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Iodine gives red colour with | Amylose: Gives blue with iodine testAmylopectin: Gives reddish violet with iodine testGlycogen: With iodine-: deep red colour | 156,100 | medmcqa_train |
Essential fatty acid - | Ans. is 'a' i.e., Linoleic acid o The three polyunsaturatedfatty acids (PUFAs), namely, linoleic acidQ linolenic acidQ, and arachidonic acidQ are called essential fatty acids.o They are called essential fatty acids because human beings require these fatty acids but cannot synthesize themQ,o Humans lack the enzymes to introduce double bonds at carbon atom beyond C9 in the fatty acid chain,o Hence, human cannot synthesize linolenic acidQ and linolenic acid having double bonds beyond C9.o Arachidonic acid can be synthesized from linoleic acid.o Therefore, in deficiency of linoleic acid, arachidonic acid also becomes essential fatty acids,o Therefore linoleic acid is the most important essential fatty acidQ as it serves as a basis for the production of other EFA | 156,101 | medmcqa_train |
Centrally acting anti hypertensive drug is - | Ans. is 'b' i.e., Methyl Dopa Centrally Aeting Svmpatholvticso These drugs reduce sympathetic outflow from vesopressor centers in brainstem. Examples are :1 .Clonidine3.Guanabenz5. Rilmenidine2. Methyldopa4. Guanfacine6. MoxonidineClonidineo It acts (partial agonist) on a, receptors, especially a2A in brainstem - Stimulation of receptors in medulla (vasomotor centre) - decrease sympathetic outflow - fall in BP and bradycardia (also due to enhanced vagal tone).o a2A receptor stimulation is responsible for sedation produced by clonidine.o Clonidine also binds to a nonadrenergic receptor, imidazoline receptor, which may also mediate antihypertensive effect.o Rilmenidine and moxonidine are selective cerebral imidazoline receptor agonists with little or, action - equivalent antihypertensive action with low sedative property.o Rapid r'.v. injection of clonidine raises BP transiently due. to activation of peripheral postsynaptic vasoconstrictor a2B receptors at high concentrations so attained. Ora! doses producing lower plasma levels cause only fall in BP, because clonidine has lower intrinsic activity on a2B receptors which predominate in vascular smooth muscle,o Uses of clonidine# Hypertension# Opioid withdrawl# Menopausal syndrome# Alcohal withdrawal# Smoking cessation# Loose motions in diabetic neuropathy# Test for pheochromocytoma o Abrupt discontinuation of clonidine therapy can lead to rebound hypertension (treated with phentolamine); therefore this drug is not suitable for people having travelling job like business executives who are likely to miss the doses.Methvldopao It is a prodrug - a-methyl norepinephrine formed in the brain from methyldopa acts on a-receptor in brainstem- decrease sympathetic out flow.o In large doses, methyldopa inhibits the enzyme dopa decarboxylase in brain and periphery - reduces NA synthesis and forms the false transmitter methyl-NA in periphery as well,o Methyldopa is DOCfor hypertension in pregnancy.Guanabenz and guanfacin are centrally active antihypertensive drugs that share the central otj-adrenoceptor- stimulating effects of clonidine. | 156,102 | medmcqa_train |
Local anaesthetics act by? | Ans. is 'a' i.e., Na channel inhibition inside gate Local anesthetics act by inhibiting Na' channels from inside. Mechanism of action of LA Local anaesthetics block generation and conduction of nerve impulse at all pa of neuron where they come in contact, without causing structural damage. Thus not only sensory but motor impulses and autonomic control is also interrupted. Mechanism of action Normally Na+ channel in axonal membrane has following phases : Recovery Resting (close) - Active (open) - Inactive (open) LAs prolong the inactive state --> channel takes longer to recover - refractory period of the fiber is increased. LAs first penetrate the axonol membrane to come inside and then their active species (cationic form) bind to Net' channel from inside. Cationic form (active form) is able to approach its receptor only when the channel is open at the inner face - So resting nerve is resistant to block as Na' channels are not activated and cationic form is not able to approach its receptor. So blockade develops rapidly when the nerve is stimulated repeatedly. Degree of blockade is frequency dependent greater blockade at higher frequency of stimulation. Exposure to higher concentration of Ca' reduces inactivation of Na' channels and lessens the block. Order of blockade of fibres B > C > AS> Ace, (3 & y (Autonomic > Sensory > Motor). Order of recovery is in reverse order. Among sensory afferent order of block is : Temperature (cold before heat) > Pain > touch > deep pressure. When applied to tongue, bitter taste is lost first followed by sweet and sour, and salty taste last of all. Myelinated nerves are blocked earlier than nonmyelinated. Smaller fibres are more sensitive than larger fibres. | 156,103 | medmcqa_train |
APACHE II score involves all except? | Ans. (d) Serum amylaseRef-.Harrison 19th edition, Chapter 267* Acute Physiology and Chronic Health Evaluation II is the most commonly used Severity of illness scoring system in America* Age, type of ICU admission (after elective surgery vs. nonsurgical or after emergency surgery), a chronic health problem score, and 12 physiologic variables (the most severely abnormal of each in the first 24 h of ICU admission) are used to derive a score.* The predicted hospital mortality is derived from a formula that takes into account the II score, the need for emergency surgery, and a weighted, disease-specific diagnostic categoryVITALS* Rectal temperature, degC* Mean blood pressure, mmHg* Heart rate* Respiratory rate* Arterial Ph* Oxygenation* If Flo2>0.5,use(A-a)Do2* If Fo2 <0.5, use Pao2LABS* Serum sodium, meq/L* Serum potassium, meq/L* Serum creatinine, mg/dL* Hematocrit* WBC count, 103/mL* Glasgow Coma ScorePoints Assigned to AgeAge, Years<4545-5455-6465-74>75Points Assigned to Chronic HealthNoneIf patient is admitted after elective surgeryIf patient is admitted after emergency surgery or for reasons other than after elective surgery | 156,104 | medmcqa_train |
Extensive surgical debridement, decompression or amputation may be indicated in the following clinical setting except | Superficial thrombophlebitis management This is a superficial venous thrombosis. An abnormal endothelium is a much more common precipitating factor than in most DVTs. Common causes include external trauma (especially to varicose veins), venepunctures and infusions of hyperosmolar solutions and drugs. The presence of an intravenous cannula for longer than 24-48 hours often leads to local thrombosis. Some systemic diseases such as thromboangiitis obliterans (Buerger's disease) and malignancy, especially of the pancreas, can lead to a flitting thrombophlebitis (throm bophlebitis migrans), affecting different veins at different times. Finally, coagulation disorders such as polycythaemia, thrombocytosis and sickle cell disease are often associated, as is a concomitant DVT. The surface vein feels solid and is tender on palpation. The overlying skin may be attached to the vein and in the early stages may be erythematous before gradually turning brown. A linear segment of vein of variable length can be easily palpated once the inflammation has died down. A full blood count, coagulation screen and duplex scan of the deep veins should usually be obtained. Any suggestion of an associated malignancy should be investigated usingappropriate endoscopy and imaging studies, such as an abdominal CT scan. Most patients are treated with non-steroidal anti- inflammatory drugs and topical heparinoid preparations and the condition resolves spontaneously. Rarely, infected thrombi require incision or excision. Ligation to prevent propagation into the deep veins is almost never required, although some advocate saphenofemoral ligation when the thrombus is seen on ultrasound to be at the SFJ. Associated DVT or thrombophilia is treated by anticoagulation. Ref: Bailey and love 27th edition Pgno : 990 | 156,105 | medmcqa_train |
Acetyl CoA is used for synthesis of following, except : | Acetyl-CoA is the third branch point of primary metabolic control, and coordinates carbohydrate, ketone, and fat/lipid pathways.Acetyl-CoA is the product of carbohydrate, protein, and lipid catabolism.Acetyl-CoA is a substrate for the citric acid cycle and can be oxidized to generate energy. It is not used for the synthesis of non ketogenic amino acids only. Ref:Valencik M.L., Mastick C.C. (2012). Chapter 10. Metabolism and Vitamins/Minerals. In L.W. Janson, M.E. Tischler (Eds), The Big Picture: Medical Biochemistry. | 156,106 | medmcqa_train |
All of the following are absolute indications for tonsillectomy, except | Recurrent throat infections, peritonsillar abcess, tonsillitis causing febrile seizures, hyperophy of tonsils causing sleep apnoea or speech interference and any suspicion of malignancy are absolute indications for tonsillectomy. | 156,107 | medmcqa_train |
Which of the following is found in secondary granules of neutrophils? | Neutrophils have two main types of granules
The smaller specific (secondary) granules contain lysozyme, collagenase, gelatinase, lactoferrin, plasminogen activator, histaminase, and alkaline phosphatase.
