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Landau-Kleffner syndrome is characterized by all of following except | Ans. C. Normal EEG during sleep Ref : Nelson Textbook of Pediatrics 20th/ed p2837ExplanationLandau-Kleffner syndrome is a condition of unknown cause characterized by:# Loss of language skills attributed to auditory agnosia in a previously normal child# Seizures (focal, generalized tonic-clonic, atypical absence, partial complex, and, occasionally, myoclonic seizures).# High-amplitude spike-and-wave discharges ON EEG which are always more apparent during non-rapid eye movement sleep; thus, a child in whom Landau-Kleffner syndrome is suspected should have an EEG during sleep, particularly if the awake record is normal.# CT and MRI studies typically yield normal results. | 155,500 | medmcqa_train |
Nicotinic acid ? | Ans. is 'a' i.e., Increases HDL Nicotinic acid (Niacin) There arc three main type of lipases related to metabolism of lipoproteins ? Lipoprotein lipase - Present in blood vessels and causes hydrolysis of tryglyceride content of VLDL and chylomicrones. Hepatic lipase - Conves IDL to LDL by hydrolysing the triglyceride content of IDL. Hormone sensitive lipase - Present intracellularly in peripheral tissue and causes intracellular lipolysis by hydrolysing triglycerides. Niacin (Nicotinic acid) inhibits intracellular lipolysis by inhibiting hormone sensitive lipase - intracellular FFA to liver - 4 .1, triglyceride synthesis. Niacin also increases the activity of lipoprotein lipase - T hydrolysis of VLDL triglyceride. Nicotinic acid also reduces the production of VLDL in liver by inhibiting TG-synthesis - indirectly the VLDL degradation products IDL and LDL are also reduced. Nicotinic acid is the most effective drug to raise HDL-CH. Increased HDL is due to interference of direct pathway of HDL cholesterol to liver which involves apo-Ai - Niacin decreases apo- A, mediated hepatic clearance. Nicotinic acid is used in type I, III, IV & V hyperlipoproteinemias. | 155,501 | medmcqa_train |
Circulus aeriosus iridis major is formed by the anastomosis of | Anterior ciliary aeries: These are derived from the muscular branches of ophthalmic aery. These aeries pass anteriorly in the episclera, give branches to sclera, limbus and conjunctiva; and ultimately pierce the sclera near the limbus to enter the ciliary muscle; where they anastomose with the two long posterior ciliary aeries to form the circulus aeriosus major, near the root of iris. Reference :- A K KHURANA; pg num:-136 | 155,502 | medmcqa_train |
A 20 year old patient presents with syncope. His current ECG is shown below. His elder brother had died suddenly while watching television. The patient was given Cardioversion and subsequent cardiac MRI revealed fibro-fatty changes in RV myocardium. What is the diagnosis of this patient? | Arythmogenic RV dysplasia(ARVD) ECG shows HR of 300/min with broad complex tachycardia. Variation in amplitude of QRS complexes which indicates a diagnosis of polymorphic Ventricular Tachycardia. In acute setting DC shock 200 J Biphasic should be given. The Cardiac MRI repo showing fibro-fatty changes in RV myocardium explains that the substrate for initiation of Polymorphic VT is originating from RV. This confirms the diagnosis as Arythmogenic RV dysplasia(ARVD) ECG - Presence of Epsilon wave. | 155,503 | medmcqa_train |
Most common phase I biotransformation reaction is? | Ans. is 'a' i.e., Oxidation Oxidation is the most impoant metabolizing reaction. | 155,504 | medmcqa_train |
Sulfasalazine is used in - | Ans. is 'a' i.e., Ulcerative colitis Inflammatory bowel disease (crohn's disease & ulcerative colitis)o 5-aminosalicylic acid (5-ASA) is the main anti-inflammatory compound that acts locally in colon. It is the first line of treatment in mild to moderate UC and CD. When given alone 5-ASA is absorbed > 80% in proximal intestine and very little reaches upto colon. To decrease the absorption it may be associated with some innert compound.o Sulfasalazine (5-AS A + sulfapyridine), olsalazine (ASA+ASA) and balsalazide (5-AS A + aminobenzoylalanine) are effective in ulcerative colitis.o Different formulations of 5-ASA have been developed to deliver it to colon, called mesalamine.o Other drugs used in IBD are :-1. Glucocorticoids - They are used only for remission of U.C. and have no role in maintenance therapy.2. Purine analogues (Azathioprine, 6-MP) - Can be used for the induction and maintenance of remission of U.C. and C.D.3. Methotrexate - Can be used in CD, but has no use in U.C.4. Anti TNF-a (Infliximab, adalimumab, certolizumab, etanercept) - Can be used in CD.5. Cyclosporine - Used in severe U.C., which is refractory to glucocorticoids.6. Anti-Integrin therapy (Natalizumab) is recently approved for moderate to severe Crohn's disease not responding to other therapies. It is targeted against a4 subunit of integrins. The patient on natalizumab therapy should not be given other immunosuppressants due to risk of progressive multifocal leukoencephalopathy. | 155,505 | medmcqa_train |
Kaposi sarcoma is caused by: March 2013 | Ans. C i.e. HHV 8 Kaposi sarcoma (KS) It is a tumor caused by Human herpesvirus 8 (HHV8), also known as Kaposi sarcoma-associated herpesvirus (KSHV). It was originally described by Moritz Kaposi , a Hungarian dermatologist practicing at the University of Vienna in 1872. It became more widely known as one of the AIDS-defining illnesses in the 1980s. Kaposi's sarcoma (KS) is a systemic disease that can present with cutaneous lesions with or without internal involvement. Four subtypes have been described: - Classic KS, affecting middle aged men of Mediterranean descent; - African endemic KS; KS in iatrogenically immunosuppressed patients; and - AIDS-related KS. Classic KS tends to be indolent, presenting with erythematous or violaceous patches on the lower extremities. African endemic KS and AIDS-related KS tend to be more aggressive. The AIDS-related KS lesions often rapidly progress to plaques and nodules affecting the upper trunk, face, and oral mucosa. The diagnosis can be made with a tissue biopsy and, if clinically indicated, internal imaging should be done. | 155,506 | medmcqa_train |
All of the following are examples of microdeletion syndromes, EXCEPT: | The term contiguous gene syndrome refers to genetic disorders that mimic a combination of single-gene disorders. They result from the deletion of a small number of tightly clustered genes. Because some are too small to be detected cytogenetically, they are termed microdeletions. The application of molecular techniques has led to the identification of at least 18 of these microdeletion syndromes. Some of the more common ones include the Wilms' tumor-aniridia complex (WAGR), Miller Dieker syndrome (MDS), and velocardiofacial (VCF) syndrome. WAGR is characterized by mental retardation and involvement of multiple organs, including kidney (Wilm's tumor), eye (aniridia), and the genitourinary system. Ref: Harrison's principle of internal medicine 17th edition, chapter 64. | 155,507 | medmcqa_train |
All are true for PTSD except | D i.e. Anxiolytic is treatment of choice | 155,508 | medmcqa_train |
Which of the following is true regarding Pneumothorax? | Spontaneous pneumothorax in most patients occurs from the rupture of blebs and bullae. Primary spontaneous pneumothorax (PSP) is typically observed in tall, young people without parenchymal lung disease and is thought to be related to increased shear forces in the apex. Secondary spontaneous pneumothoraces (SSP) occur in the presence of lung disease, primarily in the presence of COPD. Other diseases that may be present when SSPs occur include tuberculosis, sarcoidosis, cystic fibrosis, malignancy, and idiopathic pulmonary fibrosis. Chest tube drainage is the treatment of choice. | 155,509 | medmcqa_train |
'Herald patch' is seen in: | Ans. A. Pityriasis rosea. (Ref. Harrison's 18lh/pg. 367)In Pityriasis rosea, initially, there is a single 2- to 6-cm annular salmon-colored patch (herald patch) with a peripheral rim of scale, followed in days to weeks by a generalized eruption involving the trunk and proximal extremities.Pityriasis rosea:# It is an acute, self-limiting skin condition. A primary plaque ('herald patch') is followed by a distinctive, generalized itchy rash 1-2 weeks later. The rash lasts for approximately 2-6 weeks. Lesions are typically oval, dull pink or tawny and appear in a 'Christmas tree' distribution, usually on the trunk and the upper arms and legs.# It is thought that human herpes viruses 6 and 7 may play a role in etiopathogenesis. Some drugs, eg bismuth, barbiturates, captopril, gold, metronidazole, D-penicillamine and isotretinoin occasionally cause a drug-induced pityriasis rosea.# Pityriasis rosea is a self-limiting disease, and treatment is supportive.# Exposure to sunlight is helpful.# Topical zinc oxide and calamine lotion are useful for pruritus.# Pruritus can also be treated with topical corticosteroids, oral antihistamines or antipruritic lotions.# Oral erythromycin may be effective in treating the rash and decreasing the itch.