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Cerebro spinal fluid | (A) Is actively secreted by choroidal plexus > CSF fills the ventricles and subarachnoid space.> In humans, the volume of CSF is about 150 mL and the rate of CSF production is 550 mL/d.> Thus the CSF turns over about 3.7 times a day.> 50-70% of the CSF is formed in the choroid plexuses and the remainder is formed around blood vessels and along ventricular walls.> The CSF in the ventricles flows through the foramens of Magendie and Luschka to the subarachnoid space and is absorbed through the arachnoid villi into veins, primarily the cerebral venous sinuses.> Villi act as valves which permit bulk flow (direct flow) of CSF into venous blood and these villi is about 500 mL/d, with additional small amounts of CSF being absorbed by diffusion into cerebral blood vessels.> The composition of CSF is essentially the same as that of brain ECF, which in living humans makes up 15% of the brain volume and contains 50-80 mg/dL of glucose.# Functions of CSF:> Buoyancy: The brain weighs about 1400 g in air, but in its "water bath" of CSF it has a net weight of only 50 g.> The buoyancy of the brain in the CSF permits its relatively flimsy attachments to suspend it very effectively.> Protection: When the head receives a blow, the arachnoid slides on the dura & the brain moves, but its motion is gently checked by the CSF cushion and by the arachnoid trabeculae.> CSF pressure ranges from 180-10 mmg Hg); .4.4-7.3 mm Hg in newborns and < 200 mm Hg in children and adults.> Chemical stability drains metabolic wastes and maintains hemostasis.> Prevention of ischaemia is by reducing CSF pressure by decreasing its amount.> CSF pH is 7.30-7.36 | 156,400 | medmcqa_train |
What is a feature of narcolepsy | NarcolepsyThis is a disorder characterised by excessive daytime sleepiness, often disturbed night-time sleep and disturbances in the REM-sleep. The hallmark of this disorder is decreased REM latency, i.e. decreased latent period before the first REM period occurs. Normal REM latency is 90-100 minutes. In narcolepsy, REM-sleep usually occurs within 10 minutes of the onset of sleep. The common age of onset is 15-25 years, with usually a stable course throughout life. The prevalence rate of narcolepsy is about 4 per 10,000.The classic tetrad of symptoms is:i. Sleep attacks (most common):iii. Hypnagogic hallucinations:iv. Sleep paralysis (least common): Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no. 138 | 156,401 | medmcqa_train |
A young man repos chest pain retrosternal over last few hours. Pain is not related to . and relieved significantly on sitting and forward. Likely possibility is - | Acute pericarditis is a type of pericarditis (inflammation of the sac surrounding the hea, the pericardium) usually lasting less than 6 weeks. It is the most common condition affecting the pericardium. Ref Davidson 23rd edition pg 525 | 156,402 | medmcqa_train |
Which of the following statements about Mollaret meningitis is true? | Answer is A (Caused by Herpes simplex 2 in most of the cases): Mollaret's Meningitis is a form of Self-limiting Benign Recurrent Aseptic Lymphocvtic Meningitis that is most commonly caused by HSV-2 infection of the CNS. Several etiologies have been proposed for Mollaret's Meningitis however recent studies suggest that most cases of Mollaret's Meningitis result from Herpes Simplex Virus -2 (HSV-2) infection Mollaret's Meningitis It is the name given to a Self-Limited Recurrent form of Aseptic Meningitis It is also referred to as Benign Recurrent Lymphocytic Meningitis Recurrent episodes (typically> 3 episodes) of meningismus and fever lasting for 2-5 days with spontaneous resolution is highly suggestive of a diagnosis of Mollaret's Meningitis CSF Examination is characterized by a cloudy spinal fluid with lymphocytic pleocytosis and normal glucose and protein. Presence of large granular cells on Papanicolaou's stain of the CSF called `Mollaret's Cells' is considered pathognomonic (Mollaret's cells were once thought to be endothelial cells but are now believed to be from the monocyte/ macrophage family) Several etiologies. have been proposed for Mollaret's Meningitis however recent studies suggest that most cases of Mollaret Meningitis result from Herpes Simplex Virus -2 (HSV-2) infection Presence of HSV DNA on PCR is highly suggestive of Mollaret's Meningitis (In most cases HSV-2 DNA is detected It is not associated with genital herpetic lesions | 156,403 | medmcqa_train |
Volume of air taken in and given out during normal respiration is referred to as | Ans. (b) TV(Ref: Ganong, 25th ed/p.628)Tidal volume is the volume of air inspired or expired with each breath during normal quiet breathing. It is 500- 750 ml | 156,404 | medmcqa_train |
60 year old diabetic female presented with burning sensation to spicy food. Intraoral examination revealed multiple periodontal abscess and keratotic area in a lace pattern with occasional erosive areas inside the lace pattern.
Histological feature will be | The histological features include hyperparakeratosis or hyperorthokeratosis,with thickening of granular layer, acanthosis with intracellular edema, saw tooth appearance of rete ridges, band like subepithelial mononuclear infiltrate, degenerating basal keratinocytes that form colloid known as Civatte, hyaline, cytoid bodies. | 156,405 | medmcqa_train |
Formication and delusion of persecution occurs together in abuse with: | In cocaine psychosis formication occur along with delusion of persecution and is known as cocaine bug. Formication refers to the sensation of small animals crawling over the body. Cocaine is a natural stimulant derived from the leaves of coca plant. In the brain it increase the level of neurotransmitters like norepinephrine and dopamine. Regular use of cocaine can damage the brain circuit and produces a feeling of pleasure. Regular use of cocaine can result in arrythmias, stroke caused by spasm of blood vessels and respiratory arrest. Ref: Psychology: Concepts and Applications By Jeffrey S. Nevid page 165. Fish's clinical psychopathology : signs and symptoms in psychiatry 3rd edn, By Frank James Fish,page 25 | 156,406 | medmcqa_train |
Macula densa is a pa of | The thick end of the ascending limb of the loop of Henle reaches the glomerulus of the nephron from which the tubule arose and nestles between its afferent and efferent aerioles. Specialized cells at the end form the macula densa, which is close to the afferent and paicularly the afferent aeriole. The macula, the neighboring lacis cells, and the renin-secreting juxtaglomerular cells in the afferent aeriole form the juxtaglomerular apparatus.Ref: Ganong&;s review of medical physiology,23rd edition, page: 641 | 156,407 | medmcqa_train |
Ectocervix is predominantly lined by which of the following type of epithelium? | The poion of the cervix exterior to the external os is called ectocervix. It is lined predominantly by nonkeratinized stratified squamous epithelium. The endocervical canal is covered by a single layer of mucin-secreting columnar epithelium. During pregnancy mucus produced by the endocervical epithelium becomes thick and forms a mucus plug within the endocervical canal. During pregnancy, the endocervical epithelium moves out and onto the ectocervix during enlargement of the cervix. Ref: Cunningham F.G., Leveno K.J., Bloom S.L., Hauth J.C., Rouse D.J., Spong C.Y. (2010). Chapter 2. Maternal Anatomy. | 156,408 | medmcqa_train |
Protein requirement of 4 kg new born (daily) ? | Ans. is 'None' o Daily protein requirement upto 6 months of age is 1.16 g/kg/day. o 4 kg infant requires 4 x 1.16 =4.64 gm proteins/day. | 156,409 | medmcqa_train |
A 63-year-old man with a long history of alcohol abuse presents with ascites. He is experiencing mild abdominal discomfort and nausea. Examination reveals tense ascites and generalized tenderness but no rigidity. A diagnostic paracentesis of the fluid is performed. Which of the following ascitic fluid results is most likely to suggest an uncomplicated ascites due to portal hypertension from cirrhosis? | Ascitic fluid in uncomplicated cirrhosis of the liver shows a specific gravity < 1.016. Protein is < 25 g/L, and the gross appearance is straw-colored. In spontaneous bacterial peritonitis, the fluid may be cloudy and the number of white cells (neutrophils) increased. In uncomplicated ascites, the difference between plasma albumin and ascitic fluid albumin is > 1.1 g/dL. | 156,410 | medmcqa_train |
