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Fetal middle cerebral artery Doppler is most useful in the evaluation of - | Ans-CMCA - PSA for fetal anemia in Rh- pregnancy. | 156,500 | medmcqa_train |
A durck granuloma is seen in - | Durck granuloma → Ring hemorrhages and small focal inflammatory reaction seen in Brain in cerebral malaria | 156,501 | medmcqa_train |
Most common cause of HUS in children is | Ans. is 'a' i.e., E coli 0157/H7 The majority of HUS in children (90%) is related to prototypic diarrhea associated form, predominately in previously healthy children 6 months to 4 years of age with a peak between 1 and 2 years. Shiga toxin producing E coli (STEC) is the major cause of diarrhea associated HUS. Specifically, E coli with serotype 0157:H7 is the bacteria most commonly associated with HUS (90%) and is the most virulent. Other common bacteria implicated in causation of HUS are : Shigella dysenteriae Salmonella typhae Camphylobacter jejuni Yersinia species Pseudomonas species Clostridium difficle | 156,502 | medmcqa_train |
What is first sign noticed in the eye after death of a person? | Fragmentation of blood columns in a retinal vessel is called Kevorkian sign. It is the first sign in eye after death of a person. | 156,503 | medmcqa_train |
Carotene is not found in high amounts in - | The cheapest source is green leafy vegetable such as spinach and amaranth. Vitamin A also occur in most green and yellow fruits and vegetables. REF. PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE 21ST EDITION. PAGE NO - 615 | 156,504 | medmcqa_train |
A foy year old female visit the hospital with complaint of pain in her right hypochondriac region radiating towards the right shoulder tip. The pain begins after eating food and increases steadily over the period of 10-30 minutes then gradually decreases. She might have:- | Most probable diagnosis of this case is cholelithiasis. Cholelithiasis is commonly seen in fat foy feile females. In the given case the patient is experiencing pain after the meals and it increases for the period of 10 mins means during the time of gall bladder contraction to release bile. Gall bladder is supplied by the sympathetic nerves celiac and hepatic plexus. A few twigs from the right phrenic nerve carrying post ganglionic sympathetic fibers reach the gall bladder through the right phrenic and hepatic plexuses. This explains the referred pain of gall bladder inflammation at right shoulder tip. | 156,505 | medmcqa_train |
Which of the following is the most common etiological agent in parNasal sinus mycoses: | Most common type of fungal infection of nose and paranasal sinuses are due to aspergillus. A.fumigatus>A.niger>A.flavus are the most frequent offenders. Ref Maqbool 11/e,p 255. | 156,506 | medmcqa_train |
Salmonella osteomyelitis is common in | ANSWER: (A) Sickle cell diseaseREF: Textbook of orthopedics and trauma, By GS Kulkarni, page 289Salmonella osteomyelitis is more common in children with sickle cell disease, hemoglobinopathies and thalassemia. The reason for this higher incidence is as follows:Local thrombosis of intestinal mucosa causes disruption of mucosal integrity causing invasion of intra luminal bacteriaHyposplenmic state leads to prolongation of bacteremia to establish infectionHypoxia and aseptic necrosis causes multiple infarction of bone, leading to the point of low resistance favoring localization and spread of salmonella. | 156,507 | medmcqa_train |
Structure passing through foramen Rotundum: | Maxillary nerve | 156,508 | medmcqa_train |
Sensitivity is | Repeated question | 156,509 | medmcqa_train |
Which of the following is labile cell ? | Ans. is 'd' i.e., Surface epitheliumWhen a cell proliferates, it pass through a cell cycle. o Cell cycle has a series of phases : -G iphase --> Rest phase (Presynthetic phase) S phase --> Synthetic phase in which synthesis of DNA takes place.a G2phase --> Resting phase (Postsynthetic or postmitotic phase). Mphase --> Mitotic phase in which mitosis takes place.Go phase When cell is not proliferating, it remains in quiescent phase (Go).Based on their proliferative capacity, cells are divided into.1. Labile cells (Continously dividing cells) or interinitotic cells. o Have capacity to proliferate and regenerate.o Have very sho Go and almost always remain in cell cycle. Example are : -u Surface epithelium (stratified squamous) of skin, oral cavity, vagina and cervix. Lining mucosa of all excretory ducts of glands (Salivary gland, pancreas, biliary duct). Columinar epithelium of GIT and uterus. Transitional epithelium of the urinary tract. Bone marrow cells and hematopoietic cells. Basal cells of epithelia.2. Stable or quiescent or reversible postimitotic cells. o Have limited capacity to proliferate and regenerate.o Ramain in Go phase of cell cycle but can enter in G1 phase when stimulated i.e., they usually remain quiescent, but proliferate in response to stimuli. Example are -Parenchymal cells of liver, kidney and pancreas. Mesenchymal cells, e.g., fibroblast and smooth muscles. Vascular endothelium Osteoblast, chondroblast Resting lymphocytes and other leukocytes.3.Permanent or nondividing or irreversible postmitotic cells. o Cannot divide and regenerate.o These cells are nondividing and have left the cell cycle, i.e., they do not belong to any phase of cell cycle. Example are -u Neurons Cardiac muscle Skeletal muscle | 156,510 | medmcqa_train |
Animal waste such as placenta is disposed by- | - animal wastes comes under category no 2 of biomedical wastes. - it should be disposed by incineration. Reference: Park's textbook of preventive and social medicine, 23rd edition, pg no:793 <\p> | 156,511 | medmcqa_train |
Acute fluoride toxicity is seen at | - 5.0 grams – in AIPG
- 2.2 grams – in PGI | 156,512 | medmcqa_train |
All of the following are pa of the ASEPSIS wound grading except ? | REF : BAILEY AND LOVE 27TH ED. | 156,513 | medmcqa_train |
How is under-nutrition defined? | Ans. b. Weight for height < -2 SD (Ref: Ghai 8/e p96)Under nutrition is defined in terms of Height for Height, i. e. < -2 SD. Height for Height < -3 SD is severe under nutrition.Indicators of MalnutritionIndicatorParameterInterpretationStuntingLow height for ageChronic malnutritionQWastingLow weight for heightAcute malnutritionQUnder weightLow weight for ageBoth acute & chrome malnutritionQ WHO Classification of Malnutrition Moderate malnutritionSevere malnutrition (type)Symmetrical edemaNoYes (edematous malnutrition)Weight-for-heightSD score from -2 to -3SD score < -3 (severe wasting)Height-for-ageSD score from -2 to -3SD score < -3 (severe stunting) | 156,514 | medmcqa_train |
Which of the following is higher at the apex of the lung than at the base when a person is standing? | Ans. A. V/Q ratioa. The alveoli at the apex of the lung are larger than those at the base so their compliance is less. Because the compliance is reduced, less inspired gas goes to the apex than to the base.b. Also, because the apex is above the heart, less blood flows through the apex than through the base.c. However, the reduction in airflow is less than the reduction in blood flow, so that the V/Q ratio at the top of the lung is greater than it is at the bottom.d. The increased V/Q ratio at the apex makes PA CO2 lower and PA O2 higher at the apex than they are at the base. | 156,515 | medmcqa_train |
Growth factor oncogene is - | Sis oncogene is a growth factor.
Myc, jun and fos oncogenes are nuclear regulatory proteins
Following information have been added in 8th/ e of Robbin's
miRNA and cancer
It has already been explained in genetics that miRNA is a gene-silencing RNA, i.e. it inhibits gene expression at post-transcription level.