The larger azurophil (primary) granules contain myeloperoxidase, bactericidal factors (such as defensins), acid hydrolases, and a variety of neutral proteases (elastase, cathepsin G, nonspecific collagenases, proteinase).
Reference-Robbins BASIC PATHOLOGY 10th edition pg-68 | 156,108 | medmcqa_train |
Deep peroneal nerve doesn't supply - | Muscles of anterior compartment of leg are supplied by deep peroneal nerve.
Muscles of lateral compartment of leg (Peroneus longus, peroneus brevis) are supplied by superficial peroneal nerve. | 156,109 | medmcqa_train |
In carcinoma base of tongue pain is referred to ear through | Ans. is 'c' i.e., Glossopharyngeal Referred otalgiao As ear receives nerve supply from Vth (auriculotemporal branch), IXth (tympanic branch) and IXth (auricular branch) cranial nerves; and from C2 (lesser occipital) and C2 and C3 (greater auricular), pain may be referred from these remote areas.Via IXth cranial nerveDental: - Caries tooth, apical abscess, impacted molar, malocclusion.Oral cavity: - Benign or malignant ulcerative lesions of oral cavity or tongue.Temporomandibular joint disorders: - Bruxism, osteoarthritis, recurrent dislocation, ill-fitting denture.Sphenopalatine neuralgiaVia IXth cranial nerveOropharynx : - Acute tonsillitis, peritonsillar abscess, tonsillectomy. Benign or malignant ulcers of soft palate, tonsil and its pillars.Base of tongue: - Tuberculosis or malignancyElongated styloid process.Via Xth cranial cerve : Malignancy or ulcerative lesion of vallecula, epiglottis, larynx or laryngopharynx, oesophagus.Via C2 and C3 spinal nerves : Cervical spondylosis, injuries of cervical spine, caries spine. | 156,110 | medmcqa_train |
Clinical feature(s) seen in Kwashiorkar is/are _______ | Kwashiorkar is a form of severe acute malnutrition (SAM) characterized by edema and apathy. Edema is most likely to appear first on the feet and then in the lower legs. It can develop into generalized edema affecting the hands, arms and face. Moon face Skin changes include depigmentation of skin, dermatoses, dark, cracked peeling patches (flaky paint dermatosis) with pale skin underneath that is easily infected Hair is sparse, easily pulled out, and may turn reddish. Flag Sign: Alternating bands of hypopigmented and normal pigmented areas on hair strand The liver is often enlarged with fat (fatty liver) The children are miserable and apathetic and often refuse to eat Muscle wasting and growth failure is seen Villous atrophy of small intestine and diarrhea Marasmus (severe wasting) is characterized by simian facies, wrinkled old-man appearance, loose wrinkled skin with marked wasting of fat and muscle, and fretful and irritable behaviour Ref: Nelson Textbook of pediatrics 21st edition Pgno: 337 | 156,111 | medmcqa_train |
A 25 year old male presented with pigmentation of nose and pinna. After voiding, his urine becomes dark. His spine is most likely to show- | Ans. is 'd' i.e., Calcification of disc Clinical features of the patient suggests the diagnosis of AlkaptonuriaClinical problems arise from degenerative changes in articular cartilage with the development of ochronotic arthritis and from calcification of intervertebral discsOther clinical features areScleral pigmentation (Foci of grey brown pigments)Generalized darkening of concha, anthelix and finally helixPigmentation of heart valves, larynx, and tympanic membranes develops.Urine turns black on exposure | 156,112 | medmcqa_train |
Following is a doctrine related to negligence - | Ans. is 'a' i.e. Therapeutic misadventureo Diagnostic or Therapeutic misadventure is the occurrence of misadventure causing injury or death of the patient due to inherent risk of procedure or drug, e.g. adverse effects of a drug. It is unintentional.Doctrines related with negligence1) Resp Ipsa Loquitar (fact speaks for itself)2) Calculated risk doctrine3) Doctrine of common knowledge4) Diagnostic or Therapeutic misadventure5) Medical maloccurance (inevitable accident or Act of god)6) Novus Actus Interveniens (an unrelated action intervening)7) Contributory negligence8) Vicarious responsibility (Liability)9) Borrowed servant doctrine (captain of the ship doctrine)10) Product liability. | 156,113 | medmcqa_train |
Cytokine causing fever - | Ans. is 'a' i.e., IL-6 Pyrogeneso Pyrogenes are substances that cause fever,o Pyrogens may be exogenous or endogenousExogenous - Bacterial toxinsEndogenous - IL-1, TNF-a, IL-6, Interferons, Ciliory's neurotropic factoro These pyrogenes increase the level of PGE2 in the hypothalamus that elevates the thermoregulatory set point and causes fever. | 156,114 | medmcqa_train |
Best diagnosed with USG at first trimester | Ans. A. Anencephaly Ref: DC Dutta's obstetric p408ExplanationIn the first half of pregnancy, the diagnosis of anencephaly is made by elevated alpha-fetoprotein in amniotic fluid and confirmed by sonography.Question not recalled properly: Imerslund-Grasbeck syndrome, its cause was asked.ExplanationCaused by low levels of vitamin B12 (also known as cobalamin).The characteristic features are# Megaloblastic anemia.# Proteinuria (-50% cases)# Normal kidney function.Typically begins in infancy or early childhood.Symptoms include:# An inability to grow and gain weight at the expected rate (failure to thrive),# Pale skin (pallor),# Excessive tiredness (fatigue), and# Recurring gastrointestinal or respiratory infections.# Other features include mild neurological problems, such as weak muscle tone (hypotonia), numbness or tingling in the hands or feet, movement problems, delayed development, or confusion.Mutations in the AMN or CUBN gene. The AMN gene provides instructions for making a protein called amnionless, and the CUBN gene provides instructions for making a protein called cubilin which are in turn responsible for uptake of Vit bl2 in body.Management is symptomatic. | 156,115 | medmcqa_train |
GFR is increased when - | D i.e., Increased renal blood flow | 156,116 | medmcqa_train |
What is the investigation going on in Ophthalmology examination | Goldmann Applanation tonometry Gold standard. Based on Imbe Fick law. If cornea is thinner than reading is falsely low. If cornea is thicker, it is falsely high. Applanation tonometry Other Options Pachymetry: Corneal thickness Biometry: Calculation of Power of IOL to be implanted after cataract surgery LASER interferometry: used to detect the maximum visual potential of the eye | 156,117 | medmcqa_train |
The most common site of nasopharyngeal carcinoma is | The commonest site of origin of nasopharyngeal carcinoma is fossa of Rosenmuller in the lateral wall of the nasopharynx.
Tumor can spread to the following areas:-
Cranium through foramen lacerum & ovale → cranial nerves involvement (III, IV, V, VI); facial pain, and ophthalmic symptoms.
Parapharyngeal space → cranial nerves (IX, X, XI, XII) involvement, Horner's syndrome, Trismus (Pterygoid muscle).
Retropharyngeal nodes → Neck pain & stiffness.
Eustachian tube → Serous OM.
Nose and orbit → Obstruction, epistaxis, proptosis.
Cervical nodes → Upper jugular and posterior triangle nodes enlargement.
Distant metastasis → Lung, liver, bone.