Deep venous system of brain consist of | It is single median vein formed by union of 2 internal cerebral vein. along with inferior petrosal sinus terminate in straight sinus. Its tributaries are basal vein, veins from pineal body, colliculus, cerebellum& occipital lobes. Ref: Gray's 40e/p256 | 156,411 | medmcqa_train |
The term &;Id&; was coined by- | Ans. is 'a' i.e., Freud o Structural theory of mind (the id, ego and superego) was given by sigmund freud.Structural theory of mindo Freud coined the term "The Ego and The Id", and divided the mental apparatus (Personality) into three dynamic structures : -The Id :- The id is the only component of personality that is present from birth. This aspect of personality is entirely unconscious and includes the instinctive and primitive reflexive behavior. The Id is the source of all psychic energy, making it the primary component of personality. The id is driven by the pleasure principle, which strives for immediate gratification of all desires, wants, and needs. If these needs are not satisfied immediately, the result is a state anxiety or tension. For example, an increase in hunger or thirst should produce an immediate attempt to eat or drink. The id is very important early in life, because it ensures that an infant's needs are met. If the infant is hungry, he or she will cry until the demands of id are met.The Ego :- The ego is the component of personality that is responsible for dealing with reality. The ego develops from the id and ensures that the impulses of the id can be expressed in manner acceptable in the real world. The ego functions in conscious, preconscious and unconscious mind. The ego operates based on the reality principle, which strives to satisfy1 the Id's desires in realistic and socially appropriate ways. The superego :- The last component of personality to develop is the superego. The superego is the aspect of personality that holds all of our internalized moral standards and ideals that we acquire from both parents and societyOur sense of right and wrong. The superego based on idealism principle and acts to perfect and civilize our behavior. It works to supress all unacceptable urge of id, i.e.. It tries to prove or disprove the urge of Id, and struggles to make the ego act upon idealistic standards rather than upon realistic principles. The activities of superego occur largely unconscious. There are two components of superego : -The ego ideal: - Includes rules and standard for good behaviors. These behaviors include those which approved of by parental and other authority figures. Obeying these rules leads to feeling pride, value and accomplishment.The conscience : - Include information about things that are viewed as bad by parents and society. These behaviours are often forbidden and lead to bad consequences, punishments or feeling of guilt or remorse. | 156,412 | medmcqa_train |
A patient presents with low grade fever, his ECG is as shown below. What is the most probable diagnosis? | The electrocardiogram (ECG) is very useful in the diagnosis of acute pericarditis. Characteristic manifestations of acute pericarditis on ECG most commonly include diffuse ST-segment elevation. However, other conditions may have ECG features similar to those of acute pericarditis. Pericarditis is inflammation of the pericardium (the fibrous sac surrounding the hea).Symptoms typically include sudden onset of sharp chest pain.The pain may also be felt in the shoulders, neck, or back. It is typically better sitting up and worse when lying down or breathing deeply.Other symptoms may include fever, weakness, palpitations, and shoness of breath. Occasionally onset of symptoms is gradual. Substernal or left precordial pleuritic chest pain with radiation to the trapezius ridge (the bottom poion of scapula on the back) is the characteristic pain of pericarditis. The pain is usually relieved by sitting up or bending forward, and worsened by lying down (both recumbent and supine positions) or by inspiration (taking a breath in). The pain may resemble that of angina but differs in that pericarditis pain changes with body position, where hea attack pain is generally constant and pressure-like. Other symptoms of pericarditis may include dry cough, fever, fatigue, and anxiety. Due to its similarity to the pain of myocardial infarction (hea attack), pericarditis can be misdiagnosed as a hea attack. Acute myocardial infarction can also cause pericarditis, but the presenting symptoms often differ enough to warrant diagnosis. Ref Harrison20th edition pg 2776 | 156,413 | medmcqa_train |
Autonomic disturbances are seen in? | Diabetes REF: Harrison's Internal Medicine 17'h edition chapter 370 I. Autonomic disorders with brain involvement A. Associated with multisystem degeneration 1. Multisystem degeneration: autonomic failure clinically prominent Multiple system atrophy (MSA) Parkinson's disease with autonomic failure Diffuse Lewy body disease (some cases) 2. Multisystem degeneration: autonomic failure clinically not usually prominent Parkinson's disease Other extrapyramidal disorders (inherited spinocerebellar atrophies, progressive supranuclear palsy, coicobasal degeneration, Machado-Joseph disease) B. Unassociated with multisystem degeneration 1. Disorders mainly due to cerebral coex involvement Frontal coex lesions causing urinary/bowel incontinence Paial complex seizures 2. Disorders of the limbic and paralimbic circuits Shapiro's syndrome (agenesis of corpus callosum, hyperhidrosis, hypothermia) Autonomic seizures 3. Disorders of the hypothalamus Wernicke-Korsakoff syndrome Diencephalic syndrome Neuroleptic malignant syndrome Serotonin syndrome Fatal familial insomnia Antidiuretic hormone (ADH) syndromes (diabetes insipidus, inappropriate ADH) Disturbances of temperature regulation (hypehermia, hypothermia) Disturbances of sexual function Disturbances of appetite Disturbances of BP/HR and gastric function Horner's syndrome 4. Disorders of the brainstem and cerebellum Posterior fossa tumors Syringobulbia and Arnold-Chiari malformation Disorders of BP control (hypeension, hypotension) Cardiac arrhythmias Central sleep apnea Baroreflex failure Horner's syndrome H. Autonomic disorders with spinal cord involvement Traumatic quadriplegia Syringomyelia Subacute combined degeneration Multiple sclerosis Amyotrophic lateral sclerosis Tetanus Stiff-man syndrome Spinal cord tumors III. Autonomic neuropathies A. Acute/subacute autonomic neuropathies 1. Subacute autoimmune autonomic neuropathy (panautonomic neuropathy, pandysautonomia) Subacute paraneoplastic autonomic neuropathy Guillain-Barre syndrome Botulism Porphyria Drug induced autonomic neuropathies Toxic autonomic neuropathies B. Chronic peripheral autonomic neuropathies 1. Distal small fiber neuropathy 2. Combined sympathetic and parasympathetic failure Amyloid Diabetic autonomic neuropathy Autoimmune autonomic neuropathy (paraneoplastic and idiopathic) Sensory neuronopathy with autonomic failure Familial dysautonomia (Riley-Day syndrome) | 156,414 | medmcqa_train |
MC site of gastrinoma:- | Agastrinomais a gastrin-producing tumor usually located in the pancreas or the duodenal wall. Gastric acid hypersecretion and aggressive, refractory peptic ulceration result (Zollinger-Ellison syndrome).Diagnosisis by measuring serum gastrin levels. Treatment is proton pump inhibitors and surgical removal. | 156,415 | medmcqa_train |
In a young patient who had extensive soft tissue and muscle injury, which of these muscle relaxants used for endotracheal intubation might lead to cardiac arrest – | Sch can cause dangerous hyperkalemia in patients with extensive soft tissue & muscle injury (crush injury) which may cause cardiac arrest. | 156,416 | medmcqa_train |
Which of the following is not an RNA virus ? | Ans. is 'b' i.e., Simian 40 | 156,417 | medmcqa_train |
