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McBurney's point corresponds to which pa of appendix: | Base | 155,800 | medmcqa_train |
Muscle not supplied by median nerve REPEATED | Opponens pollicis, abductor pollicis brevis and first lumbrical is supplied by the recurrent branch of median nerve in palm.Extensor pollicis brevis is supplied by the deep division of radial nerve in the forearm.B D Chaurasia 7th edition Page no: 182 | 155,801 | medmcqa_train |
Thyroid malignancies appear on USG as | On sonography, thyroid tumors are solid,hypoechoic masses. | 155,802 | medmcqa_train |
Which micronutrient deficiency causes anemia? | Ans. is 'a' i.e., CopperCopper containing protein ceruloplasmin is necessary for transpo of iron in the Ferric form across membranesCopper is an integral component of ALA synthase, which is necessary for heme synthesisCopper helps in the uptake of iron across normoblasts | 155,803 | medmcqa_train |
A 45-year-old female has a solitary gall stone 1.5 cm in size which was incidentally diagnosed by ultrasound. She has no symptom. What should be the best line of management? | Cholecystectomy only if she develops biliary colic * Symptomatic gallstones are the main indication for cholecystectomy. * Absolute contraindications for the procedure are uncontrolled coagulopathy and end-stage liver disease. | 155,804 | medmcqa_train |
Which one of the following is not seen in pheochromocytoma | Refer Robbins page no 1135 The dominant clinical manifestation of pheochromocytoma is hypeension observed in 90 percnt of patients.Approximately two thirds of patients with hypeension demonstrate paroxysmal episodes which are described as an abrupt precipitation elevation in blood pressure | 155,805 | medmcqa_train |
Most common site of venous thrombosis: March 2013 | Ans. B i.e. Veins of lower extremity Commoner sites of venous thrombosis includes deep vein in the lower extremity below the knee and superficial saphenous, hepatic and renal veins; dural sinuses. | 155,806 | medmcqa_train |
Duffy antigen is present in: | Ans. (c) P. VivaxRef: Microbiology by Ananthanarayan and Paniker 8th ed. 1694* Duffy antigen/chemokine receptor (DARC) also known as CD234, is a protein that in humans is encoded by DARC gene.* The Duffy antigen is located on the surface of red blood cells.* The Duffy antigen protein is also the receptor for the human malarial parasites Plasmodium vivax.* Polymorphisms in this gene are the basis of the Duffy blood group system.Clinical Significance of Duffy Antigen* Asthma: There appears to be a correlation with both total IgE levels and asthma and mutations in the Dufly antigen.* Malaria: On erythrocytes the Duffy antigen acts as a receptor for invasion by the human malarial parasites P. vivax and P. knowles.* Duffy negative individuals whose erythrocytes do not express the receptor are believed to be resistant to merozoite invasion.* HIV infection: The absence of the DARC receptor appears to increase the susceptibility to infection by HIV. HIV-1 appears to be able to attach to erythrocytes via DARC* Lung transplantation: The Duffy antigen has been implicated in lung transplantation rejection.* Multiple myeloma: An increased incidence of Duffy antigen has been reported in patients with multiple myeloma compared with healthy controls* Pneumonia: The Duffy antigen is present in the normal pulmonary vascular bed. Its expression is increased in the vascular beds and alveolar septa of the lung parenchyma during suppurative pneumonia.* Prostate cancer: Experimental work has suggested that DARC expression inhibits prostate tumor growth. The reasons for this increased risk are not known.* Sickle cell anemia: Duffy antigen-negative individuals with sickle cell anaemia tend to suffer from more severe organ damage than do those with the Duffy antigen. | 155,807 | medmcqa_train |
Hea failure cells are? | Breakdown of red cells and hemoglobin leads to the appearance of hemosiderin-laden alveolar macrophages-- so-called hea failure cells--that reflect previous episodes of pulmonary edema. (Robbins Basic Pathology,9th edition,pg no.367) | 155,808 | medmcqa_train |
Prolactinoma in pregnancy, all are true except: | Prolactinoma pituitary adenoma Prlactin level is >100ng/dl most are microadenoma<1cm diameter macroadenoma has bad prognosis visual field examination is essential to detect any compression effect on the optic nerves D.C.DUTTA&;S TEXTBOOK OF GYNECOLOGY,Pg no:464,6th edition | 155,809 | medmcqa_train |
Not true about red degeneration of myomas is : | Ans. is b i.e. Immediate Surgical intervention is required Lets see each option one by one. Red Degeneration of fibroid commonly occurs during pregnancy. (Option "a" is thus correct) The pathogenesis of fibroid is obscure but the initial change appears to be one of sub acute necrosis which is presembly due to an interference with its blood supply. Some say that aerial or venous thrombosis is the basis of this and the lesion is the result of infarction. (Option "c" is thus correct). Red degeneration should be managed conservatively with bed rest and analgesics to relieve the pain. (option "d" is thus correct) There is no need for surgical intervention. For more details on Red Degeneration, refer answer 6 | 155,810 | medmcqa_train |
Stuart's medium is a transport media for | Stuart's and Amies medium are transport media for Neisseria. | 155,811 | medmcqa_train |
Which of following is not seen in nephritic syndrome: | d. Hypocholesterolemia(Ref: Nelson's 20/e p 2521-2528, Ghai 8/e p 477-482)Features of nephritic syndrome are: Hematuria and RBC casts, Nephritic range Proteinuria (<3.5g/day), hence edema is present, Hypertension, Uremia and Oliguria. | 155,812 | medmcqa_train |
Fulminant hepatic failure can be caused by | The first modern halogenated volatile anesthetic, halothane, was introduced in 1955. Clinical exposure to halothane is associated with two distinct types of hepatic injury. Subclinical hepatotoxicity occurs in 20% of adults who receive halothane. It is characterized by mild postoperative elevations in alanine aminotransferase and aspaate aminotransferase, but is reversible and innocuous. Anaerobic halothane reduction by CYP2A6 to a 2-chloro-1,1,1-trifluoroethyl radical is thought to mediate this mild hepatic injury. The fulminant form of hepatotoxicity, commonly known as halothane hepatitis, is characterized by elevated alanine aminotransferase, aspaate aminotransferase, bilirubin, and alkaline phosphatase levels, massive hepatic necrosis following the administration of halothane. Halothane hepatitis is rare (1 in 5000 to 35,000 administrations in adults), but is fatal in 50% to 75% of these cases. Because of the potential for fatal hepatitis, halothane is no longer used in adult patients in many countries. Halothane hepatitis is caused by a hypersensitivity reaction associated with the oxidative metabolism of halothane. The highly reactive trifluoroacetyl chloride metabolite of halothane oxidation can react with nearby liver proteins. In most patients who developed hepatic necrosis after halothane anesthesia, antibodies against TFA-modified proteins were detected, suggesting that the hepatic damage is linked to an immune response against the modified protein, which acts as a neoantigen. Accordingly, patients who develop halothane hepatitis often have a history of prior exposures to halothane or other volatile anesthetics, together with symptoms suggestive of immune reactivity, such as fever, rash, ahralgia, and eosinophilia. A current hypothesis is that TFA-protein adducts induce a cytotoxic T cell reaction in sensitized individuals, which leads to liver damage. However, the immune responses observed in halothane hepatitis might not mediate liver injury. Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e | 155,813 | medmcqa_train |
Hartnup disease can present with: | Ans. (a) Pellagra like symptomsRef: Harrisons 20th ed. P 3021Hartnup Disease* It is an AR condition, mainly seen due to defect in the transport of tryptophan and other neutral amino acids from the renal tubules and intestine* Molecular defect: SLC6A19 gene (encode transporter protein of these amino acid)Clinical Features:* MC: Cutaneous photosensitivity* Constant neutral aminoaciduria* Intermittent pellagra like symptoms* Intermittent ataxia (unsteady wide based gait)Diagnosis: Obermeyer test (urinary test for indole compound)Treatment: High protein diet and Nicotinic acid Extra Mile* Drummond syndrome/Blue diaper syndrome: Tryptophan transport defect lies only in intestine, NOT in kidneyClass of substance and disorderIndividual substratesTissues manifesting transport defectMolecular defectMajor clinical manifestationsInheritanceAmino acids CystinuriaCystine, lysine, arginine, ornithineProximal renal tubule, jejunal mucosaShared dibasic-cystine transporter SLC3A1, SLC7A9Cystine nephrolithiasisARLysinuric protein intoleranceLysine arginine, ornithineProximal renal tubule, jejunal mucosaDibasic transporter SLC7A7Protein intolerance, hyperammonemia, intellectual disabilityARHartnup diseaseNeutral amino acidsProximal renal tubule, jejunal mucosaNeutral amino acid transporter SLC6A19Constant neutral aminoaciduria, intermittent symptoms of pellagraARBrain branched- chain amino acid deficiencyLeucine, isoleucine, valinePlasma membrane of blood brain barrierBranched-chain amino acid transporter SLC7A5Microcephaly, intellectual disability, seizuresARCitrullinemia type 2Aspartate, glutamate, malateInner mitochondrial membraneMitochondrial aspartate/glutamate carrier 2 SLC25413Sudden behavioral changes with stupor, coma, hyperammonemiaAR | 155,814 | medmcqa_train |
A 8-year-old boy presents with petechiae, azotemic oliguria and altered sensorium, in casualty. There is a history of diarrhoea for the past 5 days. The clinical diagnosis is – | Hemolytic uremic syndrome
HUS is characterized by the triad of -
Anaemia (microangiopathic hemolytic anaemia)
Renal failure (microangiopathy of kidney involving glomerular capillaries and arterioles).
