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Congenital toxoplasmosis, all are true, except | Congenital toxoplasmosis is a disease that occurs in fetuses infected with Toxoplasma gondii, a protozoan parasite, which is transmitted from mother to fetus.
It can cause miscarriage or stillbirth.
It can also cause serious and progressive visual, hearing, motor, cognitive, and other problems in a child.
Most infected infants appear healthy at birth.
They often do not develop symptoms until months, years, or even decades later in life.
Infants with severe congenital toxoplasmosis usually have symptoms at birth or develop symptoms within the first six months of life.
Symptoms may include:
Premature birth — as many as half of infants with congenital toxoplasmosis are born prematurely, abnormally low birth weight, eye damage, jaundice, yellowing of the skin and whites of the eyes, diarrhea, vomiting, anemia, difficulty feeding, swollen lymph nodes, enlarged liver and spleen, macrocephaly, an abnormally large head, microcephaly, an abnormally small head, skin rash, vision problems, hearing loss, motor and developmental delays, hydrocephalus, a buildup of fluid in the skull, intracranial calcifications, evidence of areas of damage to the brain caused by the parasites, seizures, mild to severe mental retardation.
Ref : https://www.healthline.com/health/congenital-toxoplasmosis#risks | 158,000 | medmcqa_train |
The reagent used in Apt test is | Alkali denaturation test (Apt-Downey test / apt test)Used to detect differentiate Fetal or neonatal blood from maternal blood (Qualitative).PrincipleMethodFetal hemoglobin (alpha 2 gamma 2 subunits) is resistant to alkali (basic) denaturation, whereas adult hemoglobin (alpha2 beta 2 subunits) is susceptible to such denaturation.Exposing the blood specimen to sodium hydroxide (NaOH) will denature the adult but NOT the fetal hemoglobin.The fetal hemoglobin will appear as a pinkish color under the microscope while the adult hemoglobin will appear as a yellow-brownish colorThe blood is mixed with sterile water to cause hemolysis of the RBCs, yielding free hemoglobin,The 5 ml pink hemoglobin-containing supernatant is then mixed with 1 mL of 1% NaOH.Fetal hemoglobin will stay pink and adult hemoglobin will turn yellow-brown.Adult hemoglobin changes color because it is less stable and will conve to hematin.Clinical UsesVaginal bleeding in late pregnancy is tested to rule vasa pre.Neonatal bloody vomitus or bloody stool to rule out swallowed maternal blood.To detect the presence of fetal blood in the maternal circulation in cases of suspected fetal-maternal hemorrhage.Positive test indicates that blood is of fetal origin.Negative test indicates that the blood is of maternal origin. | 158,001 | medmcqa_train |
Predict the effect of aldosterone hypersecretion on body fluid pH and electrolytes ? | Aldosterone increases the rate of sodium absorption and potassium secretion by the kidneys, but in high concentrations aldosterone also stimulates hydrogen ion secretion. Therefore elevated aldosterone levels such as occur in patients with Cushing's syndrome can elevate body fluid pH above normal (alkalosis). The major factor that influences the rate of hydrogen ion secretion, however, is pH of the body fluids. Ref: Barrett K.E., Barman S.M., Boitano S., Brooks H.L. (2012). Chapter 20. The Adrenal Medulla & Adrenal Coex. In K.E. Barrett, S.M. Barman, S. Boitano, H.L. Brooks (Eds), Ganong's Review of Medical Physiology, 24e. | 158,002 | medmcqa_train |
Isovolumetric relaxation preceeds: | Ventricular ejection | 158,003 | medmcqa_train |
Saw tooth appearance in abdominal barium enema X ray is seen in | Diveicula These are abnormal outpouchings or sacs of colon wall that occur due to interactions of high intraluminal pressures, disordered motility and low diet in fiber Formed on mesenteric side of antimesenteric taenia coli Results in protrusion of mucosa and submucosa through layers of muscle It is Pseudodiveiculum or False diveiculum Radiological evidence in prediveicular disease Saw tooth appearance of colon Shoening of bowel Crowding of haustra Picket fencing of folds Ischemic colitis- Ba. Enema - Thumb print sign Ulcerative colitis | 158,004 | medmcqa_train |
Receptor responsible for malignant hyperthermia is? | ANSWER: (B) Ryanodine receptorREF: Morgan 3ra e p. 869This condition is known by a number of names, including malignant hyperthermia (MH), malignant hyperthermia syndrome (MHS), and malignant hyperpyrexia.Signs and symptoms:The typical symptoms of malignant hyperthermia are due to a hyper catabolic state, which presents as a very high temperature, an increased heart rate and breathing rate, increased carbon dioxide production, increased oxygen consumption, acidosis, rigid muscles, and rhabdomyolysis.The symptoms usually develop within one hour after exposure to trigger substances, but may even occur several hours later in rare instances.Causes:Volatile anesthetic gases Local anesthetics Depolarizing muscle 1 relaxantshalothane, sevoflurane, desfluranelidocaine, bupivicaine, mepivacainesuccinylcholineOtherOpiates (morphine, fentanyl), ketamine, barbiturates, nitrous oxide, propofol, etomidate, benzodiazepinesGenetics:Malignant hyperthermias inheritance is autosomal dominant. The defect is typically located on the long arm of the nineteenth chromosome (19ql3.1) involving the ryanodine receptor. | 158,005 | medmcqa_train |
Hinge axis face bow records: | Kinematic facebow or Hinge axis facebow
A facebow with adjustable caliper ends used to locate the transverse horizontal axis of the mandible (GPT8)
It locates the true (exact) centre of condylar rotation or transverse horizontal axis.
It is preferred in full mouth reconstructions.
Hinge axis face-bow records—relationship of teeth to the axis of rotation of the jaw.
It usually requires a fully adjustable articulator.
When we consider the rotation of any circular object, only the central point rotates, any other point within the circle will show translatory movement. Similarly in the condyle, the centre alone will display pure rotation. This principle used to determine the true centre of rotation using kinematic facebow. • The condylar rods are first positioned arbitrarily similar to facia type of facebow at a point 13 mm anterior to the auditory meatus on the canthotragal line.
The patient is instructed to make opening and closing movements in CR. The opening should not be greater than 12 mm as then the condyle will then begin to translate instead of rotating.
The position of the condylar rod is shifted around the arbitrary mark until it shows pure rotation. This is the centre of condylar rotation. This point is marked, the condylar rods are locked, the facebow assembly is removed and mounted on an appropriate articulator.
Key Concept:
Hinge axis face-bow records—relationship of teeth to the axis of rotation of the jaw.
Face-bow measures relationship of maxilla to Opening and closing axis.