So, miRNA can be involved in tumorigenesis in two ways :
Reduced activity of miRNA that inhibits translation of an oncogene will result in excess of oncoprotein and tumorigenesis. For example, mRNA inhibits expression of anti-apoptotic gene Bcl 2. Reduced activity of this miRNA results in over-expression of Bcl-2 which inhibits apoptosis and results in leukaemia and lymphoma. Similarly, miRNA mediated upregulation of Ras and Myc oncogenes has been detected in lung tumor and B-cell leukemia, respectively.
On the other hand, overactivity of miRNA that targets a tumor suppression gene will result in inhibition of expression of tumor suppressor gene and tumorigenesis. | 156,516 | medmcqa_train |
A young lady is present with history of repeated episodes of overeating followed by purging using laxatives, she is probably suffering from | Bulimia Nervosa Bulimia nervosa is an eating disorder charac terised by the following clinical features: 1. Bulimia nervosa usually has an onset in early teens or adolescence. 2. There is an intense fear of becoming obese. There may be an earlier history of anorexia nervosa. 3. There is usually body-image disturbance and the person is unable to perceive own body size accurately. 4. There is a persistent preoccupation with eating, and an irresistible craving for food. There are episodes of overeating in which large amounts of food are consumed within sho periods of time (eating binges). 5. There are attempts to 'counteract' the effects of overeating by one or more of the following: selfinduced vomiting, purgative abuse, periods of starvation, and/or use of drugs such as appetite suppressants. 6. No known medical illness is present which can account for the disorder. 7. Absence of any other primary psychiatric disorder. Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no.144 | 156,517 | medmcqa_train |
A neonate delivered at 32 weeks, is put on a ventilator, X–ray shows 'white out lung' and ABG reveals PO2 of 75. Ventilator settings are an, FiO2 of 70, and rate of 50/minute. Next step to be taken should be ? | Lets see the individual findings.
The neonate is premature.
X - Ray shows 'White - Out' : is a sign of Hyaline Membrane disease in the Newborn i.e. RDS.
ABG reveals p0, of 75 : which is acceptable.
FiO, : Fractional Inspiratory 0„ here in the ventilator settings, is 75% well above the normal.
Respiratory Rate settings in the ventilator is 50/min : Normal for that age.
Now, we have the complete picture here :
The premature baby is having HMD, and so has been put on Artificial respiration.
The FiO2 being given is in the higher normal range, and also the partial pressure of 0, in the neonates blood is acceptable . So we will avoid increasing the Fi0„ as this carries a risk of blindness by ROP (Retinopathy of Prematurity). As a rule, we avoid tampering with the ventilator rate settings, because it causes changes in the CO, levels of the blood, and consequent disturbances in the acid - base balance. This is also one of the reasons for keeping this rate of 50/min. in this neonate.
Weaning from ventilator will start once the baby shows hyper - oxygenation with the currect settings, i.e. the p0, in the range of 120 .
The answer here would be to continue the current settings till such time when the baby shows hyper-oxygenation, and then slowly wean him off the ventilator | 156,518 | medmcqa_train |
True pseudo rosettes are seen in all except | Thecoma *Neuroblastoma: Homer-Wright pseudo rosettes can be found in which the tumor cells are concentrically arranged around the central space filled with neutrophil. *Medulloblastoma: The tumor has the potential to express neural cells or Homer Wright rosettes as occur in neuroblastoma. *Retinoblastoma: In well differentiated tumors there are Flexner-Winter-Steiner rosettes and fleurettes reflecting photoreceptor differentiation. *Thecoma: They are composed of well differentiated fibroblasts with more or less scant collagenous connective tissue interspace between the cells. | 156,519 | medmcqa_train |
Burkits Lymphoma is caused by: | EBV | 156,520 | medmcqa_train |
Quantitative assessment of liver function can be done by: | Answer is D (Estimation of Galactose Elimination capacity): Estimation of Galactose Elimination capacity (GEC) is an example of quantitative liver tests Liver Function tests Non quantitative Tests for Liver Function Although generally termed as Liver function tests, these are either not related to function or only reflect given aspects of liver function and are not over all parameters of latter These Include Serum Bilinthin Serum Alkaline phosphatase Serum Transminases Serum Bile Acids Serum Albumin Serum prothrombin time, etc Quantitative tests for Liver Function Quantitative tests for Liver function measure the true functional reserve of the liver These Include Galactose Elimination capacity Urea synthesis capacity Inducyanine clearance Sorbitol clearance caffeine clearance Aminopvrine Breath test Ketoisocaproic acid breath test | 156,521 | medmcqa_train |
Which of the following is true of botulinum toxin? | It acts on the postsynaptic membrane of peripheral nerves to block acetylcholine receptors Botulinum toxin is the most potent bacterial toxin known. One microgram of purified toxin is able to kill 200,000 mice. The toxin is released only upon the death and autolysis of the organism, and is thus classified as an exotoxin. Its activity is limited to the peripheral nervous system, where it is internalized into the presynaptic membrane at the neuromuscular junction and blocks the release of acetylcholine. Antibiotics have no direct effect on the toxin. The currently used antitoxin is of equine origin and is usually given as polyvalent. Injection of botulinum toxin is used in medical settings to treat strabismus and blepharospasm and has gained popularity recently as a cosmetic approach to lessen wrinkles (Botox). | 156,522 | medmcqa_train |
All are disorders of Phagocytosis except | Nezelof Syndrome is autosomal recessive condition characterised by cellular immunodeficiency. | 156,523 | medmcqa_train |
Characteristic feature of the urine in diabetes insipidus include the following EXCEPT | Ans. c (Specific gravity > 1.020). (Ref. Harrison, Medicine, 18th. Ch. 340 and 44)Fluid deprivation test: If fluid deprivation does not result in urine concentration (osmolarity >300 mosmol/L, specific gravity >1.010) before body weight decreases by 5% or plasma osmolarity/sodium rise above the upper limit of normal, the patient has severe pituitary or severe nephrogenic DI. These disorders usually can be distinguished by administering desmopressin (0.03 g/kg SC or IV) and repeating the measurement of urine osmolarity 1-2 hours later. An increase of >50% indicates severe pituitary DI, whereas a smaller or absent response is strongly suggestive of nephrogenic DI.Criteria for Dl (Diabetes insipidus)# Polyuria of > 3 L/d# Urine osmolality < 3000 mOsm/kg# Urine specific gravity < 1.00.Criteria for central Dl# Inappropriately dilute urine even with strong stimuli for AVP secretion.# Absence of intrinsic renal disease.# Rise in urine osmolality with ADH.Criteria for nephrogenic Dl# Normal rates of renal filtration and solute excretion.# Persistent hypotonic urine.# Failure of exogenous ADH to raise urine osmolality or to reduce urine volume. Source: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J: Harrison's principles of Internal Medicine, 18th Edition: www. accessmedicine. ComCopyrightr (S) The McGraw-Hill Companies, Inc. All rights reserved. | 156,524 | medmcqa_train |
