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Spinal epidural space contains | Epidural space This is the interval which seperates the periosteum in the veebral canal from the spinal duramater.The space is filled with loose areolar tissue,semiliquid fat,a network of veins,and the small aeries which supply the structures in the veebral canal. REF.CUNNINGHAM'S MANUAL OF PRACTICAL ANATOMY,Vol.3,PG.193 | 156,600 | medmcqa_train |
Brachytherapy is the internal radiation therapy procedure for treating tumors. All are used in brachytherapy, EXCEPT: | Clinically used isotopes in brachytherapy include iridium 192 (192 Ir), iodine 125 (125 I), cobalt 60 (60 Co), cesium 137 (137 Cs), gold 198 (198 Au), and palladium 103 (103 Pd). Iodine 131 is not used in brachytherapy. Ref: Nuclear Development Beneficial Uses and Production of Isotopes 2004 Update ... By OECD, Nuclear Energy Agency, 2005, Page 23; Brachytherapy: Applications and Techniques By Phillip M. Devlin, M.D., 2007, Page 52. | 156,601 | medmcqa_train |
Which one of the following is not a feature of liver histology in non-cirrhotic poal fibrosis (NCPF)? | Ans. is 'd' i.e., Bridging fibrosis | 156,602 | medmcqa_train |
Derelation & depersonalisation seen in which type of disorder ? | Ans. A. Dissociative disorder | 156,603 | medmcqa_train |
Nerve involved in Arcade of Frohse ? | Ans. is 'c' i.e., PIN | 156,604 | medmcqa_train |
The primary respiratory regulatory centre is located at | The respiratory centers are located in the medulla oblongata and pons, which are pas of the brainstem. The respiratory centers are divided into four major groups, two groups in the medulla and two in the pons. The two groups in the medulla are the dorsal respiratory group and the ventral respiratory group. The two groups in the pons are the pneumotaxic center also known as the pontine respiratory group, and the apneustic center. The Inspiratory center (Dorsal respiratory group) -Location: Dorsal poion of medulla -Nucleus: Nucleus tractus solitarius. Ref: guyton and hall textbook of medical physiology 12 edition page number:370,371,372 | 156,605 | medmcqa_train |
In cases of burn, which is the fluid of choice in first 24 hours? | Ans is 'a' i.e. Ringer lactate | 156,606 | medmcqa_train |
A surgeon was doing a laparoscopic hernia surgery and he visualised the triangle of doom. Which of the following is not the boundary of the same | The preperitoneal anatomy seen in laparoscopic hernia repair led to characterization of impoant anatomic areas of interest, known as the triangle of doom, the triangle of pain, and the circle of death. The triangle of doom is bordered medially by the vas deferens and laterally by the vessels of the spermatic cord. The contents of the space include the external iliac vessels, deep circumflex iliac vein, femoral nerve, and genital branch of the genitofemoral nerve Ref: Schwaz's principle of surgery 10th edition Pgno: 1499 | 156,607 | medmcqa_train |
Which of the following are histopathological features of Extra hepatic Biliary Atresia - | (c) Marked Bile duct proliferation | 156,608 | medmcqa_train |
Drug emerging as the agent of choice for initial treatment of tourette syndrome - | Ans. is 'd' i.e., ClonidineTounette syndromeo Mild and non disbling-Education and counselling without pharmacological tic suppression therapyo With bothersome Tics-Tetrabenzineo Only focal or vocal motor Tics-Botulinum toxin injection into the affected muscleso With ADHD-Guanafacine or clonidine | 156,609 | medmcqa_train |
What is NOT a feature of Sturge Weber syndrome : | Answer is D (Empty sella): The clinical hallmark in the form of convulsions, Rail road tract appearance on X-ray and unilateral coical atrophy (hemiatrophy) on CT scan are diagnosis of Sturge-Weber syndrome. Sturge weber syndrome It results from the anomalous development of primordial vascular bed during early stages of cerebral vascularization. The leptomeninges are richly vascularized and the brain beneath becomes atrophied and calcified, paicularly in molecular layer of coex | 156,610 | medmcqa_train |
Dark field microscopy used in ? | Ans. is 'b' i.e., Syphilis Dark field microscopy is used for spirochetes (for example T pallidum which causes syphilis). Dark ground/ Dark field microscope Very slender organisms such as spirochetes and filamentous organs such as flagella are not visible under ordinary illumination. The contrast in dark field microscopy gives an illusion of increased resolution so that these structures can be seen under the dark field mcroscope. In dark field microscopy reflected light is used instead of the transmitted light used in the ordinary microscope. | 156,611 | medmcqa_train |
Eustachian tube opens in middle ear in- | 70. Ans: b. Anterior wall
(Refer: PL Dhingra, Diseases of Ear, Nose & Throat, 7th edition, pg no. 61)
Eustachian tube
Cylindrical channel connecting tympanic cavity & nasopharynx called Pharyngotympanic tube
Opens in the anterior wall of middle ear
Epithelium – Ciliated columnar epithelium
Length – 36 mm (Lateral 1/3 bony & Medial 2/3 fibrocartilaginous)
Position – Placed at angle of 45 ͦ with sagittal plane
Muscles of ET – Tensor palati supplied by branch of mandibular nerve & Levator palate supplied by pharyngeal plexus of 11th nerve
Neurovascular supply
Arterial supply
Venous drainage
Nerve supply
Ascending pharyngeal artery
Middle meningeal artery
Artery of pterygoid canal
Pterygoid venous plexus
Tympanic plexus | 156,612 | medmcqa_train |
Erythema chronicum migrans is seen in ? | 'a' i.e. Lyme's disease | 156,613 | medmcqa_train |
Sympathetic stimulation has following effect on insulin release | Sympathetic stimulation decreases the release of insulin Ref: guyton and hall textbook of medical physiology 12 edition page number:610,611,612 | 156,614 | medmcqa_train |
In a child admitted with H. Influenza meningitis, Cefotaxime was staed instead of ampicillin. Which of these is the likely reason for this? | Ans. (a) H. influenzae stains known to produce Beta lactamase Approximately 20-35% of nontypable strains of hemophilus produce 13-lactamase. In addition to 0-lactamase alteration of penicillin binding proteins is a second mechanism of ampicillin resistance has been detected in isolates of H. influenzae. | 156,615 | medmcqa_train |
With respect to ticlopidine, clopidogrei: | (Ref: KDT 6/e p610) Ticlopidine and clopidogrel are ADP antagonists and are used as antiplatelet drugs. Antiplatelet action, chances of bleeding and formation of antibodies is similar with these two agents. Clopidogrel is better tolerated because it is less likely to cause severe neutropenia and thrombocy topenia as compared to ticlopidine. | 156,616 | medmcqa_train |
Floor of Petit triangle is formed by- | Ans. is 'b' i.e., Internal oblique The lumbar triangle (Petit's triangle) is a weak area in the posterior part of the abdominal wall. It is bounded anteriorly by the posterior margin of the external oblique muscle, posteriorly by the anterior border of the latissimus dorsi muscle, and inferiorly by the iliac crest. The floor of the triangle is formed by the internal oblique and the transversus abdominis muscles. | 156,617 | medmcqa_train |
Glucose transpoer in myocyte? | D i.e. GLUT 4 | 156,618 | medmcqa_train |
Time taken for conversion of CIN cervix to invasive carcinoma is - years : | 10 | 156,619 | medmcqa_train |
What is Nitroblue tetrazolium test used for? | . Phagocytosis | 156,620 | medmcqa_train |
Which of the coagulation factor is least affected in a patient with vitamin K deficiency? | Factor VIII Patient with vitamin K deficiency will have mostly involvement of dependent clotting factors. I.e. Factors II, VII, IX & X | 156,621 | medmcqa_train |
All are true about sphincter urethrae except | The urethral sphincter is two muscles used to control the exit of urine in the urinary bladder through the urethra. Two muscles either the female or male, external urethral sphincter and internal urethral sphincter. ref - BDC vol2 pg376,380 | 156,622 | medmcqa_train |