Ref: Textbook of prosthodontics V Rangarajan Ed. 2nd | 158,006 | medmcqa_train |
During a routine checkup, a 50-year-old man is found to have blood in his urine. He is otherwise in excellent health. An abdominal CT scan reveals a 2-cm right renal mass. You inform the patient that staging of this tumor is key to selecting treatment and evaluating prognosis. Which of the following is the most important staging factor for this patient? | The choice of surgical approach or treatment modalities is influenced more by the stage of a cancer than by its cytologic grade. The significant criteria used for staging vary with different organs. Commonly used criteria include (1) tumor size, (2) extent of local growth, (3) presence of lymph node metastases, and (4) presence of distant metastases. The other choices reflect grade of the tumor.Diagnosis: Renal cell carcinoma | 158,007 | medmcqa_train |
Part of colon with no mesentery- | Ans. C. Ascending colona. The large intestine develops as a fully mesenteric organ. However, after the rotation of the gut tube in utero, large portions of it come to lie adherent to the retroperitoneum, which means that some parts of the colon are fixed within the retroperitoneum, and other parts are suspended by a mesentery within the peritoneal cavity. Those portions of the colon within the retroperitoneum are separated from other retroperitoneal structures by a thin layer of connective tissue which forms an avascular field during surgical dissection, but which offers little or no barrier to the spread of disease within the retroperitoneum.b. The caecum may be within the retroperitoneum, but more frequently is suspended by a short mesentery. The ascending colon is usually a retroperitoneal structure although the hepatic flexure may be suspended by a mesentery. The transverse colon emerges from the retroperitoneum on a rapidly elongating mesentery and lies, often freely mobile, in the upper abdomen.c. The transverse mesocolon shortens to the left of the upper abdomen and may become retroperitoneal at the splenic flexure. Occasionally the splenic flexure is suspended by a short mesentery. The descending colon is retroperitoneal usually to the level of the left iliac crest.d. As the colon enters the pelvis it becomes increasingly more mesenteric again at the origin of the sigmoid colon, although the overall length of the sigmoid mesentery is highly variable. The distal sigmoid colon lies on a rapidly shortening mesentery as it approaches the pelvis; by the level of the rectosigmoid junction the mesentery has all but disappeared, so that the rectum enters the pelvis as a retroperitoneal structure. The caecum and proximal ascending colon are often more mobile on a longer mesentery in the neonate and infant than they are in the adult.e. The mesorectum is enclosed by meso rectal fascia, a distinct covering derived from the visceral peritoneum that is also called the visceral fascia of the mesorectum, fascia propria of the rectum or the presacral wing of the hypogastric sheath. The fascia bounds the mesorectum posteriorly and thus lies anterior to the retro rectal space and the pre-sacral fascia. The meso rectal fascia is surrounded by a very thin layer of loose areolar tissue which separates it from the posterior and lateral walls of the true pelvis. Superiorly, the meso rectal fascia blends with the connective tissue bounding the sigmoid mesentery. Laterally, it extends around the rectum and mesorectum and becomes continuous with a denser condensation of fascia anteriorly. In males this anterior fascia is known as the rectovesical fascia of Denon Villiers, and in females it forms the fascia of the rectovaginal septum. | 158,008 | medmcqa_train |
Among patients with polymyositis, which one of the following auto-antibodies is associated with an increased risk of interstitial lung disease? | Myositis Specific Antibodies Anti Jo-1 and anti synthetase antibodies Polymyositis and dermatomyositis with Interstitial lung disease, ahritis, mechanic's hands Anti-Mi-2 Dermatomyositis with rash Anti MDAS Dermatomyositis with rapidly progressive lung disease Anti-10 Juvenile dermatomyositis Anti-Signal recognition paicle Severe acute necrotizing myopathy | 158,009 | medmcqa_train |
One gm of Hb liberates _______ mg of billurubin . | Approximately 35mg of bilirubin is formed from 1g of Hb. About 6g of Hb is broken down per day. A total of 300mg of bilirubin is formed everyday; of which 80% is from destruction of old RBCs, 10% from ineffective erythropoiesis and the rest 10% from degradation of myoglobin and other heme containing proteins. Reference : page 249 Textbook of Biochemistry D M Vasudevan 6th edition | 158,010 | medmcqa_train |
A 60-year-old man with no significant past medical history is scheduled for elective cholecystectomy. He has been taking aspirin daily. Preoperative recommendations should include which of the following? | Discontinuation of aspirin at least 1 week before surgery. Aspirin inactivates platelet cyclo-oxygenase and thus inhibits platelet aggregation. The effect of aspirin is irreversible and lasts for the entire life span of the platelets. Therefore, aspirin should be discontinued for at least 1 week before surgery. | 158,011 | medmcqa_train |
Missing cases are detected by? | ANSWER: (C) Sentinel surveillanceREF: Park 20th edition page 38The word surveillance is the French word for "watching over"Sentinel surveillance is useful for answering specific epidemiologic questions because sentinel sites may not represent the general population or the general incidence of disease, they may have limited usefulness in analyzing national disease patterns and trends. (REF: http://www.usaid. gov/our_work/global_health/id/surveillance/sentinel.html)SURVEILLANCE:Continuous scrutiny of factors that determine the occurrence and distribution of diseases and other conditions of ill healthTypes:1. Active Surveillance:* One way to overcome the limitations of passive surveillance and get a better picture of disease burden in the community is for health workers to visit health facilities and communities to seek out cases. This is known as active surveillance.Eradication and elimination programmes may require a very active surveillance programme aimed at detecting every case.During outbreak situations surveillance must be intensified with the introduction of active case findingPassive Surveillance:Passive surveillance yields only limited data because many sick people do not visit a health facility and because those cases that do show up may not be correctly classified, recorded, or reportedSentinel Surveillance:A method of identifying the missing cases and thereby supplementing the notified casesFor example, in HIV/AIDS surveillance the proportion of the population positive for HIV7 must be monitored as well as the number of new cases of AIDS. This requires special HIV seropre vale nee surveillance usually done in a few representative sites ('sentinel surveillance"). | 158,012 | medmcqa_train |
Malignant transformation is commonly seen in: | Ans. (b) Gastric ulcer* Malignant transformation is very rarely seen in gastric ulcer (<1%) - Not so common.* Giant gastric ulcer (>2cm) is associated with cancer in 6-15% cases* Of the above choices we can opt for choice B' only - but it is not so common. | 158,013 | medmcqa_train |