The structures passing posterior to diaphragm are all except ? | The aoa passess posterior to the diaphragm.Accompanying the aoa through the aoic hiatus is the thoracic duct and the azygous vein.The greater and lesser splanchinic nerves passess through the crura on either side. | 156,525 | medmcqa_train |
In cryptorchidism, hallmark histological changes appear in testis at: | Histopathology- Abnormal germ cell histology- 1-2 Years:* Earliest change - Hypoplasia of Leydig cells (1 month of age)- Degeneration of Seoli Cells- Delayed disappearance of gonocytes- Delayed appearance of adult dark spermatogonia | 156,526 | medmcqa_train |
All are features of iridocyclitis except | Ans) b (Mucopuntlent discharge) Ref: Kansk, 6th ed p447-448Mucopurulent discharge is seen in conjunctivitis Symptoms of iridocyclitis-Sudden onset painPhotophobiaRednessLacrimationSignsVisual acuity decreased,Circumcomeal congestionMiosisKeratic precipitatesAqueous cells and flare, hypopyon occAnterior vitreous cellsPosterior synechiaLow IOP | 156,527 | medmcqa_train |
The local anaesthetic with the longest duration of action is : | * Longest acting, most potent and most toxic LA is dibucaine. * Chlorprocaine is the shoest acting LA. | 156,528 | medmcqa_train |
Among all the layers of the scalp which layer is highly vascular? | Scalp consists of the overlying soft tissues as well as underlying calvarium. The soft tissues composing the scalp are skin, connective tissue (subcutaneous), aponeurosis (galea aponeurotica), loose areolar connective tissue, and pericranium. The connective tissue layer (subcutaneous) contains the vast majority of the vasculature and nerve supply of the scalp. This layer is laced with strong fibrous reticula that hold the vessels open when the scalp is cut, causing profuse bleeding. The external carotid aery and internal carotid aery provides vessels to the scalp, with extensive anastomoses. | 156,529 | medmcqa_train |
Multifactorial causation of disease theory was proposed by | Traits and conditions that are caused by more than one gene occurring together are multifactorial, and diseases that are caused by more than one factor interacting (for example, heredity and diet in diabetes) are multifactorial. Ref: 25th edition, Park's Textbook of Preventive and Social Medicine, Page no. 40 | 156,530 | medmcqa_train |
Predisposing factors for skin cancer are-a) Smokingb) U-V-light c) Chronic ulcerd) Infrared light | Exposure to Sun (UV rays) Major predisposing factors. o Old burn scars
Industrial carcinogens (Tars and oils) o Ingestion of arsenicals
Chronic ulcers and draining osteomyelitis. o Ionizing radiation
Note : Cigarette smoking and tobacco & betel nut chewing are predisposing factors for squamous cell carcinoma of lips and oral cavity. | 156,531 | medmcqa_train |
A 58-year-old man with cirrhosis complains of worsening fatigue and confusion over the past 5 days. He also repos that over the past 48 hours he has had a declining urinary output. On examination, he is gaunt and jaundiced. He has tense ascites and a liver span of 7 cm in the midclavicular line. Lab result reveals a WBC 4600/mm3, Hb 9.4 g/dL, and PCB 29%. BUN of 34 mg/dL and a creatinine of 3.1 mg/dL. A urinary Na <10 mEq/L. Most appropriate treatment for his elevated BUN and creatinine? | This patient with well-advanced cirrhosis and poal hypeension has developed the onset of renal insufficiency consistent with hepatorenal syndrome. This occurs during the end stages of cirrhosis and is characterized by diminished urine output and low urinary sodium. In the setting of end-stage liver disease, renal vasoconstriction occurs, and the distal convoluted tubule responds by conserving sodium. Unless the renal function is allowed to deteriorate fuher, liver transplantation will reverse this vasoconstriction and kidney function will return to normal.A large volume paracentesis may relieve the ascites but will have no significant benefit on the impaired renal function. There are no indications in this question to suggest that the patient requires acute hemodialysis. A mesocaval shunt is a surgical procedure that may decompress the poal pressure but will not have any benefit on renal function. Renal transplantation is of no value in this patient since the underlying lesion is in the liver; the kidneys will return to normal function if there is the improvement in hepatic function. Ref - Harrison's internal medicine 20e pg 2401,2422 | 156,532 | medmcqa_train |
False about eukaryotic protein synthesis is: | A i.e. N formyl Met is the first - RNA to come into action | 156,533 | medmcqa_train |
Loosening of association is an example of - | Ans. is 'a' i.e., Formal thought disorder Thought disordersFormal thought disorders (Disorders of thought process)Disorders of thought contenti) Racing thoughts :- Anxiety, Schizophreniaii) Retarded thoughts :- Depressioniii) Circumstantiality :- Mania, Schizophreniaiv) Thought blocking :- Schizophrenia, Severe anxietyv) Perseveration :- Organic brain disease, Schizophrenia ( occasionally)vi) Loosening of association :- Schizophreniavii) Flight of ideas:- Maniaviii) Tangentialityix) Clunging & punning :-Mania & schizophreniax) Neologism, word salad, Echolalia :-Schizophreniai) Delusion :- Psychosis (Schizophrenia, mania, depression & othersii) Obsessioniii) Compulsioniv) Preoccupationsv) Phobiasvi) Depersonalization & Derealizationo In schizophrenia and mood disorders (depression, mania) all parts of the thought (thought process as well as content) are involved.o However, schizophrenia is conventionally referred as formal thought disorder. | 156,534 | medmcqa_train |
Epstein-Barr virus (EBV) VCA-IgG 1 :80 and EBV antibody to early antigen EA1 :320 suggest which one of the following diseases? | Infectious mononucleosis (IM) may be suspected clinically but it is confirmed serologically. The heterophil antibody test, however, may be negative in up to 15% of adults and 35 to 40% of children. Because IM is caused by Epstein-Barr virus (EBV), a specific test for viral capsid antigen (VCA) of EBV is indicated when heterophil tests are negative. Acute IM is characterized by a VCA-IgM titer, and no VCA-IgG antibody or EBNA. Chronic EBV disease causes elevated VCA-IgG titers as well as high EA antibody titers. | 156,535 | medmcqa_train |
Chyluria is caused by all except: March 2007 | Ans. D: Bile duct stones Chyluria/chylous urine is a condition involving the presence of chyle in the urine stream, which results in urine appearing milky white. Chyluria is often caused by filariasis due to the parasite Wuchereria bancrofti, a thready nematode which lodges the lymph channels. Another cause is pregnancy or childbih. It may also be seen in ascariasis, malaria, tumour and tuberculosis. Once the lymph channels are blocked, one may open into the kidney hilum or ureter or sometimes into the bladder and chyle can leak into the urinary tract resulting in milky white urine.It may also result in renal colic and hypoproteinemia. Blood sometimes mixes with the urine resulting in haemato-chyluria. Usually the condition is self limiting. If left untreated, chronic chyluria can lead to malnutrition and vitamin deficiency. | 156,536 | medmcqa_train |
Most common organ affected in polyarteritis nodosa? | Ans. b (Kidneys). (Ref. Harrisons Medicine, 18th/ Chapter 326. The Vasculitis Syndromes)PAN is necrotising vasculitis of small and medium sized arteries.Descending order of frequency of involvement of organs in PAN is# Kidney# Heart# Liver# GIT# Muscle# Pancreas# Testis# CNS# Skin | 156,537 | medmcqa_train |
A patient with blunt trauma of abdomen at 48 hours, USG shows normal, but patient had tenderness in left lumbar region. Best appropriate diagnosis is by: | Suspect - injury of kidney in left abdomen. MCU is IOC for Vesicourethral Reflux IVP is IOC for Ureterocele | 156,538 | medmcqa_train |