- Pityriasis alba is an uncommon feature of atopic dermatitis that presentsin children and adolescents. Light- coloured skin spots also occur in pityriasis alba (slightly scaly, on skin exposed to the light), Gibert's pityriasis rosea, pityriasis versicolor (Gr. "pityron" = bran; refers to the light skin scaliness). Pityriasis versicolor is a very common skin infection with a fungus: Pityrosporum ovale (yeast stage) or Malassezia furfur (mycelium stage). This lipophilic fungus forms the tyrosinase inhibitor azelaic acid from sebaceous fats, a substance which inhibits melanin synthesis. This explains the white appearance of the skin spots. Account must be taken of the fact that depigmented skin spots can also be caused by damage to the melanocytes (pigment cells) after an ordinary infection, wound or bum (post-inflammatory hypopigmentation), due to vitiligo (the texture of the skin with this condition is otherwise normal), as a residual lesion in endemic treponematosis and syphilis (the differential diagnosis is often difficult here). It is important to know that people with leprosy often have a false positive VDRL (screening for syphilis). TPHA permits differentiation.Pityriasis rubra pilaris (also known as "Devergie's disease,"or "Lichen ruber acuminatus," and "Lichen ruber pilaris"refers to a group of chronic disorders characterized by reddish orange, scaling plaques and keratotic follicular papules. Symptoms may include reddish-orange patches (Latin: rubra) on the skin, severe flaking (Latin: pityriasis), uncomfortable itching, thickening of the skin on the feet and hands, and thickened bumps around hair follicles. | 155,510 | medmcqa_train |
A 34-year-old man is brought to the emergency room by his family because of extreme lethargy. After further questioning, he admits to taking a large number of phenobarbital tablets. Which of the following is the most appropriate next step in management? | Activated charcoal absorbs barbiturates very effectively and is useful in decontamination of the GI tract. Renal elimination of phenobarbital is enhanced by alkalinization of the urine to a pH of 8 with sodium bicarbonate and fluids. Hemodialysis and hemoperfusion are reserved for extreme cases with refracting hypotension. Short-acting barbiturates are metabolized in the liver, so fluid administration and alkalinization are not helpful. | 155,511 | medmcqa_train |
Degree of freedom for 2/2 contingency table is? | Ref: Parks 23rd edition Degree of freedom = (r-1)(c-1) =(2-1)(2-1)= 1 | 155,512 | medmcqa_train |
Most common cause of lobar hemorrhage in the elderly | Answer- C. Amyloid angiopathyLobar intracerebral hemorrhage is bleeding in the largest pa of the brain called the cerebrum.Intracerebral hemorrhage are attributed to hypeensive vasculopathy in small penetrating brain aeries and subcoical vessels in patients with amyloid angiopathy.Amyloid angiopathn a chronic deposition of congophilic rnaterial in brain vessels, is the most common cause of lobar hemorrhage in older patients. | 155,513 | medmcqa_train |
Which of the following is not true about spasmodic dysphonia | SPASMODIC DYSPHONIA Spasmodic dysphonia is also called as laryngeal dysphonia. The condition is characterised by spasm of phonatory muscles. It is a neurological disorder and is of following types: (A) Adductor spasm (M/C):- Adductor muscles go into spasm lead ing to strained and strangled voice (scratchy creaky voice). Management :- Botulinum toxin injection in thyroarytenoid muscle. (B) Abductor spasm:- Abductor muscles go into spasm. Vocal cords are unable to abduct leading to leakage of air during speech. The voice is breathy or whispery. Management :- Botulinum toxin injection in posterior cricoarytenoid muscle. Ref:- Dhingra; pg num:-314 | 155,514 | medmcqa_train |
Which of the following organism is biggest ? | Ans. is 'a' i.e., Balantidium coli | 155,515 | medmcqa_train |
Drug producing haematological side effect is: | Ans: A (Nitrous oxide) Ref: Ajax Yadav, Short Textbook of Anesthesia, 1st edition, pg 59.Explanation:Nitrous oxide produces Aplastic anemia and Megaloblastic anemiaNITROUS OXIDE (LAUGHING GAS)Stored as liquid in blue color cylinderE5 times more heavier than air35 times more soluble than nitrogenAnesthetic propertiesIt is not a complete anesthetic.It is used as a carrier gas to other anestheticsMAC is 104% (It is not possible to deliver, so not a complete anesthetic).Maximum concentration which can be given is 66%.A minimum of 33% of Oxygen has to be given (Otherwise can cause severe hypoxia)It is usually given as N20 66% and 02 33% mixtureBlood gas coefficient is 0.47 making it agent w ith faster induction and recoveryGood analgesicNot a muscle relaxantWhen given with other inhalational agent, it increases the concentration of that agent (Second gas effect) and also its own concentration (Concentration effect)Sudden stoppage can lead to Diffusion Hypoxia (Should always be tapered slowly by giving 100% oxygen)MetabolismIt is not metabolized in human body.It is excreted unchanged in lungsSmall amount is excreted via skin (Percutaneous excretion)Impurities in N20 cylinder can cause severe laryngospasm, methhemoglobinemia and Pulmonary edemaSystemic ActionsCVS: It does not depress the myocardium in vivo, so it can be safely used in patients with cardiac disease and shockCNS: It increases cerebral metabolic rate and raises intra cranial tensionRS: It causes tachypnea and decrease tidal volume, maintaining minute volumeVentilatory response to hypoxia is bluntedNo significant effect on Liver and KidneysSide EffectsHematological: It inactivates vitamin B12 (If used for >6 hours) - defective folate metabolism - Bone marrow depression - Aplastic anemia and Megaloblastic anemiaCNS: Vitamin B 12 deficiency can cause Demyelination of spinal cord (Subacute degeneration of spinal cord) especially involving posterior columns and lateral spinothalamic tractsClosed Gas Spaces: Compliant spaces like gut. penumoperitoneum, pneumothorax and non- compliant spaces like middle ear cavity, pneumoencephalum can develop very high pressure following nitrous oxide inhalation.This happens because for I mole of nitrogen removed. 35 moles of nitrous oxide enter (35 times more soluble than nitrogen.Therefore, Nitrous oxide is contraindicated inPneumothoraxPneumoperitoneumPneumoencephalumMiddle ear surgeryPosterior fossa surgeryLaproscopic surgeryAcute intestinal obstruction and volvulus of gutEye surgeriesUses in AnesthesiaAs a supplement to anesthesia (not a complete anesthetic)As a carrier gas for inhalational agentsAs analgesic in obstetrics, dental pain, burn dressing and acute trauma | 155,516 | medmcqa_train |
A patient presents with endocrinopathy. fibrous dysplasia of bone and hyperpigmentation. What should be the possible diagnosis? | Mc Cune Albright syndrome is a triad of Precocious puberty (endocrinopathies) fibrous dysplasia, cafe-au-lait spots. | 155,517 | medmcqa_train |
Paneth cells characterized by | Paneth cells are zinc-containing cells widely distributed in Lieberkuhn's crypts of small intestine in many species, but their function has remained obscure. Our previous study showed that a single intravenous injection of diphenylthiocarbazone (dithizone), a zinc chelator, forms zinc-dithizonate complexes in the cytoplasm of Paneth cells to ensure rapid and selective killing of the cells. REFERENCELE nih.gov | 155,518 | medmcqa_train |
The following drug has significant drug interaction with the digoxin except | Cholistyramine inhibits intestinal absorption of digoxin Thiazides result in hypokalemia and thus me precipitate digitalis toxicity by pharmacodynamic interaction Quinidine and verapamil reduces the excretion of digoxin and Thus may precipitate the toxicity(pharmakokinetic interaction) Refer kDT 6/e p499 | 155,519 | medmcqa_train |
Acute cholinesterase inhibitors intoxication include all of the following except | Cholinesterase inhibitors have cholinomimetic actions. The major source of such intoxications is pesticide use in agriculture.The dominant initial signs are those of muscarinic excess: miosis, salivation, sweating, bronchial constriction, vomiting, and diarrhea. Central nervous system involvement (cognitive disturbances, convulsions, and coma) usually follows rapidly, accompanied by peripheral nicotinic effects, especially depolarizing neuromuscular blockade.Katzung 13e pg:118 | 155,520 | medmcqa_train |
Calcium is absorbed from: | All the divalent cations, except Mg++ , are absorbed from duodenum. Mg++ is absorbed from ileum. Calcium is absorbed mainly in duodenum and upper jejunum, not whole of jejunum. | 155,521 | medmcqa_train |
A 62-year-old childless woman noticed a blood-tinged vaginal discharge twice during the past month. Her last menstrual period was 10 years ago. Bimanual pelvic examination shows that the uterus is normal in size, with no palpable adnexal masses. There are no cervical erosions or masses. Her body mass index is 33. Her medical history indicates that for the past 30 years she has had hypertension and type 2 diabetes mellitus. An endometrial biopsy specimen is most likely to show which of the following? | Postmenopausal vaginal bleeding is a red flag for endometrial carcinoma. Such carcinomas often arise in the setting of endometrial hyperplasia. Increased estrogenic stimulation is thought to drive this process, and risk factors include obesity, type 2 diabetes mellitus, hypertension, and infertility. Choriocarcinomas are gestational in origin. A submucosal leiomyosarcoma could produce vaginal bleeding, but the uterus would be enlarged because leiomyosarcomas tend to be large masses. Malignant mullerian mixed tumors are much less common than endometrial carcinomas, but they could produce similar findings. Malignant mullerian mixed tumors are typically uterine neoplasms that have glandular and stromal elements; the malignant stromal component can be heterologous and may resemble mesenchymal cells that are not ordinarily found in the myometrium, such as cartilage. Squamous carcinomas of the endometrium are rare, and more likely to arise in the cervix. | 155,522 | medmcqa_train |