The following is a characteristic symptom of chronic pelvic inflammatory disease : | Backache | 156,623 | medmcqa_train |
Onion skin thickening of aeriolar wall is seen in | Hyperplastic aeriolosclerosis is more typical of severe hypeension. Vessel exhibit onion skin , concentric laminated thickening of aeriolar walls and luminal narrowing Robbins 9 th edition page no. 334 | 156,624 | medmcqa_train |
A young lady presented with bilateral nodular lesions on shins. She was also found to have bilateral hilar lymphadenopathy on chest X-ray. Mantoux test reveals indurations of 5 mms. Skin biopsy would reveal: | Ans. is 'a' Non caseating granulomas Skin lesions in this patient in Erythema nodosum.Erythema nodosum, bilateral hilar lymphadenopathy negative Mantoux test in strongly suggestive of sarcoidosis.Skin biopsy {or biopsy from hilar nodes, conjunctiva, lip, or spleen, intraabdominal nodes) would reveal non- caseating granulomas. | 156,625 | medmcqa_train |
Catecholamines are synthesized from ? | Ans. is 'b' i.e., Tyrosine Catecholamines (epinephrine, norepinephrine and dopamine) are synthesized from tyrosin. Has been explained in previous seesions. | 156,626 | medmcqa_train |
Not a selective serotonin reuptake inhibitor: | Buspirone | 156,627 | medmcqa_train |
Lipotropic factor are all except | Arginine
Lipotropic factors are substances which prevent the accumulation of fat (TGs) in the liver.
Primary lipotropic factors → choline, betaine, methionine, lecithin, inositol.
Other factors with some lipotropic action:- Vitamin-B12, folic acid, casein, glycine, essential fatty acids, selenium, vitamin E and serine. | 156,628 | medmcqa_train |
Bony nasal septal perforation is seen in? | Ans. (b) SyphilisRef: Dhingra 5thed p.166 | 156,629 | medmcqa_train |
Which chromosomal anomaly associated with alzheimer's dementia? | Several genes play impoant pathogenic roles in at least some patients with Alzheimer's disease(AD). One is the APP gene on chromosome 21. Adults with trisomy 21 (Down syndrome) consistently develop the typical neuropathologic hallmarks of AD if they survive beyond age 40. Presenilin-1 (PS-1) is on chromosome 14 and encodes a protein called S182. Mutations in this gene cause an early-onset AD transmitted in an autosomal dominant, highly penetrant fashion. The Apo E gene on chromosome 19 is involved in the pathogenesis of late-onset familial and sporadic forms of AD. AD most often presents with an insidious onset of memory loss followed by a slowly progressive dementia over several years. Pathologically, atrophy is distributed throughout the medial temporal lobes, lateral and medial parietal lobes and lateral frontal coex. Microscopically, there are neuritic plaques containing A-beta, neurofibrillary tangles (NFTs) composed of hyperphosphorylated tau filaments, and accumulation of amyloid in blood vessel walls in coex and leptomeninges. Clinical Manifestation begins with memory impairment and spreading to language and visuospatial deficits.The management of AD is challenging and gratifying, despite the absence of a cure or a robust pharmacologic treatment. Donepezil (target dose, 10 mg daily), rivastigmine (target dose, 6 mg twice daily or 9.5-mg patch daily), galantamine (target dose 24 mg daily, extended-release), memantine (target dose, 10 mg twice daily), and tacrine are the drugs presently approved by the Food and Drug Administration (FDA) for treatment of AD.Ref:Harrison's Internal Medicine, 18th Edition, Pages 3307, 3309, 3049 | 156,630 | medmcqa_train |
The usual voltage of alpha rhythm is | Alpha waves are neural oscillations in the frequency range of 8-12 Hz arising from the synchronous and coherent (in phase or constructive) electrical activity of thalamic pacemaker cells in humans. Ref: guyton and hall textbook of medical physiology 12 edition page number: 818,819,820 | 156,631 | medmcqa_train |
Commonly injured in blunt abdominal injury is/are - | Answer is 'b' i.e. Prox.Jejunum Small bowel is frequently injured after a penetrating injury After blunt trauma small bowel injury can be seen in 5-20% of patients who required laprotomy. Mechanism of injury of small bowel by blunt trauma Small bowel is injured by 3 postulated mechanisms 1) crushing of the bowel between the veebral bodies and the blunt object, such as steering wheel or handle bar. 2) deceleration shearing of the small bowel at points where it is fixed such as ligament of Treitz (duodenojejunal jn), the ileocecal junction and around the mesentric aery. 3) closed loop rupture caused by sudden increase in intra-abdominal pressure. | 156,632 | medmcqa_train |
For a population of 10000, sex ratio of more than 1000 means | In the given question
Total population is 10,000.
Also, Ideal sex ratio implies 5000 females for 5000 males
So, Sex ratio is more than 1000, it implies, Females are more than 1000 per 1000 males
Thus, females are > 5000 and males are < 5000 | 156,633 | medmcqa_train |
Which of the following is not true regarding Wolff-Parkinson-White (WPW) syndrome? | Wolff-Parkinson-White (WPW) syndrome Bundle of Kent is an aberrant anomalous path that connects SA node directly to the ventricles, bypassing the AV node. It is found in Wolff-Parkinson-White (WPW) syndrome There is no AV nodal delay. Hence, ventricular contraction stas very early, before its filling has occurs substantially. This will reduce the stroke volume In the absence of AV nodal delay, there is shoened PR interval on ECG. d ("delta") wave is seen on ECG; it results from the shoened PR interval. | 156,634 | medmcqa_train |
Which of the following chemotherapeutic agents is specific for the M phase of the cell cycle? | Vincristine (and vinblastine) are Vinca alkaloids that bind to tubulin, a component of cellular microtubules. This leads to disruption of the mitotic spindle apparatus and results in metaphase arrest since the chromosomes are unable to segregate. Since these drugs interfere with mitosis, they are considered cell-cycle specific for the M phase. Cytarabine belongs to the class of antineoplastics that are antimetabolites. This drug class interferes with normal metabolic pathways by competing for enzymatic sites. Specifically, cytarabine (Ara-C) is a pyrimidine nucleoside analog. It interrupts DNA synthesis and function by inhibiting DNA polymerase and incorporating into the DNA or RNA of the cell. As you would expect, this drug is cell-cycle specific for the S phase. Daunorubicin is one of the antibiotic antineoplastic agents (others include dactinomycin, doxorubicin, bleomycin, plicamycin, and mitomycin). These agents work by disrupting DNA functioning. Daunorubicin binds to DNA between base pairs on adjacent strands, resulting in uncoiling of the helix and destruction of the DNA template. While this drug has its maximum effect during the S phase, it is not cell-cycle specific. (Note: the only antibiotic that is cell-cycle specific is bleomycin.) Hydroxyurea works by interfering with ribonucleoside diphosphate reductase, the enzyme responsible for generating the deoxyribonucleotides needed for DNA synthesis. It is S-phase specific. Ref: Chu E., Saorelli A.C. (2012). Chapter 54. Cancer Chemotherapy. In B.G. Katzung, S.B. Masters, A.J. Trevor (Eds), Basic & Clinical Pharmacology, 12e. | 156,635 | medmcqa_train |
Mouth breathing is an example of | Non pressure habits are habits, which do not apply a direct force on the teeth or its supporting structure. Mouth breathing is an example of non pressure habit. | 156,636 | medmcqa_train |
Boys over 16 years who are too difficult to be handled in a certified school or have misbehaved there are sent to a : - | Borstals: Boys over 16 years who are too difficult to be handled in a certified school or have misbehaved there, are sent to a Borstal. Borstal, as an institution, falls between a certified school and an adult prison.