Middle ear → Rarely, tumor grows up the tube into the middle ear. | 156,118 | medmcqa_train |
All of them are true about ERG except | Electroretinography (ERG) is the record of changes in the resting potential of the eye induced by a flash of light. Components of normal electroretinogram (ERG) a-wave. It is a negative wave possibly arising from the rods and cones (photoreceptors). b-wave. It is a large positive wave which is generated by Muller's cells, but represents the activity of the bipolar cells . c-wave. It is also a positive wave representing metabolic activity of pigment epithelium (seen only in dark adapted eye). A flash ERG requires a large area of retina to be abnormal for being detectable and thus in macular disorder where only small pa of retina is involved , flash erg doesn't detect it | 156,119 | medmcqa_train |
Contracted socket occurs because of all the following except: | Ans. Loss of fatty tissue during surgery of enucleation | 156,120 | medmcqa_train |
In a population of 100 prevalence of candida glabrata was found to be 80%. If the investigator has to repeat the prevalence with 95% confidence what will the prevalence be | Confidence Intervals for Population proportions (For 95% Confidence)
CI = P + 2 SEP = P + 2 √pq/n
Here, P=0.80 (80%); p=0.80;
q= 1-p = 1-0.80 = 0.20;
n=100 CI = 0.80 + 2 √0.8*0.2/100
= 0.80 + 0.08
= 0.72, 0.88 (72%, 88%) | 156,121 | medmcqa_train |
Trendelenburg test is positive in which of the following condition: | In L5 S1 PIVD Superior gluteal nerve is effected which supplies the abductors of hip i.e Gluteus medius and minimus causes trendelenburg gait. TRENDELENBURG SIGN Normally when the body weight is suppoed on one limb, the glutei (medius and minimus) of the suppoed side contract and raise the opposite and unsuppoed side of pelvis If the abductor mechanism is defective the unsuppoed side of pelvis drops- positive Trendelenburg's test. It is positive in the conditions in which any of the three??"fulcrum (Femoral Head), lever arm (neck length) or power (muscles/nerve) is affected. In other conditions superior gluteal nerve is not affected. | 156,122 | medmcqa_train |
Primitive streak develops from? | Around day 14, the epiblast cells form primitive streak,. Notochord is formed by the mesoderm cells developed by epiblast cells. | 156,123 | medmcqa_train |
Fluid flow in and out of the dentinal tubules is proportional to the tubule diameter by: | Fluid flow in dentin tubules follows Poiseuille’s law as all tubular structures: | 156,124 | medmcqa_train |
Primary closure of incised wounds must be done within: | WOUNDS CAN BE CLOSED BY
Primary suture:
- Clean wounds
- Selected contaminated wounds after thorough wound toileting and debridement
Delayed primary suture:
- Heavily contaminated wounds
- Wounds in which wound toileting has been delayed for 6-8 hours
Left open to heal by secondary closure | 156,125 | medmcqa_train |
Dose of MgSO4 in asthma is | Bronchodilators Bronchodilator therapy is central to the management of breathlessness. The inhaled route is preferred and a number of different agents delivered by a variety of devices are available. Choice should be informed by patient preference and inhaler assessment. Sho-acting bronchodilators may be used for patients with mild disease but longer-acting bronchodilators are usually more appropriate for those with moderate to severe disease. Significant improvements in breathlessness may be repoed despite minimal changes in FEV1, probably reflecting improvements in lung emptying that reduce dynamic hyperinflation and ease the work of breathing. Oral bronchodilator therapy, such as theophylline preparations, may be contemplated in patients who cannot use inhaled devices efficiently but their use may be limited by side-effects, unpredictable metabolism and drug interactions; hence the requirement to monitor plasma levels. Orally active, highly selective phosphodiesterase inhibitors remain under appraisal. Combined inhaled glucocoicoids and bronchodilators The fixed combination of an inhaled glucocoicoid and a LABA improves lung function, reduces the frequency and severity of exacerbations and improves quality of life. These advantages may be accompanied by an increased risk of pneumonia, paicularly in the elderly. LABA/inhaled glucocoicoid combinations are frequently given with a long-acting muscarinic antagonist (LAMA). LAMAs should be used with caution in patients with significant hea disease or a history of urinary retention. Oral glucocoicoids Oral glucocoicoids are useful during exacerbations but maintenance therapy contributes to osteoporosis and impaired skeletal muscle function, and should be avoided. Oral glucocoicoid trials assist in the diagnosis of asthma but do not predict response to inhaled glucocoicoids in COPD. Pulmonary rehabilitation Exercise should be encouraged at all stages and patients reassured that breathlessness, while distressing, is not dangerous. Multidisciplinary programmes that incorporate physical training, disease education and nutritional counselling reduce symptoms, improve health status and enhance confidence. Most programmes include two to three sessions per week, last between 6 and 12 weeks, and are accompanied by demonstrable and sustained improvements in exercise tolerance and health status. Oxygen therapy Long-term domiciliary oxygen therapy (LTOT) improves survival in selected patients with COPD complicated by severe hypoxaemia (aerial PaO2 < 7.3 kPa (55 mmHg)). It is most conveniently provided by an oxygen concentrator and patients should be instructed to use oxygen for a minimum of 15 hours/ day; greater benefits are seen in those who use it for more than 20 hours/day. The aim of therapy is to increase the PaO2 to at least 8 kPa (60 mmHg) or SaO2 to at least 90%. Ambulatory oxygen therapy should be considered in patients who desaturate on exercise and show objective improvement in exercise capacity and/or dyspnoea with oxygen. Oxygen flow rates should be adjusted to maintain SaO2 above 90%. Surgical intervention Bullectomy may be considered when large bullae compress surrounding normal lung tissue. Patients with predominantly upper lobe emphysema, preserved gas transfer and no evidence of pulmonary hypeension may benefit from lung volume reduction surgery (LVRS), in which peripheral emphysematous lung tissue is resected with the aim of reducing hyperinflation and decreasing the work of breathing. Both bullectomy and LVRS can be performed thorascopically, minimising morbidity. Lung transplantation may benefit carefully selected patients with advanced disease (p. 567). Other measures Patients with COPD should be offered an annual influenza vaccination and, as appropriate, pneumococcal vaccination. Obesity, poor nutrition, depression and social isolation should be identified and, if possible, improved. Mucolytic agents are occasionally used but evidence of benefit is limited. Palliative care Addressing end-of-life needs is an impoant, yet often ignored, aspect of care in advanced disease. Morphine preparations may be used for palliation of breathlessness in advanced disease and benzodiazepines in low dose may reduce anxiety. Decisions regarding resuscitation should be addressed in advance of critical illnes Magnesium sulfate is a bronchodilator. It relaxes the bronchial muscles and expands the airways, allowing more air to flow in and out of the lungs. This can relieve symptoms of asthma, such as shoness of breath. initial loading dose 2 gm over a period of 20 minutes where infused Ref Davidson edition23rd pg 577 | 156,126 | medmcqa_train |
Trendelenburg test is positive due to injury to which of the following nerve? | Superior Gluteal A positive Trendelenburg is relatively non-specific and may indicate:Pain (e.g. due to osteoahritis of the hip joint)Weak hip abductors (gluteus medius, gluteus minimus)Sho femoral neck/ fracture of neckDislocation or subluxation of the hipNeuropathyGluteus medius and minimus are supplied by Superior Gluteal nerve. Trendelenburg testNormally when a person is made to stand on one leg, the hip abductors of the ipsilateral side raise the opposite and the unsuppoed side of the pelvis. If the abductor mechanism is defective, the unsuppoed side of the pelvis drops and this is known as positive Trendelenburg test.The abductor mechanism consists of:The hip abductors i.e. Glutei medius and minimus supplied by Superior Gluteal nerveThe fulcrum formed by the hip jointThe weight transmitted by the head and neck of femurFailure of any of the component of the abductor mechanism may result in positive Trendelenburg test. | 156,127 | medmcqa_train |
Nerve supply of opponens pollicis ? | Hand muscles supplied by median nerve are :- i) Thenar muscles (except adductor pollicis) :- Flexor pollicis brevis, opponens pollicis and abductor pollicis brevis. Adductor pollicis is supplied by ulnar nerve. ii) First two lumbricals. Hand muscles supplied by ulnar nerve are :? 1) Superficial terminal branch : It supplies palmaris brevis and skin of palmar surface of medial 1% fingers. 2) Deep terminal branch : It supplies adductor pollicis, all interossei, medial two (3rd & 4th)lumbricals and all hypothenar muscles except palmaris brevis (i.e. abductor digiti minimi, flexor digiti minimi, opponens digiti minimi). | 156,128 | medmcqa_train |