Thrombocytopenia (due to platelet destruction)
HUS is common in children under 2 years of age. (But may also occur in older children).
It usually follows an episode of acute gastroenteritis.
The prodrome is usually of abdominal pain, diarrhoea and vomiting.
Shortly thereafter, signs and symptoms of acute hemolytic anaemia, thrombocytopenia and acute renal failure ensue.
Sometimes neurological findings also occur (But usually absent and differentiates HUS from TTP). | 155,815 | medmcqa_train |
True about Hb dissociation curve: | Oxygen-hemoglobin dissociation curve is shifted to right in the following conditions:
Decrease in partial pressure of oxygen.
Increase in partial pressure of carbon dioxide (Bohr effect).
Increase in hydrogen ion concentration and decrease in pH (acidity).
Increased body temperature.
Excess of 2,3-diphosphoglycerate (DPG) in RBC. It is also called 2,3-biphosphoglycerate (BPG). DPG is a byproduct in Embden-Meyer-hof pathway of carbohydrate metabolism. It combines with β-chains of hemoglobin. In conditions like muscular exercise and in high attitude, the DPG increases in RBC. So, the oxygen-hemoglobin dissociation curve shifts to right to a great extent. | 155,816 | medmcqa_train |
Regarding the antibacterial action of gentamicin, which of the following statements is most accurate? | (Ref:Katzung 10/e p756, 757) Aminoglycosides show concentration dependenbt killing and prolonged post antibiotic effect. For details, refer to text. | 155,817 | medmcqa_train |
Actinomycetoma is caused by: | Bacteria | 155,818 | medmcqa_train |
An important clinical feature of a concussed tooth is: | Concussion
Tooth is not displaced.
Mobility is not present.
Tooth is tender to percussion because of edema and hemorrhage in the periodontal ligament.
Pulp may respond normal to testing. | 155,819 | medmcqa_train |
Which component of the eye has maximum refreactive index | centre of the lens Repeat from Nov 08 Refractive index of each component of the eye as optical system Refractive medium Refractive index Air 1.000 Cornea ea 1.376 Aqueous humour 1.336 Lens (coex-core) 1.386-1.406 Vitreous humour 1.336 "The refractive indices of the successive layers of the lens increase from the periphery towards the nucleus. "Parson 20/e p53, 59 Note that Cornea has the strongest refractive power. The anterior surface of cornea is responsible for about 2/3rds of the eye's refractive power. | 155,820 | medmcqa_train |
Which of the following extraocular muscle of the eye is involved in intorsion, depression and abduction of the eyeball? | Superior oblique muscle of the eye innervated by the trochlear nerve is involved in intorsion (primary action), depression (secondary action) and abduction (teiary action) of the eyeball. Action of extraocular muscles: Muscle Primary action Secondary action Teiary action Medial rectus Adduction Lateral rectus Abduction Superior rectus Elevation Intorsion Adduction Inferior rectus Depression Extoion Adduction Superior oblique Intorsion Depression Abduction Inferior oblique Extoion Elevation Abduction Ref: Textbook of Ophthalmology edited by Sunita Agarwal, page 404. | 155,821 | medmcqa_train |
Which layer of epidermis is underdeveloped in the VLBW infants in the initial 7 days: | D i.e. Stratum corneum | 155,822 | medmcqa_train |
All of the following are side effects of tacrolimus, EXCEPT: | Side effects with the use of tacrolimus includes nephrotoxicity, hepatotoxicity, hypeension, tremor, seizures, diabetes mellitus, neuropathy and blurring of vision. No ototoxicity has been observed. Ref: KDT 6th Edition, Page 840; Immunopharmacology By Manzoor M. Khan, Pages 91-3; Goodman and Gilman's The Pharmacological Basis of Therapeutics, 10th Edition, Page 1470; Applied Clinical Pharmacokinetics By Baver, 2nd Edition, Page 685; Harrison's Principles of Internal Medicine, 17th Edition, Page 1987 | 155,823 | medmcqa_train |
Bacillus anthracis - | Anthrax is an endemic zoonosis in many countries; it causes human disease following inoculation of the spores of Bacillus anthracis. B. anthracis was the first bacterial pathogen described by Koch and the model pathogen for 'Koch's postulates' (see Box 6.1, p. 100). It is a Gram-positive organism with a central spore. The spores can survive for years in soil. Infection is commonly acquired from contact with animals, paicularly herbivores. The ease of production of B. anthracis spores makes this infection a candidate for biological warfare or bioterrorism. B. anthracis produces a number of toxins that mediate the clinical features of disease. The simple polychrome methylene blue (PMB) staining procedure for blood or tissue smears from dead animals (M'Fadyean reaction) established in 1903 remained accepted as a highly reliable, rapid diagnostic test for anthrax for six decades while that disease was still common in livestock throughout the world. Improvements in disease control led to anthrax becoming rare in industrialized countries and less frequent in developing countries with the result that quality controlled, commercially produced PMB became hard to obtain by the 1980s. Mixed results with alternative methylene blue-based stains then led to diagnosis failures, confusion among practitioners and mistrust of this procedure as a reliable test for anthrax. We now repo that, for laboratories needing a reliable M'Fadyean stain at sho notice, the best approach is to have available commercially pure azure B ready to constitute into a solution of 0.03 g azure B in 3 ml of 95% ethanol or methanol to which is then added 10 ml of 0.01% KOH (0.23% final azure B concentration) and which can then be used immediately and through to the end of the tests. Stored in the dark at room temperature, the shelf life is at least 12 months. Smears should be fixed with ethanol or methanol (95-100%), not by heat, and the stain left for 5 min before washing off for optimum effect. Ref Harrison20th edition pg 1078 | 155,824 | medmcqa_train |
Shift to right of oxygen dissociation curve is caused by all, EXCEPT: | Three impoant conditions affect the oxygen-hemoglobin dissociation curve: the pH, the temperature, and the concentration of 2,3-biphosphoglycerate (BPG; 2,3-BPG). A rise in temperature or a fall in pH shifts the curve to the right. When the curve is shifted in this direction, a higher PO2 is required for hemoglobin to bind a given amount of O2. Conversely, a fall in temperature or a rise in pH shifts the curve to the left, and a lower PO2 is required to bind a given amount of O2. A convenient index for comparison of such shifts is the P50, the PO2 at which hemoglobin is half saturated with O2. The higher the P50, the lower the affinity of hemoglobin for O2. Ref: Ganong's Review of Medical Physiology 23rd edition, Chapter 36. | 155,825 | medmcqa_train |