Fractional excretion of sodium < 1 is seen in - | The fractional excretion of filtered sodium (FENa) has been demonstrated to be a reliably discriminating test between prerenal azotemia and acute tubular necrosis. One paicular urinary index cannot be expected to reliably discriminate between prerenal azotemia and acute renal failure in all cases Prerenal azotemia Oliguria (urine volume < 500 mL/day) or anuria (< 100 mL/day), high urine specific gravity (>1.015), normal urinary sediment, and low urinary sodium (< 20 mEq/L; fractional excretion of sodium < 1%) are seen Ref Harrison20th edition pg 267 | 156,418 | medmcqa_train |
A neonate delivered at 38 weeks of gestation with a bih weight of 2.2 kg develops intolerance to feed/ abdominal distension on second day. Physical examination is unremarkable. Sepsis screen is negative. PCV is observed to be 72%. Which of the following represents the best management option ? | Ans is 'b' i.e., Paial Exchange Transfusion o PCV 72% in a neonate suggests the diagnosis of neonatal polycythemia. o Polycythemia is defined as central venous hematocrit Ialso called packed cell volume (PCV) or erythrocyte volume fraction (EVF)J level ofgreater than 65%. o The neonate in question is also having intolerance to feed and abdominal distension. So, this neonate is having symptomatic neonatal polycythemia. Treatment of neonatal polycythemia Therapy in newborns with polycythemia is based on both the measured central venous hematocrit level and the presence or absence of symptoms. (1) Symptomatic polycythemia o Paial exchange transfusion is the treatment of choice. (2) Asymptomatic polycythemia o In asymptomatic polycyhthemia, treatment depend upon hematocrit level (PCV). PCV 65-75% Perform cardiorespiratory monitoring and monitoring of hematocrit and glucose levels every 6-12 hours and observe the patients for symptoms If hematocrit (PCV) becomes more than 75%, consider paial exchange transfusion (PET). (ii) PCV> 75% o Paial exchange transfusion (PET) is the treatment of choice. | 156,419 | medmcqa_train |
DOC for schizophrenic patient with poor oral absorption is? | Ans. B. FluphenazineLong-acting injectable (LAI) antipsychotics (APs) (LAI APs) have proved effective in schizophrenia and other severe psychotic disorders because they assure stable blood levels, leading to a reduction of the risk of relapse.LAIs bypass the initial deactivating process by avoiding first-pass metabolism in the liver. | 156,420 | medmcqa_train |
Hepatotoxic drugs are - | Ans. is 'a' i.e., Chloroform Hepatotoxic anaesthetic agents are 1. Chloroform 3. Carbon tetrachloride 5. Methoxyflurane 2. Halothane 4. Trichloroethylene | 156,421 | medmcqa_train |
A retrobulbar anaesthetic is least likely to produce anaesthesia of which cranial nerve? | Retrobulbar anaesthesia: 4th cranial nerve lies outside the muscle cone in orbit and the least likely to get paralysed by retrobulbar anesthesia. Main goal of this procedure is to obtain anesthesia of the cornea, uvea, and conjunctiva, as well as akinesia of the extraocular muscles by blocking the ciliary nerves and II, III, VI cranial nerves, | 156,422 | medmcqa_train |
Oral rehydration therapy takes advantage of which transpoer in GIT ? | Ans. is'a'i.e., Na Glucose co transpolRef; KDT 7/ep.679)Oral rehydration is possible if glucose is added with salt.It capitalizes on the intactness of glucose coupled Na+ absorption (Na glucose co transpo), even when other mechanisms have failed or when intestinal secretion is excessive, because the secreted fluid lacks glucose and cannot be reabsorbed. | 156,423 | medmcqa_train |
Sentinal node of gall bladder is | The lymphatic vessels of gallbladder(subserosal & submucosal)drain into the cystic lymph node of Lund(Fred Bates Lund)-Mascagni's node.This lies in the fork created by the junction of cystic duct and common hepatic duct.Efferent vessels from this node go to the hilum of liver and to coeliac lymph nodes. Virchow's node is located in left supraclavicular fossa.Clouquet node is located in the femoral canal. Reference:Bailey & Love's sho practise of surgery,25 th edition,page no:1112. | 156,424 | medmcqa_train |
Test based on counting the direction of each within paired sample is- | * The 'Sign test' is non parametric / distribution free test which can be utilized to analyze paired sample * It is based on counting the direction (or Sign) of each 'within-pair difference | 156,425 | medmcqa_train |
Paralysis of 3rd, 4th, 6th nerves with involvement of ophthalmic division of 5th nerve, localizes the lesion to - | Paralysis of 3rd, 4th, 6th nerve and involvement of ophthalmic division of 5th nerve → cavernous sinus thrombosis.
Paralysis of 3rd, 4'h, 6th nerve, ophthalmic division of 5th nerve plus optic nerve signs→ orbital apex syndrome. | 156,426 | medmcqa_train |
Thoracic duct is also called as | Thoracic duct- pecquet duct.Hensen&;s duct : A sho membranous tube passing from the lower end of the saccule to the cochlear duct of the membranous labyrinth.Bernard&;s duct- Accessory pancreatic duct.Hoffman&;s duct- pancreatic duct. | 156,427 | medmcqa_train |
A middle-aged male comes to the OPD with the only complaint of hoarseness for the past 2 years. He has been a chronic smoker for 30 years. On examination, a reddish area of mucosal irregularity overlying a portion of both cords was seen. Management would include all except: | In the data given above, clinical diagnosis of cancer larynx is made but biopsy is mandatory. Indicators are: chronic smoking habits, hoarse voice persisting for 2 years, irregular vocal cord lesion involving both cords. The lesion is stage I glottic cancer as the pathology is localized to glottis. Treatment of choice in this case would be radiotherapy. | 156,428 | medmcqa_train |
25 years old 2nd gravida with B negative blood group reaches in labour room in full dilatation. All the following norms to be followed except: | Use of ergot derivatives is contraindicated in Rh negative mother to avoid chances of feto-maternal micro transfusions. As the mother is Rh -ve so to decrease the chances of Rh isoimmunization, early cord clamping is done. Cord blood is sampled for baby's blood group and Direct Coombs Test Manual removal of placenta is avoided as it would increase risk of microtransfusion to mother causing fuher sensitisation | 156,429 | medmcqa_train |
Fleischer ring is characteristic of | D i.e. Keratoconus Corneal Pigmentation Condition Deposited Material Site Of Deposition Argyrosis Sliver nitrate (AgNO3) Brown discolouration of descement's membrane Fleischer ring Iron Epithelial iron deposits at the base of Keratoconus Chalcosis (Kayser Fleischer ring) Cu Grayish-green or golden brown discolouration of stroma of peripheral cornea Wilson's disease/Hepatolenticular degeneration (Kayser Fleischer ring) Cu Grayish-green or brown ring is seen just inside the limbus due to Cu deposition between Descemet's membrane and endothelium Siderosis Fe (hemosiderin) - Green or brown discolouration of deeper layers of cornea. Blood staining can follow massive hyphaema either from contusion or surgery - Fleischer's ring representing deposition of haemosiderin is found in keratoconus Q Hudson-Stahli line Elderly Brown horizontal line in inferior third or cornea Krukenberg's spindle Myopic men Veical spindle shaped brown uveal pigment deposition Topical epinephrine Used for glucoma Result in black cornea. | 156,430 | medmcqa_train |
Socialized medicine is | *State Medicine: Provision of free medical services to the people at government expense*Socialized Medicine: Provision of medical service and professional education by the state, but the programme is operated and regulated by professional groups rather than by the government.*Social Medicine: study of social, economical, environmental, cultural, psychological and genetic factors, which have a bearing on health. | 156,431 | medmcqa_train |