A patient presented with splenomegaly, anemia & shows reticulocytosis with increased bone marrow cellularity. The diagnosis is: | Hemolytic anemia - reticulocytosis with splenomegaly is seen. Skull and skeletal deformities can occur in childhood due to a marked increase in hematopoiesis and resultant bone marrow expansion | 156,129 | medmcqa_train |
Which is pleuripotent stem cell ? | Answer- A. Embryonic stem cellStem cellsEmbryonic stem cells : These are pleuripotent cellsAdutt stem cells | 156,130 | medmcqa_train |
Which of the following statement is true regarding time of ovulation? | Ans. c. Occurs after follicular ripening by FSH (Ref: Williams Obstetrics 23/e p355-356: Ganong 22/e p438: Shaw's 13/e p212)Follicular phase is under control of FSH and LH. Both FSH and LH is responsible for follicular ripening, but a surge in LH secretion triggers ovulation.OvulationLH surge is primarily caused by 'positive feedback' from sustained levels of estrogen.A surge in LH secretion triggers ovulation.A surge in LH secretion triggers ovulation and ovulation normally occurs about 9 hours after the peak of LH surge at midcycle.Tests of OvulationBasal body temperature:BBT falls at the time of ovulation by about 1/2 degree FahrenheitQ.Subsequently, during the progestational half of the cycle the temperature is slightly raised above the preovulatory level, and the rise is order of 1/2 to 1 degreeQ.This phenomenon is due to the thermogenic action of progesteroneQ, and is therefore presumptive evidence of presence of functioning corpus luteum and hence ovulation.Endometrial BiopsyDone preferably one or two days before the onset of menstruationQSecretary changes prove that the cycle has been ovulatoryQEndometrium should be subjected to guinea pig inoculation and culture to rule out genital tuberculosis which is present in 5-10 % of Indian women complaining of sterilityToday, endometrial biopsy is omitted as a routine investigation or infertility and ovulation best monitored by serial ultrasound scanning. Endometrial biopsy is taken only in suspected tubercular endometritisFern TestCervical mucus, when viewed under low power microscope it shows during the oestrogenic phase, a characteristic pattern of fern formationQ.This feming disappears after ovulation, and if previously present its disappearance is presumptive evidence of corpus luteum activity.The ferning is due to the presence of sodium chloride in the mucus secreted under estrogen effectQOvulation mucus has the property of great elasticity and will withstand stretching upto 10 cm, phenomenon is k/a Spinnbarkeit or thread testQ for estrogen activity.UltrasoundUltrasound has now become the standard procedure for monitoring maturation of the graffian follicle, and in detecting imminent ovulation in in-vitro fertilization and timing intercourse.This requires daily ultrasonic visualization of ovaries from 10th to 16th day of menstrual cycle. | 156,131 | medmcqa_train |
Not true regarding Choledochal cyst | Choledochal cyst Cystic dilation of the biliary ducts, more common in females Clinical features. Classical triad : Pain, jaundice (intermittent) & abdominal mass(10%). Most common symptom in infants : Jaundice (in 80%) Most common symptom in patients >2 years of age : Abdominal pain. In children, the major clinical symptoms are recurrent abdominal pain (81.8%), nausea & vomiting (65.5%), mild jaundice (43.6%), an abdominal mass (29%), and fever (29%) In adults, abdominal pain (87%), and jaundice (42%), and present frequently. Less common clinical findings include nausea (29%), cholangitis (26%), pancreatitis (23%), and an abdominal mass(13%) Treatment of choice is Roux-en-Y hepaticojejunostomy Ref: Sabiston 20th edition Pgno :1511 | 156,132 | medmcqa_train |
Maximum contribution to atomospheric air is- | Ans. is 'a' i.e., N2 * The constituents of air:-# Major - Nitrogen (N2) - 78.1 %, Oxygen (O2) - 20.93%, Carbon dioxide (CO2) - 0.03%# Minor - Argon, neon, krypton, xenon, helium, water vapour, traces fo ammonia, suspended matter (dust, bacteria, spores, vegetable debris). | 156,133 | medmcqa_train |
Ring Enhancing lesion In AIDS patient is Most Likely due to? | *Toxoplasmosis and CNS lymphoma are the major differentials for a Ring Enhancing lesion in AIDS Patients Toxoplasmosis produces Eccentric target sign within a ring Enhancing lesion | 156,134 | medmcqa_train |
Which group of drugs is most effective for the healing of Non steroidal Anti Inflammatory Drug (NSAID) induced gastric ulcer- | Ans. is 'c' i.e., Proton pump inhibitors o Drug of choice for NSAIDs induced peptic ulcer ---> PPIs o Most specific drug for NSAIDs induced peptic ulcer --> Prostaglandin analogue. | 156,135 | medmcqa_train |
Mature RBC contains all except - | Ans:B .) Enzymes of TCA cycle Erythrocytes (RBC) lack mitochondria (so TCA cycle enzymes) and completely rely on glucose as their metabolic fuel. They metabolize it by anaerobic glycolysis. | 156,136 | medmcqa_train |
A patient developed fixed drug eruptions after taking ceain medications. Which of the following drug will give rise to these skin lesions in this patient? | A fixed drug eruption (FDE) is an adverse cutaneous reaction to an ingested drug, characterized by the formation of a solitary (but at times multiple) erythematous patch or plaque. Most commonly implicated agents in fixed drug eruptions: Tetracyclines (tetracycline, minocycline) Sulfonamides, other sulfa drugs Metronidazole, nystatin, salicylates, NSAIDs, phenylbutazone, phenacetin Barbiturates Oral contraceptives Quinine (including quinine in tonic water), quinidine Phenolphthalein Food coloring (yellow): in food or medications Ref: (2013). Section 23. Adverse Cutaneous Drug Reactions1. In Wolff K, Johnson R, Saavedra A.P. (Eds), Fitzpatrick's Color Atlas and Synopsis of Clinical Dermatology, 7e. | 156,137 | medmcqa_train |
A woman with amenorrhea is having negative progesterone challenge test but has bleeding on combined estrogen-Progesterone challenge. What can be the cause - | Ans. is 'd' i.e., Pituitary tumor Negative progesterone challenge test - which rules out PCOD - (otherwise too, PCOD is a cause of secondary amenorrhea).When next step was done i.e., estrogen, progesterone combined test - It comes out to be positive i.e., compament I system (uterus, endometrium and outflow tract) is normal if properly stimulated by estrogen which rules out mullerian agenesis and ashermann syndrome.Positive estrogen progesterone combined test means the defect is in the production of estrogen i.e., either ovaries, pituitary or hypothalamus. | 156,138 | medmcqa_train |
Multiple bih are commonest among . | Negroes | 156,139 | medmcqa_train |
Given immediately in hemorrhagic shock: | Ans. (c) CrystalloidsRef: Bailey & Love 26th ed. /16-17* Crystalloid is the first fluid of choice for resuscitation. Immediately administer 2 L of isotonic sodium chloride solution or lactated Ringer's solution in response to shock from blood loss. Fluid administration should continue until the patient's hemodynamics become stabilized. Because crystalloids quickly leak from the vascular space, each liter of fluid expands the blood volume by 20-30%; therefore, 3 L of fluid needs to be administered to raise the intravascular volume by 1 L.* About the use of RL and NS in hemorrhagic shock, it has been shown that Resuscitation with NS modulates hypercoagulability after trauma and results in increased fluid requirements Administration of RL during resuscitation appears to have no effect on the hypercoagulable state induced by trauma. This hypercoagulable state may reduce bleeding and be protective initially, but may lead to thromboembolic complications later in the course of trauma admission. Due to this reason RL may be preferred in the trauma (hemorrhagic shock) in the initial phase over NS.* As the RL is a little hypotonic solution large volume of RL in patients with head injury may lead to cerebral oedema therefore NS may be preferred over LR in patients of hemorrhagic shock with head injury. (Also remember that head injuries may also precipitate hyponatremia. The most common metabolic abnormality after head injury is SLADH). | 156,140 | medmcqa_train |
Structures passing through the sigmoid (mandibular) notch are: | The upper border of the ramus of mandible is thin, and is surmounted by two processes, the coronoid process anteriorly and the condyloid process posteriorly, separated by a deep concavity, the mandibular notch, or sigmoid notch. It allows the passage of the masseteric nerve (a branch of the mandibular nerve (V3) division of the trigeminal nerve), masseteric artery and masseteric vein. | 156,141 | medmcqa_train |
All are first rank symptoms of schizophrenia, except: TN 06; UPSC 08; Karnataka 11; NIMHANS 11; NEET 13; PGI 14 | Ans. Perplexity | 156,142 | medmcqa_train |