Paralysis of 3rd, 4th, 6th nerves with involvement of ophthalmic division of 5th nerve, localizes the lesion | A i.e. Cavernous sinus Abrupt (sudden/ very rapid) onset of marked systemic features (high grade fever) with proptosis, chemosis especially with prostration, sequential ophthalmoplegia (i.e. initial lateal gaze involvement), bilateral involvement and mastoid edemaQ strongly suggest the diagnosis of cavernous sinus thrombosis. - In cavernous sinus, the ophthmic division of trigeminal (Vi)nerve picks up sympathetic fibers from cavernous plexus. These are for dilator papillae muscle. Vi divides just posterior to superior orbital fissure into 3 branches (lacrimal nerve, frontal nerve, nasociliary nerve), which pass through superior orbital fissureQ - Lesions of cavernous sinus e.g. thrombosis, rupture of aneurysm of internal carotid aery at may lead to paralysis of 3rd 4th, 5th and 6th nerve Q Feature Cavernous Sinus Thrombosis Orbital Cellultis Orbital Apex Syndrome Arise from - Most septic CST arise from - Exension of inflammation - < 1% of orbital cellulitis result in sphenoid or ethmoid sinuses >> from neighbouring tissues esp OAS; howeve, >50% of these dental, facial & ear infection by gram positive bacteria sinuses (mc ethmoid); eyelid, eyeball, face etc or occur in patient with diabetes meltitus and most frequently - Aseptic thrombosis (rare) is penetrating injuries & d/t rhinocerebral caused by conditions that 1/t surgeries mucormycosis. venous thrombosis eg - Bacterial OC is more common - Ketoacidosis is most impoant polycythemia, sickle cell anemia, in children whereas, fungal risk factor b/o lack of inhibitory (vasculidities), trauma, neurosurgery, pregnancy & oral condraceptive use. (mucor or Aspergillus) affect diabetic (ketoacidosis) & immune compromised activity against Rhizopus in serum. Involve Cavernous sinus i.e. - All orbital contents may be - Superior orbital fissure - 6th CN & carotid plexus of involved and may evolve into transmitting 3rd,4th, 6th and Vi sympathetic nerves run through the substance orbital abscess cranial nerves - Optic canal transmitting optic - 3rd,4th,ophthalmic (Vi) and maxillary (V2) division of 5th (2nd) cranial nerve CN and trigeminal ganglion lie in lateral wall Onset & progression Abrupt / violent /Very RapidQ Slower (relatively) Slower (relatively) Systemic Features MarkedQ (fever, headache, nausea, vomiting) Mild (less prominent) Mild (less prominent) Mastoid edema DiagnosticQ (Present) Absent Absent Laterality Bilateral (in >50%), although initially unilateral Unilateral Unilateral Proptosis & Chemosis Marked (with eye pain) Marked (with severe eye pain) Mild to moderate (do not always complain of pain) Vision Not affected in early stagesQ May lost early if retrobulbar Lost in early stages d/t optic (2" CN) optic neuritis or compression develop nerve involvement (RAPD) present Ophthalmoplegia Sequential (beginning with 6th Concurrent & complete Concurrent & complete external (3,4,6 CN) nerve) and completeQ. Initial external ophthalmoplegia ophthalmoplegia involving 3rd,4th lateral rectus (gaze) palsyQ is d/ t early involvement of 6th nerve in substance of CS. involving 3rd,4th & 6th nerve & 6th nerve Irigeminal (V) nerve Opthalmic (V1) and maxillary - Opthalmic (V1) division involved (5 CN) (V2) division involved (= decreased corneal sensation) Clinical Features Abrupt onset marked periorbital Signs of anterior eye Visual loss (2" CN) and edema, orbital congestion (chemosis), proptosis, adnexal involvement (chemosis, edema) are usually out of ophthalmoplegia are out of propoion and often precede edema, eye pain, ptosis and ophthalmoplegia (involving 3rd, 4th, 6th cm CN) with involvement of VI & Vz. propoion to ophthalmoplegia at least initially signs of anterior eye involvement, such as proptosis periorbital (adnexel) edema, and orbital congestion | 155,826 | medmcqa_train |
False about Haptens is | Haptens are low molecular weight molecules. | 155,827 | medmcqa_train |
True about N2O – | N2O is least potent (MAC = 105%).
It has a good analgesic but poor muscle relaxant activity. | 155,828 | medmcqa_train |
Incidence of absent of kidney is | (1500) (1305-LB) (1286-B & L 25th)* An absent or grossly atrophic kidney is found in about 1:1400 individuals (1305-LB)* Renal ectopia - In approximately 1:1000 people, the kidney does not ascend, ectopic kidneys are usually found near the pelvic brim (1306-LB) | 155,829 | medmcqa_train |
BCG is not given to patient with - | <p>BCG Aim- To induce a benign,aificial primary infection which will stimulate an acquired resistance to possible subsequent infection with virulent tubercle bacilli, and thus reduce the morbidity and moality from primary tuberculosis among those most at risk. WHO recommends the &;Danish 1331&; strain for vaccine production. Stable for several weeks at ambient temperature in a tropical climate and for upto 1 year if kept away from direct light and stored in a cool environment below 10 deg celcius. Vaccine must be protected from light ( wrapped up in a double layer of red/ black cloth). Normal saline is recommended as diluent for reconstituting the vaccine as distilled water may cause irritation. Reconstituted vaccine may be used within 3 hours. Dosage-0.1 mg in 0.1 ml volume. The dose of newborn below 4 weeks is 0.05 ml. Administered intradermally using tuberculin syringe. Injected slightly above the inseion of left deltoid. If injected too high / too low adjacent lymph nodes may become involved and tender. The vaccine must not be contaminated with an antiseptic/detergent. If alcohol is used to swab the skin , it must be allowed to evaporate before the vaccine is given. Phenomenon after vaccination:/ 2-3 weeks after a correct intradermal injection of a potent vaccine, a papule develops at the site of vaccination. It increases slowly in size and reaches a a diameter of about 4-8 mm in 5 weeks. It then subsides or breaks into a shallow ulcer but usually seen covered by a crust. Healing occurs within 6-12weeks leaving a permanent,tiny, round scar (4-8 mm in diameter).This is a normal reaction. Normally the individual become mantoux postive after 8 weeks has elapsed. Adverse reactions: prolonged severe ulceration at the site of vaccination, suppurative lymphadenitis, osteomyelitis and disseminated BCG infection. Contraindications: BCG should not be given to patients with generalised eczema, infective dermatosis, hypogammaglobulinemia , those with history of deficient immunity, patients under immunosuppressive treatment and in pregnancy. {Reference: park&;s textbook of preventive and social medicine, 23rd edition, pg no.196}</p> | 155,830 | medmcqa_train |
Depression of consciousness level in hypothermia stas when the core body temperature falls below: COMEDK 14 | Ans. 32degC | 155,831 | medmcqa_train |
Most prevalent incidentaloma is: | Adrenal Incidentaloma- - Incidentally detected adrenal mass through imaging performed for unrelated disease Nonfunctioning adenoma - 82% of incidentalomas Preclinical cushing - 5% Pheochromocytoma - 5% Adrenocoical Ca - 5% Metastatic Ca - 2% Aldosterone producing adenoma - 1% | 155,832 | medmcqa_train |
Indomethacin can antagonize the diuretic action of loop diuretics by: | Loop diuretics release PGs that induce intrarenal hemodynamic changes which secondarily affect salt output. Indomethacin and other NSAIDs inhibit the formation of PG. Therefore, NSAIDs blunt the action of loop diuretics. | 155,833 | medmcqa_train |
