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All are pas of vulva except | The vulva includes the mons pubis, labia majora (outer lips), labia minora (inner lips), clitoris, and the external openings of the urethra and vagina. ref - BDC 6e vol2 pg 358 , pubmed.com | 157,200 | medmcqa_train |
A 41 year female patient is taking steroids from long duration. Now she presents with onset of severe pain in the hip. Which imaging investigation can be used to diagnose this condition? | Patient on long term steroids that presents with pain must be suffering from AVN( avascular necrosis). IOC to look for AVN is MRI. | 157,201 | medmcqa_train |
b-adrenergic receptor antagonists such as propranolol is used in the treatment of which of the following? | Ans. D. All of the aboveIndications for b-adrenergic receptor antagonists are lithium tremor, major depressive disorders, substance use disorders, performance anxiety, and neuroleptic-induced akathisia. The five b-adrenergic receptor antagonists most frequently studied for psychiatric applications are propranolol, metoprolol, atenolol, and pindolol. Propranolol is the most commonly used b-adrenergic receptor antagonist and is not known to exert a teratogenic effect in humans. | 157,202 | medmcqa_train |
Splenectomy can be performed after immunization against which of the following organisms: | Ans. D. All of the aboveSplenectomy is usually performed after 6 years of age following immunizations against H influenza type b, streptococcal pneumonia and Neisseria meningitides. Post splenectomy patients receive penicillin prophylaxis to prevent sepsis usually up to adulthood. | 157,203 | medmcqa_train |
An elderly male presents with pain in his shoulders and hips. Temporal arteries are tender to palpation. ESR is 105 mm/L. | The large vessel vasculitides include temporal (giant cell) arteritis and Takayasu arteritis. Temporal arteritis typically occurs in older patients and is accompanied by aching in the shoulders and hips, jaw claudication, and a markedly elevated ESR. Takayasu arteritis, a granulomatous inflammation of the aorta and its main branches, typically occurs in young women. Symptoms are attributed to local vascular occlusion and may produce arm or leg claudication. Systemic symptoms of arthralgia, fatigue, malaise, anorexia, and weight loss may precede the vascular symptoms. Surgery may be necessary to correct occlusive lesions. | 157,204 | medmcqa_train |
A butcher, who is fond of eating raw hamburger, develops chorioretinitis; a Sabin-Feldman dye test is positive. This patient is most likely infected with | Toxoplasmosis, for example, is generally a mild, self-limiting disease; however, severe fetal disease is possible if pregnant women ingest Toxoplasma oocysts. Consumption of uncooked meat may result in either an acute toxoplasmosis or a chronic toxoplasmosis that is associated with serious eye disease. Most adults have antibody titers to Toxoplasma and thus would have a positive Sabin-Feldman dye test. | 157,205 | medmcqa_train |
Cyclo propagative means: | Ref: Park 'Textbook of Preventive and Social Medicine', 22nd edition.Explanation:Biological transmission PropagativeOnly multiplication, eg - plague bacilli in flea, dengue virus in mosquitoCyclo developmentalOnly development eg- filariai parasite in mosquitoCylco propagativeMultiplication and development eg. malarial parasite in mosquito* Cylco - development cycle* Propagative - multiplication | 157,206 | medmcqa_train |
All of the following have non-scarring alopcia, EXCEPT: | Lichen planus - Lichen Planus is a muco-cutaneous disease of immunological origin. It leads to a characteristic pruritic, papular, violaceous eruption of polygonal shape and is often covered with fine scales. Lichen planus most commonly leads to thick patchy rough, scaly skin that develops on the flexor surfaces of the upper extremities, around the ankles, in the genital region genitalia, and on the mucous membranes and is itchy in nature. It causes scarring alopecia leading permanent hair damage. Taenia capitis - It is a fungal dermatophyte infection of the scalp and hair caused especially by the Trichophyton and Microsporum. It causes contagious non-scarring alopecia. It causes inflammatory lesions such as pustules, scaling and itching. The hallmark of diagnosis is patches of hair loss with a "black-dot" pattern on examination. The clinical diagnosis is confirmed by mycological examination. Androgenic alopecia - It is an autosomal dominant disorder which is the most common cause of alopecia in both men and women. It causes miniaturisation of the hair follicles which is androgen dependent and caused by scalp dihydrotestosterone. There is a typical shoening of the hair cycle leading to increased numbers of anagen hairs entering the telogen phase and thus leading to premature hair fall. It leads to scarring alopecia. Alopecia areata - It is a inflammatory non-scarring alopecia of auto-immune origin. There is a inappropriate immune response due to the hair follicle associated antigens. The patient presents with well - demarcated patches of reversible hair loss. Histologically there is a typical peribulbar lymphocyte infiltration. The disturbance of hair shaft growth leads to characteristic exclamation point hairs which is the hallmark for diagnosis. Ref: Textbook of Cosmetic Dermatology By Robe Baran, 3rd Edition, Page 561; The Manual of Dermatology By Jennifer A. Cafardi, Page 15-64; Aging Hair By Ralph M. Trueb, Desmond J. Tobin, Pages 201-202; Evidence-Based Dermatology By Hywel Williams, Pages 386-387 | 157,207 | medmcqa_train |
In IV hyperalimentation, we give -a) Hypertonic salineb) Fatsc) Amino acidsd) Dextrosee) LMW dextran | Parenteral alimentation involves the continuous infusion of a hyperosmolar solution containing carbohydrates (Dextrose), proteins, fat and other necessary nutrients (eg. Vitamins, trace minerals). | 157,208 | medmcqa_train |
Which of the following is not a derivative of the middle ear cleft ? | Ans. is 'a' i.e., Semicircular canal The middle - ear cleft in the temporal bone includes :? Eustachian tube The middle ear (tympanic cavity) Aditus which leads posteriorly to the mastoid antrum and air cells. | 157,209 | medmcqa_train |
Sinus bradycardia with MI T/T- | Sinus bradycardia is a common arrhythmia in patients with inferior or posterior acute myocardial infarctions (AMIs). The highest incidence, 40%, is observed in the first 1-2 hours after AMI. Use of atropine in patients with acute myocardial infarction and sinus bradycardia. Atropine is the drug of choice for management of patients with SB and hypotension and is effective in the treatment of ventricular arrhythmias as well as conduction disturbances in patients with inferior myocardial infarction Ref Davidson 23rd edition pg 455 | 157,210 | medmcqa_train |
All are helpful for the diagnosis of CSF rhinorrhea except: | Following trauma of the midface, CSF may emanate from a dural tear, resulting in rhinorrhea, otorrhea, or both.
The disruption usually occurs lateral to the cribriform plate but may also result from disruption of the sphenoidal, ethmoidal, and frontal sinuses producing a dural tear and communication with the subarachnoid space.
Diagnosis of CSF leakage is often complicated by mixture with nasal secretions, lacrimal secretions, and blood. Clear CSF should be collected in a vial, an absence of sediment and a glucose level of approximately 45 mg/dL is usually confirmatory.
A more specific, albeit slower, laboratory examination is the CSF-specific beta-2 transferrin test.
CSF will also form concentric rings when poured on linen or soft filter paper.
CSF has a more rapid diffusion than blood, leading to a larger, clearer CSF ring surrounding a sanguineous central ring. This is termed the double-ring or halo sign. When bleeding is present, one should suspect the presence of a CSF leak until proven otherwise. Once a provisional diagnosis is made, the patient should be placed in a semirecumbent position and instructed on how to minimize increases in intracranial pressure, including straining, sneezing and blowing of the nose.