Intralobar sequestration of lung takes its blood supply from - | Ans. is 'b' i.e., Descending abdominal aorta o A sequestration consists of normally developed bronchioles and alveoli supplied by systemic rather than pulmonary arteries.o This blood supply is from the Aorta either above or below the diaphragm.o Mostly fapprox 95%) this is from the descending thoracic aorta.o Other characteristic features of sequestration -They occur most commonly in the lower lobes, L > RLung sequestrations are of two typesIntralobar (~75%)Extralobar (~25%)o Draing through pulmonary veinso Are in communication with tracheobronchial tree o Prone to infection and lung abscess formationo Drain into the azygous venous systemo Do not communicate with lungo Commonly asymptomatico Associated with congenital diaphragmatic herniaTreatmentIntralobar sequestration - LobectomyExtralobar sequestration - Excision | 156,143 | medmcqa_train |
a 25 year old female presented to the hospital on 3rdday of menstruation with complaints of high fever vomiting and rash on her trunk and extremities. on investigations she had leukocytosis and negative blood culture. she is diagnosed as : | TOXIC SHOCK SYNDROME Toxic shock syndrome (TSS) is an acute, febrile illness produced by a bacterial exotoxin, with a fulminating downhill course involving dysfunction of multiple organ systems. It is not unusual for the syndrome to develop from a site of bacterial colonization rather than from an infection. A woman with TSS may develop rapid onset of hypotension associated with multiorgan system failure. Medical Management I/V fluids to stabilize blood pressure I/V antibodies to fight source of infection For GAS infection- clindamycin (600 mg -900 mg IV 8h) Or combined therapy, in which penicillin G (4 million U IV 8h) is combined with clindamycin. ref : ananthanaryana 9th ed | 156,144 | medmcqa_train |
In centrilobular (centriacinar) emphysema, there is an abnormal, permanent enlargement of the - | . Respiratory bronchioles | 156,145 | medmcqa_train |
Final common pathway of metabolism of carbohydrate, lipids and protein metabolism is? | ANSWER: (C) TCAREF: Lippincott's biochemistry 4th ed page 109, Harper's 28th ed page 306See Biochemistry 2013 Session 2 for details of TCA/kerb cycle cyde is an aerobic pathway, because O2. is required as the final electron acceptor. Most of the body's catabolic pathways converge on the TCA cyde. Reactions such as the catabolism of some amino adds generate intermediates of the cycle and are called anaplerotic reactions. The citric add cycle also participates in a number of important synthetic reactions. For example, the cycle functions in the formation of glucose from the carbon skeletons of some amino acids, and it provides building blocks for the synthesis of some amino acids and heme. | 156,146 | medmcqa_train |
Stapes footplate covers : | Ans. is 'b' i.e. Oval window Oval window is present in the medial wall of the middle ear. It is covered by foot plate of stapes.The other window round window is also present on the medial wall. It is covered by secondary tympanic membrane.Role of these 2 windows in hearingOval window -It receives sound vibration and transmits it to labyrinth.Round window -It acts as a relief window - Absence or damage of either of these windows will lead to loss of movement of cochlear fluids resulting in conductive hearing loss. | 156,147 | medmcqa_train |
Newborn 7 days old with vomiting and dehydration clinical examination was normal except for hyperpigmentation of nipple. Electrolytes Na: 120 meq. K: 9 meq. most likely diagnosis - | Congenital adrenal hyperplasia due to a defect in CYP21A2 is suggested by episodes of acute adrenal insufficiency with hyponatremia, hyperkalemia, dehydration & vomiting | 156,148 | medmcqa_train |
Volume of air taken in and given out during normal respiration is referred to as: | B i.e. T V | 156,149 | medmcqa_train |
Which of following anti-gout drugs act by inhibiting the enzyme xanthine oxidase? | DRUGS USED IN CHRONIC GOUT Group Mechanism Drugs Uric acid synthesis inhibitors Xanthine oxidase inhibitors Allopurinol, Febuxostat Uricosuric agents URAT-1 transpoer inhibitors Probenecid, Sulfinpyrazone, Benzbromarone, Lesinurad Recombinant uricase Cause oxidation of urate to allantoin Rasburicase, Pegloticase | 156,150 | medmcqa_train |
Salvizol is a root canal irrigants with composition: | SALVIZOL
Salvizol is a detergent suggested for irrigating root canals during instrumentation. It is a root canal chelating irrigant, N1-decamethylene-bis-4-aminoquinaldinium-diacetate. Kaufman et al, has showe that salvizol, with a neutral pH level has a broad spectrum of bactericidal. | 156,151 | medmcqa_train |
All the following statements about leukotriene modifers in the management of bronchial asthma are true except | Leukotriene modifers ( monteleukast,zafirulukast) may be considrrco as alternatives to low dose inhaled coicosteroids in patients with mild persistent asthma . Has no role in treating acute severe asthma Ref Harrison 19th edition pg 1673 | 156,152 | medmcqa_train |
Which of the following passes through the foramen magnum? | Foramen magnum transmits Lower end of medulla Anterior spinal aery Posterior spinal aery 4th pa of veebral aery Spinal pa of XIth nerve Other structures: Apical ligament and tip of dens, membrana tectoria, veical band of Cruciate Ligament. | 156,153 | medmcqa_train |
The most common cause of trismus is due to infection in muscle: | The most common cause of trismus is due to infection adjacent to muscles of jaw closure i.e., masseter, medial pterygoid, temporalis mostly due to involvement of pericoronal, submasseteric, and pterygo mandibular spaces. | 156,154 | medmcqa_train |
A soldier from Siachen came in emergency. How will you rule out hypothermia? | Ans. (B) Rectal temperature style="font-size: 1.04761904761905em; font-family: Times New Roman, Times, serif">(Ref: ?)Preferred is two sites temperature check--rectal and esophageal.In the given clinical scenario rectal temperature would be preferred site to measure the core body temperature.During the low or high temperature like in Siachen, the axillary and the oral temperature are highly misleading and should not be used to measure the core body temperature.Infrared tympanic thermometer measures the temperature of the eardrum which is the representative of core body temperature. However, more often the thermometer is not inserted adequately or for safety reason they are manufactured in such way that they do not reach deep into ear canal or contains cerumen which can disturb the measurement. Hence the Infrared thermometer more commonly delivers the temperature of ear canal, cerumen and hence not a reliable method of measuring he core body temperature. | 156,155 | medmcqa_train |
Which of these doesn't present with granulomatous Vasculitis? | Ans. (d) Microscopic polyangitisRef: Harrison 19th ed. / 2186* MPA is characterized by pauci-immune, necrotizing, small vessel vasculitis without clinical or pathological evidence of granulomatous inflammation* The family of vasculitic granulomatoses comprise# Wegener s granulomatosis# Necrotising sarcoidal granulomatosis# Churg-Strauss syndrome# Lymphomatoid granulomatosis# Polyarteritis nodosa# Bronchocentric granulomatosis# Giant cell arteritis# Systemic lupus erythematosus. | 156,156 | medmcqa_train |
Following can be used in the treatment of myoclonic seizures except – | Drugs used in myoclonic epilepsy
Valproate (DOC)
Lamotrigine
Topiramate
Clonazepam
Felbamate
Zonisamide | 156,157 | medmcqa_train |
Mushroom cap sign in MRI is seen in:- | Rectosigmoid endometriosis: - The endometrial deposit on rectum causes proliferation of muscularis propria and the surrounding tissues which is seen as "mushroom cap sign" in T2 weighted MRI. | 156,158 | medmcqa_train |
Left axis deviation is seen in which of the following cyanotic congenital heart disease | Left axis deviation seen in tricuspid atresia (TA), since it is the only cyanotic congenital heart disease with Left ventricle dominance | 156,159 | medmcqa_train |
A patient presents with fever. Peripheral smears shows band across the erythrocytes. Diagnosis is ? | Ans. is 'd' i.e., P malariae Band across erythrocytes (band-form trophozoites) is characteristic of P malariae. | 156,160 | medmcqa_train |
Which of the following statements about 'Late Expanding Phase of Demographic Cycle' is TRUE? | In late expanding phase of demographic cycle death rates declines faster than the bih rate and there is a steady decrease in the demographic gap. In this state population grow at a steadily decreasing rate. Most of the developing countries are now at early expanding and late expanding stages of demographic cycle. Ref: Park's Textbook of Preventive and Social Medicine By K. Park, 19th Edition, Page 379; Foundations of Community Medicine By Dhaar, 2nd Edition, Page 667 | 156,161 | medmcqa_train |
Which among the following is NOT a feature of Consolidation? | ANSWER: (D) Trachea shifted to side of consolidationREF: Oxford Handbook of Clinical Examination and Practical Skills by James Thomas, TanyaMonaghan Page 212"Trachea is in midline in consolidation because consolidation does not change the mediastinalposition"SIGNS OF CONSOLIDATION:Increased vocal fremitusDullness on percussionBronchial breath soundsTrachea in midline | 156,162 | medmcqa_train |
Commonest salivary gland tumour in children - | Most common tumor of salivary gland in children - Hemangioma.