Human Development Index is | Ans. b (Knowledge, Longevity and Income). (Ref. Park PSM 22nd /pg. 16).# HUMAN DEVELOPMENT INDEX- Consist of three dimensions:- Longevity (life expectancy at birth);- Knowledge (Adult literacy rate and mean years of schooling); and- Income (real GDP per capita in purchasing power).- The HDI ranges between 0 to 1.- In India HDI is 0.602# PHYSICAL QUALITY OF LIFE INDEX (PQLI)- Consists of:- Infant mortality,- Life expectancy at age one, and- Literacy.- National and international comparison can be done- Kerala has highest PQLI# KUPUSWAMY INDEX- Kupuswamy index of social classification includes:# Education# Occupation# Income# SULLIVAN'S INDEX- This index (expectation of life free of disability is computed by subtracting from life expectancy the probable duration of bed disability and inability to perform major activities.- It is considered one of the most advanced indicators/measures of disability rate, currently available.# DALY (Disability Adjusted Life Years)- Measure of burden of disease in defined population and effectiveness of intervention.- 1 DALY = 1 lost year of healthy life.- HALE (Health Adjusted Life Years)- It consists of life expectancy at birth and adjustment of time spent in poor health. | 155,834 | medmcqa_train |
Method of sterilization which is least effective is: | Ans. is d i.e. Hysteroscopic tubal occlusion Coplc tubal occlusion Cauterisation (Failure rate 30%) Sclerosants (Failure rate 15%) I - Due to high failure rate these methods are obsolete now Hysteroscopic tubal occlusion is done by 2 methods and both these methods have high failure rates. Also Know : Pomeroy's method 0.4'3/0deg Madiener 7% Irwing Irreversible Fimbriectomy Irreversible Laparoscopic sterilization 0.6% Hysteroscopic tubal block Cauterisation 30% Sclerosants 15% | 155,835 | medmcqa_train |
The drug of choice for prevention of seizures in a patient with severe preeclampsia is | given by i.v. infusion, it has been used for long to control convulsions and to reduce BP in toxaemia of pregnancy. As per WHO, it is the drug of choice for prevention and treatment of seizures in preeclampsia and eclampsia Ref: KD Tripathih 8th ed. page 333 | 155,836 | medmcqa_train |
All of the following forces are involved in antigen antibody reaction, EXCEPT: | Answer is D (Covalent bond) : The combination between antigen and antibody is effected during the primary stage of an Ag-Ab reaction. This reaction is essentially reversible and effected by the weaker intermolecular forces such as: Vander Waal's, Hydrogen bonds, Ionic bonds and not by the firmer covalent bonds. Frequently asked questions on immunoglobulins: Immunoglobulin to fix complements classical pathway Immunoglobulin to fix complements alternate pathway Immunoglobulin with maximum serum conc. Immunoglobulin with minimum serum conc. Immunoglobulin that in heat labile Immunoglobulin in primary immune response Immunoglobulin in secondary immune response Immunoglobulin with maximum molecular weight Immunoglobulin present in milk Immunoglobulin with maximum sedimentation coefficient Immunoglobulin with shoest 1/2 life Immunoglobulin in seromucinous glands Immunoglobulin resp. for hypersensitive pneumonitis Immunoglobulin mediating the prausnitz Kustner reaction Homocytotropism is seen in which Ig IgG & IgM (IgM > IgG)Q IgAQ & IgDQ IgGQ IgEQ IgEQ IgMQ IgGQ IgMQ IgAQ & IgGQ IgMQ IgEQ IgG & IgAQ IgGQ IgEQ IgEQ | 155,837 | medmcqa_train |
Not true about deep cervical lymph nodes | The deep cervical lymph nodes are situated along the internal jugular vein, and include the jugulodigastric node below the posterior belly of the digastric and the jugulo-omohyoid node above the inferior belly of the omohyoid Ref : B D Chaurasia's Human Anatomy, seventh edition, volume 3 , pg. no. 100 ( fig. 8.28 - pg. no. 162 ) | 155,838 | medmcqa_train |
Which anesthetic agent is contraindicated in porphyria: | Ans: (c) ThiopentoneRef: KDT 6th ed./374* Thiopentone is an ultrashort acting thiobarbiturate because of rapid redistribution.* It has poor analgesic property.* I/v injection is very painful. Therefore it is contraindicated unless opioids or N2O has been given.* Contraindicated in porphyria patientsAlso Know*Etomidatei insufficiency.* Drugs safe in patients with porphyria: Propofol | 155,839 | medmcqa_train |
Biconcave shape of RBC is due to binding of spectrin to- | Ans. is 'a' i.e., Ankyrin * RBCs biconcave shape is due to membrane cytoskeleton.* RBC membrane cytoskeleton contains a filamentous meshwork of proteins that form a membrane cytoskeleton along the entire cytoplasmic surface of membrane. The most abundant and most important protein in this membrane cytoskeleton is Spectrin, a long flexible heterodimers. At ends it binds with junctional complex composed of F-actin tropomyocin, adducin and protein-4.1.* This cytoskeletal network is tethered to cell membrane at two sites-i) Mediated by ankyrin that links spectrin to Band-3.ii) Mediated by protein-4.1 that links junctional complex to Glycophorin C. | 155,840 | medmcqa_train |
Lipid peroxidation of polyunsaturated lipids of subcellular membranes produces - | Lipofuscin is an insoluble pigment, also know n as lipochrome or wear-and-tear pigment.
Lipofuscin is composed of polymers of lipids and phospholipids in complex with protein, suggesting that it is derived through lipid peroxidation of polyunsaturated lipids of subcellular membranes.
Lipofuscin is not injurious to the cell or its functions.
Its importance lies in its being a telltale sign of free radical injury and lipid peroxidation.
The term is derived from the Latin (fuscus, brown), referring to brown lipid. In tissue sections, it appears as a yellow-brown, finely granular cytoplasmic, often perinuclear, pigment. | 155,841 | medmcqa_train |
A 35 years old man gets up from sleep with sudden onset breathlessness, anxiety, palpitation, shaking hand, profuse sweating, discomfort in chest & fear of dying. There is history of similar episodes in past. Physical examination is normal. Probable diagnosis is- | Ans. is 'a' i.e., Panic attack * Sudden onset of breathlessness, anxiety, palpitation and feeling of impending doom suggest the diagnosis of panic attack (severe anxiety)* A panic attack has following characteristics: -A. Discrete episode of intense fearB. Abrupt onset (sudden onset)C. Reaches as maximum within few minutes and lasts for some minutes.D. At least four of the following symptoms : - 1) Palpitation 2) Sweating 3) Shortness of breath (Breathlessness) 4) Feeling of choking 5) Chest pain or discomfort (chest constriction) 6) Nausea or abdominal distress 7) Trembling or shaking 8) Dizziness, unsteady, fainting 9) Derealization or depersonalization 10) Fear of losing control 11) Fear of dying (impending doom) 12) Paresthesias 13) Chills or hot flushesE. At least one of the attack is followed by 1 month (or more) of one (or more) of the following ; - a) Persistent concern of future attacks, b) Worry about the consequences of attacks (Heart attack, Stroke) c) Significant change in behavior related to attack. | 155,842 | medmcqa_train |
Rhinophyma complicates- | Ans: B | 155,843 | medmcqa_train |
Hypoglycemia in new born is seen in:a) IUGRb) Mother with hypothyroidismc) Rh incompatibilityd) Macrosomiae) Hyperthyroidism | Hypoglycemia is defined as blood glucose of less than 40 mg/dL, irrespective of the gestational age.