Meningitis is a potential complication of skull base fracture with a concomitant dural tear. The absence of leakage does not imply the absence of a tear.
Reference: Fonseca 4th ed page no 437,439 | 157,211 | medmcqa_train |
Hemorrhage leads to: September 2005 | Ans. C: Hypovolemic shock Hypovolemic shock refers to a medical or surgical condition in which rapid fluid loss results in multiple organ failure due to inadequate circulating volume and subsequent inadequate perfusion. Most often, hypovolemic shock is secondary to rapid blood loss. Acute external blood loss secondary to penetrating trauma and severe GI bleeding disorders are 2 common causes of hemorrhagic shock. Hypovolemic shock can result from significant fluid (other than blood) loss. Two examples of hypovolemic shock secondary to fluid loss include refractory gastroenteritis and extensive burns. | 157,212 | medmcqa_train |
Renin is synthesized as a large preprohormone: Renin is secreted by which among the following? | Ans. D. Juxtaglomerular apparatusActive renin:In the juxtaglomerular apparatus and is formed in the secretory granules of the granular cells. Only known function of its is to cleave the decapeptide angiotensin I from the amino terminal end of angiotensinogen i.e. renin substrate. | 157,213 | medmcqa_train |
Define perinatal period? | Perinatal period: The interval between the bih of an infant born after 20 weeks' gestation and the 28 completed days after that bih. When perinatal rates are based on bihweight, rather than gestational age, it is recommended that the perinatal period is defined as commencing at 500 g.Ref: William&;s Obstetrics; 24th edition; Chapter 1; Overview of Obstetrics | 157,214 | medmcqa_train |
Skin is not involved in - | Ans. is 'c' i.e., Acute intermittent porphyriaType of PorphyriaNeuropsychiatric symptomsSkin symptoms/PhototoxicityA. Hepatic porphyrias1) Acute intermittent porphyria2) 5-ALA dehydratase deficiency3) Hereditary coproporphyria4) Variegate porphyria5) Porphyria cutanea tarda++++---+++B. Erythropoietic porphyrias1) Erythropoietic protoporphyria2) Congenital erythropoietic porphyria3) X-linked sideroblastic anemia---++-Porphyriaso Porphyrias are heterogenous group of disorders characterized by defective metabolism of porphyrins. Porphyrins are important intermediates in biosynthesis of heme from glycine and succinyl CoA. Each step is controlled by specific enzyme. So, prophyrias are due to inherited or acquired deficiency of enzymes in heme bio-synthetic pathways (also called porphyrin pathway). They manifest with either neurological complications or skin problems (or rarely both). Based on the site of overproduction and accumulation of porphyrins, porphyrias are broadly classified asAcute (hepatic prophyria)Acute intermettant porphyria5-ALA dehydratase deficiencyHereditary CoproporphyriaVariegate porphyriaPorphyria cutanea tardaCutaneous (erythropoeitic) porphyriaErythropeitic protoporphyriaCongenital erythropoeitic porphyriaX-linked sideroblastic Anemiao The acute (hepatic) porphyrias primarily affect nervous system resulting in abdominal pain, vomiting, acute neuropathy, seizures, muscle weakenss, psychiatric/mental symptoms (i.e., Hallucination, depression, anxiety, paronoia); and autonomic nervous disturbances like hypertension, tachycardia, constipation, arrhythmias, sweating,o The cutaneous (erythropoietic) porphyrias primarily affect skin causing photosensitivity (photodermatitis) blisters, itching, maculopapular rash. There is no abdominal pain,o There are some variation in above presentation.Following two types of hepatic (acute) porphyrias also affect skin : - Hereditary coproporphyria and varigated porphyria. Therefore these two have both neuropsychiatric as well as skin manifestations.Porphyria cutanea tarda (a hepatic porphyria) does not have neuropsychiatric symptom, rather it has only skin manifestation.X-linked sideroblastic anemia (an erythropoietic porphyria) has neither neuropsychiatric nor skin symptoms. | 157,215 | medmcqa_train |
MEDNIK syndrome - which of the following is true | A rare multisystem disorder of copper metabolism with features of both Menke's and Wilson's diseases has been repoed. It is termed the MEDNIK (mental retardation, enteropathy, deafness, neuropathy, ichthyosis, keratodermia) syndrome and is caused by mutations in the AP1S1 gene, which encodes an adaptor protein necessary for intracellular trafficking of copper pump proteins ATP7A (Menke's disease) and ATP7B (Wilson's disease). | 157,216 | medmcqa_train |
Nerve tested in pupillary reflex is | Afferent - 2nd nerve.
Efferent - 3rd nerve. | 157,217 | medmcqa_train |
Rivastigmine and Donepezil are drugs used predominantly in the management of - | Ans. is 'd' i.e., Dementia o Rivastigmine, Donepezil, Galantamine and tacrine all are central cholinesterase inhibitors and are used in senile dementia of Alzheimer's desease. | 157,218 | medmcqa_train |
Sphincter of Oddi consists of | The sphincter of Oddi is a muscular valve that controls the flow of digestive juices through the ampulla of vater into the second pa of the duodenum. It is named after ruggero oddi. Ref - BDC 6e vol2 pg259 , britannica.com | 157,219 | medmcqa_train |
Rabies is identified by - | Few Important Bodies in Microbiology
Bollinger bodies — Fowlpox
Brassy body — Dark shrunken blood corpuscle found in malaria
Call exner bodies — Granulosa theca cell tumour
Chromatid bodies — Entamoeba histolytica precyst
Citron bodies — cl. Septicum
Cigar bodies — Sporotrichosis
Councilman bodies — Yellow fever/viral hepatitis
Coccoid X bodies — Psittacosis
Donovan bodies — Granuloma inguinale (LGV)
Guarnieri bodies — Inclusion bodies of vaccinia
Henderson paterson bodies — Molluscum contagiosum
Levinthal cole lillie bodies — Psittacosis
Mooser bodies — Endemic typhus
Negri bodies — Rabies
Paschen bodies — Vaccinia, variola
Ross’s bodies — Syphilis
Sclerotic bodies — Chromoblastomycosis | 157,220 | medmcqa_train |
A 24-year-old woman presents with abdominal pain, joint discomfort, and lower limb rash. She was well until 1 week before presentation. On examination, she has a palpable purpuric rash on her legs, nonspecific abdominal discomfort, and no active joints. She has 3+ proteinuria, normal WBC, no eosinophils, and elevated creatinine of 1.6 mg/dL. Biopsy of the rash confirms vasculitis with immunoglobulin A (IgA) 3+and C3 (complement 3) deposition on immunofluorescence.For the above patient with vasculitis syndrome, select the most likely diagnosis. | Henoch-Schonlein purpura, characterized by palpable purpura, arthralgias, GI symptoms, and glomerulonephritis, can be seen in any age-group but is most common in children. It can resolve and recur several times over a period of weeks or months and can resolve spontaneously. | 157,221 | medmcqa_train |
In acute intermittent porphyria which enzyme is deficient? | It is inherited as an autosomal dominant trait. PBG-deaminase (uroporphyrinogen-I-synthase) is deficient. 2. This leads to a secondary increase in the activity of ALA synthase since the end-product inhibition is not effective. The levels of ALA and PBG are elevated in blood and urine. As they are colorless compounds, urine is colorless when voided, but the color is increased on standing due to photo-oxidation of PBG to porphobilin. Hence urine samples for PBG estimation should be freshly collected and transpoed in dark bottles. Porphyrins are not excreted or elevated in blood; so there is no photosensitivity.Ref: DM Vasudevan, Page no: 246 | 157,222 | medmcqa_train |
A 72 year old male presented with complete rectal prolapse with
history of constipation from the last 10 years. Management for this
patient Is | For young pts - Abdominal rectopexy is preferred.