Eye lens dislocation seen in –a) Marfan\'s syndromeb) Homocystinuriac) Down\'s syndromed) Klinefelter syndrome | Marfan syndrome and homocystinuria can cause dislocation of lens. | 158,014 | medmcqa_train |
'First order 'symptoms of schizophrenias' schizopremia include all except: | There are 11 first rank symptoms first three are related to thoughts - thought inseion , withdrawal & broadcasting next three are related to hallucinations -1St person ,2ND person & 3RD person next three are made phenomena remember MADE VOLITION, MADE IMPULSE, MADE AFFECT (mood) Last two are Somatic passivity & Delusional perception | 158,015 | medmcqa_train |
Micro nodular cirrhosis is commonly seen in all except, | Ans. is 'a' i.e., Chronic hepatitis B Cirrhosis of the liver is a pathological entity which clinically represents the end stage of chronic liver disease.It is characterized by three features.Bridging fibrous septa Q in the form of delicate bands or broad scars linking portal tracts with one another and portal tracts with terminal hepatic veins.Parenchymal nodules Q containing proliferating hepatocytes encircled by fibrosis with diameters varying from very small to large. iii) Disruption of architecture of the entire liver.Cirrhosis is defined as micronodular or macronodular depending upon the size of parenchymal nodules Micronodular cirrhosis Q - Parenchymal nodules < 3 mm in size * Macronodular cirrhosis - Parenchymal nodules > 3 mm in size Viral hepatitis commonly causes macronodular cirrhosis Q.In viral hepatitis the cirrhosis is characterized by irregularly large sized nodules separated by variable but mostly broad scars.This pattern of cirrhosis is historically called postnecrotic cirrhosis Q.Postnecrotic cirrhosis is not only applied to viral hepatitis but to all forms of cirrhosis in which the liver shows large irregular sized macronodules with broad scars regardless of the etiology.Also remember theseAlcholic cirrhosis is typically micronodular Q, but can become macronodular in later stages.Viral cirrhosis is typically macronodular. Cirrhosis associated with virus is called postnecrotic cirrhosis. Postnecrotic cirrhosis is also called posthepatitis cirrhosis macronodular cirrhosis and coarsely nodular cirrhosis.Cirrhosis in hemochromatosis is typically micronodular (can be macronodular sometimes).Wilson's disease causes macronodular cirrhosis.Biliary cirrhosis whether primary or secondary is micronodular. | 158,016 | medmcqa_train |
Most common cause of hypercalcemic crisis is : | A hypercalcaemiccrisisis an emergency situation with a severehypercalcaemia, generally above approximately 14 mg/dL (or 3.5 mmol/l)The most common cause is hypercalcemia of malignancy, although granulomatous diseases, previously undetected primary hyperparathyroidism, medication-induced hypercalcemia, and a few rarer causes may result in this endocrine emergency as well. Stepwise approach for management of Hypercalcemic crisis Step 1: Confirm the diagnosis. Step 2: Restore normal hydration - Through IV fluids(200-500 ml/hr of NS )should be administered to maintain a urine output of >100 ml/hr. Step 3: Use of loop diuretics to be limited to hypercalcemic crisis associated with hea failure or renal failure. Calcitonin or bisphosphonates-Preferred drugs for hypercalcemic management after restoring normal hydration with IV fluids. | 158,017 | medmcqa_train |
Scarring loss of hair is seen in | Conditions causing scarring alopecia Causes of non-cicatricial alopecia (non-scarring) Traumatic causes of scarring alopecia may be due to: Injury Surgery Radiation Traction (tight curls) Central centrifugal cicatricial alopecia Infections causing scarring alopecia include: Bacterial infection: boils and abscesses (Staphylococcus aureus) Fungal infection: kerion (inflammatory tinea capitis) Viral infection: shingles (herpes zoster) Inflammatory skin diseases causing scarring alopecia include: Folliculitis decalvans Dissecting cellulitis Lichen planopilaris Frontal fibrosing alopecia Alopecia mucinosa Discoid lupus erythematosus Localised scleroderma Anagen effluvium Androgenetic alopecia Dermatopathia pigmentosa reticularis Telogen effluvium Trichotillomania (Trichotillosis) Conditions resulting in reversible patchy hair thinning, poor hair quality and bald patches include: Localised alopecia areata Localised infection, such as tinea capitis Severe local skin disease, such as psoriasis, seborrhoeic dermatitis, atopic dermatitis, pityriasis rubra pilaris, cutaneous lupus erythematosus, cutaneous T-cell lymphoma Generalised skin disease (erythroderma) Systemic diseases resulting in reversible patchy hair thinning, poor hair quality and bald patches include: Iron deficiency Thyroid hormone deficiency Systemic lupus erythematosus Syphilis Severe acute or chronic illness (Ref: Harrison 20th edition pg 1234 | 158,018 | medmcqa_train |
60 year old asymptomatic female shows following change in tunica media of blood vessels. Diagnosis? | Ans. (a) Medial calcificationMedial artery calcification (MAC) is also known as Monckeberg's arteriosclerosis, is a nonobstructive condition leading to reduced arterial compliance that is commonly considered as a nonsignificant finding.With the H&E stain, calcium appear deep blue-purple. | 158,019 | medmcqa_train |
The results of the pulmonary functions tests shown below, the best diagnosis is -ParametersActualPredictedFE VI (L)1[?]23[?]5-4[?]3FVC(L)4[?]14[?]6-5[?]4FEVL'FVC (%)2972-80PEF (L/min)80440-540DLCO120%100% | Ans. is 'a' i.e. Asthma o .All expiratory parameters are reduced in the data given with timed vital capacity of 29%.o FEV1/FVC is reduced in obstructive airway disease with lowering of peak expiratory flow rates. Due to air trapping in asthma the DLco may be normal or increased. | 158,020 | medmcqa_train |
1.5 mL of a solution containing 20 mg/mL of Evans blue dye is injected into plasma, the final concentration of the dye is 0.015 mg/mL, the volume of the plasma is: | Volume of plasma = volume of dye injected / final concentration of the dye Volume of dye injected = 1.5 * 20 = 30 mg Volume of plasma = 30/0.015 = 2000 mL | 158,021 | medmcqa_train |
Chloride shift is due to | Chloride shift (also known as the Hamburger phenomenon or lineas phenomenon, named after Haog Jakob Hamburger) is a process which occurs in a cardiovascular system and refers to the exchange of bicarbonate (HCO3-) and chloride (Cl-) across the membrane of red blood cells (RBCs Ref: guyton and hall textbook of medical physiology 12 edition page number:360,361,362 | 158,022 | medmcqa_train |
Pityriasis versicolor is caused by- | Tinea Versicolor or Pityriasis Versicolor: It is a chronic recurrent condition involving stratum corneum of skin, caused by a lipophilic fungus - Malassezia furfur. Malassezia furfur is a lipophilic fungus that is found on skin. Clinical manifestation: Characterized by scaly patches of hypo to hyper pigmentation of skin * Areas rich in sebaceous glands are commonly involved (neck, chest or upper arms). E. floccosum - cause Tinea unguium M. gypseum - cause Ectothrix infection T. tonsurans and T. violaceum- cause Endothrix | 158,023 | medmcqa_train |
Greenish colour in a contussion is due to : | B i.e. Haematoidin | 158,024 | medmcqa_train |
