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All the following are hormonal agents used against breast cancer except | Refer Katzung 10th/897 Letrozole, anastrozole and exemestane are aromatase inhibitors useful for the treatment of tamoxifen resistant breast cancer Tamoxifen is a SERM It is also used for breast cancer Taxol is commonly used term for paxclitaxel | 157,900 | medmcqa_train |
True about generator potential: | Generator potentialare graded potentials whose magnitude is propotional to ghe intensity of the stimulus . Graded potentials have different names depending on which type of stimulus causes them and where they occur. For eg, when a graded potential occurs in the dendrites or cell body of a neuron in response to a neurotransmitter, it is called a postsynaptic potential. On the other hand, the graded potentials that occur in sensory receptors are termed receptor or generator potentials. Other examples: end-plate potentials, pacemaker potentials, and slow wave potentials. PROPEIES OF GRADED POTENTIAL | 157,901 | medmcqa_train |
In normal pressure hydrocephalus, all are seen except? | Ans. is 'a' i.e. Convulsion Normal Pressure Hydrocephalus is an uncommon syndrome consisting of an abnormal gait (ataxic or apractic) dementia (usually mild to moderate) urinary incontinence This is a communicating hydrocephalus with patent aqueduct of Sylvius. NPH is presumed to be caused by obstruction to normal flow of CSF over the cerebral convexity and delayed absorption into the venous system. The indolent nature of process results in an enlarged lateral ventricles but relatively little increase in CSF pressure. Following conditions have been seen to cause NPH by producing scarring of basilar meninges (blocking upwards flow of CSF) - meningitis - subarchnoid haemorrhage - head injury Approx 30-50% of the patients of NPH will show improvement with a ventricular shunting procedure. | 157,902 | medmcqa_train |
All of the following are a features of mania except - | Psychomotor activity is increased in mania. | 157,903 | medmcqa_train |
Maximum age of foetus for MTP is : | 20 weeks | 157,904 | medmcqa_train |
Tonsiloliths are best treated with: | The treatment for these tonsillar concretions or chronic tonsillitis is aggressive mouth care, which includes irrigation of the tonsils or cleaning them with a cotton swab soaked in 3% hydrogen peroxide. With time, the cellular debris is often retained in the branching crypts and with recurrent formation of focal bacterial abscesses in the tonsillar parenchyma, which later undergoes fibrosis and scarring; local care may not control these symptoms. Tonsillar surgery and elimination of these cryptic structures may be needed to control these infections. | 157,905 | medmcqa_train |
The lacerated wound will look like an incised wound in the region of- | Ans-B (4.10-Parikh 6th)Split lacerations (Incised like or incised looking wound)* Blunt force on areas where the skin is close to bones, and the subcutaneous tissues are scanty, may produce a wound which by the linear splitting of the tissues may look like an incised wound. Common sites (4.10 Parikh 6th)(181- Reddy 32th edition)* Scalp* Scalp* Face* Eyebrows* Hands* Cheekbones* Lower legs* Lower jaw * Iliac crest * Perineum * Shin* Flying is seen in Avulsion type lacerations.* The incisional wound on genital is seen commonly in Homicides.* Face - lesser impact causes a maximum bruise.* Rickshaw tire mark is an example of patterned abrasion/bruise since it reproduces the pattern of the object (Tread of Rickshaw tyre).* Primary impact injury are commonly seen on the legs.* Commonest organ to be injured in primary blast injury is - EAR drum or tympanic membrane (Eardrum > Lumg > Eye > Intestine).* Antemortem abrasion can be confused with Ant-bite marks** | 157,906 | medmcqa_train |
Most common tumour of pineal region is? | Most common tumour of pineal region is germinoma. Most common tumour of pineal parenchymal gland is pineocytoma. | 157,907 | medmcqa_train |
Reflux oesophagitis is common in which type of Hiatus Hernia | HIATUS HERNIA It is displacement of stomach into the chest through oesophageal opening of the diaphragm. Most patients are elderly, past 40 years. This disorder is of two types: 1. Sliding:- Stomach is pushed into the thorax, in line with the oesophagus. Reflux oesophagitis is common and may give rise to ulceration and stenosis. Haematemesis may occur. It is caused by raised intra-abdominal pressure. 2. Paraoesophageal: A pa of the stomach along with its peritoneal covering passes up into the thorax by the side of oesophagus. The gastro-oesophageal junction still remains below the diaphragm and the angle between oesophagus and stomach is maintained. There is no reflux oesophagitis in this type of hernia. The main symptom is dyspnoea on exeion due to position of stomach in the thorax and sometimes bleeding. Ref:- Dhingra; pg num:-343 | 157,908 | medmcqa_train |
An elderly male presented with fever, dry cough and chest pain. The causative organism was detected in sputum which is cultured on charcoal yeast medium. The organism is: | This is a case of Legionella infection. The established approach to diagnosis combines direct fluorescent antibody (DFA) with culture of infected tissues. Cultures must be made on buffered charcoal yeast extract (BCYE) agar medium that includes supplements (amino acids, vitamins, L-cysteine, ferric pyrophosphate), which meets the growth requirements of Legionella. It is buffered to meet the acidic conditions--optimal for Legionella growth (pH 6.9). The isolation of large Gram-negative rods on BCYE after 2 to 5 days that have failed to grow on routine media (blood agar, chocolate agar) is presumptive evidence for Legionella. Diagnosis is confirmed by DFA staining of bacterial smears prepared from the colonies. Ref: Ray C.G., Ryan K.J. (2010). Chapter 34. Legionella. In C.G. Ray, K.J. Ryan (Eds), Sherris Medical Microbiology, 5e. | 157,909 | medmcqa_train |
All of the following are pneumatic bones except? | Pneumatic bones are maxilla, frontal, sphenoid, ethmoid bones and mastoid process. | 157,910 | medmcqa_train |
Management of stage 2 pressure sore, clean ulcer without cellulitis is | Answer- B. Moist dressing | 157,911 | medmcqa_train |
The ductus aeriosus is derived from the following aoic arch | The pa of the left sixth arch aery, between the branch to the lung bud and aoa,forms the ductus aeriosus HUMAN EMBRYOLOGY-INDERBIR SINGH TENTH EDITION-PAGE NO:255 | 157,912 | medmcqa_train |
Turner no of chromosomes - | Ans. is 'a' i.e., 45 Molecular pathogenesis of Turner's syndromeo Turner's syndrome results from complete or partial monosomy of the X chromosome and is characterized primarily by hypogonadism in phenotypic females,o The genotype in Turner's syndrome is AOo As already discussed absence of Y chromosome allows the development of female gonads ovary,o So these patients have female gonads.o What is the abnormality produced due to loss o f one X chromosome.o Both X chromosomes are active durine oosenesis and are essential for normal development of ovaries.o In Turners syndrome fetal ovaries develop normally early in embryogenesis, but the absence of second X chromosome leads to loss of oocytes from the ovary' and the ovaries are atrophied,o The ovaries are reduced to atrophic fibrous strands devoid of ova and follicles "Streak ovaries". (Gonadal dysgensis)o Short stature in Turner *s syndrome is also attributed to the loss ofhomeobox (SHOX) gene.o Homeobox gene is present on both the X chromosomes and is responsible for skeletal development.o Loss of this gene in Turner's syndrome results in short stature,o Congenital cardiac defects occur in Turner's syndrome.o Turner's syndrome results from complete or partial monosomy of the X chromosome and is characterized primarily by hypogonadism in phenotypic females.o It is the most common sex chromosome abnormality in females.Features of Turner syndrome in childreno The most severely affected patients generally present during infancy writh edema (owing to lymph stasis) of the dorsum of the hand and foot and sometimes swelling of the nape of the neck.o Swelling of the neck is related to markedly distended ly mphatic channels, producing so called cystic hygroma.o As these infants develop, the swelling subsides but often leave bilateral neck webbing and persistent looseness of skin on the back of the neck.o Congenital heart disease is also common, particularly preductal coarctation of Aorta and bicuspid Aortic valve,o C.V.S abnormalities are most important cause of mortality in children with Turner s syndrome.Features of Turner's syndrome in Adolescents and Adulto At puberty there is failure to develop normal secondary sex characteristics.o The genitalia remains infantile, breast development is inadequate and there is little pubic hair. Nipples are widely- spaced.o Turner syndrome is the single most important cause of primary- amenarrhoea accounting for approximately 1/3 of the cases.a Short stature (height rarely exceeds 150 cm).o The mental status of these patients is usually normal but subtle defects in nonverbal, visual spatial information processing have been noted (Recall that mental retardation is associated with the presence of extra chromosome) not with loss of X chromosome.o About 50% of the patients develop autoantibodies directed to the thyroid gland and upto one half of these patients develop hypothyroidism.o Glucose intolerance, obesity and insulin resistance are also seen. | 157,913 | medmcqa_train |