For old pts - perineal rectopexy is preferred (delormes, altamaier).
Underlying cause must be treated. | 157,223 | medmcqa_train |
The most impoant example of a compensated hemolytic anemia becomes decompensated, is when: | A patient with a hemolytic condition may present without anemia (Compensated hemolytic anemia) It becomes decompensated in Pregnancy Folate deficiency Renal failure (Interfering with adequate EPO production). Also in Acute infections- which depresses erythropoiesis. The most dramatic example is parvovirus B19 infection, which may lead to aplastic crisis. Ref: Harrison, E-18,P-873. | 157,224 | medmcqa_train |
Powerful vasoconstrictor is? | Ans. is 'b' i.e., Epinephrine Among the given options, only epinephrine has significant action on a-receptor, thus causes vasoconstriction. Svmpathomimetic drugs Non selective Adrenaline - a, + a, + 13, + [3, Noradrenaline- a, + a, + [3, + Slight 13, no. 132 Isoprenaline- R + [32+ 133 but no a action Mephentramine- a and 13 Selective al agonists - Phenylephrine, methoxamine, naphazoline, oxymetazoline, xylometazoline. a, agonists- Clonidine, methyldopa, brimonidine, apraclonidine, guanfacine, guanabenz 13, agonists- Prenalternol, dobutamine [3, agonsits - Salbutamol, terbutaline, salmeterol, orciprenaline, ritodrine, isotharine, bitolterol, pirbuterol, tenoterol, formoterol. | 157,225 | medmcqa_train |
All of the following statements are true regarding ligamentum denticulatum except | Ligamentum denticulatum is not a modification of arachnoid mater. It is a modification of the pia mater. The ligamentum denticulatum is a flat fibrous sheet on either side of the spinal cord present between the ventral and dorsal spinal roots. It serves as a neurosurgical landmark for hemisectioning of the spinal cord. (Option C) Its medial border is continuous with the subpial connective tissue and lateral border forms a series of 21 triangular processes on each side connecting it to the dura mater giving it a serrated appearance. (option B and Option D) The lowest of the dentate ligaments lies between the T12 and L1 spinal nerves. Ref: Gray&;s Anatomy 41st edition Pgno: 765 | 157,226 | medmcqa_train |
Wrong about clonidine is ? | Ans. is 'b' i.e., First line for ADHD o Behavioural therapy is the first line therapy for the treatment of ADHD. The first line drug for ADHD is Methylphenidate. Clonidine It acts (paial agonist) on areceptors, especially a2 in brainstem - Stimulation of a2A receptors in medulla (vasomotor centre) - decrease sympathetic outflow - fall in BP and bradycardia (also due to enhanced vagal tone). Uses of clonidine Hypeension Opioid withdrawal Menopausal syndrome Alcohol withdrawal Smoking cessation Loose motions in diabetic neuropathy | 157,227 | medmcqa_train |
A 25 years old man marries a 13 years girl and has intercourse with her, this constitutes rape as she is- | Sexual intercourse with wife, even with her consent is rape, if she is below 15 years of age. | 157,228 | medmcqa_train |
'Gamma knife' is a term used to denote which of the methods of treatment? | Gamma Knife radiosurgery allows for the destruction of a brain lesions without cutting the skin. By focusing many small beams of of radiation on abnormal brain tissue the abnormality can be destroyed while preserving the normal surrounding structures. The Gamma Knife uses 201 narrow beam Cobalt 60 sources all aimed at a common focal point. When the intracranial abnormality is placed at this focal point it can be effectively destroyed. Conditions treatable with Gamma Knife Radiosurgery include: metastatic brain tumors, aeriovenous malformations, acoustic neuromas, meningiomas, pituitary adenomas, and tic doulouroux (trigeminal neuralgia). Patients with malignant tumors, including gliomas and astrocytomas, may also be candidates for Gamma Knife treatment. | 157,229 | medmcqa_train |
A child having H/0 profuse watery diarrhoea not taking oraly and not passed urine since 2 days, what to be given | Ans. is 'c' i.e., I.V. fluid Child having history of profuse watery diarrhoea with poor oral intake and not passed urine since 2 days is suffering from diarrhoea with dehydration and probably acute renal failure of pre renal types. Here best choice is intravenous I.V. fluid If I.V. access not possible, then you can give feed through Ryle's tube or intra osseous fluid. | 157,230 | medmcqa_train |
The right atrium chronic overload is indicated by a P wave of more than: | Ans. a. 2.5 mm (Ref: Harrison 19/e p1453, 18/e p1832; Marc Gertsch's The ECG; A Two-Step Approach to Diagnosis';Ch-4)The right atrium chronic overload is indicated by a P wave of more than 2.5 mm."Normal atrial depolarization vector is oriented downward and towards the subject's left, reflecting the spread of depolarization from the sinus node to the right and then the left atrial myocardium. This vector points toward the positive pole of lead II and toward the negative pole of lead aVR. Normal P wave is less than 2.5 mm in lead II. If it is more than 2.5 mm, this indicate right atrial overload."- Harrison 19/e p1453, 18/e p1832Right Atrial Enlargement (P Pulmonale): Peaked, tall and narrow P waves in leads II, III and aVF in lung disease are called 'P pulmonale'. The presence of P pulmonale is taken as P wave of more than 2.5 mm in leads, II, III and aVF. Though many factors such as verticalization of the heart, increased residual volume and impaired lung function have been reported to be correlated with these changes in the P wave, right atrial overload (right atrial enlargement or increased right atrial pressure or both) is still thought to be responsible for P pulmonale in lung disease."- Maeda S, Katsura H. Chida K. Imai T. Kuboki K. Watanabe C, Kida K. Ohkawa S, Matsushita S, Ueda K and Kuramoto K. Lack of correlation between P pulmonale and right atrial overload in chronic obstructive airways disease. Br Heart J. 1991; 65:132-6."Right Atrial Enlargement (P Pulmonale): As the activation of the right atrium begins earlier than that of the left atrium, an increase of the right atrial (RA) vector does not prolong the P duration. P pulmonale is characterized by tall and sometimes pointed P waves in leads II, aVF and III. The amplitude of the P waves is 2.5 mm in at least one of these leads. In the opposite 'lead aVL, the P wave is completely negative. The P wave may be higher than normal and pointed in leads V1/V2 rarely in the other precordial leads."- Marc Gertsch's 'The ECG: A Two-Step Approach to Diagnosis';- Ch-4 | 157,231 | medmcqa_train |
Marbling is noticed by | Ans. (c) 36 hours. | 157,232 | medmcqa_train |
Chlamydia causes all the following diseases except? | Ans. is 'd' i.e., Parotitis | 157,233 | medmcqa_train |
Exposure to darkness leads to increased melatonin secretion. It is brought about by: | Ans. is 'b' i.e. increasing the serotonin N-acetyl transferase Ref Ganong 21st/e p 468, 20th/e p448First let's see the synthesis of melatonin from serotoninSerotonin| N. Acetyl transferase + Acetyl CoA N-Acetyl serotonin|Hydroxy indole - 0 methyl transferase + S-Adenosylmethionine Melatonin (N-acetyl-5-methoxytryptamine)Regulation of Melatonin SecretionIn humans and all other species studied to date, melatonin synthesis and secretion are increased during the dark period of the day and maintained at a low level during the day-light hours.The remarkable diurnal variation in secretion is brought about by training of the hypothalamus to the light-dark cycle via retino-hypothalamic nervesThe hypothalamus in turn cause norepinephrine secretion by the postganglionic sympathetic nerves (nervi conarii) that innervate the pineal glandThe norepinephrine acts via b adrenergic receptors in the pineal gland to increase intracellular cAMP, and the cAMP in turn produced a marked increase in N-acetyltransferase activity. This results in increased melatonin synthesis and secretionExposure to darkness|Retino hypothalamic fibres| supra chiasmatic nuclei in hypothalamus|Preganglionic sympathetic neurons in spinal cord| postganglionic sympatheticnerves (nervi conarii) arising in superior cervical ganglion|| norepinephrine secretion in pineal gland|| intracellular cAMP ||N-Acetyltransferase activity|| Hydroxyindole - O methyl transferase activity|| Melatonin | 157,234 | medmcqa_train |
