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Potassium sparing diuretics ? | Ans. is 'd' i.e., All of the above | 156,000 | medmcqa_train |
A 12-year-old child presents with fever and cervical lymphadenopathy. Oral examination shows a grey membrane on the
right tonsil extending to the anterior pillar. Which of the following medium will be ideal for the culture of the throat swab for rapid identification of the pathogen : | Ans. is ‘a’ Loeffler’s Serum slope
Fever, cervical lymphadenopathy and grey membrane on the tonsil extending to the anterior pillar | 156,001 | medmcqa_train |
Median nerve injury at the wrist causes - | Injury at the wrist or in carpal tunnel produces low median nerve palsy.
Long flexors of fingers are spared and there is paralysis of thenar muscles only.
Following features are seen : -
Pentest for abductor pollicis Brevis paralysis.
Loss of opposition and abduction of thumb.
Ape thumb deformity
Loss of sensation of lateral 31/2 fingers and lateral 2/3 of palm.
In contrast to high median nerve palsy, pointing index and Benediction test is not seen as long fexors are spared in low median nerve palsy | 156,002 | medmcqa_train |
Commonest fungal infection of the female genitalia in diabets – | In a diabetic patient, commonest fimgal infection of genitalia in both female (vulvoginitis) as well as in male (Balanitis) is candida albicans. | 156,003 | medmcqa_train |
Frontal mucocele presents as: | Mucocele of the frontal sinus: presents in the superomedial quadrant of the orbit (90%) and displaces the eyeball forward, downward and laterally. The swelling is cystic and nontender; egg-shell crackling may be elicited. Sometimes, it presents as a cystic swelling in the forehead (10%). Patient's complaints are usually mild and may include headache, diplopia and proptosis. Imaging of the frontal sinus usually reveals clouding of the sinus with loss of scalloped outline which is so typical of the normal frontal sinus . Treatment is frontoethmoidectomy with free drainage of frontal sinus into the middle meatus. Ref: Dhingra 7e pg 252 | 156,004 | medmcqa_train |
Lipofuscin, the golden yellow pigment is seen in hea muscle - | Ans. is 'b' i.e., Atrophy | 156,005 | medmcqa_train |
All the following cause malignant hyperpyrexia except ? | A i.e. N20 | 156,006 | medmcqa_train |
A 74-year-old man presents with fatigue, shortness of breath on exertion, and back and rib pain, which is made worse with movement. Investigations reveal he is anemic, calcium, urea, and creatinine are elevated. X-rays reveal multiple lytic lesions in the long bones and ribs, and protein electrophoresis is positive for an immunoglobulin G (IgG) paraprotein. Which of the following is the most likely mechanism for the renal injury? | In multiple myeloma, tubular damage by light chains is almost always present. The injury is a direct toxic effect of the light chains or indirectly from the inflammatory response. Infiltration by plasma cells and glomerular injury is rare. Hypercalcemia may produce transient or irreversible renal damage as do amyloid and myeloma cell infiltrates. | 156,007 | medmcqa_train |
Micro-albuminuria refemsto | (30-300 mg/d) (249-H) (1077-8-CMDT-09)(272, 1533, 1792-H17th)* Currently, ultrasensitive dipsticks are available to measure microalbuminuria (30 to 300 mg/d), an early marker of glomerular disease that has been shown to predict glomerular injury in early diabetic nephropathy (249-H)* Normal subjects excrete less than 15 mg/min during overnight urine collections; values of 20 mg/min during or higher are considered to represent abnormal microalbuminuria. In the early morning spot urine, a ratio of albumin (mg/L) to creatinine (mg/L) of < 30 mg/mg creatinine is normal and a ratio of 30-300 mg/mg creatinine suggests abnormal microalbuminuria.* Increased microalbuminuria correlates with increased levels of blood pressure and increased LDL cholesterol, and this may explain why increased proteinuria in diabetic patients is associated with an increase in cardiovascular deaths even in the absence of renal failure (1186-CMDT-05) | 156,008 | medmcqa_train |
All seen in multiple myeloma, except : | Answer is C (Plasmocytosis > 2%): Diagnosis of Multiple Myeloma requires plasmacytosis of> 10%. The classic triad of myeloma is: a) Marrow plasmacytosis > 10% b) Lytic bone lesions c) Serum or urine 'M' component | 156,009 | medmcqa_train |
During laproscopic cholecystectomy, patient develops wheezing. What is the next best line of management? | Ref: Ajay Yadav, Short Textbook of Anaesthesia, 1st edition. Page 97Explanation:BRONCHOSPASM DURING ANESTHESIALight anaesthesia in asthmatics can induce bronchospasni.Secretions and noxious stimuli can also induce bronchospasni.Treatment:Good depth of anesthesia.Bronchodilators.Light anaesthesia during Lord's (Anal) stretching and cervical dilatation can initiate parasympathetic overactivity causing laryngospasm, broncho- spasm, bradycardia and cardiac arrest. This is called Breur Lockhgard reflex.The most common cause of asthmatic attack during surgery is inadequate depth of anesthesia. What to be done during an asthmatic attack during anaesthesia?First, deepen die level of anesthesia.Increase Fi02.Patient is under anesthesia and undergoing surgery, so medical interventions such as beta agonist administration is not the first choice of treatment.When the level of anaesthesia is light, the patient may develop bucking, straining or coughing as a result of endotracheal tube in the trachea and then hronchospasm.Other Methods:IV Ketamine: Increases BP, deepens anaesthesia, causes bronchodilation.Beta agoinst nebulization: Causes bronchodilation. | 156,010 | medmcqa_train |
Kocher Langenbeck approach for emergency acetabular fixation is done in all Except | Progressive sciatic nerve injury "Sciatic nerve palsies as a result of the initial injury occur in approximately 10% to 15% of patients with acetabular fractures. Sciatic nerve injury as a result of surgery occurs in 2% to 6% of patients and is more often associated with posterior fracture patterns treated through the Kocher-Langenbeck and extensile exposures." - Campbell's operative ohopaedics 11/e Chapter 53 -Fractures of Acetabulum and Pelvis Despite searching extensively I could not get any relevant text explaining the rest of options. Here's some material on Kocher-Langenbeck approach, which might be useful. Ref: http://www.maitrise- ohop.com/ corpusmaitri/ohopaedichno74Jractures_cotyle/index_us.shtml The posterior Kocher-Langenbeck approach is probably the best-known and the easiest incision for the management of acetabular fractures. Indications of the Kocher-Langenbeck Approach The following fractures are always accessed through a Kocher-Langenbeck approach: - Posterior wall fractures; - Posterior column fractures; - Posterior column plus posterior wall fractures; - Juxtatectal or infratectal transverse fractures. The following fractures may be accessed through a Kocher-Langenbeck approach: - Transverse fractures through the acetabular roof. However, a lateral approach will often be preferred. - T-shaped fractures, especially if the anterior column is not excessively displaced. Where difficulties are encountered, a large lateral approach is often preferred . - Low both-column fractures that do not involve the iliac wing . The following fractures are never accessed through a Kocher-Langenbeck approach: - Both-column fractures; - Anterior column fractures; - Anterior column plus posterior hemitransverse fractures. | 156,011 | medmcqa_train |
Daily dose of vitamin A in a 6-12 months old child is - | Ans. is 'c' i.e., 300 microgramDaily dose of vitamin in o Infants 300-400 microgramo Children 400-600 microgramo Adolescents 750 microgram | 156,012 | medmcqa_train |
Drawback of aesunate is: | Because aemisinins are sho acting drugs, monotherapy needs to be extended beyond the disappearance of the parasites to prevent recrudescence. After 5 days treatment recrudescence rate is -10%, while with a 3 day course it is -50%. Recrudescence can be totally prevented by combining 3 day aesunate/aemether with a long acting drug ESSENTIALS OF MEDICAL PHARMACOLOGY page no. 830 | 156,013 | medmcqa_train |
Which TLR is present on flagella of bacteria | Toll like receptor (TLR) - 5 is present in flagellin. | 156,014 | medmcqa_train |
All of the following statements about Sternberg Canal are true, Except - | Sternberg's canal (persistent lateral craniopharyngeal canal)
Originally described by Sternberg in 1888 and was reported to be constantly present in children at the age of 3-4 years. He described an incidence of 4% in adults. (Persistent vestiges have been reported in upto 30% of adults).