Phosphofructokinase is the key enzyme of | Step 3 of Glycolysis -6-phosphate is fuher phosphorylated to fructose1,6-bisphosphate. The enzyme is phosphofructokinase. ii.PFK is an allosteric, inducible, regulatory enzyme. It is an impoant key enzyme of this pathway. This is again an activation process, the energy being derived by hydrolysis of yet another molecule of ATP. This irreversible step is the rate-limiting reaction in glycolysis. However, during gluconeogenesis, this step is circumvented by fructose-1,6-bisphosphatase.Ref: DM Vasudevan, 7th edition, page no: 109 | 157,914 | medmcqa_train |
Which of the following drugs inhibits de nove synthesis of purines? | (Ref: KDT 6/e p841) By inhibiting the enzyme IMP dehydrogenase, mycophenolate inhibits the de novo synthesis of purines. | 157,915 | medmcqa_train |
Level of lower border of lung at mid axillary line is | B i.e. 8th rib | 157,916 | medmcqa_train |
In femoral hernia the base of sac lies - | Ans. is 'a' i.e., Below and lateral pubic tubercle * The base of hernia sac appears below and lateral to the pubic tubercle and lies in the upper leg rather than in the lower abdomen.Femoral hernia* In this hernia the abdominal contents pass through the femoral ring, traverse the femoral canal and come out through the saphenous opening.* It is more common in females (But remember that most common hernia in the females is not femoral, but it is indirect inguinal)* Femoral hernia is rare in men and nulliparous women but more common in multiparous women due to stretching of the pelvic ligaments.* In contrast to inguinal hernia, femoral hernia is rare in infancy and childhood. It is rare before puberty.* It is more common on right side* It is bilateral in 20% of cases.* Among all the types of hernia, femoral hernia is most liable to become strangulated, mainly because of the narrowness of the neck of the sac and the rigidity of the femoral ring. Infact strangulation is the initial presentation of 40% of femoral hernias. | 157,917 | medmcqa_train |
Screening test for cervical cancer is: | Ans. (b) Papaniculaou smearRef. Shaw's Gynae 15th ed./. 403* Pap smear is taken from cervix, with Arye spatula, rotated 360deg to pick up cells from squamo-columnar junction. Vaginal smear for hormonal evaluation is taken from lateral fornix* The objective of screening is to reduce the incidence and mortality from cervical cancer* Pap smear test has been effective reducing the incidence of cervical cancer by 80% and the mortality by 70%.* Please refer to above explanation also. | 157,918 | medmcqa_train |
Multiple myeloma is a tumor of? | Ans. (d) Plasma cell(Ref: Robbins 9th/pg 598-602)Multiple myeloma is a malignant proliferation of plasma cells derived from a single clone. | 157,919 | medmcqa_train |
A 3 year old boy is brought to the emergency depament after the acute onset of headache, vomiting, nuchal rigidity, and impaired mental status. MRI reveals a posterior fossa tumor that fills the 4th ventricle. Surgery is immediately staed, and intraoperative consultation leads to a "frozen section" diagnosis of medulloblastoma. Which of the following pathologic mechanisms most likely accounts for this child's clinical presentation? | Any tumor "filling the 4th ventricle" blocks the circulation of cerebrospinal fluid (CSF). This blockage leads to increased intracranial pressure, which manifests with nausea, vomiting, headache,nuchal rigidity, and mental status changes. If surgery is not performed promptly, cerebellar tonsillar herniation and rapid death will ensue. In children, medulloblastoma and ependymoma are the most frequent neoplasms presenting in this manner. There is no evidence in this case suggesting that acute hemorrhage into the 4th ventricular cavity has occurred, nor is medulloblastoma typically associated with this complication. CNS tumors that frequently bleed are metastases from melanoma, renal cell carcinoma, and choriocarcinoma. Alterations in medullary function lead to cardiorespiratory instability and may be caused by direct tumor compression or infiltration of the medulla, neither of which is suppoed by MRI findings in this case. Infiltration of the cerebellar vermis is ceainly seen in many cases of medulloblastoma, a tumor that arises from this midline cerebellar structure. However, this would lead to truncal ataxia and gait instability, not symptoms of increased intracranial pressure. Ref: Ropper A.H., Samuels M.A. (2009). Chapter 30. Disturbances of Cerebrospinal Fluid and Its Circulation, Including Hydrocephalus, Pseudotumor Cerebri, and Low-Pressure Syndromes. In A.H. Ropper, M.A. Samuels (Eds), Adams and Victor's Principles of Neurology, 9e. | 157,920 | medmcqa_train |
A 40 yrs old female who is known case of ischemic hea disease (IHD) is diagnosed having hypothyroidism. Which of the following would be most appropriate line of management for her - | Levothyroxine replacement in ischaemic hea disease Hypothyroidism and ischaemic hea disease are common conditions that often occur together. Although angina may remain unchanged in severity or paradoxically disappear with restoration of metabolic rate, exacerbation of myocardial ischaemia, infarction and sudden death are recognised complications of levothyroxine replacement, even using doses as low as 25 mg per day. In patients with known ischaemic hea disease, thyroid hormonereplacement should be introduced at low dose and increased veryslowly under specialist supervision. It has been suggested that T3 has an advantage over T4, since T3 has a shoer half-life and any adverse effect will reverse more quickly, but the more distinct peak in hormone levels after each dose of T3 is a disadvantage. Coronary intervention may be required if angina is exacerbated by levothyroxine replacement therapy Ref - davidsons 23e p641 | 157,921 | medmcqa_train |
Increased sweat chloride is seen in all except - | Ans. is d i.e., Obesity Increased sweat chloride is seen in - i) Cystic fibrosis v) Familial cholestasis ix) Untreated adrenal insufficiency (Addison disease) ii) Malnutrition vi) Ectodermal dysplasia x) Hereditary nephrogenic diabetes insipidus iii) Pancreatitis vii) Fucosidosis xi) Hypoparathyroidism iv) Hypothyroidism viii) Mucopolysaccharidosis xii)Glucose-6-phosphatase deficiency | 157,922 | medmcqa_train |
True about colour blindness: September 2005 | Ans. D: Defect in 1 or more prime colours Colour blindness is inherited as recessive and X-linked characteristics. The prefixes "Prot-" "Deuter-"and "Trit-" stands for defects of Red, Green and Blue cone systems. So tritanopia (Rarest) has Defect of blue colour. Trichromats are normal individuals. | 157,923 | medmcqa_train |
Causes of unilateral dysmenorrhea are all except: | Ans. is 'd' i.e., Large fundal fibroid * Causes of unilateral dysmenorrhea1) Ovarian Dysmenorrhea (Right ovarian vein syndrome)2) Bicornuate uterus3) Unicornuate uterus4) Rudimentary horn5) Unilateral pelvic endometriosis6) Small fibroid polyp near one cornu | 157,924 | medmcqa_train |
Smallest cross-section of large bowel is seen at: | (Refer: Richard S. Snell’s Clinical Anatomy by Regions, 9th edition, pg no: 158)
Characteristic Features of Rectosigmoid Junction
The diameter of the large intestine narrows.
