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Muscles forming floor of pelvis are all except- | Ans. is 'd' i.e., Iliacus * The pelvic floor is formed by the levator ani muscle which consists of three parts.1. Pubococcygeus2. Iliococcygeus3. Ischiococcygeus | 156,700 | medmcqa_train |
At which level does methionine enter the TCA cycle? | Reference: Lehninger illustrated biochemistry 5th edition | 156,701 | medmcqa_train |
'Knudson's two-hit' hypothesis is associated with | Harshmohan textbook of pathology 7th edition.
☆ Familial retinoblastoma comprises 40% of cases and may be bilateral.
In this cases, all somatic cells inherit one mutant RB gene from a carrier parent. Later during life, the other mutational event of 2nd allele affecting the somatic cells occurs.
This forms the basis of two hot hypothesis given by Knudson in 1971. | 156,702 | medmcqa_train |
Wilson's disease is characterized by ? | Ans. is 'c' i.e., Increased copper in liver Diagnosis of Wilson disease The gold standard for diagnosis is liver biopsy with quantitative copper assay - concentration of copper in a liver biopsy sample > 200 mg/g dry weight. Other tests are ? Serum ceruloplasmin level - low Urine copper excretion - increased KF rings DNA Haplotype analysis. | 156,703 | medmcqa_train |
In cervical spondylosis, the disc space narrowing is most often evident on x-ray at | Cervical spondylosis is a degenerative condition of the cervical spineDegeneration of disc results in the reduction of disc space and peripheral osteophyte formation. The posterior interveebral joints get secondarily involved and generate pain in the neck. The osteophytes impinging on the nerve roots give rise to radicular pain in the upper limb.Cervical spondylosis occurs most commonly in the lowest three cervical interveebral joints (the commonest is at C5-C6).Maheswari 5th edition PG 297 | 156,704 | medmcqa_train |
Common cause of neonatal hypoglycemia is: March 2013 (d) | Ans. D i.e. Infant of diabetic mother | 156,705 | medmcqa_train |
True about Rh factor is | There are no natural anti-Rh antibodies in serum Approximately 15% of the population lacks this antigen D- is the most immuno-genic Rh antigen | 156,706 | medmcqa_train |
What is not true regarding Bochdalek hernia? | A Bochdalek hernia is one of two forms of a congenital diaphragmatic hernia , the other form being Morgagni hernia. A Bochdalek hernia is a congenital abnormality in which an opening exists in the infant's diaphragm, allowing normally intra-abdominal organs (paicularly the stomach and intestines) to protrude into the thoracic cavity. In the majority of patients, the affected lung will be deformed , and the resulting lung compression can be life-threatening. Bochdalek hernias occur more commonly on the posterior left side (85%, versus right side 15%) Ref - Internet | 156,707 | medmcqa_train |
Bile solubility is used for? | Bile solubility test In the presence of surface active agents such as bile and bile salts (sodium deoxycholate or sodium dodecyl sulfate), the cell wall of S.pneumoniae undergoes lysis. Other members of alpha-hemolytic streptococci are not lysed by the agents ( are bile insoluble) REF:Ananthanarayan & Panicker's Textbook of Microbiology 8th Edition pg no: 674 | 156,708 | medmcqa_train |
Cloudy cornea is/are seen: | Answer- D. MucopolysaccharidosisS-SclerocorneaT-TraumaU-UlcerM- MucopolysaccharidosisP-Peter anomalyED- Congenital hereditary endothelial dystrophy | 156,709 | medmcqa_train |
All of the following are example of feed forward control system except | BP regulation is example of negative feedback control.
Feedforward control :
In this, it anticipates the discharge and prevent the change in 'controlled variable' by generating a corrective command that anticipates the change in 'controlled variable'
Example :
Temperature regulation
Cephalic phase of gastric secretion
Increase in heart rate and respiratory rate even before exercise.
Cerebellar action in motor co-ordination. | 156,710 | medmcqa_train |
Complement complex that attacks cell membrane is | The complement complex attacking the cell membrane is membrane attack complex having a composition of C56789
Action of this complex leads to entry of fluid and ions inside the cells leading to cell lysis.
Complement system has three main function
1. Inflammation
2. Opsonization
3. Cell lysis | 156,711 | medmcqa_train |
All of the following organs may be involved in Leprosy except - | leprosy mainly affects peripheral nerves.it also affects skin,muscles,eyes,bones,testis and internal organs park edition 23 page 314 | 156,712 | medmcqa_train |
Snow storm appearance on IJSG seen in: | Ans: A (Hydatiform mole) "Sonography: Characteristic echogram of molar pregnancy is snowstorm appearance"- Dutta Obstetrics 6th/196Also know"The ultrasound appearances of testicular microlithiasis: 'SnowStorm' testis- www.bjm.org/cgi"Sonographic appearances in neonates with generalized meconium peritonitis: the snowstorm sign"-http://b}r.birjournals. org /cgi/reprint/57/6 76/340.pdf | 156,713 | medmcqa_train |
Which of the following is false regarding apoptosis? | Apoptosis can be both physiological and pathological.
Necrosis is always pathological. | 156,714 | medmcqa_train |
All the following are true about Retinitis spunctata albescens except NOT RELATED-OPTHALMOLOGY | . | 156,715 | medmcqa_train |
Which of the following is not a contraindication for extra corporeal
shockwave lithotripsy for renal calculi | C/I for ESWL are
absoulete
Pregnancy
Bleeding disorder
Relative
Stone > 2cm
Cystine stone
Children
Obstructed stone. | 156,716 | medmcqa_train |
A patient with visual acuity of <6/60 in better eye but more than 3/60 is having: | Definitions of blindness: WHO definition of blindness: "Visual acuity of less than 3/60 (Snellen) or its equivalent". Economical blindness: Vision in better eye <6/60 to 3/60 Social blindness: Vision in better eye <3/60 to 1/60 Legal blindness: Vision in better eye <1/60 to perception of light Absolute/total blindness: No light perception Ref: Ophthalmology By A. K. Khurana, 3rd edition, Page 443, 444. | 156,717 | medmcqa_train |
Sirolimus (Rapamune) is prescribed to a post-renal transplantation client. Upon the review of the chart, the nurse expects which of the following laboratory results? | Sirolimus (Rapamune) raises cholesterol and triglyceride levels. This medication also causes a decrease in potassium and platelet count. | 156,718 | medmcqa_train |
To fully activate a naive CD4 T cell, the antigen-presenting cell has to express? | MHC class II molecules present antigen to CD4 T cells and co-stimulation binding of B7 to CD28 on the T cell leads to full activation of the naive T cell. Must Know: Feature Class I MHC Proteins Class II MHC Proteins Present antigen to CD4-positive cells No Yes Present antigen to CD8-positive cells Yes No Found on surface of all nucleated cells Yes No Composed of two peptides encoded in the HLA locus No Yes Composed of one peptide encoded in the HLA locus and a 2-beta 2 microglobulin Yes No Ref: Review of Medical Microbiology & Immunology, 12e, Chapter 62. Major Histocompatibility Complex & Transplantation. | 156,719 | medmcqa_train |
Pyridoxine should be given when treating with ? | Ans. is 'a' i.e., Isoniazid Peripheral neuritis associated with isoniaide probably relates to interference with pyridoxine (vitamin B6). Thus when treating a patient with isoniazid it is essential to supplement with pyridoxine to reduce chances of peripheral neuritis. | 156,720 | medmcqa_train |