It is caused by incomplete fusion of greater wing of sphenoid with presphenoid at a point where primordial sphenoid portions fuse.
It lies anterior and medial to foramen rotadum in parasellar region in middle cranial fossa.
It can communicate with sphenoid sinus, pterygopalatine fossa, nasopharynx, or pass right through the bone to emerge at the base of the skull.
Clinically Sternberg's canal is important as it is clinically associated with:-
Infection to sphenoid sinus or cranial fossa.
Congenital intrasphenoid meningocele (& encephalocele).
Lateral sphenoidal sinus 'spontaneous' CSF leak. | 156,015 | medmcqa_train |
A 2-year-old boy is brought to the physician because his parents noticed a mass on his right testicle. Physical examination confirms the parents' observation. An orchiectomy is performed. Microscopic examination of the surgical specimen shows neoplastic cells forming glomeruloid Schiller-Duval bodies. Which of the following serum markers is most useful for monitoring the recurrence of tumor in this patient? | Most testicular neoplasms in the first 4 years of life are classified as yolk sac tumors. Microscopic examination of a yolk sac tumor shows interlacing strands of epithelial cells surrounded by loose connective stroma. The lobular arrangement of cells, surrounded by empty spaces, leads to the formation of glomeruloid structures referred to as Schiller-Duval bodies. Although yolk sac tumors are malignant, timely orchiectomy results in a 95% cure rate. These tumors produce a -fetoprotein, which can be used for monitoring the recurrence of disease following surgery Human chorionic gonadotropin (choice E) is secreted by choriocarcinoma.Diagnosis: Yolk sac tumor | 156,016 | medmcqa_train |
Tick borne hemorrhagic fever is seen in | Omsk hemorrhagic fever :
vector - Tick
Manifestation - Hemorrhagic fever
Reservoir -Small mammals | 156,017 | medmcqa_train |
The most commonly used resuscitation fluid in burns is | The most common fluid used is Ringer lactate/Hamann's solution Ringer lactate is a mixture of sodium chloride, sodium lactate, potassium chloride, calcium chloride in water. Crystalloids are said to be as effective as colloids for maintaining the intravascular volume and are given during initial 24 hrs Colloids should ideally be given after the first 12 hrs of burn because before this period, the massive fluid shift cause protein to leak out of cells. | 156,018 | medmcqa_train |
The inheritance pattern of Familial hypercholesterolemia is | Mutations involving single genes follow one of three patterns of inheritance: autosomal dominant, autosomal recessive, or X-linked. Autosomal Dominant Inheritance Familial hypercholesterolemia Huntington disease Marfan syndrome Ehlers-Danlos syndrome Hereditary spherocytosis Neurofibromatosis, type 1 Adult polycystic kidney disease Familial Hypercholesterolemia Familial hypercholesterolemia is among the most common mendelian disorders; the frequency of the heterozygous condition is 1 in 500 in the general population. It is caused by a mutation in the LDLR gene that encodes the receptor for low-density lipoprotein (LDL), the form in which 70% of total plasma cholesterol is transpoed. A brief review of the synthesis and transpo of cholesterol follows. Normal Cholesterol Metabolism. Cholesterol may be derived from the diet or from endogenous synthesis. Dietary triglycerides and cholesterol are incorporated into chylomicrons in the intestinal mucosa, which drain by way of the gut lymphatics into the blood. These chylomicrons are hydrolyzed by an endothelial lipoprotein lipase in the capillaries of muscle and fat. The chylomicron remnants, rich in cholesterol, are then delivered to the liver. Some of the cholesterol enters the metabolic pool (to be described), and some is excreted as free cholesterol or bile acids into the biliary tract. The endogenous synthesis of cholesterol and LDL begins in the liver (Fig. 6-2). The first step in the synthesis of LDL is the secretion of triglyceride-rich very- low-density lipoprotein (VLDL) by the liver into the blood. In the capillaries of adipose tissue and muscle, the VLDL paicle undergoes lipolysis and is conveed to intermediate- density lipoprotein (IDL). In comparison with VLDL, the content of triglyceride is reduced and that of cholesteryl esters enriched in intermediate-density lipoprotein (IDL), but IDL retains on its surface two of the three VLDL- associated apolipoproteins B-100 and E. Fuher metabo- lism of IDL occurs along two pathways: Most of the IDL paicles are directly taken up by the liver through the LDL receptor described later; others are conveed to cholesterol- rich LDL by a fuher loss of triglycerides and apolipopro- tein E. In the liver cells, IDL is recycled to generate VLDL. Two thirds of the resultant LDL paicles are metabo- lized by the LDL receptor pathway, and the rest is metabo- lized by a receptor for oxidized LDL (scavenger receptor), to be described later. The LDL receptor binds to apolipo- proteins B-100 and E and thus is involved in the transpo of both LDL and IDL. Although the LDL receptors are widely distributed, approximately 75% are located on hepatocytes, so the liver plays an extremely impoant role in LDL metabolism. The first step in the receptor-mediated transpo of LDL involves binding to the cell surface receptor, followed by endocy- totic internalization inside so-called "clathrin-coated pits" (Fig. 6-3). Within the cell, the endocytic vesicles fuse with the lysosomes, and the LDL molecule is enzymatically degraded, resulting ultimately in the release of free cholesterol into the cytoplasm. The cholesterol not only is used by the cell for membrane synthesis but also takes pa in intracel- lular cholesterol homeostasis by a sophisticated system of feed- back control: * It suppresses cholesterol synthesis by inhibiting the activity of the enzyme 3-hydroxy-3-methylglutaryl- coenzyme A reductase (HMG-CoA reductase), which is the rate-limiting enzyme in the synthetic pathway. * It stimulates the formation of cholesterol esters for storage of excess cholesterol. * It downregulates the synthesis of cell surface LDL recep- tors, thus protecting cells from excessive accumulation of cholesterol. The transpo of LDL by the scavenger receptors, alluded to earlier, seems to take place in cells of the mononuclear- phagocyte system and possibly in other cells as well. Monocytes and macrophages have receptors for chemically modified (e.g., acetylated or oxidized) LDLs. The amount catabolized by this "scavenger receptor" pathway is directly related to the plasma cholesterol level. (Robbins Basic Pathology,9th edition,pg no. 219) | 156,019 | medmcqa_train |
A 68 yr old man came with pain and swelling of right knee. Ahlbeck grade 2 osteoahritic changes were found on investigation. What is the fuher management: | D i.e. Total knee replacement - Ahlbeck grade 2 osteoahritis (i.e. complete or almost complete obliterated joint space) with symptoms of pain and swelling in a sedentary patient (>65 years of age) is managed by knee replacementQ - Old (65 yrs) age, long standing history of pain & swelling interfering activities of daily living and grade III radiological grade of OA indicate moderately severe OA and is best managed by Total knee ahroplasty. Although it must be remembered that TKA is done only after conservative treatment measures have been exhausted. And in this case we have presumed that conservative treatment must have been tried (b/o long course) & failed. - Because ahroscopic lavage (wash out) provides symptomatic improvements in patients with normal alignment, joint space >3mmQ, stable ligaments, unicompamental OA with relevant osteophytes at the site of symptom, loose bodies, minimal Fair bank lesions, meniscal flap tear, chondral fracture/flap and outerbridge I or II lesions. And patients with bi/tri compamental OA, malalignment, irrelevant osteophytes away from symptom site, diffuse chondrosis, degenerative meniscus, significant Fair bank lesion and outbridge III or IV are poor