Lack of alpha-oxidation of fatty acids leads to | Refsum&;s Disease It is a metabolic error due to lack of alpha-hydroxylase (phytanic acid oxidase) so that alpha-oxidation does not occur and phytanic acid accumulates in the tissues. The patient presents with severe neurological symptoms, polyneuropathy, retinitis pigmentosa, nerve deafness and cerebellar ataxia. Regressions of symptoms are observed with restricted dietary intake of phytanic acid. Milk is a good source of phytanic acid, which may be avoided.Ref: DM Vasudevan - Textbook of Biochemistry, 6th edition, page no: 135 | 156,432 | medmcqa_train |
All are T cell lymphomas, EXCEPT: | Lymphoplasmacytic lymphoma is a B cell lymphoma, all others are T cell lymphomas. Ref:Harrisons principles of internal medicine 18th edition, Page: 920. | 156,433 | medmcqa_train |
All the following statements are true regarding torsion of testis EXCEPT | Ans. (a) Anatomical abnormality is unilateral and contralateral testis should not be fixedRef: Bailey and Love 26th ed. /1379Anatomical abnormality is unilateral and contralateral testis should not be fixedThe other testis should also be fixed because the anatomical predisposition is likely to be bilateral. An infarcted testis should be removed and prosthetic device deployed.Prompt exploration and twisting & fixation is the only way to save the torted testisMost common between 10 & 25 years of ageInversion of testis is the most common predisposing causePatient presents with sudden agonising pain in the groin and the lower abdomen. The patient feels nauseated and may vomit.If the testis is viable when the cord is untwisted it should be prevented from twisting again by fixation with non- absorbable sutures between the tunica vaginalis and the tunica albuginea.Testicular torsion is most common between 10 and 25 years of age, although a few cases occur in infancy.Inversion of the testis is the most common predisposing cause.The testis is rotated so that it lies transversely or upside down. | 156,434 | medmcqa_train |
A 27 year old patient presented with left sided abdominal pain to the emergency room, 6 hours after an A. He was hemodynamically stable and FAST positive. Contrast Enhanced CT (CECT) scan showed grade III splenic laceration. What will be the most appropriate treatment? | There are criterias for conservative mangement in splenic injured patients such as hemodynamical stability, minimal transfusion requirement, no other abdomen injuries and ablity to perform series of abdominal examination. A stable defect on repeat imaging also suppos. As this patient is hemodynamically stable, with no other abdominal injuries along with grade iii laceration of spleen will fit in this criterion. Ref: Surgery : Basic Science and Clinical Evidence By Jeffrey A. Noon, Philip S. Barie, Randall Bollinger, 2nd Edition, Pages 1116, 1117 | 156,435 | medmcqa_train |
Achromatopsia is due to lesion in which area of occipital coex? | Area v4 REF: Yanoff's ophthalmology p- 1300 Patients who have acquired, central cerebral achromatopsia (inability to identify colors) may have complete loss or miss only one primary color. The isolation of single color defects links with research performed in macaque monkeys, which showed that an area of prestriate coex, identified as area V4, contains neurons that respond to specific color stimuli. Patients with cerebral achromatopsia generally describe objects as "washed out" or "faded." Patients still may be able to use contrast clues to separate the edge of one intense color from another. If two colors or a color and a shade of gray match pseudoisochromatically, however, patients demonstrate a distinct inability to isolate colored targets. Despite the achromatopsia, other pas of the parvicellular system may remain intact. Patients may have normal visual acuity and contrast sensitivity. Postmoem and radiological studies of these patients reveal bilateral lesions of the inferior occipital coex. | 156,436 | medmcqa_train |
Bansdola is a form of strangulation by – | In Bansdola one strong bamboo stick is placed across the back of the neck and another across the front. Both the ends are tied with a rope due to which the victim is squeezed to death. Sometimes a stick is placed across the front of neck & the assailant stands with a foot on each end of the stick | 156,437 | medmcqa_train |
A 25-year old patient with a history of recent respiratory tract infection complains of severe chest pain at rest. The ECG of the patient is given. The most probable diagnosis of the patient is? | The history points to a recent viral infection that could contribute to the development of pericarditis. Acute Pericarditis -Most common cause of pericarditis is idiopathic or viral. -ECG findings: Hea rate= 75 bpm Axis= normal PR interval= 0.16 sec QRS= 0.08 sec QT= 400 msec Uniform ST segment elevation - Concave upwards (RED) in all the leads ST segment depression (BLUE) in aVR seals the diagnosis of pericarditis. | 156,438 | medmcqa_train |
Which vein is preferable for coronary by pass grafting- | Ans. is 'a' i.e., Saphenous vein o Most common conduits used is greater saphenous vein. Ideal characteristics of a saphenous vein conduit are that it should be atleast having diameter of 3.5 mm and free from any varicosity or areas of structure,o If the saphenous vein is inadequate or unavailable^ short saphenous vein can be used,o Other conduits for CABG :* Internal mammary artery- (Left or right) - Preferred arterial conduits for LAD - Patency rate > 90% at 10 years* Radial artery * Gastroepiploic artery * Inferior epigastric arteries | 156,439 | medmcqa_train |
Hyperplastic arteriolitis with necrotizing arteriolitis is seen in? | Hyperplastic arteriolosclerosis is more typical of severe hypertension. Vessels exhibit "onion skin" ."concentric, laminated thickening of arteriolar walls and luminal narrowing . The lamination consists of smooth muscle cells and thickened , re duplicated basement membrane . In malignant hypertension these changes are accompnied by fibrinoid deposits and vessels wall necrosis . | 156,440 | medmcqa_train |
All of the following, statements ubout Digoxin induced arrhythmias are true, Except - | Digoxin remains one of the most frequently prescribed drugs in the management of atrial fibrillation. The main indications for digoxin in atrial fibrillation are restoration of sinus rhythm, prevention of recurrence and slowing of the ventricular rate Other common dysrhythmias associated with digoxin toxicity include: Frequent PVCs (the most common abnormality), including ventricular bigeminy and trigeminy. Regularised AF = AF with complete hea block and a junctional or ventricular escape rhythm. Ventricular tachycardia, including polymorphic and bidirectional VT Adenosine can, at times, terminate the rhythm, but not always. Ablation of atrial tachycardia is also an option, especially when medical therapy fails. Special Situations: Atrial tachycardia with 2:1 block; when atrial tachycardia occurs with a 2:1 conduction block digoxin is best and toxicity should be considered Ref Davidson 23rd edition pg 460 | 156,441 | medmcqa_train |
Which of the following is the most useful investigation for thyroid function: September 2011 | Ans. C: TSH TSH is usually regarded as the most useful investigation of thyroid function Thyroid pathology: Primary hypehyroidism: - Decreased TSH - Raised T4 Secondary hypehyroidism: Raised TSH Hypothyroidism: Raised TSH | 156,442 | medmcqa_train |
LMW heparin is preferred over unfractionated heparin because: | LMW heparin inhibit factor Xa only and have a weak effect on thrombin , aPTT, or CT are not prolonged. Heparin acts by activation of antithrombin III. LMW heparin is given subcutaneosly due to better bioavalability.LMW heparin have subcutaneous bioavalability of 70 - 90%. From medical pharmacology padmaja 4th edition Page no 337 | 156,443 | medmcqa_train |
In TCA cycle of tricarboxylic acid, which is first formed | B i.e. Citrate | 156,444 | medmcqa_train |
Salt loosing nephritis is due to | Salt-losing nephritis is one of many clinical situations involving electrolyte disturbance in renal disease. This type of nephropathy is characterized by hyponatremia and hypochloremia, lassitude, thirst, polyuria, azotemia, and circulatory collapse. Interstitial nephritis is a kidney disorder in which the spaces between the kidney tubules become swollen (inflamed). This can cause problems with the way your kidneys work. Refer robbins 9/e p930 | 156,445 | medmcqa_train |