There is an absence of complete peritoneal investment.
There is no true mesentery.
The three taeniae coli diverge to form a continuous longitudinal muscle coat on the rectum.
There are no appendices epiploicae.
Endoscopically, an acute angle is encountered at the narrowing of the rectosigmoid and the rectal mucosa is smooth and flat, whereas the mucosa of the sigmoid forms prominent rugal folds. | 157,925 | medmcqa_train |
A young patient presents to the ophthalmic outpatient depament with gradual blurring of vision in the left eye. Slit lamp examination reveals fine stellate keratatic precipitates and aqueous flare and a typical complicated posterior subcapsular cataract. No posterior synechiae were observed. The most likely diagnosis is: | Ans. Heterochromic iridocyclitis of Fuch's | 157,926 | medmcqa_train |
Granular layer is absent in: | A i.e. Ichtyosis vugaris Icthyosis vulgaris - Icthyosis vulgaris is autosomal dominant disorderQ, occurring due to reduced or absence of filaggrin protein and granular layerQ. It presents with dry scaly skin resembling fish (reptile or crocodile) skin K/a sauroderma. AD means one parent should also manifest disease. It is a congenital condition which is not present at bih but develops during first year of life. - Diy looking large mosaic like scales most commonly over anterior (extensor) surface of legs. Major flexors (axillae, groins, popliteal & cubital fossa) are always and face is usually spared; though cheeks & forehead may be rarely involved. Condition improves in humid & summers and deteriorates in winter. It may be associated with atopic diathesis, keratosis pilaris, hyper linear & exaggerated palm & sole creases, and occasionally, keratoderma. | 157,927 | medmcqa_train |
Which method is not used for autopsy - | Ans. is 'd' i.e., ThomasMethods of removal of organso Virchow's technique - organs are removed one by one. Crania] cavity is exposed first, followed by thoracic, cervical & abdominal organs.o Rokitansky rs technique - It involves in situ dissection in part, combined with en block removal,o Lettulle's technique - Cervical, thoracic, abdominal & pelvic organs are removed en masse & dissected as organ block. | 157,928 | medmcqa_train |
Which of the following toxin acts by inhibiting protein synthesis? | Shiga toxin also known as verotoxin, was first identified in a major cause of dysentry called Shigella dysentriae. Shiga toxin contains an enzymatic domain and 5 binding domains which bind to globotriaosylceramide (Gb3), a glycosphingolipid on the surface of cells and the complex is internalized. The internalized shiga toxin hydrolyse the ribosomes, preventing fuher protein synthesis. Shiga toxin is composed of two distinct peptide subunits: The first located on the larger A subnit is an N-glycosidase that hydrolyzes adenine from specific sites of ribosomal RNA of the mammalian 60s ribosomal subunit, irreversibly inhibiting protein synthesis. The second is a binding site on the B subunit that recognizes glycolipids of target cell membranes (glycolipid Gb 3). Ref: Toxins and Hemostasis: From Bench to Bedside By R.Manjunatha Kiri, Page 642-643 ; Textbook of Pathology By V. Krishna, Page 178 ; Interaction of Pathogenic Bacteria with Host Cells By Virginia L. Clark, Volume 236, Page 67 ; Microorganisms in foods 5: Microbiological Specifications of Food Pathogens By International Commission on Microbiological Specifications for Food, Page127 | 157,929 | medmcqa_train |
The phenomenon of cancer cells switching to glycolysis even in the presence of adequate oxygen for oxidative phosphorylation is known as: | Even in the presence of ample oxygen, cancer cells shift their glucose metabolism away from the oxygen hungry, but efficient, mitochondria to glycolysis. This phenomenon, called the Warburg effect and also known as aerobic glycolysis, has been recognized for many years (indeed, Otto Warburg received the Nobel Prize for discovery of the effect that bears his name in 1931), but was largely neglected until recently. This metabolic alteration is so common to tumors that some would call it the eighth hallmark of cancer. Ref: Robbins 8th edition Chapter 2. | 157,930 | medmcqa_train |
All of the following structures are present deep to Pterion except | Structures present deep to Pterion areMiddle meningeal vein and aeryStem of lateral sulcus of brain Reference: Chourasia; 6th edition; 12th page | 157,931 | medmcqa_train |
The appropriate size of LMA for an average adult patient weighing 50 kg is: | Ans. c. 4.0 | 157,932 | medmcqa_train |
Incidence of scar rupture in a pregnant lady with previous LSCS is : | 0.20% | 157,933 | medmcqa_train |
Capsicum seed can be confused with: NEET 14 | Ans. Dhatura | 157,934 | medmcqa_train |
"Groundglass hepatocytes" are seen in which of the following viral hepatitis? | Ans. b (Hepatitis B) (Ref Robbins 7th/899; TABLE 18-7)Robbins 7th/B99HBV HISTOLOGY# HBV infected hepatocytes may exhibit a cytoplasm packed with spheres and tubules of HBsAg, producing a finely granular eosinophilic cytoplasm (GROUNDGLASS HEPATOCYTES).Key Morphologic Features of Viral HepatitisAcute Hepatitis (Enlarged. reddened liver: greenish if cholestatic)Parenchymal changes:Regenerative changes:Hepatocyte injury: swelling (ballooning degeneration)- hepatocyte proliferationCholestasis: canalicular bile plugs- Sinusoidal cell reactive changesHCV: mild focal fatty change of hepatocytes- Accum of phagocytosed debris in Kupffer cellsHepatocyte necrosis: isolated cells or clusters- Influx of mononuclear cells into sinusoidsCytolysis (rupture) or apoptosis (shrinkage)- Portal tracts: Inflammation: pred mononuclearIf severe: bridging necrosis (portal-portal, central-central, portal-central)- Inflammatory spillover into adj parenchymaLobular disarray: loss of normal architecture- hepatocyte necrosisChronic Hepatitis- Changes shared with acute hepatitis: Hepatocyte injury, necrosis, and regeneration- Sinusoidal cell reactive changes; Portal tracts:- Inflammation: Confined to portal tracts, or Spillover into adjacent parenchyma, with necrosis of hepatocytes (interface hepatitis); Bridging inflammation and necrosis- Fibrosis: Portal deposition, or Portal and periportal deposition, or Formation of bridging fibrous septa- HBV: "ground-glass" hepatocytes ; "sanded" nuclei- HCV: bile duct epithelial cell proliferation, lymphoid aggregate formation; Cirrhosis: The end-stage outcome | 157,935 | medmcqa_train |
Tumour arising from Rathke's pouch is | Rathke's pouch develop at the roof of oral cavity from surface ectoderm to form most of pituitary . Posterior pituitary develops from diencephalon. Craniopharyngioma is a tumor that develop in the sella turcica. | 157,936 | medmcqa_train |
All are presentation of retinoblastoma except: | C i.e. Cataract | 157,937 | medmcqa_train |
During Hysterectomy, Ureter is liable for injury at? | Where it crosses uterine aery REF: Novak's Gynecology chapter 5, chapter 22 "About 75% of all iatrogenic injuries to the ureter result from gynecologic procedures, most commonly abdominal hysterectomy" "Significant aerial bleeding during hysterectomy usually arises from the uterine aeries or the ovarian vessels near the inseion of the infundibulopelvic ligaments. Blind clamping of these vessels presents a risk for ureteral injury; therefore, the ureters should be identified in the retroperitoneal space and traced to the area of bleeding to avoid inadveent ligation" At about the level of the ischial spine, the ureter crosses under the uterine aery in its course through the cardinal ligament; the ureter divides this area into the supraureteric parametrium surrounding the uterine vessels and the infraureteric paracervix molded around the vaginal vessels and extending posteriorly into the uterosacral ligament. In this location, the ureter lies 2 to 3 cm lateral to the cervix and in proximity to the inseion of the uterosacral ligament at the cervix. This proximity warrants caution when using the uterosacral ligament for vaginal vault suspension | 157,938 | medmcqa_train |