prognostic factors for ahroscopic debridement. So obliterated joint space rules out the possibility of conservative and ahroscopic treatments. - High tibial osteotomy is indicated in physiologically young (years) and active patients with unicompamental OA of tibiofemoral jointsQ. Radiological Grading Scale of OA of Tibiofemoral Joint Ahroscopic Grading of Aicular Cailage Defect of knee joint Ahlback Kellgren Lawrence Brandt Noyes 0 No radiographic findings of osteoahritis No radiographic findings of osteoahritis No radiographic findings of osteoahritis 0 Normal aicular cailage 1 Joint space Minute osteophytes of lA Mild softening or discoloration of narrowing < 3mm doubtful clinical significance with secondary features aicular cailage 2 Joint space Definite osteophytes 50-75% joint space narrowing 1B Severe softening or discoloration of obliterated or almost obliterated with unimpaired joint space without secondary features aicular cailage 3 Minor bone attrition Definite osteophytes 50-75% joint space narrowing 2A Paial-thickness defect of ( with moderate joint space narrowing with secondary features the total thickness of aicular cailage 4 Moderate bone Definite osteophytes >75% joint space narrowing 2B Paial-thickness defect of >50% of attrition (5-15 mm) with severe joint space narrowing, subchondral sclerosis and definite deformity of bone contour. with secondary features Severe subchondral sclerosis and definite deformity of bone contour the total thickness of aicular cailage 5 Severe bone attrition (>15 mm) 3A Full-thickness aicular cailage defect with normal subchondral bone * Secondary radiological features of OA include osteophytes, subchondral 3B Full-thickness aicular cailage sclerosis & subchondral defect with erosion of subchondral bone Surgical Management Plan of Ahritis Knee - Before surgery is considered, conservative management (including anti-inflammatory medications, modification of daily activities, weight reduction for obese patients, and use of cane for ambulation) should be exhausted (adequately tried). Intra aerial injections of hyaluronic acid & steroid may be helpful in early minimal ahritis. Ahroscopic lavage (wash out) provides symptomatic improvements in patients with normal alignment, joint space >3mmQ, stable ligaments, unicompamental OA with relevant osteophytes at the site of symptom, loose bodies, minimal Fair bank lesions, meniscal flap tear, chondral fracture/flap and outerbridge I or II lesions. And patients with bi/tri compamental OA, malalignment, irrelevant osteophytes away from symptom site, diffuse chondrosis, degenerative meniscus, significant Fair bank lesion and outbridge III or IV are poor prognostic factors for ahroscopic debridement. Total (Tricompamental) Knee Replacement (TKR) : Indications - Primary indication of TKR is to relieve pain caused by severe ahritis with or without significant deformityQ. Radiological finding must correlate with clinical impression of knee ahritis. Patient who do not have complete cailage space loss before surgery tend to be less satisfied with their clinical result after TKR. - Severe pain from chondrocalcinosis & pseudogout in an elderly patient is an occasional indication of TKR in absence of complete cailage space loss. Severe patellofemoral ahritis in elderly may justify TKR because the expected outcome is better than that of patellectomy in these patients. - Osteonecrosis with subchondral collapse of femoral condyle. - Because knee replacement has a finite expected survival that is adversely affected by activity level, it generally is indicated in older patients with more sedentary life styles. It is preferable that patients undergoing TKA have a remaining normal life expectancy of between 20 & 30 years so that need for a repeat ahroplasty for a failed TKA will be minimal. It is clearly indicated in young patients who have limited function b/o systemic ahritis (eg rheumatoid ahritis) with multiple joint involvement. But the patient must understand the limitations of the procedure, be willing to modify life style to prolong the life of prosthesis and be willing to risk the lower success rate in a revision TKA. - Deformity can become the principle indication for TKR in patient with moderate ahritis & variable levels of pain when the progression of deformity begins to threaten the expected outcome of an anticipated TKR. This includes flexion contractures beyond 20deg and vurus/ valgus laxity. However, deformity without pain is not a suitable indication for surgery as it may be well tolerated by elderly. - Indications for leaving the patella unresurfaced are, a primary diagnosis of OA, satisfactory patellar cailage with no eburnated bone, congruent patello femoral tracking, a normal anatomical patellar shape and no evidence of crystalline or inflammatory ahropathy and lighter weight of patient. TKR: Contraindications - Absolute contraindications include recent or current knee infection; a remote source of ongoing infection; extensor mechanism discontinuity or severe dysfunction; recurvatum deformity secondary to muscular weakness; and presence of painless, well functioning knee ahrodesis. - Relative contraindications include fragile medical conditions, severe atherosclerotic disease of operative leg, skin conditions such as psoriasis within the operative field, venous stasis disease with recurrent cellulitis, neuropathic ahropathy, morbid obesity, recurrent UTI, and a h/o osteomyelitis in the proximity of knee. | 156,020 | medmcqa_train |
A 45-year-old man has recently been the recipient of a hea transplant. Which one of the following drug is least likely to cause tachycardia in this patient | The transplanted hea doesn't have sympathetic innervation. Hence an indirectly acting sympathomimetic like Amphetamine has the least likelihood of causing tachycardia when compared to the directly acting ones. | 156,021 | medmcqa_train |
Chemical structure of hemoglobin is | Hemoglobin is a protein with a molecular weight of 64,450.Hemoglobin is a globular molecule made up of four subunits . Each subunit contains a heme moiety conjugated to a polypeptide. Ref: Ganong's Review of Medical Physiology Twenty-Third Edition Page No: 523 | 156,022 | medmcqa_train |
Vande Matram Scheme is included in- | Ans. is 'a' i.e., RCH o New initiatives in RCH are : i) Training of PHC doctors in life saving anaesthetic skills for emergency obstetric care a FRUS ii) Setting up blood storage centres at FRUS. iil) Janani suraksha yojna iv) Vandernataram scheme v) Safe aboion services vi) Integrated management of childhood illnesses. | 156,023 | medmcqa_train |
An improved selective media to carry out the Lactobacillus Colony Test is: | Lactobacillus Colony Test:
The oldest and the most widely used microbiological method for assessing the caries activity is the Lactobacillus colony count. This method, measures the number of aciduric bacteria in a patient’s saliva by counting the number of colonies which appear on tomato peptone agar plates, a selective medium with pH 5.0, after inoculation of the patient’s saliva and incubation. An improved selective media with an acidic pH having high amounts of acetate, salts and lower surface tension that is highly selective for growth of Lactobacillus is the Rogosa’s medium. The colonies grown on media upon incubation reflect the number of aciduric flora in the patient’s saliva.
Note:
Hektoen enteric agar (HEK, HE or HEA) is a selective and differential agar primarily used to recover Salmonella and Shigella from patient specimens. HEA contains indicators of lactose fermentation and hydrogen sulfide production; as well as inhibitors to prevent the growth of Gram-positive bacteria. It is named after the Hektoen Institute in Chicago, where researchers developed the agar.
Mitis Salivarius Agar (MSA), a selective streptococcal medium with increased concentration of sucrose (20%) and 0.2 U bacitracin per ml to suppress the growth of most non S.mutans colonies. Agar plates are incubated at 37° C for 48 hours; 95% N2 - 5% CO2.