Slow onset of action is seen with? | TYPE ONSET (MIN/HR) PEAK (HR) DURATION RAPID ACTING Aspa 5-15 min 0.5-1.5 3-4 Lispro 5-15 0.5-1.5 3-4 SHO ACTING Human regular 30-60 2-3 4-6 Intermediate Lente 2-4 hr 6-12 18-26 NPH 2-4 4-12 18-26 LONG ACTING Determir 1-4 5-24 20-24 Glargine 1-4 5-24 20-24 Ultralente 4-8 10-30 Over 36 | 157,235 | medmcqa_train |
Busulfan toxicity does not include - | Ans. is 'b' i.e., Toxic carditis o Adverse effects of busulfan --> Myelosuppression, hyperuricemia, pulmonary fibrosis, sterility, impotence, amenorrhea, addison's disease like syndrome (asthenia and hypotension). o High dose causes veno-occlusive disease of liver, seizures, hemorrhagic cystitis, alopecia, cataract. About option 'a' - In addison's disease there is hyperpigmentation (Busulfan causes addison's disease like syndrome). | 157,236 | medmcqa_train |
Which of the following is primordial prevention - | Ans. is 'a' Level of prevention Examples o Primordial prevention o Discouragement from adapting a harmful lifestyle, e.g. smoking o Primary prevention o Immunization (vaccination) o Chemoprophylaxis o Nutritional supplementation programmes o Chlorination of water o Using a mosquito net o Health education o Secondary prevention o Screening test o Case finding programmes o Early diagnosis & treatment o Tertiary prevention o Disability limitation # Resting the affected limb in neutral position in PRPP to prevent deformity o Rehabilitation # Estabilishing schools for blind # Provision of aids for crippled # Reconstructive surgery in leprosy # Muscle re-education and graded exercise in neurological disorder like polio # Changing profession for a more suitable one | 157,237 | medmcqa_train |
A 52-year-old, nonsmoking man complains of pain and paresthesias in his right hand, paicularly at night. Examination reveals a diminished radial pulse when he abducts his arm when his head is turned to either side. A bruit is audible over the upper right anterior chest. His neurologic examination is unremarkable. You suspect the patient has | The patient has a thoracic outlet syndrome (TOS), which is an abnormal compression of the aeries, veins, or nerves in the neck. TOS is more common in adults than in children, and may occur in either sex. The compression may be caused by a cervical rib, the scalenus anticus muscle, or positional changes. The diagnosis is confirmed with an aeriogram. Nerve conduction studies do not distinguish TOS from cervical disc disease, since the nerves are also involved in TOS. | 157,238 | medmcqa_train |
Which of the following carriers received source of infection from other carriers is called - | <p> Incubatory carriers They are potential patients. Since then incubation period of cholera is sho(1-5 days) ,incubatory carriage is of sho duration. Park&;s textbook of preventive and social medicine,K.Park,23rd edition,page no:230 <\p> | 157,239 | medmcqa_train |
Very low bih weight babies are | Low bih weight (LBW) neonate- A neonate weighing less than 2500g at bih irrespective of the gestational age. Very low bihweight (VLBW) neonate- A neonate weighing leas than 1500g at bih irrespective of the gestational age. Extremely low bih weight (ELBW) neonate- A neonate weighing leas than 1000g at bih irrespective of the gestational age. Reference : page 125 Ghai Essential Pediatrics 8th edition | 157,240 | medmcqa_train |
Causative factor acne are following except: | Acne is a chronic inflammatory disease of the pilosebaceous units, skin structures consisting of a hair follicle and its associated sebaceous gland Major factors are involved in the pathogenesis: - Hormonal factors (| androgens, Insulin resistance, Insulin growth factor-1(IGF-1) - | IL-1a activity - | Lenoleic acid - Increased sebum production k/a Seborrhea, - Hypercornification of the pilosebaceous duct, - Abnormality of the microbial flora especially colonization of the duct with Cutibacterium acnes. - The activity of bacteria (C.acnes) within the comedones releases free fatty acids from sebum, causes inflammation within the cyst, and results in rupture of the cyst. | 157,241 | medmcqa_train |
Osiander's sign is positive in? | The pelvic changes are diverse and appear at different periods during pregnancy. There is increased pulsation, felt through the lateral fornices at 8th week called Osiander's sign. Similar pulsation is also felt in acute pelvic inflammatory disease. Ref: Textbook of Obstetrics D.C.Dutta 6th Ed Page 65. | 157,242 | medmcqa_train |
Comment on the diagnosis of this patient with hypokalemic periodic paralysis. | Ans. (c) Grave's disease.* Thyrotoxicosis is sometimes associated with a form of hypokalemic periodic paralysis; this disorder is particularly common in Asian males with thyrotoxicosis.* Lid retraction, causing a staring appearance, can occur in any form of thyrotoxicosis and is the result of sympathetic overactivity.* However, Graves' disease is associated with specific eye signs that comprise Graves' ophthalmopathy* Many scoring systems have been used to gauge the extent and activity of the orbital changes in Graves' disease. The "NO SPECS" scheme is an acronym derived from the following eye changes:0 = No signs or symptoms1 = Only signs (lid retraction or lag), no symptoms2 = Soft-tissue involvement (periorbital edema)3 = Proptosis (>22 mm)4 = Extraocular-muscle involvement (diplopia)5 = Corneal involvement6 = Sight loss | 157,243 | medmcqa_train |
A 60-year-old man has his left forearm amputated because he has invasive rhabdomyosarcoma. The pathologist notes calcification in the wall of the radial aery, which otherwise appears unremarkable. Which of the following is the appropriate diagnosis? | Monckeberg medial sclerosis is characterized by calcification of the media of large and medium-sized aeries of older persons who are not otherwise affected by atherosclerosis . On gross examination, the involved aeries are hard and dilated. These aerial changes are usually asymptomatic. None of the other choices display calcification. | 157,244 | medmcqa_train |
Platelet count is decreased in all of the following condition except: | Answer is A (H. S. Purpura) The mechanism of ecchymosis or purpura in Henoch Schonlein is vasculitis. There is no thrombocytopenia. All other options are known causes of thrombocytopenia. | 157,245 | medmcqa_train |
Ehlers Danlos syndrome is? | Ehler-Danlos syndrome is classified into 8 types and more than 5 types show autosomal dominant transmission. | 157,246 | medmcqa_train |
drugs with high plasma protein binding are | plasma protein binding causes restriction of drugs in the vascular compament and thus lower volume of distribution | 157,247 | medmcqa_train |
In beta-oxidation of fatty acids, carnitine is required for | Transport of long-chain fatty acid to mitochondria' inner layer | 157,248 | medmcqa_train |