Aquaporin deficiency cause? | 1. Nephrogenic diabetes insipidus: Aquaporin 2" gene mutation impede the normal functionality of the kidney water channel, which results in the kidney being unable to absorb water. Autosomal recessivemanner. 2. Liddle syndrome: Gain of function of epithelial Na channel (ENaC) 3. Bater syndrome:- Defect in "Na-K-2Cl cotranspoer, Cl channel & ROMK" in loop of Henle. 4. Gitelman syndrome: Defect in "Na+-Cl- cotranspoer and TRPM6 transpoer" in DCT. | 155,523 | medmcqa_train |
Sonographic criteria for diagnosing PCOD includes all except | Presence of 12 or more cysts on ultrasound is diagnostic of PCOD. | 155,524 | medmcqa_train |
Letrozole belongs to which group? | Ans. is 'd' i.e., Aromatase inhibitors Aromatase inhibitorso Aromatase inhibitors are drugs which inhibit the enzyme Aromatase.o Aromatase is an enzyme responsible for the conversion of testosterone (androgens) to estrogens.o This conversion of androgens to estrogens occur in several tissues including ovary, adrenal cortex, peripheral tissues.o Inhibition of Aromatase leads to decrease in estrogen level.o Aromatase inhibitors prevent the conversion of androgens to estrogens only in postmenopausal women, not in premenopausal women.o In premenopausal women, as the level of estrogens decrease it activates the pituitary hypothalamic axis. Activation of pituitary hypothalamic axis leads to increased secretion of pituitary gonadotropins. The pituitary gonadotropins inturn increase the secretion of estrogens. Thus the estrogen level returns back to their normal level.o On the other hand aromatase inhibitors effectively decrease the secretion of estrogen in postmenopausal women.o In postmenopausal women, the production of estrogen from androgens occurs, only in extraovarian sites such as peripheral tissues where the conversion of androgens to estrogens is blocked by aromatase inhibitors.Use of aromatase inhibitorso Aromatase inhibitors are used in the t/t of Hormone receptor positive breast carcinomas in postmenopausal women. They are not effective in premenopausal women.How are Aromatase inhibitors useful in Breast carcinomas ?o In breast carcinomas, estrogen delivers growth signals to the hormone receptors. The hormone receptors upon receiving the growth signals, cause the proliferation of tumor cells,o After the inhibition by aromatase inhibitors, estrogen level decreases, this leads to lesser delivery of growth signals and in turn lesser proliferation of tumor cells.Aromatase inhibitors are of two types :o Type I (steroidal) aromatase inhibitor - They cause irreversible inhibition of aromatase, e.g. Exmestane. formestane.o Type II (non-steroidal) aromatase inhibitor - They cause reversible inhibition of aromatase e.g. Anastrazole, Letrozole, vorozale.o Above classification is based on chemical structure (steroidal or non-steroidal ) and type of inhibition (reversible or irreversible). Based on the evolution the aromatase inibitors are:First generation - AminoglotethimideSecond generation - Steroidal type I(Example, formestane), non-steroidal type II (Anastrazole, Letrozole, Vorozole, fadrozole)o Side effects - Hot flushes, nausea, diarrhoea, dyspepsia, thinning of hair and Joint Pain (Arthralgia) and increased risk of fracture.o There is no endometrial proliferation (no risk of endometrial carcinoma), no risk of venous thromboembolism and no deterioration of lipid profile.Remembero Anastrozole and letrozole are nonsteroidol compound, while exemestane is steroidol.o Exemestane also has weak androgenic activity',o Anastrozole is more potent than letrozole.o First generation aromatase inhibitors - Aminoglutethimide.o Second generation aromatase inhibitors - Letrozole, anastrozole, fadrozole and exemestone. | 155,525 | medmcqa_train |
CAD predisposing factors-a) Homocysteinemiab) ↓ Lipoprotein Bc) ↑ Fibrinogend) ↑ HDLe) ↑ plasminogen activator inhibitors 1 | Homocysteine and Prothrombotic (↑ fibrinogen and ↑ plasminogen activator inhibitors) factors are emerging risk factors for atherosclerosis and coronary heart disease. | 155,526 | medmcqa_train |
Drug of choice for prophylaxis of acute mountain sickness is? | DOC for acute mountain sickness are Carbonic anhydrase inhibitors like Acetazolamide. BEST treatment is to descent down because it occurs due to decreased pO2 at high altitudes. DOC for motion sickness is Hyoscine. | 155,527 | medmcqa_train |
In modern day obstetrics, most common cause of rupture uterus is - | Ans. is 'b' i.e., Previous LSCS scar rupture * Disruption in the continuity of all uterine layers: endometrium, myometrium and serosa anytime beyond 28 weeks of pregnancy is called rupture of uterus.Incidence* 1 in 2000 to 1 in 200 deliveries. Rupture uterus from obstructed labor is becoming less because of improved obstetric care, but prevalence of scar rupture is increased because of increase in LSCS rates.Etiology* Rupture of previous LSCS scar during VBAC is one of the commonest cause of rupture uterus today.* Spontaneous (intact or unscarred uterus)* Scar rupture* Iatrogenic.* LSCS scar generally ruptures in labor (mainly in second stage or towards end of first stage) and unlikely to rupture during pregnancy.* Iatrogenic rupture is mainly due to injudicious use of oxytocin or prostaglandins (for induction or augmentation of labor) and very very rarely due to Internal Podalic Version and destructive operations as they are not performed in modern day obstetrics. | 155,528 | medmcqa_train |
A child develops non blanching macules and papules on lower extremities, mild abdominal pain and skin biopsy showed IgA deposition. Most appropriate diagnosis is - | Henoch-Schonlein purpura (HSP), also known as IgA vasculitis, is a disease of the skin, mucous membranes, and sometimes other organs that most commonly affects children. In the skin, the disease causes palpable purpura (small, raised areas of bleeding underneath the skin), often with joint pain and abdominal pain. With kidney involvement, there may be a loss of small amounts of blood and protein in the urine (hematuria and proteinuria), but this usually goes unnoticed; in a small propoion of cases, the kidney involvement proceeds to chronic kidney disease. HSP is often preceded by an infection, such as a throat infection HSP is a systemic vasculitis (inflammation of blood vessels) and is characterized by deposition of immune complexes containing the antibody immunoglobulin A (IgA); the exact cause for this phenomenon is unknown. In children, it usually resolves within several weeks and requires no treatment apa from symptom control but may relapse in a third of cases and cause irreversible kidney damage in about one in a hundred cases. In adults, the prognosis is different from in children. The average duration of cutaneous lesions is 27.9 months.For many, it tends to be relapsing-remitting over a long period of time, rather than self-limiting and there tend to be more complications sogns and symptoms: Purpura, ahritis, and abdominal pain are known as the "classic triad" of Henoch-Schonlein purpura. Purpura occur in all cases, joint pains and ahritis in 80%, and abdominal pain in 62%. Some include gastrointestinal hemorrhage as a fouh criterion; this occurs in 33% of cases, sometimes, but not necessarily always, due to intussusception. The purpura typically appear on the legs and buttocks, but may also be seen on the arms, face and trunk. The abdominal pain is colicky in character, and may be accompanied by nausea, vomiting, constipation or diarrhea. There may be blood or mucus in the stools.The joints involved tend to be the ankles, knees, and elbows, but ahritis in the hands and feet is possible; the ahritis is nonerosive and hence causes no permanent deformity.Foy percent have evidence of kidney involvement, mainly in the form of hematuria (blood in the urine), but only a quaer will have this in sufficient quantities to be noticeable without laboratory tests. Problems in other organs, such as the central nervous system (brain and spinal cord) and lungs may occur, but is much less common than in the skin, bowel and kidneys. Of the 40% of patients who develop kidney involvement, almost all have evidence (visible or on urinalysis) of blood in the urine. More than half also have proteinuria (protein in the urine), which in one eighth is severe enough to cause nephrotic syndrome (generalised swelling due to low protein content of the blood). While abnormalities on urinalysis may continue for a long time, only 1% of all HSP patients develop chronic kidney disease. Hypeension (high blood pressure) may occur. Protein loss and high blood pressure, as well as the features on biopsy of the kidney if performed, may predict progression to advanced kidney disease. Adults are more likely than children to develop advanced kidney disease ref Harrison20th edition pg 2134 | 155,529 | medmcqa_train |