Causes of hypoglycemia Let us see each option one by one.
Option ‘a’ IUGR
“Hypoglycemia is due to shortage of glycogen reserve in the liver as a result of chronic hypoxia”
Dutta Obs. 6/e, p 465
Option ‘b’ Mother with hypothyroidism
Maternal hypothyroidism can cause hypoglycemia if it leads to fetal hypothyroidism also but “Maternal TSH receptor bloking antibodies can cross the placenta and cause fetal thyroid dysfunction.They however have little or no effect on fetal thyroid function even though they too cross the placenta.”.
Williams 23/e, p 1131, 1132
So according to latest editon of Williams, maternal hypothyroidism does not lead to fetal hypothyroidism, thus it does not cause fetal hypoglycemia.
Option ‘c’ Rh incompatibility
There is no definite correlation between Rhincompatibility and hypoglycemia.
Option ‘d’ Macrosomia
Macrosomia usually is due to maternal diabetes which inturn results in fetal hyperinsulinemia due to beta cell hyperplasia, which further results in neonatal hypoglycemia.
Dutta Obs. 6/e, p 287
Option ‘e’ Hyperthyroidism : Hyperthyroidism is a diabetes like state with increased insulin resistance. | 155,844 | medmcqa_train |
Which of the following is the major anaplerotic enzyme? | Ans. a)Pyruvate carboxylase Anaplerotic (gap-filling) reactions are the reactions that replenish the depleted TCA cycle intermediates that were used up in the biosynthetic reactions. Oxaloacetate is the catalyst of TCA cycle. Thus, production of oxaloacetate is the major anaplerotic reaction. Intermediate Depleted (used) by Replenished by Oxaloacetate Amino Acid synthesis Pyruvate carboxylase - Major anaplerotic enzyme Succinyl-CoA Heme Synthesis From Propionyl-CoA by carboxylase and Methyl malonyl-CoA mutase Oxaloacetate, Fumarate Gluconeogenesis From Amino acids | 155,845 | medmcqa_train |
Toxoid is prepared from - | Ans. is 'a' i.e., Exotoxin Toxoids o Ceain organisms produce exotoxins e.g., diphtheria and tetanus bacilli. o The toxin produced by these organisms are detoxicated and used in the preparation of vaccines. o The antibodies produced neutralize the toxic moiety produced during infection, rather than act upon the organisms. | 155,846 | medmcqa_train |
In pancoast tumor, following is seen except? | Answer is 'c' i.e. Haemoptysis Haemoptysis is seen in central tumors or endobronchial growth (Pancoast tumor is a peripheral tumor) Pancoast's tumor (also k/a superior sulcus tumor) Is a tumor of the apex of the lung It may grow to cause shoulder and arm pain - d/t involvement of C8, TI & 72 nerves Erosion of ribs Homer's syndrome (Enopthalmos, Ptosis, Miosis & Ipsilateral loss of sweating) | 155,847 | medmcqa_train |
A patient presented with a 1 x 1.5 cms growth on the lateral border of the tongue. The treatment indicated would be. | Ans- B Interstitial brachytherapy Ref- Although this study is retrospective, the results are noteworthy, considering its long follow up and the description of results in terms of LCR, toxicities, and functional outcome. Our study recommends treating patients with brachytherapy alone in T1 stage and demonstrates the need for addressing nodal region either by neck dissection or nodal irradiation in T2 stage patients. The highlight of the study is that it establishes the need for dose escalation (from the doses used in the study) in both T1 and T2 stage tumors when using interstitial brachytherapy either as sole modality or as a boost. | 155,848 | medmcqa_train |
Colour of nitrous oxide cylinder is? | N2O (blue) Cyclopropane (orange) Oxygen (black & white) Entonox (blue & white) | 155,849 | medmcqa_train |
A 45 year old female presents with 48 hour history of right upper quadrant pain, dyspnea, non-productive cough, fever with chills and rigor. The pain radiates to right shoulder tip. She has history of perforated duodenal ulcer repair 3 weeks ago. Temperature 39.3degC. O/E there is acute tenderness over right hypochondrium. CXR shows right sided pleural effusion. Diagnosis | Ans. (b) Subphrenic abscessRef: Bailey 26th edition Page 977* Bailey says- "Pus Nowhere, Pus Some where- search Pus Under the Diaphragm"* In a post op case (patient lying)- most dependent site of abscess formation is Subphrenic Space | 155,850 | medmcqa_train |
Donovan bodies are seen in ? | Ans. is 'd' i.e., Calymmatobacteriumgranulomatis | 155,851 | medmcqa_train |
Stroke volume is increased by - | Ans. is 'c' i.e., Increased end-diastolic volume and decreased end-systolic volume o The stroke volume is the amount of blood pumped out by left ventricle in each stroke.o Stroke volume is given by the difference between end-diastolic ventricular volume (the volume of blood in the left ventricle at the end of diastole; normal 120 ml) and end-systolic ventricular volume (the volume of blood at the end of systole; normal 50 ml).Stroke volume (70 ml) = End-diastolic ventricular volume (120 ml) - End-svstolic ventricular volume (50 ml) | 155,852 | medmcqa_train |
When do we have to start antibiotics to prevent post-operative infection? | Prophylactic antibiotics are administered before the skin incision is made. Repeat dosing occurs at an appropriate interval, usually 3 hours for abdominal cases or twice the half-life of the antibiotic.