Most common malignant tumor of salivary gland in children - Mucoepidermoid Carcinoma.
After hemangioma, pleomorphic adenoma is the most Common salivary gland neoplasm. | 156,163 | medmcqa_train |
Best way to prevent hypotension during spinal anesthesia | A i.e. Preloading with crystalloids | 156,164 | medmcqa_train |
Following pattern in DNA electrophoresis is seen in | . | 156,165 | medmcqa_train |
Nephrocalcinosis is seen in - | Ans. is 'b' i.e., Medullary sponge kidneyo Deposition of calcium stones on renal papillae is called nephrocalcinosis.o Nephrocalcinosis seen in -Renal tubular acidosis type I (A). Bater's syndrome Excess calcium intake Medullary sponge kidney Multiple myeloma Sarcoidosis Severe hypercalciuria Vitamin-D intoxication TB kidney (Love & Bailey) Hyperparathyroidism Metastatic bone disease | 156,166 | medmcqa_train |
CSF in meningococcal meningitis shows | CSF examination in Meningococcal meningitis: one poion of the CSF is centrifuged and gram-stained smears are prepared from the deposit. Meningococci will be seen inside the polymorphs but extracellularly also. Gram-negative diplococci in pus cells are seen. Reference: Textbook of Microbiology; Anathanarayan and panicker's; 10th edition; Page no: 232 | 156,167 | medmcqa_train |
All of the following are causes of hypovolemic hyponatremia lead to urine sodium > 20 except? | OPTION B - Vomiting It will induce dehydration and lead to renal conservation of salt and water . OPTION A - Renal Losses Tubular damage explains salt wasting and high urine sodium. OPTION C - Cerebral salt wasting syndrome Release of BNP will promote natriuresis and salt wasting . OPTION D - Mineralocoicoid deficiency Aldosterone deficiency will also cause salt wasting . | 156,168 | medmcqa_train |
Which vaccine among the following options is not kept in the freezer component in Cold Chain | Ans. is 'c' i.e., DPT o A vaccine which must be stored in the cold part but never allowed to freeze. # Typhoid # DPT # TT # Hepatitis B # DT # BCG # Diluents Important facts- o All vaccines are usually stored (for routine storage) in the refrigerator (ILR), i.e. at +2 to +8degC (even OPV). o But OPV is stored in the freezer at -20 to -40degC, if required for prolonged storage. o Measles, mumps and rubella (MMR) can also be stored in the freezer (i.e. freeze-dried). o Vaccines which must never be allowed to freeze are typhoid, DPT, TT, DT, BCG, hepatitis B and diluents. | 156,169 | medmcqa_train |
All of the following drugs are used as immunosuppressants EXCEPT: | 1 . Calcineurin inhibitors (Specific T-cell inhibitors) Cyclosporine (Ciclosporin), Tacrolimus 2. Antiproliferative drugs (Cytotoxic drugs) Azathioprine, Cyclophosphamide, Methotrexate, Chlorambucil, Mycophenolate mofetil (MMF) 3. Glucocoicoids Prednisolone and others 4. Antibodies Muromonab CD3, Antithymocyte globulin (ATG) Rho(D) immunoglobulin, etc Whereas cephalosporins come under Beta-Lactam antibiotics which are related to penicillins ESSENTIALS OF MEDICINE PHARMACOLOGY SIXTH EDITION -K. D TRIPATHI Page 851 IMMUNOSUPPRESSANT | 156,170 | medmcqa_train |
Optic radiations arise from | Answer- A. Lateral Geniculate bodyThe optic radiations (geniculocalcarine pathway) extend from the lateral geniculate body to the visual coex. Inferior fibres of optic radiations ,subserve upper visual fields and superior fibres subserve inferior visual fields.The visual pathway staing from retina consists of optic nerve, optic chiasma, optic tracts, lateral geniculate bodies, optic radiations, visual coex. | 156,171 | medmcqa_train |
If a new sputum smear positive patient of tuberculosis continues to be smear positive at the end of intensive phase of category I treatment under DOTS, fuher management of this patient would be to - | <p> Patients in category I &II , who have a positive sputum smear at the end of the initial intensive phase , receive an additional month of intensive phase treatment. Reference:Park&;s textbook of preventive and social medicine,K.Park,23rd edition,page no:188. <\p> | 156,172 | medmcqa_train |
Which of the following porphyrias is not inherited as an Autosomal Dominant disorder- | Ans. is 'b' i.e., Congenital erythropoietic porphyria Inheritance of Porphyrias Autosomal dominant Autosomal Recessive X-linked o Acute intermittent porphyria (AIP) o ALA dehydratase deficiency o X-linked protoporphyria o Porphyria cutanea Tarda (PCT) o Congenital erythropoietic porphyria o Hereditary coproporphyria (HCP) o Erythropoietic protoporphyria o Variegate porphyria (VP) | 156,173 | medmcqa_train |
Following statements about Fibrolamellar carcinoma of Liver are TRUE, EXCEPT: | In fibrolamellar carcinoma, AFP is within the normal range in most cases. Mild elevations of AFP may be seen in 10-15% of cases, but are usually below 200ng /ml. Fibrolamellar HCC is a disease of younger adults often teenagers and predominantly females. Patients typically have elevated neurotensin levels, normal LFTs and has no cirrhosis. It occurs multifocally in the liver and is non resectable. It shows metastasis to lungs and locoregional lymph nodes. Surgical resection is the best management option, even for metastases, as these tumors respond much less well to chemotherapy than adult-type HCC. Ref: Gastrointestinal and Liver Tumors edited by Wolfgang Scheppach, page 264. Molecular Pathology of Liver Diseases edited by Satdarshan P. S. Monga page 849. Harrison's principles of internal medicine 18 e chapter 92. | 156,174 | medmcqa_train |
Man is intermediate host of: | Malaria REF: Jawett's 24th edition Section VI. Parasitology > Chapter 46. Medical Parasitology Repeat in December 2011, June 2009 Man is the defenitive host in most parasitic infections except in: Echino co ccus granulosus Plasmodium Taenia Solium(man is both defenitive and intermediate host) Toxoplasma gondii Sarcocytis lindemanii | 156,175 | medmcqa_train |
The most potent topical coicosteroids is - | Super potent topical coicosteroids Clobetasol propionate 0.05% halobetasolpropionate 0.05% betametnasone dipropionate 0.05% Fitzpatricks textbook of dermatology, principles of topical therapy page 3363 | 156,176 | medmcqa_train |