Not true about iodophores ? | Ans. is 'a' i.e., Inorganic compounds Iodine Iodine is more sporicidal than chlorine. Iodine is often used in aqueous and alcoholic solution as skin disinfectant. Aqueous and alcohol based povidone iodine preparations (Betadine) are best and safe skin disinfectants (antiseptics). Iodophores are organic compounds that slow the release of iodine. The iodophores additionally serve as surfactants, thus increasing penetration while simultaneous steadily supplying iodine over long periods. So, iodophores are more active. | 155,530 | medmcqa_train |
Giant cells seen in Measles are called? | Lymphoid organs typically have marked follicular hyperplasia, large germinal centers and randomly distributed multinucleated giant cells called Wahin-Finkeldey cells, which have eosinophilic nuclear and cytoplasmic inclusion bodies.Found in the paracoical region of hyperplastic lymph nodes in some patients of measles and AIDS. It consists of fused lymphocytes and can be seen in a lymph node biopsy after a measles vaccination.Ref: Robbins Pathology, 7th Ed, page 363 | 155,531 | medmcqa_train |
The term anisometropia indicates | Ans. Refractive error | 155,532 | medmcqa_train |
A 40-year-old man presents to casualty with history of regular and heavy use of alcohol for 10 years and morning drinking for one year. The last alcohol intake was three days back. There is no history of head injury or seizures. On examination, there is no icterus, sign of hepatic encephalopathy or focal neurological sign. The patient had coarse tremors, visual hallucinations and had disorientation to time. Which of the following is the best medicine to be prescribed for such a patient: March 2013 (e) | Ans. A i.e. Diazepam | 155,533 | medmcqa_train |
The features of uterine contraction in spastic lower segment are all except | Fundal dominance ,which indicates that the intensity is strongest ath the fundus,(not at the lower segment) with a gradual decrease downwards. Refer page no 109 of Text book of obstetrics ,sheila balakrishnan,2 nd edition. | 155,534 | medmcqa_train |
10 year old child with posterior fossa mass. On biopsy following features were seen. What are these dense eosinophilic fibers marked with arrow? | Ans. (a) Rosenthal fibers*Rosenthal fibers are eosinophilic, corkscrew fibers found in pilocytic astrocytoma, the most common primary brain tumor in children. They contain two heat-shock proteins (aB-crystallin and hsp27) as well as ubiquitin.*They are seen in Alexander disease and, pilocytic astrocytoma. | 155,535 | medmcqa_train |
A large baby is born with which complication in pregnancy | Ans. is a i.e. Gestational diabetes | 155,536 | medmcqa_train |
A woman was involved in an accident in which her left leg was crushed and immediate amputation had to be done but you couldn't get a prior consent as the victim was unconscious and the relatives were not available. Later her husband sues you you for doing an amputation without a valid consent. Which of the following sections will provide you protection in this scenario? | Any harm caused to a person in good faith, even without consent is not an offence if the circumstances are such that it is impossible for the person to signify consent and has no guardian from whom it is possible to obtain a consent in time for the thing to be done in benefit as per section 92 IPC. Also know: As per section 90 IPC the consent given by an intoxicated/insane person is invalid. Ref: Textbook of Forensic Medicine and Toxicology by Narayan Reddy, Edition 21, Page - 42, 43 | 155,537 | medmcqa_train |
The Rorschach Inkblot test consists of a set of .......... standardized inkblots. These vary in colour, shading, form, and complexity. | Rorschach Inkblot test- Evaluation of Personality, it contains 10 cards having ambiguous inkblot patterns and the subject has to interpret what he is seeing in the card from preselected options Extra Edge Thematic Apperception Test- Test is built on the assumption that people's stories reveal impoant aspects of their needs and self-perceptions as well as their views about significant others' in their life. In rhis 20 stimulus cards depicting a number of scenes of varying ambiguity will be shown. | 155,538 | medmcqa_train |
Following are acute porphyrias except | The acute porphyrias are acute intermittent porphyria (AIP), variegate porphyria (VP), aminolevulinic acid dehydratase deficiency porphyria(ALAD) and hereditary coproporphyria (HCP). The non-acute porphyrias are X-linked dominant protoporphyria (XLDPP), congenital erythropoietic porphyria (CEP), porphyria cutanea tarda (PCT), and erythropoietic protoporphyria (EPP). The non-acute porphyrias along with two acute porphyrias, VP and HCP, that may also involve skin manifestations--are sometimes called cutaneous porphyrias. ref : Harrisons 20th ed pg 2523 | 155,539 | medmcqa_train |
Which of the following glycolytic enzymes is used in gluconeogenesis? | Aldolase is the enzyme which catalyses reversible reaction of glycolysis. So this enzyme is utilised in gluconeogenesis. Glucokinase, pyruvate kinase and phosphofructokinase are enzymes which catalyse the reversible reaction of glycolysis. | 155,540 | medmcqa_train |
An organism with sterols in their cell wall is | “Mycoplasma lacks a rigid cell wall and they are bounded by a triple-layered unit membrane that contains sterols.
” Mycoplasma PPLO - by Nocard & Roux • Smallest free-living organism • Gram-negative.highly pleomorphic organism,
stained by Giemsa • Found in the form of elementary bodies & filaments of various size • Facultative anaerobe, require a source of cholesterol for growth
• Media = hayflick media, Eaton's media • Colonies = biphasic with a fried egg appearance • C/F: Primary atypical pneumonia. Bullous myringitis.
Otitis • Lab diagnosis: 1. Isolation of organism - from throat swab, respiratory secretion 2. serological diagnosis -1.
Specific - HI, IF. metabolic inhibition 2. Nonspecific- streptococcus MG 3.
Cold agglutination Treatment: DOC- Erythromycin (Presence of 70 S ribosome makes it susceptible to antibiotics that inhibit protein synthesis;
but due to the lack of cell wall they are resistant to penicillin) Remember
• Ureaplasma ureolyticum belongs to the family mycoplasmatacea; which can hydrolyse urea & is a cause for nongonococcal urethritis •
L forms of bacteria - are due to the loss of bacteria but they retain the biochemical & antigenic properties of present bacteria. | 155,541 | medmcqa_train |
Chest X-ray of an industrial worker exposed to asbestos for 20 yrs shows diffuse appearance of lower lobe with 'comet tail' infarct on PA view. The most likely diagnosis is: | This is a case of mesothelioma secondary to asbestos exposure. The diffuse appearance of lower lobe with 'comet tail' infarct is typical of mesothelioma. Ref: Aicle: The Comet Tail Sign1; 1999 | 155,542 | medmcqa_train |
In starvation, earliest to become depleted - | Ans. is 'a' i.e., CarbohydratesMetabolic alteration during fasting-starvationo he metabolic changes observed in fasting are generally opposite to those described for absorptive (fed) state. In the absence of food, plasma levels of glucose, amino acids, and TGs fall, triggering a decline in insulin secretion and an increase in glucagon release. This results in decreased insulin: glucagon ratio. Which is responsible for most of the metabolic changes.o The primary role of altered metabolism during fasting is to maintain blood glucose through the synthesis (gluconeogenesis) and utilization of alternate substrates. Fasting-starvation is divided in three broad categories:-Initial stage :- Lasts upto 2-3 daysIntermediate stage Lasts upto 24 daysAdvanced stage:- begins after 24 days.Initial stage (first stage):- Liver glycogen is the first main provider of energy. But due to limited storage it can not last longe (16-18 hrs.). Further glucose is provided by gluconeogenesis by non- carbohydrate sources (muscle protein breakdown is increased which provides amino acids alanine and glutamine for gluconeogenesis). Utilization of alternate substrates (other than glucose) starts increasing interminal period of this stage. Free fatty acids and ketone bodies start rising in this stage. Glycogenis completely depleted by the end of this stage. Blood glucose is slightly decreased.Intermediate stage (Second stage):- Free fatty acids are the major substrates for energy production. They are derived from hydrolysis of fat (triglycerides) in adipose tissue. Ketone bodies serve as additional source of energy. As glycogen source is already depleted, the only source of glucose is increased gluconeogenesis. After sometimes muscle breakdown decreases due to decreased need of glucose as a fuel for brain which has began using ketone bodies as a source of energy.Advanced stage (Third stage):- When fat stores are almost exhaused, energy requirment is obtained from breakdown of tissue proteins and protein stores once again enter in stage of rapid depletion. | 155,543 | medmcqa_train |