Most commonly involved ossicle in CSOM is | Ossicular necrosis is one of the sequale of CSOM. Most commonly, long process of incus gets necrosed. Sometimes, stapes superstructure also gets necrosed. This increases the conductive hearing loss to more than 50 dB Ref: Diseases of ENT by Dhingra 6th edition Pgno : 73 | 158,025 | medmcqa_train |
Superior intercostal aery is a branch of | Superior intercostal arery is a branch of costocervical trunk of subclan aery. BD chaurasia's human anatomy.6th edition volume 1.page no 219. | 158,026 | medmcqa_train |
The amniotic membrane is characterized by all the following Except | AMNIONAt term, amnion is tough and tenacious.It provides almost all of the tensile strength of the fetal membranes.It is avascular and pliable.It is the innermost fetal membrane and is contiguous with the amniotic fluid. | 158,027 | medmcqa_train |
Keratan sulfate I and II is found in | Biologically Important GAGs: | 158,028 | medmcqa_train |
Tetralogy of Fallot's present with one of the following: | Ans. is 'a' i.e. . Central cyanosis with clubbing. TOF is the commonest cyanotic congenital* heart disease in children above the age of 2 years.The four constituents of Tetralogy are :Ventricular septal defect*Pulmonic stenosis*Overriding of dextroposed Aorta *Right ventricular hypertrophy *Physiologically the pulmonary stenosis causes concentric right ventricular hypertrophy without cardiac enlargement. When the right ventricular pressure is as high as the left ventricular or the aortic through the VSD. Since right ventricle is effectively decompressed by V.S.D. congestive cardiac failure never occurs in TOF*Right ventricular hypertrophy in E.C.G. reflected by Right axis deviation*.The flow from the right ventricle into the pulmonary artery occurs across the pulmonary stenosis producing an ejection systolic murmur*.Clinical features of TOF :Cyanosis usually presents after neonatal period*Hypoxemic or cyanotic spells* (Tet spells)*Commonest congenital lesion with which squatting* is usedClubbing*Auscultatory findings :s1-Normals2-Single predominantly AorticMurmur-Ejection systolic* TOF patients are RARELY CYANOTIC AT BIRTH*Chest x-rayNormal heart size *Oligemic lung fields*Right aortic arch present in 25% caseECG - Right axis deviation* | 158,029 | medmcqa_train |
Ferning of cervical mucus depends upon: | The Ferning of the cervical mucus is because of the high estrogen content and its DOES NOT diagnose ovulation. Maximum before ovulation and once ovulation happens, the ferning actually reduces and finally disappears due to the high progesterone. This implies that loss of ferning pattern is suggestive of ovulation. Due to the presence of sodium chloride in the mucus under estrogen effect. This fern pattern is also known as Arborisation. | 158,030 | medmcqa_train |
Neurotransmitter depleted in Parkinson's disease:September 2007 | Ans. A: DopamineParkinson's disease has both hypokinetic and hyperkinetic features. In this condition, which was originally described by James Parkinson and is named for him, the nigrostriatal dopaminergic neurons degenerate. The fibers to the putamen are most severely affected.Dopaminergic neurons and dopamine receptors are steadily lost with age in the basal ganglia in normal individuals, and an acceleration of these losses apparently precipitates parkinsonism. Symptoms appear when 60-80% of the nigrostriatal dopaminergic neurons are lost. Parkinsonism is also seen as a complication of treatment with the phenothiazine group of tranquilizer drugs and other drugs that block D2 dopamine receptors. | 158,031 | medmcqa_train |
Dangerous area of scalp is ? | Ans. is 'b' i.e., Loose areolar tissueThe scalp consists of five layers:SkinClose network of connective tissue (superficial fascia)Aponeurosis (galea aponeurotica) with occipitofrontalis musclesLoose areolar (subaponeurotic) tissuePericranium (outer periosteum of skull)First three layers are intimately connected and move as one unit, and are called surgical layers of scalp or scalp proper.Loose subaponeurotic areolar tissue (4th layer) is called dangerous area of scalp because it contains emissary veins through which infection in subaponeurotic space may spread readily to intracranial venous sinuses. | 158,032 | medmcqa_train |
A rickshaw tyre passed on a 8 year old child. Tyre marks were found on the body. This is an exmaple of: | Ans is 'b' i.e. Imprint abrasion Real confusion in this question is between imprint abrasion and patterned bruising. In both imprint abrasion and patterned brusing there is mark or pattern of the object causing injury.* Abrasion is caused by friction and/or pressure between the skin and some rough object or surface. For abrasions to occur some movement along with pressure is essential between the object or instrument or weapon and the skin. Inabrasions superficial layers of skin are crushed and damaged.* Bruises or contusions are caused by blunt trauma resulting in rupture of small blood vessels which lead to effusion of blood in subcutaneous or subepithelial tissues. However skin is intact in most cases until associated withabrasions.* In an accident in which victim is overrun by vehicle, there will be movement and friction between the tyre and skin along with pressure by the tyre leading to imprint or patterned abrasion. There can be intradermal bruises also whichare usually associated with patterned objects. So the tyre mark will be primarily an imprint or patterned abrasion (tyre has a pattern because of ridges and grooves) associated with bruises too.Also know-Abrasions are of following types - 1. Scratches - a linear injury produced by a sharp object, such as a pin, thorn, nail or tip of any sharp weapon.2. Graze - An injury which is produced when a broad surface of skin slides or scraps against a rough surface. These are the most common type. Commonly seen in road accidents.Violent lateral (tangential) rubbing against a rough surface can produce abrasion known as 'brush burn' or 'gravel rash'.'Friction burn' can occur due to tangential contact with a smooth surface.3. Patterned abrasions: In it pattern of the object causing injury is produced over the skin when the force is applied at right angle to the surface of the skin. Patterned abrasions are produced either by pressure of the object or by impactwith a rough object. The former is called pressure (crushing or friction) abrasion and the latter is known as impact (contact or imprint) abrasion. There can be associated bruising in the surrounding area. Examples are ligaturemark, nail and thumb mark, teeth bite marks, whip marks, radiator, grill or tyre marks in vehicular accidents and muzzle marks in gunshot injuries. | 158,033 | medmcqa_train |
What is present in the part of the bone which received radiotherapy - | Infection and radiation, both cause bone destruction and predispose to pathological fracture. | 158,034 | medmcqa_train |
Malate shuttle is important in ________ | NADH cannot penetrate the mitochondrial membrane, but it is produced continuously in the cytosol by 3-phosphoglyceraldehyde dehydrogenase, an enzyme in the glycolysis sequence.
The transfer of reducing equivalents is carried out by using the various shuttle systems.
Malate shuttle system is of more universal utility. Used to transport NADH from cytosol to mitochondria.
In glycolysis, the impermeable NADH produced in the cytosol are taken up into mitochondria for oxidation via malate shuttle.