Insulin acts on glucose metabolism by | Insulin signals the cells of insulin-sensitive peripheral tissues, primarily skeletal muscle, to increase their uptake of glucose.Secondly, insulin acts on the liver to promote glycogenesis.Finally, insulin simultaneously inhibits glucagon secretion from pancreatic a-cells, thus signalling the liver to stop producing glucose glycogenolysis and gluconeogenesis Ref: DM Vasudevan, 7th edition, page no: 165, 318, 323 | 156,539 | medmcqa_train |
Which is wrong about the treatment of condition shown? | CXR - Ellis S shaped curve CP angle blunting Pleural effusion Thoracocentesis: Done with patient sitting in scapular line If patient cannot sit, he should be at edge of bed, arm raised above level of head, head end elevated by 30deg Severe Hiccoughs is a contraindication to thoracentesis Max fluid can be removed safely per sitting is about < 1500 ml/day. We don't remove fluid >1500 ml due to risk of development of re-expansion pulmonary edema. | 156,540 | medmcqa_train |
HLA typing is useful in: September 2004 | Ans. D i.e. Parental dispute | 156,541 | medmcqa_train |
Chronic constipation in children is seen in all A/E? | Ans. is 'b' i.e., Jejunal polyp | 156,542 | medmcqa_train |
Autoantibody specific for SLE - | Ans. is 'a' i.e., ds DNA Antinuclear antibodies in SLEo Systemic lupus erythematosus is characterized by bewildering array of autoantibodies, particularly antinuclear antibodies.o The antibodies are directed against an array of nuclear and cytoplasmic components of the cell, in addition a third group of antibodies is directed against cell surface antigen of group cells,o The existence of seemingly limitless number of antibodies in patients against self-constituents indicate that the fundamental defect in SLE is a failure of the mechanism that maintain self-tolerance.o ANA is positive in virtually every patient of SLE, hence this test is sensitive but is not specific because patients with other autoimmune diseases are also positive.o Of the numerous antinuclear antibodies, antibodies to double stranded DNA and the antibodies, to (Smith) antigen are virtually diagnosis of SLEQ.o Presence of abtibodies to antismith and anti double stran ded DNA is virtually diagnostic of SLE.o The best serening test for SLE is demonstration of antinuclear antibodies.o Most sensitive antibody test for SLE - Antinuclear antibody test for SLE.o Afost specific antibody test for SLE - Anti ds DNA and Anti Sm antibodyo Antibody associated with drug induced SLE - Antihistone antibodyAutoantibodies in Systemic Lupus Ery thematosus (SLE! Prevalence Antibody%Antigen RecognizedClinical Utilityo Antinuclear antibodies98Multiple nuclearBest screening test; repeated negative tests make SLE unlikelyo Anti-ds DNA70DNA (double-stranded)High titers are SLE-specific and in some patients correlate with disease activity, nephritis, vasculitiso Anti-Sm25Protein complexed to 6 species of nuclear U1 RNASpecific for SLE; no definite clinical correlations; most patients also have anti-RNP; more common in blacks and Asians than whiteso Anti-RNP40Protein complexed to U1 RNAyNot specific for SLE; high titers associated with syndromes that have overlap features of several rheumatic syndromes including SLE; more common in blacks than whiteso Anti-Ro (SS-A)30Protein complexed to hY RNA, primarily 60 kDa and 52 kDaNot specific for SLE; associated with sicca syndrome, predisposes to subacute cutaneous lupus, and to neonatal lupus with congenital heart block; associated with decreased risk for nephritis -o Anti-La (S3-B)1047-kDa protein com- plexed to hY RNAUsually associated with anti-Ro; associated with decreased risk for nephritiso Antihistone70Histones associated with DNA (in nucleo-some, chromatin)More frequent in durg-induced lupus than in SLEo Antiphospholipid50Phospholipids, b2 glycoprotein 1 cofac- tor prothrombinThree tests available - ELISAs for cardiolipin and b2G1, sensitive prothrombin time (DRVVT); predisposes to clotting, fetal loss, thrombocytopeniao Antierythrocyte60Erythrocyte membraneMeasured as direct Coombs' test; a small proportion develops overt hemolysiso Antiplatelet30Surface and altered cytoplasmic antigens on plateletsAssociated with thrombocytopenia but sensitivity and specificity are not good; this is not a useful clinical testo Anti neuronal (includes anti-glutamate receptor!60Neuronal and IvmphoIn some series a positive test in CSF correlates with cyte surface antigens active CNS lupuso Antiribosomal P20Protein in ribosomesIn some series a positive test in serum correlates with depression or psychosis due to CNS lupus | 156,543 | medmcqa_train |
Which of the following accessory ligaments of the TMJ is likely to have significance upon mandibular movements? | The stylomandibular ligament is formed due to thickening of the investing layer of deep cervical fascia, which separates the parotid and submandibular glands. This ligament also becomes taut when the mandible is protruded.
The accessory ligaments of temporomandibular joints control range of motion (ROM) of TMJs and with mandible form a ‘swing’.
The ligaments are the fibrous capsule, temporomandibular, sphenomandibular, and stylomandibular ligaments. The latter two are accessory ligaments. | 156,544 | medmcqa_train |
The commonest true benign tumour of the bone is | OSTEOID OSTEOMA It is the commonest true benign tumour of the bone. Pathologically, it consists of a nidus of tangled arrays of paially mineralised osteoid trabeculae surrounded by dense sclerotic bone. Clinical presentation: The tumour is seen commonly between the ages of 5-25 years. The bones of the lower extremity are more commonly affected; tibia being the commonest. The tumour is generally located in the diaphysis of long bones. The presenting complaint is a nagging pain, worst at night, and is relieved by salicylates. There are minimal or no clinical signs, except for mild tenderness at the site of the lesion, and a palpable swelling if it is a superficial lesion. Diagnosis: It is generally confirmed on X-ray. The tumour is visible as a zone of sclerosis surrounding a radiolucent nidus, usually less than 1 cm in size. In some cases, the nidus may not be seen on a plain X-ray because of extensive surrounding sclerosis, and may be detected on a CT scan. Treatment: Complete excision of the nidus along with the sclerotic bone is done. Prognosis is good. It is not a pre-malignant condition. Reference: Maheshwari; Essential Ohopaedics 9th ed; Page no:235 | 156,545 | medmcqa_train |
Type of inheritance in Tuberous sclerosis - | Ans. is 'a' i.e., Autosomal dominant | 156,546 | medmcqa_train |
In normal adult wave V of ABR is generated from | Wave I - Distal pa of CN VIII Wave II - Proximal pa of CN VIII near the brainstem Wave III - Cochlear nucleus Wave IV - Superior olivary complex Wave V - Lateral lemniscus Waves VI and VII - Inferior colliculus Note: Auditory brainstem response (ABR): Also called BAER or BAEP (brainstem auditory evoked response or potential) or BERA (brainstem evoked response audiometry) is to elicit brainstem responses to auditory stimulation by clicks or tone bursts. Ref: Dhingra; 6th Edition; pg no 27 | 156,547 | medmcqa_train |
Umblicated nodules are produced by? | Ans. is 'a' i.e., Poxvirus Nodules with central umblication is produced in molluscum contagiosum, caused by a Poxvirus. | 156,548 | medmcqa_train |