Low Erythropoetin levels are seen in: | Answer is B (Renal failure) Renal Failure is associated with reduced erythropoietin levels due to decreased production of erythropoietin by the diseased kidney. The kidney is the primary site of erythropoietin production producing more than 85 percent of total erythropoietin. Chronic Renal failure is associated with severe anemia. The most impoant contributor to the anemia of chronic renal failure is insufficient production of Erythropoetin. Patients with inflammatory disorders (Anemia of chronic disease) also have inappropriately low levels of Erythropoetin. Examples include Rheumatoid ahritis, some forms of Cancer and AIDS. This is believed to result from suppression of EPO gene expression by inflammatory cvtokines in these disorders. Causes of Anemia in Chronic Renal Failure and other Chronic Diseases Decreased production of ErythropoetinQ Reduced survival of RBCsQ Impaired flow of iron from bone marrow macrophages to erythroblasts. | 156,721 | medmcqa_train |
Predisposing factor for Nasal myiasis - | Ans. is 'c' i.e., Atrophic rhinitis Nasal mviasis (Maggots in nose)o It results from the presence of ova of flies particularly chrysomia species in the nose which produce ulceration and destruction of nasal structure. Mostly seen in atrophic rhinitis when the mucosa becomes insensitive to flies laying eggs inside.Clinical featureso Initial symptoms (3-4 days maggots) Intense irritation, sneezing, headache, blood stained disharge, lacrimation. o Later Maggots may crawl out of nose and there is foul smell.Complicationso Destruction of nose, sinuses, soft tissues of face, palate and eyeball, o Fistulae in nose and palate, o Death occurs due to meningitis.Treatmento Chloroform water or vapor must be instilled in order to anaesthetize or kill the maggots and so release their grip from the skin. | 156,722 | medmcqa_train |
Resolution when visual acuity is 6/6: | Resolution when visual acuity is 6/6 is 1 minute of an arc. Snellen's test types: The distant central visual acuity is usually tested by Snellen's test types. The fact that two distant points can be visible as separate only when they subtend an angle of 1 minute at the nodal point of the eye, forms the basis of Snellen's test-types. The lines comprising the letters have such a breadth that they will subtend an angle of 1 min at the nodal point. The entire character (optotype) subtends an angle of 5 min of an arc at the nodal point, each stroke is 1 min at the nodal point. | 156,723 | medmcqa_train |
A 30 Yr old male underwent excision of the right radial head following surgery, the patient has developed inability to move fingers and thumb of the right hand, he did not have any sensory deficit. Which of the following is most likely cause | Clinical feaurues of injury to posterior Interosseus nerve : It is prone to be injured in injury and operations of radial Head neck There is no sensory deficit as it is a pure motor nerve Wrist extension is preserved due to spared extensor carpi radialis longus Presents with loss of extension of MP joints Refer Maheshwari 9th ed p 65 | 156,724 | medmcqa_train |
Axillary sheath is an extension of- | Ans. is 'b' i.e., Prevertebral layer of deep cervical fascia 'Axillary sheath and fascia around trunk of brachial plexus are derived from prevertebral fascia (prevertebral layer of deep cervical fascia).' | 156,725 | medmcqa_train |
The following are features of pneumococcus except- | Ans. is 'a' i.e., Bile insolubility | 156,726 | medmcqa_train |
With glucose which of the following is transpoed:March 2010 and 2011, March 2013 | Ans. D: Sodium ions | 156,727 | medmcqa_train |
Veins draining into poal vein are all except: | Tributaries of Poal vein: Mnemonic: Paraumbilical veins. Right gastric vein. Splenic vein. Superior mesenteric vein. Superior pancreatico-duodenal vein. Left gastric vein. | 156,728 | medmcqa_train |
All of the following drugs are useful in detrusor instability, EXCEPT: | Detrusor muscle contraction causes micturition. When detrusor relaxes and the sphincters close urine is stored. Whereas voiding requires contraction of detrusor -accompanied by relaxation of sphincters. Since detrusor contracts under parasympathetic influence, anticholinergic (specifically antimuscarinic) drugs are used to treat overactive bladder disease or detrusor instability. Overactive urinary bladder can be successfully treated with muscarinic receptor antagonists. These agents can lower intravesical pressure, increase capacity, and reduce the frequency of contractions by antagonizing parasympathetic control of the bladder; they also may alter bladder sensation during filling. Solifenacin is relatively selective for muscarinic receptors of the M3 subtype, giving it a orable efficacy. Oxybutynin, Tolterodine are commonly used drugs competitively bind to cholinergic receptors. These medications appear to work at the level of the detrusor muscle by competitively inhibiting acetylcholine at muscarinic receptors (M2 and M3). These agents thereby blunt detrusor contractions to reduce the number of incontinence episodes and volume lost with each. These medications are significantly better than placebo at improving symptoms of urge urinary incontinence and overactive bladder. Duloxetine is a selective serotonin and norepinephrine reuptake inhibitor. It is approved for the treatment of major depression, generalized anxiety disorder, and diabetic peripheral neuropathic pain in adults. It is not used for detrusor instability. Ref: Brown J.H., Laiken N. (2011). Chapter 9. Muscarinic Receptor Agonists and Antagonists. In L.L. Brunton, B.A. Chabner, B.C. Knollmann (Eds), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e | 156,729 | medmcqa_train |
An 44 year old engineer noticed that he has an eye that is persistent directed toward his nose. A lesion of which of the following nerves could produce this finding? | CN VI | 156,730 | medmcqa_train |
Epidemic pleurodynia is caused by ? | Ans. is 'c' i.e., Coxsackie -B virus There are two types of Coxsackie viruses :Coxsackie A (Seotypes 1 to 24) : They cause aseptic meningitis (especially A7 and A9), Herpangina, febrile illness, acute hemorrhagic conjucntivitis (by A24), and 'Hand-foot-mouth disease'.Coxsackie B (Sterotypes 1 to 6) : They cause aseptic meningitis (all serotypes), neonatal disease, Bornholm disease (plurodynia or epidemic myalgia), myocarditis, hepatitis, pancreatitis & DM (serotype B4), and pneumonia. | 156,731 | medmcqa_train |
Risk factor for carcinoma stomach are all, EXCEPT: | Impoant quotes (Maingot's 10/e, Page 1007): In several large studies from the scandinan countries, it was found that there is no correlation between gastric cancer and blood group A. Ref: Maingot's 10/e, Page 1007. | 156,732 | medmcqa_train |
What is the cell of origin of primary lymphoma of the GI tract associated with celiac disease? | Lymphomas are progressive neoplastic condition of lymphoreticular system arising from stem cells. Lymphomas are the 3rd most common malignancy among children comprising 15% of paediatric cancers. Primary lymphoma of the GI tract associated with Celiac sprue--intestinal T cell lymphoma. Reference : page 253 SRB's manual of surgery 5th edition | 156,733 | medmcqa_train |
Onycholysis is seen in all of the following, except: | Nephrotic syndrome | 156,734 | medmcqa_train |
