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Stage of contraction of family starts at - | Ans. is 'd' i.e., Leaving home of first child Basic model of nuclear family life cyclePhases of family life cycleEvents characterizingNo. DescriptionBeginning of phaseEnd of phaseI FormationII ExtensionIII Complete extensionIV ContractionV Competed contractionVI DissolutionMarriageBirth of 1st childBirth of last child1st child leaves homeLast child has left home of parents1st spouse diesBirth of 1st childBirth of last child1st child leaves homeLast child leaves home of parents1st" spouse diesDeath of survivor (extinction) | 157,700 | medmcqa_train |
Most pathogenic species of candida is | C. albicans is most common and most pathogenic. | 157,701 | medmcqa_train |
The inheritance pattern of familial retinoblastomas is ? | Ans. is 'a' i.e., AD | 157,702 | medmcqa_train |
All of the following are true about excitation-contraction coupling in skeletal muscle except that | Ca2+ binds to troponin C (not Tropomyosin) to initiate muscle contraction. Ref: Ganong&;s Review of Medical Physiology 26th edition Pgno: 105 | 157,703 | medmcqa_train |
Aqueous humor is produced by the | Aqueous humor is produced by the ciliary processes of the ciliary body. It flows from the posterior chamber, through the pupil, into the anterior chamber, and finally to the canal of Schlemm, which empties into the extraocular/episcleral veins. | 157,704 | medmcqa_train |
Met-tRNA would recognize: | Ans. AUG(Ref: Harper 31/e page 395)The first AUG sequence after the marker sequence is defined as the start codon.AUG codon binds with met tRNAI | 157,705 | medmcqa_train |
Which of the following tests helps to differentiate between concomitant squint and paralytic squint | Cover tests 1) Direct cover test: It confirms the presence of manifest squint. To perform it, the patient is asked to fixate on a point light. Then, the normal looking eye is covered while observing the movement of the uncovered eye. In the presence of squint the uncovered eye will move in opposite direction to take fixation, while in apparent squint there will be no movement. 2) Alternate cover test: It reveals whether the squint is unilateral or alternate and also differentiates concomitant squint from paralytic squint (where secondary detion is greater than primary). Ref:- A K KHURANA; pg num:-327 | 157,706 | medmcqa_train |
Teaching children about the side effects of taking drugs comes under: March 2013 (e) | Ans. D i.e. Primordial prevention Primordial prevention It consists of actions and measures that inhibit the emergence of risk factors in the form of environmental, economic, social, and behavioral conditions and cultural patterns of living etc. For example, many adult health problems (e.g., obesity, hypeension) have their early origins in childhood, because this is the time when lifestyles are formed (for example, smoking, eating patterns, physical exercise). In primordial prevention, effos are directed towards discouraging children from adopting harmful lifestyles | 157,707 | medmcqa_train |
Which sinus is present over falx cerebelli? | Occipital sinus is the smallest sinus, situated along the attached margin of falx cerebelli.Straight sinus runs along the line of attachment of falx cerebelli with the tentorium cerebelliInferior petrosal sinus lies in the groove between the petrous temporal bone and clivus of sphenoid.Sigmoid sinus lies between the two layers of dura of posterior cranial fossa.(Ref: Vishram Singh textbook of clinical neuroanatomy, second edition-pg189,191) | 157,708 | medmcqa_train |
Duplex steel is made up of: | Duplex stainless steel is a combination of both ferritic and austenitic grains of stainless steel. The basic chemical composition of duplex stainless steel is an equal mix of ferrite and austenite. This combination creates some very beneficial properties for this family of stainless steels. | 157,709 | medmcqa_train |
While dispatching blood and urine for chemical analysis, sodium fluoride is added as preservative in the following concentration - | 10 mg/ml of Na-fluride (i.e. 100 mg/10 ml) is used with 3 mg of potassium oxalate for preserving blood. | 157,710 | medmcqa_train |
In an Rh negative mother who has delivered an Rh positive baby, prophylactic anti D is indicated: | If the Indirect Coomb's test (ICT) negative | 157,711 | medmcqa_train |
The limit of loudness expressed as decibels that people can tolerate without substanial damage to their hearing is - | Sound in dB Effect 20 Whispering 40 Quiet library 60 Normal conversation 70 heavy street traffic 80 printing press 85 Recommended maximum 110 Train passing through station 120 Motor car horn 140 Threshold of pain 150-160 Mechanical damage Park's Textbook of Preventive and Social Medicine, 25th edition, Page No. 802 | 157,712 | medmcqa_train |
Highest amount iron is seen in - | Food rich in haem iron are liver, meat, poultry and fish. REF. PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICAL 21ST EDITION. PAGE NO - 622 | 157,713 | medmcqa_train |
Drugs which cause both physical and psychological dependence are | All the above-mentioned drugs produce both physical and psychological dependence in varying degrees Ref: Essentials of postgraduate psychiatry By JN Vyas 1st ed Pg 326 | 157,714 | medmcqa_train |
Which of the following is the shoest acting non-depolarizing muscle relaxant (NDMR) and causes bronchospasm? | Rapacuronium has a rapid onset of action, minimal cardiovascular side effects, and a sho duration of action. It was withdrawn by the manufacturer following several repos of serious bronchospasm, including a few unexplained fatalities. Histamine release may have been a factor. Ref: Morgan, Jr. G.E., Mikhail M.S., Murray M.J. (2006). Chapter 9. Neuromuscular Blocking Agents. In G.E. Morgan, Jr., M.S. Mikhail, M.J. Murray (Eds), Clinical Anesthesiology, 4e. | 157,715 | medmcqa_train |
If stage lb cervical cancer is diagnosed in a young woman, while performing radical hysterectomy which structure would you not remove | Ovaries are not removed in radical hysterectomy if not diseased Types of Hysterectomy Type I : Extrafascial Hysterectomy Simple total abdominal hysterectomy with or without bilateral salpingo-oophorectomy Type II: Modified Radical Hysterectomy Removes the medial half of cardinal and uterosacral ligaments Type II differs From Type III by Uterine aery is transected at the level of ureter; Preserving the ureteral branch to the ureter Cardinal ligament is divided close to the midpoion near the ureteral dissection Anterior vesicouterine ligament is divided but posterior vesicouterine ligament is conserved Smaller margin of vagina is removed Type III Removal of most of the uterosacral, cardinal ligaments and upper one-third of the vagina Associated with Pelvic lymphadenectomy Extended Radical Hysterectomy Type IV: Additional structures removed Periureteral tissue Superior vesicle aery Three fouhs of vagina Type V: Poions of distal ureter and bladder are resected Reference: Berek and Novak's Gynecology; 15th edition; Chapter 36 | 157,716 | medmcqa_train |
Maximum margin of excision is needed for: | Margins of excision: Malignant melanoma: Margins to be taken depends on the tumor thickness and depth of invasion* < 1mm thickness - 1 cm margin* 1-4 mm thickness - 2cm margin* > 4mm thickness - 2-3 cm margin BCC: If tumor is non-aggressive involving trunk or extremities -Wide Local Excision If tumor is aggressive involving vital areas, cosmetic areas and recurrent - MOH'Smicrographic surgery SCC: Small or non-invasive SCC - Wide Local excision MOH'S MICROGRAPHIC Surgery- Large tumors- Aggressive tumors- Tumors involving vital areas/ cosmetic areas- Recurrent tumorsMOH'S MICROGRAPHIC SURGERY- Serial excision of tumor in small increments- Coupled with immediate microscopic analysis to ensure tumor removal- To limit resection of aesthetically valuable tissues Dermatofibrosarcoma protuberans: WLE with 2-4 cm circumferential margin + removal of underlying fascia Has unpredictable radial extensions of tumor|Permeate through large distances from primarynodule|Increased risk of recurrence after simple excision|(2-4 cm) circumferential margin is resected toprevent recurrence | 157,717 | medmcqa_train |
The best X Ray view for minimal pleural effusion | D i.e. Lateral decubitus | 157,718 | medmcqa_train |
A30-years-old primipara in labor with transverse lie. Treatment of choice is: | Ans. is b, i.e. Emergency cesarean sectionRef Dutta Obs. 9/e, p 372; Williams Obs. 22/e, p 510, 23/e, p 478Patients in labor with transverse lie can be managed by external cephalic version followed by surgical rupture of the membrane.But it is important to note that the patient is a primigravida with age 30 years, i.e. elderly primi, so ECV is contraindicated.This patient requires an emergency cesarean section. | 157,719 | medmcqa_train |
Palmer sign seen in pregnancy is? | ANSWER: (B) Rhythmic contaction of uterusREF: Dutta 6th ed p. 65SIGNFEATURESEEN INJacqemiers sign or chadwick's signDusk)!- blue hue of vagina due to congestion8th week of pregnancy and fibroidOslanders signIncreased pulsations felt through lateral fornix8th week and PIDGoodell's signSoftening of cervix when it feels like lip6th week and pill usersHegar's signAbdominal and vaginal fingers on bimanual examination oppose , seen due to softening of cervix6-10 weeksPalmer's signRegular and rhythmic contractions of uterus4-8 weeks | 157,720 | medmcqa_train |