A borstal sentence is usually for 3 years, and is regarded as a method of training and reformation. | 156,637 | medmcqa_train |
a child wins the first prize in school, he is given choclates that he likes, he tend to get high marks in future, this is what line of terapy | Behavioral therapy is learning given by BF Skinner , according to him all behaviors are learned phenomenon and thus can be unlearned Positive reinforcement a type of reinforcement when a behavior is rewarded there is more chance that the behavior is repeated Negative reinforcement is that when a behavior is done and an aversive response is removed, the behavior is repeated. When I go and meet my girlfriend, she checks my messages and picks up fight (aversive response) suddenly I delete all messages one day and that day there was no fight (no aversive response) then that behavior is repeated (delete all messages before meeting my girlfriend) Extinction is the type of reinforcement where a behavior is done and a rewarding response is removed the chance is that behavior will not be repeated A child likes to play with children( reward) but when the child fights with other children( undesirable behavior) the child will be removed from playing( removing a reward) , then the child stops fighting with other children( reduction of undesirable behaviour) Ref. kaplon and sadock synopsis, 11 th edition, pg no. 845 | 156,638 | medmcqa_train |
The serum concentration of which of the following human IgG subclasses is maximum? | IgG is the major class of immunoglobulin present in the serum. The IgG molecule consists of two L chains and two H chains (H2L2). There are four subclasses of IgG: IgG1, IgG2, IgG3, and IgG4. Each subtype contains a distinct but related H chain and each differs somewhat regarding their biological activities. IgG1 represents 65% of the total IgG.IgG2- 23%, IgG3 -8% and IgG4 - 4%Reference: Jawetz, Melnick, & Adelberg's Medical Microbiology; 27th edition; Chapter 8; Immunology | 156,639 | medmcqa_train |
Bucky diaphragm? | Potter Bucky grid is a type of moving grid. These devices reduce the amount of scattered radiation reaching the film while still allowing the patterns containing the primary beams to reach the film.
The image of radiolucent grid lines on the film can be deleted by moving the grid perpendicular to the direction of grid lines, this has the effect of blurring out the radiolucent line and allowing a more uniform exposure. This movement doesn't interfere with absorption of scattered photons. | 156,640 | medmcqa_train |
Spinocerebellum is involved in: | Vestibulocerebellum (flocculonodular lobe) concerned with equilibrium (postural balance) and eye movements. Spinocerebellum is responsible for smoothening and coordination of movements. Cerebrocerebellum has role in planning and programming of movements. Initiation of skilled voluntary movements: Coical association area. | 156,641 | medmcqa_train |
Total T3 T4 and TSH all decrease in | (B) Hypopituitarism | 156,642 | medmcqa_train |
Marked dermatome is | Dermatome supply of the marked area is S2 | 156,643 | medmcqa_train |
Which of the following is commonest source of Extradural haemorrhage: | Ans is 'a' ie Middle meningeal artery (Ref. Chandrasoma Taylor, 3/e, p 924)"Extradural Haemorrhage is an accumulation of blood between the skull and the dura. In 90% of cases, bleeding is from a branch of the middle meningeal artery". ChandrasomaAlso remember *Subdural Haemorrhage, commonest source is - communicating veins b/w the cerebral cortex and superior sagittal sinus.Intracerebral Haemorrhage, commonest source is - lenticulostriate arteries in the region around the basal ganglia* and internal capsule. It is frequently d/t rupture of Charcot-Bouchard aneurysms in the lenticulostriate arteries.Subarachnoid Haemorrhage - MC cause is rupture of Berry aneurysms. | 156,644 | medmcqa_train |
Characteristic of Bacillus cereus food poisoning is | Bacillus cereus is an impoant cause of food poisoning. Two patterns: diarrheal and emetic. Diarrheal: associated with cooked meat and vegetables. Diarrhea and abdominal pain 8-16 hours after the ingestion of contaminated food. Vomiting rarely. Bacilli are not found in the fecal specimen of these patients. Emetic: associated with consumption of cooked rice, usually fried rice from restaurants. Nausea and vomiting 1-5 hours after the meal. Bacilli present in large numbers in cooked rice and fecal samples from these patients. Reference: Textbook of Microbiology; Anathanarayan and paniker's; 10th edition; Page no: 253 | 156,645 | medmcqa_train |
Which of the following is typical hanging | Refer the byte "Hanging and strangulation". | 156,646 | medmcqa_train |
In terms of bih defect potential, the safest of the following drugs is | Alcohol sequelae include retardation of intrauterine growth, craniofacial abnormalities, and mental retardation. Isotretinoin, a drug for acne, is asoociated with congenital anomalies like Microtia, Micrognathia, cleft palate, thymic aplasia, CVS anomalies, NTDs Tetracyclines interfere with development of bone and can lead to stained teeth in children. Regarding progesterones use in pregnancy, controlled studies have failed to demonstrate a significant association with increased risk. | 156,647 | medmcqa_train |
A toddler has few drops of blood coining out of rectum. Probable diagnosis is:(AIIMS May 2013, May 2012) | Ans. a. Juvenile rectal polyp (Ref: Sabiston 19/e p1342; Schwartz 9/e p1043: Bailey 25/e p1228; Schackelford 7/e p2030; Harrison 19/e p537, 18/e p313, 352; 17/e p250)Most common cause of passage of few drops of blood per rectum in a toddler is Juvenile rectal polyp.Juvenile polypsJuvenile polyps are the MC type of colorectal hamartomasQOccur most commonly in children <5 years of ageQ.Up to 80% of juvenile polyps occur as a single lesion of the rectumQTypical symptoms are rectal bleeding, mucus discharge, diarrhea, and abdominal painQ.Also called retention polyps due to the inflammatory obstruction of the crypt necks that leads to cystic dilation of the mucus-filled glands.No increased risk of cancerQ | 156,648 | medmcqa_train |
According to Gutman's classification periapical surgery includes all except: | GOT MAN’S CLASSIFICATION
1. Fistulative surgery
I & D
Cortical Trephination
Decompression Pracedure
2. ieri Apical Surgery
Periapical curellage
Root end Resection
Root end Preparation
Root end Filling
3. Corrective Surgery
Performation Repairs
Pathological Performance Repair
Iatrogenic Performance Repair
Root Reseation
Radisection/ He
Hemi section – Bicuspidization
Intertional Replaniation. | 156,649 | medmcqa_train |