RDS in Neonate is due to deficiency of? | Ans. is 'c' i.e., dipalmitoyl HMD (Respiratory distress syndrome) Primary seen in : PRETERM Baby of diabetic mother Multiple bih LSCS delivery Bih asphyxia Incidence in preterm inversely related to gestational age and bih weight. Primary cause - Surfactant deficiency leads to atelectatic lung. Major constituent of surfactant - la Dipalmitoyl phosphatidylcholine (lecithin) Phosphatidylglycerol A protein Cholesterol Synthesized and stored in type II alveolar cell. X-ray fine granuloreticular pattern with air bronchogram | 156,735 | medmcqa_train |
Ranitidine differs from cimetidine because of? | Ans. is 'a' i.e., Ranitidine does not have antiandrogenic side effect | 156,736 | medmcqa_train |
Scrambled egg appearance is seen in | Scrambled egg appearance is the ERCP finding in carcinoma pancreas. Other findings in ERCP in pancreatic carcinoma are: abrupt block of pancreatic duct with irregular stricture, pancreatic duct encasement, Double duct sign - cut off of both pancreatic and bile duct, parenchymal filling. Reference : page 706 SRB's manual of surgery 5th edition | 156,737 | medmcqa_train |
Most crucial pa of tuberculosis control programme is - | Park&;s Textbook of Preventive and Social Medicine 23rd edition Page no: 182 Sputum smear examination by direct microscopy is now considered the method of choice. The reliability, cheapness and ease of direct microscopic examination have made it number one case finding method all over the world. It enables us to discover the epidemology most impoant cases of pulmonary tuberculosis | 156,738 | medmcqa_train |
Minimum level of HCG detected by radio immunoassay is : | Ans. is d i.e. 0.001 1U/m1 Pregnancy tests All the pregnancy tests used now days are immunological, which function on the principle of detecting HCG quantitatively or qualitatively, either in the urine or blood : | 156,739 | medmcqa_train |
True abut 'X' Chromosome inactivation: | A i.e. X-gene Although females have 2X chromosomes (XX), but due to inactivation (lyonization) genes on one X chromosome becomes transcriptionally inactive. Thus X inactivation prevents expression of most genes on one of the X- chromosome in every cell of femaleQ. | 156,740 | medmcqa_train |
Mucosal melanosis and hamaomatous polyps are seen in? | Peutz-jeghers syndrome: Autosomal dominant disorder Mutation- STK 11 / LKB1 gene Multiple gastrointestinal hamaomatous polyps + Mucocutaneous hyperpigmentation Increased risk for colon, pancreas, breast, lung, ovaries, uterus, testes neoplasms Gross- Polyps are large & pedunculated with lobulated contour. | 156,741 | medmcqa_train |
Which one of the following is a major component in activation of the complement alternative pathway: | - Alternate complement pathway Activators factor- Cobra venom , Properidin ,nephritic - C3b , Bb - C3 convease of alternate complement pathway - C5 - C9 is MAC (membrane attack complex) - C1,4,2 are not consumed in the alternate complement pathway | 156,742 | medmcqa_train |
Which of the following is seen in 95% of patient with diabetes mellitus - | The inheritance of type 1 diabetes is polygenic , with over 20 different regions of the human genome showing an association with type 1 diabetes risk. Most interest has focused on the human leucocyte antigen (HLA) region within the major histocompatibility complex on the sho arm of chromosome 6. The HLA haplotypes DR3 and/or DR4 are associated with increased susceptibility to type 1 diabetes in Caucasians and are in 'linkage disequilibrium', i.e. they tend to be transmitted together, with the neighbouring alleles of the HLA-DQA1 and DQB1 genes. The latter may be the main determinants of genetic susceptibility, since these HLA class II genes code for proteins on the surface of cells that present foreign and self-antigens to T lymphocytes (p. 82). Candidate gene and genome-wide association studies have also implicated other genes in type 1 diabetes, e.g. CD25, PTPN22, SH2B3, IL2RA and IL-10. Ref - davisosn 23e p751 | 156,743 | medmcqa_train |
Metabolic alkalosis seen in following except | Causes of Metabolic Alkalosis I. Exogenous HCO3-loads A. Acute alkali administration B. Milk-alkali syndrome II. Effective ECFV contraction, normotension, K+ deficiency, and secondary hyperreninemic hyperaldosteronism A. Gastrointestinal origin 1. Vomiting 2. Gastric aspiration 3. Congenital chloridorrhea 4. Villous adenoma B. Renal origin 1. Diuretics 2. Posthypercapnic state 3. Hypercalcemia/hypoparathyroidism 4. Recovery from lactic acidosis or ketoacidosis 5. Nonreabsorbable anions including penicillin, carbenicillin 6. Mg2+ deficiency 7. K+ depletion 8. Bater's syndrome (loss of function mutations of transpoers and ion channels in TALH) 9. Gitelman's syndrome (loss of function mutation in Na+-Cl-cotranspoer in DCT) III. ECFV expansion, hypeension, K+ deficiency, and mineralocoicoid excess A. High renin 1. Renal aery stenosis 2. Accelerated hypeension 3. Renin-secreting tumor 4. Estrogen therapy B. Low renin 1. Primary aldosteronism a. Adenoma b. Hyperplasia c. Carcinoma 2. Adrenal enzyme defects a. 11b-Hydroxylase deficiency b. 17a-Hydroxylase deficiency 3. Cushing's syndrome or disease 4. Other a. Licorice b. Carbenoxolone c. Chewer's tobacco IV. Gain-of-function mutation of renal sodium channel with ECFV expansion, hypeension, K+ deficiency, and hyporeninemic-hypoaldosteronism A. Liddle's syndrome (Ref: Harrison's principles of internal medicine 19E, pg 321) | 156,744 | medmcqa_train |
For the following cardiac abnormalities, select the characteristic JVP finding.Complete heart block | Large a waves occur with increased resistance to filling (tricuspid stenosis, pulmonary hypertension) or when the right atrium contracts against a tricuspid valve closed by right ventricular systole (Cannon a waves) in complete heart block or other arrhythmias. | 156,745 | medmcqa_train |
Treatment of orthostatic hypotension is - | Ans. is 'c' i.e., Fludrocortisone Management of chronic orthostatic hypotensiono Correct precipitating factors (e.g,, hypovolemia) and withdraw offending drugs (diuretics, vasodilators, tranquilizers and sedatives)Physical measureso Raise the head of the bed by 10 to 20dego Arise slowly, in stages, from supine to seated to standingo Dors (flexion of the feet, handgrip isometric, leg cross ing/squatting before standingo Liberalize salt and fluid intakeo Small meals and coffee only in the early morningo Jobst stockings and pressure suits (often not acceptable)Drugso Fludrocortisone with a high salt diet is the initial treatment of choiceo Sympathomimetic drugs - ephedrine, phenylpropanolamine, pseudoephedrine, phenylephrine, midodrine, methylphenidate, dextroamphetamineo Supplemtary agentsNonsteroidal antiinflammatory drugsCaffeineErythropoietin (if anemic)o Third-line and experimental drugsVasopressin receptor agonistd-dDA VP, lysine vasopressinPyridostigmineYohimbineSomatostatin analogues - octreotide, especially for postprandial hypotension DihydroergotamineFluoxetineDihydroxyphenylserineDopamine antagonists - metocloramide, domperidoneMonoamine oxidase inhibitor with tyramine - can produce severe hypertension. | 156,746 | medmcqa_train |
A 12-year-old child presents with tingling sensation and numbness in the little finger and gives a history of fracture in the elbow region 4 years back. The probable fracture is - | Similar to previous question, the child is presenting with tardy ulnar nerve palsy.
Here the age of child at the time of injury to elbow is 8 years (child is 12 years old and he/she sustained injury 4 years back).
So, age group matches with lateral condyle fracture (5-10 years).
