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Shock lung is characterized by | ref Robbins 7/r p715,9/e p134 Harrison 17/e p1680_1681 The cellular and tissue effects of shock are essentially those of hypoxic injury (Chapter 1) and are caused by a combina- tion of hypoperfusion and microvascular thrombosis. Although any organ can be affected, brain, hea, kidneys, adrenals, and gastrointestinal tract are most commonly involved. Fibrin thrombi can form in any tissue but typically are most readily visualized in kidney glomeruli. Adrenal cor- tical cell lipid depletion is akin to that seen in all forms of stress and reflects increased utilization of stored lipids for steroid synthesis. While the lungs are resistant to hypoxic injury in hypovolemic shock occurring after hemorrhage, sepsis or trauma can precipitate diffuse alveolar damage (Chapter 12), leading to so-called shock lung. | 155,700 | medmcqa_train |
Most common muscle involved in Tropical pyomyositis | Tropical pyomyositis is caused by S.Aureus which mainly involves Quadriceps > Gluteus. | 155,701 | medmcqa_train |
Visual analog scale is a - | Ans. is 'a' i.e., Pain scale Visual analog Scaleo The visual analogue scale or visual analog scale (VAS) is a psychometric response scale which can be used in questionnaires.o It is a measurement instrument for subjective characteristics or attitudes that cannot be directly measured,o When responding to a VAS item, respondents specify their level of agreement to a statement by indicating a position along a continuous line between two end-points,o VAS is the most common pain scale for quantification of severity of pain. | 155,702 | medmcqa_train |
Type of pneumonia in P. jiroveci: | Ans. b. Interstitial pneumonia | 155,703 | medmcqa_train |
Which of the following neurotransmitter has an inhibitory control over the GnRH neurons before the onset of pubey? | Before the onset of pubey, the GnRH neurons are under the inhibitory control of GABA. Gamma amino butyric acid is a dominant inhibitory neurotransmitter in the hypothalamus. Inhibition of GnRH neurons by GABA is mediated Glutamergic neurons. A reciprocal innervations between GABAergic and Glutamergic neurons are found. During development GABA concentration and the number of GABAergic neurons increase from 13th day to second postnatal week, which is then followed by a decline in 3rd postnatal week. GABA release in the median eminence decrease concomitantly with the pubeal increase of GnRH secretion. Ref: Male Hypogonadism: Basic, Clinical, and Therapeutic Principles By Stephen J. Winters, Page 69 ; Goldfrank's Toxicologic Emergencies By Lewis R, Page 232 - 238. | 155,704 | medmcqa_train |
A middle aged female presents with chronic pain in right side of abdomen with intermittent fever. Clinical examination revealed mild hepatomegaly and hence a contrast enhanced CT abdomen was performed. Based on the imaging characteristics of this focal lesion the most likely diagnosis is? | Ans. B. Hydatid cystThe Portal phase CT demonstrates a large cystic structure with a discrete wall, separated internal membranes and several 'daughter cysts'This is an infection of the liver with Echinococcus granulosus, a parasitic tapeworm presents worldwide and transmitted from sheep, foxes and other wild animals to humans as part of its lifecycle. Larvae migrate from the gut and embed in the liver, where they encyst and develop, slowly provoking a surrounding inflammatory reaction. The disease may remain occult for several years. On imaging there is a wide range of appearances, from a simple cyst indistinguishable from a true hepatic cyst to a complicated cyst with any or all of the following features: debris (hydatid 'sand" made up of dead scolices, which may calcify), daughter cysts, membrane separation, and wall calcification. The lesions may be multiple and vary widely in size. Serological testing can be employed to confirm the presence of infection prior to any therapy or intervention. Although the risk of anaphylaxis following aspiration or surgery of these lesions is well recognized, it is less than previously thought, and uncomplicated aspiration following medical treatment has been described.US demonstrates clearly not only the simple cyst form but also the more complex cyst features, such as the dependent debris, daughter cysts (cyst within a cyst appearance), membrane separation and wall calcification. CT defines all these features as well and is helpful where wall calcification obscures the view on US. MRI will define the cystic structure and internal anatomy but is insensitive to the calcification. | 155,705 | medmcqa_train |
Millard Gubler syndrome includes the following except | Millard-Gubler syndrome (MGS) is one of the classical brainstem-crossed syndromes caused due to a unilateral lesion in ventral pons, manifesting as ipsilateral palsy of CN VI and VII with contralateral hemiplegia Ref Harrison20th edition pg 2234 | 155,706 | medmcqa_train |
C. trachomatis is a well-known cause of venereal disease. This organism is also implicated in which of the following? | Trachoma has been the greatest single cause of blindness in the world. Chlamydia trachomatis is the most common cause of sexually transmitted disease in the United States and is also responsible for the majority of cases of infant conjunctivitis and infant pneumonia. | 155,707 | medmcqa_train |
Prostaglandins are produced by ? | Ans. is 'd' i.e., All of the above | 155,708 | medmcqa_train |
All of the following statements about Parvovirus B -19 are TRUE, EXCEPT: | Parvovirus B-19 causes a infection called Erythema infectiosum or Fifth disease. Around 50-70% cases are around 5-15 years of age. Transmission from mother to fetus is around 15-30%. It causes, anemia, aplastic crisis, rashes, ahralgia, rarely hydrops fetalis. Ref: Kliegman, Behrman, Jenson, Stanton (2008), "Nelson textbook of Pediatrics", Chapter 248, "Parvovirus B19", Volume 1, Page 1357; Medical Microbiology By Jawetz , 24th Edition, Pages 414, 417 | 155,709 | medmcqa_train |
'Pie in the sky' visual field defect seen in lesions of: | A. Left Hemianopia Left optic nerve lesion B. Bitemporal Hemianopia Optic chiasm lesion C. Right Nasal Hemianopia Outer optic tract lesion Internal carotid aery thrombus D. Right Homonymous Hemianopia Optic tract lesion E. Right Superior Quadrantanopia Meyer's Loop lesion Left temporal lesion F. Right Inferior Quadrantanopia Dorsal optic radiation lesion Left parietal lesion G. Right Hemianopia with Macular Sparing PCA infarct Superior/ Inferior quadrantanopia Lesion of optic radiation. Lesion of the meyer's loop (temporal pathway)-Superior quadrantanopia (pie in the sky) Lesions of the parietal pathway- inferior quadrantanopia (pie on the floor) causes- neoplasm, inflammatory process, ischemia, infection (eg: encephalitis) | 155,710 | medmcqa_train |
What is true regarding Barret's esophagus: | Answer is B (Premalignant condition) Barret's oesophagus is a premalignant condition with increased risk of adenocarcinoma. Barret's esophagus is more common in males More common in males (Males > Females)0 More common in White (Whites > Blacks)e More common with increasing ageU Barret's metaplasia once established does not respond to conservative management `Established Metaplasia does not regress with antisecretory treatment' - Harrison Although medical treatment does not regress the metaplastic changes, it is still advocated to prevent continued insult. Barret's esophagus is associated with columnar metaplasia and not squamous metaplasia. | 155,711 | medmcqa_train |
Gas shadow in hea and vessels are seen in | Robe sign - the presence of a gas shadow within the hea or the greater vessels, seen in cases of fetal death in utero.It is a rare sign caused by postmoem blood degeneration, usually seen 1-2 days after death; and may be seen as early as 12 hours(Ref: Diagnostic Ultrasound by Carol M. Rumack, Stephanie R. Wilson, J. William Charboneau, and Deborah Levine,4thed, page 1090) | 155,712 | medmcqa_train |
Latte's crust of blood stain is used to detect: NEET 14 | Ans. Blood group | 155,713 | medmcqa_train |