Adrenaline, noradrenaline and dopamine act through? | Ans is 'c' i.e. Seven pass receptor o Adrenergic receptors (Adrenaline, noradrenaline) and dopamine receptors are G-protein coupled receptors which are heptahelical receptors, i.e., have seven transmembrane spanning segments (Seven pass receptors) | 156,446 | medmcqa_train |
Renauld Braud phenomenon is seen in | Candida albicans has the ability to form germ tubes within 2hours when incubated in human serum at 37C - Reynolds-Braude phenomenon. Ref: Textbook of Microbiology, Ananthanarayan and Paniker; 9th edition | 156,447 | medmcqa_train |
Pseudolymphoma occurs because of long term use of : | Side effects of phenytoin Gingival hyperplasia Lymphadenopathy Hirsutism Osteomalacia Facial coarsening Skin rash | 156,448 | medmcqa_train |
Dimension of HDI which is measured to check good standard of living ? | Ans. is 'a' i.e., Income HDI is a composite index combining indicators representing three dimensions ? Longevity (life expectancy at bih) Knowledge (Adult literacy rate and mean years of schooling, i.e. Gross enrolement ratio) Income (real GDP per capita in purchasing power parity in US dollars) Among these three, income is included in standard of living. Standard of living It refers to the usual scale of our expenditure, goods we consume and services we enjoy. It includes :? Income & occupation Standards of housing, sanitation & nutrition Level of provision of health, educational, recreational and other services. Standard of living depends on per capita GNP | 156,449 | medmcqa_train |
Nerve supply of trapezius is by | the and sternocleidomastoid are supplied by spinal accessory nerve. Both of them develop from brachial arch mesoderm. The principal action of trapezius is to rotate scapula during abduction of arm beyond 90deg. Clinically the muscle is tested by asking the patient to shrug his shoulder against resistance. REF: BD Chaurasia 7th edition Page no: 64. | 156,450 | medmcqa_train |
Which of the following structure is not a primary suppo of uterus? | Broad ligament is a secondary suppo of uterus. Structures forming primary suppo to the uterus are pelvic diaphragm, perineal body, urogenital diaphragm, uterine axis, pubocervical ligament, transverse cervical ligament, uterosacral ligament and round ligament of uterus. | 156,451 | medmcqa_train |
Which of the following drug used in treating leprosy acts as a bactericidal agent? | Dapsone, rifampicin and clofazimine are WHO recommended drugs used in the treatment of leprosy. Among these only rifampicin is bactericidal. Rifampin binds to the beta subunit of bacterial DNA-dependent RNA polymerase and thereby inhibits RNA synthesis. It is bactericidal, it penetrates most tissues and into phagocytic cells. Indications: Treatment of tuberculosis along with other antimycobacterial drugs. Used to eliminate meningococcal carriage Leprosy Prophylaxis in contacts of children with Haemophilus influenzae type b disease In combination with a second agent is used to eradicate staphylococcal carriage In serious staphylococcal infections such as osteomyelitis and prosthetic valve endocarditis Ref: Gelber R.H. (2012). Chapter 166. Leprosy. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e. | 156,452 | medmcqa_train |
Epley's maneuver is used in the treatment of | Epley`s maneuver is used in the treatment of Positional Veigo (BPPV)Dix Hallpike`s test is the diagnostic testOther exercises are: Semont`s maneuver, Brandt Darrof exercisesSurgeries: Singular neurectomy, Posterior canal occlusion, Labyrinthectomy, Vestibular nerve sectionRef: Hazarika; 3rd edition; Page no: 108 | 156,453 | medmcqa_train |
Bacitracin acts on : | Bacitracin acts by inhibiting the synthesis of the cell wall.
Other polypeptide antibiotics like polymyxin B, colistin and tyrothricin act by an affecting membrane. | 156,454 | medmcqa_train |
Spinal epidural space is the largest at the level of the | Spinal epidural space is largest at 3rd lumbar veebrae .Spinal epidural space is a closed anatomic space between the dura mater and the bony spinal canal. It extends from the foramen magnum to the sacrum. Unlike its intracranial counterpa, spinal epidural space is real. The presence of anchoring plicae and meningoveebral ligaments divide the space into anterior, lateral and posterior compaments. Ref - pubmed.com | 156,455 | medmcqa_train |
Which cell does not NOT differentiate in bone marrow? | Bone marrow provides the environment for development of precursor cells into erythrocytes, platelets, granulocytes, monocytes, and B lymphocytes. Although it is likely that T lymphocytes progenitor cells also arise in bone marrow, differentiation and programming of new T lymphocytes occurs in the thymus. Ref: Levinson W. (2012). Chapter 58. Cellular Basis of the Immune Response. In W. Levinson (Ed), Review of Medical Microbiology & Immunology, 12e. | 156,456 | medmcqa_train |
Which of the following is not true about medullary thyroid carcinoma? | Ans. is 'c' i.e., Form about 25% of the thyroid malignancies Medullary carcinoma of thyroid* Medullary carcinomas of the thyroid are neuroendocrine neoplasms derived from the parafollicular cells, or C cells, of the thyroid, and account for approximately 5% of thyroid neoplasms.* Medullary carcinomas, similar to normal C cells, secrete calcitoniny the measurement of which plays an important role in the diagnosis and postoperative follow-up of patients.* In some instances the tumor cells elaborate other polypeptide hormones, such as serotonin, ACTH, and vasoactive intestinal peptide (VIP).* About 70% of tumors arise sporadically. The remainder occurs in the setting of MEN syndrome 2A or 2B or as familial tumors without an associated MEN syndrome.* Activating point mutations in the RET proto-oncogene play an important role in the development of both familial and sporadic medullary carcinomas. | 156,457 | medmcqa_train |
Which drug has inverse agonist activity at benzodiazepine receptors? | Benzodiazepine Binding Site Ligands: The components of the GABA A receptor-chloride ion channel macromolecule that function as benzodiazepine binding sites exhibit heterogeneity. Three types of ligand-benzodiazepine receptor interactions have been repoed: Agonists: facilitate GABA actions, and this occurs at multiple BZ binding sites in the case of the benzodiazepines. Antagonists are typified: by the synthetic benzodiazepine derivative flumazenil. Inverse agonists act as negative allosteric modulators of GABA-receptor function. Their interaction with BZ sites on the GABA A receptor can produce anxiety and seizures, an action that has been demonstrated for several compounds especially the b carbolines Naltrexone: Opioid receptor antagonist. Zopiclone: In contrast to benzodiazepines, zolpidem, zaleplon, and eszopiclone bind more selectively because these drugs interact only with GABA A -receptor isoforms that contain a1 subunits. | 156,458 | medmcqa_train |
Most common lesion in diabetic nephropathy | m/c - Diffuse glomerulosclerosis
Pathognomonic - Kimmelstiel Wilson nodule | 156,459 | medmcqa_train |
A thirty one year old male with neprhrotic syndrome complains of pain in right hip joint of 2 months duration. The movements at the hip are free but painful terminally. The most likely diagnosis is - | This patient has : -
Nephrotic syndrome (must be taking steroids)
Pain in hip
Terminal restriction of movements (in AVN, initially movements are restricted terminally only).
The diagnosis is AVN of Hip.
In all other three options movements of hip are grossly restricted (not terminally). | 156,460 | medmcqa_train |
A 35-year-old woman presents with infertility and palpable pelvic mass. Her CA-125 level is 90 rnIU/mL diagnosis is: | In this question we have insufficient information to make any definite diagnosis. At the best we can try to make the most probable diagnosis.
CA-125
• This is a non-specific tumor marker
• CA-125 is a glycoprotein which is normally not produced by ovarian epithelium but may be produced by both
malignant and benign epithelial ovarian tumors.
• Cut off level of CA-125 is < 35 U/mL.