All of the following are essential amino acids include all, EXCEPT: | The essential amino acids are leucine, isoleucine, lysine, methionine, phenylalanine, threonine, tryptophan, valine, and histidine. Protein is required for growth and for maintenance of body structure and function. The true requirement is for nine essential amino acids plus additional nitrogen for protein synthesis. Adequate protein must be consumed each day to replace essential amino acids lost through protein turnover. Allowing for differences in protein quality and utilization and for individual variability, the RDA (USA) for protein is 56 g/d for men and 45 g/d for women. Ref: Baron R.B. (2013). Chapter 29. Nutritional Disorders. In M.A. Papadakis, S.J. McPhee, M.W. Rabow (Eds), CURRENT Medical Diagnosis & Treatment 2013. | 156,549 | medmcqa_train |
Syndrome of inappropriate antidiuretic hormone secretion (SIADH) causes | The syndrome of inappropriate antidiuresis (SIAD) is the most frequent cause of euvolemic hyponatremia. Glucocoicoid deficiency, Hypothyroidism, Stress, Drugs are other causes of euvolemic hyponatremia. Common causes of SIAD include pulmonary disease (e.g., pneumonia, tuberculosis, pleural effusion) and central nervous system (CNS) diseases (e.g., tumour, subarachnoid haemorrhage, meningitis). SIAD also occurs with malignancies, most commonly with small-cell lung carcinoma (75% of malignancy-associated SIAD) SIAD is also a frequent complication of ceain drugs, most commonly the selective serotonin reuptake inhibitors (SSRIs). Ref: Harrison 19e pg: 300 | 156,550 | medmcqa_train |
All of the following are true about case control study except - | Ans. is 'd' i.e., Less prone to bias Case control studyo Case control study is a common first approach to test causal hypothesis.o Caseo Control--Case is an individual who has developed the disease.Is an individual who has not developed the disease but is otherwise comparable to case (e.2. age, sex, occupation, social status etc).o The case - control study has three distinct features - Both exposure (risk factor) and outcome (disease) have occurred before the start of study - so, there is no further risk for subjects. Study proceeds backn'ards from effect to cause - retrospective study.It uses a control or comparison group to support or refute an inference.o The focus is on a disease that has already developed.o Association between risk factor and disease can be tested - risk factor can be identified,o For example, if it is our intention to test the hypothesis that cigarette smoking causes lung cancer, the investigation begins by assembling a group of lung cancer cases (a + b) and a group of suitable matched control (not having lung cancer). Then past history for the presence or absence of smoking is explored in both groups.Suspected risk factorCases(disease present)Control(disease absent)PresentAbsentacbda + cb + do If the frequency of smoking, a / (a + c) is higher in cases than in control b / (b + d), an association is said to exist between smoking and lung cancer,o Case - control study is rapid and inexpensive,o Problem of bias is common. | 156,551 | medmcqa_train |
True statements about congenital megacolon include all of the following except: | S. Das writes - "The symptoms appear within 3 days of birth and the presenting features are as follows:
Constipation
Abdominal distention"
Nelson writes - "The clinical symptoms of Hirschprung disease usually begin at birth with the delayed passage of meconium."
Loud borborygmi are heard due to intestinal obstruction.
About stool, Nelson writes -
"The stools when passed may consist of small pellets, maybe ribbon-like or may have fluid consistency; the large stools and faecal soiling of patients with functional constipation are absent."
Also, know
a large faecal mass may be palpable in the left lower abdomen, but on rectal examination, the rectum is usually empty of faeces (faeces in rectum are found in functional constipation). | 156,552 | medmcqa_train |
Which of the following remnant of wolffian duct is present on medial part of broad ligament | All remnants of wolffian duct are present in lateral part of broad ligament except paroophoron. | 156,553 | medmcqa_train |
WHO stage IV HIV includes all, except - | <p> Oral thrush is not included in the clinical stage 4 for HIV. Reference:Park's textbook of preventive and social medicine,K.Park,23rd edition,page no:349.<\p> | 156,554 | medmcqa_train |
A 55-yrs-old woman complains of stiff, aching hands, especially in the morning. Radiographs of the hands reveal expansion at the base of the terminal phalanges & tapering of the proximal phalanges. This patient most likely has: | There are three main varieties of psoriatic arthritis (an inflammatory arthritis affecting 5 to 42% of patients with psoriasis): asymmetric inflammatory arthritis, symmetric arthritis , and psoriatic spondylitis. The pathology is similar to that seen in RA (early neutrophil and later monocytic synovial infiltration). There are no characteristic laboratory abnormalities in patients with psoriatic arthritis, but radiographs, if they reveal features unique to this disease relative to RA, may be diagnostically helpful. Such special features include the pencil-in-cup appearance of the distal terminal phalanx due to cuplike erosions. and bony proliferation with tapering of the proximal phalanx; proliferation of the bone near osseous erosions, terminal phalyngeal osteolyis, bone proliferation and periostitis, and telescoping of one bone into another (opera-glass deformity). Inflammation of the tendons and ligaments (ethesopathy) is also characteristic. Nonsteroidal anti-inflammatory agents are the therapeutic mainstays; sulfasalazine or methotrexate is often required in difficult cases. | 156,555 | medmcqa_train |
Amide group containing amino acid is: | Amide (-CONH) group is present in:- Asparagine Glutamine Asparagine is the amide of Aspaate Glutamine is the amide of Glutamate | 156,556 | medmcqa_train |
All are true regarding superior laryngeal nerve block, except: | Superior laryngeal nerve supplies sensory supply to the mucosa of larynx upto the level but not including the vocal cords. Sensory supply of vocal cords and larynx below vocal cords is by recurrent laryngeal nerve. Thus in superior laryngeal nerve block, sensory supply below the level of vocal cords will be maintained. | 156,557 | medmcqa_train |
About ureter true is | Abdominal ureter. The ureter is roughly 25-30 cm long in adults and courses down the retroperitoneum in an S curve. At the proximal end of the ureter is the renal pelvis; at the distal end is the bladder. The ureter begins at the level of the renal aery and vein posterior to these structures . Ref - BDC 6e vol2 pg 318 | 156,558 | medmcqa_train |
A patient is taking ketoconazole for fungal infection develops cold for which he is prescribed terfenadine. Possible interaction between terfenadine and ketoconazole is | (A) Ketoconazole decreases metabolism of terfenadine# Large amounts of Terfenadine reach systemic circulation if erythromycin, ketoconazole, clarithromycin are concurrently administered, as these drugs are P450 enzyme inhibitors.> Azithromycin, fluconazole have no effect & found to be safe. | 156,559 | medmcqa_train |
Where is the Cave of Retzius present? | Space of Retzius
- Horseshoe shaped space
- Between the anterolateral pelvic wall and the sides of bladder and prostate. | 156,560 | medmcqa_train |
Prolonged treatment with INH leads to deficiency of: | Ans. (A) Pyridoxine(Ref: Katzung 11th/e p825, KDT 8th/e p818)Isoniazid can cause peripheral neuropathy due to deficiency of pyridoxine. | 156,561 | medmcqa_train |
Klebsiella pneumonia is | Klebsiella pneumonia :
Air bronchogram sign positive.
Involves upper lobe.