The cause of fetal death in ectopic pregnancy is postulated as: | Ans. is a, i.e. Vascular accidentRef Williams Gynae 1/e, p 158Ectopic pregnancy is the leading cause of early pregnancy related deaths.Most common cause of death in ectopic pregnancy is tubal rupture - severe hemorrhage - death.Ectopic pregnancy can have 2 outcomes:1. Tubal abortion - M/C outcome. It is most common outcome of ectopic pregnancy in ampulla2. Tubal rupture-ectopic pregnancy of isthmus are the ones which usually rupture. | 155,714 | medmcqa_train |
When a stretch reflex occurs the muscles that antagonize the action of the muscle involved relaxes. This phenomenon is known as: | Reciprocal innervation is a phenomenon in which, when a stretch reflex occurs the muscles that anotogonize the action of the muscle involved relaxes. The pathway mediating this effect is bisynaptic. Golgi bottle neurons (inhibitory interneurons) are involved in this phenomenon. Ref:Ganong's Review of Medical Physiology, 21st Edition, Page 133 | 155,715 | medmcqa_train |
Jaw tightness is typically seen in: | Answer is C (Giant Cell Aeritis): Jaw Claudication (law Tightness) is a typical manifestation of Temporal aeritis or Giant cell aeritis. | 155,716 | medmcqa_train |
Salpingitis/Endosalpingitis is best confirmed by: | Ans. is a, i.e. Hysteroscopy and laparoscopyRef: Shaw 15th/ed, p451; William's Gynae 1st/ed, p74; Gynecology by Ostrzenski (Lippincott Williams 2(X)l/282); Dutta Gynae 6th/ed, p130Laparoscopy is considered the "gold standard". While it is the most reliable aid to support the clinical diagnosis but it may not be feasible to do in all cases. It is reserved only in those cases in which differential diagnosis includes salpingitis, appendicitis or ectopic pregnancy. Nonresponding pelvic mass needs laparoscopic clarification.Hysterscopy may also provide confirmatory evidence for salpingitis."Fallopian tube culture can be obtained laparoscopically and recently the hysteroscopic approach has been introduced. The specimen is obtained during hysteroscopy with a cytobrush." - Ref: Gynecology by Ostrzenski (Lippincott Williams) (200l)/282Also KnowSince laparoscopy is an invasive procedure for diagnosis of salpingitis/PID, diagnosis should first be made clinically. | 155,717 | medmcqa_train |
Lymes disease all are true except | Polymorphonuclear leucocytosis in C.S.F. suggests meningeal involvement Spread of infection and immune response in Lyme disease Lyme disease is caused by Borrelia Burgdorferi. Borrelia burgdorferi is transmitted to humans the bite of ixodes tick vector. Borrelia burgdorferi is inoculated in the skin, where local replication takes place locally and outward migration in the dermis occurs. Days to week after the tick bite, hematogenous dissemination to secondary sites (like joints, hea eye, nervous system) takes place. If untreated, the bacteria may persist in the body for months or even years, despite the production of anti-Borrelia burgodorferi antibodies by the immune system. The following mechanisms have been described - i) Tick saliva, which accompanies the spirochete into the skin during the feeding process, contains substances that disrupt the immune response at the site of the bite. - This provides a protective environment where the spirochete can establish the infect on. ii) Once inside the body, Borrelia burgdorferi becomes a "stealth invader" i.e., it changes shape. In the tick and mice which host the bacterium through most of its life cycle, the bacterium has a thick cell wall and spiral shape. If it maintains its thick cell wall and its spiral shape, immune system can control infection. However, in the human body, it can shed its cell wall and can take a different shape. When under attack from immune system, it simply changes shape so it is not recognized. iii) Borrelia burgdorferi produces antigenic variation in a "cell surface lipoprotein VIsE", during the course of infection The VIsE system presents a challenge to immune system because after an immune response is generated to one version of VIsE protein, a different version is quickly produced. By using this type of antigenic variation, B. burgdorferi can escape the adaptive immune system. Lyme meningitis Meningitis (meningeal involvement) is the most common neurological event that occurs in the setting of early lyme dissemination. - In this clinical setting CSF is always abnormal and shows: I) Pleocytosis with predominantly lymphocytosise (not polymorphonuclear leukocytosis). 2) Increased protein 3) Glucose content is usually normal, but it falls below the serum concentration in 20% of patients. Immunoglobulin abnormalities are common in the CSF of patients with lyme meningitis. - Specific IgM, IgG or IgA antibody against B. burgdorferi appears in CSF and indicates intrathecal antibody synthesis. | 155,718 | medmcqa_train |
Approximate time, at the end of which the quantity of ATP within ischemic cardiac myocytes is reduced to 10% of the original is | Metabolic changes slow as the duration of ischemia increases. Irreversibly injured myocytes exhibit (a) very low levels of ATP (less than 10% of control); (b) cessation of anaerobic glycolysis; (c) high levels of H+, AMP, INO, lactate, and alpha GP; (d) a greatly increased osmolar load; (e) mitochondrial swelling and formation of amorphous matrix densities; and (f) disruption of the sarcolemma. Approximately 40 minutes of time may there as the metabolic changes slow down with the decrease in ATP levels Ref internet and Robbins 9/e p,27;28 | 155,719 | medmcqa_train |
Aluminium phosphide poisoning - all true except | inhibits cytochrome a oxidase Aluminium phosphide produces phosphine gas on coming in contact with moisture which inhibits cytochrome c oxidase (and not cytochrome a oxidase). Sub-endocardial infarction and esophageal strictures both have been described with ALP poisoning (Ref: various journals on web) Aluminium phosphide poisoning It is one of the most common causes of acute poisoning in India. Acute aluminium phosphide (Celphos) poisoning is an extremely lethal poisoning. The absence of a specific antidote results in very high moality and the key to treatment lies in rapid decontamination and institution of resuscitative measures. Aluminium phosphide (A1P) is one of the most commonly used grain fumigants because of its propeies which are considered to be near ideal; it is toxic to all stages of insects, highly potent, does not affect seed bility, is free from toxic residues. After ingestion of aluminium phosphide, phosphine gas is released in the stomach which after absorption into the circulation results in early signs and symptoms. AlP causes widespread organ damage due to cellular hypoxia as a consequence of non-competitive inhibition of the enzyme cytochrome oxidase of the mitochondria. Organs with the greatest oxygen requirements appear to be especially sensitive to phosphine, including the brain, kidneys, hea, and liver. The initial symptoms after ingestion are retrosternal burning, epigastric pain and vomiting which are soon followed by development of hypotension which is the cardinal feature. Other common features are restlessness, tachypnoea, oliguria or anuria, jaundice, impaired sensorium and cardiac arrhythmias. Several EKG abnormalities have been described. These have been attributed to focal myocardial necrosis and changes in action membrane potential as result of alteration in permeability of Na+, Mg++ and Ca+ ions Diagnosis A positive history of ingestion is the basis of diagnosis in most cases. The presence of typical clinical features, garlicky (or decaying fish) odour from the mouth and highly variable arrhythmias in a young patient with shock and no previous history of cardiac disease points towards aluminium phosphide poisoning. Confirmation can be done by the Silver Nitrate Test. In this test, 5 ml of gastric aspirate and 15 ml of water are put in a flask and the mouth of the flask is covered by filter paper impregnated with 0.1N silver nitrate. The flask is heated at 50 o C for 15 to 20 min. If phosphine is present the filter paper turns black. However the most specific and sensitive method for detecting the presence of P1-13 in blood/air is gas chromatography. (Vies Jansen A, Thrane KE. Gas chromatographic determination of PH3 in ambient air. Analysis 1978;103:1195-8.) Management The management continues to be unsatisfactory as there is no specific antidote and remains suppoive only. The most impoant factor for success is resuscitation of shock and institution of suppoive measures as soon as possible. To reduce the absorption of phosphine, gastric lavage with potassium permanganate (1:10,000) is done. Permanganate is used as it oxidizes PH3 to form non-toxic phosphate. This is followed by a slurry of activated charcoal (approximately 100 gin) given through a nasogastric tube. A cathaic (liquid paraffin) is given to accelerate the excretion of aluminium phosphide and phosphine. Antacids and proton pump blockers are added for symptomatic relief. | 155,720 | medmcqa_train |