Intravenous resuscitation is required in a patient with 30% burns. Which of the following will be the best choice of fluid in the first 24 hours? | Most commonly used fluid for resuscitation in burns is ringer lactate. Some centres use human albumin solution or fresh-frozen plasma, and some centres use hypeonic saline. Intravenous resuscitation is indicated for children with a burn greater than 10% TBSA and adults with 15% TBSA. Parkland formula is the most widely used formula for calculating fluid replacement in the first 24 hours. The formula is Volume in ml = Total percentage body surface area x weight in kilograms x 4. Half of this volume is given in first 8 hours, and the second half is given in the subsequent 16 hours. In children, maintanence fluid is also given which is primarily dextrose saline. Ref: Bailey and Love's Sho Practice of Surgery, 24th edn, Page 271-2 | 157,939 | medmcqa_train |
Which of the following criteria can be used to determine if a pheochromocytoma lesion is benign or malignant | Ref Robbins 8/e p1159-1161;9/e p1135 Pheochromocytoma and their related counterpas in extra adrenal sites called paraganglioma, are notorious Because the only reliable indicator of metastasis potential is the presence of distant metastasis . Very malignant appearing tumors may not metastasize and benign appearing tumors may produces metastases . These tumors should all be considered " potentially malignant" . | 157,940 | medmcqa_train |
Non cicatrical alopecia is present in- | C. i.e. Psoriasis | 157,941 | medmcqa_train |
Time dependent Killing is exhibited by all the following drugs except: | * Time dependent killing(TDK) : Here, the killing activity depends upon the length of time, plasma concentration is above MIC. It is shown by:* Beta Lactams.* Vancomycin Concentration dependent killing(CDK) : Here, killing activity depends upon the ratio of plasma concentration to MIC.It is shown by:* Aminoglycosides.* Flouroquinolone* MetronidazoleSo, Gentamicin is the answer. | 157,942 | medmcqa_train |
Prozone phenomenon is due to- | Ans. is 'b' i.e., Excess antibody | 157,943 | medmcqa_train |
Rocky mountain spotted fever Cause and vector are:- | RICKETTSIAL DISEASE CAUSE VECTOR RESERVOIR EPIDEMIC TYPHUS R. prowazekii Louse Man ENDEMIC TYPHUS R. typhi Flea Rodents SCRUB TYPHUS R. tsutsugamushi Trombiculid mite Rodents INDIAN TICK TYPHUS R. conori Tick Rodents RMSF R. ricketisii Tick Rodents R.POX R. akari Mite Rodents Q FEVER Coxiella - Cattle TRENCH FEVER Baonella Louse Man | 157,944 | medmcqa_train |
Emergency contraceptives are effective if administered within following period after unprotected intercourse: | Ans. is d, i.e. 120 hoursRef: Shaw 15th/ed, p237; Current Concepts in Contraception and Women Death, pl05, Leon Speroff8th/ed, p1042The standard recommendation is to start emergency contraceptive not later than 72 hours. The greatest protection is offered, if it is taken within 12 hours, as postponing the dose by 12 hours raises the chances of pregnancy by almost 50%.For this reason, the treatment should be initiated as soon as possible after sexual exposure.Note: But here the question says - till how long are ECs effective or till how long can they be administered. - Ref: Shaw 14th/ed, p213 says"The tables can be offered up to 120 hours, but its efficacy decreases with the longer coital - drug interval.""Treatment should be initiated as soon after exposure as possible, and the standard recommendation is that it be no later than 120 h." - Ref: Leon Speroff 8th/ed, p1042 According to current concepts in contraception's and women health alsoEmergency contraception can be given up to 5 days.This is because"Emergency contraception is not an abortifacient i.e. it will not act after implantation has occured. This is also the basis for the window period of 5 days for use effectiveness of EC, as the whole process from deposition of sperms to implantation takes about 5 days." - Ref: Current Concepts in Contraception and Women Health p108 | 157,945 | medmcqa_train |
All of the following are true regarding Temporal arteritis except | (B) Unilateral headache # Giant cell arteritis or Cranial arteritis or Temporal arteritis> Occurs almost exclusively in individuals > 50 years> The disease is characterized by the complex of fever, anemia, high ESR, and headaches in a patient over the age of 50 years.> A well recognized & dreaded complication of giant cell arteritis, particularly in untreated patients, is ischemic optic neuropathy, which may lead to serious visual symptoms, even sudden blindness in some patients. | 157,946 | medmcqa_train |
Adequate Total per capita water for Urban domestic purposes? | Ans. is 'c' i.e., 150-200 litresThe basic physiological requirements for drinking water have been estimated at about 2 litres per head per day.A daily supply of 150-200 litres per capita is considered as an adequate supply to meet the needs for all urban domestic purposes. | 157,947 | medmcqa_train |
An autoimmune disease is – a) Pemphigus vulgarisb) Psoriasisc) Lichen planusd) Acne vulgaris | Autoimmune skin disorders
Autoimmune bullous skin disorders
Pemphigus
Bullous pemphigoid
Dermatitis herpetiformis
Lichen planus
Lichen planus is believed to be an autoimmune disorder as it often occurs concurrently with other autoimmune disorders like primary biliary cirrhosis, diabetes, chronic active hepatitis.
Psoriasis
The theory that psoriasis is an autoimmune disorder is based on the fact that scientist have found an abnormally large number of T cells in the patch of psoriasis.
Autoimmune connective tissue disorders
Lupus erythematosus
Dermatomyositis
Scleroderma
Mixed connective tissue disease
Bechet's disease | 157,948 | medmcqa_train |
Aerial blood supply to Little's area is from all the following except | Aeries supplying Little's area are: a. Sphenopalatine aery. b. Superior labial aery. c. Anterior ethmoidal aery. d. Septal branches of greater palatine aery. | 157,949 | medmcqa_train |
Ligamentum teres is the remnant of | (A) Umbilical vein SOME FREQUENTLY ASKED REMNANTS* Ductus arteriosusLigamentum arteriosum* Ductus venosusLigamentum venosum* Left umbilical veinLigamentum teres of liver* Right umbilical veinDisappears* Vitello-intestinal ductMeckel's diverticulum* Wolffian ductGartner duct> After obliteration, the umbilical vein forms the ligamentum teres and the ductus venosus becomes ligamentum venosum. | 157,950 | medmcqa_train |
Classification of aoic dissection depends upon | Aoic dissection occurs when blood splays apa the laminarplanes of the media to form a blood-filled channel within theaoic wall.The clinical manifestations of dissection depend primarily on the poion of the aoa affected; the most serious complicationsoccur with dissections involving the proximalaoa and arch.Thus, aoic dissections generally are classified into two types-Proximal lesions: type A dissections, Distal lesions,type B dissectionsRobbins Basic pathology,9th edition,pg no.347 | 157,951 | medmcqa_train |
All are indications for penile angiography except: | Priapism is of two types. A low-flow (ischemic), painful priapism and the other high-flow (non-ischemic), painless priapism.