18 months old child cellulitis of leg Sp02 88%, no prior history of hospitalization or illness most probable organism is? | Ans. is 'c' i.e., Streptococcal pyogenes Cellulitis is characterized by infection and inflammation of loose connective tissue, with limited involvement of the dermis and relative sparing of the epidermis. Streptococcus pyogenes and S. aureus are the most common etiologic agents. Children with relapsed nephrotic syndrome may develop cellulitis due to Escherichia coli. Cellulitis presents clinically as an area of edema, warmth, erythema, and tenderness. The lateral margins tend to be indistinct because the process is deep in the skin, primarily involving the subcutaneous tissues in addition to the dermis. Application of pressure may produce pitting. Although distinction cannot be made with ceainty in any paicular patient, cellulitis as a result of S. aureus tends to be more localized and may suppurate, whereas infections due to S. pyogenes (group A streptococcus) tend to spread more rapidly and may be associated with lymphangitis. MRSA is usually seen in hospitalised child. | 157,721 | medmcqa_train |
Provocative Test for detecting CDH? | Ans. b (Barlow test) (Ref Maheshwari orthopedics 4th/87).All newborn babies should be screened for hip instability by a skilled examiner using the Barlow and Ortolani tests. The baby should be relaxed and the hips flexed to 90 degree. It is possible to reduce a dislocated hip by abduction and gentle forward pressure (Ortolani) or dislocate an unstable hip by adduction and gentle backward pressure (Barlow). In both cases a soft clunk is felt as the hip reduces or dislocates repectively.DEVELOPMENTAL DISLOCATION (DYSPLASIA) OF THE HIP # Etiology:- Hereditary predisposition to jt laxity- Hormone induced jt laxity (in females)- Breech malposition# Pathology:- Femoral head dislocated upwards and laterally- Femoral neck is excessively anteverted- Acetabulum shallow- Ligamentum teres hypertrophy- Inverted limbus/fibrocartilaginous labrum of acetabulum- Stretched capsule of hip joint- Adaptive shortening of adductor muscles and hip joint,# Findings in older children:- Limitation of hip abduction- Asymmetrical thigh folds- Higher buttock fold on affected side- Galeazzi's sign (level of knees compared with hip fixed to 70deg and knees flexed)+.- Ortolani's test +.- Trendelenburg's test +.- Shortening of limb and externally rotated.- Lumbar lordosis- Telescopy +.- Trendelenburg's gait in unilateral; waddling gait in bilateral DDH.# Diagnosis:- Difficult during infancy, but USG with high frequency probe (Graff's classification) is very useful.- Clinical tests:# Barlow's test (provocative test having two parts)# Ortolani test# Radiological features:- Von Rosen's view helpful in diagnosis- Signs in older children:# Delayed appearance of ossific centre of head of femur# Retarded development of ossific centre of femoral head# Sloping acetabulum# Lateral and upward displacement of ossific centre of femoral head# Break in Shenton's line# Rx:Birth to 6 months6 months-6 yrs6 yrs-10 yrs11 yrs onwardsClosed manipulation & maintained in plaster cast or von Rosen splint.Up to 2 yrs: reduction by closed methods.After 2 yrs: Salter's osteotomyNone in bilateral.Indication is pain. Rx:THR>arthrodesis | 157,722 | medmcqa_train |
A 25-year-old man has a negative Dick test and a positive Schick test. These results indicate that he has | The patient has a negative Dick test and a positive Schick test, which indicates that he has neutralizing antibodies against the group A streptococcus that causes scarlet fever. In both tests, the antigen that is injected is the toxin. If neutralizing antibodies are present, they neutralize the toxin and skin reactions do not occur. This indicates that the patient is immune to the specific strain of bacteria producing the disease. For example, the patient&;s negative Dick test means that he has neutralizing antibodies that will protect him against the strain of streptococcus that produces scarlet fever, but not against strains that may be associated with pharyngitis or other infections. Absence of the antibodies allows the toxin to host an inflammatory reaction, which indicates a lack of immunity. If the patient had a full complement of diphtheria-peussis-tetanus (OPT) immunizations, neutralizing antibodies against diphtheria should be present. The presence of a reaction for the Schick test is a not a test of cellular immunity, because it is an antigen-antibody reaction. | 157,723 | medmcqa_train |
Commonest intrabronchial cause of haemoptysis is | The two most common causes for haemoptysis are bronchitis and bronchiogenic carcinoma. Bronchitis is not provided amongst the options and hence bronchiogenic carcinoma is the single best answer of choice Ref Harrison 19th edition pg 227 | 157,724 | medmcqa_train |
A female presented with swelling over angle of mouth. Investigation shows pleomorphic adenoma of the superficial lobe.Treatment of choice is: | Pleomorphic adenomas, or benign mixed tumors, are the most common neoplasms of the salivary glands. They represent approximately 60-70% of all parotid tumors and 90% of submandibular benign tumors. The mixture of epithelial, myoepithelial, and stromal elements is represented by the name, benign mixed tumor. Any of these individual components may predominate in the histology, but all three must be present to confirm the diagnosis. Both immunohistochemical stains specific for myoepithelial cells and epithelial cells can help to distinguish pleomorphic adenoma. Complete surgical excision of the tumor with uninvolved margins is the recommended treatment. For example, a superficial parotidectomy with clear margins is the treatment of a pleomorphic adenoma located in the superficial lobe of the parotid gland. Ref: Butt F.Y. (2012). Chapter 18. Benign Diseases of the Salivary Glands. In A.K. Lalwani (Ed), CURRENT Diagnosis & Treatment in Otolaryngology--Head & Neck Surgery, 3e. | 157,725 | medmcqa_train |
A young woman complains of recurrent rhinitis, nasal discharge and bilateral nasal blockage since one year. She also had history of allergy and asthma. On examination, multiple polyps with mucosal thickening and impacted secretions are seen in nasal, cavities. Biopsy was taken and the material on culture showed many hyphae with dichotomous branching typically at 45 degree. Which of the following is most likely organism responsible? | Patient is suffering from allergic fungal sinusitis caused by aspergillus. Septate hyphae which show dichotonomous branching at 45 degree are characteristics of aspergillus. Allergic fungal sinusitis patients suffer from chronic sinusitis, nasal polyp, asthma and atopy. Ref: Textbook of Microbiology and Immunology By Parija, Page 640; Aspergillus Fumigatus and Aspergillosis By Jean-Paul Latge, William J. Steinbach, Page 302; Harrison's Principles of Internal Medicine, 17th Edition, Page 1259. | 157,726 | medmcqa_train |
Anti - mullerian Hormone is | AMH is a Glycoprotein, declines progressively with menopause. | 157,727 | medmcqa_train |
Separation for the period of communicability of infected persons in such places or under such conditions as prevent transmission of infectious agent to the susceptible is known as: | Isolation: Separation for the period of communicability of infected persons in such places or under such conditions as prevent transmission of infectious agent to the susceptible. Quarantine: It is the limitation of movement of such well persons or animals exposed to communicable diseases for a period usually not longer than the longest incubation period of the disease to prevent effective contact with those not exposed. Segregation: It is the separation for special consideration, control of observation of some pa of a group of persons from others to facilitate control of communicable disease. Ref: Park 21st edition, page 110-111. | 157,728 | medmcqa_train |
Cellulose is a: | Option b : Cellulose is a non-starch homopolysaccharide Cellulose unbranched, non-starch homopolysaccharide It is made up of glucose molecules linked by beta (1- 4) glucosidic linkages (see fig). This linkage can't be broken down by any human enzyme due to beta anomerism at C-1. Intestinal bacteria ferments cellulose to sho-chain fatty acid (Butyrate). The most abundant organic molecule on Eah (Second most abundant is Chitin). Cellulose is present in the cell walls of plants and other organisms Starch storage polysaccharide of plants consisting of both linear and branched chain glucose molecules. | 157,729 | medmcqa_train |
Which of the following carries the least risk of Metabolic side effects | Ziprasidone, Aripiprazole & Asenapine carries negligible risk of metabolic side effects like weight gain, hyperlipidemia. | 157,730 | medmcqa_train |
True regarding Crohn's disease are all except | The skin involvement in Crohn's disease causes erythema nodosum, scleroderma does not occur in Crohn's disease.