The small intestine secretes various triglyceride-rich lipoproteins, but the liver secretes only | Although both chylomicrons and VLDLs are triglyceride-rich lipoproteins, the liver, unlike the small intestine, produces only VLDLs. LDLs and HDLs are not triglyceride-rich lipoproteins. Chylomicron remnants are generated in the circulation by the metabolism of chylomicrons. | 155,721 | medmcqa_train |
Features not seen in Cushing's Syndrome is : | Answer is A (Hypoglycemia): Cushing's syndrome is characterised by Hy perglycemia. Increased hepatic gluconeogenesis and insulin resistance causes increase in blood glucose. Hypeension is common, & emotional changes may be profound, ranging from irritability & emotional liability to severe depressions, confusion or even frank psychosis. Hvpokalemia. hypochloremia and metabolic alkalosis may be seen | 155,722 | medmcqa_train |
Fulminant hepatitis is most commonly associated with which type of hepatitis - | Ans. is 'b' i.e., Hepatitis B Fulminant hepatits* The most feared complication of viral hepatitis is fulminant hepatitis (massive hepatic necrosis); fortunately, this is a rare event.* Fulminant hepatitis is primarily seen in hepatitis B and D, as well as hepatitis E, but rare fulminant cases of hepatitis A occur primarily in older adults and in persons with underlying chronic liver disease, including, according to some reports, chronic hepatitis B and C.* Hepatitis B accounts for > 50% of fulminant cases of viral hepatitis, a sizable proportion of which are associated with HDV infection and another proportion with underlying chronic hepatitis C.* Fulminant hepatitis is hardly ever seen in hepatitis C, but hepatitis E, as noted above, can be complicated by fatal fulminant hepatitis in 1-2% of all cases and in up to 20% of cases in pregnant women.* Patients usually present with signs and symptoms of encephalopathy that may evolve to deep coma.* The liver is usually small and the PT excessively prolonged.* The combination of rapidly shrinking liver size, rapidly rising bilirubin level, and marked prolongation of the PT, even as aminotransferase levels fall, together with clinical signs of confusion, disorientation, somnolence, ascites, and edema, indicates that the patient has hepatic failure with encephalopathy.* Cerebral edema is common; brainstem compression, gastrointestinal bleeding, sepsis, respiratory failure, cardiovascular collapse, and renal failure are terminal events.* The mortality rate is exceedingly high (> 80% in patients with deep coma), but patients who survive may have a complete biochemical and histologic recovery.* If a donor liver can be located in time, liver transplantation may be life- saving in patients with fulminant hepatitis. | 155,723 | medmcqa_train |
Blood samples for glucose estimation are collected in fluoride bulbs/tubes as fluride prevents glycolysis byinhibition of | Ans. a (Enolase) (Ref. Harper's Illustrated 26th ed., 137; 27th/Ch. 18)ENOLASE# The step of glycolysis catalyzed by enolase involves dehydration, forming phosphoenolpyruvate.# Enolase is inhibited by fluoride.- To prevent glycolysis in the estimation of glucose, blood is collected in tubes containing fluoride.# The enzyme is also dependent on the presence of either Mg2+ or Mn2+.# The phosphate of phosphoenolpyruvate is transferred to ADP by pyruvate kinase to generate, at this stage, two molecules of ATP per molecule of glucose oxidized.# The product of the enzyme-catalyzed reaction, enolpyruvate, undergoes spontaneous (nonenzymic) isomerization to pyruvate and so is not available to undergo the reverse reaction.# The pyruvate kinase reaction is thus also irreversible under physiologic conditions. EnzymeInhibitorPathway1.AconitaseFluoroacetateKrebs cycle2.L-KG dehydrogenaseArseniteKrebs cycle3.EnolaseFluorideGlycolysis4.Succinate dehydrogenaseMalonate oxaloacetateKrebs cycle5.Glyceradehyde-3 phosphateLactoacetate dehydrogenaseGlycolysis6.MOAIproniazid 7.Pyruvate dehydrogenaseArsenite 8.Carbonic anhydraseSulfanilamide | 155,724 | medmcqa_train |
Which is a communicating hydrocele? | Funicular hydrocele Communicating hydrocele: (a) Funicular hydrocele, and (b) Congenital hydrocele. a. Funicular Hydrocele: Processus vaginalis remains patent up to the top where it is shut off from the tunica vaginalis. Diagnostic features: (i) The swelling is inguinal rather than scrotal. (ii) The test is it can be felt separate! (iii) Other features are similar to those of congenital hydrocele. b. Congenital Hydrocele: In this condition the processus vaginalis remains patent so there is direct communication of the tunica vaginalis with the peritoneal cavity. The communicating orifice at the deep inguinal ring is too small for the development of a hernia. | 155,725 | medmcqa_train |
Which of the following structures is most significant in resisting hyperextension of the hip joint?, | The Iliofemoral Ligament resist both hyperextension and lateral rotation at the hip joint. The Pubofemoral ligament reinforces the joint inferiorly and limits extension and abduction. The Ischiofemoral ligament reinforces the joint posteriorly and limits extension and medial rotation. The Gluteus Maximus muscle extends and laterally rotates the thigh and does not paicularly resist hyperextension | 155,726 | medmcqa_train |
Rhinophyma occurs as complication of | Rosacea:-Chronic skin infection characterised by symptoms of facial flushing and a spectrum of signs including erythema, telangiectasia,coarseness of skin and inflammatory papulopustular lesion.Features:-1. Red papules and pustules on nose ,forehead,cheeks and chin.2. Frequent flushing 3. Aggravated by sun exposure,foods , alcolhol, spicy foods, hot tea or coffeeextreme temperatures,vasodilator drugs,, h.pylori infection There are 4 subtypes of rosacea erythematotelengieatatic rosacea- flushing,central facial erythema, telengiectasia papulopustular rosacea- persistent central facial erythema with transient papules , pustules, in central facial distribution phymatous rosacea: thick skin with modularity most common over nose-rhinophyma ocular rosacea watery eyes, foreign body sensation, burning/stinging, dryness, itching blepharitis. iadvltextbook of dermatology, page page 856 | 155,727 | medmcqa_train |
In CuT 200, the number stands for: | Ans: A (Surface...) "The number included in the names of the devices refer to the surface area (in sq, mm) of the copper on the device. Park 21st/459 IUDs: Review of Facts# CuT-200 B being used in India , under the national family welfare programme,Later CuT 380A is introduced in the programme.# Studies have shown that the effectiveness of copper device is directly related to the amountofcopper surface area (usually this is 200 or 220 mm2')- Park 19th/395# IUD is not a method of first choice for nulliparous women. They have more problems such as expulsion, low abdominal pain Si pelvic infection.intra-Uterine Devices; Classification 1st Generation IUDs (inert or non medicated devices) 2nd Generation IUDsEarlier devices* Copper 7* Copper T - 200Newer devices* Variants of the T device(i) T Cu - 220 C(jj) T Cu - 380 A or Ag* Nova T*Multi load devices(i)-Cu-250(ii)-Cu-375 3rd Generation IUDs (Hormonal deinces)* Progestasert* LNG-20 (Mirena)13 | 155,728 | medmcqa_train |
Chauffers fracture involves what ? | Chauffeur&;s fracture, also known as Hutchinson fracture, is a type offracture of the forearm, specifically the radial styloid process. The injury is typically caused by compression of the scaphoid bone of the hand against the styloid process of the distal radius. Ref : essential ohopaedics maheshwari and mhaskar 9th ed p 103<img alt="" src=" /> | 155,729 | medmcqa_train |