About option 'b'
Ulnar nerve injury due to trauma will present immediately not after 4 years. | 156,747 | medmcqa_train |
All the following statements are true about transposons Except | Mobile genetic elements (e.g., transposons):Remarkably, more than one-third of the human genome is composed of these elements, popularly denoted as "jumping genes." These segments can move around the genome, exhibiting wide variation in number and positioning even amongst closely related species (i.e., humans and other primates). They are implicated in gene regulation and chromatin organization, but their function is still not well established.The miRNAs do not encode proteins; instead, they function primarily to modulate the translation of target mRNAs into their corresponding proteins.Ref: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Chapter 1; The genome; Page no: 2 | 156,748 | medmcqa_train |
Under the programme of control and prevention of anemia by RCH (Rural child health) what dosage of Iron and Folic acid tablets are given? | Iron deficiency anemia is widely prevalent in young children. The National family health Survey II (1998-99) revealed that 74.3% of children under the age of 3 years were anemic. Under this programme of control & prevention of anemia, tablets containing 20 mg of elemental Iron & 0.1mg of folic acid are provided at sub-centre level. Ref: Park, 20th Edition, Page 383 | 156,749 | medmcqa_train |
Smoke index is used for- | Monitoring of air pollution
Monitoring of air pollution is done by : -
Sulphur dioxide.
Gritt and dust measurement.
Co-efficient of haze.
Air pollution index.
Smoke or soiling index | 156,750 | medmcqa_train |
Neural crest cells give rise to all the dental structures except ? | Ans. is 'c' i.e., EnamelTeeth developmentA) Neural crest derivaties (Derivatives of neuroectoderm)Mesenchymall cells (derived from neural crest) of dental papilla form :?i) Odontoblasts which form Dentineii) Tooth pulpB) Derivatives of surface ectodermIt gives rise to ameloblasts which form enamel. | 156,751 | medmcqa_train |
Growth hormone secretion, true is | Growth hormone (GH), also known as somatotropin (or as human growth hormone in its human form), is a peptide hormone that stimulates growth, cell reproduction, and cell regeneration in humans.A number of factors are known to affect GH secretion, such as age, sex, diet, exercise, stress, and other hormones. Young adolescents secrete GH at the rate of about 700 mg/day, while healthy adults secrete GH at the rate of about 400 mg/day. Sleep deprivation generally suppresses GH release, paicularly after early adulthood.Stimulators of growth hormone (GH) secretion include:peptide hormones GHRH, Ghrelinsex hormonesincreased androgen secretion during pubey (in males from testis and in females from adrenal coex)estrogeNdeep sleepfastingvigorous exerciseInhibitors of GH secretion include:GHIH (somatostatin) from the periventricular nucleuscirculating concentrations of GH and IGF-1 (negative feedback on the pituitary and hypothalamus)hyperglycemiaglucocoicoidsdihydrotestosteroneRef: Ganong&;s review of medical physiology;24th edition; page no-330 | 156,752 | medmcqa_train |
A 42 year old female brought by her relative complaining that she always tell everyone that she is getting instructions from other planets. All of the following are first rank symptoms of schizophrenia, EXCEPT: | Perception is physical sensation given meaning, the integration of sensory stimuli to form an image or impression, in a manner or configuration influenced by past experience.Heightened perception occurs in delirium, mania, after hallucinogens, and in the rare ecstatic states that occur as pa of acute schizophrenia or "transpoed" hysterical trances. Dulled perception occurs in depression and organic delirium. Ref: Nurcombe B., Ebe M.H. (2008). Chapter 4. The Psychiatric Interview. In M.H. Ebe, P.T. Loosen, B. Nurcombe, J.F. Leckman (Eds), CURRENT Diagnosis & Treatment: Psychiatry, 2e. | 156,753 | medmcqa_train |
Joint between sphenoid & vomer is ? | Ans. is 'd' i.e., SchindylesisVomer-sphenoid rostrum junction is schindylesis type of suture.Fibrous joints 1. SuturesPlane sutures : Intranasal suture, median palatine suture.Serrate (limbus) suture : Sagittal suture (interparietal suture).Denticulate suture : Lambdoid suture (parieto-occipital suture), coronal suture (fronto-parietal suture). iv)Squmous suture : Temporo-parietal suture.Schindylesis : Vomer-sphenoid rostrum junction. 2. Syndesmosis : Interosseous radio-ulnar joints, interosseous tibiofibular joints, inferior tibiofibular joints, joints between adjacent laminae of veebrae, tympano-stapedial joint and posterior pa of SI joint. 3. Gomphoses : Root of the tooth in its bony socket. | 156,754 | medmcqa_train |
Patient a known case off alcohol dependence after 12 to 18 hrs of last drink develops seizure for the first time in his life.possible diagnosis is rum fits. treatment for the above patient | DETOXIFICATION Detoxification implies removal of the toxic substance from the body, this can be done by using a drug similar to alcohol and thus benzodiazepine is chosen. This is the main drug used in treatment of alcohol withdrawal despite the problem being simple withdrawal, rum fits or delirium tremens IF LIVER FUNCTION IS WITHIN NORMAL LIMITS CHOOSE CHLORDIAZEPOXIDE, AS IT HAS A SIMILAR STRUCTURAL FORMULA LIKE ALCOHOL IF LIVER FUNCTION IS ABNORMAL CHOOSE LORAZEPAM, AS IT DOES NOT WORSEN LIVER DERANGEMENTS FRONT LOADING=====patient is loaded with benzodiazepines SYMPTOM TRIGGER=== benzodiazepines is offered only as and when the withdrawal symptom arises FIXED DOSAGE====== regular fixed dosage of benzodiazepine is given in divided doses and slowly tapered so that the patient is not on any drugs by the end of 2 weeks Ref.Kaplon and Sadock, synopsis of psychiatry, 11 th edition , pg no.626 | 156,755 | medmcqa_train |
Guardian of the genes is? | Ans. is 'b' i.e., p53 * p53 is a tumor suppressor gene. p53 gene is located on chromosome 17. p53 acts as molecular policeman that prevents the propagation of genetically damage cell.* p-53 is the most common target for genetic alteration in human tumors; A little over 50% of human tumors contain mutation in this gene.(Note - Amongst oncogene RAS is involved most commonly)* The major functional activities of the p53 protein are cell cycle arrest and initiation of apoptosis in response to DNA damage. | 156,756 | medmcqa_train |
All are features of Intravascular hemolysis except - | Hemolytic anemia
Hemolytic anemia is anemia due to hemolysis, i.e. the abnormal breakdown of red blood cells.
Hemolytic anemia has the following features -
A shortened red cell lifespan, i.e. premature destruction of red cells.
Elevated erythropoietin level and increased erythropoiesis in the marrow and other sites, to compensate for the loss of red cells→ characterized by increased reticulocyte count.
Accumulation of the products of hemoglobin catabolism due to an increased rate of red cell destruction.
Hemolysis may occur either inside the blood vessels (intravascular hemolysis) or within the mononuclear phagocytic system of spleen, liver or bone marrow (extravascular hemolysis).
Intravascular hemolysis
Due to the destruction of RBC, hemoglobin is released into blood → Hemoglobinemia.
Excess of hemoglobin may be excreted by kidney → hemoglobinuria.
Some of the hemoglobin is reabsorbed in kidney and is converted to hemosiderin which is then excreted → hemosiderinuria.
Free hemoglobin in plasma bound to haptoglobin and this complex is rapidly cleared by mononuclear phagocytic system Decreased haptoglobin.
When haptoglobin is depleted, free hemoglobin is oxidized to methemoglobin → methemoglobinemia.
Excess heme groups are catabolized to bilirubin within the mononuclear phagocytic system → Increased indirect bilirubin and jaundice.