Other extraintestinal manifestations of Crohn's disease:
1. Migratory polyarthritis
2. Sacroiliitis
3. Ankylosing spondylitis
4. Uveitis
5.. Hepatic pericholangitis
6. Primary sclerosing cholangitis
7. Clubbing | 157,731 | medmcqa_train |
Prolonged treatment with INH leads to a deficiency of? | Isoniazid can cause peripheral neuropathy due to deficiency of pyridoxine. | 157,732 | medmcqa_train |
Local anesthetics are typically injected or applied very close to their intended site of action. From which of the following routes absorption of local anaesthetic is maximum? | The rate of systemic absorption is propoionate to the vascularity of the site of injection: intravenous > tracheal > intercostal > caudal > paracervical > epidural > brachial plexus > sciatic > subcutaneous. Ref: Morgan, Jr. G.E., Mikhail M.S., Murray M.J. (2006). Chapter 14. Local Anesthetics. In G.E. Morgan, Jr., M.S. Mikhail, M.J. Murray (Eds), Clinical Anesthesiology, 4e. | 157,733 | medmcqa_train |
True regarding Mitral valve prolapse syndrome is all,except- | MVP, also variously termed the systolic click-murmur syndrome, Barlow's syndrome, floppy-valve syndrome, and billowing mitral leaflet syndrome, MVP is more common in women and occurs most frequently between the ages of 15 and 30 years; Most patients are asymptomatic and remain so for their entire lives. Transient cerebral ischemic attacks secondary to emboli from the mitral valve due to endothelial disruption have been repoed. Infective endocarditis may occur in patients with MR and/or leaflet thickening. (Harrison's Principles of internal medicine, 18 th edition, page 1937 ) | 157,734 | medmcqa_train |
Which of the following is a relatively cerebroselective anticholinesterase found to afford symptomatic improvement in Alzheimer&;s disease | Rivastigmine:- This lipophilic relatively cere-broselective ChE inhibitor has been introduced for Alzheimer's disease (AD). Donepezil:- Another centrally acting anti-AChE that has produced cognitive and behavioral improvement in AD. It is long-acting and suitable for once daily administration. Galantamine:- This natural alkaloid inhibitor of cerebral AChE has in addition weak agonistic action on nicotinic receptors. It is being used to afford symptomatic relief in AD. Ref:- kd tripathi; pg num:-108 | 157,735 | medmcqa_train |
Amsel's criteria is used for; | Amsel's criteria is used for diagnosis of Bacterial vaginosis MC Vaginitis Caused by Hemophilus vaginalis aka Gardnerella vaginalis Amsel's criteria - >= 3 out of 4 required for diagnosis of Bacterial vaginosis Creamy discharge Whiff test + Fishy odor Clue cells | 157,736 | medmcqa_train |
Steroids are indicated in all of the following forms of tuberculosis except. | Ans. (C) Ileo-caecal tuberculosis(Ref: Katzung 10/e p1263; KDT 8/e p319)*If used in intestinal tuberculosis, steroids can result in silent perforation, therefore are contra-indicated in ileo-caecal tuberculosis. | 157,737 | medmcqa_train |
Spontaneous CSF leak occurs in all except - | Ans. is 'a' i.e., Increased intracranial tensionWe are not sure of the answer.We have gone for increased intracranial tension because spontaneous C.S.F. leak is associated with intracranial hypotension.Increased intracranial tension is not associated with spontaneous C.S.F. leak.All other options mentioned in the question are associated with spontaneous C.S.F. leak.Pseudotumor CerebriPseudotumor cerebri usually presents with triad of headache, papilledema and minimal or absent focal neurological signs, but rarely the presenting feature may be a nasal C.S.F. leak.Empty sella syndromeIn empty sella syndrome, the sella turcica (the bony structure which contains pituitary enlarges). In this disease there is a defect in tissue barrier that normally keeps the cerebrospinal fluid around the brain separate from the sella turcica. As a result cerebrospinal fluid puts increased pressure on the pituitary glands and the walls of the sella turcica. The sella tunica enlarges and the pituitary shrinks.The empty sella syndrome may produce no symptoms at all and seldom produces serious symptom. About half of those affected have headaches. In rare cases there is leaking of the cerebrospinal fluid from the nose.EncephaloceleEncephalocele may present with C.S.F. leak.More on spontaneous C.S.F. leak or spontaneous intracranial hypotensionSpontaneous intracranial hypotension is a condition where patient gets postural headache due to leak of the cerebrospinal fluid in the spinal membrane.What happens is that the leak causes low C.S.F. pressure within the nervous system and thus causes a string of headache to the patient.The problem with SIH is that it is hard to diagnose and there is not a great deal of information on why it occurs.It has been associated with connective tissue diseases which may involve the dura causing tear in it.To summarize it, spontaneous C.S.F. leak is very rare and unlike other causes it does not occur due to any specific traumatic event or surgical procedure in the nervous system.Although there is not much information on the possible causes of C.S.F. leak, it is suspected that an intrinsic weakness of the spinal membrane or an abnormality of the brain structure causes the rare condition. The symptoms of SIH are so small and so common that it can often be misdiagnosed. | 157,738 | medmcqa_train |
Following is associated with maximum risk of invasive cervical cancer:- | HSV & HIV predisposes more to pre invasive cervical cancer than invasive disease. Severity of dysplasia is directly propoional to malignancy. HPV 16 is the most common association, HPV 18 is this most malignant association with ca cervix LSIL (CIN I) , HSIL (CIN II and CIN III) and carcinoma in situ (CIS) are degrees of cervical dysplasia noted on a paps smear and confirmed on a colposcopic biopsy. Their risk of transforming into invasive cancer are CIS>HSIL>LSIL | 157,739 | medmcqa_train |
A 40 years old man presents with a recurrent hemoptysis and purulent cough. X-ray was found to be normal. To next investigation done to aid in diagnosis is : | B i.e. Bronchoscopy As a rule, you can remember, for almost all cases of hemoptysis the investigation of choice is Bronchoscopy followed by HRCT; Except for hemoptysis associated with parenchymal (interstitial) lung disease where investigatim of choice is HRCT> Bronchoscopy, and in suspected bronchitis where you observe and wait for recurrence for performing Bronchoscopy. | 157,740 | medmcqa_train |
Ionophores have following action except | Hydrophilic in character
Inophors are lipophilic (not hydrophilic).