Essentials of preventive and community dentistry
Soben Peter
5th edition | 156,024 | medmcqa_train |
For diagnosis of mania symptoms should be- | Ans. is 'a' i.e., > 1 Week Diagnostic criteria for Mania Three or more of the following for at least 1 week : - Inflated self esteem or grandiosity Decreased need for sleep Ovealkativness Flight of ideas or racing thoughts Distractibility increased goal directed activity or psychomotor agitation Excessive involvement in pleasurable activities that have a high potential for painful consequences. The mood disturbance is sufficiently severe to cause marked impairment in occupational & social functioning, or there are psychotic features. If the symptoms occur for 4 days, and do not cause impairment of social/occupational functioning, and psychotic feature are absent, then the diagnosis is hypomania. | 156,025 | medmcqa_train |
Absolute contraindication of HRT is? | ANSWER: (D) Breast cancerREF: Harrisons 18th ed edition chapter 348Contraindications to HT should be assessed routinely and include unexplained vaginal bleeding, active liver disease, venous thromboembolism, history of endometrial cancer (except stage 1 without deep invasion) or breast cancer, and history of EURHD, stroke, transient ischemic attack, or diabetes.Relative contraindications include hypertriglyceridemia (>400 mg/dl) and active gallbladder disease; in such cases, transdermal estrogen may be an option | 156,026 | medmcqa_train |
In valvular hea disease complicating pregnancy the following statements are true except : | Open hea surgery is associated with a reduction in fetal loss | 156,027 | medmcqa_train |
A farmer presents with multiple discharging sinuses in the leg not responding to antibiotics. Most likely diagnosis is : | Ans. is 'a' madurella This is a case of Mycetoma (or Madura foot)Mycetoma is of 2 typesAbout the t/t, Harrison states * "Actinomycetoma may respond to prolonged combination chemotherapy e.g with streptomycin and either dapsone or trimethoprim-sulfamethoxazole "About t/t of eumycetoma it adds "eumycetoma rarely responds to chemotherapy in some cases caused by Madurella mycetoma have appeared to respond to ketoconazole or itraconazole "Thus RememberAlso, RememberThe granules from the draining sinuses are microcolonies of the organism*.The color of the granule may provide information about the agent eg-White to yellow -Actinomycotic mycetoma* Dark red to black granules-Madurella mycetomatis* | 156,028 | medmcqa_train |
In Aspergillus infection all the following drugs are used except- | Fluconazole is an antifungal medication used for a number of fungal infections. This includes candidiasis, blastomycosis, coccidiodomycosis, cryptococcosis, histoplasmosis, dermatophytosis, and pityriasis versicolor. It is also used to prevent candidiasis in those who are at high risk such as following organ transplantation, low bih weight babies, and those with low blood neutrophil counts. It is given either by mouth or by injection into a vein. Fluconazole is a first-generation triazole antifungal medication. It differs from earlier azole antifungals (such as ketoconazole) in that its structure contains a triazole ring instead of an imidazole ring. While the imidazole antifungals are mainly used topically, fluconazole and ceain other triazole antifungals are preferred when systemic treatment is required because of their improved safety and predictable absorption when administered orally. Fluconazole's spectrum of activity includes most Candida species (but not Candida krusei or Candida glabrata), Cryptococcus neoformans, some dimorphic fungi, and dermatophytes, among others. Common uses include The treatment of non-systemic Candida infections of the vagina ("yeast infections"), throat, and mouth. Ceain systemic Candida infections in people with healthy immune systems, including infections of the bloodstream, kidney, or joints. Other antifungals are usually preferred when the infection is in the hea or central nervous system, and for the treatment of active infections in people with weak immune systems. The prevention of Candida infections in people with weak immune systems, such as those neutropenic due to cancer chemotherapy, those with advanced HIV infections, transplant patients, and premature infants. As a second-line agent for the treatment of cryptococcal meningoencephalitis, a fungal infection of the central nervous system. Ref Harrison20th edition 1011 | 156,029 | medmcqa_train |
Regarding campylobacterium jejuni not true is ? | Human is the only reservoir "Campylobacter jejuni is a common cause of bacterial gastroenteritis in most pas of the world". Reservoir The bacterium has a broad host range and has been isolated from a range of sources including surface and ground waters, domestic and wild mammals, insects and wild birds. The most prominent source of human infection is consumption of chicken meat (poultry) either directly or through cross-contamination with other food items. The intestines of poultry are easily colonized with campylobacter jejuni. Day old chicks can be colonized with as few as 35 organisms. Pathogenesis :? Infection is acquired by ingestion. The jejunum and ileum are the first sites to become colonized. The organisms are invasive; in well developed infections the mesenteric lymph nodes are enlarged. Clinical features The average incubation period is 3 days with a range of 1-7 days. Abdominal pain and diarrhoea are main symptoms. Severe watery diarrhoea may lead to prostration. Leucocytes are almost always present in the feces and .frank blood may be apparent. Symptoms usually resolve within few day.s. Sequaleae of Campylobacter jejuni infection There are two conditions that may arise 1-2 weeks after the infection. Guillain Barre Syndrome -Guillain Barre syndrome (GBS) a demyelenating disorder resulting in acute neuromuscular paralysis is a serious sequlae of campylobacter jejuni infection. - An estimated one case of GBS occurs for every 1000 cases of campvlobacteriosis. Upto 40% of patients with this syndrome have evidence of recent campylobacter infection. 2) Reiters Syndrome -A reactive (aseptic) ahritis affects 1-2% of patients. - It typically affects the knees, ankles and wrists. | 156,030 | medmcqa_train |
Ducts of Bellini are found in - | Ans. is 'a' i.e., Kidneys Ducts Of Bellini* Papillary (collecting) ducts are anatomical structures of the kidneys, previously known as the ducts of Bellini.* Papillary ducts represent the most distal portion of the collecting duct system.* They receive renal filtrate (precursor to urine) from several medullary collecting ducts and empty into a minor calyx.* Papillary ducts continue the work of water reabsorbtion and electrolyte balance initiated in the collecting tubules. | 156,031 | medmcqa_train |
High risk pregnancy includes all except : | GROUP A GROUP B GROUP C GROUP D UNIVERSAL REPRODUCTIVE HISTORY PRESENT OBSTETRIC HISTORY INTRAPAUM FACTORS Maternal age >35 or<17 primiparity grand multiparity height <140cm low socioeconomy long period of infeility recurrent miscarriage previous IUD,Stillbih previous preterm instrumental delivery previous CS Third stage complications bih weight less than 2.5kg Rh or ABO isoimmunisation unbooked patient medical disorders hypeensive ectopic or hydatidiform mole IUGR Rh isoimmunisation APH Multiple pregnancy hydramnios malpresentations prolonged pregnancy obesity PROM Cord complications fetal distress prolonged labour PPH retained placenta unskilled attendant TEXTBOOK OF GYNECOLOGY,SHEILA BALAKRISHNAN,Pg no:586,2nd edition | 156,032 | medmcqa_train |
Commonest malignancy type in oral cavity is: September 2010 | Ans. C: Squamous cell carcinoma | 156,033 | medmcqa_train |
Commonest association seen in carcinom gall bladder? | Ans. is 'c' i.e. Secondaries liver | 156,034 | medmcqa_train |
Antral obstruction with vomiting is NOT characterised by: | Repeated vomiting leads to hypochloremic, hypokalemic metabolic alkalosis. Acidosis is not seen. Ref: Schwaz 9/e, Page 1426; Nelson 17/e, Page 1229. | 156,035 | medmcqa_train |
Which of the following is most appropriate about grade 4 burns- | Ans. is 'b' i.e., Involves the whole skin along with muscle tissue Classification of burns o Burn depth is an important topic and repeatedly asked. # Bums are classified according to increasing depth in 2 ways 1. Into degrees i.e. 1st degree to IVth degree bum 2. Into a less precise classification i.e. Shallow & Deep bums. # Relationship among these two classifications 1st degree } - - Superficial Shallow bums IInd degree - Deep } IIIrd degree Deep bums IVth degree Depth of Burn Colour & Appearance Skin Texture Capillary Refill Pinprick Sensation Healing First degree Superficial epidermis Red Normal Yes Yes 5-10 days. No scar Shallow Burn Second degree Superficial partial thickness Red may be blistered Edematous Dry to very small blisters Yes Yes 7-14 days. No. or minimal scar Deep partial Thickness Pink to White bullae or moist Thick Possibly Possibly 25-60 days, dense scar Deep Third degree Full thickness White black or brown Leathery Dry & Inelastic No No No spontaneous healing Burn Fourth degree Involves underlying subcutaneous tissue tendon or bone Variable Variable No No No spontaneous healing | 156,036 | medmcqa_train |