LDH is stored in the blood. During hemolysis this enzyme is released in the blood → Increased serum LDH. | 156,757 | medmcqa_train |
Wolf Chaikoff effect: | Answer is A (Iodine Induced Hypothyroidism) Repeat Iodine Induced Transient Suppression of Thyroid Gland is called Wolf Chaikoff Effect. | 156,758 | medmcqa_train |
Chronic urticaria is a - | Ans. is 'a' i.e., Type 1 hypersensitivity reaction Types of hypersensitivity reactionType of hypersensitivity reactionExamplesMediatorsType 1 (immediate type)Atopic dermatitisUrticariaAnaphylaxisInsect bite hypersensitivityAllergic rhinitis and asthmaIgEType 2 (cytotoxic, antibody dependent)Autoimmune hemolytic anemiaRheumatic heart diseaseThrombocytopeniaErythroblastosis foetalisGoodpasture's syndromeGrave's diseaseMyasthenia gravisIgG or IgMMACComplementType 3 (immune complex disease)Serum sicknessArthus reactionRheumatoid arthritisPost streptococcal glomerulonephritisMembranous nephropathyLupus nephritisSystemic lupus erythematosusExtrinsic allergic alveolitis(hypersensitivity pneumonitis)Generalized drug eruptionErythema multiformeErythema nodosumTENIgGComplementNeutrophillsType 4 (delayed type)TuberculosisLeprosyContact dermatitisChronic transplant rejectionMultiple sclerosisT-cells | 156,759 | medmcqa_train |
In depressions, there is deficiency of ? | Ans. A. 5-HTDepression = Decrease in serotonin and norepinephrine.Serotonin is the most imPoant neurotransmitter in depression.Mania= Increased of norepipherine. | 156,760 | medmcqa_train |
Enlargement of pituitary tumor after adrenalectomy is called as: | Nelson Syndrome: Nelson syndrome refers to a spectrum of symptoms ansd signs arising from an adrenocoicotropin (ACTH)- secreting pituitary macroadenoma after a therapeutic bilateral adrenalectomy The spectrum of clinical features observed relates to the local effects of tumors on surrounding structures , the secondary loss of other pituitary hormones, and the effects of the high serum concentrations of ACTH on the skin Ref: Harrison 19th edition PGno: 2273 | 156,761 | medmcqa_train |
The stapes is a derivative of which of the following pharyngeal arch? | Structures derived from second pharyngeal arch are stapes, styloid process of temporal bone, lesser cornu of hyoid bone and upper pa of hyoid bone. Skeletal and ligamentous elements derived from pharyngeal arches: First archMalleus and incusPoions of the mandibleMeckels cailageSphenomandibular ligamentAnterior ligament of malleusSecond archstapesStyloid process of temporal boneLesser cornu of hyoid boneUpper pa of hyoid boneThird archGreater cornu of hyoid boneLower pa of hyoid boneFouh archThyroid cailageCricoid cailageArytenoid cailageCorniculate and Cuneiform cailage Ref: General Anatomy and Musculoskeletal System (THIEME Atlas of Anatomy) By Michael Schuenke, page 12. | 156,762 | medmcqa_train |
Which is true about stab wound - | The synopsis of forensic medicine & toxicology ; Dr k.s narayan reddy ; 28th edition ; Pg.no. 116 ; In a stab wound the depth ( length of track ) is greater than the width & length of external injury ,the depth of a stab wound is usually equal to or less than length of blade ,that is used in producing it ,but in anterior abdominal wall depth of wound is greater due to the force of thrust that may press the tissue underneath . | 156,763 | medmcqa_train |
Longest acting muscle relaxant is- | Ans. is 'c' i.e., Doxacurium o Amongst the given options doxacurium is longest acting (Duration of action 90-120 minutes),o Rocuronium (duration of action 30-60 minutes), Atracurium (duration of action 30-60 minutes) and vecuronium (duration of action 60-90 minutes) have shorter duration of action than doxacurium.Properties of NM Blockerso Longest acting Neuromuscular blocker - Pancuronium (duration of action 120-180 minutes). (Goodman & Gilman llth/e p. 222) (Note: In some books pipecuronium or Doxacurium have given as the longer activity),o Shortest and fastest acting neuromuscular blocker - Succinylcholine (suxamethonium) - duration of action 5-8 minutes.o Shortest acting competitive (nondepolarizing) neuromuscular blocker - Mivacurium (duration of action 12-18 minutes).o Fastest acting nondepolarizing blocker - Rocuronium (can be used for endotracheal intubation as an alternative to Sch).o Non-depolarizing neuro-muscular blockers can cause ganglion block, vagal block and Histamine release (different agents has different propensity).o Histamine release is caused by - D-TC (maximum tendency), succinylcholine, mivacurium, doxacurium, atracurium, tubocurarine - can cause bronchoconstriction.o Virtually no histamine release - Pancuroniumo Vagal block is caused by - Pancuronium, recuronium, Gallamine.o Maximal vagal block and tachycardia is caused by - Pancuronium (Previously it was gallamine, but it is not used now).o Vagal stimulation is caused by - succinylcholine (can cause bradycardia).o Ganglion block is caused by -d-Tc, Meiocurine, Alcuronium.o Maximum ganglion blockade is caused by - d-TC.o Ganglion stimulation is caused by - Succinylcholine.o Most commonly used muscle relaxant for routine surgery ->> vecuronium.o Most potent skeletal muscle relaxant - Doxacurium.o Least potent skeletal muscle relaxant - Succinylcholine (Gallamine was /east potent but it is not used now).o Least potent nondepolarising muscle relaxant - Rocuronium.o MR of choice for - intubation - Sch (1st choice), Rapacuroium (2nd choice), Rocuronium (3rd choice),o Mivacurium is the only non-depolarizing blocker that is metabolized by plasma cholinesterase.o Gallamine was the most nephrotoxic NM blocker - was contraindicated in renal failure. Due to its nephrotoxic and tetratogenic potential it has been withdrawn,o Recuronium produces pain on injection.o Succinylcholine is the muscle relaxant of choice for rapid endotracheal intubation. Rapacuronium and rocuronium are alternates. | 156,764 | medmcqa_train |
Low insulin/glucagon levels to increase in the activity of | Insulin has several effects in liver which stimulate glycogen synthesis. First, it activates the enzyme hexokinase, which phosphorylates glucose, trapping it within the cell. Coincidently, insulin acts to inhibit the activity of glucose-6-phosphatase.When the insulin level is decreased, activity of enzyme glucose-6-phosphatase is increased, thereby increasing glycogenolysis and gluconeogenesis | 156,765 | medmcqa_train |
Second National Family Health Survey was done in the year? | The second National Family Health Survey (NFHS-2), conducted in 1998-99, is another impoant step to strengthen the database fuher for implementation of the Reproductive and Child Health approach adopted by India after the International Conference on Population and Development (ICPD) in Cairo. The second National Family Health Survey is the outcome of collaborative effos of many organizations. The International Institute for Population Sciences (IIPS) was designated as the nodal agency for this project by the Ministry of Health and Family Welfare (MOHFW), Government of India, New Delhi. The project was funded by the United States Agency for International Development (USAID), with additional suppo from UNICEF. Technical guidance was provided by Macro International and the East-West Center, USA. Responsibility for data collection was entrusted to 13 reputed organizations in India, including some Population Research Centres. As in the earlier survey, the principal objective of NFHS-2 is to provide state and national estimates of feility, the practice of family planning, infant and child moality, maternal and child health and the utilization of health services provided to mothers and children. In addition, the survey includes information on the quality of health and family welfare services and provides indicators of the status of women, women's reproductive health, and domestic violence. Another feature of NFHS-2 is measurement of the nutritional status of women. Height and weight measurements, which were available only for young children in the earlier survey, were extended to cover all eligible women in NFHS-2. In addition, ever-married women and their children below age three had their blood tested for the level of haemoglobin, using the HemoCue instrument. Through these blood tests, for the first time the survey provides information on the prevalence of anaemia throughout India. In two metropolitan cities, Delhi and Mumbai, a fuher test was done for children below age three to measure the lead content in their blood. The survey also measured the extent to which households in India use cooking salt that has been foified with iodine. The survey covers a representative sample of about 91,000 ever-married women age 15-49 from 26 states in India who were covered in two phases, the first staing in November 1998 and the second in March 1999. The survey provides state-level estimates of demographic and health parameters as well as data on various socioeconomic and programmatic dimensions, which are critical for bringing about the desired change in demographic and health parameters. One impoant feature of NFHS-2 is the data on the nutritional status of women and children collected by carrying out blood tests for haemoglobin levels in addition to the measurement of their height and weight. Ref: GOI | 156,766 | medmcqa_train |