• Levels of CA 125 can be raised in | 156,461 | medmcqa_train |
True regarding surface anatomy of internal jugularvein - | Ans 'b' i.e., Line passing from ear lobule to medial end of clavicle SURFACE MARKINGS OF IMPORL4N VESSELS OF NECKSurface anatomy of internal jugular vein:o Internal jugular vein is marked by a line joining a point on the neck, medial to the ear lobule to a point at the medial end of the clavicle.Surface anatomy of the external jugular vein:o Marked by a line joining a point a little below and behind the angle of the mandible to a point on the clavicle just lateral to the posterior border of the stemocleidonastoid.Subclavian vein:o Marked by a line joining the medial end of the bone to its midpoint.Common carotid artery:o Marked by a line joining a point on the stemovlavicular joint to a point on the anterior border of the sternocleidomastoid at the level of upper border of the thyrroid cartilage.Internal carotid artery :o Marked by a line joining a point on the anterior border of the stemocleidommastoid at the level of upper border of thyroid cartilage to a point on the posterior border of the condyle of the mandible.External carotid artery:o Marked by a line joining a point on the anterior border of the stemocleidommastoid at the level of upper border of thyroid cartilage to a point on the posterior border of the neck of the mandible. | 156,462 | medmcqa_train |
Pyruvate dehydrogenase contains all except - | A i.e. BiotinPyruvate, the end product of aerobic glycolysis is transpoed into mitochondria by specific pyruvate transpoer, where it is conveed to acetyl CoA by pyruvate dehydrogenase (PDH) complexQ. | 156,463 | medmcqa_train |
Pleomorphism is most commonly seen in: | H. influenzae | 156,464 | medmcqa_train |
Drugs causing macular toxicity when given intiavitreally- | Ref:comprehensive ophthalmology AK Khurana 4th edition page no :152 Gentamycin is 4 times more retinotoxic (causes macular infarction) than amikacin. Preferably the aminoglycosides should be avoided. | 156,465 | medmcqa_train |
The recently approved antiepileptic drug lacosamide acts by: | (Ref: Katzung, 14th ed. pg. 417)* CRMP is Collapsing Response Mediator Protein, which causes neuronal excitotoxicity by releasing BDNF (Brain Derived Neurotropic Factor).* The drug Lacosamide acts by inhibiting CRMP protein, thereby causing protective action against neuronal excitotoxicity. | 156,466 | medmcqa_train |
Radioisotopes used in Myocardial perfusion imaging: Thallium 201 18 FDG PET Tc-99m Sestamibi Tc-99m Pyrophosphate Tetrafosmin N-13 Ammonium | - Thallium-201, Sestamibi, Tetrofosmin scan are used for Myocardial Perfusion Imaging. - Pyrophosphate scan for Myocardial Infarction. - 18 FDG PET is used to detect Myocardial Viability - N-13ammoniaPETmyocardial perfusion imaging(MPI) yields larger stressperfusiondefects than dipyridamole stress and might reflect the truemyocardialischemic burden. | 156,467 | medmcqa_train |
Sensitivity of chemoreceptors in COPD | The main chemoreceptors involved in respiratory feedback are: Central chemoreceptors: These are located on the ventrolateral surface of medulla oblongata and detect changes in the pH of spinal fluid. They can be desensitized over time from chronic hypoxia (oxygen deficiency) and increased carbon dioxide Ref: guyton and hall textbook of medical physiology 12 edition page number:365,366,367 | 156,468 | medmcqa_train |
Which of the following is the most impoant neurotransmitter deficient in the coex of patients with Alzheimer's Disease | Answer is A (Acetylcholine):The most impoant biochemical abnormality in Alzheimer's disease is the decrease in coical levels of AcetylcholineBiochemically Alzheimer's disease is associated with a decrease in the coical levels of several proteins and neurotransmitters especially acetylcholine, its synthetic enzyme choline-acetyl-transferase, and nicotinic cholinergic receptors. Reduction of acetylcholine is related in pa to degeneration of cholinergic neurons in the nucleus basalis of Meyne (NBM) that projects through the coex. There is also noradrenergic and serotonergic depletion due to degeneration of brainstem nuclei such as the locus ceruleus and dorsal raphe' - Harrison's | 156,469 | medmcqa_train |
The most useful incision in the operating room for patients with penetrating pericardium injury is | The subxiphoid incision is useful for determining if there is blood in the pericardium and if there is an intracardiac injury; however, exposure is extremely limited, and definitive repair can rarely be performed through the incision. Left (or right) anterior thoracotomy is easily performed, especially in the emergency room, and gives adequate exposure to ceain areas of the hea. However, each has significant limitations in exposure. Either may be extended across the thoracotomy into the other side of the chest, thus producing a bilateral anterior thoracotomy. Exposure is excellent through this incision, and most injuries can be satisfactorily repaired through this approach. Most cardiac operations today are performed through median sternotomy incisions. If the patient is in the operating room, this incision is easily performed and always provides excellent exposure for all areas of the hea. | 156,470 | medmcqa_train |
Which of the following organisms is visualized by gram staining: | Ans: b (Borrelia)Ref: Ananthanarayan and Paniker's Textbook of Microbiology, 8th ed.* Treponema - do not stain by ordinary method. Prolonged Giemsa, Fontana or Levaditis method is used* Mycoplasma - has no cell wall. So they are gram negative but are better stained by Giemsa* Mycobacterium-resist decolonisation by alcohol even without mordant effect of iodine. Can be called gram positive even though it is not used for diagnosis* Borrelia - readily stain by ordinary methods and are gram negative | 156,471 | medmcqa_train |
Deficiency of the following vitamin is most commonly seen in sho bowel syndrome ileal resection | If the distal 2/3rd of the ileum is including the ileocecal valve is resected, significant abnormalities of absorption of bike salts and Vitamin B12 may occur resulting in diarrhoea and anaemia. These abnormalities occur even though only 25% of total length of the small bowel is removed Proximal bowel resection is better tolerated than distal resection because the ileum can adapt and increase its absorptive capacity more efficiently than jejunum Ref: Sabiston 20th edition Pgno : 1171 | 156,472 | medmcqa_train |
Shawl sign is seen in - | Shawl signConfluent macular violaceous erythema on the posterior neck and shoulders in patients of dermatomyositis is called Shawl sign. IADVL textbook of dermatology page 1246 | 156,473 | medmcqa_train |
Live vaccines are | BCG consists of living bacteria derived from an attenuated bovine strain of tubercle bacilli. The bacilli used for vaccine production are descendants of the original Calmette strain of BCG (refer pgno:196 park 23rd edition) | 156,474 | medmcqa_train |
Prolonged QT interval is not seen in | Hypercalcemia: The most common ECG findings of hypercalcemia are a sho QT interval secondary to a shoened ST segment. There may also be a widened or flattened T wave; however, significant hypercalcemia can cause ECG changes that mimic an acute myocardial infarction cuases of prolonged QT Bradycardia Central Nervous System diseases (intracranial trauma, subarachnoid hemorrhage, stroke) Congenital long QT syndrome Dysautonomy (Diabetes mellitus, amyloidosis, others) Elderly Electrolyte disturbances (hypomagnesemia, hypokalemia) Hea Failure Hypoglycaemia Hypothermia Hypothyroidism Ion channel polymorphism Ischemic myocardiopathy Obesity Reduced repolarization reserve Ref : Harrison 20th edition pg 1534 | 156,475 | medmcqa_train |
Which of the following is diagnostic of GDM by 75 g GTT as per NICE 2015 criteria? | Ans. is c, i.e. Fasting blood glucose 5.6 mmol/LNICE 2015 guidelines for diagnosing Gestational diabetesGestational DiabetesDiagnose gestational diabetes if the woman has either:-A fasting plasma glucose level of 5.6 mmol/litre or above or-A 2-hour plasma glucose level of 7.8 mmol/litre or above. Also know - Metabolic goals as per NICE 2015Advise pregnant women with any form of diabetes to maintain their capillary plasma glucose below the following target levels, if these are achievable without causing problematic hypoglycaemia:Fasting: 5.3 mmol/litre and1 hour after meals: 7.8 mmol/litre or2 hours after meals: 6.4 mmol/litre. | 156,476 | medmcqa_train |
In facial nerve injury, loss of lacrimation is due to involvement of- | Ans. is 'c' i.e., Greater superficial petrosal nerve o In facial nerve injuryLoss of lacrimation Due to involvment of greater superficial petrosal nerve.Loss of stapedial reflex Due to involvement of nerve to stapedius.Lack of salivation Due to chordatympani.Loss of taste sensation from Anterior 2/3 of tongue: - due to chordatympani.Paralysis of muscle offacial expression Due to terminal (peripheral) branches.Hyperacusis (intolerance to loud noice) Due to involvement of nerve to stapedius (causing parolysis of stapedius). | 156,477 | medmcqa_train |
Polypeptide chain termination is enhanced by | Termination requires stop codon (UAA, UAG, UGA) and releasing factors .