"French paradox" is - | The French paradox is a catchphrase first used in the late 1980s, that summarizes the apparently paradoxical epidemiological observation that French people have a relatively low incidence of coronary hea disease (CHD), while having a diet relatively rich in saturated fats,in apparent contradiction to the widely held belief that the high consumption of such fats is a risk factor for CHD. The paradox is that if the thesis linking saturated fats to CHD is valid, the French ought to have a higher rate of CHD than comparable countries where the per capita consumption of such fats is lower. The French paradox implies two impoant possibilities. The first is that the hypothesis linking saturated fats to CHD is not completely valid (or, at the extreme, is entirely invalid). The second possibility is that the link between saturated fats and CHD is valid, but that some additional factor in the French diet or lifestyle mitigates this risk--presumably with the implication that if this factor can be identified, it can be incorporated into the diet and lifestyle of other countries, with the same lifesaving implications observed in France. Both possibilities have generated considerable media interest, as well as some scientific research. It has also been suggested that the French paradox is an illusion, created in pa by differences in the way that French authorities collect health statistics, as compared to other countries, and in pa by the long-term effects, in the coronary health of French citizens, of changes in dietary patterns which were adopted years earlier. In 1991, Renaud extended his studies in panership with then junior researchers, cardiologist Michel de Lorgeril and dietician Patricia Salen. The three enhanced Renaud's study, with their paper concluding that: a diet based on southwestern Mediterranean cuisine; which is high in omega-3 oils, antioxidants and includes "moderate consumption" of red wine; created lower cases of cancer, myocardial infarction and cardiovascular disease; paly through increasing HDL cholesterol whilst reducing LDL cholesterol Ref Davidson 23rd edition pg 529 | 155,730 | medmcqa_train |
A 64-year-old man with heart failure is recently started on 80 mg/day of furosemide. He now feels weak and tired, but notes that his heart failure symptoms have improved. There is no change in his urine output and he gets a good diuretic response every time he takes his furosemide.Select the characteristic ECG findings. | Hypokalemia results in prolongation of the QU interval. The delayed repolarization in hypokalemia is best expressed at QU rather than QT prolongation since it can be difficult to separate the T wave from the U wave. In severe cases, the ST segments become depressed. Quinidine, even in therapeutic doses, can cause similar ECG findings. This is felt to be a risk factor for ventricular arrhythmias, including Torsades des pointes. | 155,731 | medmcqa_train |
Diagnostic criteria for Bulimia nervosa are all EXCEPT | (B) Presence of other psychiatric disorders # BULIMIA NERVOSA (BN) is an eating disorder characterized by eating binges typically followed by efforts to purge calories through self-induced vomiting, laxative and/or diuretic abuse, prolonged fasting, or excessive exercise. Fear of weight gain leads to the characteristic purging behavior, but BN is centered around the practice of binge eating.> The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), describes diagnostic criteria for BN and includes the following:> Recurrent episodes of binge eating, characterized by the following:> Eating an amount of food, in a discrete period of time, that is larger than most people would eat during a similar period of time under similar circumstances.> A perceived lack of control over eating during the episode of binge eating> Recurrent inappropriate compensatory behavior used to prevent weight gain> Occurrence of binge eating and inappropriate compensatory behaviors, on average, at least twice a week for 3 months> Self-evaluation unduly influenced by body shape and weight> Does not occur exclusively during episodes of anorexia nervosa. | 155,732 | medmcqa_train |
Prolonged exposure to noise levels greater than the following can impair hearing permanently - | Repeated or continuous exposure to the noise around 100 decibels may result in a permanent hearing loss; inner ear damage may vary from minor changes in the hair cells to complete destruction of the organ of Coi. Park's Textbook of Preventive and Social Medicine, 22nd edition, Page No. 689 | 155,733 | medmcqa_train |
Defect in type II hyperlipidemia | Familial hypercholesterolemia (type Ha) is due to deficiency of functional LDL receptors as a result of different types of mutations. | 155,734 | medmcqa_train |
What is meant by suppositious child - | Ans. is 'c' i.e., Child rear up by a woman & She claims the child Suppositious child Suppositious child means a factitious child. o Women may pretend pregnancy as well as delivery & later produces a child as if it is her own. She may substitute a living male child for a dead child or for a living female child born of her. | 155,735 | medmcqa_train |
Corneal endothelial cell count is done by - | Ans. is 'a' i.e., Specular microscopy o Specular microcopy is used for corneal endothelial density.Important corneal examinationsCsed foro Keratometry. Comeal topographyCurvature of corneao Specular microscopyCorneal endothelial densityo Slit lampCorneal opacityo PachymeterThickness of corneao Placido's discCorneal sheeno Fluorescein, Alacian blue & Bengal rose stainComeal stainingo Window reflex, slit lamp biomicroscopy, Placidos' discComeal surface | 155,736 | medmcqa_train |
All are true about Amoebic liver abscess except: March 2007 | Ans. B: Alcoholics are susceptible to develop amoebic liver abscess Amebic liver abscess is the most frequent extraintestinal manifestation of Entamoeba histolytica infection. This infection is caused by the protozoa Ehistolytica, which ascends the poal venous system. The right lobe (posterior superior quadrant) of the liver is more commonly affected than the left lobe. This has been attributed to the fact that the right lobe is supplied predominantly by the superior mesenteric vein, whereas the left lobe is supplied by the splenic vein. Histologic Findings of abscess The abscess contains acellular proteinaceous debris and is surrounded by a rim of amebic trophozoites invading tissue. The abscess contains a chocolate-colored fluid that resembles anchovy paste and consists predominantly of necrotic hepatocytes. Complications Pleuropulmonary infection is the most common complication. Cardiac involvement results following the rupture of an abscess involving the left lobe of the liver. It usually is associated with very high moality. Intraperitoneal rupture occurs in 2-7% of patients. Left lobe abscesses are more likely to progress to rupture because of their later clinical presentation. Bacterial superinfection can occur. | 155,737 | medmcqa_train |
All of the following conditions are associated with primary amenorrhea except: | Ans. is b, i.e. Stein-Leventhal syndromeRef: Shaw 15th/ed, p284-285The Stein-Leventhal Syndrome also known as Polycystic Ovarian Disease (PCOD) is an important cause of Secondary Amenorrhea in young women.Testicular Feminizing syndrome, Turners syndrome and Mayer Rokitansky Kuster Hauser syndrome are causes of Primary amenorrhea. | 155,738 | medmcqa_train |
What is the drug of choice for Obsessive Compulsive Disorder? | Ans. (B) Fluoxetine(Ref: Harrison 17/e p2715; CMDT 2010/943; KDT 8/e p492)SSRIs are drug of choice for most of the neurotic disorders including OCD. | 155,739 | medmcqa_train |
The drug causing curare like effects are all except | Refer KDT 6/e p 346 Drugs causing curare like effect are Aminoglycosides Polypeptide antibiotics Tetracycline Clindamycin, lincomycin | 155,740 | medmcqa_train |
Investigation of choice on Meckel's Diveicula in pediatric age group is | In case of children 99mTc-peechnetate is preferentially taken up by the mucus secreting cells of gastric mucosa and ectopic gastric tissue in Meckel's Diveicula. In adults less ectopic gastric tissue is seen so the test is not much accurate in adults Ref: Sabiston 20th edition Pgno :1285 | 155,741 | medmcqa_train |
Os trigonum is which type of epiphysis ? | C i.e. Atavistic | 155,742 | medmcqa_train |