Medullary cystic disease of the kidney is best diagnosed by: | Answer is D (Biopsy): Although ultrasonography and CT scan can be useful in making a diagnosis of medullary cystic disease, an open renal biopsy that ensures recovery of tissue from the coicomedullary junction is definitive. | 156,767 | medmcqa_train |
Cutaneous larva migrans is caused by: September 2012 | Ans. A i.e. A. braziliense Cutaneous larva migrans(CLM) It is a skin disease in humans, caused by the larvae of various nematode parasites of the hookworm family (Ancylostomatidae). The most common species causing this disease in the Americas is Ancylostoma braziliense. These parasites live in the intestines of dogs, cats and wild animals and should not be confused with other members of the hookworm family for which humans are definitive hosts, namely Ancylostoma duodenale and Necator americanus. Colloquially called creeping eruption due to its presentation, the disease is also somewhat ambiguously known as "ground itch" or (in some pas of the Southern USA) "sandworms", as the larvae like to live in sandy soil. Another vernacular name is plumber's itch. The medical term CLM literally means "wandering larvae in the skin" | 156,768 | medmcqa_train |
Which of the following is not a sign of successful stellate ganglion block – | Signs of successful stellate ganglion block :- Horner's syndrome, flushing of face, conjuctival congestion, nasal stuffiness (Guttman's sign), injection of tympanic membrane (Mueller's syndrome), increased skin temprature, lacrimation. | 156,769 | medmcqa_train |
Kocher langenback approach for emergency acetabular fixation is done in all Except- | *Morel-Lavalle lesion is a localized area of subcutaneous fat necrosis over the lateral aspect of hip caused by same trauma that causes the acutabular fracture. The operation through it has been a/w a higher (12%) rate of post - operative infection , wound dehiscence and healing by secondary intention. The presence of a significant Morel-Lavallee lesion can be suspected by hypermobility of the skin and subcutaneous tissue in the affected area from the shear type separation of the subcutaneous tissue from the underlying fascia lata. Alternatively, some fractures can be treated through ilioinguinal approach, thus avoiding the affected area. *Therefore, in the presence of Morel - Lavalle lesion posterior kocher langenbeck approach is avoided. Ref: Essentials of ohopaedics surgery 3rd/e p.1219 | 156,770 | medmcqa_train |
Which of the following organ is usually the first site of metastasis in a case of osteosarcoma of young female? | Lung is the earliest site for metastasis in osteosarcoma. A chest X-ray should be done to detect the same. CT scan may be required in cases where the metastatic lesion is unclear on chest X-ray. Reference: Maheshwari; Essential Ohopaedics; Page no: 240 | 156,771 | medmcqa_train |
Chromosomes involved in early onset Alzheimer's disease: | A i.e. 1,14,21Ref: Genetic Home ReferenceExplanation:Genes Involved in Alzheimers Disease:Early onset Alzehimer's disease involves three genes: APP-Ch 21.PSEN1 (Presenilin 1) - Ch 14.PSEN 2 (Presenilin 2) - Ch 1.Genes causing autosomal dominant AD* APP* PSEN1* PSEN 2All can cause early onset disease but PSEN2 is associated with a broad range of onset ages.Susceptibitity genes* Apolipoprotein E gene (APOE)- c2 allele: associated with decreased risk- s3 allele: neutral- e4 allele: high-risk* SORL1 | 156,772 | medmcqa_train |
Fibronectin in fetus indicates: | Preterm labor | 156,773 | medmcqa_train |
Which is true of Entero bacteriacae - | . Ans. is 'a' i.e., All are oxidase negative . Motile by peritrichate flagella (not by polar flagellum) or are non motile. . Glucose is feremented by all but some produce acid and gas, while other produce acid only. . Catalase (+) ye . Oxidase negative . Reduce nitrates to nitrite . May or may not be capsulated. . Are aerobic and facultatively anaerobic. | 156,774 | medmcqa_train |
NOT a hybrid muscle among the following is | Nerve supply of above muscles-
Brachialis
Musculocutaneous Nerve and Radial nerve (proprioception)
Flexor pollicis brevis
Superficial head by Median Nerve
Deep head by Ulnar nerve
Sternocleidomastoid
Spinal accessory nerve and C3 , C4
Adductor pollicis
Ulnar nerve | 156,775 | medmcqa_train |
Treatment of choice in postauricular abscess as a complication of otitis media is: | Postaural abscess usually follows coalescent mastoiditis as after acute otitis media or in cases of mastoiditis with cholesteatoma; a mastoidectomy is therefore important in its treatment. | 156,776 | medmcqa_train |
Moderately severe hearing loss: | Ans. (c) 56-70 dBRef. Dhingra's ENT 6th ed./38 WHO classification for hearing loss:0-25 dBNormal hearing26-40 dBMild hearing loss41-55 dBModerate hearing loss56-70 dBModerately severe hearing loss71-90 dBSevere hearing loss> 90 dBProfound hearing loss | 156,777 | medmcqa_train |
Stool specimen is transpoed in ? | Ans. is 'a' i.e., Cary blair medium Transpo media for stool specimen are :? Cary-Blair medium Buffered glycerol saline Stua medium Inoculate media for routine stool culture are :- Blood agar MacConkey agar Hektoen enteric HE ( agar) Selective media for campylobactor : Campy BAP, skirrow Selenite F broth or GN Broth Xylose-lysine deoxycholate agar (XLD agar) For specific situations, selective media are used :- Vibrio : TCBS agar or Alkaline peptone broth. Yersinia : Cefsulodin-Irgasan-Novobiosin (CIN) agar or Phosphate Buffered Saline (PBS) broth. E.coli 0157:H7: Sarbitol-MacConkey agar. | 156,778 | medmcqa_train |
True about Fibrolamellar carcinoma of Liver is all, except- | Ans. is 'd' i.e., Serum AFP levels are usually greater than 1000mg/litreFibrolamellar carcinoma ?o It is a distinctive variant of hepatocellular carcinomao It is seen in young adults (20-40 yrs of age)It has equal sex incidence o It has better prognosis o It has no association with HBV or cirrhosiso It is grossly encapsulated mass.o AFP elevation is not seen in Fibrolamellar Ca | 156,779 | medmcqa_train |
Method of sterilization which is least effective is - | Ans. is 'd' Hysteroscopic tubal occlusion Hysteroscopic tubal occlusion is done by 2 methods and both these methods have high failure rates.Due to high failure rate this method is obsolete nowPomeroy's method has failure rate of 0.4%Laparoscopic sterilization has failure rate 0.6%Fimbriectomy - Permanent sterilization | 156,780 | medmcqa_train |
Antiarrhythmic drug causing hypothyroidism is: (E. REPEAT 2007) | Ref: Drug-Induced Diseases: Prevention, Detection and Management, James E. Tisdale, 2nd edition, Page 587Explanation:Amiodarone causes both Hypo and Hyperthyroidism.DRUGS CAUSING HYPOTHYROIDISMEthionamide.Amiodarone.Nitroprusside.Perchlorate.Povidone iodine (Betadine).Sulfonylureas.INF alpha.Lithium.Octreotide.Rifampin.Aldesleukin.Thalildomide.Leuprolide.DRUGS CAUSING HYPERTHYROIDISMAmiodarone.Cyclosporine.INF alpha.INF beta.lodinated compounds.Lenalidomide.Leuprolide.Lithium. | 156,781 | medmcqa_train |