Thoracic duct enters from abdomen to thorax at ? | Thoracic duct is also called as Pecquet duct. It is the largest lymphatic duct in body, about 45 cm (18 inches) long. o It has a beaded appearance because of the presence of many valves in its lumen. Thoracic duct begins as a continuation of the upper end of the cisterna chylinear the lower border of Tuveebra and enters the thorax through the aoic opening of diaphragm (at T12 ). It then ascends through the posterior mediastinum and at T5 level crosses from right side to the left side and ascends along left margin of oesophagus to enter the neck. At the level of C7 veebrae, arches towards left side to open into left brachiocephalic vein at the angle of union of left subclan and left internal jugular veins. | 156,037 | medmcqa_train |
Embryonic hemoglobin is - | Ans. is 'c' i.e., Gower | 156,038 | medmcqa_train |
In a woman presenting with amenorrhea headache, blurred vision and galactorrhea appropriate investigation : | Ans. is a i.e. Prolactin level A woman presenting with headache, blurred vision and galactorrhea, raises the suspicion of a pituitary tumor and so, appropriate investigations would be : S. prolactin (most impoant)deg TSH (as patients with hypothyroidism have elevated TRH which acts to stimulate the release of prolactin) X Ray skulldeg (shows space occupying lesion) MRIdeg Contrast enhanced CT.deg Also know : Amenorrhea associated with elevated prolactin levels is due to prolactin inhibition of the pulsatile secretion of GnRH. | 156,039 | medmcqa_train |
All of the following are associated with non-ketotic hypoglycemia, EXCEPT: | Von Gierke's disease leads to ketotic hypoglycemia Hypoglycemia is of two types Ketotic hypoglycemia Non-ketotic hypoglycemia Von Gierke's disease Alcoholism When ketone bodies are formed in response to hypoglycemia, which is also a normal body's response to hypoglycemia Insulinoma hypoglycemia ( insulin decreases blood glucose) Ketone bodies are not formed insulin inhibits the formation of ketone bodies. Defects in beta-oxidation Carnitine deficiency, MCAD Jamaican vomiting sickness | 156,040 | medmcqa_train |
Which of the following is not a pneumatic bone? | (d) Malleus(Ref Scott Brown, 8th ed., Vol 2, page 538)Pneumatic bones are those bones which contain an air filled cavity within them which make them light in weight. In humans, they are seen in relation to the nasal cavity, and enclose the paranasal sinuses. Besides making the skull light in weight, they also help in resonance of sound and act as air conditioning chambers for the inspired air.Pneumatic bones are-maxilla, frontal bone, sphenoid and ethmoid.The mastoid is also most commonly a pneumatic (air filled) bone which encloses numerous air cell spaces giving it a honeycomb appearance. However in some people the mastoid may be diploic (marrow filled) or sclerotic (solid bone without air). | 156,041 | medmcqa_train |
Treatment of choice for extrahepatic poal thrombosis | Since obstruction is in the poal vein, to bypass the obstruction the shunt should be preferably REX shunt (mesenteric-left poal shunt) Splenorenal shunt is also done in EHPVO but in 50% of patients of EPHVO, splenic vein is thrombosed, not available for splenorenal shunt | 156,042 | medmcqa_train |
"Induseum Griseum" is a thin layer of grey matter in proximity to the corpus callosum. How is it related to it? | The convex superior pa of corpus callosum(dorsal) is covered by a thin layer of grey matter, the indusium griseum, embedded in which are the fibre bundles of bilateral medial and lateral longitudinal striae.Superiorly, it is also related to anterior cerebral vessels and cingulate gyrus.Ventrally, it is attached with the convex superior aspect of fornix by septum pellucidum. It is also related to lateral ventricle.(Ref: Vishram Singh textbook of clinical neuroanatomy, second edition pg 164, fig14.4) | 156,043 | medmcqa_train |
The transmission of which of the following neurotransmitters is blocked in strychnine poisoning | Glycine is a inhibitory neurotransmitter and strychnine competitively antagonizes Glycine. | 156,044 | medmcqa_train |
A neonate following BCG vaccination developed a side effect. Which of the following side effect would the neonate most likely develop after vaccination? | Ulceration is the most common side effect post BCG vaccination. Following vaccination, the local tissue response begins in 2-3 weeks, with scar formation and healing within 3 months. Side effects most commonly are ulceration at the vaccination site and regional lymphadenitis. Some vaccine strains also rarely cause osteomyelitis. In immunocompromised states, disseminated BCG infection can occur. Reference: Ananthanarayan and Paniker&;s Textbook of Microbiology Tenth edition | 156,045 | medmcqa_train |
Fibroadenoma of the breast are: | Ans. (d) Solitary mobile mass(Ref: Schwartz 10/e p510)* Fibroadenoma is the MC benign tumor of Female breast* MC in 15-30 years* Also known as Breast mouse | 156,046 | medmcqa_train |
According to sustainable development Goal 3- "Ensure healthy life and promote well being for all at ages", Target 3.1 is to reduce maternal moality ratio by 2030 is less than | By 2030, reduce the global maternal moality ratio to less than 70 per 100,000 live bihs. Indicators for this are- Maternal deaths per 100,000 live bihs Propoion of bihs attended by skilled health personnel. It comprises of 17 Sustainable Development Goals (SDGs) . Health is centrally positioned within the 2030 Agenda, with one comprehensive goal - SDG 3 : Ensure healthy lives and promote well-being for all ages. Goal 3 includes 13 targets covering all major health priorities | 156,047 | medmcqa_train |
ANCA is found in all except | (D) Bacterial vasculitis # ANTI-NEUTROPHIL CYTOPLASMIC ANTIBODIES (ANCA) are antibodies directed against certain proteins in cytoplasm of neutrophils. It is of two types:(i) Cytoplasmic (c) ANCA: Refers antibodies against proteinase-3 in azurophilic granules. It is found in - weger's granulomatosis(ii) Perinuclear (p) ANCA: Refers antibodies against myeloperoxidase (major target), elastase, cathepsin G, Lactoferin, Lysozyme.# ANCA is found in: PAN, Microscopic polyangitis, Churg-Strauss syndrome, Crescentic GN, Good-pasture's syndrome Non vascular causes like rheumatic and non-rheumatic autoimmune diseases, IBD, drugs, endocarditis, bacterial infections in patient of cystic fibrosis, primary sclerosing cholangitis etc.> There are three primary diseases that are consistently associated with ANCA: Wegener's granulomatosis, microscopic polyangiitis, and glomerulonephritis. The antibodies are assumed to be involved in the generation and/or progression of lesions and clinical signs.> Classically, c-ANCA is associated with Wegener's granulomatosis; p-ANCA is associated with microscopic polyangiitis arid focal necrotizing and crescentic glomerulonephritis. However, in recent years ANCA targeted against other autoantigens have been identified.> Patients with a number of other diseases, such as ulcerative colitis and Ankylosing spondylitis, will commonly have ANCA as well.> However in these cases there is no associated vasculitis, and the ANCA are thought to be incidental or epiphenomena rather than part of the disease itself.> Churg-Strauss syndrome is associated with p-ANCA directed against MPO. | 156,048 | medmcqa_train |
DOC for intermittent preventive therapy during pregnancy in malaria is: | Ans. is c, i.e Sulfadoxine - pyrimethamineRef. Williams 24/e, pg1257, high risk pregnancy fernando arias 4/e, pg 313Intermittent Preventive Therapy is a newer modification of prophylaxis. In chemo prophylaxis, the drugs have to be given daily or weekly, wherein in IPT the pregnant females are treated for malaria presumptively at fixed times (either twice or thrice) during pregnancy using drugs with long half life.The WHO allows for use of IPT during pregnancy. This consists of at least two treatment doses of sulfadoxine- pyrimethamine in second and third trimesters.DOC for chemoprophylaxis during pregnancy is chloroquine or hydroxyl chloroquine. | 156,049 | medmcqa_train |
A 20 year old primi at 30 weeks of gestation has polyhydraminos. She should be advised:- | Indomethacin acts by decreasing fetal urine production and thereby reduces amnionic fluid volume. This is presumed due to an increase in vasopressin levels and vasopressin responsiveness However, it may cause constriction of fetal ductus aeriosus, resulting in pulmonary hypeension. Hence, should not be used beyond 32 weeks | 156,050 | medmcqa_train |
Duration of cycloplegic by atropine in an adult: | Ans. (c) 7 - 10 daysRef.: A.K. Khurana 6th ed. 1573, Khurana 4th ed./146Cycloplegics and its duration of actionDrugDuration of Effect (days)Atropine7-10Scopolamine3-7Homatropine1-3Cyclopentolate1Tropicamidedays (6 hrs) | 156,051 | medmcqa_train |
Special feature of glargine insulin is ? | Ans. is 'a' i.e., It produces a smooth peakless effect InsuinGlargine It is long acting biosynthetic insulin. It remains soluble at pH 4 of the formulation and precipitates at neutral pH on subcutaneous administration. Onset of action is delayed. It produces a smooth peakless effect. It is suitable for once daily administration. Low incidence of night time hypoglycemia. It does not control meal time yperglycemia. | 156,052 | medmcqa_train |