In a man lifting up suitcase, posterior dislocation of glenohumeral joint is prevented by: | Ans. (c) CoracobrachialisRef: Maheshwari 5th ed. / 88* Glenohumeral joint is the most important joint of shoulder complex.* It is a synovial ball and socket articulation between the head of the humerus and glenoid cavity of scapula.* Movements at this joint includes flexion, extension, abduction, adduction, medial rotation, lateral rotation and circumduction.* Posterior dislocation of glenohumeral (shoulder) joint would be prevented by the muscle which originate posteriorly and inserted anteriorly.# For Example: Corachobrachialis muscle originate from Coracoid process of scapula and inserted at Medial aspect of shaft of humerus.* The net vector of pull of this muscle would be anteriorly, opposing the posterior dislocation of shoulder joint.Origin & Insertions of Muscles Around Shoulder Joint:MuscleOriginInsertionDeltoidAnt. Fibres- Lateral l/3rd of anterior border of clavicleMiddle Fibres- Lateral border of acromionPosterior Fibres- Lower lip of crest of spineDeltoid Tuberosity of humerusCoracobra- chialisCoracoid process of scapulaMedial aspect of shaft of humerusLatissimus dorsiPosterior l/3rd of iliac crest, lumbar fascia, spine of lower 6 thoracic vertebrae, lower 4 ribs inferior angle of scapulaFloor of bicipital grooveBicepsLong head: supra glenoid tubercle of scapulaShort head: coracoids process of scapulaTuberosity of radiusThe classical clinical feature of posterior dislocation of shoulder is- arm is held in medial rotation and is locked in that position, and an examiner can not externally rotate it. | 156,177 | medmcqa_train |
Most common presentation of Renal Tuberculosis is: | Answer is B (Sterile Pyuria): The most common clinical presentation of Urological Tuberculosis is Sterile Pyuria. 'The most common clinical presentation of urological tuberculosis is sterile pyuria and painless hematuria - Textbook of Pulmonary and Critical Care Medicine `Renal Tuberculosis is probably underdiagnosed because it is frequently asymptomatic Many cases are diagnosed as a result of routine detection of sterile pyuria. The development of symptoms reflects a more advanced stage of disease' - Oxford Textbook of Medicine Classical Renal Tuberculosis Early Clinical Features: Symptoms of cystitis; Microscopic or macroscopic hematuria; Pyuria with negative bacterial culture (`sterile pyuria'); Constitutional symptoms. Late Clinical Features: Nephrolithiasis and ureteral colic; Intractable frequency and urgency; Refractory hypeension; Renal insufficiency due to obstructive nephropathy. | 156,178 | medmcqa_train |
All the following drugs are used in various regimens of medical termination of pregnancy except | Various Regimens for Medical Termination of PregnancyFirst TrimesterMifepristone/MisoprostolMifepristone, 200-600 mg orally; followed in 24-48 hr by:Misoprostol, 200-600 mg orally or 400-800 mg vaginally, buccally, or sublinguallyMisoprostol Alone800 mg vaginally or sublingually every 3 hr for 3 dosesMethotrexate/MisoprostolMethotrexate, 50 mg/m2 BSA intramuscularly or orally; followed in 3-7 days by:Misoprostol, 800 mg vaginally. Repeat if needed 1 week aer methotrexate initially givenSecond TrimesterMifepristone/MisoprostolMifepristone, 200 mg orally; followed in 24-48 hr by:Misoprostol, 400 mg vaginally or buccally every 3 hr up to 5 dosesMisoprostol AloneMisoprostol, 600-800 mg vaginally; followed by 400 mg vaginally or buccally every 3 hr up to 5 dosesDinoprostone20 mg vaginal suppository every 4 hrConcentrated Oxytocin50 units oxytocin in 500 mL of normal saline infused during 3 hr; then 1-hr diuresis (no oxytocin); then escalate sequentially in a similar fashion through 150, 200,250, and finally 300 units of oxytocin each in 500 mL normal salineReference: William's Obstetrics; 25th edition; Chapter 18; Aboion | 156,179 | medmcqa_train |
A complete denture patient presents with angular cheilitis. A review of recent medical examination revealed that vitamin deficiency is not a factor. A possible predisposing factor is: | A closed or insufficient vertical dimension of occlusion is thought to be the one predisposing condition for angular cheilitis, which usually is associated with Candida albicans.
Improperly balanced occlusion or poor contour of the denture base are not predisposing conditions for angular cheilitis. | 156,180 | medmcqa_train |
If an adolescent boy falls on a out-stretched hand, the most common bone to be injured is | C i.e. Scaphoid | 156,181 | medmcqa_train |
Following is true of pyonephrosis except: | Ans. (b) Always unilateralRef: Smith 17th Edition, Pages 204-206# In pyonephrosis kidney is a bag of pus.# Most common cause is stones followed by Infected hydronephrosis and acute pyelonephritis# Mostly unilateral but can be bilateral also# Percutaneous nephrostomy is the initial treatment# Subcapsular nephrectomy is needed sometimes. | 156,182 | medmcqa_train |
A 5-year-old child comes to hospital with history of loose stools but no history of fever or blood in stools. Mother says he is irritable and drinks water if given. On examination eyes are sunken and on Skin pinch test--the skin retracted within two seconds but not immediately. What will be the appropriate management? | This child has acute diarrhea with some dehydration. So, the treatment of choice is ORS with zinc for 14 days. For treatment of some dehydration, 75 ml/kg ORS has to be given over 4 hours. | 156,183 | medmcqa_train |
Mucous retention cysts are most commonly found on: | Mucous retention cysts are more commonly found on the lower lip, the floor of the mouth and buccal mucosa. The pooled up saliva causes dilation of the duct and development of an aneurysm-like lesion lined by epithelium.
The retention phenomenon involving accessory salivary gland structures occurs most frequently on the lower lip, but may also occur on the palate, cheek, tongue (involving the glands of Blandin-Nuhn), and floor of the mouth.