Most common cause of pneumonia in children less than 2 years is ? | Respiratory syncytial virus is the most impoant cause of pneumonia in children less than 2 years of age.At other ages ,influenza, parainfluenza, adeno virus are common. Bacteria causing pneumonia are klebsiella, S.pneumonia, E.coli, H.influenza, staphylococci, Atypical organisms like Mycoplasma and Pneumocystis carinii. Ref : ESSENTIAL PEDIATRICS,O.P.GHAI,PG NO:352,7th edition | 157,249 | medmcqa_train |
A school going boy was noted with vacant stare several times a day. There was no history of fever, seizures and neurological deterioration. What is the diagnosis - | Ans. is 'b' i.e., Absence seizures o Absence seizure is characterized by a few seconds of impairment of conciousness without loss of postural control. There is associated eye blinking or staring which may occur as clustered events. | 157,250 | medmcqa_train |
Multiple brain abscesses are characteristic of | (C) Hematogenous # Metastatic abscesses are commonly located in the parietal, frontal, or temporal lobes, and multiple brain abscesses are usually the result of metastatic spread from remote primary foci, accounting for 6% to 22% of cases.> Most common cause of brain abscesses was haematogenous spread, accounting for 26% of the episodes. | 157,251 | medmcqa_train |
Indications for ECT are : | B i.e. Depression with sucidal tendency | 157,252 | medmcqa_train |
Metacarpophalangeal joints are most commonly affected in: March 2005 | Ans. C: Rheumatoid Ahritis RA is characterized by diffuse cailage loss and erosion of bone and cailage. It stas in the synol membrane, with the initial processes of edema, neovascularization, and hyperplasia of the synol lining. Proliferation of synoviocytes and macrophages causes thickening of the synol lining and, together with lymphocytes, plasma cells, and mast cells, develops into pannus. Pannus is a sheet of invasive cellular tissue that is continuous with the synol lining. As a result of the higher propoion of synoviocytes and macrophages, pannus causes erosion of bone and cailage at the margin of joints. In the hands, the metacarpophalangeal (MCP), proximal interphalangeal (PIP), and thumb interphalangeal (IP) joints are most frequently involved. The distal interphalangeal (DIP) joints are involved only in the presence of a coexisting MCP or PIP disease. Tenosynovitis of the flexor tendons causes a reduction in finger flexion and grip strength. Nodular thickening in the tendon sheath may also produce a trigger finger. In osteoahritis and psoriatic ahritis, DIP is commonly involved. | 157,253 | medmcqa_train |
Factors responsible for the development of multidrug resistant pneumonia are all, EXCEPT: | Factors responsible for the development of multidrug resistant pneumonia are Widespread use of potent oral antibiotics Earlier transfer of patients out of acute-care hospitals to their homes or various lower-acuity facilities Increased use of outpatient IV antibiotic therapy General aging of the population More extensive immunomodulatory therapies Ref: Harrison, E-18, P-2130. | 157,254 | medmcqa_train |
All aggravates myastheia gravis,except ? | Ans. is 'a' i.e., Azathioprine o Tetracycline, aminoglycoside and quinidine can aggravate mysthenia gravis. | 157,255 | medmcqa_train |
Genetic anticipation is characteristic of: | Genetic Anticipation refers to the progressive increase in severity of an illness as it manifests in its transmission from parent to child, occurring in a more severe form and at an earlier age with succeeding generations. It is more commonly seen in trinucleotide repeat disorders. Classical examples are Huntington's Disease - CAG Myotonic Dystrophy - CTG Dyskeratosis congenita - TTAGGG (telomere repeat sequence) Fragile X syndrome - CGG Crohn's disease Behcet's disease Ref: Genetic Instabilities and Neurological Diseases, Second Edition, edited by Robe D. Wells, Tetsuo Ashizawa, 2nd Edition, Page 56. | 157,256 | medmcqa_train |
All the following are examples of diseases causing Aplastic anemia except : | Answer is D (Cold haemoglobinuria) Paroxysmal Cold Hemoglobinuria is a form of immune mediated hemolytic anemia and is not a form of aplastic anemia. Pregnancy, PNH and hepatitis have all been mentioned as causes of Aplastic anemia. Classification Of Aplastic Anemia And Cytopenias : Acquired Aplastic Anemia Inherited Aplastic Anemia Radiation Drugs and chemicals Regular effects Idiosyncratic reactions Viruses Epstein-Barr virus (infectious mononucleosis) Hepatitis (non-A, non-B, non-C hepatitis) Parvovirus B19 (transient aplastic crisis. PRCA) HIV-1 (AIDS) Immune diseases Eosinophilic fasciitis Hypoi-immunophilic globulinemia Thymoma/thymic carcinoma Graft-versus-host disease in Immunodeficiency Paroxysmal nocturnal hemoglobinuria Pregnancy Idiopathic Fanconi's anemia Dyskeratosis congenita Shwachman-Diamond syndrome Reticular dysgenesis Amegakaryocytic thrombocytopenia Familial aplastic anemias Preleukemia (monosomy 7, etc.) Nonhematologic syndrome (Down's Dubowitz, Seckel) | 157,257 | medmcqa_train |
Commonest ligament injured in ankle injury: | ANKLE LIGAMENT INJURY The most common mode of ankle injury is inversion of plantar flexed foot. Commonest ligament injured- Anterior talofibular ligament | 157,258 | medmcqa_train |
An 8-month old child presented with itchy, exudative lesions on the face, palms and soles. The siblings also have similar complaints. Which of the following is the treatment of choice? | The child in the question is showing features of scabies cause by Sarcoptes scabei. The treatment of choice in scabies is 5% permethrin cream. In adults, it is applied from the neck down and washed off after 8-14 hours. In children younger than 5 years of age and the elderly, it should be applied to the entire skin surface except the eyes. Other treatment options includes 1% gamma benzene hexachloride, Ivermectin, 25% Benzyl benzoate and Topical crotominton 10%. Ref: CURRENT Diagnosis and Treatment of Sexually Transmitted Diseases, Chapter 30. | 157,259 | medmcqa_train |
All are true about Carvedilol except | Carvedilol blocks both β1 & β2 receptors and hence it is a non selective β - blocker. | 157,260 | medmcqa_train |
Lateral ventricle is connected to third ventricle by ? | Ans. is 'a' i.e., Foramen of Monro | 157,261 | medmcqa_train |
The drug that can cause hirsutism is | Ans: a (Minoxidil)Ref: katzung 9 ed., Pg. 247Topical minoxidil is used for treating androgenic alopecia. The mechanism of action of minoxidil on hair follicles is unknownDrugs causing hirsutism- Minoxidil- Phenytoin- Cyclosporine- Diazoxide- Androgens- Oral contraceptives - containing progesterone- Penicillamine- Heavy metals- Acetazolamide | 157,262 | medmcqa_train |
What is the ideal site to make a burr hole in a patient of head injury with rapidly deteriorating sensorium & progressive dilatation of pupil with no localizing sign? | Burr hole surgery should be done by taking into consideration side of pupillary dilatation 1. One sided pupillary dilatation: Burr hole on that side 2. Both sided pupillary dilatation: Burr hole on the side of first dilated pupil/ side with obvious external trauma. 3. No localizing sign: Burr hole on the side of dominant hemisphere i.e left temporal. | 157,263 | medmcqa_train |
Most common muscle to be congenitally absent - | Congenital absence of Pectoralis major is the most common. | 157,264 | medmcqa_train |