Penile angiography is not indicated in the painful, low-flow priapism. It is indicated for the high-flow, non-ischemic priapism which is painless.
Priapism
Priapism is defined as prolonged erection in the absence of a sexual stimulus.
It can be classified into 2 types:
A. Low-flow (ischaemic) priapism.
features little or absent intracorporal blood flow
due to veno-occlusion
it represents a true compartment syndrome involving the penis
manifests as painful, rigid erection
cavernous blood gas values are consistent with hypoxia, hypercapnia, and acidosis
ischaemic priapism beyond 4th hour requires emergency intervention (decompression of the corpora cavernosa is recommended for counteracting the ischemic effects)
B. High-flow (non-ischemic) priapism
due to unregulated arterial blood flow
presents with semi-rigid, painless erection
Penile or perineal trauma is frequently associated
cavernous blood gas values do not reveal hypoxia or acidosis
Penile angiography is indicated in high-flow priapism and not in low-flow, painful priapism.
Campbell Urology 8/e p845 writes-
"Penile arteriography has use as an adjunctive study to identify the presence and site of a cavernous artery fistula in the patient with nonischemic priapism. At this time, arteriography is not routinely used for diagnosis and is otherwise usually performed as part of an embolization procedure."
About other options
Peyronie's disease
It is also k/a penile fibromatosis
It is due to fibrous plaques in one or both corpus cavernosum. They may later calcify or ossify.
It affects middle-aged and older men.
Patients present with complaints of painful erection, curvature of the penis, and poor erection distal to the involved area. The penile deformity may be so severe that it prevents satisfactory vaginal penetration.
Examination of the penile shaft reveals a palpable dense, fibrous plaque of varying size involving the tunica albuginea.
Spontaneous remission occurs in about 50% of cases. Initially, observation and emotional support are advised. If remission does not occur, p-aminobenzoic acid powder or tablets or vitamin E tablets may be tried for several months. However these medications have limited success. Surgery is done in refractory cases-Excision of the plaque with replacement with a dermal or vein graft or tunica vaginalis graft. Penile prosthesis can be inserted after plaque incision.
We are not quite sure about use of penile angiography in Peyronie' s disease.
Campbell's Urology 8/e p826 writes about Peyronie's disease -
"Currently, the use of vascular testing is variable. Some centers perform duplex Doppler testing on all patients with Peyronie's disease; other centers do not perform vascular testing at all, despite that patients are routinely operated on for Peyronie's disease and, in some cases, receive prostheses as the primary treatment option. At our center, vascular testing is done on all patients who are prospective surgical candidates. Initially, these patients are examined with color Doppler ultrasonography. If the peak systolic velocity, end-diastolic velocity, and resistive index are normal, the patients are not further tested. If the end-diastolic velocity and the resistive indices are not normal, our patients are tested with DICC"
What is DICC?
DICC or Dynamic Infusion Cavernosometry and Cavernosography are widely accepted as the reference diagnostic techniques for evaluation of veno-occlusive dysfunction.
Cavernosometry refers to a method of determining cavernosal pressure response to standardized rates and volumes of fluid infusion in order to define the presence and degree of venous leak.
Cavernosography refers to a radiographic demonstration of the corpora cavernosa and their venous effluents after intracavernosal injection of dilute contrast agent.
Cavernosometry and cavernosography as angiographic techniques which along with arteriography constitute the gold standard for diagnosis of vasculogenic impotence.
But Campbell's urology mentions DICC separate from selective penile angiography.
Thus we are not very sure about Peyronie's disease. But we are dead sure, painful priapism is not an indication for penile angiography
Erectile dysfunction
"Penile arteriography is another invasive test mainly used prior to penile surgical revascularization in young men with posttraumatic surgical revascularization in young men with posttraumatic or congenital arteriogenic erectile dysfunction with on vascular risk factors, or in studying cases of high flow priapism."- Handbook of Sexual and Gender Identity Disorders By David L Rowland, Luca Incrocci p55
A-V malformation
Well, penile A-V malformation is quite rare. I could not find any documented evidence for use of penile angiography in A-V malformation, but its use is quite self-evident. | 157,952 | medmcqa_train |
Most impoant enzyme in DNA replication for chain elongation | Ans. is 'c' i.e.,DNA polymerase III Impoant DNA PolymerasesIn ProkaryotesDNA polymerase I :- Helps in gap filling and synthesis between okazaki fragments of lagging strand, and replaces ribonucleotides of RNA primer by deoxyribonucleotides. It has (i) 3' 5' exonuclease activity, (ii) 5' 3' exonuclease activity and (iii) polymerase (5' -> 3' polymerase) activityDNA polymerase II:- Helps in (i) proof reading (3' 5' exonuclease activity), and (ii) DNA repair.DNA polymerase III :- It is the main enzyme that synthesizes prokaryote DNA, i.e., synthesis of leading and lagging strand. It has (i) 5' -> 3' polymerase (or simply polymerase) activity for DNA synthesis, and (ii) 3'->5' exonuclease activity for proof reading.In EukaryotesDNA polymerase a :- It has primase activity (i.e. synthesizes RNA primer), and initiates DNA synthesis.DNA polymerase p :- It is a DNA repair enzymeDNA polymerase y :- Replicates mitochondrial DNADNA polymerase ?:- Helps DNA synthesis on lagging strand, i.e. elongation of okazaki fragments on lagging strand. It also has 5'->3' exonuclease activity for proof reading.DNA polymerase c :- Helps in DNA synthesis on leading strand. It also has 5'43 'exonuclease activity for proof reading. | 157,953 | medmcqa_train |
Which of the following is the least common site of pain in a case of rheumatoid ahritis? NOT RELATED- OHO | . | 157,954 | medmcqa_train |
Superficial perineal muscles include- | Muscles in superficial perineal space.