Peptidyl transferase is also required which along with releasing factor hydrolyses peptide bond between tRNA at 'P' site and promotes the release of a newly synthesized polypeptide chain from ‘P’ site. | 156,478 | medmcqa_train |
Trauma from occlusion causes all except: | Clinical features of TFO
Mobility (progressive)
Pain on chewing or percussion
Fremitus
Occlusal prematurities/discrepancies
Wear facets in the presence of other clinical indicators
Tooth migration
Chipped or fractured tooth (teeth)
Thermal sensitivity
Key notes :
TFO hardly affects the gingival soft tissues. | 156,479 | medmcqa_train |
Which of the following is essential for tumor metastasis | Ref Harrison 17/e p 509; Robbins 9/e p305_306 Metastasis is a complex series of steps in which cancer cells leave the original tumor site and migrate to other pas of the body ,the bloodstream or the lympatic system ,to do so malignant cells break away from the primary tumor and degrade protein of the extacellular matrix .one of the critical events required for metastasis is the growth of a new network of blood vessels called tumor angiogenesis Vacularisation is promoted by VEGF and bFGF and inhibited by angiostatin ,endostatin and tumstatin it has been found that angiogenesis inhibitors would therefore prevent growth of metastasis | 156,480 | medmcqa_train |
Fatal dose of methanol : | C i.e. 60-250 ml | 156,481 | medmcqa_train |
All of the following immunohistochemical markers are positive in the neoplotic cells of granulocytic sarcoma, EXCEPT: | A variety of markers for myeloid precursors in granulocytic sarcoma are identified. CD43, lysozyme, myeloperoxidase and CD 15 are the most sensitive markers staining a large propoion of the cells of the majority of well-differentiated tumors. CD 45 RO is not mentioned as a immunohistochemical marker of granulocytic sarcoma. Ref: Manual of Diagnostic Antibodies For Immunohistology By Anthony Siew-Yin Leong, Kumarasen Cooper, F. Joel W.-M. Leong, 2002, Page 339. | 156,482 | medmcqa_train |
Response to iron in iron deficiency anemia is denoted by? | Ans. is 'b' i.e., Reticulocytosis Response to iron therapy When specific iron therapy is given, patients often show rapid subjective improvement, with disappearance or marked diminution of fatigue, lassitude, and other non-specific symptoms. This response may occur before any improvment in anemia is observed. The earliest hematological evidence of recovery is increase reticulocytes and their hemoglobin content. The reticulocytes attain a maximal value on the 5th to 10th day after institution of therapy and thereafter gradually return to nonnal. The reticulocyte response may not be detectable in mild iron deficiency anemia. The blood hemoglobin level is the most accurate measure of the degree of anemia in iron deficiency anemia. During the response to therapy, the red cell count may increase temporarily to values above normal, but the hemoglobin value lags behind. The red cell indices may remain abnormal for some time after the normal hemoglobin level is restored. As recovery occurs, a normocytic cell population gradually replaces the microcytic population; and one of the early signs of response to therapy is an increase in RBW from pretreatment level. When treatment is fully effective, hemoglobin reaches normal levels by 2 months after therapy is initiated, regardless of staing values. Of the epithelial lesions in iron deficiency, those affecting the tongue and nails are the most responsive to treatment. | 156,483 | medmcqa_train |
Which organism causes toxin shock syndrome ? | Ans. is 'c' i.e., Staphylococcus aureus Toxic shock syndrome TSS is a potentially fatal multisystem disease characterized by sudden high fever, fainting, watery diarrhea, headache and muscle ache. There are two types of TSS :? 1. Staphylococcal TSS Staphylococcal TSS results from the elaboration of toxic shock syndrome toxin type-1 (TSST-1) also known as enterotoxin type F or pyrogenic exotoxin C. Enterotoxin B or C may also produce TSS. 2. Streptococcal TSS Streptococcal TSS results from the elaboration ofpyrogenic exotoxin A. | 156,484 | medmcqa_train |
Busacca and Koeppe&;s nodules are characteristically seen in | Non-granulomatous uveitisGranulomatous uveitisBehcet disease HLA - B27 associated ankylosing spondylitis Reiter syndrome Inflammatory bowel disease Idiopathic Infections - Lyme disease, Kawasaki disease, rickettsia, mumps, measles, Chlamydia, influenza, adenovirusPsoriatic ahritis Secondary syphilis Trauma UGH syndrome Glaucomatocyclitic crisis Lens-induced uveitis Corneal graft rejection Sarcoidosis Sympathetic ophthalmitis Phacoanaphylaxis Vogt - Koyanagi - Harada syndrome Infections - Tuberculosis, Leprosy, Syphilis, Leptospirosis, Brucellosis, Herpes simplex, herpes zoster, varicella, systemic mycosisKoeppe' s nodules- situated at papillary border -posterior synechiae smaller in sizeBusacca' s nodules- situated at the collarette; larger in size(Refer: AH Khurana, Comprehensive Textbook of Ophthalmology,5thedition, pg no: 149) | 156,485 | medmcqa_train |
Which of the following centers are involved in maintaining the circadian rhythm? | The entrainment process in most cases is dependent on the suprachiasmatic nuclei (SCN) located bilaterally above the optic chiasma. Efferents from the SCN initiate neural and hormonal signals that enteain a wide variety of well known circadian rhythms including the sleep wake cycle and the secretion of the pineal hormone melatonin. | 156,486 | medmcqa_train |
P-value is the probability of - | • P-value:
– Is the ‘Probability of Type I error’ (Null hypothesis is true but rejected)
– Significance (a) level: is the maximum tolerable probability of Type I error
– P- value is calculated (on basis of data while Alpha is fixed in advance: by the choice of level of significance employed in the test
– P – value calculated can be less than, equal to or greater than alpha (a)
– Keep Type I error to be minimum (P < a): Then results are declared statistically significant. | 156,487 | medmcqa_train |
Which of the following is not a prefabricated pontic: | Example of prefabricated pontics are:
Trupontic, Long pin facing,
Flatback, Sanitary facings, Reverse pin facing, Pontips. | 156,488 | medmcqa_train |
Pneumatocele is caused by? | Ans. A. Staphylococcus aureus* S. aureus is a cause of serious respiratory tract infections in newborns and infants; these infections present as shortness of breath, fever, and respiratory failure.* Chest X-ray may reveal pneumatocele (shaggy, thin- walled cavities). Pneumothorax and empyema are recognized complications of this infection. | 156,489 | medmcqa_train |
Psychosurgery is used in ? | Ans. is 'c' i.e., OCD | 156,490 | medmcqa_train |
Odynophagia means: | Ans. a (Pain during swallowing). (Ref. Diseases of ENT by PL Dhingra /3rd 402, 444)TermDefinationOdynophagiapainful deglutition.Dysphagiadifficulty in deglutition.Dysphagia lusoriaesophageal compression due to aberrant vessel, leading to dysphagia.Globus hystericusa psychiatric condition characterized by dysphagia.Halitosisbad odour from mouth. | 156,491 | medmcqa_train |
In oral poisoning with carbamate insecticides, .............................. may be hazardous: | Oximes are ineffective in carbamate poisoning. Rather, these can worsen the poisoning due to weak anticholinesterase activity of its own. | 156,492 | medmcqa_train |