Wolff-chaikoff effect is - | Ans. is 'c' i.e., Reduced thyroxine synthesis by iodides Iodine and Iodideso Iodine is the fastest acting thyroid inhibitor.o Most important action is inhibition of hormone release (thyroid constipation)\ but all facets of thyroid synthesis may be affected.o Excess iodide inhibits its own transport in thyroid cells and may alter the redox potential of cells, thus interfering iodination - reduced T4/T3 synthesis (Wolff-chaikoff effect). | 155,743 | medmcqa_train |
Growth of virus in embryonated egg, eggs are incubated for - | Ans. is 'c' i.e., 5-12 days "For virus isolation, feile chicken eggs are incubated for 5-12 days, and a viral Suspension or suspected virus - containing" tissue is injected into the fluid of the egg. | 155,744 | medmcqa_train |
Which of the following is primarily a bactericidal drug? | Aminoglycosides: Streptomycin, Gentamicin, Amikacin, Neomycin, etc. are considered as bactericidal drugs. | 155,745 | medmcqa_train |
N K cell shows presence of - | Ans. is 'b' i.e., CD 16 o NK cells have CD-56 and CD-16 on their surface. | 155,746 | medmcqa_train |
A radiologist notes the presence of fine, radiographically dense crystals in the tissues of a knee joint. This patient most likely has which of the following types of ahropathy? | Radiographically dense calcium pyrophosphate dihydrate (CPPD) crystals are deposited in cailage and joint soft tissues in pseudogout, which can involve the knees, wrists, elbows, shoulders, or ankles. If the patient is asymptomatic because the deposition is primarily within cailage, the condition is sometimes called chondrocalcinosis. In its more severe form, the joint involvement can clinically resemble rheumatoid ahritis. Neither gonococcal ahritis, osteoahritis, nor rheumatoid ahritis are associated with crystal formation. The monosodium urate crystals deposited in joints in gouty ahritis are not radio-opaque. Ref: Wyatt C., Kemp W.L., Moos P.J., Burns D.K., Brown T.G. (2008). Chapter 19. Pathology of the Bones and Joints. In C. Wyatt, W.L. Kemp, P.J. Moos, D.K. Burns, T.G. Brown (Eds), Pathology: The Big Picture. | 155,747 | medmcqa_train |
All are seen with Pneumocystis carini in AIDS except: | In addition to pneumonia, a number of other clinical problems have been repoed in HIV-infected patients as a result of infection with P. jiroveci as:- Otic involvement may be seen as a primary infection, presenting as a polypoid mass involving the external auditory canal. In patients receiving aerosolized pentamidine for prophylaxis against PCP, one may see a variety of extrapulmonary manifestations of P. jiroveci. These include ophthalmic lesions of the choroid, a necrotizing vasculitis that resembles Buerger's disease, bone marrow hypoplasia, and intestinal obstruction. Other organs that have been involved include lymph nodes, spleen, liver, kidney, pancreas, pericardium, hea, thyroid, and adrenals. | 155,748 | medmcqa_train |
All of the following aeries are common sites of occlusion by a except: | Answer is D (Marginal aery) | 155,749 | medmcqa_train |
von Willebrand disease is a defect of | Primary hemostasis: the formation of the platelet plug.Disruption of the endothelium exposes subendothelial von Willebrand factor (vWF) and collagen, which promote platelet adherence and activation. Activation of platelets results in a dramatic shape change as well as the release of secretory granules. Within minutes the secreted products recruit additional platelets, which undergo aggregation to form a primary hemostatic plug.Defects of primary hemostasis (platelet defects or von Willebrand disease) often present with small bleeds in the skin or mucosal membranes. These bleeds typically take the form of petechiae, minute 1 to 2 mm hemorrhages, or purpura, which are slightly larger (>=3 mm) than petechiae. Mucosal bleeding associated with defects in primary hemostasis may take the form of epistaxis (nosebleeds), gastrointestinal bleeding, or excessive menstruation (menorrhagia).Ref: Robbins and Cotran Pathologic; 9th edition; Chapter 4; Hemodynamic Disorders, Thromboembolic Disease, and Shock; Page no: 122 | 155,750 | medmcqa_train |
All true about sodium Thiopentone except - | Thiopentone is ultrasho acting barbiturate. Thiopentone does not produce analgesia and may even produce antianalgesia by reducing the pain threshold. Thiopentone has rapid onset of action (within 30 s) due to high lipid solubility and high non ionized fraction (60%). And ultra-sho duration of action (within 20 mins) due to rapid redistribution. Thiopentone does not completely suppress airway responses to laryngoscopy and intubation and may lead to bronchospasm in asthmatics. Thiopentone is cerebro protective: It reduces CSF volume by facilitating its absorption. It decreases CBF and cerebral blood volume, thus lowering intracranial pressure. It also has anticonvulsant propey which is advantageous in neurosurgical patients who are at increased risk of seizures. | 155,751 | medmcqa_train |
Which of the following antihypeensive inhibits vesicular uptake of NA - | Ans. is 'c' i.e., Reserpine o Reserpine inhibits vesicular uptake of NA, 5-HT & DA --) monoamines are gradually depleted and degraded by MAO. | 155,752 | medmcqa_train |
Gastric emptying is decreased by all of the following EXCEPT: | Acidity of the chyme, hyper- or hypo-osmolarity of the duodenal contents, irritation of the duodenal mucosa, protein or fat breakdown products in duodenum are the factors sensed by the duodenal receptors. Gastric emptying will then be decreased, by a combination of neural and hormonal signals. Neural signals would be enterogastric reflexes in the ENS; they are triggered by the acidic chyme in the duodenum. Hormonal signals would be in the form of CCK, Secretin, G.I.P. released from duodenal mucosa. Fat in the duodenum is very potent inhibitor of gastric emptying; it causes CCK release. Hormonal factors decrease the gastric motility and cause constriction of pyloric sphincter. Other effects include: fundic relaxation, inhibition of antral motor activity. Gastrin, in physiological amounts, is known to increase gastric motility. | 155,753 | medmcqa_train |
Cystic supratentorial tumor is? | Ans. is 'a' i.e. Craniopharyngioma * Craniopharyngioma is supratentorial slow growing cystic tumor.Other options* Ependymoma can both supra and infratentorial.* Medulloblastoma is an infratentorial tumor. | 155,754 | medmcqa_train |
Microbiologic studies on a gram-positive coccus isolated from a skin abscess demonstrate a positive catalase test and a positive coagulase test. This is most consistent with which of the following organisms? | All of the organisms listed are gram-positive cocci. The positive catalase test excludes the Streptococci, S. pyogenes, and S. pneumoniae. Of the Staphylococci, only S. aureus has a positive coagulase test. S. epidermidis and S. saprophyticus are coagulase-negative Staphylococci. Ref: Ray C.G., Ryan K.J. (2010). Chapter 24. Staphylococci. In C.G. Ray, K.J. Ryan (Eds), Sherris Medical Microbiology, 5e. | 155,755 | medmcqa_train |
True about incest is: Karnataka 11 | Ans. Not punishable in India | 155,756 | medmcqa_train |
Pneumocytes are cells found in epithelial lining of: | PneumocytesTwo types of pneumocytes contribute to the maintenance of the alveoli of the lungsType I pneumocytes and Type II pneumocytes.These cells function to aid in gas exchange, secretion of pulmonary surfactant, and self-regeneration | 155,757 | medmcqa_train |
Which one of the following is not a feature of liver histology in Non cirrhotic poal fibrosis (NCPF) ? | Ans. is 'd' i.e., Bridging fibrosisFibrosis bridging one poal tract to another (bridging fibrosis) is not seen.Pathology : o Non cirrhotic poal fibrosis is primarily a vascular disorder of the liver characterized by fibrous intimal thichening of the poal vein or its branches in patients with non cirrhotic protal hypeension.Vascular changesHallmark of the disease is thrombosis/sclerosis of the poal vein branches.The poal vein is dilated with sclerosis of the walls and in autopsy thrombin in medium or small poal vein branches with accompanying areas of ischaemic necrosis have been repoed.Aberrant Intrahepatic vessels may be present in the peripoal area, which correspond to dilated terminal poal vein branches or venules. These are often termed as "megasinusuoids" or peripoal angiomatosis. FibrosisVascular changes are accompanied by poal and peripoal fibrosis of varying extent. | 155,758 | medmcqa_train |