- Ischiocavernosus
- Bulbospongiosus
- Superficial transverse perinei | 157,955 | medmcqa_train |
Commonest cause of ureteric injury during surgical operation is | Surgical trauma during pelvic surgery is the most common cause of ureteric trauma This occurs most often during vaginal or abdominal hysterectomy when the ureter is mistakenly divided, ligated, crushed or excised. Pre-emptive ureteric catheterisation makes it easier to identify the ureters. ( ref : Bailey 27th ed , chap 76 , pg no 1415 ) | 157,956 | medmcqa_train |
Misoprostol is an analogue of | Misoprostal: PGE-1 Given transvaginally and orally Dose of 25 micrograms every 4 hrs is found to be more effective than PGE -2 for cervical ripening and labor induction. Oral use of misoprostal is less effective than vaginal administration . Ref: Dutta Obs 9e pg 485. | 157,957 | medmcqa_train |
Which of the following is true about seminoma?a) It is radiosensitiveb) It arises only from cryptorchid testisc) AFP is increasedd) It is chemosensitive | Seminomas are both radiosensitive & chemosensitive tumors. | 157,958 | medmcqa_train |
Not a feature of traumatic optic neuropathy: | Macular edema is not a characteristic feature of traumatic optic neurpathy. Traumatic Optic Neuropathy Loss of vision. Dilatation of pupil. Impaired Pupillary light reflex. Contrast sensitivity is decreased. Central or centrocecal scotoma (though less common, it can be seen in traumatic optic neuropathy) MRI is the investigation of choice for visualization of optic nerve. Treatment -Steroids/ Surgical decompression. | 157,959 | medmcqa_train |
Codex alimentarius is related to - | Food standards are done by CODE ALIMENTARIUS, PFA STANDARDS, THE AGMARK STANDARDS, BUREAU OF INDIA STANDARDS. REF. PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICAL 21ST EDITION. PAGE NO - 610) | 157,960 | medmcqa_train |
Sinus not present at birth is - | Development and grwoth of paransal sinuses | 157,961 | medmcqa_train |
Tillaux fracture involves: | Tillaux fracture Lower tibial epiphysis injury (anterolateral pa) | 157,962 | medmcqa_train |
EEG rhythm in full awake and ale state? | Ans. is 'b' i.e., BetaBeta wave is seen when the person is fully awake and ale and is thinking with maximum concentration.Therefore it is also called arousal or ale response. | 157,963 | medmcqa_train |
Atractiloside act as ? | Ans. is 'b' i.e., Inhibitor of oxidative phosphorylationInhibitors of electron transpo chain?Inhibitors of respiratory chain may be divided into three groups : ?1. Inhibitors of electron transpo chain properThese inhibitors inhibit the flow of electrons through the respiratory chain. This occurs at following sites.Complex I (NADH to CoQ) is inhibited by : - Barbiturates (amobarbital), Piericidin A (an antibiotic), rotenone (an insectiside), chlorpromazine (a tranquilizer), and guanethidine (an ntihypeensive). These inhibitors block the transfer of reducing equivalents from FeS protein to CoQ.Complex II is inhibited by : - Carboxin and TTFA inhibit transfer of electon from FADH2 to CoQ, whereas malanate competitively inhibit from succinate to complex II. Complex III (Cytochrome b to cytochrome CI) is inhibited by : - Dimercaprol, antimycin A, BAL(British antilewisite), Naphthyloquinone. These inhibitors block the transfer of electrons from cytochrome b to cytochromeComplex IV (cytochrome C oxidase) is inhibited by : - Carbon monoxide, CN-, H2S and azide (N3-). These inhibitors block the transfer of electrons from cytochrome aa3 to molecular oxygen and therefore can totally arrest cellular respiration.2. Inhibitors of oxidative phosphorylationThese compounds directly inhibit phosphorylation of ADP to ATP. Oligomycin inhibits Fo component of F0F, ATPase. Atractiloside inhibits translocase, a transpo protein that transpos ADP into mitochondria for phosphorylation into ATP.3. UncouplesAs the name suggests, these componds block the coupeling of oxidation with phosphorylation. These compounds allow the transfer of reducing equivalents in respiratory chain but prevent the phosphorylation of ADP to ATP by uncoupling the linkage between ETC and phosphorylation. Thus the energy instead of being trapped by phosphorylation is dissipated as heat. Uncouplers may be :-Natural :- Thermogenin, thyroxineSynthetic :- 2, 4-dinitrophenol (2, 4-DNP), 2, 4-dinitrocresol (2, 4-DNC), and CCCP (chlorocarbonylcyanidephenyl hydrazone). | 157,964 | medmcqa_train |
Champagne glass pelvis is seen in | (Achandroplasia): (306- Maheshwari 4th edition)Champagne - glass' pelvic cavity found in ACHONDROPLASIA(275-Aids to radiological differential diagnosis chapman)ACHONDROPLASIA(Primary defect of enchondral bone formation, Autosomal dominant (but 80% are spontaneous mutations)SkullPelvis1. Large skull, small base, small sella, steep clivus small funnel shaped foramen magnum2. Hydrocephalus - of variable severity (+ obstruction)1. Square iliac wings2. "Champagne-glass" pelvic cavity3. Short narrow sacrosciatic notch4. Horizontal sacrum articulating low on the iliamThoraxAppendicular Skeleton1. Thick, stubby sternum2. Short ribs with deep concavities to the anterior ends1. Rhizometic micromelia with bowing of long bones2. Widened metaphyses3. Ball and socket epiphyseal/metaphyseal junctions4. Broad and short proximal and short proximal and middle phalanges5. Trident shaped hands**Axial Skeleton1. Decreasing interpedicular distance caudally in the lumber spine2. Short pedicles with a narrow sagittal diameter of the lumber spinal canal3. Disc heigh/ body weight ratio is 1.0 (Normal 0.3)4. Posterior scalloping5. Anterior vertebral body beak at T12/L1/L2 | 157,965 | medmcqa_train |
Type A (augmented) adverse drug reactions are characterized by all EXCEPT: | Predictable (Type A or Augmented) reactions - quantitatively responses- includes side effects, toxic effects and consequences of drug withdrawal. They are more common, dose-dependent and mostly preventable and reversible. Ref ; KD Tripathi pharmacology 7 th edition (page no; 82) | 157,966 | medmcqa_train |
A specimen from a lung biopsy reveals occasional plexiform lesions within pulmonary aerioles. This abnormality is most characteristic of | ) Pulmonary vascular sclerosis refers to the vascular changes associated with pulmonary hypeension. Elevation of the mean pulmonary aerial pressure is the result of endothelial dysfunction and vascular changes. The vascular changes vary with the size of the vessel. The main aeries have atheromas that are similar to systemic atherosclerosis, but are not as severe. Medium-sized aeries show intimal thickening and neomuscularization. Smaller aeries and aerioles show intimal thickening, medial hyperophy, and reduplication of the internal and external elastic membranes. A distinctive aeriolar change, a plexiform lesion, consists of intraluminal angiomatous tufts that form webs. This pattern is thought to be diagnostic of primary hypeension The changes of pulmonary vascular sclerosis may be primary or secondary. Primary pulmonary vascular sclerosis almost always occurs in young women, who develop fatigue, syncope (with exercise), dyspnea on exeion (DOE), and chest pain. Secondary sclerosis may occur at any age, and symptoms depend on the underlying cause. Possible causes include ceain types of hea disease, such as mitral valve disease, left ventricular failure, and congenital valvular disease with left-to-right shunt, as well as ceain types of pulmonary disease, such as chronic obstructive or interstitial lung disease and recurrent pulmonary emboli. Pulmonary hypeension is also associated with diet pills (Redux and Fen-Phen), while "exotic" causes include Crotalaria spectabilis ("bush tea") and adulterated olive oil Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition. | 157,967 | medmcqa_train |
Incised looking laceration is seen in all, except AFMC 11; NEET 13 | Ans. Chest | 157,968 | medmcqa_train |