A 12 year old girl complains of pain persisting in his leg for several weeks with a low grade fever. A radiograph reveals a mass in the diaphyseal region of the left femur with overlying cortical erosion and soft tissue extension. A biopsy of the lesion shows numerous small round cells, rich in PAS positive diastase sensitive granules. The most likely histological diagnosis is : | Ans. is 'c' i.e. Ewing's Sarcoma Small round cells rich in PAS positive diastase sensitive granules confirms the diagnosis of Ewing's sarcoma.The histopathological features of Ewing's sarcoma are:Small round cells having scant cytoplasmThese cells are rich in glycogen* this glycogen filled cytoplasm is detected by staining with periodic acid - shiff (PAS +ve)These cells are diastase sensitive. Diastase is an enzyme which splits glycogen.Homer wright rosettes* (the tumor cells are arranged in circles around a central fibrillary space)Remember: The other round cell tumours of boneOsteosarcomaReticulum cell sarcomaMetastatic neuroblastomaAlso RememberGross pathological features of Ewing's sarcoma:The tumour arises in the medullary cavity from the endothelial cells.New bone formation may extend along the shaft and sometimes it appears as fusiform layers of bone around the lesion, (onion peel effect)*The tumour erodes the cortex early often extending into the soft tissues with radiating streaks of ossification and reactive periosteal bone at the proximal and distal margins, (these features the 'sunray appearance' and codman's triangle are usually associated with osteosarcoma but they are just as common in Ewing's sarcoma)Clinical features of Ewing's sarcomaIt occurs most commonly between the age of 10-20 years especially in the tibia, fibula or clavicle.The patient presents with pain and swelling often arising in the diaphysis Sometimes fever is also associated with it confusing it with osteomyelitis | 156,650 | medmcqa_train |
Spores of bacteria are destroyed by | Ans. is 'c' i.e., Halogen Amongst the given options, only halogens have sporicidal propey | 156,651 | medmcqa_train |
Congenital rubella syndrome (CRS) is associated with all of the following EXCEPT? | Cherry Red spot- not seen in congenital rubella syndrome. Congenital rubella syndrome (CRS) includes:-> Gregg's triad: Cataract Deafness (Sensorineural hearing loss) Congenital hea disease (Most common- PDA and less common-ASD) Rubella (German measles or 3-Day Measles) Mild , exanthematous disease Incubation period: 14-21 days Prodrome of low- grade fever, sore throat , red eyes, headache and lymphadenopathy Rash begins on face and neck and spread centrifugally Forchheimer spots on soft palate may be present | 156,652 | medmcqa_train |
All are true about breastfeeding Except | All mothers should be suppoed to initiate breastfeeding as soon as possible after bih, within the first hour after delivery.Provision of mother's breast milk to infants within one hour of bih is referred to as "early initiation of breastfeeding" and ensures that the infant receives the colostrum, or "first milk", which is rich in protective factors. | 156,653 | medmcqa_train |
Delayed labour occurs in:a) Early use of epidural anesthesia with analgesiab) Early use of analgesiac) Unripened cervixd) Preeclampsiae) Use of sedative early in course of labour | Delayed/prolonged labour:
“Labour is said to be prolonged when the combined duration of the first and second stage is more than the arbitrary time limit of 18 hours or when the cervical dilatation rate is less than 1 cm/hr and descent of the presenting part is < 1 cm/hr for a period of 4 hours (WHO-1994).”
Causes of Prolonged labour: | 156,654 | medmcqa_train |
Outermost nuclei of the basal ganglia includes | Ans. is 'a' i.e., Putamen * Basal ganglia include following nuclei:- caudate nucleus, putamen, globus pallidus, subthalamic nucleus and substantia nigra.* Putamen is the outermost basal ganglia nucleus lying just lateral to globus pallidus | 156,655 | medmcqa_train |
McMurray's test is useful clinical test to assess injury to? | Ans. C. Meniscus injury. (Ref. Orthopedics by Ebnezar 4th/Pg. 257).A positive McMurray fs test is diagnostic of a meniscal injury.McMurray test# The McMurray test, also known as the McMurray circumduction test is used to evaluate individuals for tears in the meniscus of the knee. It is a rotation test for demonstrating tom cartilage of the knee. A tear in the meniscus may cause a pedunculated tag of the meniscus which may become jammed between the joint surfaces,# To perform the test, the knee is held by one hand, which is placed along the joint line, and flexed to complete flexion while the foot is held by the sole with the other hand. The examiner then places one hand on the lateral side of the knee to stabilize the joint and provide a valgus stress in order to identify a valgus deformity. The other hand rotates the leg externally while extending the knee. If pain or a "click" is felt, this constitutes a "positive McMurray test" for a tear in the medial meniscus. Likewise the medial knee can be stabilized in a fully flexed position and the leg internally rotated as the leg is extended. A tag, caused by a tear will cause a palpable or even audible click on extension of the knee. A positive test indicates a tear of the lateral meniscus.# Studies show that this clinical test had a sensitivity of 58.5%, a specificity of 93.4%, and the predictive value of a positive result was 82.6%.The pivot-shift test, anterior drawer test and the Lachman test are used during the clinical examination of suspected ACL injury.Anterior drawer testThe anterior drawer test for anterior cruciate ligament laxity is one of many medical tests used to determine the integrity of the anterior cruciate ligament. It can be used to help diagnose sprain and tears.The test is performed as follows: the patient is positioned lying supine with the hip flexed to 45deg and the knee to 90deg. The examiner positions themselves by sitting on the examination table in front of the involved knee and grasping the tibia just below the joint line of the knee. The thumbs are placed along the joint line on either side of the patellar tendon. The index fingers are used to palpate the hamstring tendons to ensure that they are relaxed; the hamstring muscle group must be relaxed to ensure a proper test. The tibia is then drawn forward anteriorly. An increased amount of anterior tibial translation compared with the opposite limb or lack of a firm end-point indicates either a sprain of the anteromedial bundle of the ACL or a complete tear of the ACL. This test should be performed along with other ACL-specific tests to help obtain a proper diagnosis.Lachman testThe Lachman test is an orthopedic test used for examining the anterior cruciate ligament (ACL) in the knee for patients where there is a suspicion of a tom ACL.The Lachman test is most reliable and sensitive clinical test for the determination of anterior cruciate ligament integrity.