In gluconeogenesis, pyruvate in the mitochondria yields impermeable oxaloacetate, which gets translocated to the cystol via malate shuttle for the sythesis of glucose.
Harper 30th edition Pg-125,126,173 | 158,035 | medmcqa_train |
Programmed cell death is known as- | Ans. is 'b' i.e., Apoptosis o Programmed cell death is apoptosis. o But remember this impoant fact that not all apoptosis are programmed cell death (read text below) Apoptosis o Apoptosis is pathway of cell death that is induced by a tightly regulated intracellular program in which cell destined to die activate enzymes that degrade the cell's own nuclear DNA, and nuclear & cytoplasmic proteins. o Apoptosis generally involves single cells in contrast to necrosis that usually involve a group of cells. o Apoptosis may be of two types ? A. Physiological (most of the time) Programmed cell death. B. Pathological Unprogrammed cell death. A.Physiological apoptosis o Death by apoptosis is a normal phenomenon that serves to eliminate cells that are no longer needed. o It is impoant in the following physiologic situation :? The programmed destruction of cells during embryogenesis, including implantation, organogenesis, and metamorphosis. Hormone dependent involution in adult, e.g., endometrial cell breakdown during menstural cycle, ovarian follicular atresia in the menopause, the regression of lactating breast after weaning, and prostatic atrophy after castration. Cell deletion in proliferating cell population in order to maintain a constant number, e.g., intestinal crypt epithelium. Death of host cells that have served their useful purpose, such as neutrophils after an acute inflammatory response, and lymphocytes at the end of an immune response. Elimination of potentially harmful self-reactive lymphocytes in thymus. Cell death induced by cytotoxic T cells to eliminate virus infected and neoplastic cells. Same mechanism occurs in graft versus host disease. B.Pathological apoptosis o Apoptosis may also be pathological. o When cells are damaged beyond repair, especially when the damage affects the cell's DNA, the irreparably damaged cells are eliminated : ? Cell death produced by injuries stimuli --> Radiation and cytotoxic anticancer drugs damage DNA, and if repair mechanisms cannot cope with the injury, the cell kills itself by apoptosis. In these situations, elimination of the cell may be a better alternative than risking mutations and translocations in the damaged DNA which may result in malignant transformation. Cell injury in ceain viral diseases, e.g., in viral hepatitis. Pathologic atrophy in parenchymal after duct obstruction, such as occurs in pancreas, parotid gland. Cell death in tumors. | 158,036 | medmcqa_train |
All of the following are decreased in Nephrotic syndrome except : | Answer is D (Fibrinogen): Nephrotic syndrome is characteristically associated with increased fibrinogen levels Nephrotic syndrome is characteristically associated with increased fibrinogen levels - Hyper fibrinogenemia. This is due to increase hepatic synthesis, impaired fibrinolysis, and increased platelet aggregability. It is an impoant factor responsible for hypercoagulability seen in Nephrotic syndrome. Patient of nephrotic syndrome can develop spontaneous peripheral aerial or venous thrombosis. - Renal vein thrombosis Q - Pulmonary embolisms. Serum albumin is decreased due to proteinuriaQ Hypoalbumnimia is compounded by increased renal catabolism and inadequate albeit increased hepatic synthesis of albumin. Transferrin loss in urine leads to decreased levels of serum transferrin. This is responsible for iron resistant microcytic hypochromic anemia. Q Ceruloplasmin level, too are decrease on account of its loss in urine. Q | 158,037 | medmcqa_train |
Which of the following does not occur in a patient with gastrinoma - | Laboratory Studies in gastrinoma Due to the elusive nature of the neoplasm, the diagnosis is based on the following 3 criteria: Fasting hypergastrinemia is present (>150 pg/mL with levels >100,000 pg/mL in some patients; a serum gastrin level >1,000 pg/mL in the appropriate clinical setting is viually diagnostic of Zollinger-Ellison syndrome ). Basal acid output (BAO) is greater than 10 mEq/h. Results from a secretin stimulation test are positive. Ref - harrison's internal medicine 20e , Medscape.com | 158,038 | medmcqa_train |
A school teacher gives consent for treating a child who becomes sick during a picnic away from home town. This type of consent is known as? | Loco Parentis: In an emergency involving children, when parents or guardians are not available, consent is taken from the person in charge of the child. Paternalism: Is an abuse of medical knowledge so as to disto the doctor-patient relationship in such a way that the patient is deprived of his autonomy, or his ability to make a rational choice. Vicarious liability (Liability for act of another): An employer is responsible not only for his own negligence but also for the negligence for his employees. Novus Actus Interveniens: A person is responsible not only for his actions, but also for the logical consequences of those actions. This principle applies to cases of assault and accidental injury. Ref: The Essentials of Forensic Medicine and Toxicology 29th Ed Page 45. | 158,039 | medmcqa_train |
The "water act" passed in 1974 deals with: | The Act provides for the creation of the Central Pollution Control Board and State Pollution Control Boards. The main function of the Central Board is to promote cleanliness of streams and wells in the States. It also provides ceain functions in the nature of advice, planning, co-ordination, publications, education and programmes for preventing, controlling and abating water pollution. The State Boards are expected not only to plan comprehensive programmes for the prevention and control of water pollution in the State but also to inspect sewage or trade effluents, works and plants for their treatment, to lay down standards for such effluents, their treatment and for the quality of receiving waters, and to make orders for waste disposal. Ref: Park, 21st Edition, Page 657. | 158,040 | medmcqa_train |
A 80 year old patient presents with a midline tumor of the lower jaw, involving the alveolar margin. He is endentulous. Rx of choice is : | Ans. is 'c' i.e., Segmented mandibulectomy The best t/t for such tumor is excision of the growth along with segmental mandibulectomy. Hemimandibulectomy would not be useful, as the tumor is midline. Since the bone is involved by the growth, marginal mandibulectomy would not be a good choice. | 158,041 | medmcqa_train |
Modern monitors to measure ETCO2 make use of | Measurements of variations in the respiratory cycle of expired carbon dioxide by displayed waveform and by absolute numerical values is defined as Capnography and Capnometry respectivelyMeasurement of the exhaled CO2 at the level of upper airway at the end of expiration (when CO2 is at its maximum) is referred to as 3end tidal CO2 (EtCO2)Modern monitors used to measure EtCO2 in the exhaled air make use of infrared absorption spectroscopy(Refer: Morgan and Mikhail's Clinical Anaesthesiology, 5th edition, pg no. 126) | 158,042 | medmcqa_train |
Flag sign is seen in ___________ | In kwashiorkor, the hair is straight and hypopigmented. The length of hair that grows during the period of nutritional deprivation appears reddish brown. During the phases of better nutrition, the growing pa of hair gets appropriately pigmented. This gives the appearance of alternate bands of hypopigmented and normally pigmented hair known as flag sign. Ref: Page 105; Ghai essential pediatrics; 6th edition | 158,043 | medmcqa_train |
A 30-year-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 | (A) Naegleria fowleri # The clinical syndrome associate a with N. fowleri infection is Primary 'amoebic' meningoencephalitis (RAM).> When naegleria are suspected they can be identified by their Motility in wet preparation.> Acute meningoencephalitis which can be caused by either Naegleria or Acanthamoeba. (Entamoeba histolytica and T. cruzi do not cause it.> Out of Naegleria and Acanthmoeba only Naegleria are motile on CSF wet mount.> Aqanthmoeba actually cause Granulomatous amoebic encephalitis. | 158,044 | medmcqa_train |