Which of the following is a harmful: March 2009 | Ans. A: Alpha Paicle The radiation one typically encounters is one of four types: alpha radiation, beta radiation, gamma radiation, and X-radiation. Neutron radiation is also encountered in nuclear power plants and high-altitude flight and emitted from some industrial radioactive sources. A Alpha radiation is a heavy, very sho-range paicle and is actually an ejected helium nucleus. Some characteristics of alpha radiation are: Most alpha radiation is not able to penetrate human skin. Alpha-emitting materials can be harmful to humans if the materials are inhaled, swallowed, or absorbed through open wounds. A thin-window Geiger-Mueller (GM) probe can detect the presence of alpha radiation. Instruments cannot detect alpha radiation through even a thin layer of water, dust, paper, or other material, because alpha radiation is not penetrating. Alpha radiation travels only a sho distance (a few inches) in air, but is not an external hazard. Alpha radiation is not able to penetrate clothing. Examples of some alpha emitters: radium, radon, uranium, thorium. Alpha paicle has poor penetration but maximum ionizing power and is most damaging. B. Beta radiation is a light, sho-range paicle and is actually an ejected electron. Some characteristics of beta radiation are: Beta radiation may travel several feet in air and is moderately penetrating. Beta radiation can penetrate human skin to the "germinal layer," where new skin cells are produced. If high levels of beta-emitting contaminants are allowed to remain on the skin for a prolonged period of time, they may cause skin injury. Beta-emitting contaminants may be harmful if deposited internally. Most beta emitters can be detected with a survey instrument and a thin-window GM probe (e.g., "pancake" type). Examples of these difficult-to-detect beta emitters are hydrogen-3 (tritium), carbon-14, and sulfur-35. Clothing provides some protection against beta radiation. Examples of some pure beta emitters: strontium-90, carbon-14, tritium, and sulfur-35. Beta paicle has moderate penetration, moderate ionizing power and is moderate damaging. C. Gamma radiation and X-rays are highly penetrating electromagnetic radiation. Some characteristics of these radiations are: Gamma radiation or X-rays are able to travel many feet in air and many inches in human tissue. They readily penetrate most materials and are sometimes called "penetrating" radiation. X-rays are like gamma rays. X-rays, too, are penetrating radiation. Sealed radioactive sources and machines that emit gamma radiation and X-rays respectively constitute mainly an external hazard to humans. Gamma radiation and X-rays are electromagnetic radiation like visible light, radiowaves, and ultraviolet light. Dense materials are needed for shielding from gamma radiation. Clothing provides little shielding from penetrating radiation, but will prevent contamination of the skin by gamma-emitting radioactive materials. Gamma radiation is easily detected by survey meters with a sodium iodide detector probe. Gamma radiation and/or characteristic x rays frequently accompany the emission of alpha and beta radiation during radioactive decay. Examples of some gamma emitters: iodine-131, cesium-137, cobalt-60, radium-226, and technetium-99m. Gamma paicle are most penetrating, minimum ionizing power and is least damaging | 155,759 | medmcqa_train |
Drug of choice for treatment of leptospirosis is: | Penicillin is the drug of choice for treatment of leptospirosis. Other drugs used are tetracycline and doxycycline. Ref: Park 21st edition, page 267. | 155,760 | medmcqa_train |
A 42 year old paraplegic woman has a neurogenic bladder and requires an indwelling urinary catheter. She develops a urinary tract infection and is seen by a urologist, who orders abdominal x-rays and an intravenous pyelogram. The radiographic studies demonstrate a very large stone that fills and follows the contours of the renal pelvis. The stone is most likely composed of which of the following? | Staghorn calculi, such as described in the question, are associated with infection by urea-splitting bacteria (notably Proteus species) and are composed of magnesium ammonium phosphate (struvite). They are more common in women than men, and are far more common in patients requiring chronic bladder catheterisation. Calcium-containing stones are typically seen in patients with hypercalciuria without hypercalcemia; one-fifth of patients with this type of stone have hyperuricosuria. Cholesterol is found in gallstones, not kidney stones. Cystine stones are rare; they may be seen in patients with cystinuria, an autosomal recessive disorder of amino acid metabolism. Ref: Wyatt C., Butterwoh IV J.F., Moos P.J., Mackey D.C., Brown T.G. (2008). Chapter 16. Pathology of the Kidney and Bladder. In C. Wyatt, J.F. Butterwoh IV, P.J. Moos, D.C. Mackey, T.G. Brown (Eds), Pathology: The Big Picture. | 155,761 | medmcqa_train |
Temporary and permanent removed by – | Permutit method (Base exchange process) can remove both permanent and temporary hardness. | 155,762 | medmcqa_train |
Puerperal pyrexia is defined as a temperature of more than: | A temperature of 38.0degC (100.4degF) or higher--in the puerperium. Causes Genital tract infection Breast engorgement Urinary infections Wound infection Perineal lacerations infection Respiratory complications Predisposing factors Home bih in unhygienic conditions, low socioeconomic status poor nutrition primiparity anemia prolonged rupture of membranes prolonged labor multiple vaginal examinations in labor cesarean section obstetrical maneuvers retained bits of placental membranes, tissues within the uterus Maternal complications septicemia endotoxic shock peritonitis or abscess formation | 155,763 | medmcqa_train |
CB 1 antagonist used in smoking cessation is ? | Ans. is 'b' i.e., Rimonabant Rimonabant A selective cannabinoid receptor-1 (CB-1) antagonist which is being tried as antismoking and antiobesity drug. | 155,764 | medmcqa_train |
Which of the following is not true about the difference between congenital cataract surgery and senile cataract surgery? | The energy used in phacoemulsification is lesser as compared to the senile cataract. Congenital Cataract Surgery Treatment of choice: Lens aspiration by manual SICS technique or by phaco-emucification technique. Lensectomy can be done in total cataract with retinal detachment or ROP or any congenital retinal condition where lens aspiration can't be done. IOL should be put in every child above 2 yrs of age and even in less than 2 year of age, less than 6 month avoid putting IOL. A unilateral cataract has to be operated asap.(within days) Note- Bilateral dense cataracts-removed early that is within 6 weeks of bih to prevent stimulus deprivation amblyopia. Extra edge: - In congenital cataract surgeries, Ziegler knife is used to open lens capsule & aspirate lens material. ZIEGLER KNIEF | 155,765 | medmcqa_train |
What is the ideal treatment for a 55-years-female with Simple hyperplasia of the endometrium with Atypia? | Management of Atypical Endometrial Hyperplasia:
"Hysterectomy is the best treatment for women at any age with atypical endometrial hyperplasia because the risk of concurrent subclinical invasive disease is high."
Williams Gynae 1st ed p 691
"In presence of atypia, response to progesterone therapy is poor and the relapse rate is high. Nearly one-third of them will progress to cancer and one-fourth may already have associated undiagnosed cancer. In women approaching or post menopause, hysterectomy is a safer choice in those with complex or atypical hyperplasia."
Jeffcoate 7th/ ed p 425
So Remember: Best management of atypical hyperplasia is hysterectomy.
Also, Know Management of Endometrial Hyperplasia:
Management depends on the patient's age and the presence or absence of cytological atypia.
Non-atypical hyperplasia:
Premenopausal women: Progesterone therapy-
options: - Medroxyprogesterone acetate for 21 days a month daily for 3 months.
Progesterone-containing IUCD.
Postmenopausal women
Simple hyperplasia without atypia - Generally followed without therapy.
Complex hyperplasia without atypia - Cyclical/continuous progesterone therapy.
These patients should be followed annually by endometrial biopsy.