Sal monella infection is most commonly caused by- | Ans. is 4a & b' i.e., Infected water & Infected vegetable Transmission of salmonella tvphio Typhoid fever is transmitted via the faecal-oral route or urine-oral routes. This may take place directly through soiled hands contaminated with faeces or urine of cases or carriers, or indirectly by the ingestion of contaminated water, milk and/or food, or through files.Dynamics of typhoid fever transmission | 156,053 | medmcqa_train |
Chemotherapy for dysgerminoma is: September 2012 | Ans. A i.e. Cisplatin, etoposide, bleomycin | 156,054 | medmcqa_train |
Illusion is a disorder of- | Ans. is 'b' i.e., Perception Disorders of perceptiono Altered perception:- Sensory distortion (micropsia, hyperacusis), Illusiono False perception:- Hallucination.Thought disordersFormal thought disorders (Disorders of thought process)Disorders of thought contenti) Racing thoughts:- Anxiety, Schizophreniaii) Retarded thoughts:- Depressioniii) Circumstantiality:- Mania, Schizophreniaiv) Thought blocking Schizophrenia, Severe anxietyv) Perseveration:- Organic brain disease, Schizophrenia (occasionally)vi) Loosening of association:- Schizophreniavii) Flight of ideas:- Maniaviii) Tangentialityix) Clunging & punning:- Mania & schizophreniax) Neologism, word salad, Echolalia:- Schizophreniai) Delusion:- Psychosis (Schizophrenia, mania, depression & othersii) Obsessioniii) Compulsioniv) Preoccupationsv) Phobiasvi) Depersonalization & Derealizationo In schizophrenia and mood disorders (depression, mania) all parts of the thought (thought process as well as content) are involved.o However, schizophrenia is conventionally referred as formal thought disorder. | 156,055 | medmcqa_train |
30-year-old married female who has been diagnosed as case of prolactinoma in your hospital. Her MRI Pituitary shows a 5 mm microadenoma. She is currently on bromocriptine and her urine pregnancy test has turned positive. What is the best advice for her? | This is an interdisciplinary question and has been discussed here to widen the scope of discussion. The guidelines are that once a lady with prolactinoma on Bromocriptine conceives, all drug treatment should be stopped to reduce possibility of any teratogenic effect on fetus. Monitor her Prolactin levels and only if headache and visual symptoms develop that bromocriptine can be re-staed. Harrison snap shot is attached for reference. Mechanical contraception should be used through three regular menstrual cycles to allow for conception timing. When pregnancy is confirmed, bromocriptine should be discontinued and PRL levels followed serially, especially if headaches or visual symptoms occur. For women harboring macrodenomas, regular visual field testing is recommended, and the drug should be reinstituted if tumor growth is apparent. Although pituitary MRI may be safe during . | 156,056 | medmcqa_train |
Ratio of incidence among exposed and non exposed is known as ? | Ans. is 'a' i.e., Risk ratio Relative risk (risk ratio) Relative risk is the ratio of the incidence of the disease (or death) among exposed and the incidence among nonexposed. | 156,057 | medmcqa_train |
According to PALS, which of the following is not included in initial impression? | Initial impression includes: Consciousness Breathing Color. Airway is included in Primary assessment. Reference: GHAI Essential pediatrics, 8th edition | 156,058 | medmcqa_train |
Post spinal headache lasts for - | Ans. is 'c' i.e., 10 days o Post dural puncture headache is due to CSF leak. Typical location is bifrontal or occipital,o Headache gets worsen on sitting or upright posture and is relieved by lying down position and abdominal pressure - The hallmark of postdural puncture headache i.e.. association with body position,o The onset of headache is usually 12-72 hours following the procedure, however, it may be seen almost immediately. In most cases it lasts for 7-10 days.o PDPH is believed to result from leakage of CSF from a dural defect and decreased ICT. Loss ofCSF ata rate faster that it can be produced causes traction on structure supporting the brain, particularly dura and tentorium. Traction on cranial nerve (particularly 6th nerve) produces diplopia,o Factors that increase the incidence of PDPH art young age, female sex, Pregnancy, large bore needle and multiple punctures.o Use of small bore needle can prevent PDPH .o Intially conservative treatment is given which includes analgesics (NSAIDs), oral or i.v., fluids, Sumatriptan, cosyntropin, caffeine and recumbent position.o If conservative treatment fails, epidural blood patch can be used. It involves injecting 15-20 ml of autologus blood into the epidural space which stop leakage of CSF by coagulation and mass effect. | 156,059 | medmcqa_train |
In spinal anesthesia, the needle is piereced upto - | Subarachinoid space, between pia and arachnoid | 156,060 | medmcqa_train |
LGV is caused by - | Lymphogranuloma venerum is caused by Chlamydia Trachomatis, serovars L1, L2 and L3. From illustrated synopsis of dermatology and sexually transmitted diseases neena khanna 5th edition page no 330 | 156,061 | medmcqa_train |
The Most common type of imperforate anus is | (C) Anorectal agenesis # Imperforate anus> (The term is used as a well-recognised description. Strictly it should be 'agenesis' and 'atresia' of the rectum and anus.)> One infant in 4500 is born with an imperforate anus, or with imperfect fusion of the post-allantoic gut with the proctodaeum.> The condition is divided into two main groups: the high and the low, depending on whether the termination of the bowel is above or below the pelvic floor.> Low varieties are easy to diagnose and relatively simple to treat, and the outlook is good.> High varieties often have a fistula into the urinary tract together with a deficient pelvic floor, and are difficult to treat.# Low abnormalities:> Covered anus. The underlying anal canal is covered by a bar of skin with atrack running forwards to the perineal raphe. The track should be opened with scissors, followed by routine dilatation of the anus.> Ectopic anus. The anus is situated anteriorly and may open in the perineum in boys, or more commonly in the vulva in girls, or rarely into thevagina. A plastic 'cut back' operation isrequired (Pena).> Stenosed anus. The anus is microscopic, but careful examination usually reveals a minute opening which responds to regular dilatation.> Membranous stenosis. Here the anus is normally sited, but is covered with a thin membrane which bulges with retained meconium. It is rare, and an incision will cure the condition.# High abnormalities:> These are often associated with a fistulous connection between the blind rectal stump and the bladder, or other abnormalities of the pelvic structures.> Anorectai agnesis. A blind rectal pouch lies just above the pelvic floor -- its anterior aspect in the male is attached to the bladder and often there is a rectovesical fistula manifested by the passage of gas or meconium in the urine. In the female, the fistula is usually into the posterior fornix.> Rectal atresia. The anal canal is normal but ends blindly at the level of the pelvic floor. The bowel also ends blindly above the pelvic floor without a fistulous opening. This anomaly is rare but must be treated by mobilisation of the rectum and excision of the stricture. After that, end-to-end anastomosis of the anus and rectum must be attempted.> More conservative measures are followed by an intractable stricture.> Cloaca. This occurs only in females and here the bowel, urinary and genital tracts all open into a common wide cavity. Commonly severe malformations of the area are associated with other developmental abnormalities, e.g. tracheobronchial fistula. | 156,062 | medmcqa_train |
An individual has been on a fad diet for 6 weeks and has begun to develop a number of skin rashes, diarrhea, and forgetfulness. These symptoms could have been less severe if the diet contained a high content of which one of the following? | At least eight different carrier proteins transport different groups of amino acids.a. Sodium-amino acid carrier system(1). A number of transport systems involve the uptake by the cell of a sodium ion and an amino acid by the same carrier protein on the luminal surface (examples are systems A, ASC, N, and B).(2). The sodium ion is pumped from the cell into the blood by the Na+-K+ ATPase, whereas the amino acid travels down its concentration gradient into the blood.(a). Thus, the transport of amino acids from the intestinal lumen to the blood is driven by the hydrolysis of adenosine triphosphate (ATP) (secondary active transport).b. The L-system of amino acid transport is not dependent on sodium for cotransport. The L-system transports branched-chain and aromatic amino acids and will be exploited in a treatment for phenylketonuria (PKU).The individual has developed pellagra caused by a lack of dietary niacin. Although dietary niacin is the major source of the nicotinamide ring of NAD, it may also be produced from excess tryptophan. Tyrosine, thiamine, thymine, and riboflavin cannot contribute to the synthesis of the nicotinamide ring of NAD. | 156,063 | medmcqa_train |