Inophors inhibit ATP formation by inhibiting oxidative phosphorylation by abolishing proton gradient or pH gradient. | 157,741 | medmcqa_train |
Which of the following nerves transmits impulses originating from the vestibular apparatus? | The vestibular poion of cranial nerve VIII (vestibulocochlear nerve) carries impulses from the vestibular apparatus to the vestibular ganglion, which then conveys the impulses to the vestibular nuclei of the brainstem. | 157,742 | medmcqa_train |
Antibodies most commonly seen in drug induced lupus are: | Answer is D (Antihistone Antibodies): The most commonly used marker for drug induced lupus is Antihistone Antibodies. Drug Induced Lupus is characterized serologically by the presence of Anti-Histone Antibodies and the absence of antibodies against double stranded DNA (dsDNA Antibody Negative; Anti-Histone Antibody Positive). Anti-dsDNA Serology in Drug Induced Lupus Erythematosus Almost all patients with Drug Induced Lupus will test positive for Antinuclear Antibodies (Positive ANA Test) The spectrum of Antinuclear antibodies in Drug Induced Lupus includes Positive Antihistone antibodies (most common; not specific; also seen in SLE) Positive autoantibodies against single stranded DNA (common ; not specific; also seen in SLE) Negative (absence of) autoantibodies against double stranded DNA(dsDNA) The presence of autoantibodies against dsDNA strongly suggests a diagnosis of SLE Drug Induced Lupus is typically associated with a Homogeneous ANA pattern due to the presence of Antihistone Antibodies Antibodies are seen in less than 5 percent of patients with Drug Induced Lupus The presence of Antihistone antibodies alone is not a specific test for diagnosis of Drug Induced Lupus as Antibodies to histones may also be seen in up to 50 to 80 percent of patients with idiopathic SLE. Note : Hypocomplementemia is uncommon in Drug Induced Lupus but not in SLE. | 157,743 | medmcqa_train |
About Ectopia vesicae, following is true except - | Ectopia vesicae is associated with epispadias in which dorsal or upwards curvature of penis is noted.
Ventral curvature is noted in hypospadias. | 157,744 | medmcqa_train |
Frisch bacillus affects most commonly - | Ans. is 'b' i.e., Noseo Frisch bacillus is Klebsiella rhinoscleromatis, which causes rhinoscleroma, a granulomatous disease of nose.Bacteria and their alternate nameso Bordetellao Clostridium tetanio Corynebacterium diphtheriaeo Corynebacterium pseudotuberculosiso Haemophilus aegypticuso Haemophilus influenzao Klebsiella pneumoniao Klebsiella ozaenaeo Klebsiella Rhinoscleromatiso Mycobacterium tuberculosiso Mycobacterium intracellulareo Mycobacterium paratuberculosiso Mycoplasmao Pseudomonas pseudomalleiBordet Gengou bacillusNicolaire s bacillusKlehs-Loeffler '.s bacillusPreisz-Nocard bacillusKoch-Weeks bacillusPfeiffer s bacillusFriedlander s bacillusAbel's bacillusFrisch's bacillusKoch's bacillusBatteys bacillusJohne's bacillusEaton agentWhitmore s bacillus | 157,745 | medmcqa_train |
Measles shows age distribution. It is found most commonly in which age group? | Impoant diseases & their age distribution: Measles - 6 months to 3 years Mumps - 5-9yrs Chicken pox - 5-9yrs Rheumatic fever - 5 to 15 years Cancers, Cataract - >50 years Rota virus - younger infants Diabetes , HTN, CHD - > 40yrs | 157,746 | medmcqa_train |
All of the following substances can cause seizures except | Lamotrigine is antiepilepticDrugs and Other Substances That Can Cause SeizuresAlkylating agents (e.g., busulfan, chlorambucil)Antimalarials (chloroquine, mefloquine)Antimicrobials/antiviralsb-lactam and related compoundsQuinolonesAcyclovirIsoniazidGanciclovirAnesthetics and analgesicsMeperidineFentanylTramadolLocal anestheticsDietary supplementsEphedra (ma huang)GingkoImmunomodulatory drugsCyclosporineOKT3 (monoclonal antibodies to T cells)TacrolimusInterferonsPsychotropicsAntidepressants (e.g., bupropion)Antipsychotics (e.g., clozapine)LithiumRadiographic contrast agentsDrug withdrawalAlcoholBaclofenBarbiturates (sho-acting)Benzodiazepines (sho-acting)ZolpidemDrugs of abuseAmphetamineCocainePhencyclidineMethylphenidateFlumazenilRef: Harrison 19e 2547 | 157,747 | medmcqa_train |
Death caused by rash and negligent of doctor is punishable under | Refer the byte "Legal sections". | 157,748 | medmcqa_train |
Ductopenic cholestasis is seen in all, EXCEPT: | Disappearance of bile ducts, "ductopenic" cholestasis is seen with carbamazepine, chlorpromazine, tricyclic antidepressant agents. Reference: Harrisons Principles of Internal Medicine, 18th Edition, Page 2560 | 157,749 | medmcqa_train |
False regarding cecal voluvus: | CECAL VOLVULUS -Misnomer -Involvement of ileum, cecum, transverse colon; Not only cecum. -Correct name should have been Cecocolic volvulus. -Volvulus is Mainly clockwise. -Caecum is relatively fixed. | If free or mobile | Increased chances of torsion *Predisposing factors:- -Multipara patients (due to release of relaxin) -H/O previous surgery (ligaments are divided) -Malrotation (abnormal location of cecum which is free) -Distal obstructing lesion (proximal pa of colon distention leading to torsion) *Clinical features:- Because Twisting/ is at the level of ileum -patient will present with signs and symptoms of SBO * -Colicky pain * -Bilious vomiting * -Absolute constipation *Investigations:- -IOC - Plain x-ray * KIDNEY BEAN sign -Comma shaped cecum *Treatment:- Ileocecectomy + Ileotransverse anastomosis - Most cases require operation to correct the volvulus and prevent ischemia. - If ischemia has already occurred, immediate operation is obviously required. Right colectomy with primary anastomosis is the procedure of choice In frankly gangrenous bowel, resection of the gangrenous bowel with ileostomy is a safer approach - Recurrence rates are high with cecopexy, and right colectomy remains the procedure of choice for cecal volvulus. | 157,750 | medmcqa_train |
Which of the following disease is more common in patients with alfa 1 antitrypsin deficiency? | Alfa 1 antitrypsin is an inhibitor of proteinase 3. Antiproteinase antibodies are seen in Wegeners granulamatosis. Ref: Harrisons Principles of Internal Medicine, 18th Edition, Page 2343 | 157,751 | medmcqa_train |
Low dose progestational contraceptives primarily act on | Progesterone in bih control pills thickens cervical mucus (primary action): hinders the travel of sperm to the uterus and making it hard for sperm to enter the tubes and feilise the egg. thins the lining of the uterus: makes implantation unlikely. Progestogen only pills are generally less effective than other forms of oral contraceptive pill with a failure rate of 2 - 6 per 100 women years. The main side effects are Irregular, low-grade, breakthrough uterine bleeding but this may settle into a regular cycle after 6 - 9 months. Skin reactions, Breast fullness Depression Increased risk of ectopic pregnancy. Benefits include: Do not carry risk of thromboembolism Do not inhibit lactation - so can use when breast feeding Suitable for diabetics - as pills containing oestrogen exacerbate risk of aerial disease in such patients Suits smokers for whom oestrogen containing formulations are contra-indicated | 157,752 | medmcqa_train |
Stye is an acute suppurative inflammation of | EXTERNAL HORDEOLUM (STYE) It is an acute suppurative inflammation of gland of the Zeis. Etiology: Causative organism commonly involved is Staphylococcus aureus. Signs : 1) Stage of cellulitis is characterised by localised, hard, red, tender swelling at the lid margin associated with marked oedema 2) Stage of abscess formation is characterised by a visible pus point on the lid margin in relation to the affected cilia. Usually there is one stye, but occasionally, these may be multiple. Ref:- A K KHURANA; pg num:-345 | 157,753 | medmcqa_train |
Features of vernal keratitis are: | A i.e. Papillary hyperophy | 157,754 | medmcqa_train |
Hydrocele is a type of ..... cyst - | Ans. is 'c' i.e., Exudation | 157,755 | medmcqa_train |
Which is not true regarding the basisbof functional divisionsnof liver | All of the given option are true. If we have to choose one, most preferred option is 'liver is divided into 8 segments' because sometimes segment IX is described. Segment IX is a recent subdivision of segment I, and describes that pa of the segment that lies posterior to segment VIII Current understanding of the functional anatomy of the liver is based on couinand's division of the liver into eight (subsequently nine) functional segments, based upon the distribution of poal venous branches and the location of the hepatic veins in the parenchyma Segment IX is a recent subdivision of Segment I, and describes that pa of the segment that lies posterior to segment VIII Ref: Gray's anatomy Pgno :1165-1166 | 157,756 | medmcqa_train |