Atypical hyperplasia:
The ideal treatment is a hysterectomy
Premenopausal women willing to preserve fertility - High dose progesterone therapy after full information of risk of undiagnosed cancer or progression to cancer. In these cases periodic TVS and endometrial biopsy is necessary. | 155,766 | medmcqa_train |
Ehrlich phenomenon is seen in | The difference between the amount of diphtheria toxin that will exactly neutralize one unit of antitoxin and that which, added to one unit of antitoxin, will leave one lethal dose free is greater than one lethal dose of toxin; i.e., it is necessary to add more than one lethal dose of toxin to a neutral mixture of toxin and antitoxin to make the mixture lethal (the basis of the L+ dose). Reference: Textbook of Microbiology; Anathanarayan and panicker's; 9th edition | 155,767 | medmcqa_train |
"Boiler's notch" is suggestive of ? | Boiler notch/Acoustic dip is seen in Noise induced hearing loss NIHL Boiler notch at 4000Hz Notch is seen in BC curve AC curve notch are insignificant Maximum seen at 3000-6000Hz Sound causing maximum NIHL 2000-3000Hz Stereocilia of Outer hair cells are first to be affected | 155,768 | medmcqa_train |
A 40 year old woman presents with a three day history of irritation, pain, and watery discharge of her left ear. She has just returned from holiday, where she admits to using her towel, aificial nails, and ear buds to try to allete itching in her ear. What is the likely diagnosis? | Inflammation of the ear canal with or without infection is the charecteristic of acute otitis externa. If symptoms are recurrent or if they last longer than three months, the condition is classed as chronic otitis externa. Acute otitis externa can also be classified according to its cause. These are split into three main groups: Infective (bacterial, fungal, and viral), Non-infective dermatitis (allergic, eczematous, and irritant), and Mixed infective and non-infective Exacerbating factors include: Warm humid climates, swimming, frequent hair washing (especially if in the bath), and inseion of foreign bodies can introduce bacterial infection and cause local trauma to the ear canal, making infection more likely. Prolonged use of hearing aids may also predispose to infection. | 155,769 | medmcqa_train |
Following anterior dislocation of the shoulder, apt develops weakness of flexion at the elbow and lack of sensation over the lateral aspect forearm; nerve injured is - | The most common complication of anterior dislocation of the shoulder is axillary (circumflex) nerve injury.
There is consequent paralysis of the deltoid muscle, with a small area of anaesthesia at the lateral aspect of the upper arm.
However, in this question, the sensation is lost on the lateral aspect of the forearm (not arm). The lateral side of the forearm has sensory supply from the lateral cutaneous nerve of foreign, a branch of musculocutaneous nerve. The musculocutaneous nerve also supplies the biceps brachii (a flexor of elbow joint).
Therefore, musculocutaneous nerve injury will cause sensory loss over the lateral aspect of the forearm with the weakness of flexion at the elbow.
As occasionally other branches of brachial plexus (other than axillary nerve) can also be injured, the answer to this question is a musculocutaneous nerve. | 155,770 | medmcqa_train |
Heavy smoker for elective hernia repair, smoking should be stopped before how much period? | Ans. is 'd' i.e., 6-8 weeksRef: Postgraduate anaesthesia p. 786'Limited prospective data suggest that cessation for at least 6-8 weeks preoperative is necessary to decrease the incidence of pulmonary complication." | 155,771 | medmcqa_train |
A nerve injured in radical neck dissection leads to loss of sensation in medial side of the arm, nerve injured is:- | Nerve injured in radical neck dissection leads to loss of sensation in medial side of the arm, nerve injured is medial cutaneous nerve of arm. The medial cutaneous nerve of arm supplies the skin of the medial aspect of the arm. It is the smallest branch of the brachial plexus, and arises from the medial cord and contains fibres from the eighth cervical and first thoracic ventral rami. | 155,772 | medmcqa_train |
Inward flow of Na+ in hea leads to | Entry of Na ions into cardiac cell leads to depolarisation. (REF TEXTBOOK OF MEDICAL PHYSIOLOGY GEETHA N 2 EDITION, PAGE NO 52) | 155,773 | medmcqa_train |
Apoplexy is: DNB 08 | Ans. Sudden onset of bleeding in the brain | 155,774 | medmcqa_train |
A 17-year old male complains of recurrent episodes of cough, wheezing and shoness of breath paicularly at night for the last 3 days. His sibling has a history of similar symptoms. A Skin test with pollen produces immediate wheal and flare. The laboratory finding most consistent with his clinical findings would be | Atopy is the major risk factor for asthma.Patients with asthma commonly suffer from other atopic diseases,paicularly allergic rhinitis and atopic dermatitis.Eosinophilic infiltration of airways along with peripheral eosinophilia is a characteristic feature seen in asthmatic patients.There will also be elevated total serum IgE and specific IgE to inhaled allergens(radioallergosorbent test) in atopic asthma. Ref:Harrison's medicine-18th edition,page no:2109. | 155,775 | medmcqa_train |
HLA complex in humans is located on? | Ans. b (Short arm of chromosome 6). (Ref Harrison's medicine 16th ed. 1930)MAJOR HISTOCOMPATIBILITY COMPLEX (MHC)# MHC is a gene cluster of various loci grouped together on a single locus.# The MHC of humans, or the HLA complex, is located on the short arm of chromosome 6 approximately 32 CM from the centromere.# The loci of the HLA complex may be divided into three classes: Class I, Class II, and Class III.# The products of Class I and Class II genes play an important role in the communication between cells. These MHC molecules are surface proteins which present antigenic peptides to T lymphocytes. | 155,776 | medmcqa_train |
With which of the following receptors theophylline has an antagonist interaction? | theophylline is an eg of methylxanthine the action of this identified as a) release of ca from sarcoplasmic reticulum b) inhibition of phosphodiesterase c)blockade of adenosine receptor ESSENTIALS OF MEDICAL PHARMACOLOGY SEVENTH EDITION KD TRIPATHI PG NO.226 | 155,777 | medmcqa_train |
Prodrug of cetrizine is | Ans. is 'c' i.e., Hydroxyzine Cetrizine is a metabolite of Hydroxyzine with marked affinity for peripheral HI receptors; penetrates brain poorly. It inhibits release of histamine and of cytotoxic mediators from platelets as well as eosinophil chemotaxis during secondary phase of allergic response. It is indicated in upper respiratory allergies, pollinosis, uicaria and atopic dermatitis; also used as adjuvant in seasonal asthama. | 155,778 | medmcqa_train |
All the following are true of Craniopharyngioma except | Answer is C (Present in sella or infrasellar location): Some of these lesions arise from the sella, but most are suprasellar Q (Not infra-sellar). They arise from near the pituitary stalk and commonly extend into the supra sellar cistern. Craniopharyngiomas arise from Rathke's pouch and constitute 3-5% of all intracranial neoplasms. Some of these lesions arise from the sella, but most are suprasellar Q (Not infra-sellar). They arise from near the pituitary stalk and commonly extend into the supra sellar cistern. Consists of nests of cords of stratified squamous or columnar epithelium embedded in a spongy reticulum -- Robbins 61h/1129 Visual complaints are the presenting feature in about 80% of adults and 60% of children. | 155,779 | medmcqa_train |
Characteristic feature of early congenital syphilis is: | D i.e. Vesicular rash with bulla over palms & soles | 155,780 | medmcqa_train |
All of the following are true of pulmonary embolism except: | Classic Findings in Pulmonary Embolism:- Right Hea strain and Acute Cor Pulmonale - sudden onset of pleuritic chest pain, hemoptysis and hypotension - Tall, peaked P waves in lead II (P pulmonale) - Right axis detion - Right bundle-branch block - S1Q3T3 pattern. On Xray :- Hampton's hump, Westermark sign (areas of relative oligemia secondary to decreased caliber of regional pulmonary aeries) and Palla's sign (Enlarged right descending pulmonary aery )are seen. - CTPA is imaging modality of choice - It shows Rt. ventricular stress instead of left ventricular stress. | 155,781 | medmcqa_train |
A patient presented with pain in left eye associated with visual distrubance, also a history of blunt trauma to eye 4 month back, first investingation of choice is | A i.e. Intraocular tension This is a case of angle recession glaucoma | 155,782 | medmcqa_train |