Endocrinologic factors associated with recurrent aboion include all of the following except- | Endocrinologic factors associated with recurrent aboion include - Luteal phase insufficiency Diabetes mellitus Hypersecretion of luteinizing hormone (LH) Thyroid disease Insulin resistance Polycystic ovarian syndrome, Hyperprolactinemia Decreased ovarian reserve. | 155,544 | medmcqa_train |
Primitive streak remanants give rise to ? | Sacrococcygeal teratoma (SCT) is a type of tumor known as a teratoma that develops at the base of the coccyx (tailbone) and is thought to be derived from the primitive streak. Sacrococcygeal teratomas are benign 75% of the time, malignant 12% of the time, and the remainder are considered "immature teratomas" that share benign and malignant features. Benign sacrococcygeal teratomas are more likely to develop in younger children who are less than 5 months old, and older children are more likely to develop malignant sacrococcygeal teratomas. The Currarino triad (OMIM 176450), due to an autosomal dominant mutation in the MNX1 gene, consists of a presacral mass (usually a mature teratoma or anterior meningocele), anorectal malformation and sacral dysgenesis. Ref: https://en.m.wikipedia.org/wiki/Sacrococcygeal_teratoma | 155,545 | medmcqa_train |
Which is safest to be used in asthmatic patients: | C i.e. Chloral hydrate | 155,546 | medmcqa_train |
True statements about the twin-to-twin transfusion syndrome include which of the following? | In the twin-to-twin transfusion syndrome, the donor twin is always anemic, owing not to a hemolytic process but to the direct transfer of blood to the recipient twin, who becomes polycythemic. The recipient may suffer thromboses secondary to hyper-transfusion and subsequent hemoconcentration. Although the donor placenta is usually pale and somewhat atrophied, that of the recipient is congested and enlarged. Hydramnios can develop in either twin but is more frequent in the recipient because of circulatory overload. When hydramnios occurs in the donor, it is due to congestive heart failure caused by severe anemia. | 155,547 | medmcqa_train |
Craniotabes is seen in | (A) Rickets # Craniotabes is an abnormal softening or thinning of the skull, although normally present in new boms.> Seen mostly in occipital bone & posterior part of parietal bone.> Bone is soft and has a ping pong ball like feeling on pressing.> The word comes from the German work crani for skull and the Latin word tabes for wasting.> Any condition that affects bone growth, such as rickets, marasmus, syphilis,or thalassemia present during a time of rapid skull growth can cause craniotabes.lt can be a "normal" feature in premature infants. | 155,548 | medmcqa_train |
Most common site of March fracture is? | ANSWER: (A) Shaft of 2nd and 3rd metatarsalsREF: Apley's 8th ed p. 757See APPENDIX-68 below for "ALPHABETICAL LIST OF EPONYMOUS FRACTURES"March fracture: stress fracture of second metatarsal APPENDIX - 68Alphabetical List of Eponymous FracturesFractureDescriptionMechanism of injuryAviators fractureFracture neck of talusDorsiflexionBumper fracturecompression fracture of lateral condyle of tibial (always intra articular)Forced valgus of knee when struck from side by car bumperBoxer's fractureFracture of distal 5th metacarpalPunching solid objectBos worth fractureFracture of distal fibula with posterior dislocation of the proximal fibula behind the tibiaSevere external rotation of the footBennett's fractureIntra-articular fracture of base of first metacarpalAxial load along metacarpal in a partially flexed thumb (Abductor pollids longus pull)Barton's fractureIntra articular distal radius fracture invoking the articular surface with dislocation of the radio carpal jointFall on outstretched handBankart's fractureFracture of anterior glenoid associated with anterior shoulder dislocationExternal rotation and abduction of shoulderColies' fractureDistal radius fracture with dorsal angulation, impaction and radial driftFall on outstretched handCotton's fractureTrimalleolar fracture of ankle Clay shoveller's fractureStress avulsion fracture of Spinous process of C6, C7 or T1Forced hyper flexion of neckCh opart's fracture- dislocationFoot dislocation through talonavicular and calcaneocuboid joints with associated fractures, usually after ankle twisting. Treated in a non-weight bearing cast for 6-8 weeks Chauffeur's fractureIntra-articular fracture of radial styloidForced ulnar deviation of the wrist causing avulsion of the radial styloidChance fractureHorizontal fracture of vertebral bodyHyper flexion of spine, seen in car accidents when lap belts xvere usedDuverney fractureIsolated fracture of the iliac wingDirect traumaEssex-LoprestifractureComminuted radial head fracture xvith interosseous membrane disruption and distal radioulnar joint subluxationFall from heightGosselin fractureV-shaped distal tibia fracture extending into the tibial plafond Galeazzi fractureRadius shaft fracture with dislocation of distal radioulnar jointBlow to forearmHolds worth fractureUnstable spinal fracture-dislocation at the thoracolumbar junction Hume fractureOlecranon fracture with anterior dislocation of radial head Hill-Sachs fractureImpacted posterior humeral head fracture occurring during anterior shoulder dislocation Hangman s fractureFracture of both pedicles of C2Distraction and extension of neck (judicial hanging)Jones fractureFracture of base of 5th metatarsal extending into intermetatarsal jointInversion of ankle (pronator brevis pull)Jefferson fractureBurst fracture of 1st cervical vertebraCompression of neckLisfranc fractureFracture dislocation of midfootForced plantar flexion of foot or dropping heavy weight on footLe Forts fracture of the ankleVertical fracture of distal fibula with avulsion of medial malleolus Le Fort fracturesSeries of facial fracturesDirect trauma to faceMoores fractureDistal radius fracture with ulnar dislocation and entrapment of styloid process under annular ligament Monteggia fractureProximal ulna fracture with dislocation of radial headBlow to forearmMarch fractureStress fracture of 2n<1 /3rd metatarsal shaftHeavy or unaccustomed exerciseMalgaignesfractureVertical pelvic fracture through both pubic rami and the ilium or sacroiliac joint with vertical displacementHigh energy impact to pelvis (front to back)MaisonneuvefractureSpiral fracture of proximal fibulaExternal rotation of anklePipkin fracture- dislocationPosterior dislocation of hip with avulsion fracture of fragment of femoral head by the ligamentum teresImpact to the knee with the hip flexed (dashboard injury)Pilon fractureComminuted fracture of distal articular fracture with fibular fracture Pott's fractureBimalleolar fracture of the ankleEversion of ankleRolando fractureIntra articular T or Y shaped Comminuted fracture of base of V metacarpalAxial load along the metacarpal causing splitting of the proximal articular surfaceRunner's fractureStress fracture of distal fibula 3-8 cm above the lateral malleolusRepeated axial stress on fibulaStieda fractureAvulsion fracture of the medial femoral condyle at the origin of the medial collateral ligament Smith's fractureDistal radius fracture with volar displacementFall on outstretched hand with wrist in flexed positionShepherd s fractureFracture of the lateral tubercle of the posterior process of the talus Segond fractureLateral tibial plateau avulsion fracture with anterior cruciate ligament tear| Internal rotation of the kneeSalter-HarrisfracturesFractures involving a growth platevariousTitlaux fractureSalter-Harris III fracture of the tibiaForced lateral rotation of footToddlers fractureUndisplaced spiral fracture of distal tibia in children under 8 years oldLow-energy trauma t often rotational | 155,549 | medmcqa_train |
A man, after skinning a dead animal, developed a pustule on his hand. A smear is prepared from the lesion showed the presence of Gram-positive bacilli in long chains which were positive for McFadyean&;s reaction. The most likely aetiological agent is | The person is likely to have anthrax caused by Bacillus anthracis. Anthrax is a zoonotic disease. Infected animals shed in discharges from mouth, nose and rectum, large numbers of bacilli that sporulate in the soil and remain as the source of infection. Bacillus anthracis is a gram-positive bacillus, found singly, in pairs or in sho chains, being surrounded by a capsule. M' Fadyean's reaction: When blood films containing anthrax bacilli are stained with polychrome methylene blue for a few seconds and examined under a Microscope, amorphous purplish material is noticed around the bacilli. This represents the capsular material and is characteristic of the anthrax bacilli. Reference: Textbook of Microbiology; Anathanarayan and panicker's; 10th edition; Page no: 251 | 155,550 | medmcqa_train |
Most common organism associated with cystic fibrosis | Pseudomonas may colonise s of patients with cystic fibrosis and causes recurrent pulmonary exacerbations. Ref : Essential pediatrics,O.P.Ghai,7 th edition,pg no:355 | 155,551 | medmcqa_train |