A very potent and short-acting benzodiazepine was given to a patient Kallu for the purpose of causing hypnosis but the drug caused psychiatric disturbances in him. Which of the following can be the hypnotic used? | Triazolam is a very potent BZD with ultra-rapid elimination. Some cases of paranoia and psychiatric disturbances have been noted with this drug. | 156,782 | medmcqa_train |
True about competitive inhibition of enzyme | It is obvious that in the case of competitive inhibition, the Km is increased in presence of competitive inhibitor. Thus competitive inhibitor apparently increases the Km. In other words, the affinity of the enzyme towards the substrate is apparently decreased in presence of the inhibitor.In competitive inhibition, the inhibitor will be a structural analog of the substrate. There will be similarity in three-dimensional structure between substrate (S) and inhibitor (I). For example, the succinate dehydrogenase reaction is inhibited by malonate (Fig. 5.19). v. Competitive inhibition is usually reversible. Or, excess substrate abolishes the inhibition. In the previous example of 100 moles of E and 100 moles of I, if 900 moles of S are added, only 1/10th of enzyme molecules are attached to the inhibitor and 90% are working with substrate. Thus 50% inhibition in the first example is now decreased to 10% inhibition But Vmax is not changed. Clinical significanceof such inhibitionRef: DM Vasudevan, Page no: 52 | 156,783 | medmcqa_train |
Which of the following is XLR? | Ans (b) HaemophiliaRef: Robbings pathology 9th ed. 1142X-LINKED RECESSIVE* X-linked recessive disorders are also caused by mutations in genes on the X chromosome.* Males are more frequently affected than females, and the chance of passing on the disorder differs between men and women.* Families with an X-linked recessive disorder often have affected males, but rarely affected females, in each generation.* A characteristic of X-linked inheritance is that fathers cannot pass X-linked traits to their sons (no male-to- male transmission).Mnemonic for XLR disorders"Less HCG is Detected Clinically in A Fragile Woman"* Lesch-Nyhan syndrome* Hemophilia, Hunters* Chronic granulomatous disease* G6PD deficiency* Duchenne muscular dystrophy* Colorblindness* Agammaglobulnimea* Fragile X Syndrome* Wiskott-Aldrich syndrome | 156,784 | medmcqa_train |
Shirodkar stitch is given at ..... of pregnancy : | 14-16 weeks | 156,785 | medmcqa_train |
Most sensitive test for screening of " SLE" is | Ref Robbins 9/e p219, 8/e p214 ,7/e p228 Spectrum of Autoantibodies in SLE Antibodies have been identified against a host of nuclear and cytoplasmic components of the cell that are specific to neither organs nor species. Another group of antibodies is directed against surface antigens of blood cells, while yet another is reactive with proteins in complex with phospho- lipids (antiphospholipid antibodies) (Chapter 3). * Antinuclear antibodies. ANAs are directed against several nuclear antigens and can be grouped into four catego- ries: (1) antibodies to DNA, (2) antibodies to histones, (3) antibodies to nonhistone proteins bound to RNA, and (4) antibodies to nucleolar antigens. Table 4-10 lists several autoantibodies, including ANAs, and their asso- ciation with SLE as well as with other autoimmune dis- eases, to be discussed later. The most widely used method of detecting ANAs is the indirect immunofluo- rescence assay (IFA), which screens for autoantibodies that bind to a variety of nuclear antigens, including DNA, RNA, and proteins. Four staining patterns are seen with IFA: homogeneous or diffuse, rim or periph- eral, speckled, and nucleolar. While each pattern can be suggestive of the presence of specific autoantibodies, the strength of these associations is limited and should not be relied on. ANA testing by IFA is extremely sensitive, as more than 95% of patients with SLE will test positive, but the test's specificity is quite limited, because patients with other autoimmune diseases, chronic infections, and cancer will test positive as well. Fuhermore, ANAs are seen in approximately 5% to 15% of healthy people, and the incidence increases with age. Recently, the IFA has been replaced in many clinical laboratories by multiplex flow cytometry immunoassays that can simultaneously test for multiple specific autoantibodies, but these assays may lack the sensitivity of the IFA. Antibodies to double- stranded DNA (dsDNA) and the so-called Smith (Sm) antigen can be detected by ELISA or multiplex flow methods and are specific for SLE. * Other autoantibodies. Antibodies against blood cells, including red cells, platelets, and lymphocytes, are found in many patients. Antiphospholipid antibodies are present in 40% to 50% of patients with lupus and react with a wide variety of proteins in complex with phospholipids. Some bind to cardiolipin antigen, used in serologic tests for syphilis, so patients with lupus may have a false-positive test result for syphilis. Antiphos- pholipid antibodies contribute to coagulation abnormal- ities, which are described below. Mechanisms of Tissue Injury Regardless of the exact sequence by which autoantibodies are formed, they are likely to be the mediators of tissue injury, probably through multiple mechanisms. * Most organ damage in SLE is caused by immune complex deposition. Skin and kidney biopsies from patients with SLE typically demonstrate diffuse and heavy granular deposits of complement and immunoglobulin. Autoan- tibodies complexed with DNA can be detected as well. These deposits of immune complexes had been thought to cause tissue damage by activating the classical com- plement pathway (type III hypersensitivity); 75% of patients will have reduced serum levels of C3 and C4 at the time of SLE flares, presumably because complement is being activated and consumed faster than it can be produced. However, people and rodents deficient in C1q are not protected from SLE and actually can spon- taneously develop SLE, raising the possibility that complement-independent mechanisms may also con- tribute to tissue damage. * Autoantibodies of different specificities contribute to the pathology and clinical manifestations of SLE (type II hyper- sensitivity). Autoantibodies against red cells, white cells, and platelets opsonize these cells and lead to their phagocy- tosis, resulting in cytopenias. Autoantibodies against various phospholipids lead to increased thrombosis in patients, with varied clinical consequences, including recurrent spontaneous aboion and thrombotic epi- sodes. These disorders are pa of the antiphospholipid syndrome. Paradoxically, these antibodies interfere with clotting tests and are actually called "lupus anticoagu- lants." Autoantibodies are also produced against clot- ting factors such as thrombin, and these too may contribute to clotting disorders. Autoantibodies against central nervous system receptors for various neurotransmit- ters have been implicated in the neuropsychiatric com- plications of the disease. * There is no evidence that ANAs can permeate intact cells. However, if cell nuclei are exposed, the ANAs can bind to them. In tissues, nuclei of damaged cells react with ANAs, lose their chromatin pattern, and become homogeneous, to produce so-called LE bodies or hema- toxylin bodies. An in vitro correlate of this is the LE cell, a neutrophil or macrophage that has engulfed the dena- tured nucleus of another injured cell. When blood is withdrawn and agitated, a number of leukocytes are sufficiently damaged to expose their nuclei to ANAs, with secondary complement activation; these antibody- and complement-opsonized nuclei are then readily phagocytosed. Although the LE cell test is positive in as many as 70% of patients with SLE, it is now largely of historical interest. | 156,786 | medmcqa_train |
If a neonate has warm abdomen, but cold extremities then the baby has? | Diagnosis of hypothermia by human touch: Trunk Extremities Interpretation Warm Warm Normal Warm Cold Cold stress Cold Cold Hypothermia | 156,787 | medmcqa_train |