# The knee is flexed at 20-30 degrees# Examiner pulls on the tibia to assess the amount of anterior motion of the tibia in comparison to the femur# An ACL-deficient knee will demonstrate increased forward translation of the tibia at the conclusion of the movementPivot shift test# Test to asses ACL injuryPerson lies on one side of the body# Knee is extended and internally rotated# Surgeon applies stress to lateral side of the knee, while the knee is being flexed# A crash felt at 30 degrees flexion indicates positive test.Some clinical Orthopedic tests:DeQuervain's diseaseFinkelstein's testAnterior shoulder instabilityJobe's testSubscapularis injuryLift off testAcromioclavicular joint pathology and Labral tearsO'Brien's active compression testHip dysplasiaBarlow's maneuver, Ortolani testHip Impingement (Femoroacetabular Impingement)Flexion, Adduction and Internal Rotation (F-Ad-lr) testLow back painWaddell's signsLow back flexibilityOtt test, Schober testIliotibial Band SyndromeOber's testSacroiliitisLarrey's signBest clinical test to diagnose ACL tearLachman testACL tearPivot shift test, Anterior drawer testMeniscus injuryApley grind test, McMurray testMedial meniscus, MCL and ACL tearO' Donoghue's triadMeniscal tearThessaly TestTendo Achilles ruptureThompson/ Simond's testWatson's testInstability between the scaphoid and lunate bones of the wrist.Meniscal injury:# A twisting injury which is the common mechanism of injury in sports tackles involving the legs usually leads to a meniscal tear.# Injury to the medial meniscus is far more common than lateral meniscal injury. This is due to the medial meniscus being less mobile and thinner anteriorly.# Healing may be slow especially if the tear involves the deeper/inner 2/3 where there is a poor blood supply compared to the superficial/outer l/3rd.# Treatment:a) Conservative - Analgesia, supportive treatmentb) Surgical - Repair of meniscus, meniscectomy | 156,656 | medmcqa_train |
Malonyl acetyl transferase has activity of how many enzymes? | Malonyl acetyl transferase (MAT) is a pa of multienzyme complex : Fatty acid synthase.It has two activities:?Acetyl transferase or acetyl transacylase (E1)Malonyl transferase or malonyl transacylase (E2) | 156,657 | medmcqa_train |
Wucheria bancrofti, true is - | The somatic cells or nuclei appear as granules in the cental axis of the embryo and extend from the head to the tail end The granules do not extend into the tail end which is a distinguishing feature of Microfilaria bancrofti (refer pgno:165 baveja 3 rd edition) | 156,658 | medmcqa_train |
A 40-year-old man underwent kidney transplantation. Two month after transplantation, he developed fever and feature suggestive of bilateral diffuse interstitial pneumonia. Which of the following is most likely etiologic agent? | Ans. (b) Cytomegalovirus Remember CMV is the MC infection complicating organ transplantation. CMV is MC cause of intrauterine infection. Risk of post-transplant CMV infection is greatest 5-13 weeks after transplant Infections after Kindeny Transplan Period after transplanatation Infection site Early (< 1 month) ttiddle(1-lmonths) lafc(> 6 months) Urinary fact Bacteria (Escherichia coli, Klebsiella, Enterobac- teriaceae, Pseudomonas,Enterococcus) associated withbacteremia and pyelonephritis,Candida Cytomega(fever alone is common)BK virus (nephropathy, grafr failure, vasculopathy), JC virus. Bacteria; late infections usuallynot associaed with bacteremia Lungs Legionella CMV diffuse interstitial pneumonitis, Pneumocystis, Aspergillus, Legionella Nocardia, Aspergills, Mucor Central nervoussystem Listeria meningitis, CMV encephalitis, Toxoplasma gondii CMV retinitis, Listeria meningitis, cryptococcal meningitis, Aspergillus, Nocardia | 156,659 | medmcqa_train |
All of the following statements are true about warfarin except:- | WARFARIN It acts by inhibiting the activation of vitamin K dependent clotting factors. These factors include clotting factors II, VII, IX and X. Half life of warfarin is 36-48 hours. Bleeding is the most common adverse effect of all anticoagulants. If a patient develops bleeding due to overdose of warfarin, fresh frozen plasma (to supply clotting factors) is the treatment of choice but specific antidote is vitamin K1 (but the action will be delayed). It crosses the placenta and can cause fetal warfarin syndrome; also known as Contradi syndrome (growth retardation, stippled epiphyses, hypoplasia of nose and hand bones etc.) if used during pregnancy (therefore contraindicated). Prothrombin time is used to adjust the dose of warfarin (because it mainly affects the extrinsic pathway). Better test for monitoring the effect of oral anticoagulants is INR (international normalized ratio). In liver disease, there is decrease in formation of clotting factors. The dose of warfarin therefore should be reduced. | 156,660 | medmcqa_train |
Clinical effect of vitamin D is reduced by ? | Ans. is 'a' i.e., Simultoneous ingestion of phytates The main clinical effect of vitamin D is to enhance intestinal absorption of calcium. With an average intake of 1000 mg of calcium its net intestinal absorption is only 150-250 mg/day. Calcium is absorbed mainly in the duodenum and jejunum (proximal intestine) by an active transpo mechanism regulated by 1, 25 (OH)2 D, (calcitriol). Parathormone indirectly promotes absorption of calcium by increasing the renal synthesis of 1, 25 (OH)2 D3. Dietary lactose, proteins and an acidic environment promote calcium absorption. On the other hand, phytates, phosphates, oxalates, tetracycline and and alkaline environment impair calcium absorption. | 156,661 | medmcqa_train |
A newborn is found to have stridor. What is the the commonest cause of stridor in a newborn? | Laryngomalacia is the most common cause of stridor in infants, and is also the most common congenital laryngeal abnormality, accounting for approximately 60% of cases. Stridor occurs as a result of prolapse of the supraglottic structures into the laryngeal inlet on inspiration. Also know: Stridor is generally of laryngeal or tracheal origin. As a general rule, inspiratory stridor originates from the supraglottis and glottis, expiratory stridor from the trachea, and biphasic stridor from the subglottis. Ref: Yates P.D. (2012). Chapter 33. Stridor in Children. In A.K. Lalwani (Ed), CURRENT Diagnosis & Treatment in Otolaryngology--Head & Neck Surgery, 3e. | 156,662 | medmcqa_train |
Isthmus of thyroid gland is across tracheal rings: | The isthmus of the thyroid gland extends across the midline in front of the 2nd, 3rd, and 4th tracheal rings. | 156,663 | medmcqa_train |