A newborn presents with mid anterior abdominal wall defect. The House-surgeon is told that this swelling has a characteristic feature i.e spontaneous resolution at age of 5 years by his Professor. What could be the diagnosis? | (Umbilical hernia) (1317-18- CSDT 12th) (1289,1355 B & L 24th) (980-Baily & Love 25th) * Gastroschisis is the most common abdominal defect (726- Nelson 18th) * Ectopia vesicae (exstrophy of the bladder) - Caused by the incomplete development of the infra-umbilical part of the anterior abdominal wall, associated with incomplete development of the anterior wall of the bladder owing to delayed rupture of the cloacal membrane {penis is epispadic, mons and clitoris are bifid the urethra is open, umbilicus is absent) * Patent urachus - a patent urachus seldom reveals itself until maturity or even old age. This is because the contractions of the bladder commence at the apex of the organ an pass towards the base. * A patent urachus because it opens into the apex of the bladder is closed temporarily during micturition and so the potential urinary system from the bladder is cut off Omphalocele - midline abdominal wall defect. When the defect is less than 4 cm it is termed a hernia of the umbilical cord; when greater than 10 cm it is termed a giant omphalocele Umbilical hernia - a fascial defect at the umbilicus less than 1cm in diameter close spontaneously by 5 years of age in 95% of cases. Greater than 1.5cm in diameter it seldom closes spontaneously. Unlike inguinal hernia, protrusion of bowel through the umbilical defect | 155,552 | medmcqa_train |
Most common form of diabetic neuropathy is: September 2009 | Ans. C: Sensorimotor polyneuropathy The overall prevalence of neuropathy is 66% for type I and 59% for type II diabetes.It can be divided into: Symmetric-may present as small-fiber involvement (dysthesia of feet) or autonomic dysfunction (sexual impotence) but often both occur together. Asymmetric neuropathies are divided into - Asymmetric abrupt onset neuropathies-diabetic truncal radiculoneuropathy, diabetic lumbosacral radiculoplexus neuropathy and oculomotor neuropathy. Cranial neuropathies-The 3rd,6th and 4th cranial nerve (in decreasing order of frequency) are involved. - Neuropathy of gradual onset includes entrapment/compression neuropathies. Diabetic Sensorimotor polyneuropathy (DSPN), a type of symmetric diabetic neuropathy is by far the most common form of diabetic neuropathy. Its prevalence is 55% for type I and 45% for type II diabetes. Initial symptoms includes numbness, tingling, burning or prickling sensation affecting the toes and feet. | 155,553 | medmcqa_train |
All of the following our the diagnosis of PCOS except | BIOCHEMICAL MARKERS OF PCOD LH level is elevated and/or ratio of LH:FSH is > 3:1 Reversed estradiol:estrone ratio- The estrone level is markedly elevated. SHBG level is reduced. Androstenedione level is elevated. Serum testosterone and DHEA may be marginally elevated. Raised serum insulin level (ratio of fasting glucose: fasting insulin is < 4.5) | 155,554 | medmcqa_train |
All of the following are Vitamin-K deficiency features EXCEPT: | Ans. (a) Associated thrombocytopenia with prolonged bleedingRef: Harrison 19th ed. / 96e-8* Vitamin-K is a fat soluble compound. It promotes blood clotting by increasing hepatic biosynthesis of prothrombin and other coagulation factors.* The best sources are green leafy vegetables, liver, cheese, butter and egg yolk. Deficiency, usually seen only in neonates, in disorders of absorption or during antibiotic therapy is characterized by hemorrhage.* Warfarin acts by inhibiting Vitamin K, and does not causes deficiency of the same. | 155,555 | medmcqa_train |
Which is poor man's meat | Pulses (legumes) Pulses comprise a variety of grams, also known as dhals. Most commonly eaten pulses are bengal gram (chana), red gram (tuvar or arhar), green gram (mung) and black gram (urd). Others include lentils (masur), peas and beans including soyabean. Khesari dhal (lathyrus sativus), is consumed in pas of Madhya Pradesh, Uttar Pradesh and Bihar, excessive consumption of which is associated with lathyrism. Pulses contain 20 to 25 per cent of proteins, which is double that found in wheat and three times that found in rice. II') fact, pulses contain more protein than eggs, fish or flesh foods. But in regard to quality, pulse proteins are inferior to animal proteins. Pulse proteins are poor in methionine and to a lesser extent in cysteine. On the other hand they are rich in lysine. Soyabean is exceptionally rich in protein, containing up to 40 per cent. In addition, pulses are rich in minerals and B-group vitamins such as riboflavin and thiamine. In the dry state, pulses do not contain vitamin C. Germinating pulses, however, contain higher concentration of vitamins, especially vitamin C and B vitamins. Fermentation also modifies the nutritive value of pulses .in that the vitamin content paicularly that of riboflavin, thiamine and niacin is enhanced. Although pulses are called "poor man's meat", they are eaten by the rich and poor alike in India. They give variety to the diet and make the food more palatable. Ref: Park 25th edition Pgno : 649 | 155,556 | medmcqa_train |
Milian's ear sign is seen is | Erysipelas being a cutaneous condition can spread to ear lobule = Milian's ear sign. | 155,557 | medmcqa_train |
Morbid obesity causes death due to - | The increased moality due to obesity is brought about mainly by the increased incidence of Hypeension and coronary hea diseases . Ref-Park&;s textbook of Preventive and Social Medicine 24th edition. . | 155,558 | medmcqa_train |
A 60-year-old woman visits the ophthalmologist because of eye pain. Tests show that her right eye has an intraocular pressure of 22 mm Hg and her left eye has an intraocular pressure of 25 mm Hg. Which of the following is the most likely cause of eye pain in this woman? | This woman has open-angle glaucoma, which is the most common type of glaucoma. Glaucoma is the second leading cause of blindness worldwide after cataracts. Blindness occurs because of damage to the optic nerve. The high intraocular pressure causes blood vessels and axons of the optic nerve to be compressed at the optic disc, which leads to poor nutrition with possible death of the neurons. The main cause of open-angle glaucoma is reduced flow of aqueous humor through the trabecular meshwork because of tissue debris, white blood cells, deposition of fibrous material, and other factors that increase the hydraulic resistance of the meshwork | 155,559 | medmcqa_train |
The enzyme PeudochoIinesterase acts on: | Suxamethonium is Succinyl choline. Abnormal Psuedocholinestrase is a hereditary defect. In such people S-ch doesn't get metabolized. Usual dose results in prolonged apnoea and paralysis that lasts for hours. Aificial ventilation and blood transfusion are needed to supply Psuedocholinestrase. From padmaja 4th edition Page no 86 | 155,560 | medmcqa_train |
Foramen Ovale in middle cranial fossa transmits | (B) Mandibular nerve # Foramen ovale;> Mnemonic:> At the base of the skull, the foramen ovale (skull) is in the greater wing of the sphenoid bone in the middle cranial fossa and transmits the mandibular division of the trigeminal nerve, otic ganglion, accessory meningeal artery, lesser petrosal nerve and emissary veins. | 155,561 | medmcqa_train |
All are premalignant conditions of oral cavity except: | All the given options increase the risk of carcinoma of oral cavity but, oral Lichen planus has the least risk as it is Low-risk or Equivocal lesion. Conditions associated with Malignant Transformation HIGH RISK LESIONS Medium-risk Lesions Low-risk or Equivocal Lesions Erythroplakia Speckled Erythroplakia Chronic Hyperplastic -Candidiasis Oral submucous fibrosis Syphilitic glossitis Sideropenic dysphagia (Paterson-Kelly syndrome) Oral Lichen Planus Discoid Lupus erythematous Discoid keratosis congenita Speckled Erythroplakia is also known as Erythroleucoplakia. Leucoplakia Malignancy: -Speckled Erythroplakia > Erythroplakia > Leucoplakia | 155,562 | medmcqa_train |
Most common cause of acute mesenteric ischemia is: | Acute Mesenteric Ischemia :
• Emboli (50%) :
−− Arrhythmia, Valvular disease, Myocardial infarction
−− Hypokinetic ventricular wall
−− Cardiac aneurysm, Aortic atherosclerotic disease
• Thrombosis (25%) : Atherosclerotic disease
• Nonocclusive (5–15%) :
−− Pancreatitis, Heart failure, Sepsis.
−− Cardiac bypass, Burns, Renal failure.
• Venous occlusion:
−− Hypercoagulable state.
−− Sepsis Compression, Pregnancy, Portal hypertension. | 155,563 | medmcqa_train |
Irreversible ototoxicity is caused by - | Ans. is 'a' i.e., Cisplatin "Cisplatin induced hearing loss is usually bilateral and irreversible"Drugs causing ototoxicityA) Vestibular (primarily)o Aminoglycosides o Mustineo Quinidineo Quinineo Chloroquineo Vancomycino Furosemide o Ethacrynic acido Salicylates (high dose)B) Auditory (primarily)o NSAIDso Ethacrynic acido Vancomycino Aminoglycosideso Cisplatin | 155,564 | medmcqa_train |
A 2 years old child comes with one-year h/o of generalised oedema. His B.P. is 107/70mm urine examination shows hyaline cast, proteinuria +++, WBC & RBC are nil. the likely diagnosis is – | It is a case of nephrotic syndrome due to minimal change disease (MCD).
MCD is the most common cause of nephrotic syndrome in children*
Microscopic findings of urine in MCD
Proteinuria
Principally albumin (which is a low molecular weight protein)
High molecular weight proteins are seen in minimal amounts.
This type of proteinuria is known as selective proteinuria.