Term used for death of full family suicide is | (D) Familicide# FAMILICIDE is a type of murder or murder-suicide in which at least one spouse and one or more children are killed, or in which a parent or parents and possibly other relatives such as siblings and grandparents are killed.> In some cases all of the family members' lives are taken. If only the parents are killed, the case may also be referred to as a parricide. Where all members of a family are killed, including when the killing takes the form of a murder-suicide, the crime may be referred to as family annihilati> Jauhar (Jowhar) is the self-immolation of women, always including queens and female royals of Hindu kingdoms, most notably the Rajput kingdoms of Rajasthan in India, when facing defeat at the hands of an enemy.> Massacre is the deliberate slaughter of members of one group by one or more members of another more powerful group. A massacre may be indiscriminate or highly methodical in application. A massacre is a single event, though it may occur during the course of an extended military campaign or war.> Mass suicide occurs when a group of people commit suicide simultaneously. Contents. Examples 1. Historical mass suicides; 2. Religiously motivated. | 157,757 | medmcqa_train |
Marble bone disease is | (Osteopetrosis): (307- Malushwari 4th edition)OSTEOPETROSIS (Marble bones, Alber's - Schonberg disease)* Characterised by dense but brittle bones* Autosomal dominant disorderCP-* Pathological fractures* Cranial nerve compression]---Due to bone encroachment on foramena* Jaw osteomyelitis (After tooth extraction)* Anemia* X-ray shows - Increased density of the all the all the bones* Cortices are widened leaving narrow medullary canal Sclerotic vertebral end plates producing a striped appearance (rugger Jersey spine)* Skull is thickened and the base densely sclerotic | 157,758 | medmcqa_train |
An entity of pneumothorax which leads to build up of positive pressure within the hemithorax, leading to collapse of lung, flattened diaphragm, mediastinal shift to contralateral side and eventually the venous return to the right side of hea is compromised is known as | During inspiration,air is pumped into the pleural cavity through a valvular opening in the visceral pleura and underlying injured lung,leading to build up of positive pressure within the hemithorax.Lung collapses first,and as air continuously collects in the pleural cavity,mediastinum shifts towards the oppposite side,fuher decreasing the volume of the functioning lung.Fuher increase in the pleural pressure,reduces the venous return,atrial filling,and ventricular filling and so cardiac output and cardiac function.It causes sudden death & emergency treatment is required. Reference:Bailey & Love's sho practise of surgery,25th edition,page no:1116,1117. | 157,759 | medmcqa_train |
Which of the following signs is not suggestive of a cervical spinal cord injury : | Answer is B (Increased Rectal Sphincter tone): Cervical spinal cord injury is associated with a decreased rectal sphincter tone (and not an increased rectal sphincter tone). | 157,760 | medmcqa_train |
Milk is deficient in? | a. Iron and Vit C(Ref: Nelson's 20/e p 286-290, Ghai 8/e p 150-161)About the options:IronIron content (1mg/L) in cow & breast milk makes it difficult to maintain body iron & meet RDA of infant (8-10mg). Breastfed infants absorb iron 2-3 times more efficiently than infants fed cow's milkVit CInfants consuming pasteurized or boiled animal milk are at significant risk of developing Vitamin C deficiencyPhosphorusCow's milk is rich in phosphate; So, an infant on a diet rich in cow's milk has chances of developing hypocalcemiaVit ABreast milk as well as cow's milk contains adequate amounts of Vit A to meet the needs of infantsHence, cow's milk is deficient in Iron & Vitamin C.Note: Breast milk contains adequate amounts of all vitamins except Vit D, Vit K & Vit B12 (in strictly vegan mothers). | 157,761 | medmcqa_train |
Which of the following is not true regarding schirmer test:- | The Schirmer's I test Measures combined basal and reflex tear secretion Relatively specific, but poorly sensitive Eyes closed / blink normally for 5 minutes Not useful in non co-operative adults and children Amount of wetting >10mm -normal 5-10mm -borderline < 5 mm is abnormal 5-minute Schirmer test with and without anesthesia is abnormal <5 mm with anesthesia <10 mm without anesthesia The Schirmer's II test Measures reflex tearing Addition of nasal mucosal irritation with a cotton tipped applicator Amount of wetting < 15 mm after 5 minutes - abnormal reflex secretion -moderate to severe dry eye For differentiating non-Sjogren's from Sjogren's syndrome Patient cooperation is essential for performing the test. | 157,762 | medmcqa_train |
Hay's sulpher test is used to detect w hich of the following - | Ans. is 'a' i.e., Bile salts in urineTestsUsed foro Rothera's test (nitroprusside test)o Gerhardt's test (ferric chloride test)Ketone bodies in urine acetone and acetoacetateKetone bodies in urine acetoacetate.o Benedict's testo Fchling's testReducing sugars in urine Reducing sugars in urineo Hay's sulpher testBile salts in urineo Fouchet's (borium sulphate test)o Gmelin's (nitric acid) testo Vanden Bergh testo Ehrlich's testo Schlesinger's testBile pigment: bilirubinBile pigment: bilirubinBile pigment: bilirubinBilinogens (stercobilinogen, urobilinogen)Bilinsfstercobilin. urobilin).o Ehrlich's aldehyde testPorphobilinogen and urobilinogen in urine | 157,763 | medmcqa_train |
Serum gamma glutamyl transpeptidase maximum increased in | A. i.e. (Alcoholism) (107- U. Satyanarayan 3rd) (600- Rana -Shinde 7th)Important enzymes in the diagnosis of disease* SGPT / ALT- Liver disease (Hepatitis)* SGOT/AST- MI & Liver disease* LDH- MI, Infective hepatitis* CPK- Myocardial infarction* Aldolase- Muscular dystrophy* 5 - Nucleotidase- Hepatitis* Y- Glutamyl- transpeptidase (GGT)- Alcoholism* Y- GT is the most sensitive indicator in alcoholism* Useful test for MI in later stages* Increase serum activity seen with pancreatic disease* It is a valuable parameter in differentiating between skeletal (bone) and hepatic dysfunction associated withincreased serum ALP | 157,764 | medmcqa_train |
The EEG rhythm having lowest frequency is- | Ans. C. DeltaThe various types of EEG waveforms are depicted below- | 157,765 | medmcqa_train |
A pregnant female presents with pain in abdomen on examination, tenderness is found in right lumbar region. TLC is 12000/cmm. and urine examination is normal.For diagnosis further test done is --> | Ans. is 'b' ultrasound abdomen [Ref Love & Bailey 24/e p. 1211 (23rd/e p. 1084)Ultrasound is a useful diagnostic method in a pregnant female presenting with right iliac fossa pain to exclude tubal or ovarian disease | 157,766 | medmcqa_train |
Best site for collection of specimen for N. meningitides ? | Ans. is 'c' i.e., Nasopharyngeal swab Best site for specimen collection for meningococci :? For cases - CSF (by lumbar puncture) For carriers - Nasopharyngeal swab As CSF is not there in options, examiner is, most probably, asking about specimen in carrier. Laboratory diagnosis of meningococcal infection Specimens CSF - Divided into three poions : One poion is centrifuged and Gram stained smears are prepared from the deposit The second poion is inoculated on blood agar or chocolate agar plates. The third poion of CSF is incubated overnight and than subcultured on chocolate agar. Blood - for culture in patients with meningococcemia and early meningitis. Nasopharyngeal swab - for carriers Petechial lesions - In cases of meningococcemia. Autopsy specimens - from meninges, lateral ventricle, surface of brain or spinal cord. Smear will show Gram negative diplococci inside the polymorphs but often extracellularly also. They are arranged in pairs, with the adjacent sides flattened. Capsulated nonmotile Transpo medium - Stua's medium Culture Blood agar, chocolate agar and Muller-Hinton starch casein hydrolysate agar are the media commonly used for culturing meningococci. Modified Thayer - Main (with vancomycin, colistin and nystatin) is a useful selective medium. Serology Antibodies to meningococcal polysaccharides can be measured by latex agglutination or hemagglutination tests or by their bactericidal activity. | 157,767 | medmcqa_train |