Perioperative antibiotic prophylaxis generally is not continued beyond the day of surgery. | 155,853 | medmcqa_train |
Comment on the diagnosis of the ECG tracing shown below. | Symmetry in PR interval before and after the missed beat --> Indicating Second degree AV block type 2: infranodal. In Second degree AV block type 1 --> Serial lengthening of PR interval before and after the missed beat. In Third degree AV block --> complete dissociation b/w atria and ventricles. | 155,854 | medmcqa_train |
A businessman notices a lump in front of his ear while shaving one morning. His wife thinks it has been there for several months. What is the most likely cause of a mass in the parotid gland in this patient? SELECT ONE. | Benign mixed tumor (pleomorphic adenoma) requires appropriate excision (superficial parotidectomy). If the tumor is shelled out, recurrence is likely. Approximately 80% of tumors of the salivary glands occur in the parotid gland. | 155,855 | medmcqa_train |
Grenz zone is absent in which type of leprosy | LEPROSY:- Ref:- Review of Dermatology by Alikhan; pg num:-303 | 155,856 | medmcqa_train |
Bone density is decreased in which of the following - | Osteoporosis is characterized by an abnormally low bone mass (reduced bone density) and defects in bone structure. | 155,857 | medmcqa_train |
Flexion of metacarpophalangeal joint is produced by? | Ans. is 'd' i.e., All of the aboveMetacarpophalangeal joints o These are ellipsoid joints between head of metacarpals and base of proximal phalanx. Movement at MCP joints are flexion, extension, abduction and adduction.Movement Muscles producing movementsFlexion Main muscles :- The lumbricals and the interossei. Suppoive :- Flexor digitorum profundus and superficialis.Extension Main muscles :- Extensor digitorum.Suppoive muscles :-Extensor indicis (for index finger), Extensor digiti minimi (for little finger)Adduction Palmar interosseiAbduction Dorsal interosseiImpoant fact MCP joint is functionally an ellipsoid joint, but it is condylar joint structurally. | 155,858 | medmcqa_train |
Thornwaldt cyst is also called as: | Thornwaldts bursa is also called as nasopharyngeal bursa, hence thornwaldts cyst is also called as Nasopharyngeal cyst. | 155,859 | medmcqa_train |
Best treatment for meningioma with low recurrence rate is | The best treatment for meningioma of low recurrence rate is complete tumour resection including resection of underlying bone and associated dura. The constant principles in meningioma resection are the following: If possible, all involved or hyperostotic bone should be removed. The dura involved by the tumor as well as a dural rim that is free from tumor should be resected (duraplasty is performed). Dural tails that are apparent on MRI are best removed, even though some may not be involved with the tumor. Transaerial embolization has become a standard preoperative procedure in the preoperative management. Radiotherapy is mainly used as adjuvant therapy for incompletely resected, high-grade and/or recurrent tumors. | 155,860 | medmcqa_train |
Condyloma acuminata is repoed on pap-smear as - | Ans. is'd'i.e.LSIL Cervical Precursor lesion associated with both low and high risk HPV subtypes.This category includes:Flat mature LSIL (flat condyloma or CIN-I)Mature Exophytic LSIL (exophytic condyloma, condyloma acuminatum)Extensive Exophytic LSIL (giant condyloma)Immature Exophytic LSIL (immature condyloma, squamous papilloma, papillary immature metaplasia)Immature Flat Metaplastic LSIL | 155,861 | medmcqa_train |
Minamata disease in Japan is caused by toxicity of | (A) Mercury > Minamata disease (Chisso-Minamata disease), is a neurological syndrome caused by severe mercury poisoning. Symptoms include ataxia, numbness in the hands and feet, general muscle weakness, narrowing of the field of vision and damage to hearing and speech. In extreme cases, insanity, paralysis, coma and death follow within weeks of the onset of symptoms. A congenital form of the disease can also affect fetuses in the womb. | 155,862 | medmcqa_train |
Glucose transpo along cell membranes occurs along with | The co-transpo system may either be a sympo or an antipo. In sympo, (Fig. 2.12) the transpoer carries two solutes in the same direction across the membrane, e.g. sodium-dependent glucose transpoer (Chapter 8). Phlorhizin, an inhibitor of sodium-dependent co-transpo of glucose, especially in the proximal convoluted tubules of the kidney, produces renal damage and results in renal glycosuria. Amino acid transpo is another example for sympo.Ref: MN Chatterjea Textbook of Medical Biochemistry, 6th edition, page no: 17 | 155,863 | medmcqa_train |
Verocytotoxin of E. coli acts by - | Ans. is 'c' i.e., Decreasing protein synthesis | 155,864 | medmcqa_train |
A patient with acute psychosis, who is on haloperidol 20 mg/day for last 2 days, has an episode characterized by tongue protrusion, oculogyric crisis, stiffness and abnormal posture of limbs and trunk without loss of consciousness of last 20 minutes before presenting to casualty. This improved within a few minutes after administration of diphenhydramine HCI. The most likely diagnosis is: | Antipsychotic drugs Extrapyramidal symptoms- dur to D2 blockade in limbic system Extrapyramidal symptoms Clinical features Special DOC Acute dystonia Oculogyric crisis ocular muscles spasm and opisthotonos Toicollis Protrusion of tongue leading to laryngospasm Grimacing Earliest to develop (days) Anticholinergic drugs Acute akathisia Constant purposeless involuntary movement from one place to another Most common EPS Days to week Propranolol Tardive dyskinesia chewing and sucking movements Grimacing Choreoathetoid movements Akathisia Seen after long(years) use of anti-psychotic Tetrabenazine Malignant neuroleptic syndrome Fluctuating level of consciousness Hypehermia -muscles rigidity Increase level of CPK Increase level of liver enzyme Confusion Diaphoresis Most common cause of death in this syndrome is acute renal failure Most serious side effect dantrolene DRUG induced parkinsonism Few weeks anticholinergics | 155,865 | medmcqa_train |
Blanket/ mass treatment is indicated in all EXCEPT: September 2004 | Ans. D i.e. Dengue fever | 155,866 | medmcqa_train |
Mucin layer tear flilm deficiency occurs in: | A i.e Keratoconjunctivitis sicca | 155,867 | medmcqa_train |
Reactive ahritis is a result of exposure to all of the following, EXCEPT: | Reactive ahritis is an inflammatory condition that occurs after exposure to ceain gastrointestinal and genitourinary infections, paicularly Chlamydia species, Campylobacter jejuni, Salmonella enteritidis, Shigella, and Yersinia. Patients may give a history of an antecedent genitourinary or dysenteric infection 1 to 4 weeks before the onset of ahritis. Only a minority of these patients have the findings of classic reactive ahritis, including urethritis, conjunctivitis, uveitis, oral ulcers, and rash. Studies have identified microbial DNA or antigen in synol fluid or blood, but the pathogenesis of this condition is poorly understood. Ref: Madoff L.C. (2012). Chapter 334. Infectious Ahritis. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e. | 155,868 | medmcqa_train |
Dose of Vit D in children with malnutrition - | Vitamin A deficiency treatment: Vitamin A on days 1,2 and 14 each Age >12 months - 200,000 IU Age 6-12 months - 100,000 IU for age 0-5 months - 50,000 IU Ref: Guidelines for the inpatient treatment of severely malnourished children, WHO Pgno : 23 | 155,869 | medmcqa_train |
All are components of basement membrane except | Ans. is 'd' i.e. Rhodopsin Basement membrane is a part of extracellular matrix Extracellular matrix is composed ofCollagenThey are family of proteins which provide structured support to the multicellular organisms.It is the main component of tissues such as fibrous tissue, bone, cartilage, valves of heart, cornea, basement membrane etc.Adhesive glycoproteinsVarious adhesive glycoproteins acting as glue for the ECM and the cells consists ofFibronectinTenascin (cytotactin) andThrombospondinBasement membraneBasement membranes are periodic acid-schiff positive amorphous structures that lie underneath epithelia of different organs and endothelial cellsThey consists ofLamininFibronectinTenascinProteoglycansEntactin (Nidogen)Perlecan (heparin sulphate)Collagen type IVElastic fibresWhile the tensile strength in the tissue comes from collagen, the ability to recoil is provided by the elastic fibresElastic fibres consist of 2 components elastin glycoprotein and elastic microfibrilElastase degrades the elastic tissue e.g. inflammation, emphysema etc.ProteoglycansThese are a group of molecules having 2 components- an essential carbohydrate polymer (called polysaccharide or glycosaminoglycan) and a protein bound to it, and hence the name proteoglycan.Various proteoglycans in different tissues:(i)Chondroitin sulphate-abundant in cartilage, dermis(ii)Heparan sulphate-in basement membranes(iii)Dermatan sulphate-in dermis(iv)Keratan sulphate-in cartilage(v)Hyaluronis acid-in cartilage, dermis | 155,870 | medmcqa_train |