Enzyme defective in Maple syrup urine disease is: | Enzyme deficiencies and conditionsTyrosinase is deficient in albinismPhenylalanine hydroxylase is deficient in phenylketonuriaMaple syrup urine disease is due to a defect in the enzyme branched chain alpha-keto acid dehydrogenaseHomogentisate oxidase is deficient in alkaptonuria | 156,664 | medmcqa_train |
Which of the following is true about vasa previa except? | Ans. is b, i.e. Mortality rate of 20% with undiagnosed caseRef Williams Obs 23/e, p 583-584, High risk pregnancy" Fernando Anas 3/e p 348, progress in Obs. and Gynae- John Studd vol. 17/e p 209Vasa previa: It is a condition in which the fetal blood vessels unsupported by either umbical cord or placental tissue, overlies the internal os and is vulnerable to rupture when supporting membrane rupture.Thus bleeding in case of vasa previa is of fetal origin and not maternal origin (unlike placenta previa and abruptio)It is rare condition and occurs in 1 in 2000 - 3000 deliveries (i.e. option ais correct).Vasa previa should be suspected if any of the following condition exists-Velamentous cord insertion-Bilobed placenta-Succenturiate lobed placenta-Placenta previa/low lying placenta in second trimester (option 'c' is correct)-Pregnancy resulting from IVF-Multiple pregnanciesVasa previa is associated with high fetal mortality - (75-100%) because---Wharton's jelly is absent around the fetal vessels, hence they can be easily lacerated at the time of rupture of membranes leading to severe fetal bleeding.-Vessels can be easily compressed by the fetal presenting part during uterine contractions leading to fetal exsanguination.This explains that option b i.e. mortality rate is 20% in undiagnosed case is incorrect (mortality is 75-100%)Maternal mortality is not increasedDiagnosis of vasa previa - In all cases of antepartum and intrapartum hemorrhage, the possibility of vasa previa should be kept in mind and blood should be tested for fetal hemoglobin characterized by resistance to denaturation by alkaline reagent (Singer alkali denaturation test/Apt test)Doppler examination can also reveal fetal blood vessels traversing below the presenting partManagement: In a diagnosed case of vasa previa elective cesarean section should be done or emergency LSCS should be done if it is diagnosed intrapartum. | 156,665 | medmcqa_train |
Flight of idea is seen in | A i.e. Mania | 156,666 | medmcqa_train |
Use of filters result in: | Ans. Beam of greater intensity | 156,667 | medmcqa_train |
Metabolic disorder leading to acute pancreatitis | (B) Hyperparathyroidism# Causes of Acute Pancreatitis> Common Causes Gallstones (including microlithiasis) Alcohol (acute and chronic alcoholism); Hypertriglyceridemia Endoscopic retrograde cholangiopancreatography (ERCP), especially after biliary manometry Trauma (especially blunt abdominal trauma) Postoperative (abdominal and non-abdominal operations) Drugs (azathioprine, 6-mercaptopurine, sulfonamides, estrogens, tetracycline, valproic acid, anti-HIV medications) Sphincter of Oddi dysfunction> Uncommon causes Vascular causes and vasculitis (ischemic-hypoperfusion states after cardiac surgery) Connective tissue disorders and thrombotic thrombocytopenic purpura (TTP) Cancer of the pancreas Hypercalcemia Periampullary diverticulum Pancreas divisum Hereditary pancreatitis Cystic fibrosis Renal failure> Rare causes Infections (mumps, coxsackievirus, cytomegalovirus, echovirus, parasites) Autoimmune (e.g., Sjogren's syndrome)> Causes to consider in patients with recurrent bouts of acute pancreatitis without an obvious etiology Occult disease of the biliary tree or pancreatic ducts, especially microlithiasis, sludge Drugs Hypertriglyceridemia Pancreas divisum Pancreatic cancer Sphincter of Oddi dysfunction Cystic fibrosis Idiopathic | 156,668 | medmcqa_train |
A 60-year-old woman complains to a physician because several of her toe nails are discolored. Physical examination demonstrates crumbling, friable nails with distal-lateral separation from the nail bed. Hyperkeratotic debris is present under the affected pa of the nail. Which of the following is the most likely pathogen? | The patient has a fungal nail infection. These infections are seen most commonly in the elderly, and are usually caused by dermatophyte infection, typically Trichophyton rubrum, Trichophyton mentagrophytes, or Epidermophyton floccosum. Some of the more superficial lesions can be removed by simply scraping the fungus off the nail. Systemic fungal therapy (notably terbinafine) of months duration (because nails are grown so slowly) may be required for deeper nail lesions. Aspergillus (1st Choice) may be a lung saprophyte or cause invasive disease. Candida (2nd Choice) is a rare cause of fungal nail infection. Associate Mucor (3rd Choice) with sinonasal infection. | 156,669 | medmcqa_train |
Black colour code is used in four code system of triage management in disaster for - | -triage consists of rapidly classifying the injured on the basis of severity of their injuries and the likelihood of their survival with prompt medical intervention. - black colour triage is for moribund and dead patients Reference: Park's textbook of preventive and social medicine, 23rd edition, pg no: 796 <\p> | 156,670 | medmcqa_train |
In which of the following conditions Berlin&;s edema is | Blunt trauma to eye may produce Berlin&;s edema or commotio retinae Q which is a cloudy swelling characterized by a grey appaerance, most frequently in the temporal region. It may also manifest as cherry red spot in the foveal region. Ref: AK khurana 7th ed. | 156,671 | medmcqa_train |
The patient presented with chest pain to the emergency room and dies within 12 hours of arrival. After 5 days, autopsy shows necrosis in the Myocardium. What is the type of necrosis? | Ans-ARef: Chapter I. Ceil injury; page: 15: Robbins and Cot ran Pathologic Basis of Disease: 8th edition).Explanation:Organs with end arterial blood supply will show usually the Coagulative type of necrosis; solid organs like a heart will always show Coagulative necrosis.Caseous necrosis is usually seen in tuberculosis. and shows associated granulomatous inflammation.Liquefactive necrosis is usually seen in brain parenchyma.Fibrinoid necrosis is a special form of necrosis seen in the immune complex-mediated destruction of blood vessels like in various types of vasculitis. | 156,672 | medmcqa_train |
Commonest cause of Cerebral Infarction is: | Aerial thrombosis | 156,673 | medmcqa_train |
Following is true about bronchial carcinoids - | Ans. is 'c' i.e., Carcinoid syndrome does not manifest Bronchial carcinoid o Most patients < 40 years o Not related to smoking o Most tumors are confined to main stem bronchi and commonly project into lumen. Some tumors penetrate the bronchial wall to fan out in the peri-bronchial tissue producing the collar-button lesion. o Most bronchial carcinoids :Do not have secretory activity. Do not metastasize to distant sites (follow a benign course for long periods). Are amenable to resection. o Most common presentation is intraluminal growth which can cause cough, hemoptysis, secondary infections, bronchiectasis, emphysema and atelectasis. o Though very rare, some bronchial carcinoids may also present : i) Carcinoid syndrome ( due to release of vasoactive amines) :- Flushing, diarrhea, cyanosis ii) Symptoms due to metastasis. | 156,674 | medmcqa_train |