Not seen in the peripheral smear in plasmodium falciparum infection - | Schuffner&;s dot in the Rbc can be seen in P. vivax and P. Ovale infection Maurer&;s dot -falciparum Ziemman&;s dot- malariae (refer pgno:61 baveja 3 rd edition) | 155,783 | medmcqa_train |
Carina is situated at which level | Carina is located at the bifurcation of trachea at lower border of T4.carina is the lower margin of lowest cailaginous ring that is a keel-shaped process curving downwards and backwards between the bronchi.The mucous membrane lining the area is highly sensitive and is origin of the protective cough reflex. It is visible during bronchoscopy and hence is an impoant landmark.If lymph nodes here enlarge due to spread of bronchogenic cancer, the carina becomes flattened and distoed.Reference: Clinical Anatomy for students, a problem-solving approach, Neeta v Kulkarni, 2nd edition, page no.211,212 | 155,784 | medmcqa_train |
Bromocriptine can be used in following conditions except | Refer KDT 7th/e Pg 239. Bromocripine is approved in diabetes mellitus not diabetes insipudus Bromocriptine is an ergoline derivative and dopamine agonist that is used in the treatment of pituitary tumors, Parkinson's disease, hyperprolactinaemia, neuroleptic malignant syndrome, and type 2 diabetes. | 155,785 | medmcqa_train |
Calcification of soft tissues without any distrubances of calcium metabolism is called | Ref,Robbins 9/e p65 | 155,786 | medmcqa_train |
Wavelength of Nd:Yag laser | A i.e. 1040 nm | 155,787 | medmcqa_train |
Least common organ affected in blast injury is - | Ans. is 'c' ie., Muscles * An explosion is a phenomenon resulting from sudden release of energy which is then dissipated by a blast wave, by translocation of objects, or by the generation of heat.* Injuries in explosion occur due to four factors:-1) Blast or shock wave# When an explosion occurs, the explosive material produces a large volume of gas and releases a large amount of energy. It produces a 'shock wave' which spread concentrically from the site of explosion.# The injuries depend on the enviornment in which blast occurs:-i) Air blast (most common):* Explosion occurs in air. There is barotrauma to airfilled hollow organs. Tympanic membrane (ear drum) is most sensitive and most commonly injured. Lung is the second organ to be injured and is the most commonly injured hollow organ and most common cause of life threatening injury.* Other parts injured are middle ear, cochlea, eyes, bowels, mesentery, omentum and brain. Homogenous solid organs like liver and muscles are usually not affected.ii) Under water blast (explosion under water):* Gastrointestinal tract is injured most commonly. Lungs are also injured.iii) Solid blast:* Explosive is detonated near a rigid/solid structure and wave of energy spreads through it. If people are in contact with that rigid structure, injuries take place.* The injuries are mostly skeletal; fracture of legs and vertebral column are more common. GIT damage is more common than lung.2) Flame or hot gases# Burns or burning of body may occur.3) Flying missiles (debris)# Flying pieces of explosive debris may be driven through air against the skin causing bruises, abrasions, lacerations, and ragged perforations.4) Anoxia# Various gases liberated during explosion may cause anoxia, e.g. carbon monoxide, nitrous oxide, nitric oxide, HCN and SO2 | 155,788 | medmcqa_train |
A 58-year-old postmenopausal woman on estrogen replacement complains of recent onset of spotting. A bimanual pelvic examination is unremarkable. Most likely diagnosis? | Any postmenopausal woman who has been on unopposed estrogen and who is now experiencing vaginal bleeding is suspect for either endometrial hyperplasia or endometrial cancer. Endometrial hyperplasia is the end result of prolonged estrogenic stimulation of the endometrial mucosa. Morphologic forms of hyperplasia include cystic, adenomatous, and atypical hyperplasia. In cystic hyperplasia (simple hyperplasia), there are large, dilated glands lined by actively mitosing epithelial cells. Adenomatous hyperplasia refers to branching of the glands with papillary infolding or outpouchings (sometimes referred to as complex hyperplasia). Atypical hyperplasia has more glandular crowding and nuclear atypia than the latter condition and has the highest risk for progressing into carcinoma in situ and endometrial carcinoma. Endometrial carcinoma is the most common invasive cancer of the female genital tract. As with endometrial hyperplasia, the risk factors for endometrial cancer primarily relate to hyperestrinism and include obesity, nulliparity, diabetes, hypeension, infeility, breast cancer, low fiber/high fat diet, early menarche or late menopause, and tamoxifen. The most common clinical presentation is vaginal bleeding (90%) in a postmenopausal woman. | 155,789 | medmcqa_train |
Methods of introducing gene in target cells are all except | Fluorescence in situ hybridization(FISH) is a cytogenetic technique that uses fluorescent probes that bind to only those pas of the chromosome with a high degree of sequence complementarity. | 155,790 | medmcqa_train |
Treatment of pleomorphic adenoma without facial nerve infiltration and limited to superficial lobe: | Pleomorphic adenoma: * Most common salivary gland tumor * Benign, painless tumor with no facial nerve involvement * Most common site - Parotid, Submandibular, Sublingual, minor salivary gland * Location: Infront, below and behind ear lobule * Pathology: Mixed tumor has both epithelial and mesenchymal component * Tumor has finger like projections (pseudopodia)- so, Enucleation is C/I * Diagnosis: FNAC * Treatment: Superficial Parotidectomy | 155,791 | medmcqa_train |
Post is not required in all of the following conditions except: | Conditions where post should not be given:
Any sign of endodontic failures are evident, i.e. tooth exhibits:
Poor apical seal and poor quality obturation
Active inflammation
Presence of fistula or sinus
Tender on percussion
If adequate retention of core can be achieved by natural undercuts of crown.
If there are horizontal cracks in the coronal portion of the teeth.
When tooth is subjected to excursive occlusal stresses, that is, when there is presence of lateral stresses of bruxism or heavy incisal guidance. | 155,792 | medmcqa_train |
Pearson's Coefficient of skewness is defined as: | The coefficient used for checking the skewness of data, is called as the Karl Pearson coefficient, and is calculated as (Mean - Mode) S.D. Ref: Instant Medical Biostatistics, By Ranjan Das, Papri N. Das, 2009 Ane's Instant Medical Series, Page 41, 42. | 155,793 | medmcqa_train |
Stocker's line is seen a – | Stocker's line is a line of iron deposition in the corneal epithelium seen adjacent to the head of the pterygium. | 155,794 | medmcqa_train |
Ovarian artery is a branch of- | Ans. is 'a' i.e., Abdominal aorta * 'Ovarian artery is a branch of abdominal aorta' | 155,795 | medmcqa_train |
Which of the following anti-angina drugs act by inhibition of long-chain 3-ketoacyl coenzyme A thiolase? | Trimetazidine Antianginal drug that act by inhibiting mitochondrial long-chain 3-ketoacyl coenzyme A thiolase enzyme. Reduced fatty acid metabolism and increased glucose metabolism in myocardium leading to a paial shift from FFA to glucose oxidation in the hea, which provides less ATP but requires less O2 and may therefore be beneficial in ischemia. Efficient in reducing angina and increase exercise tolerance, paicularly in patients with diabetes and hea failure. | 155,796 | medmcqa_train |
Post treatment HCG levels, during the follow up of molar pregnancy evacuation, comes back to normal in: | HCG follow up of vesicular mole: - weekly HCG estimation till negative (vesicular mole takes 9 weeks and paial mole takes 7 weeks) - weekly HCG till 3 more weeks - Once in a month for 6 months . Avoid pregnancy during this time. Use contraception, best being COCPs | 155,797 | medmcqa_train |
which of the following antidepressent can be safely used in elderly depresion | NaSSA * IMPOANCE Nor adrenergic and specific serotonergic antidepressant * MECHANISM * Alpha 2 adrenergic receptor antagonism=== increase serotonin and NA * 5HT2,3 antagonist============increase sleep and appetite * DRUGS miazapine * USE Elderly with depression * SIDE EFFECTS hyperlipidemia Ref. kaplon and aock, synopsis of psychiatry, 11 th edition, 955 | 155,798 | medmcqa_train |
Most common psychiatric disorder in community is | (A) Depression # DEPRESSION is the most common psychiatric illness in India.> Neurotic depression is far common than psychotic depression.> Neurotic depression is followed by anxiety neurosis is prevalence.> This is in contrast to West, where anxiety neurosis is the commonest. | 155,799 | medmcqa_train |
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