Which of the following is a feature of absence seizure | Absence Seizures:
Age: school going children
During seizure, blank staring episodes seen
No post ictal confusion
EEG: 3 / sec spike and wave pattern
Drug of choice: Sodium Valproate. | 156,064 | medmcqa_train |
Number of inpatient beds in PHC ? | PHC → 6 beds
CHC → 30 beds | 156,065 | medmcqa_train |
Which of the following is used as preanesthetic medication which causes the longest amnesia? | The longest amnesia is produced by lorazepam although half life of lorazepam (15 hours) is shoer than diazepam (36 hours) and this is probably because of its strong receptor binding potential. Its relatively potent amnesic effect, with its anxiolytic and sedative effects, makes lorazepam useful as premedication. | 156,066 | medmcqa_train |
Dactylographic is a: | Surest sign of identification | 156,067 | medmcqa_train |
BCYE. medium is used to culture: | Ans. (d) Legionella | 156,068 | medmcqa_train |
Which one of the following statements about Km value is true? | Substrate Concentration, A small Km indicates that the enzyme requires only a small amount of substrate to become saturated. Hence, the maximum velocity is reached at relatively low substrate concentrations. A large Km indicates the need for high substrate concentrations to achieve maximum reaction velocity. | 156,069 | medmcqa_train |
Squeeze technique is used for the treatment of - | Ans. is 'b' i.e., Premature ejaculation * Squeeze technique (Seman's technique) is used for premature ejaculation. When the male partner experiences 'ejaculatory inevitability' the female partner 'squeezes' the penis on the coronal ridge thus delaying ejaculation. | 156,070 | medmcqa_train |
Pink disease is due to | Ingestion of mercurous chloridein teething powder has led to acrodynia (Pink disease/Swift disease) in infants. This condition presents as feverwith a pink-coloured rash, irritability, photophobia, painfuland swollen extremities and hypersecretion of sweat glands.It is believed to be a hypersensitivity response to the mercurouschloride.Krishan Vij textbook of forensic medicine and toxicology 5e pg: 473 | 156,071 | medmcqa_train |
Vaginal changes in normal pregnancy show | Early in pregnancy the vaginal epithelial cells are similar to those found during the luteal phase, As pregnancy advances, two pattern of response may be seen 1. Small intermediate cells called navicular cells by Papanicolaou, are found in abundance in small, dense clusters 2. Vesicular nuclei without cytoplasm or so called naked nuclei, are evident along with an abundance of lactobacillus 3. **pH is acidic, varying from 3.5-6, the result of increased production of lactic acid from glycogen in the vaginal epithelium by the action of lactobacillus acidophilus | 156,072 | medmcqa_train |
A 38-year old woman presented with shoness of breath and fatigue. Her history is unremarkable except for a vague history of fever and joint pain as a child. She notes some recent fatigue and difficulty in sleeping that she attributes to job-related stress. On examination, her hea rate is 120 beats/min. ECG of the patient is given ECHO revealed following finding. Auscultation of the hea indicates a systolic murmur (during left ventricular ejection of blood) that is harsh in character. Which of the following pathological finding is not related with the underlying etiology: - | ECG shows atrial fibrillation and ECHO shows Left atrial enlargement. Images FINDINGS: Acute and chronic rheumatic hea disease A-Aschoff body in a patient with acute rheumatic carditis. B- Acute rheumatic mitral valvulitis: Small vegetations (verrucae) are visible along the line of closure of the mitral valve leaflet C- Neovascularization of anterior mitral leaflet D- Myxomatous degeneration of the mitral valve. This 35-year-old woman most likely has atrial fibrillation with tachycardia that is irregularly irregular. One common cause of atrial fibrillation is left atrial enlargement. In this patient, the history of childhood fever and joint pain likely is the result of streptococcal caused rheumatic fever. If untreated, the microorganism can cause inflammation of the mitral valve, leading to mitral stenosis. After 3-5 years, the mitral stenosis is likely to worsen, leading to atrial enlargement, fibrillation, and pulmonary edema with intolerance to physical exeion. | 156,073 | medmcqa_train |
Many of our bad habits of day to day life can be removed by- | Reinforcement (Positive conditioning) → to promote desired behavior (good habits).
Punishment (Negative conditioning) → to remove undesired behavior (bad habits). | 156,074 | medmcqa_train |
Double-Bubble" sign in X-ray is seen in: | Duodenal atresia | 156,075 | medmcqa_train |
Morphea occurs usually in: | A i.e. Forehead Mongolian spots, milia, miliaria, neonatal acne, transient neonatal pustular melanosis and erythema toxicum are benign, spontaneously self resolving conditionsQ. Whereas, powine stain represents progressive ectasia of superficial vascular plexus mostly involving face and is best treated by 585 nm pulsed dry laser. - Mongolion spots are blue / slate gray well demarcated macular lesions, most frequently involving buttock area (sacral > gluteal & lumbar trunk)Q in 80% of black & Indians. Involvement of posterior thigh, legs, back & shoulders is not uncomonQ. It is mis- nomer because it is not related to Down's syndrome & usually disappear before 1st bihdayQ. Erythema toxicum neonatorum (toxic erythema of new born) occurs in 20-50% of term infants - usually 2nd and later deliveries who are otherwise healthyQ. It is rare in preterm & under weight (mostly appear between 24-48 hours,on face, trunk, buttocks & proximal extremities, or pressure sites, - in form of macule, papule, wheal & pustule. Palm & soles are not involved. Wright's stain of lesion show neumerous eosinophils without peripheral eosinophilia. | 156,076 | medmcqa_train |
True about dysgerminoma of ovary | All Blood spread seen; Bleomycin, etoposide and cisplatin given; and Radio sensitive Dysgerminoma are germ cell tumours. I have already discussed dysgerminoma in detail in question no. 2, here I would like to point out about the spread of dysgerminoma. Most common mode of spread - Lymphatics. Can also spread by - Blood or Direct spread. Metastatic sites : Ovary (Thus dysgerminoma is another tumour besides granulosa cell tumour which shows metastasis to opposite ovary) Lower veebrae Lungs, liver and brain Mediastinum and supraclavicular lymph nodes Dysgerminoma is the most radiosensitive tumour but radiotherapy is not the TOC as feility is impaired by Radiotherapy Treatment of Choice is Surgery. For recurrent tumour : Chemotherapy .A.fith REP i.e. bleomycin. etoposide and cisplatin.deg | 156,077 | medmcqa_train |
The radiograph of skull is suggestive of which of the following diagnosis ? | Radiograph of a patient with sickle cell anemia showing a thickened diploic space and thinning of the skull cortex. Skull showing the hair-on end bone pattern. | 156,078 | medmcqa_train |
What is the diagnosis of the following examination of the fundus? | Glaucoma results in "cupping" as the neural rim is destroyed and the central cup becomes enlarged and excavated. The cup-to-disc ratio is about 0.7/1.0 in this patient. | 156,079 | medmcqa_train |
Which of the following monoclonal antibody is used for treatment of colorectal carcinoma? | Cetuximab - Colorectal cancer, Head and neck cancer. Rituximab - B cell NHL, CLL Natalizumab - multiple sclerosis Pembrolizumab - head and neck cancer JC virus antibody titre measurement is mandatory during treatment with Natalizumab | 156,080 | medmcqa_train |
A 5-year-old girl came with history of progressively increasing pallor since bih and hepatosplenomegaly. Which is the most relevant test for achieving diagnosis? | Progressive increasing pallor along with hepatosplenomegaly in a five-year-old girl is consistent with a diagnosis of thalassemia. (Thalassemia intermedia) 'Hemoglobin electrophoresis' is the test of choice of diagnosing this condition and hence is the option of choice here. | 156,081 | medmcqa_train |
Creatine is made up of all, except - | Ans. is 'b' i.e., Alanine o Creatine and creatinine are not amino acids, but specialized products of amino acids. Creatine is synthesized from glycine, arginine and methionine. Synthesis start with formation of guanidoacetate from glycine and arginine in kidney. Further reactions takes place in liver and muscle.Thus, both creatine and creatinine are synthesized from arginine, glycine, and methionine. | 156,082 | medmcqa_train |
which of the following class antidepressent used in the management of smoking sessation | NDRI * IMPOANCE Anti-depressant which does not deal with serotonin neurotransmission Also called as Zyban * MECHANISM Prevents reuptake of nor adrenaline and dopamine * DRUGS Bupropion * USE ADHD SMOKING CESSATION HYPOACTIVE SEXUAL DESIRE DISORDER * SIDE EFFECTS seizures Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, 955 | 156,083 | medmcqa_train |