Cavitations and pleural effusion is common. | 156,562 | medmcqa_train |
For calculation of incidence denominator is taken as - | ref: Park&;s 23rd edition pg 60 INCIDENCE= No. of new cases of specific disease during a given time period / population at risk during that period x 1000 | 156,563 | medmcqa_train |
Which is NOT an oncogenic virus- | Ans. is 'None' | 156,564 | medmcqa_train |
Most impoant in establishing diagnosis of leprosy is: March 2010 | Ans. C: Slit smear for AFB Tissue smear testing/slit-skin smears. An incision is made in the skin, and the scalpel blade is used to obtain fluid from a lesion. The fluid is placed on a glass slide and stained by using the Ziehl-Neelsen acid-fast method or the Fite method to look for organisms. The bacterial index (BI) is then determined as the number of organisms at 100X with oil immersion. Skin smears have high specificity but low sensitivity because 70% of all patients with leprosy have negative smear results. However, this test is useful because it detects the most infectious patients. Presence of AFB in suggestive skin lesions, even in the absence of sensory deficit, confirms the diagnosis of leprosy. Lepromin test is not of diagnostic impoance but is of prognostic impoance. | 156,565 | medmcqa_train |
The laser procedure, most often used for treating iris neovascularization is: | C i.e. Panretinal photocoagulation (PRP) | 156,566 | medmcqa_train |
Anterior compament of leg contains all except | ANTERIOR COMPAMENT:- Muscles:-1. Tibialis anterior 2. Extensor hallucis longus3. Extensor digitorum longus 4. Peroneus teius. Aery: anterior tibial aery. The blood supply of anterior compament is reinforced by the perforating branch of peroneal aery. Nerve:-Deep peroneal nerve. {Reference: BDC 6E vol2 pg 93} | 156,567 | medmcqa_train |
All of the following methods are antilarval measures except - | Antilarval measures of mosquito control are environmental control- source reduction and minor engineering measures like filling, levelling, intermittent irrigation. chemical control- mineral oils, Paris green, synthetic insecticides (Fenthion, Chlorpyrifos, and Abate). biological control -larvivorous fishes like Gambusia and Lebister are grown in burrow pits, ponds. Park's Textbook of Preventive and Social Medicine, 25th Edition, Pg 833 | 156,568 | medmcqa_train |
in case of unstable lie of fetus, the placenta is usually: | Unstable lie This is a condition where the presentation of the fetus is constantly changed beyond 36th week of pregnancy when it should have been stabiliseed The causes are those which prevent the presenting pa to remain fixed in the lower pole of the uterus that is grand multipara,hhydramnios,contracted pelvis,placenta prae,pelvic tumor At admission the investigation is directed to exclude placenta prae,contracted pelvis,or congenital malformation of the fetus with the help of sonography for the localisation of placenta D.C.DUTTA&;S TEXTBOOK OF OBSTETRICS,Pg no:397,7th edition | 156,569 | medmcqa_train |
Capsicum seed can be confused with ? | Ans. is 'b' i.e., Dhatura | 156,570 | medmcqa_train |
The ocular basement membrane is stained with | Not only ocular almost all basement membranes are stained with PAS (Periodic acid-Schiff) Because they have mucopolysaccharides.Periodic acid-Schiff reactive (PAS) method is principally used to demonstrate structures rich in polysaccharides (glycogen), mucopolysaccharides (e.g., ground substance of connective tissues, basement membrane, and mucus), glycoproteins (thyroglobulin), and glycolipids. | 156,571 | medmcqa_train |
Kyasanur Forest Disease (KFD) is transmitted by | KFD is a tick-borne viral hemorrhagic fever endemic to South AsiaThe disease is caused by a virus belonging to family Flaviviridae, which also includes yellow fever and dengue feverThe vector for KFD is Haemophysalis spinigera, a forest tickHumans contract infection from the bite of nymphs of the tickReservoir hosts are porcupines, rats, squirrels, mice and shrewsRef: Harrison's 18/e p1236, table 189-4 | 156,572 | medmcqa_train |
Hexosaminidase A deficiency causes: | Ans: b. Tay-Sachs disease [Refs Harper 30th/251; Lippincott 6th/212; Harrison 19th/432e,433eHexosaminidase A deficiency is an enzyme deficiency that causes brain and other nerve cells to die, which can lead to severe neurological and mental problems.Hexosaminidase A (HEX A) deficiency is caused by a deficiency in an enzyme called beta-hexosaminidase A. This enzyme helps break down a paicular fatty acid called GM2 ganglioside.Without adequate amounts of functional enzymes, GM2 ganglioside will build up in nerve cells and cause them to die.There are several forms of HEX A deficiency, including acute infantile (Tay-Sachs disease), juvenile, chronic, or adult-onset forms. | 156,573 | medmcqa_train |
Monge's disease refers to: | Answer is B (High Altitude Erythrocytosis) lionge's disease (Chronic :Mountain Sickness) is also known as High Altitude Pathologic Erythrocytosis. Chronic Mountain Sickness; Monge's disease; (High Altitude Pathologic Erythrocytosis; High Altitude Excessive Polycythem a) * Excessive Erythrocytosis (Hb>19 /dL for females and 21/dL for males) Chronic Mountain Sickness is a clinical * Hypoxemia syndrome that occurs in natives or long? * Pulmonary hypeension (in some cases) life residents above 2500m. Headache, * Right hea failure or Cor-Pulmonale (in severe cases) dizziness and fatigue are typical initial * Recovery on descent to low altitude presenting symptoms | 156,574 | medmcqa_train |
All are true of police inquest, except: | Police inquest is held by a police officer (Investigation Officer--IO) not below the rank of senior head constable in all cases of unnatural deaths with the exceptions mentioned under Magistrate inquest. Police inquest (174 CrPC) : Most common type of inquest. Minimum cadre of police for conducting inquest is station officer( senior Head Constable) Panchanama - enquiry repo Can summon | 156,575 | medmcqa_train |
Vidian Neurectomy is indicated in | Vasomotor rhinitis: increased parasympathetic discharge Vidian neurectomy is done. Ref : SRB&;s 4thE | 156,576 | medmcqa_train |
Precocious puberty in girls is defined by the onset of secondary sexual characteristic before the age of | Precocious puberty :
Onset of secondary sexual characteristic before the age of 8 years in girls and 9 years in boys. | 156,577 | medmcqa_train |
Trismus in CA of temporal bone occurs due to involvement of- | Ans. is 'b' i.e., Temporo mandibular joint Clinical Assessment of Temporal bone Tumorso A long history of ear discharge suggests cancer associated with inflammatory ear disease (Maijolins ulcer)o Pulsatile tinnitus suggests tumor of vascular origin such as glomus tumor or a middle ear vascular anamoly; or a duralarteriovenous abnormality.o Deep headache raises the suspicion of dural involvement.o Facial weakness indicates invasion of the facial nerveo Onset of vertigo and sensineuronal hearing loss indicates involvement of the labyrinth and the development of speech and swallowing problems heralds involvement of the lower cranial nerves in the jugular foramen.o The onset of trismus due to the involvement of temporomandibular joint, pterygoid muscles or mandible suggests advanced disease that has spread anteriorly. Also the appearance of perauricular and parotid swelling is a grave sign. | 156,578 | medmcqa_train |
Which is the wrong statement regarding hepatitis viruses? | Hepatitis A & E are non enveloped virus Hepatitis B is the only DNA virus Hepatitis B & D have a circular genome ref - davidsons medicine 23e pg872-875 | 156,579 | medmcqa_train |
The earliest morphological evidence of ovulation on endometrial biopsy is: | Endometrial biopsy was used in the past to find out whether the female has ovulated or not. Nowadays USG follicular monitoring is being done
Subnuclear basal vacuolation is characterized by glandular growth and presence of vacuoles due to secretion of glycogen between nuclei and basement membrane. It is due to the effect of progesterone.
Basal vacuolization is the earliest evidence of ovulation (36-48 hours after ovulation) and persists until the about 21st day of the cycle.