Which of the following muscle is not supplied by Recurrent Laryngeal nerve: (PGI Dec 2008) | Ans: D (Cricothyroid) Nerve Supply of LarynxMotorAll the muscle which move the vocal cords (Abductor0- posterior cricoarytenoid; adductorQ-Lateral cricoarytenoid, Interarytenoid & thyroarytenoid: tensorQ-Cricothyroid, vocalis) are supplied by Recurrent Laryngeal nerve1'except the cricothyroid muscle. The latter receive its innervation from External Laryngeal nerveQ - a branch of superior Laryngeal nerveSensoryAbove vocal cords - Internal Laryngeal nerve, a branch of Superior Laryngeal nerve'3Below vocal cords - Recurrent Laryngeal nerveQRT Recurrent Lary ngeal Nerve - It arise from the vagusQ at level of subclavian artery, hooks around it & then ascends b/w the trachea & oesophagus.LT Recurrent Laryngeal Nerve - It arises from the vagusQ in the mediastinum at the level of arch of aorta, loops around it & then ascends into the neck in the tracheo-oesophageal groove. Thus, LTRLN has a much longer courseQ which makes it more prone to paralysis as compared to the right one. | 156,493 | medmcqa_train |
All of the following clinicopathologic features are seen more often in seminomas as compared to nonseminomatous germ cell tumors of the testis except | While hCG concentration may be inceased in patients with either nonseminoma or seminoma histology, the AFP concentration is increased only in patietns with nonseminoma." - Harrison Seminomas represent about 50% of all Germ cell tumors of testis. Median age is 4th decade (Nonseminomas are most frequent in the 3rd decade). Seminomas follow a more indolent course. Most seminomas (70%) present with stage I disease (disease limited to testis), about 20% with stage II disease (with retroperitoneal metastases), and 10% with stage III disease (spread beyond retroperitoneum) Seminomas as well as non-seminomas typically metastasize through lymphatics (except Choriocarcinoma which demonstrates early hematogenous spread) Seminomas are one of the most radiosensitive tumors (Non seminomas are insensitive to radiation). ref : Bailey & Love 25/e p1384 | 156,494 | medmcqa_train |
Chances of adverse outcome in a hea disease patient are increased in all of the following periods except | Period of pregnancy during which a hea disease patient has high chance of adverse outcome 12 to 16 wks of pregnancy 28 to 32 wks of pregnancy During Labor Immediately after delivery-Maximum deaths 4 to 5 days after delivery Reference: William's Obstetrics; 24th edition; Chapter 49 | 156,495 | medmcqa_train |
Which ofthe following drugs is used for Irritable Bowel Syndrome of the constipating type- | Management of IBS The most impoant steps are to make a positive diagnosis and reassure the patient. Many people are concerned that they have developed cancer. A cycle of anxiety leading to colonic symptoms, which fuher heighten anxiety, can be broken by explaining that symptoms are not due to a serious underlying disease but instead are the result of behavioural, psychosocial, physiological and luminal factors. In individuals who fail to respond to reassurance, treatment is traditionally tailored to the predominant symptoms. Dietary management is effective for many patients. Up to 20% may benefit from a wheat-free diet, some may respond to lactose exclusion, and excess intake of caffeine or aificial sweeteners, such as sorbitol, should be addressed. A more restrictive, 'low-FODMAP' diet, supervised by a dietitian, with gradual re-introduction of different food groups, may help some patients, as may a trial of a gluten-free diet. Probiotics, in capsule form, can be effective if taken for several months, although the optimum combination of bacterial strains and dose have yet to be clarified. Patients with intractable symptoms sometimes benefit from several months of therapy with a tricyclic antidepressant, such as amitriptyline or imipramine (10-25 mg orally at night). Side-effects include dry mouth and drowsiness but these are usually mild and the drug is generally well tolerated, although patients with features of somatisation tolerate the drug poorly and lower doses should be used. It may act by reducing visceral sensation and by altering gastrointestinal motility. Anxiety and affective disorders may also require specific treatment . The 5-HT4 agonist prucalopride, the guanylate cyclase-C receptor agonist linaclotide, and chloride channel activators, such as lubiprostone, can be effective in constipation- predominant IBS. Trials of anti-inflammatory agents, such as ketotifen or mesalazine, and the antibiotic rifaximin may be considered in some patients with difficult symptoms but are best prescribed only after specialist referral. Psychological interventions, such as cognitive behavioural therapy, relaxation and gut-directed hypnotherapy, should be reserved for the most difficult cases. A range of complementary and alternative therapies exist; most lack a good evidence base but are popular and help some patients . Most patients have a relapsing and remitting course. Exac- erbations often follow stressful life events, occupational dissatisfaction and difficulties with interpersonal relationships. Ref Davidson edition23rd pg 826 | 156,496 | medmcqa_train |
Treatment of AIDS include | (2 Reverse transcriptase inhibitors + 1 Protease inhibitors) (1124-H) (1197-1201-300-CMDT-09) (1190- H17th)Currently licenced drugs for the treatment of HIV infections fall into three categories: those that inhibit the viral reverse transcriptase enzyme: those that inhibit the viral protease enzymes, and those that interfere with viral entry (1124-H)Reverse transcriptase inhibitors include(i) Nucleoside analogues - Zidovudine, Zalcitabine, Didanosine, Zalcitabine, Stavudine, Lamivudine, abacavir, and emtricibine(ii) Nucleotide analogues - tenofovirNon-nucleoside reverse transcriptase inhibitors - nevirapine, delavirdine and efavirenzProtease inhibitors (PIs) Saquinavir, Ritonavir, Indinavir, Nelfinavir, Amprenavir, Fosamprenavir, Lopinavir, AtazanavirEntry inhibitors (Fusion inhibitors) - Enfuvirtide* The combination of Zidovudine, Lamivudine and indinavir was the first "triple combination" shown to have a profound effect on HIV replication (1134-H)Symptomatic HIV disease or asymptomatic disease and CD4 < 200/pL or asymptomatic disease and special circumstances | Best first line treatment{CombivirEfavirenz Common altemativeregimens once a day regimens |||||* Tenofovir +Lamivudine +Efavirenz Tenofovir +Efavirenz +Afazanavir +Ritonavir + | | Intolerance to regimen Progression of disease or viral load does not decrease by > 0.5 log with initiation of treatment or increase of viral load by > 0.5 log while on treatmentLow pill burden regimens Combivir +Neviripine Trizivir | Change to alternative first line regimens High potency regimens| | Perform resistance testing and change to a regimen with three drugs to which the patient is not resistant. If possible Combivir +Lopinavir withRitonavir Approach to antiretroviral therapy | 156,497 | medmcqa_train |
Eye signs can be seen in : | Toxic goitres are broadly of two distinct types: Primary & Secondary. | 156,498 | medmcqa_train |
Child belongs toBihar Shows hypopigmented patches over his face. What is the right diagnosis? | As the child belongs to an endemic area, So our answer is inclined for Leprosy. The disease is clinically characterized by one or more of the three cardinal signs: hypopigmented or erythematous skin patches with definite loss of sensation, thickened peripheral nerves, and acid-fast bacilli detected on skin smears or biopsy material. Ref Robbins 9/e pg 234 | 156,499 | medmcqa_train |
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