A 25-year-old woman complains of low-grade fever, fatigue, and persistent rash over her nose and upper chest. She also notes pain in her knees and elbows. A skin biopsy shows dermal inflammation and granular deposits of IgG and C3 complement along the basement membrane at the epidermal/dermal junction. Urinalysis reveals microscopic hematuria and proteinuria. The ANA is positive. The development of thromboembolic complications (e.g., deep venous thrombosis) in this patient is commonly associated with elevated serum levels of antibodies to which of the following antigens? | 1/3rd of patients with SLE possess elevated concentrations of anti-phospholipid antibodies. It predisposes these patients to thromboembolic complications (stroke, pulmonary embolism, deep venous thrombosis, and poal vein thrombosis). The clinical course of SLE is highly variable and typically exhibits exacerbations and remissions. The overall 10-year survival rate approaches 90%(Because of early detection & management). -Antibodies against clotting factors (choice C) or fibrinolytic enzymes (choice D) are not involved in the clotting tendency associated with SLE. Diagnosis: Systemic lupus erythematosus | 157,265 | medmcqa_train |
All of the following vascular changes are observ ed in acute inflammation, except- | Ans. is 'd' i.e., Decreased hydrostatic pressureInflammationVascular changesCellular changeso Vasoconstrictiono Vasodilatationo Increased permeability'o Chemotaxis, phagocytosiso Increased hydrostatis pressureo Marginationo Rollingo Adhesion | 157,266 | medmcqa_train |
"Target lesions" are characteristically seen in? | Iris or target lesions = Erythema multiformie Bulla spread sign and Nikolsky's sign = Pemphigus vulgaris. Auspitz sign = Plaque Psoriasis. Darrier's sign = Uicaria pigmentosa. White dermographism = Atopic dermatitis. Dimple sign = Dermatofibroma Target lesions - Central erythema surrounded by area of clearing and another rim of erythema | 157,267 | medmcqa_train |
Quadrate lobe of liver is present between | Quadrate lobe of liver is present between groove for ligamentum tetes and gallbladder | 157,268 | medmcqa_train |
A first year psychiatric resident is interviewing a patient in psychiatry ward. On asking any question, patient starts giving long details and to the point that listener may get bored, but eventually patient answers the question. Which of the following abnormality the resident could find in this patient? | Ans. D. CircumstantialityCircumstantiality is indirect speech that is delayed in reaching the point but eventually gets there. Circumstantiality is characterized by an overinclusion of details. Verbigeration is a meaningless repetition of specific words or phrases. Blocking is an abrupt interruption in the train of thinking before a thought or idea is finished. After a brief pause, the person indicates no recall of what was being said or what was going to be said. It is also known as thought deprivation. Tangentiality is the inability to have a goal-directed association of thoughts. The patient never gets from the desired point to the desired goal. Word salad is an incoherent mixture of words and phrases. | 157,269 | medmcqa_train |
Most common cause of epidural abscess - | Ans. is 'a' i.e., Staphylococcuso Therefore spinal epidural abscess is much more common than the intracranial epidural abscess.# Spinal epidural abscess is more common by a factor of nine to one.Causes of epidural abscess | 157,270 | medmcqa_train |
Feed forward control system is employed during the regulation of | Ans. (c) Temperature(Ref: UMP, 4th ed/RL Bijlani p.12)There is a control system in our body when no stimulus is required but still the system ANTICIPATES and makes corrective changes. Such a system is called Feed forward or Anticipatory or Adaptive ControlExamples of feed forward controlTemperature control - Thermoregulatory responses are initiated by hypothalamus BEFORE the changes in environmental temperature have succeeded in changing the body's core body temperatureCephalic phase of gastric secretion- Just thinking about food increases gastric acid productionThinking about exercise itself increases heart rate & respiratory rateRole of cerebellum in motor coordination | 157,271 | medmcqa_train |
Tzank smear in a case of pemphigus vulgaris shows | Tzanck smear is a very simple and rapid technique. For viral infections, samples should be taken from a fresh vesicle.The vesicle should be unroofed or the crust removed, and the base scraped with a scalpel or the edge of a spatula. The material is transferred to a glass slide.In the case of blistering disorders, the intact roof of a blister is opened along one side, folded back and the floor gently scraped. The material thus obtained is smeared onto a microscopic slide, allowed to air dry, and stained with Giemsa stain. Pemphigus vulgaris: It reveals multiple acantholytic cells (Tzanck cells). A typical Tzanck cell is a large round keratinocyte with a hyperophic nucleus, hazy or absent nucleoli, and abundant basophilic cytoplasm. The basophilic staining is deeper peripherally on the cell membrane ("mourning edged" cells) due to the cytoplasm's tendency to get condensed at the periphery, leading to a perinuclear halo. Herpes simplex, varicella, herpes zoster: multinucleated syncytial giant cells contain multiple nuclei Molluscum contagiosum: basophilic intracytoplasmic molluscum bodies (Henderson-Patterson bodies), the largest known inclusion bodies (30-35 m). Vaccinia, orf, milker's nodules and variola:[ eosinophilic cytoplasmic inclusion called a "Guarnieri body", Leishmaniasis:Cytology is very useful in detecting Leishman-Donovan (LD) bodies in early, untreated patients of leishmaniasis. LD bodies appear as light-blue, ellipsoid bodies IADVL Textbook of dermatology page 1099 | 157,272 | medmcqa_train |
Digoxin toxicity is increased by all except - | Ans. is 'b' i.e., Hyperkalemia Digitalis toxicity is a2gravated by o Hypokalemia o Hypomagnesemia o Renal insufficiency o Hypercalcemia o Advanced age o Hypoxia o Acute myocardial infarction o Thyrotoxicosis o Mvxoedema o Acute Myocarditis | 157,273 | medmcqa_train |
The electrical potential difference necessary for a single ion to be at equilibrium across a membrane is best described by the: | Ans. D. Nernst equationa. The Nernst equation calculates the membrane potential that develops when a single ion is distributed at equilibrium across a membrane.b. The Goldman equation gives the value of the membrane potential when all permeable ions are accounted for.c. The van't Hoff equation calculates the osmotic pressure of a solution.d. Fick's law refers to the diffusional movement of solute. The permeability coefficient accounts for several factors that determine the ease with which a solute can cross a membrane | 157,274 | medmcqa_train |
The most common type of Rhabdomyosarcoma is | Rhabdomyosarcoma, the most common soft-tissue sarcoma of childhood and adolescence, usually appears before age 20. It may arise in any anatomic location, but most occur in the head and neck or genitourinary tract, where there is little if any skeletal muscle as a normal constituent. Rhabdomyosarcoma is histologically sub classified into embryonal, alveolar, and pleomorphic variants. The rhabdomyoblast—the diagnostic cell in all types—contains eccentric eosinophilic granular cytoplasm rich in thick and thin filaments. Rhabdomyoblasts may be round or elongate; the latter are known as tadpole or strap cells, and may contain cross-striations visible by light microscopy.