Pseudostratification of nuclei is characteristic of proliferation phase but persists until active progesterone secretion begins. Hence, it is noted until the 18th 19th day of the menstrual cycle. | 156,580 | medmcqa_train |
What is the test being done & what sign is it used to demonstrate? | Auspitz sign is characterized by:- a) Micaceous silvery white scales b) Burkley membrane c) Pin point bleeding This is seen in psoriasis & demonstrated by grattage test. Auspitz sign is presence of pinpoint bleeding at the base of a plaque after scale is forcibly removed in patients with psoriasis. The successive removal of psoriatic scales usually reveals an underlying smooth, glossy, red membrane (membrane of Burkley) with small bleeding points where the thin suprapapillary epithelium is turn off. The red membrane is known as Burkley's membrane. | 156,581 | medmcqa_train |
Transverse myelitis usually presents | Usual time of onset of symptoms of post-radiation transverse myelitis is 12-24 months but can occur as early as 6 months after radiation. | 156,582 | medmcqa_train |
Positive nitrogen balance is seen in- | Ans. is 'd' i.e., Recovery phase of protein deficiency Nitrogen Balance* Because nitrogen is excreted as proteins are recycled or used, we can use the nitrogen in body to evaluate whether the body is getting enough protein.* To estimate the balance of nitrogen, and therefore the protein in body, nitrogen intake is compared to the sum of all sources of nitrogen output.* Nitrogen Balance = Grams of Nitrogen intake - Grams of nitrogen output* If nitrogen intake equals nitrogen output the nitrogen balance is zero and the body is in nitrogen equilibrium.* If nitrogen intake exceeds nitrogen output the body is said to be in positive nitrogen balance. Positive nitrogen balance means that the body is adding protein; growing children, pregnant women, or people recovering from protein deficiency or illness should be in positive nitrogen balance.* If nitrogen output exceeds nitrogen intake the body is in negative nitrogen balance. This means that the body is losing proteins. People who are starving or who are in extreme weight loss diets, or who suffer from fever, severe illness, or infections are in a state of negative nitrogen balance. | 156,583 | medmcqa_train |
True regarding electrophoresis are all except | Electrophoresis depends on size as well as on shape
Electrophoresis is the process that uses an electric field to drive the movement of charged particles. Electrophoresis depends on the net charge of the particle, molecular weight, pH of the medium, the strength of the electric field and temperature.
About other options
Ampholyte is used in isoelectric focusing to create a pH gradient across the supporting media. Molecules stop migrating as soon as they reach their respective isoelectric point (pI).
Electrophoresis can adversely affect the structure and function of proteins.
Electrophoresis is the most common method for protein separation.
"Electrophoresis is the most common method of protein separation in the clinical laboratory".
"PAGE and SDS-PAGE are extensively used for characterization and purification of tissue proteins, enzyme, receptors, and surface antigens".
Electrophoresis uses an electric field | 156,584 | medmcqa_train |
Asthenospermia means: | Ans: A (Immotile sperms) Ref: Harrison's 18th edn.Explanation:Azoospermia - Absence of sperm in the ejaculate.Aspermia - Zero volume ejaculate.Oligospermia - Low numbers of sperm.Asthenospermia - Poor sperm motility.Teratospermia - Abnormal morphology (shape) of sperm. | 156,585 | medmcqa_train |
Which of the following increases BMR? | Factors that influence basal metabolic rate are: Body size: Metabolic rate increases as weight, height, and surface area increase. Body composition: Fat tissue has a lower metabolic activity than muscle tissue. As lean muscle mass increases, metabolic rate increases. Gender: The basal metabolic rate (BMR) averages 5 to 10 percent lower in women than in men. This is largely because women generally possess more body fat and less muscle mass than men of similar size. Age: A decrease in lean muscle mass during adulthood results in a slow, steady decline of roughly 0 3 percent per year in BMR after the age of about 30. This can be largely avoided by strength training throughout adulthood. Climate and body temperature: The BMR of people in tropical climates is generally 5 to 20 percent higher than their counterpas living in more temperate areas because it takes energy to keep the body cool. Exercise performed in hot weather also imposes an additional metabolic load. Body fat content and effectiveness of clothing determine the magnitude of increase in energy metabolism in cold environments; it takes energy to keep the body warm if you work or exercise in very cold weather. Hormonal levels: Thyroxine (T4), the key hormone released by the thyroid glands has a significant effect upon metabolic rate. Hypothyroidism is relatively common, especially in women near or after menopause. Everyone with a weight problem should have their thyroid function checked by their doctor and treated appropriately if it turns out to be low. Health: Fever, illness, or injury may increase resting metabolic rate two-fold Ref: guyton and hall textbook of medical physiology 12 edition page number:564,565,566 | 156,586 | medmcqa_train |
Gold standard investigation for screening of breast carcinoma in patients with breast implant | MRI Indicated in scarred breast, implants and borderline lesions for breast conservation Investigation of choice for implant related complications Gold standard for imaging breast in females with implants Ref: Sabiston 20th edition pgno: 826-828 | 156,587 | medmcqa_train |
Which of the following drug can produce Dramatic improvement in patients with type 2 Lepra reaction | Refer KDT 6/e Pg 756 Steroids are drug of choice for both type 1 as well as type 2 Lepra reaction Thalidomide us used in steroid resistant type 2 Lepra reaction | 156,588 | medmcqa_train |
Which of the following colonic polyps has no risk far malignancy | .Juvenile Polyps * Commonest polyp of colorectum in infants and children. * Can cause intussusception, prolapse through rectum, bleeding.* Colonoscopic polypectomy is done. * Not a pre-malignant condition. PEUTZ-JEGHER'S POLYP is common in small intestine (jejunum) * Features are multiple, familial, hamaomatous intestinal polyps. * Asssociated with melaenosis of the oral mucosa, lips (lower lip) and occasionally digits (not in tongue). * Microscopically it contains tree like branching filaments of mucosa with smooth muscle wall. * It can occasionally turn into malignancy FAMILIAL ADENOMATOUS POLYP (FAP) * It is inherited as an autosomal dominant neoplastic condition (chromosome no. 5 * It is familial with a high potential for malignant transformation. ref:SRB&;s manual of surgery,ed 3,pg no 834 | 156,589 | medmcqa_train |
Aldosterone is known to cause sodium retention. Its Na+ retaining action is exeed on which pa of the nephron? | * Aldosterone is the principal mineralocoicoid. It stimulates the reabsorption of Na+ and excretion of K+ and H+ by its action on late distal tubules and collecting ducts. | 156,590 | medmcqa_train |
A woman of 45, a known cause of pemphigus vulgaris on a regular treatment with controlled primary disease presented with pain in the right hip and knee. Examination revealed no limb length discrepancy but the patient has tenderness in the scarpa's triangle and limitation of abduction and internal rotation of the right hip joints as compared to the other side. The most probable diagnosis is - | This patient has
Pemphigus vulgaris taking treatment (steroid is the DOC).
Pain in hip and knee (Pain of hip can refer to hip).
Limitation of abduction & internal rotation.
Diagnosis is AVN of hip. | 156,591 | medmcqa_train |
Monro-Kellie doctrine is related to injury of | An increase in volume of any one of rhe three components brain,blood, CSF must be at the expense of other two Brain is least compressible among the three Ref:Guyton and Hall textbook of medical physiology 12th edition,page number:813,814,815 | 156,592 | medmcqa_train |
Diversion of urinary bladder is best done at : | Ileal segment is the best for urinary diversion after cystectomy. Still better method is "Continent cutaneous diversion" method. But the best method is "Orthotopic neobladders".