The left subclan aery is a branch of : | C i.e. Arch of aoa | 158,045 | medmcqa_train |
Kamli Rani 75 yrs old woman present with post myocardial infarction after 6 weeks with mild CHF. He had a history of neck surgery for parathyroid adenoma 5 years ago. EKG shows slow arial fibrillation. Serum Ca+213.0 mg/L and urinary Ca+2 is 300 mg/24h. On examination a small mass is felt in the para tracheal position. Which of the following is the most appropriate management? | The patient in the question is not a good candidate for surgical removal of parathyroid mass due to the underlying medical complications, so ultrasound guided alcohol injection is the most appropriate treatment. Ultrasound guided alcohol injection of the mass is used as an alternate therapy for patients with primary hyperparathyroidism who refuse surgical treatment, who are not good surgical candidate or who present as an emergent life threatening malignant hypercalcemia. It is most commonly used postoperatively in patients with recurrent or persistent hyperparathyroidism who have a sonographically visible residual mass. Ref: Core Topics in Endocrinology in Anaesthesia and Critical Care By George Hall, Page 36; Ultrasound: A Practical Approach to Clinical Problems By Edward I. Bluth, Page 626 | 158,046 | medmcqa_train |
The chromosomal complement of a primary oocyte is : | 44XX | 158,047 | medmcqa_train |
Hypocalcemia in child -All except? | Ans. is 'd' i.e., All of above Causes of hypocakemia Hypo parathyroidism Digeorge syndrome PTH receptor defect (pseudo hypoparathyroidism) Magnesium dificiency Exogenous organic phosphate excess Vit D difeciency | 158,048 | medmcqa_train |
For development of alveolar PO2 of 60 mm Hg and high altitude illness to develop in an otherwise healthy person from sea level, rapid ascent to following height is required | People have different susceptible to altitude sickness,on an average it begins around 2000 to 3000 meters above sea level Ref:Guyton and Hall textbook of medical physiology 12th edition,page number:375,376 | 158,049 | medmcqa_train |
Drug causing decrease in late sodium current - | Ans. is 'b' i.e., Ranolazine o Ranolazine was initially assigned as paial fatty acid oxidation inhibitors. However, now it is believed that it acts by a different mechanism. It acts by blocking a late sodium current that facilitates calcium NCX (Sodium -Calcium exchanger) -4 Calcium overload and decrease left ventricular wall tension --> decreased myocardial oxygen demand. | 158,050 | medmcqa_train |
Human papillomatosis is caused by? | Ans. is b i.e., HPV Human upper respiratory papillomatosis is due to infection with human papilloma virus (HPV) type 6 and 11. | 158,051 | medmcqa_train |
By the Factory Act the age for the child to work should minimum be (in years) | Ans. a (14). (Ref. Park, PSM, 17th/pg.586)According to the Factory Act children below the age of 14 years should not work.FACTORY ACT- 1948Applicable towhole India except Jammu & Kashmir.Scope# Establishment >10 workers where power is used and > 20 where power is not used.# Minimum 500 Cu.ft of space for each worker.# Factories before 1948 minimum 350 Cu.ft.# Prohibit employment <14 years.# 15 to 18 yrs old are called adolescents and they should be duly certified by certifying surgeon. They are allowed to work only between 6 am to 7 pm.Hours of workMax 48 hours/week, Including overtime its 60 hours/week.Leave with wagesafter 12 months of continuous service- adult 1 day for 20 days of work, children 1 day for 15 days.Maximum accumulated leave# adult 30 days; Children 40 days.Notifiable diseasesAsbestosis,Byssinosis,Dermatitis (occupational), andNoise induced hearing loss.Officerssafety officer - > 1000 workers, welfare officer- >500 workers canteen > 250 workers. Creches - > 30 female workers. | 158,052 | medmcqa_train |
In organophosphorous poisoning, following are seen except: | A i.e. Pupillary dilation | 158,053 | medmcqa_train |
Epitheloid granuloma consists mainly of which type of cells: | Ans. D: Macrophages Macrophages/ histiocytes are the cells that define a granuloma. They often, but not invariably, fuse to form multinucleated giant cells. The macrophages in granulomas are often referred to as "epithelioid". Epithelioid macrophages differ from ordinary macrophages in that they have elongated nuclei that often resemble the sole of a slipper or shoe. They also have larger nuclei than ordinary macrophages and their cytoplasm is typically more pink when stained with eosin. Granulomas are seen in a wide variety of diseases, both infectious and non-infectious. Infections that are characterized by granulomas tuberculosis leprosy histoplasmosis cryptococcosis coccidioidomycosis blastomycosis cat scratch disease. Examples of non-infectious granulomatous diseases are Sarcoidosis (Sarcoid granulomas often contain star-shaped structures termed asteroid bodies or lamellar structures termed Schaumann bodies) Crohn's disease berylliosis Wegener's granulomatosis Churg-Strauss syndrome Pulmonary rheumatoid nodules Aspiration of food and other paiculate material into the lung. | 158,054 | medmcqa_train |
Nexus criteria in trauma is used for | Ref: ALTS, 10th edition Pgno: 140 | 158,055 | medmcqa_train |
Lower first molar has which of the following occlusal shapes | In previous question only one has to be selected so answer should be Pentagonal. But other occlusal forms are also found in lower first molar. | 158,056 | medmcqa_train |
"Barefoot Doctors" were from which type of medicine? | Barefoot doctors are farmers who received minimal basic medical and paramedical training and worked in rural villages in China. Their purpose was to bring health care to rural areas where urban-trained doctors would not settle. | 158,057 | medmcqa_train |
Oxygenated blood is carried to the fetus by? | - Umbilical vein -> carries oxygenated, nutrient rich blood from placenta to fetus - Umbilical aeries -> carries deoxygenated blood from fetus to placenta for oxygenation - Ductus venosus -> shunt that allows oxygenated blood from umbilical veins directly into inferior vena cava - Hypogastric aery -> aka internal iliac aery -> Supplies pelvic viscera | 158,058 | medmcqa_train |
The earliest sign of iron deficiency anaemia- | The first stage in the development of iron deficiency anaemia is the depletion of storage iron. The iron reserves are lost without compromise of iron supply for erythropoesis.Therefore the earliest sign is decreased serum ferritin level indicating poor tissue iron stores. Reference : Harsh Mohan textbook of pathology, 7th edition.Pg no.275,276 Ref Robbins 9/e pg 412 | 158,059 | medmcqa_train |
A 63-year-old man undergoes a paial gastrectomy with Billroth II reconstruction for intractable peptic ulcer disease. He presents several months postoperatively with a megaloblastic anemia. Which of the following is the best treatment for this surgical complication? | Either megaloblastic anemia due to vitamin B12 deficiency (due to lack of intrinsic factor, which is necessary for B12 absorption and is normally produced by the parietal cells of the stomach) or microcytic anemia due to iron deficiency (due to decreased iron intake and impaired absorption in the duodenum) can result after paial gastrectomy. While folate deficiency can also cause megaloblastic anemia, it is rare after paial gastrectomy. Oral B12 is not a reliable method for correcting B12 deficiency; intravenous cyanocobalamin should be administered every 3 to 4 months for life. Other complications of paial gastrectomy includes osteoporosis secondary to impaired calcium absorption due to the Billroth II reconstruction (since calcium is normally absorbed in the proximal intestine--duodenum and jejunum). Also, fatty acids may also be malabsorbed due to inadequate mixing of bile salts and lipase with ingested fat, and therefore steatorrhea may result. | 158,060 | medmcqa_train |