Isotope used in RAIU – | RAIU stands for radioactive iodine uptake. It is a thyroid imaging method that measures the fraction of orally administered iodine isotope taken up by thyroid. 1123 is the agent of choice for RAIU. | 156,788 | medmcqa_train |
Dalen Fuch's nodules are seen in: | Sympathetic ophthalmia | 156,789 | medmcqa_train |
A 35-year-old man is admitted after severing his arm on industrial machinery. His airway is patent and there is no identifiable hindrance to breathing. Hispulse is 110 beats/min, blood pressure is 130/105 mmHg, and respiratory rate is 25 breaths/min. Which stage of shock is this patient in? | The following table illustrates the clinical signs of the different stages of hypovolaemic shock. Class I Class II Class III Class IV Percent blood loss Up to 15 15-30 30-40 >40 Pulse rate <100 >100 >120 >140 Blood pressure Normal Normal | | Pulse pressure Normal | | | Respiratory rate 14-20 20-30 30-40 >35 Urine output (mL/h) >30 20-30 5-15 <5 Mental status Slight anxiety Mild anxiety Anxious, confused Confused | 156,790 | medmcqa_train |
True about point source epidemic is? | Common source single exposure epidemics is also known as point source epidemic. The exposure to the disease agent is brief and essentially simultaneous, the resultant cases all develop within one incubation period of the disease. Ref: 25th edition, Park's Textbook of Preventive and Social Medicine, Page no. 72 | 156,791 | medmcqa_train |
Ichthyosis is caused by – | Syndromal ichthyosis (ichthyosis with additional characteristics) is seen in carvaj al syndrome, CHILD syndrome, Daffier 's disease, Refsum disease, Rud syndrome, Netherton syndrome, Neutral lipid storage disease, Tey syndrome, Senter syndrome. | 156,792 | medmcqa_train |
Herd immunity provides protection to - | Ans. is 'b' i.e., Non-immunized person Herd immunity It is the level of resistance of a community or group of people to a paicular disease. It occurs when the vaccination of a poion of the population (or herd) provides protection to unprotected (non-vaccinated) individuals. How does herd immunity provide protection to nonimmunized person ? o Infection is spread from person to person. o If a large number of population are immune, it is more difficult to maintain a chain of infection. o The more immune individuals present in a population, the lower the likelihood that a susceptible person will come into contact with an infected individual. o For example, if person 'A' had a disease and exposed person 'B' who was immune because of vaccination, person `B' would not get ill and could not pass on the disease to person 'C' when he comes into contact with him. So, even if person 'C' is not vaccinated, He indirectly gets protection from the disease. o Hence herd immunity may be used to reduce spread of an infection and to protect a vulnerable, un-vaccinated subgroup. | 156,793 | medmcqa_train |
Maximum permissible radiation dose in pregnancy is – | Maximum permissible dose in pregnancy is 5 mSv (0.5 rem).
Rem = Rad x Quality factor.
Main radiation exposure during pregnancy can be by X-rays (radiography or CT), and the quality factor of X-rays is 1.
That means Rem = Rad.
Therefore, the maximum permissible dose in pregnancy is 0.5 rem or 0.5 rad. | 156,794 | medmcqa_train |
What is the appearance of the RBCs on the peripheral smear in physiological anaemia of the pregnancy? | Physiological anemia is due to hemodilution. Peripheral smear will be normocytic and normochromic, which is not to be confused with Iron deficiency Anemia & thalassemia where the women have microcytic hypochromic anemia | 156,795 | medmcqa_train |
Which of the following is related to floor of middle ear - | Ans. is 'c' i.e., Internal jugular vein o The middle ear is shaped like a cube.o When seen in the coronal section, the cavity of the middle ear is biconcave,o The boundaries of the middle ear are as follows :I Roof or tegmental wallo Separates the middle ear from the middle cranial cavity,o It is formed by a thin plate of bone called tegmen tympani.II Floor or jugular wallo Formed by a thin plate of bone which separates the middle ear from the superior bulb of the internal jugular vein.o The floor also presents the tympanic canaliculus which transmits the tympanic branch of the glossopharyngeal nerve.III Anterior or carotid wallo The uppermost part bears the opening of the canal of the tensor tympanio The middle part has the opening of the auditory' tubeo The inferior part of the wall is formed by a thin plate of bone which forms the posterior wall of the carotid canal. This plate separates the middle ear from the internal carotid artery.IV: Posterior or mastoid wallo Superiorly, is the aditus through which the epitympanic recess communicates with the mastoid antrumo Below it is the fossa incudis which lodges the short process of the incuso Below it is the pyramid giving attachment to the tendon of stapediuso Vertical part of the facial canal for facial nerveV. Lateral or membranous wallo Tympanic membrane along with the tympanic ring and sulcus.VI Medial or labrynthine wallo Promontory - rounded bulge produced by the first turn of the cochleao Oval window -- it is posterosuperior to the promontory'. It is closed by the footplate of the stapes,o Horizontal part of the facial canal -- runs just above the oval windowo Round window -- posteroinferior to the promontory. It is closed by the secondary tympanic membrane,o Processus cochleariforims -- forms a pulley for the tendon of the tensor tympanio Prominence of the lateral semicircular canal -- above the facial canal | 156,796 | medmcqa_train |
A patient was admitted epidural anaesthesia with 15 ml of 1.5%. Lignocaine with adrenaline for hernia surgery. He devoled hypotension and respiratory depression within 3 minutes after administration of block. The most common cause would be – | Hypotension and respiratory depression after epidural anesthesia suggest high spinal anesthesia.
High spinal anesthesia, i.e. spinal anesthesia ascending into the cervical levels, can occur following attempted epidural / caudal anesthesia if there is inadverent intrathecal injection. High spinal anesthesia causes severe hypotension, bradycardia, and respiratory insufficiency.
Causes of high spinal anesthesia :
Administration of excessive dose during spinal anesthesia,
Unusual sensitivity or spread of local anesthetic,
Failure to reduce standard dose in selected patients (elderly, pregnant, obese or very short),
Inadverent intrathecal injection during epidural anesthesia. | 156,797 | medmcqa_train |
The investigation of choice to detect a prolapsed intervertebral disc is? | Ans. is 'b' i.e., MRI MRI is the investigation of choice for P1D because it shows the following structures clearlyo Prolapse of disco Compression of cordo Any problems with the discs above and belowo Canal Stneosiso Associated features like Ligamentum flavum hypertrophy and facetal arthropathy | 156,798 | medmcqa_train |
Skip lesions are seen in: | Ans is 'b' i.e. Crohn's disease FeaturesUlcerative colitisCrohn's ds* Rectal involvement in > 50%> 90%*Rectum spared* Distribution of lesionsContinuous*Skip lesions** Mucosal appearanceFriable, diffusely involvedCobblestone*appearance* Ileal diseaseRare (backwash ileitis)Common* Perianal abcess, fistulasRareCommon* Intestinal strictures & obstructionNot seenCommon* Intestinal fistulasNot seenCommon* Fissures (Radiological)Not seenCommon* UlcersCollar-buttonLinear, cobblestone, fissures* Toxic megacolon*Rare but more than Crohn's dsVery rare* Extraintestinal Manifestation - - Sclerosing pericholangitisCommon*Rare- Uveitis & Arthritis *Common*Common*- Pyoderma gangrenosumCommonRarePathological Features * Depth of inflammationMucosal*,superficialTransmural* ,deep* Creeping mesentric fatNot seenCommon** Fibrous thickening of wallNot seenCommon (lead pipe)** PseudopolypsCommon*Rare* GranulomasNot seenCommon** DysplasiaCommon*Rare* Carcinoma10%*Rare | 156,799 | medmcqa_train |
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