The effective medical therapies for variceal bleeding in the setting of cirrhosis of liver are all, EXCEPT: | MEDICAL THERAPIES FOR VARICEAL BLEEDING: Somatostatin and octreotide cause selective splanchnic vasoconstriction and lower poal pressure. Vasoactive drugs (e.g., octreotide, somatostatin, terlipressin are as effective as sclerotherapy for controlling variceal bleeding. Octreotide is the drug of choice as an adjunct to endoscopic therapy for the treatment of variceal hemorrhage. Ref:Sleisenger and Fordtran's,E-9,P-306 | 157,768 | medmcqa_train |
What is meant by Superfecundation? | * Superfecundation is the feilization of two or more ova from the same cycle by sperm from separate acts of sexual intercourse, which can lead to twin babies from two separate biological fathers. * The term superfecundation is derived from fecund, meaning the ability to produce offspring REF : DUTTA BOOK OF OBESTETRICS | 157,769 | medmcqa_train |
The effect of thiopentone on the CNS is quickly terminated because of: | Thiopentone is a ultra sho acting barbiturates ,its action is terminated because of redistribution . thiopentone is highly lipid soluble ,after i.v injection consciousness is regained in 6-10 minutes due to redistribution ,while the ultimate disposal occurs by metabolism. Greater the lipid solubility of the drug ,faster is its redistribution. Ref: KD Tripathi 8th ed | 157,770 | medmcqa_train |
In HCC | Clinical features of HCC Vascular bruit (25%) GI bleed (10%) Tumor rupture (2-5%) Jaundice due to biliary obstruction (10%) Paraneoplastic syndrome (<5%) Ref:Sabiston 20th edition Pgno : 1456-1463 | 157,771 | medmcqa_train |
True about competitive inhibition with first order kinetics | Ans. (a) Km increased, Vmax sameType of InhibitionKmVmaxCompetitive inhibitionINCREASEDSAMENon-competitive inhibitionSameDECREASEDCompetitive Inhibtion: Substrate and inhibitor, both compete for same site on enzyme.Non-competitive Inhibition: Substrate and inhibitor both bind at different sites in the enzyme. | 157,772 | medmcqa_train |
Most common type of astigmatism in keratoconus is | Keratoconus usually have irregular astigmatism * B/L Non inflammatory ectatic condition of cornea Clinical Presentation * Young females with constantly changing power of glasses with myopia & high cylinder and irregular astigmatism SIGNS IN KERATOCONUS Munson sign Enlarged corneal nerves Oil droplet reflex( on DDO) Rizutti sign Hydrops Fleischer ring | 157,773 | medmcqa_train |
Kussmaul's sign is NOT seen in: March 2011 | Ans. D: Cardiac tamponade A positive Kussmaul sign is rare in cardiac tamponade Davidson's (21st ed., p-542) includes Kussmaul's sign as a clinical feature of pericardial/ cardiac tamponade Normal physiology: Ordinarily the JVP falls with inspiration due to reduced pressure in the expanding thoracic cavity. Kussmaul's sign suggests impaired filling of the right ventricle due to either fluid in the pericardial space or a poorly compliant myocardium or pericardium. This impaired filling causes the increased blood flow to back up into the venous system, causing the jugular distension. Causes of Kussmaul's sign: The differential diagnosis generally associated with Kussmaul's sign is constrictive pericarditis, along with restrictive cardiomyopathy and cardiac tamponade. With cardiac tamponade, jugular veins are distended and typically show a prominent x descent and an absent y descent as opposed to patients with constrictive pericarditis Right ventricular infarction - low ventricular compliance Right hea failure Cardiac tumours Tricuspid stenosis | 157,774 | medmcqa_train |
A 50 year old breast cancer patient presents with breathlessness. What does the ECG show? | HR is about 150/min with variation in electrical axis due to fluctuation in amplitude of QRS complex on beat to beat variation. Malignancies like breast cancer and lung cancer can metastasize to the hea leading to cardiac tamponade. | 157,775 | medmcqa_train |
Average gain of Height in the first year is? | Square root of the month of the baby. Till he reaches 7 months Ref- OP. Ghai ,9th edition, Page 14 | 157,776 | medmcqa_train |
This type of psoriasis is commonly seen in children and may follow a streptococcal sore throat – | Guttate psoriasis occurs in children and adults. It is precipitated by URTI (e.g. streptococcal tonsilitis) | 157,777 | medmcqa_train |
Which is the true statement regarding megaloblasitc anemia- | Ans. is 'a' i.e., Megaloblastic precursors are present in bone marrow; 'b' i.e., Mean corpuscular volume is increased; 'c' i.e., Serum LDH is increased Option a & b have been explained already. o Serum LDH is increased in megaloblastic anemia because of the following two processes that occur in megaloblastic anemia. 1. Ineffective erythropoiesis o There is replication of erythroid precursor in the bone marrow, but they die before maturation. So there is no functional release of red cells into circulation. 2. Hemolysis In megaloblastic anemia there is hemolytic destruction of red cells in periphery. The basis for hemolysis is not entirely clear. Due to destruction of RBCs by ineffective erythropoiesis and peripheral hemolysis, findings of hemolytic anemia may also occur in megaloblastic anemia, i..e, - T LDH, Reduced heptoglobin, Positive urine hemosiderin, Raised urine urobilinogen | 157,778 | medmcqa_train |
Acute angle closure glaucoma first line treatment? | Ans. is 'a' i.e., I.V. Mannitol Treatment of angle closure glaucoma Definitive treatment (treatment of choice) is surgery. However, intially drugs are used to decrease KW during an acute attack. Approach of treatment is as follows:- Sta i.v. mannitol or i.v. acetazolamide When IOT stas falling, sta topical pilocarpine or b-blocker (timolol). Apraclonidine/latanoprost may be added. Once IOT is reduced, surgery is done. Topical pilocarpine 2% is the preferred antiglaucomatous drug. After control of IOP, Laser (Nd : YAG) peripheral irodotomy is the definitive management of choice. If laser is not available surgical peripheral iridectomy is the procedure of choice. Other surgical procedures used are filteration surgeries (like trabeculectomy, deep sclerotomy, Viscoanulostomy). Symptomatic treatment during an attack also includes analgesics, antiemetic and topical coicosteroids to reduce inflammation. Mydriatics (e.g. atropine) are contraindicated as they precipitate glaucoma. PACG is a bilateral disease, the fellow eye is at risk of developing an acute attack in 50% cases in future. Therefore a prophylactic peripheral laser iridotomy should be performed in the fellow eye. | 157,779 | medmcqa_train |
Duhamel operation is done in - | Ans. is 'd' i.e., Hirschsprung's disease | 157,780 | medmcqa_train |
Which of the following structure is not affected in protein denaturation? | Ans. (a) Primary structureRef: Harper's Biochemistry, 30lh ed. pg. 26-29, 618-19 |PROTEIN DENATURATION* In quaternary structure denaturation, protein sub-units are dissociated and/or the spatial arrangement of protein subunits is disrupted.* Primary structure, such as the sequence of amino acids held together by covalent peptide bonds, is not disrupted by denaturation.* In secondary structure denaturation proteins adopt a random coil as they lose all regular repeating patterns such as alpha-helices and beta-pleated sheets, and configuration.* Tertiary structure denaturation involves the disruption of:1. Covalent interactions between amino acid side- chains (such as disulfide bridges between cysteine groups)2. Non-covalent dipole-dipole interactions between polar amino acid side-chains (and the surrounding solvent)3. Van der Waals (induced dipole) interactions between nonpolar amino acid side-chains. | 157,781 | medmcqa_train |