Gold standard procedure to reduce recurrence of pterygium after surgical excision is | Gold standard procedure to reduce recurrence of pterygium after surgical excision is amniotic membrane grafting. | 158,061 | medmcqa_train |
who gave the concept of id pa of mind | CONTRIBUTIONS OF FREUD o Father of psychoanalysis He founded a type of psychotherapy called psychoanalysis. It is nothing but analyzing the psych(MIND) o Interpretation of dreams According to Freud dreams are royal road to unconscious In dreams several conflicts that are present in the unconscious comes to the consciousness in the form of dreams Thus by analyzing ones dreams we could understand the unconscious conflicts o Psychosexual stages of life o Freud divided development into 5 stages namely psycho sexual development o It is divivded namely oral , anal , phallic, latent, genital phase. o Conversion disorders conversion disorder is conveing a psychological pain to physical symptoms present physical symptoms which has some connection with unconscious conflict is called SYMBOLIZATION present physical symptoms which has some resemblance with illness in family members, which is called MODELLING patient has illness like neurological deficit but they have apparent in concern towards their own illness which is known as LA BELLE INDIFFERENCE main defense mechanism in conversion disorder is REPRESSION o Repression defence mechanism * REPRESSION is called QUEEN of defense mechanisms o COUCH and FREE ASSOSIATION * He introduced a technique called as a couch technique where he makes the patient lie on the couch, he asks the patient to speak from 'cabbages to kings. This method is called FREE ASSOSIATION. By allowing the patient to speak whatever that comes to their mind randomly so that by analyzing their thoughts we could understand the conflict in the unconscious. o Topographical theory of mind Freud gave topographical theory mind It is divided into pre conscious, unconscious, conscious Later he disregarded topographical theory of mind and gave structural theory of mind o Structural theory of mind It is divided into id, ego, super ego Id= instinctual desires like anger, hunger, sexual instinct Ego= function of mind to work based on ego to avoid guilt from super ego Super ego= based on moral principle, obtained from family members and relatives, teachers Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition pg no. 845 | 158,062 | medmcqa_train |
Cross-product ratio is estimated by ? | Ans. is 'b' i.e., Case-control studyOdds - ratio (cross product ratio)From a case control study odds ratio can be derived which a measure of the strength of association between risk factor and outcome.Odds ratio is closely related to relative risk (which is analysed in coho study) 4 odds ratio represents only an estimate of relative risk. | 158,063 | medmcqa_train |
A 25-year-old man presents with a blue right arm with absent radial pulse and painful passive finger extension following a supracondylar fracture of humerus. He is suffering from: | Ans. C. Compartment syndromeFracture can lead to ischemia in the distal limb by direct injury to the blood vessel or by the effect of oedema increasing the pressure within the osteo fascial compartment which limits perfusion. In compartment syndrome, the increased pressure can lead to profound ischemia with necrosis of muscle and nerve tissue. This is a surgical emergency requiring prompt decompression by open fasciotomy. Once muscle tissue dies it is replaced by inelastic fibrous tissue giving rise to the complication of Volkmann's ischaemic contracture. | 158,064 | medmcqa_train |
Baholin gland is related to vagina | The Baholin's glands are two pea-sized compound racemose gland located slightly posterior and to the left and right of the opening of the vagina. They secrete mucus to lubricate the vagina and are homologous to bulbourethral gland in males. ref - BDC 6e vol2 pg394 | 158,065 | medmcqa_train |
A diabetic patient has black necrotic mass in nose, most likely causes is: | Ans. is 'a' i.e.Mucormycosis Mucormycosis is a fungal infection of nose and paranasal sinuses which may prove rapidly fatal if untreated.lt is seen in uncontrolled diabetes or in those taking immunosuppressive drugs.Treatment is by amphotericin B* and surgical debridement.Remember :Most common fungal infection of nose is Aspergillosis *Rhinosclerosis is caused by a bacteria Klebsiella * (& not by Rhinosporidium Seeberi, a fungus )Otomycosis is caused by Aspergillosis* | 158,066 | medmcqa_train |
An African presented with itching with rashes and inguinal lymph nodes. Skin snips shows microfilariae which are non-sheathed. The most probable organism will be: | Mansonella streptocerca is transmitted by biting midges. The major clinical manifestations involve the skin and include pruritus, papular rashes, and pigmentation changes. Many infected individuals have inguinal adenopathy, although most are asymptomatic. The diagnosis is made by detection of the characteristic microfilariae in skin snips. Ivermectin is the treatment of choice for streptocerciasis. Non-sheathed microfilariae are: Onchocerca volvulus Mansonella ozzardi M. perstans M. streptocerca Sheathed microfilariae are: Wuchereria bancrofti Brugia malayi B. timori Loa loa Ref: Harrison's Online > Pa 8. Infectious Diseases > Section 19. Helminthic Infections > Chapter 218- Filarial and Related Infections, by Thomas B. Nutman, Peter F. Weller. | 158,067 | medmcqa_train |
What is the most common loss of sense above 70 years? | (B) Vibration > Vibration sense is the most common to be lost in old age. | 158,068 | medmcqa_train |
Clergyman's knee involves ? | Ans. is 'c' i.e., lnfrapatellar bursa | 158,069 | medmcqa_train |
A drug with plasma half life of 12 hours is administered twice a day. A drug with plasma half life of 12 hours is administered twice a day. Steady state plasma concentration reached is 300 mg/dl. Which of the following statements about this drug is not true? | Ans. is 'b' i.e., Intravenous administration will always achieve a higher concentration than oral route | 158,070 | medmcqa_train |
Laminated concretions of calcium and proteins are - | Ref:Textbook of pathology (Harsh mohan) 6th edition,page no.165 Schaumann's bodies or conchoid (conch like) bodies which are concentric laminations of calcium and of iron salts, complexed with proteins.The giant cells in sarcoid granulomas contain ceain cytoplasmic inclusions Schaumann's bodies is one of them others are: Asteroid bodies which are eosinophilic and stellateshaped structures. Birefringent cytoplasmic crystals which are colourless. Similar types of inclusions are also observed in chronic berylliosis Ferrugenious bodies are asbestos fibres coated with glycoprotein and haemosiderin and appear beaded or dumbbell-shaped. The coating stains positively for Prussian blue reaction. Gandy-Gamna nodules or Gandy-Gamna bodies, sometimes known as Gamna-Gandy bodies or Gamna-Gandy nodules, are small yellow-brown, brown, or rust-colored foci found in the spleen in patients with splenomegaly due to poal hypeension, as well as sickle cell disease. | 158,071 | medmcqa_train |
Mrs. X, 25years old with a history of 2 previous pregnancies, and now 28weeks of gestation her gravidity is | Nulligravida: a woman who currently is not pregnant and has never been pregnant.Gravida: a woman who currently is pregnant or has been in the past, irrespective of the pregnancy outcome. With the establishment of the first pregnancy, she becomes a primigravida, and with successive pregnancies, a multigravida.Reference: William's obstetrics; 25th edition | 158,072 | medmcqa_train |
Lovibond angle is: | Lovibond angle or Hyponychial angle - Angle between nail bed and proximal nail fold - Normally around 1600. - It is >1800 in digital clubbing. It is described as a 'profile sign' | 158,073 | medmcqa_train |
Which of the following is a Rave drug? | Rave drugs are used for recreational purpose in parties.