Large placenta is seen in | Ans. a Twins. (Ref. Dutta, Obstetrics, 4th/pg.221)D/d of Large placenta/hyperplacentosis:# Twin pregnancy# Hydrops fetalis# Diabetes in pregnancy# IUGRHUMAN PLACENTA# It is Discoid, Deciduate and Haemchorial.# It develops from--- foetal (4/5th)--chorionic frondosum and- maternal (l/5th)--decidua basalis.# Its development begins at 6th week of gestation and is completed by 12th week.Q# Its weight is 500 gms and weight of blood in it is 500 ml.# Fetal blood flow through placenta = 400 ml/min# Decidua basalis retains its characteristic appearance till term and becomes the maternal portion of placenta.# Line of separation of placenta after birth of the baby is through decidua spongiosum.# Fetal surface has attachment of umbilical cord with ramification of umbilical vessels and aminon.# Only decidua basalis and blood in the inter villou space are of maternal origin.# Maternal surface has shaggy looks with cotyledons.# Placentome = fetal cotyledon.# Villi are the functional units of placenta. Umbilical arteryUmbilical veinO2 saturation50-60%70-80%pO2 (mm Hg)20-2530-40# Placental calcification is a feature of postmaturity.# Signs of Placental aging:- Appearance of syncytial knots.- Decreased stromal tissue including Hofbauer cells.- Partial deficiency of Langhan's cells.- Thinning of basement membrane layer of foetal endothelium.# Most common tumour of placenta is choriohaemangioma.QDiscriptionDiscriptionType of placentaPlacenta with umbilical cord attached to its marginPlacenta with chorionic plate smaller than basal platePlacenta associated with increased rate of prematurityPlacenta with accessory lobes in the membranes away from main body of placenta, connected by large vessels to main body which if it goes to cervix causes formation of "Vasa previa"--a vital cause of bleeding of fetal originBattledore placentaCircumvallate placenta.Circumvallate placenta.Succenturiate placenta.Placenta with functioning villi covering all foetal membranesPlacenta with central portion missingMembranous placenta.Fenestrated placenta. | 157,969 | medmcqa_train |
Socially acquired behavior is known as: March 2005, September 2010 | Ans. A: Culture Culture is defined as "learned behaviour which has been socially acquired". It is the central concept around which cultural anthropology has grown. Socialization refers to the process of inheriting norms, customs and ideologies. It may provide the individual with the skills and habits necessary for paicipating within their own society; a society itself is formed through a plurality of shared norms, customs, values, traditions, social roles, symbols and languages. Socialization is thus 'the means by which social and cultural continuity are attained' Acculturation means culture contact. | 157,970 | medmcqa_train |
Glucose diffusion in RBC by ? | Ans. is 'a' i.e., GLUT 1 | 157,971 | medmcqa_train |
A 58 year old woman has been diagnosed with locally advanced breast cancer and has been recommended for chemotherapy. She has five years history of myocardial infarction and congestive heart failure. Which antineoplastic drug should be best avoided? | Ans. is 'a' i.e. AnthracyclineRef: Katzung 8th/e 937-938, Harrison 16th/e p 475 (15th/e p 434)Anthracyclines are anticancer antibiotics and they include Doxorubicin (Adriamycin) and Daunorubicin.The major toxicity of anthracyclines is potentially irreversible cumulative dose related toxicity.They may causes arrhythmias and cardiomyopathy. Because of their cardiotoxicity these drugs should be avoided in the patient mentioned in the questionUses of DoxorubicinCa Breast Ca Endometrium Ca ovary Ca testicleCa thyroid Ca lungHodgkin's disease Non Hodgkin disease SarcomasUses of DaunorubicinIt has far narrower spectrum of activity than Doxorubicin It is mainly used in acute leukemia | 157,972 | medmcqa_train |
A 9-year-old girl child developed a 10 mm area of induration on the left forearm 72 hours after intradermal injection of 0.1 ml of purified protein derivative (PPD). Which of the following is most likely to be seen on the X-ray of this patient? | Most Mycobacterium tuberculosis infections are asymptomatic and subclinical infections. In most healthy people primary tuberculosis is asymptomatic, although it may cause fever and pleural effusion. Generally, the only evidence of infection, if any remains, is a tiny, fibrocalcific pulmonary nodule at the site of the infection. Viable organisms may remain dormant in such lesions for decades. If immune defenses are lowered, the infection may be reactivated, producing communicable and potentially life-threatening disease. Testing for latent tuberculosis is done by detecting T-cells specific for or delayed hypersensitivity to M. tuberculosis antigens. This can be detected by either IFN-g release assays (IGRAs) or the tuberculin (purified protein derivative , or Mantoux) skin test. | 157,973 | medmcqa_train |
All are seen in hypersplenism except: | Ans. (d) Hypocellular bone marrowRef: Sabiston 19/e p 1553-1554Hypersplenism:* Spleen Enlargement+Decrease in Cell count in more than one cell line (Anemia, thrombocytopenia, leucopenia) is known as hyper splenism* Important feature on Bone marrow study is there will be Hyper plasia and immediate improvement of blood counts after splenectomy | 157,974 | medmcqa_train |
False regarding invlovement in Crohn's disease | Ans. is 'b' i.e., Rectum | 157,975 | medmcqa_train |
Latanoprost (PGF2 alfa) is used in - | Ans. is 'd' i.e., Glaucoma PG F2 alpha (Latanoprost) is used in glaucoma. | 157,976 | medmcqa_train |
The standard sutureless cataract surgery is done with phacoemulsification and foldable IOL has an incision of – | In phacoemulsification, the nucleus is emulsified using high frequency sound waves and then sucked out of the eye through a small (3.2 mm) incision. | 157,977 | medmcqa_train |
Following sign is diagnostic of which condition? | Ans. C. Carcinoma stomacha. Ulcerating carcinoma of the stomach with mass is the most frequent type encountered in North America and Western Europe.b. These carcinomas have been described as irregular, saucer-shaped lesions with ulcerated centers.c. Such a configuration may produce the meniscus or Carman sign, which indicates a large irregular ulcer with a mass.d. This is a long-present lesion. The size of the tumor is not in itself an indication of benignity or malignancy.e. The most important criteria for malignancy are irregularity of the ulcer, failure to project from the lumen of the stomach, and nodularity of the surrounding mass.f. Occasionally a benign ulcer surrounded by a large ulcer mound may simulate an ulcerating carcinoma.Carman Meniscus SignLarge gastric ulcer seen on UGI convex in towards the lumen of the stomach, rolled edges suggestive of malignancy | 157,978 | medmcqa_train |
Glaukomflecken is – | Epithelial cell necrosis leads to focal opacification of the lens epithelium as glaucomflecken in acute angle-closure glaucoma. | 157,979 | medmcqa_train |
Elimination after 4 half lives in first order Kinetics is | Ans. is 'b' i.e., 93% Half life Elimination 1t%2 50% 2t'/2 75% 3 0/2 87.5% 41 93.75% 5 t'/ 96.875 | 157,980 | medmcqa_train |
Hyperventilation in high altitude is due to | Hyperventilation in high altitude is due to respiratory alkalosis Ref: guyton and hall textbook of medical physiology 12 edition page number:375,376,377 | 157,981 | medmcqa_train |
The following regarding colostomy are true except : | • Bailey says “Double-barrelled colostomy was designed so that it could be closed by crushing the intervening ‘spur’ using an enterotome or a stapling device. It is rarely used now, but occasionally the colon is divided so that both ends can be brought to the surface separately, ensuring that the distal segment is completely defunctioned".
• May be colostomy or ileostomy.
• May be temporary or permanent.
• Temporary or defunctioning stomas are usually fashioned as loop stomas.
• An ileostomy is spouted; a colostomy is flush.
• Ileostomy effluent is usually liquid whereas colostomy effluent is usually solid.
• Ileostomy patients are more likely to develop fluid and electrolyte problems.
• An ileostomy is usually sited in the right iliac fossa.
• A temporary colostomy may be transverse and sited in the right upper quadrant.
• End-colostomy is usually sited in the left iliac fossa.