Most common cause of aortic aneurysm is - | Ans. is 'c' i.e., Atherosclerosis Aneurysmo Aneurysm is a localized abnormal dilatation of blood vessel or the wall of hearto When an aneurysm is bounded by true arterial wall, it is called a true aneurysm.o When wall, is ruptured and there is collection of blood outside the vessel wall {extravaseular hematoma) that is freely communicating with vessel wall - false aneurysm. Most common cause of false aneurysm is post myocardial infarction rupture.o Aneurysm due to infection that causes weakening of vessel wall - mycotic aneurysm.o The two most important causes of aortic aneurysm (not only abdominal part but in any part of aorta) are atherosclerosis and cystic medial degeneration of arterial media.Abdominal aortic aneurvsmo The most common etiology for abdominal aortic aneurysm is atherosclerosis.o Atherosclerosis causes arterial wall thining through medial destruction secondary to plaque that originates in the intima.o Besides abdominal aorta, atherosclerotic aneurysm also occur in common iliac arteries, arch and descending part of thoracic aorta.o The usual site of abdominal aortic aneurism is below the origin of renal artery and above the bifurcation of the aorta.Remembero Most common cause of aortic aneurysm (overall) = Atherosclerosis.o Most common cause of ascending aortic aneurysm = Cystic medial necrosis.o Most common cause of descending aortic aneurysm = Atherosclerosis.o Most common cause of aneurysm of aortic arch = Atherosclerosis.o Syphilitic aneurysm affect = Ascending aorta, a Aneurysm ofTakayasu arteritis affects = Aortic arch.o Most common cause of mycotic abdominal aneurysm = salmonella gastroenteritis. | 157,782 | medmcqa_train |
A patient of Crohn's disease underwent resection anastomosis. Now present on 7th postoperative day with anastomotic leak from a fistula. Every day leakage volume adds up to 150-200 mL. There is no intra-abdominal collection and the patient is stable without any complaints. What will be next line of management? | Ans. (a) Conservative treatment and leave him and hope for the spontaneous resolutionRef: Sabiston 19th edition, Pages 1270-1272* As long as the patient has no signs of sepsis we can wait -- the waiting can be maximum for 4-6 weeks.* Only after 6 weeks we will plan for surgery: Excision of fistula and segmental resection of the involved bowel and reanastomosis. | 157,783 | medmcqa_train |
A 7 year old boy presented with generalized edema. Urine examination revealed marked albuminuria. Serum biochemical examinations showed hypoalbuminemia with hyperlipidemia. Kidney biopsy was undeaken. On light microscopic examination, the kidney appeared normal. Electron microscopic examination is most likely to reveal | Minimal change disease(MCD)Also known as nil lesion or lipoid nephrosis Causes 70-90% of the Nephrotic syndrome in childhood but only 10-15% of the Nephrotic syndrome in adultsCan be associated with Hodgkin&;s disease, allergies, NSAIDs, HIVClinical and laboratory findings: Abrupt onset of edema and nephrotic syndrome accompanied by acellular urinary sedimentHypeension, microscopic hematuria, allergic symptoms and decreased renal function may be presentAcute renal failure in adults is seen mostly in patients with low serum albumin and intrarenal edema (nephrosarca) that is responsive to intravenous albumin and diureticsIn children, the abnormal urine principally contains albumin with minimal amounts of higher-molecular-weight proteins, called as selective proteinuriaLight microscopy- no obvious glomerular lesionImmunofluorescent microscopy- negative for deposits or IgM deposits in mesangium(rarely)Electron microscopy- an effacement of the foot process with the weakening of slit-pore membranesPatients with steroid resistance may have FSGS on repeat biopsyPrimary responders: patients who have complete remission (<0.2 mg/24 h of proteinuria) after a single course of prednisoneSteroid-dependent: patients who relapse as their steroid dose is taperedFrequent relapsers: those having two or more relapses in the 6 months following taperSteroid-resistant: patients failing to respond to steroid therapyRelapses: - occur in 70-75% of children after the first remissionEarly relapse predicts multiple subsequent relapsesThe frequency of relapses decreases after pubey; increased risk of relapse following the rapid tapering of steroids in all groupsRelapses are less common in adults but are more resistant to subsequent therapyPrednisone is first-line therapy; cyclophosphamide, chlorambucil, and mycophenolate mofetil are used in frequent relapsers, steroid-dependent, or steroid-resistant patients(Ref: Harrison's 18/e p2345) | 157,784 | medmcqa_train |
Following muscles are the abductors of eye except (NOT RELATED) | Superior rectus The superior rectus muscle is one of the extraocular muscles. It is innervated by the superior division of the oculomotor nerve. In the primary posi on (looking straight ahead), the superior rectus muscle's primary func on is eleva on, although it also contributes to intorsion and adduc on. Superior oblique: The primary ac on of the superior oblique muscle is intorsion; the secondary ac on is depression (primarily in the adducted posi on); the ter ary ac on is abduc on (DOI). Both the obliques are abductors | 157,785 | medmcqa_train |
The following smooth muscle relaxants act by affecting calcium release except | Prazosin is alpha-1 blocker . | 157,786 | medmcqa_train |
Ig seen in breast milk & secretions: | Ans: a (IgA) Ref: Ananthanarayan, 7th ed, p. 88, 89Serum IgA is the major Ig in colostrums, saliva & tears.It is concentrated in secretions and on mucus surfaces forming an antibody paste.It is important in immunity against respiratory & intestinal pathogens.Properties of Immunoglobulins:IgMIgG* Maximum intravascular concentration* Maximum molecular weight* Maximum sedimentation co efficient* Earliest Ig by the foetus* Increased in primary immune response* Activate classical pathway* Mediates hypersensitivity pneumonitis* Maximum serum concentration* Longest half life (23 days)* Only Ig to cross placenta* Ig to increase in secondary immune response* Fixes complement by classical pathway (except IgG4) IgAigE* Secreted by seromucinous glands* Ig present in milk. (Other one is IgG)* Fix complement by Alternate Pathway* Mediator of type 1 HS* Only heat labile Ig* Shortest half life (2 days), least amount in serum* Maximum carbohydrate concentration* Shows homocytotropism* Mediate Prausnitz Kustner reaction.* Ig's activating alternate pathway - IgG4, IgA, IgD* IgG in multiple myeloma, IgM in Waldenstrom's macroglobulinemia* Ig dimer is IgA. Ig pentamer is IgM | 157,787 | medmcqa_train |
All are true about mammary gland, except | BREAST/MAMMARY GLAND: It is found in both sexes, but rudimentary in the male. It is a modified sweat gland. It forms an impoant accessory organ of the female reproductive system and provides nutrition to the newborn in the form of milk. SITUATION: The breast lies in the superficial fascia of the pectoralis region. It is divided into 4 quadrants, i.e. upper medial, upper lateral, lower medial, lower lateral. A small extension of the upper lateral quadrant, called the axillary tail of spence, passes through an opening in the deep fascia and lies in the axilla. The opening is called foramen of langer. EXTENT OF BASE: 1)Veically it extends from 2 to 6 th rib. 2)Horizontally it extends from the lateral border of the sternum to the mid-axillary line. DEEP RELATIONS: 1)The breast lies on the deep fascia {pectoral fascia} covering the pectoralis major. 2)Still deeper there are the pas of 3 muscles namely pectoralis major, the serratus anterior, and the external oblique muscle of the abdomen. 3)The breast is separated from the pectoralis fascia by loose areolar tissue, called retromammary space. Because of the presence of this loose tissue, the normal breast can be moved freely over the pectoralis major. BLOOD SUPPLY: It is extremely vascular. supplied by Internal thoracic aery lateral thoracic, superior thoracic and acromiothoracic branches of axillary aery lateral branches of the posterior intercostal aeries. NERVE SUPPLY: anterior and lateral cutaneous branches of the 4th to 6th intercostal nerves. The nerves convey sensory fibres to the skin and autonomic fibres to smooth muscles and to blood vessels. the nerves do not control the secretion of milk. secretion is controlled by hormone prolactin, secreted by pars anterior of the hypophysis cerebri. | 157,788 | medmcqa_train |
The interstitial lung disease (ILD) showing granulomas on lung biopsy is | Sarcoidosis is an inflammatory disease characterised by the presence of noncaseating granulomas.The granuloma is the pathologic hallmark of sarcoidosis. Desquamative interstitial pneumonia Is characterised by extensive accumulation of macrophages in intraalveolar spaces with minimal interstitial fibrosis.Granulomas are not formed in usual interstitial pneumonitis and diffuse alveolar damage. Reference:Harrison's Medicine-18th edition,page no:2805,2806,2167. | 157,789 | medmcqa_train |
Most common malignancy of liver in children is: | Hepatoblastoma is the most common malignancy of the liver in children, with most of these tumors diagnosed before 4 years of age. Hepatocellular carcinoma is the next most common, with a peak incidence between 10 and 15 years of age. Ref: Schwaz's principle of surgery 9th edition, chapter 39. | 157,790 | medmcqa_train |