The most common virus causing acute coryza is? | The common cold is the most common illness in humans Rhinovirus ( most commonly), Influenza, Parainfluenza, Coronavirus, Respiratory syncytial virus etc all lead to the common cold. (Ref: Cummings, 6th edition, Pg no. 725 ) | 156,675 | medmcqa_train |
Which antiviral drug is used in both HIV an hepatitis B:- | Drugs used in treatment of both HIV and Hepatitis B: * Lamivudine * Emtricitabine * Tenofovir Acyclovir and Abacavir are protease inhibitors used in treatment of HIV. Enfuviritide is a Gp41 inhibitor, it inhibits the fusion of virus with host cell. | 156,676 | medmcqa_train |
metaclopromide: | metaclopromide is aD2 receptor antagonist that increases cholinergic activity by inhibiting presynapyic D2 receptors in GIT . it increases LES tone that is also responsible for anti emetic action. it does not significantly increase colonic motility | 156,677 | medmcqa_train |
The genetically engineered &;golden rice&; is rich in - | <p> Golden rice: Variety of rice produced through genetic engineering to boisynthesize beta carotene, a precursor of vitamin A. It is indented to produce a foified food to be grown and consumed in areas with a shoage of dietary vitamin A. Golden rice differs from its parenteral strain by the addition of three beta carotene biosynthesis gene. It is rich in beta carotene and iron. </p> | 156,678 | medmcqa_train |
A patient with cancer received extreme degree of radiation toxicity. Fuher history revealed that the dose adjustment of a paicular drug was missed during the course of radiotherapy. Which of the following drugs required a dose adjustment in that patient during radiotherapy in order to prevent radiation toxicity - | Ans. is 'b' i.e., Dactinomycin o The patient was most probably taking a radiosensitiser i.e., drugs which increases the toxicity due to radiotherpy. o The dose of these drugs should be decreased during radiotherapy o Among the drugs given in the question Actinomycin D or Dactinomycin is a radiosensitizer o Hypoxic cells are resistant to radiotherapy o Augmentation of oxygen is the basis of radiosensitization | 156,679 | medmcqa_train |
Which of the following drug is not given in acute mania: September 2009 | Ans. B: Lamotrigine Lamotrigine is not recommended for acute mania. It is especially useful in rapidly cycling bipolar depression. | 156,680 | medmcqa_train |
In Addison's disease drug to be given is - | Ans. is 'a' i.e., Hydrocoisone o In Addison's disease, there is chronic insufficiency of adrenal hormones. o Both glucocoicoids and mineralocoicoids are deficient, therefore treatment includes combination of glucocoicoids and mineralocoicoid to replace the adrenal insufficiency. o Hydrocoisone along with fludrocoisone is prescribed most commonly. | 156,681 | medmcqa_train |
Which does not has a known animal reservoir | Ans. is. 'b' i. e., Bordettela peussis | 156,682 | medmcqa_train |
All of the following are the components of the white pulp of spleen, except | The spleen contains two main types of tissue - white pulp and red pulp. White pulp is lymphatic tissue (material which is pa of the immune system) mainly made up of white blood cells. Red pulp is made up of blood-filled cavities (venous sinuses) and splenic cords. <img src=" /> Ref - BDC 6e vol2 pg297 | 156,683 | medmcqa_train |
Congenital dislocations | Ans. is 'a' i.e., Scurvy | 156,684 | medmcqa_train |
Pulmonary complications of rheumatoid ahritis include the following except | Pleural disease is the most common pulmonary manifestation of RA,may produce pleuritic chest pain,and dyspnea,as well as a pleural friction rub and exudative pleural effusion.Interstitial lung disease,like fibrosing alveolitis,can also occur in patients with RA.Pulmonary function testing shows a restrictive pattern with a reduced diffusing capacity for carbon monoxide.Pulmonary nodules may be solitary or multiple.Other less common pulmonary findings include respiratory bronchiolitis and bronchiectasis. Ref:Harrison's medicine-18th edition,page no:2739. | 156,685 | medmcqa_train |
Mondor's disease is ? | Ans is 'a' i.e., Thrombophlebitis of Superficial veins of Breast Mondor's disease is thrombophlebitis of the superficial veins of anterior chest wall and breast although it has also been seen in the arm. frequently involved veins are lateral thoracic vein, thoracoepigastric vein and superficial epigastric veins. aetiology is unknown also known as 'string phlebitis', it presents as a tender cord-like structure. The women may present with acute pain in the lateral asepct of breast or the anterior chest wall. A tender cord-like superficial thrombosed vein is formed and when the skin over the breast is stretched by raising the arm, a narrow shallow subcutaneous groove alongside the cord becomes apparent. rarely it may be bilateral. Management it's a benign self-limited disorder The differential diagnosis is lymphatic permeation from an occult carcinoma of breast When the diagnosis is unceain or a mass is present near the cord, a biopsy may be done. Treatment - antiinflammatory drugs and warm compresses - restricted arm movements as well as brassiere suppo of breast - it usually resolves within 4 to 6 weeks. When symptoms persists or are refractory to treatment, the involved vein segment may be excised. | 156,686 | medmcqa_train |
The enzyme deficient is Lesch-Nyhan syndrome is: | D i.e. HGP | 156,687 | medmcqa_train |
Stage- II testicular teratoma is treated by- | • Most common testicular tumor in prepubertal adults: Teratoma
• Tumor is composed of two or more embryonic germ cell layers that may be both mature and immature.
• Tumor is very heterogeneous with both solid and cystic components.
Teratoma is divided into three subsets
1. Mature: well-differentiated ectodermal, mesodermal, or endodermal tissues
2. Immature: incompletely differentiated tissues
3. Teratoma with areas of malignant transformation: sarcoma, squamous carcinoma, adenocarcinoma
• Teratomas are potentially malignant
Clinical Features
• Age range: first, second, and third decades.
• Mature and immature forms have metastatic potential in adults but in children are uniformly benign.
• The primary tumor generally presents as an enlarged testis with both solid and cystic components.
• The teratoma component of metastatic GCT is resistant to chemotherapy and radiotherapy.
