastenbaum Surgery *Recession resection of all four horizontal recti is done according to the type and amount of nystagmus | 154,492 | medmcqa_train |
Direct standardization is used to compare the moality rates between two countries. This is done because of the differences in: | Age distributions !Ref. Park 20/e, p 55,56 (19/e, p 54, I8/e, p 53)] Repeat from May 06 & Nov 06 Because of the differences in age distribution of two populations, their moality experience could not be compared by using 'crude death rate', as it lead to wrong impression. A population (say population A) with more young people would have low crude death rate than a population (population B) with more old people, thus giving an impression that population A is healthier than B, which may not be so. This confounding effect of age is removed by means of 'standardization'. | 154,493 | medmcqa_train |
A 2-day-old newborn male develops mild cyanosis. An ultrasound examination reveals a patent ductus arteriosus. Which of the following infections will most likely lead to this congenital anomaly? | Congenital heart defects are common problems that can be caused by teratogens, such as the rubella virus, or single-gene factors or chromosomal abnormalities. | 154,494 | medmcqa_train |
Separation of first polar body occurs at the time of: September 2007, March 2012 | Ans. B: Ovulation Asymmetrical cell division (cytokinesis) leads to the production of polar bodies during oogenesis. To conserve nutrients, the majority of cytoplasm is segregated into either the secondary oocyte and, or ovum, during meiosis I or meiosis II, respectively. The remaining daughter cells generated from the meiotic events contain relatively little cytoplasm and are referred to as polar bodies. Eventually, the polar bodies degenerate. There may be one or two polar bodies in the ovum. The first polar body is one of the two products in the first stage of meiosis, just before ovulation and is considered diploid, with 23 duplicated chromosomes. The second polar body is haploid, with 23 unduplicated chromosomes and is produced only when a sperm penetrates the oocyte. | 154,495 | medmcqa_train |
According to ADA specification #1 for amalgam, what is the acceptable dimensional change? | According to ADA specification #1 for amalgam, the acceptable dimensional change is -20 to +20 micron/cm.
Reference: Marzouk Operative dentistry, pg-108 | 154,496 | medmcqa_train |
Most common complication of intertrochanteric fracture femur is:(NEET 2013; WB 1999; AI 1998, 1988; DELHI 1997) | (a) Malunion- Most common complications of intracapsular fracture -AVN followed by non-union.- Most common complication of extracapsular fracture - Malunion. | 154,497 | medmcqa_train |
The parasympathetic secretomotor fibres to parotid traverse through all of the following, EXCEPT: | The parasympathetic secretomotor fibres to parotid arises from the glossopharyngeal nerve. The nerve reaches the gland tympanic branch, the lesser petrosal nerve, the otic ganglion and the auriculotemporal nerve. Course of the nerve: Preganglionic parasympathetic fibers originate from inferior salivary nucleus in the medulla oblongata and are carried in the glossopharyngeal nerve. These fibers leave the glossopharyngeal nerve in its tympanic branch, which enters the middle ear. Here it breaks into tympanic plexus which gives origin to lesser petrosal nerve. This nerve enters the middle cranial fossa from where it enters infratemporal fossa to terminate in otic ganglion. Postganglionic fibres join the auriculotemporal nerve which provide secretomotor fibers to parotid gland. Ref: Clinical Anatomy By Regions By Richard S. Snell, 7th Edition, Page 787; Neurological Differential Diagnosis By John Patten, 2nd Edition, Page 66; Clinical Anatomy (A Problem Solving Approach) By Kulkarni, 2nd Edition, Page 341 | 154,498 | medmcqa_train |
On thyroid function test, TSH value is raised and
t4 value is decreased. Referred diagnosis is | IF TSH raised ans T4 is decreased then its primary.
IF both are decreased then its secondary. | 154,499 | medmcqa_train |
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