Ref: Shafer's textbook of oral pathology 7th edition page 543 | 156,184 | medmcqa_train |
Which one is not true regarding pseudocyst of pancreas | Percutaneous aspiration is preferred only in cases of infected cyst and abscesses, other wise internal drainage is the t/t of choice. Epigastric mass is the main symptom of the pseudocyst. Increased level of amylase is usually elevated with pancreatic pseudocysts Ref - Srb's manual of surgery 5e p690 | 156,185 | medmcqa_train |
patient with atrial fibrillation which is false | ATRIAL FIBRILLATION CLINICAL FEATURES Palpitations, which are sensations of a racing, uncomfoable, irregular heabeat or a flip-flopping in your chest. Weakness. Reduced ability to exercise. Fatigue. Lightheadedness. Dizziness. Shoness of breath. Chest pain. ECG Features of Atrial Fibrillation Irregularly irregular rhythm. No P waves. Absence of an isoelectric baseline. Variable ventricular rate. QRS complexes usually < 120 ms unless pre-existing bundle branch block, accessory pathway, or rate related aberrant conduction ref : harrisons 21st ed | 156,186 | medmcqa_train |
Microvesicular steatohepatosis seen in | Option a, c, d have macrovesicular steatosis. | 156,187 | medmcqa_train |
Disulfiram like reaction is seen with - | Ans is 'c' i.e. Metronidazole o Disulfiram is used in the treatment of chronic alcoholism by producing an acute sensitivity to ethanol (alcohol). Disulfiram works by inhibiting the enzyme acetaldehyde dehydrogenaseo "Disulfiram plus alcohol, even small amounts, produce flushing, throbbing in head and neck, throbbing headache, respiratory difficulty, nausea, copious vomiting, sweating, thirst, chest pain, palpitation, dyspnea, hyperventilation, tachycardia, hypotension, syncope, marked uneasiness, weakness, vertigo, blurred vision, and confusiono In severe reactions there may be respiratory depression, cardiovascular collapse, arrhythmias, myocardial infarction, acute congestive heart failure, unconsciousness, convulsions, and death"o Drugs associated with Disulfiram like reactions are1) Antibiotics (nitroimidazoles), e.g. metronidazole2) First-generation sulfonylureas, e.g. tolbutamide and chlorpropamide3) Several cephalosporin drugs, including cefoperazone, cefamandole and cefotetan.4) Griseofulvin5) Procarbazine6) Temposil, or citrated calcium carbimide. | 156,188 | medmcqa_train |
Which is a causative organism for malignant ot externa | Ans. (b) BacteriaRef: Dhingra's ENT 5th ed. 157-58* Malignant otitis externa is caused by pseudomonas infection in elderly, diabetics & patients on the immune- compromised drugs .* Early manifestation resembles diffuse otitis externa. Patients have severe pain & appearance of granulation in meatus.Infectious Etiology of Ear CanalBacterialFungalViral* Localized otitis externa* Diffuse otitis externa* Malignant otitis externa* Otomycosis* Herpes zoster oticus* Otitis externa hemorrhagica | 156,189 | medmcqa_train |
The following is usually the first sign of pubey in girls ? | Adolescence: Stage of transmission from childhood to adulthood. During this stage, there will be an appearance of sexual characters with changes in cognition and psychology. Adolescence refers to this entire process, pubey refers to the physical aspect. Age 10-19 year is considered as a period of adolescence and pubey marks the early half of adolescence. Pubey in girls stas with breast development( thelarche) anytime between 8-13 years. This is followed by an appearance of pubic hair ( pubarche) and subsequently menstruation ( menarche), occurring at an average of 12.6 years. Menarche occurs after 2-21/2 years of thelarche. In boys, the earliest change is an increase in testicular size( testicular volume reaching 4 ml) and this occurs between 9-14 years. This is followed by an appearance of pubic hair and lengthening of the penis. Spermarche( sperm production) stas during mid-adolescence. Laryngeal growth, manifesting as cracking of voice, begins in boys in mid-pubey, deepening of voice is complete by end of pubey. During pubey, boys gain 20-30 cm and girls 16-28 cm of height. Peak growth velocity in girls occurs before attainment of menarche. Boys have their peak growth in later stages of pubey. Reference: GHAI Essential pediatrics, 8th edition | 156,190 | medmcqa_train |
One gray equals | SI unit of radiation absorbed dose is GRAY (1 Gy= 1J/Kg)Absorbed dose is the energy absorbed as ionization or excitation per unit mass of the material irradiated.The concept of absorbed dose applies to all kinds of ionizing radiation (direct and indirect) and to any material.Before 1980 the international dose of absorbed dose is RAD1 Gy=100 rad (1rad=1cGy=10 mGy)(Ref: Farr&;s Physics for Medical Imaging, 2nd Edition, Page No 17) | 156,191 | medmcqa_train |
60 yrs old male with poor stream of urine, post void residual urine is 400ml, b/l hydronephrosis and prostate weighing 70 g. His urea is 120 and creatinine 3.5. Ideal "next immediate" step | Foley catheter is a flexible tube that a clinician passes through the urethra and into the bladder to drain urine. It is the most common type of indwelling urinary catheter. Foley catheters are used during the following situations: On patients who are anesthesized or sedated for surgery or other medical care On comatose patients On some incontinent patients On patients whose prostate is enlarged to the point that urine flow from the bladder is cut off On patients with acute urinary retention On patients who are unable due to paralysis or physical injury to use either standard toilet facilities or urinals Following urethral surgeries Following ureterectomy On patients with kidney disease whose urine output must be constantly and accurately measured Before and after cesarean section Before and after hysterectomy On patients who have had genital injury On anorexic patients who are unable to use standard toilets due to physical weakness and whose urine output must be constantly measured On patients with fibromyalgia who cannot control their bladder On patients who have severe skin impairment and/or breakdown Ref: https://en.m.wikipedia.org/wiki/Foley_catheter | 156,192 | medmcqa_train |
Dystrophic calcification is commonly seen in | (C) Atheromatous plaque # DYSTROPHIC CALCIFICATION:> Calcium and phosphorus metabolism and serum levels are normal and calcification occurs as a result of local abnormality in tissue.> Circumstances is which dystrophic calcification occurs: Necrotic tissue: Fat necrosis; Caseation necrosis in the centre of granuloma; Dead parasites (cysticercosis, hydatid cyst etc.) Abnormal blood vessels & heart: Atheromatous plaque; Organized thrombi in veins; Abnormal cardiac valve> Aging or damaged tissue: Pineal gland; Laryngeal cartilage; Monekeberg's medial sclerosis> Neoplasm: Brain tumor (meningioma,craniopharyngioma, oligodendroglioma); Papillary carcinoma thyroid; Serous tumors of ovary; Breast carcinoma; Chondrosarcoma> Tumor Calcinosis: Formation of nodular non neoplastic calcific masses in subcutaneous tissue | 156,193 | medmcqa_train |
All are true about autism EXCEPT: | ANSWER: (B) Child is able to interactREF: Kaplan & Sadocks Synopsis of Psychiatry 10tEl Edition p. 1194, Current Diagnosis & Treatment in Psychiatry Chapter 37Major Diagnostic Features of Dsm-iv Pervasive Developmental DisordersFeatureAutisticDisorderAsperger'sDisorderChildhoodDisintegrativeDisorderRett'sDisorderPervasive Developmental Disorder NOSSocial impairment+++++Language or communication disorder+ +++Repetitive interests and activities+++++Onset prior to 36 months+ + Average intelligence + Period of normal development +-t- Loss of skills in several areas + | 156,194 | medmcqa_train |
Which of the following are radioactive? | Ans. CO 60 | 156,195 | medmcqa_train |
In a patient of rheumatic carditis full dose of steroid is given for - | Ans. is 'd' i.e., 12 weeks | 156,196 | medmcqa_train |
The apex of the upright human lung compared with the base has: | The apex of the upright human lung has a high ventilation perfusion Ratio.Therefore, the apex has a higher alveolar PO2 than the base. The other choices are incorrect because the ventilation of the apex is lower than that of the base, the pH in endcapillary blood is higher because of the reduced PCO2 at the apex, the blood flow is lower as already stated, and the alveoli are larger because of the regional differences of intrapleural pressure. | 156,197 | medmcqa_train |
Rose spot is associated with | a. Typhoid fever(Ref: Nelson's 20/e p 1390)Skin rash in Enteric fever:In 25% of cases, a macular or maculopapular rash (rose spots) may be visible around the 7th-10th day of the illnessLesions may appear in crops of 10-15 on the lower chest and abdomen and last 2-3 daysThese lesions may be difficult to see in dark-skinned children. | 156,198 | medmcqa_train |
Therapeutic drug monitoring is used in ? | Ans. is 'd' i.e., Digoxin Therapeutic drug monitoring is paicularly useful in following situations ? 1. Drugs with low safety margin ? Digoxin Aminoglycoside antibiotics Anticonvulsants Lithium Antiarrythmics Tricyclic antidepressants Theophylline 2. If individual variations are large - Antidepressants, Lithium 3. Potentially toxic drugs used in presence of renal failure - Aminoglycoside antibiotic, vancomycin, cyclosporine 4. In case of poisoning 5. In case of failure of response without any apparent reason - Antimicrobials 6. To check patient compliance -. Psycho-pharmacological agents. Drugs whose response is easily measurable eg. hypoglycaemics (metformin), antihypeensive, diuretics, oral anticoagulants and general anaesthetics, monitoring of plasma conc. is of no value. | 156,199 | medmcqa_train |
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