Embryonal rhabdomyosarcoma is the most common type, accounting for 60% of rhabdomyosarcomas. It includes the sarcoma botryoides as well as spindle cell and anaplasticvariants. The tumor occurs in children younger than 10 years of age and typically arises in the nasal cavity, orbit, middle ear, prostate, and paratesticular region. This variant of rhabdomyosarcoma commonly has parental isodisomy of chromosome 11p15.5, which leads to overexpression of the imprinted IGFII gene. The sarcoma botryoides subtype develops in the walls of hollow, mucosal-lined structures, such as the nasopharynx, common bile duct, bladder, and vagina. Where the tumors abut the mucosa of an organ, they form a submucosal zone of hypercellularity called the cambium layer. | 157,275 | medmcqa_train |
Sympathomimietic causing increase in mean blood pressure, heart rate and cardiac output on intravenous infusion is- | Ans. is 'a' i.e., Adrenaline Comparative effects oflntravenous Infusion ofadrenaline, noradrenaline and Isoprenallne AdrNAIso1. Heart rate||||2 Cardiac output|| ||3. BP-Svstolic||nbv|||Diastolic||||||Mean||||4. Blood flow Skin and mm|| Sk, muscle||||Kidney-|| Liver|| |Coronary|||5. Bronchial muscle|| ||6. Intestinal muscle||||7. Blood sugar|||| | 157,276 | medmcqa_train |
What is Hinge fracture? | Hinge fracture also called motorcyclist fracture, fracture lines passes across the middle cranial fossa, separating the skull base into 2 halves. | 157,277 | medmcqa_train |
Hysterectomy when done through broad ligament causes injury to? | ANSWER: (B) UreterREF: Shaw's 13th ed p. 14, Danforth 10th ed page 456, COGT 2009 ed chapter 48, The 5-Minute Obstetrics and Gynecology Consult edited by Paula J. Adams Hillard page 582Ureter lies in the pararectal space in the medial leaf of broad ligament in pelvis, hence when dissecting through it during hysterectomy, its liable to get injured."During vaginal hysterectomy, the ureter can be traumatized at its entry point at the trigone""Uterine artery ligation consists of placing a no. 1 absorbable suture 2 to 3 cm medial to the uterine vessels through the myometrium and then through an avascular space in the broad ligament. To avoid injury to the ureter, it is important not to go too far lateral in the avascular space"Urinary injuries during hysterectomy:Urinary injuries during laparoscopy have a similar rate to open procedures (0.02-1.7%). Bladder injuries are more common than ureteral injuries and are recognized more frequently intraoperatively, About two-thirds of urinary injuries occur during laparoscopic-assisted vaginal hysterectomy.The most common sites of ureter injury during gynaecological surgeries:Where the ureters enters the pelvis, near the pelvic brim, during ligation of ovarian vesselsWhere the ureter crosses medial to the bifurcation of the iliac vessels during pelvic lymph node dissection3. Where the ureter crosses under the uterine vessels at the level of the broad ligament during ligation of the uterine vessels during hysterectomy | 157,278 | medmcqa_train |
In which part of the oral cavity has thinnest mucous membrane: | Histologically mucosa of the floor of mouth is non-keratinized, thinnest and loosely adherent to the underlying structures. Loose attachment to the underlying tissue provide free mobility to the tongue. | 157,279 | medmcqa_train |
Which of the following sphingolipidoses has a characteristic presentation of exaggerated startle response | Refer the byte "Sphingolipidoses" | 157,280 | medmcqa_train |
All true about - cocaine except- | It is ester local anesthetics Cocaine was the first local Anesthetic to be used clinically. It is only natural local anesthetic. Koller introduced this in the field of ophthalmology. It is the only local anesthetic with vasoconstrictor action. It is sympathomimetic and inhibits metabolism of catecholamine. | 157,281 | medmcqa_train |
Average duration of 3rd stage of labor is: | Stage Definition- First: From the onset of TRUE labor to full dilation of cervix. Average duration: 12 hours in primigravida and 6 hours in multigravida. Second: From full dilation of cervix to bih of the baby. Median duration is approximately 50 minutes in primigravida and 20 minutes in multigravida. Third: From bih of the baby to delivery of the placenta. Average duration: 15 minutes in both primigravida and multigravida. Fouh: 1-hour observation period, following delivery of the placenta. | 157,282 | medmcqa_train |
Fetal cardiac activity can be detected earliest by USG at which age of Intrauterine life- | Fetal cardiac activity can be detected earliest by USG at 5-6-week age of intrauterine life. | 157,283 | medmcqa_train |
Which of the following can occurs in ovary, rectum and appendix - | Ans. is 'd' Endometriosis (Ref. Shaws, 13/e, p 439 (12/e, p 370)).Endometriosis is widely dispersed. It occurs anywhere throughout the lower pelvis. The common sites are ovaries*, cul-de-sac including the uterosacral ligaments, peritoneum overlying the bladder, sigmoid colon, back of the uterus, intestinal coils and appendix.It can also be seen in umbilicus following operation* in laparotomy scars, in tubal stumps following sterilization. | 157,284 | medmcqa_train |
The most useful incision in the operating room for patients with penetrating pericardium injury is: | The subxyphoid incision is useful for determining if there is blood in the pericardium and if there is an intracardiac injury; however, exposure is extremely limited, and definitive repair can rarely be performed through the incision. Left (or right) anterior thoracotomy is easily performed, especially in the emergency room, and gives adequate exposure to certain areas of the heart. However, each has significant limitations in exposure. Either may be extended across the thoracotomy into the other side of the chest, thus producing a bilateral anterior thoracotomy. Exposure is excellent through this incision, and most injuries can be satisfactorily repaired through this approach. Most cardiac operations today are performed through median sternotomy incisions. If the patient is in the operating room, this incision is easily performed and always provides excellent exposure for all areas of the heart. | 157,285 | medmcqa_train |
All of the following are an example of Indicator media EXCEPT: | Ans. (d) Stuart mediaRef.: Microbiology by Ananthanarayan and Paniker 8th ed. / 40, 43INDICATOR MEDIA* It is also known as differential media which distinguishes one microorganism type from another growing on the same media.* This type of media is used for the detection of microorganisms and by molecular biologists to detect recombinant strains of bacteria.* Examples of differential media include:# Blood agar# Eosin methylene blue (EMB)# MacConkey (MCK)# mannitol salt agar (MSA)TRANSPORT MEDIAExamples of Transport Media Include* Thioglycolate broth for strict anaerobes* Stuart transport medium - a non-nutrient soft agar gel containing a reducing agent to prevent oxidation, and charcoal to neutralize* Certain bacterial inhibitors- for gonococci, and buffered glycerol saline for enteric bacilli.* Venkat-Ramakrishnan (VR) medium for V. cholerae. | 157,286 | medmcqa_train |
Most common malignant tumour in childhood | Leukemia is the most common malignancy of childhood.There are two main subtypes,the commoner acute lymohoblastic leukemia(ALL) & acute myeloid leukemia(AML).A small propoion may have chronic myeloid leukemia(CML) and juvenile myelomonocytic leukemia(JMML).ALL is the most common childhood malignancy accounting for one-fouh of all childhood cancers. Reference:Essential pediatrics-Ghai,8th edition,page no:599. | 157,287 | medmcqa_train |