WBC → Absent
RBC → Absent
the hyaline cast → can be seen
Focal segmental Glomerulosclerosis can also cause nephrotic syndrome but the urine examination in these patients will reveal protein, WBC's and RBC's. | 155,565 | medmcqa_train |
Which of the following is the most radiosensitive ovarian tumors? | Ans. is a, i.e. DysgerminomaRef: Bailey & Love 24th/ed, p22l"Below the age of 20 years 60% of the tumors are of germ cell origin and in girls under the age of 10 years almost 85% are of germ cell origin and are invariably malignantIn females with HNPCC gene mutation along with BSO, hysterectomy should also be done as there is an associated risk of endometrial cancer. In BRCA gene mutation Hysterectomy is not routinely recommended.RememberThe most common malignant GCT Earlier was dysgerminoma but now its incidence has declined & it is the second most common malignant GCT."Because their incidence has declined by approximately 30 percent over the past few decades, dysgenia accurately accounts for only approximately one third of all malignant ovarian germ cell tumors." - Ref: Williams Gynae 3/ed, p762"Due to a 60 percent increased incidence during the past few decades, immature teratomas are now the M/C variant & account for 40-50% of all malignant ovarian germ cell tumors." - Ref: William gynae 3rd/ed, p765Most common germ cell tumor of ovary is dermoid cyst (mature teratoma). It is benign in nature.Remember:* Most common ovarian tumor (overall) - Epithelial cell tumor.* Most common tumor in young woman is - Germ cell tumor. - Ref: Shaw 14th/ed, p555* Most common malignant tumor of ovary - Serous cystadenocarcinoma.* Most common benign tumor of ovary (overall) - Dermoid cyst. - Ref Williams Gynae 1st/ed, p219* Most common benign epithelial tumor of ovary - Serous cystadenoma. - Ref: Jeffcoate 7th/ed, p531* Most common germ cell tumor - Mature teratoma (Dermoid cyst).* Most common malignant GCT - Immature teratoma > Dysgerminoma. - Ref: Williams Gynae 3/e p765* Most common ovarian tumor in pregnancy (but in remains undiagnosed) - Serous cystadenoma.* Most Common benign tumor diagnosed in pregnancy - Dermoid cyst.* Overall most common ovarian tumor diagnosed in pregnancy - Dermoid cyst.* Most common malignant ovarian tumor detected during pregnancy - Dysgerminoma.* Germ cell Tumor with best prognosis - Dysgerminoma* Germ cell tumor with worst prognosis - endodermal sinus tumor* Germ cell tumor which has maximum bilaterality - Dysgerminoma* Germ cell tumor which presents as acute abdomen - Endodermal Sinus Tumor* Most common ovarian tumor to undergo torsion during pregnancy - Dermoid cyst.* Most common ovarian tumor to involve opposite ovary by metastasis - Granulosa cell tumor.* Most radiosensitive ovarian tumor - Dysgerminoma.. - Ref: Bailey & Love 24th/ed, p221* Most rapidly growing ovarian tumor - Yolk sac Tm- (Endodermal Sinus Tumor)Ovarian Tumor: Causing:* Pseudomyxoma peritonei- Mucinous cystadenoma/Micinous cystadenocarcinoma* Meigs syndrome- Ovarian fibroma* Pseudomeig's syndrome:- Brenner's tumor- Granulosa cell tumor- Thecoma* Ovarian tumor associated with hyperpyrexia and hypercalcemia- Mesonephroid tumor.* Ovarian tumor arising from epithelium of urinary tract- Brenner Tm* Feminizing tumors:- Granulosa cell tumor- Theca cell tumor- Fibromas* Virilising tumor:- Androblastoma- Hilus cell Tm- Gynadroblastoma- Adrenal cortical tumor* Largest benign ovarian tumor- Mucinous cyst adenoma* Tumor with lymphocytic infiltration:- Dysgerminoma. | 155,566 | medmcqa_train |
Hunters syndrome due to deficiency of - | Ans. is 'a' i.e., Iduronate sulfatase (Ghai 7th/ep. 639) o Iduronate sulfate sulfatase def. - Hunter syndrome o Hexosaminidase dediciencv seen in Tay-sachs disease o Glucocerebrosidase def. - Gaucher disease | 155,567 | medmcqa_train |
Simple Basal media is? | Ans. is 'a' i.e., Simple nutrient agar A culture medium is a liquid or gel designed to suppo the growth of microorganism or cell. A culture medium may be liquid or solid. A culture medium may be? i) Basal (Simple) media This is simple with no added ingredients. It may be liquid ( peptone water) or solid (Nutrient agar). ii) Special (Complex) media These have added ingredients for special purpose or for bringing out ceain characteristics or providing special nutrients required for the growth of the bacterium under study. It may be liquid (enrichment media) or solid (selective media). About option b Peptone water (simple peptone water) is a simple media, but not alkaline peptone water as it has added ingradient to make it alkaline. | 155,568 | medmcqa_train |
A child presents with hepatomegaly and bilateral lenticular opacities. Which of the following enzyme deficiency will NOT cause such features? | Inability to metabolize galactose occurs in the galactosemias, which may be caused by inherited defects of galactokinase, uridyl transferase, or 4-epimerase, though deficiency of uridyl transferase is best known. Galactose is a substrate for aldose reductase, forming galactitol, which accumulates in the lens of the eye, causing cataract. Ultimately, liver failure and mental deterioration result. Ref: Bender D.A., Mayes P.A. (2011). Chapter 21. The Pentose Phosphate Pathway & Other Pathways of Hexose Metabolism. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K. Murray, V.W. Rodwell (Eds), Harper's Illustrated Biochemistry, 29e. | 155,569 | medmcqa_train |
Which of the following has fibromuscular stroma ? | The prostatic pa of the urethra develops from the pelvic (middle) pa of the urogenital sinus (endodermal origin). Endodermal outgrowths arise from the prostatic pa of the urethra and grow into the surrounding mesenchyme. The glandular epithelium of the prostate differentiates from these endodermal cells, and the associated mesenchyme differentiates into the dense stroma and the smooth muscle of the prostate. ref - BDC vol2 pg 376-378 | 155,570 | medmcqa_train |
A 60-year-old female complains of dry mouth and a gritty sensation in her eyes. She states it is sometimes difficult to speak for more than a few minutes. There is no history of diabetes mellitus or neurologic disease. The patient is on no medications. On exam, the buccal mucosa appears dry and the salivary glands are enlarged bilaterally. The next step in evaluation is | (Braunwald, 15/e, pp 1947-1949.) The complaints described are characteristic of Sjogren syndrome, an autoimmune disease with presenting symptoms of dry eyes and dry mouth. The disease is caused by lymphocytic infiltration and destruction of lacrimal and salivary glands. Dry eyes can be measured objectively by the Schirmer test, which measures the amount of wetness of a piece of filter paper when exposed to the lower eyelid for 5 minutes. Most pati ents with Sjogren syndrome produce auto- antibodies, paicularly anti-Ro (SSA). Lip biopsy is needed only to evaluate unceain cases, such as when dry mouth occurs without dry eye symptoms.Mumps can cause bilateral parotitis, but would not explain the patient's dry eye syndrome. Coicosteroids are reserved for life-threatening vasculitis, paicularly when renal or pulmonary disease is severe. | 155,571 | medmcqa_train |
A girl presented with symptoms of pharyngitis. Group A hemolytic pharyngitis is due to? | Local infection is the most common cause of inflammation of pharyngeal structures or acute pharyngitis. Group A beta-hemolytic streptococcus is a common causative organism in both pharyngitis and tonsillitis. Local infection and inflammation cause lymph node enlargement, swelling, erythema, and pain. | 155,572 | medmcqa_train |
Bad dreams are a rare adverse effect of which of the following drug? | Erectile dysfunction, impotence, bad dreams and hallucinations can be seen with beta blockers REFERENCES: KDT 6th ed pg 135-140 Goodman Gillman 12th ed pg 280-285 | 155,573 | medmcqa_train |
Lowest chance of recipient failure in transplant is seen in: | Ans. (b) IsograftRef: Bailey 26th ed, page 1426* Isograft: A graft between identical donor such as identical twin* Hence the rejection rate is the lowest | 155,574 | medmcqa_train |
A patient presented with thunder clap headache followed by unconsciousness with pregressive 111 ranial nerve palsy. Likely diagnosis is | davidson's principles and practices of medicine 22nd edition. *85% of SAH are caused by saccular or berry aneurysm arise from bifurcation of cerebral aeries *SAH typically presented with a sudden ,severe ,thunderclap headache (often occipital) , which lasts for hours or even days,often accompanied by vomitting , raised blood pressure and neck stiffness or pain. *there may be loos of consciousness at the onset ,so SAHshould be consider if patient is comatose *focal neurological signs like hemiparesis,aphasia may be present at onset if there is an associated intracerebral hematoma *a third nerve palsy present due to local pressure from an aneurysm of posterior communicating aery. Ref Harrison20th edition pg 2456 | 155,575 | medmcqa_train |
A new born child developed respiratory depression in neonatal ward. Which of the following drug is the cause - | Ans is 'a' i.e., Opioids | 155,576 | medmcqa_train |
TRUE regarding chi square test is | Ref: Parks 23rd edition pg 852 Chi-square test offers an alternate method of testing the significance of difference between two propoions. Advantage: it can also be used when more than 2groups are to be compared. | 155,577 | medmcqa_train |
Necrotizing epitheloid cell granulomas are seen in all, except - | Mycobacterium leprae infection leads to formation of non caseating granulomas, which is not necrotising.the lesions are erythematous type Basic Pathology, Robbins. Page no.: 56 | 155,578 | medmcqa_train |
Splenic infarction is associated with | . | 155,579 | medmcqa_train |
Treatment of dacryocystitis in three months old child- | *Spontaneous recanalization of obstructed nasolacrimal duct occurs during first 6-8 weeks and sometimes after 6-12 months in 90%of infants. Therefore up to 9-12months only massage and antibiotic drops are indicated. After the age of 12 months high pressure syringing is indicated. | 155,580 | medmcqa_train |
Which of the following is a killed vaccine ? | Ans. is 'd' i.e., Japanese encephalitis Live attenuated Inactivated or killed Immunoglobulins Bacterial Bacterial Human normal Subunit Vaccines BCG Typhoid Hepatitis A,B Hepatitis B Typhoid oral Cholera Measles Typhoid Vi antigen Viral Peussis Rabies Toxoids Oral Polio(Sabin) Meningitis Tetanus Diphtheria Yellow fever Plague Mumps Tetanus Measles Viral Human Specific Rubella Rabies Varicella Both active & Mumps Injectable polio (Salk) Diptheria passive Chicken pox Influenza Non-Human (antisera) immunization Influenza Hepatitis A Diphtheria can be given together Rickettsial JE Tetanus Diphtheria Epidemic Typhus KFD Gas Gangrene Hepatitis B Botulism Tetanus Rabies Rabies | 155,581 | medmcqa_train |
Malignancy in a multinodular goiter is most often:- | Follicular ca: - Seen in iodine deficient areas - M/C malignancy in long standing goiter - M/c malignancy in multinodular goiter Papillary ca: - Seen in iodine sufficient areas - M/C thyroid malignancy Anaplastic ca: - Rare; m/c seen in females - Usually seen in 7th - 8th decade of life Medullary ca: - Arise from Parafollicular C cells - C cells derived from ultimobranchial bodies | 155,582 | medmcqa_train |
Dohle bodies are seen in which of the following? | Döhle bodies are basophilic leukocyte inclusions located in the peripheral cytoplasm of neutrophils. They are said to be remnants of the rough endoplasmic reticulum.