The following are the contraindications of BAL except: | BAL (British anti-lewisite, dimercaprol): It is used in arsenic, lead, bismuth, copper, mercury, gold and other heavy metal poisoning. Dose: 10% solution in oil, 3-5 mg/kg IM 4 hourly for 2 days, 6 hourly on 3rd day and then 12 hourly for next 10 days. Side effects: Nausea, vomiting, headache and hypeension. Contraindicated in liver damage, G-6-PD deficient individuals, and iron poisoning cadmium(since dimercaprol-cadmium and dimercaprol-iron complex is itself toxic). | 155,871 | medmcqa_train |
A neonate presented on day one of life with bilious vomiting. First investigation to be done is: | Ans. b. Babygram (Ref: Nelson 19/e p1278; Sabiston 19/e p1841-1842; Schwartz 9/e p1427-1428; Bailey 26/e 120, 25/e p85; Shackelford 7/e p811-813)A neonate presented on day one of life with bilious vomiting. First investigation to be done is Babygram (full body radiograph of the baby) to rule out duodenal atresia. Babygram is a full body radiograph of the baby, which shows the double bubble sign in duodenal atresia.The hallmark of duodenal obstruction is bilious vomiting without abdominal distention, which is usually noted on the 1st day of life. Peristaltic waves may be visualized early in the disease process. The diagnosis is suggested by the presence of a 'double-bubble sign' on plain abdominal radiographs. The appearance is caused by a distended and gas-filled stomach and proximal duodenum. Contrast studies are usually not necessary and may he associated with aspiration if attempted. Contrast studies may occasionally be needed to exclude malrotation and volvulus because intestinal infarction may occur within 6-12 hr if the volvulus is not relieved.'- Nelson 19/e p1278Duodenal AtresiaOccurs as a result of failure of vacuolization of the duodenum from its solid cord stageAnatomic variants of Duodenal AtresiaDuodenal stenosisMucosal web with intact muscular wall (windsock deformity)Two ends separated by a fibrous cordComplete separation with a gap within the duodenum.Associated Anomalies:Prematurity, Down syndrome, polyhydramniosQMalrotation, annular pancreas, biliary atresiaQCardiac, renal, esophageal, and anorectal anomaliesClinical Features:In most cases, the duodenal obstruction is distal to the ampulla of Vater, and infants present with bilious emesis in the neonatal periodQ.DiagnosisX-ray abdomen: Double-bubble sign (air-filled stomach and duodenal bulbQ).Diagnosis is confirmed, if there is no distal airQ.If distal air is present, an upper GI contrast study is performed rapidly, not only to confirm the diagnosis of duodenal atresia but also to exclude midgut volvulusQ.Treatment:Diamond-shaped duodenoduodenostomy is the treatment of choiceQSingle bubble signCongenital Hypertrophic Pyloric StenosisQDouble bubble signDuodenal atresiaQ, Annular pancreasTriple bubble signJejunal atresiaQ | 155,872 | medmcqa_train |
In atrial septal defect, the aoa is | The chest x-ray film is often, but not always, abnormal in patients with significant ASD. Cardiomegaly may be present from right hea dilation and occasionally from left hea dilation if significant mitral regurgitation is present in the patient with an ostium primum ASD. Right hea dilation is better appreciated in lateral films. The central pulmonary aeries are characteristically enlarged, with pulmonary plethora indicating increased pulmonary flow. A small aoic knuckle is characteristic, which reflects a chronically low systemic cardiac output state because increased pulmonary flow in these patients occurs at the expense of reduced systemic flow.(Ref: "Atrial Septal Defects in the Adult - Recent Progress and Overview". By Webb & Gatzoulis. Circulation. 2006; 114: 1645-1653.) | 155,873 | medmcqa_train |
Which complex in mitochondria is not involved in proton transpor during ETC ? | Ans. is 'b' i.e., Complex IIInner mitrochondrial membrane is impermeable to protons; therefore, proton pumps are required to pump protons (hydrogen ions) from mitochondrial matrix to the intermembrane space.The complex I (Site I), complex III (Site II) and complex IV (Site III) act as proton pumps ejecting protons (hydrogen ions) from the mitochondrial matrix to intermembrane space.Complex I (NADH-CoQ reductase) and complex III (CoQ - cytochrome c reductase) pump 4 protons each and complex IV (cytochrome c oxidase) pumps 2 protons.The concentration of hydrogen ions (protons) on the outer side of inner membrane becomes higher as compared to inner side.This results in generation of the electrochemical potential.Due to this electrochemical potential or proton motive force, the H+ ions ejected out (by proton pumps) flow back into the mitochondrial matrix down its electrochemical gradient through F0F1 ATPase molecule, which is also known as complex V of respiratory chain.This proton influx causes ATP synthesis. Fo components acts as channel for passage of hydrogen ions (Protons). F1 component possesses ATP synthase activity, which is switched on when the hydrogen ions pass through Fo component. | 155,874 | medmcqa_train |
False statement is | D i.e., Regulator gene is inducible | 155,875 | medmcqa_train |
Parvovirus B19 does not cause: | Ans. is 'a' i.e. Roseola infantum ParvovirusParvovirus is the smallest virus.It is a nonenveloped icosahedral virus with linear single stranded D.N.A.Pathogenesis of parvovirusParvovirus is highly tropic for human erythroid cells.The cellular receptors for parvovirus is blood group P antigen.P antigen is expressed on mature erythrocytes, erythroid progenitors, megakaryocytes, endothelial cells, placenta and fetal liver cells.Because of this distribution of Parvo virus receptors, the parvovirus replicates primarily in erythroid progenitors such as bone marrow and fetal liver cells and primarily causes diseases of these organs.Clinical manifestations:- Erythema infectiosum (fifth disease)Most B19 infections are asymptomatic.The main symptomatic manifestation of parvovirus is erythema infectiosum also known as fifth disease or slapped check disease.* Initially there is minor febrile prodrome and the classical facial rash develops after several days.Polyarthropathy syndromeUncommon among children but occurs in 50% of adults.Small joints of the hands and ankles are involved symmetrically.Aplastic crisisAsymptomatic transient reticulocytopenia occurs in most individuals with B19 infection.However in patients who depend on continuous rapid production of red cells, infections can cause transient aplastic crisis.In normal individuals with normal erythropoiesis few days of arrest of erythropoiesis will not cause detectable anemia.But, in cases which require continuous erythropoiesis such as cases of chronic hemolytic anemias (e.g. sickle cell anemia, hereditary spherocytosis) the life span of the R.B.C. is shortened. This leads to aplastic risis in these patients.Pure red cell aplasia/chronic anemiaParvovirus causes established persistent infection in patients with immunosuppression e.g. (AIDS, CLL).These patients have persistent anemia with reticulocytopenia.Hydrops fetalisParvovirus has tropism for fetal liver and heart. These tissues contain abundant P receptorsSo maternal infection with parvovirus pose a serious risk to the fetus resulting in hydrops fetalis and fetal death due to severe anemia.The risk of transplacental infection is 30% and the risk of fetal loss (early in 2nd trimester) is 9%.DiagnosisDiagnosis is done by the detection of B19 IgM antibodies.IqM is detected at the time of rash in erythema infectiosum and IgG is detected on the 7th day.TreatmentNo antiviral is effective against parvovirus.SPECTRUM OF DISEASE DUE TO B19 RELATED TO HOST FACTORSDiseaseHost* AsymptomaticNormal children and adults* Respiratory tract illnessNormal children and adults* Rash illnessNormal children and adults* Erythema infectiosum/fifthNormal childrendisease/ * slapped cheek syndrome * ArthralgiaNormal adults* Transient aplastic crisisPatients with increased erythropoiesis* Persistent anemiaImmuno deficient or compromised person* Congenital anemia/hydropsFetus < 20 weeks | 155,876 | medmcqa_train |
Barbiturates excretion in urine may be increased by- | In barbiturate poisoning, forced alkaline diuresis is used. | 155,877 | medmcqa_train |
All are features of raised intracranial tension in adults except: | Ans. Sutural diastasis | 155,878 | medmcqa_train |