New born male baby presented with congestive heart failure. On examination enlarged fontanelles, a loud cranial bruit and following radiological finding was noted-the most likely diagnosis: | Ref. Grainger and Allison's Diagnostic Radiology. Page. 189 | 157,791 | medmcqa_train |
Spironolactone should not be given with ? | Ans. is 'c' i.e., ACE inhibitors o Spironolactone is a potassium sparing diuretic, therefore, it can cause hyperkalemia decreasing the potassium diuresis. o ACE inhibitors can also cause hyperkalemia by inhibiting the production of angiotensin I, an inmmediate precursor of angiotensin II. Angiotensin causes excretion of Kt by increasing the secretion of aldosterone (Normally aldosterone enhances absoion of Na' in distal tubules in exhange of active secretion of Kt). o ACE inhibitors decrease potassium excretion by inhibiting the generation of Angiotensin. o Therefore, More pronoundced hyperkalemia can occur in patients receiving ACE inhibitors with sprironolactone. | 157,792 | medmcqa_train |
Late complication of elbow dislocation | Myositis ossificans: MYOSITIS OSSIFICANS * Acquired development of non neoplastic heterotopic ossification within soft tissues * Most often in response to localized trauma * Although the process most commonly develops within skeletal muscle, the term itself is a misnomer, because nonmuscular tissue may be involved, and inflammation is rare. * Adolescents & young adults, predominantly men, are affected most frequently, although it has been repoed in infancy as well Treatment * Once diagnosis is established, usually clinically, any surgical biopsy is contraindicated in FOP. * No established medical therapy exists. * Pain medications * suppoive measures -gentle occupational and/or physical therapy. Ref maheshwari 6/e p102 | 157,793 | medmcqa_train |
A neonate presented with fever, lethargy, abdominal distension, vomiting and constipation. Clinically he was diagnosed as volvulus neonatarum with suspected perforation. The best investigation would be – | Volvulus neonatorum
The fetal alimentary canal returns from the extraembryonic coelom into the abdomen at 8-10 weeks and the bowel undergoes rotation and fixation at certain points by the attachment of its mesentery to the posterior abdominal wall.
When the process is incomplete or deviates from the normal plan, the result is malfixation or malrotation.
Commonly, the normal oblique attachment of the mesentery from duodenojejunal flexure of the caecum is absent, and the small bowel is attached to the posterior abdominal wall by a narrow stalk based around superior mesenteric vessels. The caecum is undescended, i.e., situated in the right hypochondrium and abnormally fixed by peritoneal bands running laterally across the second part of the duodenum.
The poorly attached small bowel undergoes volvulus around the axis of the 'universal mesentery', which is twisted so that the flow of blood is cut off, producing a strangulating obstruction of the small bowel. This typically occurs in the newborn, hence the term `Volvulus neonatorum'. The terminal ileum and caecum are drawn into the volvulus and are wrapped around the stalk of the mesentery in two or three tight coils.
Clinical feature
A young infant, previously healthy, starts bile-stained vomiting during the first few days of the live. The abdomen is soft and non-distended; however, abdominal distension may occur which is limited to upper abdomen (epigastrium).
No obstruction may occur in the first day or two after birth and meconium may be passed normally. Then, with variable suddenness, bowel actions cease with onset of obstruction.
The signs vary, depending on the degree of intestinal obstruction versus ischemia. When strangulation occurs there are signs of shock, especially pallor and a vague mass of congested bowel may be palpable in the centre of the abdomen. Blood or blood-tinged mucus may be passed rectally.
Ischemia may result in gangrene and perforation.
Investigations
Barium contrast studies with fluoroscopy (Barium meal follow through) is the investigation of choice as X-ray is not reliable in early stages of volvulus.
However, if the perforation is suspected, barium contrast should not be used because of the risk of peritonitis. Water-soluble contrast studies (iodine based) should be used. Plain X-ray of abdomen/chest is the initial investigation to demonstrate free air under the diaphragm in suspected cases of perforation. | 157,794 | medmcqa_train |
Which of the following statement is true - | Ans. is 'b' i.e., Cohort study involves large number of subjects* Prevalence of blindness in India: 700 per 1 lakh population (0.7%) if cut of criteria is < 3/60 (WHO criteria); or 1100 per lakh population (1.1%) if cut of criteria is < 6/60 (NPCB criteria). | 157,795 | medmcqa_train |
Cottel's test is used to test the patency of the nares in: | Ans: C (Deviated nasal symptom) Ref: Diseases of the Ear Nose and Throat by PL Dhingra 5th edn 2010.Page 164-165Explanation:In this test (he cheek is pulled laterally and subjective improvement in the airway is assessedIf there is relief in nasal obstruction then the test is positive and indicates an abnormality in the vestibular component of the nasal valve. | 157,796 | medmcqa_train |
A 38 year old woman being treated for hypeension and diabetes has the sudden onset of swelling and tenderness of the wrists and knees. On examination she is febrile and flushed. A friction rub can be heard at the left lower sterna border. Which of the following drug is most likely the cause of these findings? | Hydralazine Drug induced lupus refers to a form of lupus caused by medication, it causes some symptoms similar to those of SLE (ahritis, rash, fever, and chest pain, but no kidney involvement ) that go away when the drug is Stopped common medications that may cause drug-induced lupus include hydralazine (Apresoline), procainamide (Procan, Pronestyl), methyldopa (Aldomet), quinidine (Quinaglute), isoniazid (INH), and some anti-seizure medications such as phenytoin (Dilantin) or carbamazepine (Tegretol) compications are more common in females. It is also more common in 'slow acetylators' since the metabolism of hydralazin is reduced in these patients. | 157,797 | medmcqa_train |
An elderly female presents to the emergency depament and was found to have a transmural myocardial infarction. Based on her ECG, she was staed on thrombolytie therapy with streptokinase. On fuher examination, which of the following findings would indicate that the thrombolytic therapy is risky and should be stopped | Ans. c. Significant pericardial effusion on echocardiography Fibrinolytics and anticoagulants can be continued in case of pericarditis, however, once significant pericardial effusion develops after MI, fibrinolytics should be discontinued "The risk of post MI pericardial effusion is not increased with the use of fibrinolytic agents, heparin, aspirin and other antiplatelet agents. In contrast, a pericardial effusion occurring I the setting of MI is an indication to discontinue anticoagulation and fibrinolytics. Fibrinolytic Therapy Absolute Contraindications History of cerebrovascular hemorrhage at any timeQ A non-hemorrhagic stroke or other cerebrovascular event within the past yearQ Marked hypeension (areliabl determined systolic aerial pressure >a180 mm Hg and/or a diastolic pressure>110 mm Hg) at any time during theacute presentation, suspicion of aoicdissection, and active internalbleeding (excluding menses).Q Relative Contraindications Current use of anticoagulantsQ(INR 2) A recent (<2 weeks) invasive or surgical procedure or prolonged (> cardiopulmonary resuscitation)Q Known bleeding diathesisQ PregnancyQ A hemorrhagic ophthalmic condition (e.g., hemorrhagic diabetic retinopathy) ctive peptic ulcer diseaseQ A history of severe hypeension that is currently adequatelyQ Allergic reactions to streptokinaseQ | 157,798 | medmcqa_train |
Non-appearance of social smile even after ..... weeks, is considered as abnormal: September 2011 | Ans. D: 8 weeks Child stas smiling back (social smile) when anyone talks to him or smiles at him by 6-8 weeks of age Impoant milestones: Head control: 1 month Sits with suppo: 5 months Transfer object from one hand to other: 6 months Crawls at: 8 months Says mama dada: 10 months Babies know his/ her gender: 3 years Can draw a circle: 3 years Self decisions: 7 years | 157,799 | medmcqa_train |
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