Conditions associated with Dohle bodies:
Burns
Infections
Physical trauma
Neoplastic diseases
Wissler’s disease
May-Hegglin anomaly (seen in neutrophil, monocyte, lymphocyte)
Chédiak-Steinbrinck-Higashi’s syndrome | 155,583 | medmcqa_train |
Diagnosis of TB acc to DOTS? | 1 or 2 positives put of 2 sputum smear is considered as smear positive TB Ref: PARK&;S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE 23rd edition pg 429 | 155,584 | medmcqa_train |
A person developed anterior wall MI and died within 2 hours of onset of the symptoms. The pathological autopsy of the hea and observation of the involved myocardium under light microscopy, is underway. What will the finding be, if any? | Though usually no finding may be present in the 1st four hours, there may be waviness of myocytes and on electron microscopy disruption of the sarcolemma and mitochondrial amorphous densities may be present. Coagulative necrosis begins only after 4 hours and neutrophilic infiltration occurs only after 12 hours. Here the patient has not survived that long. Ref:Robbin's illustrated, 7th Edition, Page 579 | 155,585 | medmcqa_train |
Facilitation of flexor muscle tone is by | Rubrospinal tract facilitates flexor muscle and inhibits extensor muscles.
Vestibulospinal tract facilitates extensor muscle of lower limb and inhibits flexors. | 155,586 | medmcqa_train |
Chromosomal number of primary cnermatecvte is | Ans. is a i.e. 44XY | 155,587 | medmcqa_train |
50 yr old female presented with lump in right breast. She was diagnosed having Luminal A carcinoma. All are true about this cancer except ? | Luminal A breast cancer Seen in elderly females M/c subtype ER/ PR positive Her 2 /Neu negative Low proliferation rate Ki 67 : low Best prognosis among subtypes Responsive to hormonal chemotherapeutic agents like tamoxifen and aromatase inhibitors, Respond poorly to non- hormonal chemotherapy drugs like paclitaxel. Immunohistochemistry staining of a tissue biopsy specimen of luminal type A breast cancer: | 155,588 | medmcqa_train |
True about benzodiazepines ? | Ans. is 'c' i.e., Lorazepam is shoer acting than temazepam Lorazepam has VA 10-20 hours, while Temazepam has VA 10-40 hours. About other options BZDs do not increase or decrease the release of GABA, they bind on GABAA receptors and increase Cl- conductance - GABA facilitatory action. Flumazenil (not atropine) is the antagonist of BZDs. | 155,589 | medmcqa_train |
Curling ulcer is seen in - | Answer is 'a' i.e. Burns Curling ulcer is seen in Burn Cushing ulcer is seen in head injury. | 155,590 | medmcqa_train |
Pain is carried to | Neurons in the spinal dorsal horn process sensory information, which is then transmitted to several brain regions, including those responsible for pain perception. The dorsal horn provides numerous potential targets for the development of novel analgesics and is thought to undergo changes that contribute to the exaggerated pain felt after nerve injury and inflammation. Dorsal horn neurons receive sensory information from primary afferents that innervate the skin and deeper tissues of the body and that respond to specific types of noxious and non-noxious stimuli. These afferents terminate in the dorsal horn with a distribution pattern that is determined by their sensory modality and the region of the body that they innervate. The incoming information is processed by complex circuits involving excitatory and inhibitory interneurons and transmitted to projection neurons for relay to several brain areas. In addition, nociceptive information is conveyed to the ventral horn and contributes to spinally-mediated nocifensive reflexes. Ref: guyton and hall textbook of medical physiology 12 edition page number:691,692,693 | 155,591 | medmcqa_train |
Activation of the baroreceptor reflex | The baroreceptors are stretch receptors in the walls of the heart and blood vessels. The carotid sinus and aortic arch receptors monitor the arterial circulation. The baroreceptors are stimulated by distention of the structures in which they are located, and so they discharge at an increased rate when the pressure in these structures rises. | 155,592 | medmcqa_train |
Cyclic trend is shown by- | Ans. is 'd' i.e., All of the above Cyclic trend* Some diseases occur in cyclic spread over a short period of time which may be week, days, months or years.* This is due to naturally occuring variation in herd immunity.* A build up of susceptible is again required in the herd before there can be another attack.* It may be due to antigenic variations as occur in influenza.* Examples - Epidemic of# Measles - every 2-3 years# Rubella - every 6-9 years# Pandemic of influenza - every 10-15 years. | 155,593 | medmcqa_train |
Which among the following is not a feature of Unhappy triad of O' Donoghue? | Ans. is 4d' i.e., Fibular collateral ligament injury [Ref: Apleys 9k/ep. 876}o The most common mechanism of ligament disruption of knee is adduction (valgusj, flexion and internal rotation of femur on tibia which usually occur in sports in which the foot is planted solidly on the ground and leg is twisted by rotating body (i.e., foot ball, soccer, basket ball, skiing).o The medial structures medial (tibial) collateral ligament (MCL) and medial capsular ligament are first to fail, followed by ACL tears, if the force is of sufficient magnitude. The medial meniscus may be trapped between condyles and have a peripheral tear, thus producing unhappy triad of O' Donoghue. | 155,594 | medmcqa_train |
The phenomenon of suspended animation may be seen in - | Suspended animation may be seen in electrocution, drowning, cholera, after anesthesia, shock, sunstroke, cerebral concussion, narcotic poisoning, new born infants and yogis/voluntary. | 155,595 | medmcqa_train |
Endolymph is rich in ? | Ans. is 'd' i.e., K+Fluid in inner ear There are two main fluids in the inner ear : -(i) Perilymph (ii) EndolymphPerilymphIt resembles ECF and is rich in Nu+ ions. It fills the space between bony and the membranous labyrinth, i.e., Scala vestibuli and scala tympani. It communicates with CSF through the aqueduct of Cochlea which opens into the scala tympani near the round window. Therefore It closely resembles CSF. It is formed by : -i) It is a filterate of blood serum and is formed by capillaries of the spiral ligament.ii) It is a direct continuation of CSF and reaches the labyrinth aqueduct of cochlea.EndolymphIt fills the entire membranous labyrinth including scala media (cochlear duct). It resembles intracellular fluid, being rich in IC ions. It is secreted by the secretory cells of the stria vascularis of the cochlea and by the dark cells (present in the utricle and near the ampullated ends of semicircular ducts). | 155,596 | medmcqa_train |
A 30 year old woman with a bad obstetric history presents with fever. The blood culture from the patient grows gram-positive small to medium coccobacilli that are pleomorphic, occurring in sho chains. Direct wet from the culture shows tumbling motility. The most likely organism is - | . Ans. is 'a' i.e., Listera monocytogenes . The impoant clues in this question are . Organisms are gram positive coccobacilli . Organisms are pleomorphic and occuring in sho chains. . There is tumbling motility. . All these are the features of Listeria monocytogens. . Corynebacteria are gram positive bacilli (not coccobacilli) and are nonmotile. . Enterococci (group ' d' streptococci) are gram positive cocci (not coccobacilli) and are non motile. | 155,597 | medmcqa_train |
Clinical goal for prevention of coronary hea disease aims at lowering the ratio of cholesterol/ HDL below: September 2011 | Ans. C: 3.5 A ratio of less than 3.5 has been recommended as a clinical goal for CHD prevention Total cholesterol Desirable: less than 200 milligrams (preferably 180) Borderline: 200-239 milligrams High: 240 milligrams and above LDL cholesterol Desirable: less than 130 milligrams Borderline-high: 130-159 milligrams High: 160 milligrams or above HDL cholesterol Low: less than 35 milligrams Desirable: 50 or above Hea healthy numbers: Triglycerides: under 150 mg. Cholesterol: under 200 LDL: under 130 HDL: above 50 Cholestrol/HDL: <3.5 | 155,598 | medmcqa_train |
All of the following statements regarding jaundice in a newborn are true, Except ________ | A rapidly rising unconjugated bilirubin concentration, or absolute levels >340 mmol/L (20 mg/dL), puts the infant at risk for bilirubin encephalopathy, or kernicterus. Under these circumstances, bilirubin crosses an immature blood-brain barrier and precipitates in the basal ganglia and other areas of the brain. The consequences range from appreciable neurologic deficits to death. Reference : page 2001 Harrison&;s Principles of Internal Medicine 19th edition | 155,599 | medmcqa_train |
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