The periphery of the retina is visualized with | The technique of examining the fundus of the eye is called ophthalmoscopy. In indirect ophthalmoscopy, a real and inveed image is formed between the condensing lens and the observer. The advantage of stereopsis (depth perception) and a larger field of view makes indirect ophthalmoscope (IDO) more useful both in retina clinics and during posterior segment surgeries. Reference : A K KHURANA Comprehensive Ophthalmology; edition 4; page-567 | 155,879 | medmcqa_train |
Which of the following is a false statement about the respective fungal infections? | Microsporium doesn't involve nail. Trychophyton involves skin, nail and hair. | 155,880 | medmcqa_train |
Cell-matrix adhesions are mediated by? | The cell adhesion molecules (CAMs) are classified into four main families:- * Immunoglobulin family CAMs *Cadherins * Integrins: bind to extracellular matrix (ECM) proteins such as fibronectin, laminin, and osteopontin providing a connection between cells and extracellular matrix (ECM) * Selectins | 155,881 | medmcqa_train |
The Hb level is healthy women has mean 13.5 g/dl and standard detion 1.5 g/dl, what is the Z score for a woman with Hb level 15.0 g/dI - | Ans. is 'd' i.e., 1.0 Thus the Z score for the woman in question is 1.0. Very simple funda to calculate Z score Normal variate indicates that the given observation is how many standard detion away from the mean. Here mean is 13.5 g/c11, SD is 1.5 g/dl and observation is 15 g/dl. That means observation (15 g/dl) is 1 SD (1.5 g/dl) away from mean (13.5 g/dl). So relative dete (Z-score) is 1. In same question, if we assume that the observed value is 16.5 (mean +- 2 SD) that means relative dete is 2 as the observed value is 2 SD away from mean. | 155,882 | medmcqa_train |
Development of pellagra like skin lesion in carcinoid syndrome is due to: | One of the main secretory products of carcinoid tumors involved in the carcinoid syndrome is serotonin which is synthesized from tryptophan. Up to 50% of dietary tryptophan can be used in this synthetic pathway by tumor cells, and this can result in inadequate supplies for conversion to niacin; hence, some patients (2.5%) develop pellagra-like lesions. Reference: Harrisons Principles of Internal Medicine, 18th Edition, Page 3063 | 155,883 | medmcqa_train |
Drug of choice for absent seizures | Many children appear to have a genetic predisposition to absence seizures. In general, seizures are caused by abnormal electrical impulses from nerve cells (neurons) in the brain. Ref: KD Tripathi 8th ed. | 155,884 | medmcqa_train |
Which of the following is low flow Oxygen delivery device | A nasal cannula is generally used wherever small amounts of supplemental oxygen is required, without rigid control of respiration, such as in oxygen therapy. Most cannulae can only provide oxygen at low flow rates--up to 5 litres per minute (L/min)--delivering an oxygen concentration of 28-44%. Rates above 5 L/min can result in discomfo to the patient. | 155,885 | medmcqa_train |
Which of the following is not an ester – | Bupivacaine is an amide. | 155,886 | medmcqa_train |
How will you check the quantitative assessment of liver function - | The determination of the galactose elimination capacity with the method according to Tygstrup is the only test which detects the "functional hepatocyte mass" and thus constitutes a quantitative test for the metabolic function of the liver. In this determination of the maximum hepatic elimination capacity, differences with bilirubin, hemolysis and hyperlipidemia do not occur; reliable results are also obtained in disorders of hepatic secretion. Side-effects from the test substance galactose are not to be expected. It is also possible to determine galactose without difficulty in capillary blood. The i.v. galactose test permits an estimation of the degree of severity of liver diseases and can also be recommended for routine use in the investigation of specific hepatological questions. Ref Davidson edition23rd pg853 | 155,887 | medmcqa_train |
Which of the following is detected by the antigen detection test used for the diagnosis of P. Falciparum malaria | A useful approach is immunodiagnosis of malaria by detection of parasite-specific antigens using monoclonal antibodies The Para-Sight-F test (BD) is a dipstick antigen capture test targeting the "histidine-rich protein-2" (HRP-2), specific for P.falciparum. The test is sensitive, specific and rapid, results being ready in ten minutes.TEXTBOOK OF MEDICAL PARASITOLOGY, CKJ PANIKER,6TH EDITION, PAGE NO 91 | 155,888 | medmcqa_train |
Iron overload occurs in all except | Ref Harrison 19 th ed pg 626, 673 Increased erythropoietin leads to increased haematopoasis and an increased demand for iron producing a state of iron deficiency. Polycythemia vera being a state of increased erythropoietin is a cause of iron deficiency rather than iron overload. | 155,889 | medmcqa_train |
A child is brought to the emergency depament with signs of meningeal irritation. She had suppurative otitis media in the last week. Infection of middle ear can spread to CNS through: | In the setting of middle ear infection, bacterial infection can invade through the round window causing acute suppurative labyrinthitis. From the labyrinth, bacteria gain access to the cochlear aqueduct, forming a conduit between the perilymph and the cerebrospinal fluid (CSF) resulting in meningeal infiltration. | 155,890 | medmcqa_train |
Strategies for prevention of Neonatall Tetanus include all of the following except - | <p> Injection penicillin to all neonate. Reference:Park&;s textbook of preventive and social medicine,K.Park,23rd edition,page no:310-313. <\p> | 155,891 | medmcqa_train |
Antibody in cold agglutin disease is | Cold agglutinin disease (CAD): This designation is used for a form of chronic AIHA that usually affects the elderly. First, the term cold refers to the fact that the autoantibody involved reacts with red cells poorly or not at all at 37degC, whereas it reacts strongly at lower temperatures. As a result, hemolysis is more prominent the more the body is exposed to the cold. The antibody is usually IgM; usually, it has an anti-I specificity (the I antigen is present on the red cells of almost everybody)Harrison 19e pg: 659 | 155,892 | medmcqa_train |
Type I hypersensitivity is mediated by which of the following immunoglobulins ? | Harshmohan textbook of pathology 7th edition. *type 1 or anaphylactic or atopic reaction mediated by humoral antibodies of IgE type or reagin antibodies in response to antigen. | 155,893 | medmcqa_train |
Coronal suture completely fuses by the age of: | Actually Coronal suture completely fuses by 50-60 years, but the maximum age given in this question is 45 years and hence the answer. Age from Skull Sutures- Two halves of mandible unite at- 2 years. Metopic suture (2 halves of frontal bone) closes at: 3 years. Coronal, Sagittal, Lambdoid sutures sta to close on inner side at- 25 years. On outer side, fusion occurs in the following order- (1) Posterior 1/3rd sagittal suture- 30-40 yrs. (2) Anterior 1/3rd sagittal suture + lower 1/2 of coronal suture- 40-50 yrs. (3) Middle 1/3rd sagittal suture + upper 1/2 coronal suture- 50-60 yrs. Sutures on inner side close- 5-10 years earlier than outer side. For viewing X-rays, lateral view is preferable and the most successful estimation is done from sagittal suture, next lambdoid and then coronal. "Lapsed union" occurs commonly in sagittal suture (failure of ectrocranial suture closure. | 155,894 | medmcqa_train |
Position of the patient should be as described except | Bladder should be empty during a transvaginal ultrasound | 155,895 | medmcqa_train |
Mitral valve vegetations do not usually embolise to | Ref Harrison 19 th ed pg 820 Mitral valve vegetation would obviously not go to the lung, as that would involve a backward flow | 155,896 | medmcqa_train |
Most common type of veex presentation: | M.C. position of veex is Left occipito Transverse(40%) LOT > LOA M.C. malposition of veex presenting pa is Right Occiputo posterior. | 155,897 | medmcqa_train |
Cephalic index of Mongolians is | Cephalic index (Index of Breadth) is Maximum Breadth of Skull / Maximum Length of Skull. From the Cephalic index, race can be determined in 85 - 90% of cases. The skull of an Indian is Caucasian with a few Negroid characters. Type of skull Cephalic index Race Dolicocephalic (long-headed) 70-75 Pure Aryans, Aborigines, Negroes Mesaticephalic (medium-headed) 75-80 Europeans, Chinese, Indians Brachycephalic (sho-headed) 80-85 Mongolian Ref: 1.Dr. Narayana Reddy, The Essentials of Forensic Medicine & Toxicology, 34th edition, pg. 57. 2. V.V.Pillay, Textbook of Forensic Medicine & Toxicology, 18th edition, pg. 70. | 155,898 | medmcqa_train |
In nephrotic syndrome, which infection is more commoner in children: September 2010 | Ans. D: Bacterial peritonitis | 155,899 | medmcqa_train |
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