A child with decreased levels of LH, FSH and Testosterone presents with delayed puberty. Which of the following is the most likely diagnosis – | Kallman's syndrome is an X-linked disorder characterized by a deficiency of GnRH with a resultant decrease in FSH and LH levels producing an isolated Hypogonadotrophic Hypogonadism Kallman's syndrome may be seen in both men and women but is more common in men. It is typically also associated with agenesis or hypoplasia of the olfactory bulb producing anosmia or hyposmia. | 157,288 | medmcqa_train |
Which is not a component of MELD score | Recently, the Child-Pugh system has been replaced by the Model for End-Stage Liver Disease (MELD) system for the latter purpose. The MELD score is a prospectively derived system designed to predict the prognosis of patients with liver disease and poal hypeension. This score is calculated from three noninvasive variables: the prothrombin time expressed as the international normalized ratio (INR), the serum bilirubin level, and the serum creatinine concentration.Ref: Harrison&;s Textbook of Internal Medicine; 19th edition; Chapter 357; Approach to the Patient with Liver Disease; Page no: 1993 | 157,289 | medmcqa_train |
Which of the following interventions is not recommended in active management of third stage of Labour? | Canadian pediatric society and Cochrane database UK, has recommended delayed clamping of the umbilical cord, as it reduce the need for blood transfusion in premature babies and also reduce the incidence of intraventricular hemorrhage. Ref: Clinical Gynaecological Endocrinology and Infeility By Speroff, 7th Edition, Page 1036; Medical Veritas : The Journal of Medical Truth By Gary S. Goldman, November 2005, Volume2, Page 497; Current Obstetrics and Gynecology By Gita Ganguly Mukherjee, Sudip Chakravay, Bhaskar Pal, et al, Jaypee Brothers, Medical Publishers, 2007, Page 168 | 157,290 | medmcqa_train |
Waxy flexibility and stereotype verbal and behavioural signs are seen in | Ans. c (Catatonic schizophrenia). (Ref. Psychiatry by Niraj Ahuja, 5th ed., 60, 254)Schizophrenia: Symptoms must be present at least 6 monthsSchizophreniform Disorder: > 1 month but < 6 months.FEATURES OF CATATONIC SCHIZOPHRENIA# Bizarre posturing# Rigidity# Echolalia, echopraxia# Mutism# Waxy flexibility# Ambitendancy (no goal directed actions)# Stupor# Negativism (motiveless resistance to all commands and doing opposite)# Other signs (mannerisms, stereotype verbal and behavioural automatic obedience, verbigeration)TYPES OF SCHIZOPHRENIA ***Schizophrenia Paranoid Type# MC Type of Schizophrenia# Older patients (Onset is in their late twenties or thirties)Best prognosis# Presenting Symptoms: Preoccupation with delusions and/or hallucinations, usually involving grandeur or persecution.Schizophrenia Disorganized Type# Presenting Symptoms: Disorganized speech and behavior. Flat or inappropriate affect. Marked regression to primitive disinhibited behavior (Bizarre Behavior). Severe thought disorder. Poor contact with reality# Risk Factors: These patients tend to be younger than 25Worst prognosis.Schizophrenia Catatonic Type# Presenting Symptoms: Psychomotor Disturbances, ranging from severe retardation to excitation. Extreme negativism. Peculiarities of voluntary movements. Mutism is very common.# Complications: Medical care may be necessary because of exhaustion, malnutrition, self- inflicted injury, or hyperpyrexia.Schizophrenia Residual Type# Presenting Symptoms: Absence of positive symptoms (delusions, hallucinations, disorganized speech/behavior & catatonic behavior).# Patients tend to have negative symptoms (Social Withdrawal, Flat Affect, Occupational Dysfunction).Schizophrenia Undifferentiated Type# Presenting Symptoms: Meet criteria for schizophrenia.# Do not meet criteria for other schizophrenia types. | 157,291 | medmcqa_train |
Most diffusible ion across the membrane is | The resting membrane potential is close to the Nernst potential for K+, the ion to which the membrane is most permeable. . | 157,292 | medmcqa_train |
A study of persons developing skin lesions following sun exposure is conducted. The lesions are not found on skin protected from ultraviolet light. Biopsies of involved skin show immunoglobulin G deposition along the dermal-epidermal junction, along with vacuolization of the basal layer and a perivascular lymphocytic infiltrate. No other organ involvement is present. Which of the following diseases do these patients most likely have? | The more benign discoid lupus involves just skin, unlike systemic lupus erythematosus, but is still a form of type III hypersensitivity with antigen-antibody complex deposition along the basement membrane of the epidermis. The other listed options are not associated with sun exposure. Bullous pemphigoid lesions occur at the dermal-epidermal junction from antibody deposition targeting type XVII collagen as a component of hemidesmosomes. Dermatitis herpetiformis associated with celiac disease has IgA antibodies deposited at tips of dermal papillae. Dysplastic nevi develop in relation to mutations in genes encoding for growth control proteins. A toxic epidermal necrolysis is a severe form of erythema multiforme mediated by cytotoxic CD8+ cells targeting epidermal basal cells. Early lesions of discoid lupus erythematosus appear as well-demarcated scaly purple macules or papules and later expand into discoid plaques. Microscopically there is basal vacuolar degeneration, areas of epidermal atrophy, acanthosis, keratotic follicular plugging, basement membrane thickening, and superficial and deep perivascular lymphocytic infiltrate. | 157,293 | medmcqa_train |
What is the normal cardiothoracic ratio in children? | "The cardiac silhouette occupies 50-55% of the chest width. Cardiomegaly is present when the cardiothoracic (CT) ratio is more than 55%".The CTR is measured on a PA chest x-ray and is the ratio of maximal horizontal cardiac diameter to maximal horizontal thoracic diameter (inner edge of ribs/edge of pleura). A normal measurement should be <0.5(50%).(Refer: Nelson's Textbook of Pediatrics, SAE, 1st edition, pg no. 2170) | 157,294 | medmcqa_train |
Which of the following fatty acid present in fish-oil is known for its cardio-protective function? | Eicosapentaenoic acid (EPA): o3 fatty acid Present in fish-oil Known for its cardio-protective action EPA inhibits the formation of thromboxanes (TX2) which are potent platelet aggregators. Hence, the intake of o3 fatty acids promotes platelet disaggregation. | 157,295 | medmcqa_train |
Pain in left hypochondrium vomiting, diarrhea, malena, weight loss diagnosis | Answer- C. Zollinger Ellison syndromePeptic ulceration is the most common manifestation of Zollinger Ellison syndrome leading to left hypochondriac pain, vomlting and weight loss and ulcers refractory to medical therapy.A bleeding ulcer gives rise to malena. | 157,296 | medmcqa_train |
The Normal value of P02 in healthy man is : | C i.e. 80 mm HgFeatureAerial blood--Mixed Venous blood (at rest)FeatureAerial blood--Mixed Venous blood (at rest) 02 tension/P0295 +- 5 mmHg40 +- 2 mm Hg02 tension/P0295 +- 5 mmHg40 +- 2 mm Hg 02 Content19 m1/100 ml14 ml /100 ml02 Content19 m1/100 ml14 ml /100 ml % Saturation of Hb95% +- 2%75%% Saturation of Hb95% +- 2%75% 02Content = dissolved 02 in the plasma + 02 Contained in the Hb * Aerial blood pH --> 7.4 +- 0.02* Dead space Volume --> 2 ml/kg body wt | 157,297 | medmcqa_train |
In catatonic schizophrenia, all are seen except : | D. i.e. Flight of ideas | 157,298 | medmcqa_train |
All of the following are true about paranoid schizophrenia except - | Paranoid schizophrenia is the commonest type of schizophrenia in clinical practice. The onset is later (3rd - 4th decade). The core symptoms are delusions of persecution. Other types of delusions (grandeur, reference, control, infidelity, double) and hallucinations may also occur. There is minimal or no disturbance of affect, volition, speech, motor behavior, and personality. | 157,299 | medmcqa_train |
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