"Incontinent cutaneous urinary diversion" by ileal conduit: a segment of ileum is exteriorized in the form of a stoma through the abdominal wall, around which an appliance is secured and into which urine continuously drains.
"Continent cutaneous diversions" — All continent cutaneous reservoirs rely upon a low-pressure pouch constructed of various detubularized bowel segments and a functional mechanism that connects the reservoir to the skin, designed to prevent involuntary urine flow. The most obvious advantages of this type of diversion are the ability to avoid continuous urine drainage and the need for an external appliance.
These continent cutaneous diversions require intermittent clean self-catheterization through the stoma both to empty the reservoir and to irrigate mucous. No stomal appliance is usually required.
Although continent cutaneous diversions have been largely supplanted by the orthotopic neobladder, this procedure is used when the urethra or bladder neck is non-functional or involved by tumor, and avoidance of an external appliance is desired.
"Orthotropic neobladders"— Orthotropic neobladders are internal reservoirs that are connected to the native urethra and rely upon the external striated sphincter for continence. These reservoirs are constructed from a segment of detubularized intestine (usually ileum) anastomosed to the native urinary outflow tract.
Because this approach facilitates the restoration of normal self-image by approximating normal voiding, construction of an orthotropic neobladder has become the procedure of choice for most patients following cystectomy for bladder cancer in both men and women.
It is contraindicated if the urethra is nonfunctional or involved with tumor. | 156,593 | medmcqa_train |
An 18-year-old woman presents with abdominal pain localized to the right lower quadrant, nausea and vomiting, mild fever, and an elevation of the peripheral leukocyte count to 17,000/uL. Examination of the surgically resected appendix is most likely to reveal | Acute appendicitis, a disease found predominantly in adolescents and young adults, is characterized histologically by acute inflammatory cells (neutrophils) within the mucosa and muscular wall. Clinically, acute appendicitis causes right lower quadrant pain, nausea, vomiting, a mild fever, and a leukocytosis in the peripheral blood. These symptoms may not occur in the very young or the elderly. The inflamed appendiceal wall may become gangrenous and perforate in 24 to 48 h. Even with classic symptoms, the appendix may be histologically unremarkable in up to 20% of the cases. False-positive diagnoses are to be preferred to the possible severe or fatal complications of a false-negative diagnosis of acute appendicitis that results in rupture. Lymphoid hyperplasia with multinucleated giant cells (Wahin-Finkeldey giant cells) is characteristic of measles (rubeola). These changes can be found in the appendix, but this is quite rare. Dilation of the lumen of the appendix, called a mucocele, may be caused by mucosal hyperplasia, a benign cystadenoma, or a malignant mucinous cystadenocarcinoma. If the latter tumor ruptures, it may seed the entire peritoneal cavity, causing the condition called pseudomyxoma peritonei. The most common tumor of the appendix is the carcinoid tumor. Grossly it is yellow in color and is typically located at the tip of the appendix. Histologically, carcinoids are composed of nests or islands of monotonous cells. Appendiceal carcinoids rarely metastasize Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition | 156,594 | medmcqa_train |
A 40 year old woman is being evaluated. She is noted to have a decreased latency of REM. Which disorder is this woman most likely to be suffering from? | Ans. B. Major depressionA decreased latency of REM sleep is seen in major depression. Depression is the psychiatric disorder that has been most associated with disruptions in biological rhythms. Besides the decreased latency of REM sleep, one can find early morning awakening and other neuroendocrine perturbations. | 156,595 | medmcqa_train |
Reactivation tuberculosis and primary squamous cell carcinoma of the lung are similar in that they both are commonly associated with: | Both reactivation tuberculosis (TB) and primary squamous-cell carcinoma of the lung are associated with cavitation. Other pulmonary diseases associated with cavitation include systemic fungal infections, Klebsiella pneumonias, and silicosis. In silicosis, the large fibrotic nodules undergo central necrosis from ischemia. Furthermore, silicosis predisposes patients to the development of TB within the fibrotic nodules, thus producing cavitation.
Ectopic secretion of a parathormone-like peptide producing hypercalcemia is seen only in squamous cell carcinoma. Scar carcinomas are a possible sequela of old scar tissue in TB. Adenocarcinomas are more frequently associated with scar carcinomas than squamous carcinoma. The most common extrapulmonary site for TB is the kidneys, and the adrenal gland is the most common site for metastatic squamous cancer. Silicosis predisposes patients to TB, but not to primary lung cancer. | 156,596 | medmcqa_train |
Giant hypertrophy of gastric mucosa similar to brain surface is seen in - | Menetrier disease
It is characterized by giant cerebriform (similar to brain surface) enlargement of rugal folds of gastric mucosa.
Enlargement of rugal folds is due to profound hyperplasia of surface mucous cells → gastric secretion & contain excessive mucus.
There is accompanying glandular atrophy → gastric disease is more common in males in the fourth to sixth decades.
The hypertrophic change may predominanty involve the body, fundus or antrum or may affect the entire stomach.
Patients develop protein-losing gastropathy accompanied hypoalbuminemia and edema.
Infrequently, the mucosal hyperplasia becomes metaplastic, providing a soil for the development of gastric carcinoma. | 156,597 | medmcqa_train |
In PCOD which of the following drug is not used for infertility | Clomiphene citrate:
Used for induction of ovulation; can be 50 mg/day increased to 150mg/day; Starting from day 2 to day 6 of the cycle for 5 days
Tamoxifen 10 mg daily for 6 months has been effective in treating male infertility
Testosterone 25 -50 mg daily orally improves testicular functions
Spironolactone is an antiandrogen; used for treating Hirsutism | 156,598 | medmcqa_train |
Major form of folic acid to transfer one carbon is - | Ans. is 'a' i.e.. Methylene THFFolic acido The active form of folic acid (pteroyl glutamate) is tetrahydrofolate (THF).o THF serves as a carrier of one-carbon (C1) unitQ during several biosynthetic reactions like nucleic acidQ and amino acid metabolism.o Two other cofactors are also known to be involved in the addition of one carbon (C1) unit to a metabolic precursor, biotin in carboxylation reaction and S-adenosylmethionine (SAM) as methylating agent.o However, folic acid is more versatile than either of these two because it can transfer the C1 units in several oxidation states.o THF acts as a carrier of one carbon unitQ.o The one carbon units can be : Methyl (CH3) methylene (CH2), methenyl (CH),formyl (CHO), or formimino (CH =NH)o One carbon unit binds to THF through A5 or N10 or both A5, N10position.o For example, if formyl unit is attached to N-5, it is called N5-formyl THF; if methylene unit is attached to both N5 and Nro, it is called N5, N10 methylene THF.o Carbon units attached to N5 are formyl, formimino, or methyl; attached to N10 is formyl; and attached to both N5-N10 are methylene or methenyl.o So, various possible THF are : - N5-Formyl THF, N5-formimino THF, N5-methyl THF, Nl0-formyl THF, N5-Nl0-methylene THF and N5-N10-methenyl THF.o THF receives the C, units from various donor molecules during catabolic reactions and can transfers them tospecific acceptors for the synthesis of various compounds.o The major point of entry for one-carbon unit into substituted folates is methylene THF, which is formed by the reaction of glycine, serine and choline. Serine is the most important source ofsubstitutedfolates for biosynthetic reactions, and activity' of serine hydroxymethyltransferase is regulated by the state offolate substitution and availability of folate | 156,599 | medmcqa_train |
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