• All patients should be counseled by a stoma care nurse before operation. | 157,982 | medmcqa_train |
The first step in public health procedure is- | * The steps in public health procedure are as follows- 1) Survey. 2) Situation analysis. 3) Programme planning. 4) Programme operation. 5) Financing. 6) Programme appraisal. | 157,983 | medmcqa_train |
A young patient is diagnosed to have choriocarcinoma the treatment of choice is : | Chemotherapy | 157,984 | medmcqa_train |
In a family, the father has widely spaced eyes, increased facial hair and deafness. One of the three children has deafness with similar facial features. The mother is normal. Which one of the following is least likely pattern of inheritance in this case- | Ans. is 'a' i.e., Autosomal dominant (most likely) o It is typical presentation of waardeburg syndrome type - 1. --> Widely spaced eyes, Hearing loss, Increased facial hair o It is an autosomal dominant disorder. o In autosomal disorder, if one parent is affected and the other is normal, 25% of children (1 out of 4) will manifest disease. | 157,985 | medmcqa_train |
Chvostek sign is? | 1. Chvostek sign - seen in hypocalcemia - Twitching of Circumoral Muscle on tapping of Facial Nerve 2. Inability to open eye on tapping of facial nerve - L.P.S 3rd nerve | 157,986 | medmcqa_train |
Coho study is a type of - | Ans. is 'b' i.e., Analytic study Coho study o Coho study is a type of analytic observational study (like case control study). o Coho study proceeds forward from cause to effect, i.e., disease has not occured in subjects (In contrast to case-control study which proceeds backward from effect to cause). | 157,987 | medmcqa_train |
Lambda - Panda sign is typically seen in- | Ans. is 'a' i.e., Sarcoidosis o Lambda sign and Panda sign on Gallium scan are typically described for sarcoidosis.o Active pulmonary and/or mediastinal sarcoidosis is gallium avid and a positive gallium scan can support the diagnosis of sarcoidosis. Typical patterns of uptake have been described as 'panda' and 'lambda'signs.y Lambda sign - Formed from increased uptake in bilateral hilar and right paratracheal nodes y Panda sign - Formed from increased uptake in the parotids and lacrimal glandso A Lambda sign in combination with a so-called Panda sign (Lambda-Panda Sign) is a highly specific pattern for sarcoidosis.# The degree of uptake typically depends on the activity of disease and gallium scan is positive only in the setting of active parenchymal disease and negative in remission | 157,988 | medmcqa_train |
COWS is related to ? | Ans. is'b'i.e., Caloric testln bithermal caloric< test rCold water provokes nystagmus towards the opposite ear, while wann wotet grovolecs nystagmus towards sarne ear (COWS:- Cold - opposite, Warm - same). | 157,989 | medmcqa_train |
Pulmonary fibrosis is seen with : | Bleomycin is a marrow sparing drug but it causes pulmonary fibrosis and skin toxicity as adverse effects. Another anticancer drug causing pulmonary fibrosis is busulfan. | 157,990 | medmcqa_train |
Phocomelia is- | Ans. is 'a' i.e., Absent long bones 'Phacomelia' o Is a term applied to a marked reduction in the size of limbs The distal pa of the limbs are placed very near the trunk (absent long bones). o Seen in foetuses of mothers who recieved thalidomide during pregnancy. | 157,991 | medmcqa_train |
Cutaneous vasoconstriction is mediated by | Sympathetic noradrenergic division constricts the blood vessels of the skin(which limits bleeding from wounds). Ref: Ganong&;s review of medical physiology; 23rd edition; pg: 268. | 157,992 | medmcqa_train |
Which is an indicator of severe Ulcerative colitis? | (A) Blood in lumen on sigmoidoscopy # Severe Ulcerative collitis: Bowel movements >6 per day, Severe Blood in stool, Severe Fever 37.5C mean.Tachycardia >90 mean pulse, Anemia <75%, Sedimentation rate >30 mm, Endoscopic appearance Spontaneous bleeding, ulcerations.> Sigmoidoscopy is used to assess disease activity and is usually performed before treatment. If the patient is not having an acute flare, colonoscopy is used to assess disease extent and activity.> Endoscopically mild disease is characterized by erythema, decreased vascular pattern, and mild friability.> Moderate disease is characterized by marked erythema, absent vascular pattern, friability and erosions, and severe disease by spontaneous bleeding and ulcerations. | 157,993 | medmcqa_train |
Dilator pupillae is supplied by - | Dilator pupillae muscle is suppliedby the postganglionic fibers arising from the cervical sympathetic chain. ... Oculomotor nerve supplies the skeletal as well as the smooth muscles of the eyeball. It carries the pre-ganglionic fibers from the Edinger-Westphal to supply two smooth muscles in the eyeball Ref AK khurana 6/e | 157,994 | medmcqa_train |
Non-depolarizing blockade is potentiated by: | Neuromuscular-blocking drugs block neuromuscular transmission at the neuromuscular junction, causing paralysis of the affected skeletal muscles. This is accomplished either by acting presynaptically the inhibition of acetylcholine (ACh) synthesis or release or by acting postsynaptically at the acetylcholine receptors of the motor nerve end-plate. While some drugs act presynaptically (such as botulinum toxinand tetanus toxin), those of current clinical impoance work postsynaptically. | 157,995 | medmcqa_train |
Refrigerated blood stored up to 48 hours before transfusion can destroy which of the following | Treponema pallidum is killed in 1 to 3 days at 0-4degrees centigrade, so transfusion syphilis can be prevented by storing blood in the refrigerator before transfusion Stored frozen at -70deg C in 10% glycerol, or in liquid nitrogen (-130 deg C), it remains ble for 10-15 years. Ref: Textbook of microbiology; Ananthanarayan and paniker's; 10th edition; Pg:379 | 157,996 | medmcqa_train |
A 30-yebar old patient presented with features of acute meningoencephalitis in the casualty. His CSF on wet mount microscopy revealed motile unicellular microorganisms. The most likely organism is - | Naegleria fowleri, the only pathogenic species of naegleria Human infection comes from water containing the amoebae and usually follows swimming or diving in ponds. Patients are mostly previously healthy young adults or children. The amoebae invade the nasal mucosa, pass through the olfactory nerve branches in the cribriform plate into the meninges and brain to initiate an acute purulent meningitis and encephalitis (primary amoebic meningoencephalitis). The incubation period is 2 days to 2 weeks. The disease almost always ends fatally within a week Diagnosis can be made by CSF examination. The fluid is cloudy to purulent, with prominent neutrophil leucocytosis, elevated proteins and low glucose, resembling pyogenic meningitis. Failure to find bacteria in such specimens should raise the possibility of PAM. Wet film examination of CSF may show the trophozoites. Cysts are never seen CSF or brain. At autopsy, trophozoites can be demonstrated in brain histologically.Culture can be obtained in agar seeded with Escherichia coli or in the usual cell cultures used for virus isolation. Both trophozoites and cysts occur in culture. Amphotericin B has been used in treatment with limited success TEXTBOOK OF MEDICAL PARASITOLOGY,CKJ PANIKER,6TH EDITION,PAGE NO 33 | 157,997 | medmcqa_train |
All of the following methods are used for the diagnosis of HIV infection in a 2 months old child, except: | HIV ELISA is required for detection of antibodies against the virus. The antibodies may be present in the infant because of maternal infection also because IgG antibodies can cross the placental barrier. So, this test is not reliable for diagnosis of HIV in a 2 month old child. HIV culture method is called as 'peripheral blood mononuclear cells' (PBMC) using the virus microculture in macrophages concept. PBMC are drawn in high concentration from centrifugation of freshly drawn anticoagulated venous blood. HIV-1 PCR and p24 antigen assay are standard techniques used for viral detection in infants and children. HIV-1 PCR detects both RNA and proviral DNA with sensitivity and specificity of more than 98%. | 157,998 | medmcqa_train |
Usual sign of opioid withdrawal: PGI 13 | Ans. Yawning | 157,999 | medmcqa_train |
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