False statement about bilirubin is | Bilirubin transpo: Bilirubin circulates in plasma noncovalently, bound to albumin. It is taken up across the sinusoidal membrane of hepatocytes by a carrier-mediated mechanism. Bilirubin uptake is mediated by a liver-specific sinusoidal organic anion transpo protein, (OATP1B1, SLC21A6) Then bilirubin is directed by cytosolic binding proteins (e.g., glutathione S-transferase B, fatty acid binding protein) to the ER. It is conjugated with uridine diphosphate (UDP)-glucuronic acid by the enzyme bilirubin UDP-glucuronyl transferase (B-UGT). Conjugated bilirubin is directed toward the canalicular membrane, and it is transpoed into the bile canaliculus by an adenosine triphosphate (ATP)-dependent pump. The responsible protein is multidrug resistance-associated protein-2 (MRP2, ABCC2) Small amounts of bilirubin glucuronides are secreted across the sinusoidal membrane MRP3 (ABCC3) Conjugated bilirubin in plasma undergoes renal elimination Ref: Sleisenger and Fordtran's, E-9, P-324 | 156,084 | medmcqa_train |
The cause of death in cyanide poisoning is | Anoxic anoxia: caused by a complete lack of oxygen to the brain. It occurs when a person is in an environment without enough oxygen, such as at high altitudes.Anemic anoxia: Anoxia due to anemia is not severe at rest unless hemoglobin deficiency is marked. However anemic patients may have considerable difficulty during exercise due to limited ability to increase oxygen delivery to active site.Histotoxic Anoxia: Hypoxia due to inhibition of tissue oxidative processes occurs due to cyanide poisoning. Cyanide inhibits cytochrome oxidase. Methylene blue or nitrites are used to treat cyanide poisoning.Stagnant Anoxia: Occurs due to slow circulation and is a problem in organs like kidneys and hea during shock. It is also known as hypoperfusion anemia. Ref: Ganong&;s review of medical physiology, 12th edition(South Asia), page: 621 | 156,085 | medmcqa_train |
Which of the following chromosomal abnormalities is most likely to cause mental retardation? | Ans. D. Trisomy 21An extra chromosome 21 is the most common genetic abnormality found in Down syndrome, and the abnormality most likely to cause mental retardation. Abnormalities in autosomal chromosomes are, in general, associated with mental retardation. The chromosomal aberration represented by 46 chromosomes with fusion of 15 and 21 produces a type of Down syndrome that, unlike trisomy 21, is usually inherited. Aberrations in sex chromosomes are not always associated with mental retardation, such as in XO (Turner's syndrome), XXY (Klinefelter's syndrome), and XXYY and XXXY (Klinefelter's syndrome variants) genotypes.Some children with Turner's syndrome have normal to superior intelligence.Girls with Turner's syndrome have gonadal agenesis and do not develop secondary sexual characteristics without medical intervention. Another hallmark feature is a webbed neck. In Klinefelter's syndrome and its variants, individuals have underdeveloped male genitalia and infertility and may develop gynecomastia beginning in adolescence. | 156,086 | medmcqa_train |
Which pa of subclan aery is affected by stenosis is: | Most common etiology of subclan stenosis is atherosclerosis, and it mostly affects the ostium or proximal pa of subclan aery. Ref: Peripheral and Cerebrovascular Intervention By Deepak L. Bhatt, Page 102 | 156,087 | medmcqa_train |
Valley fever or desse rheumatism is caused by | Coccidioides causes primary pulmonary disease which can be mild influenza-like fever ( valley fever) to severe pneumonia. Ref: Textbook of Microbiology, Ananthanarayan and Paniker; 9th edition | 156,088 | medmcqa_train |
Ductus arteriosus obliterates to form: | Ans. D. Ligamentum arteriosumChanges in Fetal Circulation Just after Birth After birth, the placenta is separated from newborn and lung startsoxygenating the blood, i.e., respiration is established. Now the oxygenated blood comes to heart from the lungs. As a result, the following changes take place in fetal circulation:a. Umbilical vein, as it no longer carries any blood from the placenta, obliterates and forms a fibrous ligament called ligamentum teres hepatis.b. Ductus venosus obliterates to form a fibrous ligament called ligamentum venosum.c. As the lungs are inflated and the pulmonary circulation is established, pulmonary veins bring more blood to the left atrium. Now, as the pressure of blood in the left atrium is more than that in the right atrium the septum primum is pushed to the right and the foramen ovale is closed. At first the closure of foramen ovale is physiological, but later on septum primum fuses with the septum secundum and there is an anatomical closure of foramen ovale. The closed foramenovale forms fossa ovalis.d. Ductus Arteriosus obliterates to form a fibrous ligament called the ligamentum arteriosum.e. Umbilical arteries (right and left) obliterate. However, their proximal parts remain open. The proximal parts of umbilical arteries form superior vesical arteries whereas their distal parts form fibrous ligaments called medial umbilical ligaments. | 156,089 | medmcqa_train |
What is the likely source of infection for Pus from sphenoethmoidal recess? | Ans: (a) Sphenoid sinusRef: Dhingra's ENT 6th ed. /138* Spheno ethmoidal recess is situmated above the superior turbine. Sphenoid sinus opens into is* Sphenoid sinus. It has an anterior part & posterior part.Anterior Part: roof related to the olfactory tract, optic chiasma, frontal lobe while the lateral wall is related to optic nerve internal carotid artery & maxillary nerve.Posterior Part: Roorf is related to the pituitary gland in the sella tucica while each lateral wall is related to cavernous sinus, internal carotid artery and CN 3rd and all division of 5th nerve | 156,090 | medmcqa_train |
The above nail changes are seen in: | Salmon patch or translucent oil drop like discoloration beneath nail plate is calssically seen in Psoraisis. | 156,091 | medmcqa_train |
Resource person for Training ofASHA are | Ans. is 'b i.e., AWW and ANM o Angan-Wadi Workers (AWW) and Auxiliary Nurse Midwife (ANM) act as resource persons far training of ASHA (Accredited Social Health Activist). | 156,092 | medmcqa_train |
Most common site of tuberculosis of spine is? | Ans. (a) ThoracolumbarRef: Apley 387-389, Schwartz's Principles of Surgery 9th ed ch-29 M Tuli 3rded p-192 | 156,093 | medmcqa_train |
Angiography is the investigation of choice in: | Ans. Central serous retinopathy | 156,094 | medmcqa_train |
Half life of insulin is - | Ans. is 'a' i.e., 5 min o The half-life of insulin in the circulation in humans is about 5 min. Insulin binds to insulin receptors, and some is internalized. It is destroyed by proteases in the endosomes formed by the endocytotic process. | 156,095 | medmcqa_train |
Cultivable (in vitro) hepatitis virus is - | HAV can be grown in some human and simian cell cultures and is the only human hepatitis virus which can be cultivated in vitro. REF:ANANTHANARAYAN AND PANIKER'S TEXTBOOK OF MICROBIOLOGY 9TH EDITION PAGE NO-541 | 156,096 | medmcqa_train |
Development of heart is from which of the following: | ANS. DThere has been a rising trend of asking embryology images in AIIMS. May session had asked the development of nucleus pulposus (Answer was notochord). Development of cerebral cortexDevelopment of palate and anomalies of it* Midline cleft lip: Due to non-fusion of 2 median nasal process* Harelip (not midline): Due to non-fusion of medial nasal process and maxillary process* Oblique facial cleft: Non-fusion of maxillary and lateral nasal process# Pharyngeal pouch and cleft# Another important area is remnants of various structuresRight umbilical veinDisappearsLeft umbilical veinLigamentum teresProximal part of umbilical arterySuperior vesical arteryDistal part of umbilical arteryLateral umbilical ligamentDuctus arteriosusLigamentum arteriosumDuctus venosusLigamentum venosumUrachusMedian umbilical ligamentObliterated umbilical arteryMedial umbilical foldInferior epigastric arteryLateral umbilical fold | 156,097 | medmcqa_train |
Which of the following mutations in a tumor suppressor agent causes breast carcinoma | Ref Robbins 9/e p294 Mutation in p53 tumor suppressor gene is strongly associated with breast cancer,as well as many other sarcomas and carcinomas .this condition is called li Fraumeni syndrome Li-Fraumeni syndrome is a rare, autosomal dominant, hereditary disorder that pre-disposes carriers to cancer development This syndrome is also known as the sarcoma, breast, leukaemia and adrenal gland (SBLA) syndrome. The syndrome is linked to germline mutations of the p53 tumor suppressor gene, which encodes a transcription factor (p53) that normally regulates the cell cycle and prevents genomic mutations. The mutations can be inherited, or can arise from mutations early in embryogenesis, or in one of the parent's germ cells | 156,098 | medmcqa_train |
Increased permeability in acute inflammation is due to | Formation of endothelial gaps in venules, i.e. immediate transient response is the most common mechanism causing increased vascular permeability in acute inflammation,
Mediators involved in this mechanism are
i. Immediate (more important): Histamine, bradykinin, leukotrienes, neuropeptide substance P.
ii. Somewhat delayed: IL-1, TNF, IFNγ | 156,099 | medmcqa_train |
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