Tumor Markers
• AFP is raised in 20-25% | 156,688 | medmcqa_train |
Niemann-Pick disease is characterized by: | Ans. A. Increased concentration of sphingomyelin in liverNiemann -pick disease is due to the absence of sphingomyelinase enzyme which leads to the accumulation of sphingolipids or sphingomyelin in liver. | 156,689 | medmcqa_train |
A pregnant mother at 32 weeks gestation presents in preterm labour. Therapy with antenatal steroids to induce lung maturity in the fetus may be given in all of the following conditions except : | Ans. Is d i.e. Chorioamnionitis "Coicosteroids can be given even in presence of maternal hypeension or diabetes mellitus, but should preferably be avoided if PROM is associated with definitive evidence of chorioamnionitis" "Steroid treatment is contraindicated in presence of ove infection." ... Fernando Arias 3/e, p 220 Steroid therapy in preterm labour : Steroids are recommended for all women in preterm labour before 36 weeks. Advantage : Steroids reduce the rate of respiratory distress syndrome and intraventricular hemorrhage in the newborn. The effect of treatment is maximal between 24 hours of the first dose and uptil 7 days. Earlier it was recommended to give repeated doses weekly till the patient delivers but this practice is associated with significant fetal and neonatal side effects like cerebral palsy and should be abandoned. Betamethasone is the steroid of choice and the recommendation is to give two doses of 12 mg intramuscularly 24 hours apa. | 156,690 | medmcqa_train |
Tracking of BP implies: | Ans. (d) BP of hypertensive remain hypertensiveRef : K. Park 23rd ed. / 374Park 3rd / P 374 States:If BP of a person is tracked from early childhood to adult life then those individuals whose blood pressure was initially high in the distribution, would probably continue in the same "track". | 156,691 | medmcqa_train |
35 year ahas presented with 2 episodes of hematemesis. On examination his pulse rate is 100/min with BP of 90/60 mm Hg. Per abdomen examination shows spleen palpable 3 cm below costal margin. Which is true about this patient? | Hematemesis + splenomegaly- Poal hypeension Elevated CRP + Low C3 (Only with inflammatory condition) Most common site of bleeding in 1st pa of duodenum - Peptic ulcer disease Urgent reflective intubation - bleeding esophageal varices The increased pressure of poal vein pressure should be lowered with octreotide - poal hypeension For prevention - Propranalol TOC - UGIE + Sclerotherapy 1st line - Fluid resuscitation | 156,692 | medmcqa_train |
Supine hypotension is characteristic of : | 3rd trimester | 156,693 | medmcqa_train |
Hydrostatic test is done in ? | Ans. is 'd' i.e., Infanticide Hydrostatic test (lung float test or docimasia), is used in determining whether lungs have undergone respiration. It has been employed in cases of suspected infanticide to help determine whether or not an infant was stillborn.In the test, lungs that float in water are thought to have been aerated, while those that sink are presumed to indicate an absence of air. | 156,694 | medmcqa_train |
A 3-year-old child comes with hydrocele of the hernia sac. Management will include: | Ans. a. Herniotomy (Ref: Sabiston 191120-1126; Schwartz 9/1318-1331, Bailey 26/111, 1382; Schackelford 7/568-579)Management of hydrocele of the hernia sac (congenital hydrocele) in a 3 years old child is herniotomy."A patent processus vaginalis may allow only peritoneal fluid to track down around the testis to form a hydrocoele. Hydrocoeles are unilateral or bilateral, asymptomatic, non-tender scrotal swellings. They may be tense or lax. but typically transilluminate. The majority resolve spontaneously as the processus continues to obliterate, but surgical ligation is recommended in boys older than three years of age. "--Bailey 26/e p111"In congenital hydrocele, the processus vaginalis is patent and connects with the peritoneal cavity. The communication is usually too small to allow herniation of intra-abdominal contents. Pressure on the hydrocele does not always empty it but the hydrocele fluid may drain into the peritoneal cavity when the child is lying down; thus, the hydrocele may be intermittent. Ascites should be considered if the swelling are bilateral. Congenital hydroceles are treated by herniotomy if they do not resolve spontaneously. " Bailey 26/e p1382HerniotomyLigation of hernial sacQHerniorrhaphyHerniotomy with posterior wall repair using in-situ structuresQHernioplastyHerniotomy with strengthening of posterior wall using exogenous material like meshQManagement of Inguinal HerniaObjectives of treatment: Treatment of hernia sac and Inguinal floor reconstructionManagement of Inguinal HerniaTreatment of Hernia SacInguinal Floor Reconstruction* Basic operation is inguinal herniotomy, which entails dissecting out & opening the hernial sac, reducing any contents and then transfixing the neck of the sac and removing the remainderQ.* Direct sacs are usually too broad for ligation and should not be opened but instead are simply inverted into peritoneal cavityQ.* Management of the hernia sac is sufficient for children and young adultsQ* Reconstruction (repair or strengthening) of the inguinal floor is necessary in all adult hernias to prevent recurrenceQ.* Types of repair:1. Primary tissue repairQ2. Anterior tension-free mesh repairQ3. Pre-peritoneal repairs: Open & laparoscopic approachQ Inguinal Floor ReconstructionPrimary Tissue RepairAnterior Tension-Free Mesh RepairLaparoscopic and Pre-Peritoneal Repairs* Posterior wall of inguinal wall is strengthened by approximation of tissues with suturesQ.* There is no use of prosthetic materialQ.* Advantages: Simplicity of the repair & absence of any foreign body in groin* Disadvantage: Higher recurrence rates due to tension on the repair and slower return to unrestricted physical activityQ.* Types:- Bassini repairQ- Haisled repair- McVayQ (Cooper ligament) repair Shouldice repairQ- Dam repair* Current practice in hernia management employ synthetic mesh to bridge the defect* Recurrence is very low* Types:* Lichtenstein repair0: Mesh is used to reconstruct the inguinal floor.* Patch and plug repair(r): Plug of mesh is inserted into the hernia defect and sutured in place. Then another piece of mesh is placed over the inguinal floor.* Pre-peritoneal space is reached by either trans-abdominal laparoscopy (TAPP) or by totally extra-peritoneal repair (TEP).* Both techniques are similar In actual repair but differ in the manner by which the preperitoneal space is accessed.* TAPP (Trans-abdominal Pre- PeritoneaI)(r): Peritoneal space is reached by conventional laparoscopy and pre-peritoneum overlying the inguinal floor is dissected away as a flap.* TEP (Totally Extra-Peritoneal) (r): Pre-peritoneal space is accessed without entering the peritoneal cavity Gibbon's hernia* Hernia with hydroceleQBerger's hernia* Hernia into pouch of DouglasQBedard's hernia* Femoral hernia through opening of saphenous veinQAmyand's hernia* Inguinal hernia containing appendixQOgilive's hernia* Hernia through the defect in conjoint tendon just lateral to where it inserts with the rectus sheathQStammer's hernia* Internal hernia occurring through window in the transverse mesocolon after retrocolic gastrojejunostomyQPeterson hernia* Hernia under Roux limb after Roux-en-Y gastric bypassQ | 156,695 | medmcqa_train |
Insulin increases the following pathways in liver EXCEPT: | Hormonal regulation
Insulin generally favours all pathways which decrease blood glucose level by dephosphorylating the regulatory enzymes of these pathways
In other words enzymes active under the influence of insulin is active in the dephosphorylated state.
Glucagon generally favor all pathways which increase blood glucose level by phosphorylating the regulatory enzymes of these pathways
In other words enzymes active under the influence of glucagon is active in the phosphorylated state. | 156,696 | medmcqa_train |
Figure of 8 in chest X-ray ? | Ans. is 'a' Supracardiac TAPVC Teralogy of fallot--* boot shaped hea Transposition of great vessel-* egg on side TPVC (supracardioe) --> snownan or figure of 8 configuration | 156,697 | medmcqa_train |
In dacryocystorhinostomy operation the communication of the sac is established with: | Ans. Middle meatus | 156,698 | medmcqa_train |
Scrub typhus is transmitted by: March 2011, March 2013 (d, e, g) | Ans. B: Mite Vector for Scrub typhus is trombiculid mite Scrub typhus/Bush typhus It is a form of typhus caused by Orientia tsutsugamushi first isolated and identified in 1930 in Japan Scrub typhus is transmitted by some species of trombiculid mites ("chiggers", paicularly Leptotrombidium deliense), which are found in areas of heavy scrub vegetation. The bite of this mite leaves a characteristic black eschar that is useful for making the diagnosis. Scrub typhus is endemic to a pa of the world known as the "tsutsugamushi triangle" (after the name "Orientia tsutsugamushi" (formerly "Rickettsia tsutsugamushi"), the obligate intracellular gram-negative bacterium causing same), which extends from nohern Japan and far-eastern Russia in the noh, to the territories around the Solomon Sea into nohern Australia in the south, and to Pakistan and Afghanistan in the west. It affects females more than males in Korea, but not in Japan, and this is conjectured to be because sex-differentiated chltural roles have women tending garden plots more often, thus being exposed to plant tissues inhabited by chiggers | 156,699 | medmcqa_train |
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