Methamphetamine, LSD and Ketamine are the important Rave drugs. | 158,074 | medmcqa_train |
Triangle of koch is made by: | B i.e. Coronary sinus opening | 158,075 | medmcqa_train |
Density of cells in adult corneal endothelium is | (Refer: AK Khurana Comprehensive Ophthalmology, 6th edition, pg no. 95 - 96)The cell density of corneal endothelium is around 3000 cells/mm2 in young adults, which decreases with the advancing age | 158,076 | medmcqa_train |
The National Population Policy 2001 aims to achieve net reproduction rate of 1 by the year ? | Ans. is 'b' i.e., 2010 Objectives of National Population Policy 2000 Immediate objectives: To meet unmet need of contraception; to strengthen health infrastructure; to strengthen health personnel and to promote integrated service delivery for basic RCH care Mid term objective: 'To bring the total feility rate (TFR) to Replacement Level; i. e, TFR to 2.1' Long term objective: To stabilize population by 2045 o National Socio-demographic Goals of NPP 2000 (achieve by 2010) Address the unmet needs for basic reproductive and child health services, supplies and infrastructure Make school education up to age 14 free and compulsory, and reduce drop outs at primary and secondary school levels to below 20 percent for both boys and girls Reduce infant moality rate to below 30 per 1000 live bihs Reduce maternal moality ratio to below 100 per 100,000 live bihs Achieve universal (100%) immunization of children against all vaccine preventable diseases Promote delayed marriage for girls, not earlier than age 18 and preferably after 20 years of age Achieve 80 percent institutional deliveries and 100 percent deliveries by trained persons Achieve universal access to information/counseling, and services for feility regulation and contraception with a wide basket of choices Achieve 100 per cent registration of bihs, deaths, marriage and pregnancy Contain the spread of Acquired Immunodeficiency Syndrome (AIDS), and promote greater integration between the management of reproductive tract infections (I) and sexually transmitted infections (STI) and the National AIDS Control Organisation Prevent and control communicable diseases Integrate Indian Systems of Medicine (ISM) in the provision of reproductive and child health services, and in reaching out to households Promote vigorously the small family norm to achieve replacement levels of TFR Bring about convergence in implementation of related social sector programs so that family welfare becomes a people centred programme | 158,077 | medmcqa_train |
Serum marker to return to normal level, last in myocardial infarction is: | Enzymes in MILDH is the last enzyme to rise (3-4 days) and also the last enzyme to return to normal level in MI (10-15 days)CPK returns to normal by 2-3 daysAST/ SCOT returns to normal by 4-5 daysMyoglobin returns to normal by 20-25 hours | 158,078 | medmcqa_train |
Which of the following is a new drug available to treat multi drug resistant tuberculosis? | Ans. a. Bedaquiline (Ref: Harrison 19/e p1115. 205e- 7)Two novel drugs belonging to two new antibiotic classes--the diarylquinoline bedaquiline and the nitroimidazole delamanid--have recently been approved for use in severe cases of MDR-TB by stringent regulatory authorities."Two novel drugs belonging to two new antibiotic classes--the diarylquinoline bedaquiline and the nitroimidazole delamanid--have recently been approved for use in severe cases of MDR-TB by stringent regulatory authorities (the L .S. Food and Drug Administration (FDA} and the European Medicine Agency (EMA] in the case of bedaquiline; the EM A and the Pharmaceuticals and Medical Devices Agency of Japan in the case of delamanid). "-- Harrison 19/e p1115BedaquilineBedaquiline is a new diarylquinoline with a novel mechanism of action: inhibition of the mycobacterial ATP synthetase proton pumpQ.It is bactericidal for drug-susceptible and MDR strains of M. tuberculosisQ.Mechanism of action:Inhibition of the mycobacterial ATP synthetase proton pump.Therapeutic Uses:Provisional recommendation for the use of bedaquiline for 24 weeks in adults with laboratory-confirmed pulmonary MDR-TB when no other effective treatment regimen can be provided.Side-Effects:Arrhythmias (induce long QT syndrome by blocking the hERG channel)Resistance:Resistance has been reported and is due to point mutations in the atpE gene encoding for subunit c of ATP synthetase.Anti-Tubercular DrugsFirst line (WHO Group 1)Second lineThird line* EthambutolQ (EMB or E)* IsoniazidQ (INH or H )* PyrazinamideQ (PZA or Z)* RifampicinQ (RMP or R)* StreptomycinQ (SM or S)* Second line drugs (WHO groups 2, 3 & 4) are only used to treat disease that is resistant to first line therapy, i.e., for extensively drug-resistant tuberculosis (XDR-TB) or multidrug- resistant tuberculosis (MDR-TB).* Aminoglycosides (WHO group 2): Amikacin, kanamycinQ* Polypeptides (WHO group 2): Capreomycin, viomycin, enviomycinQ* Fluoroquinolones (WHO group 3): Ciprofloxacin, levofloxacin, moxifloxacinQ* Thioamides (WHO group 4): Ethionamide, prothionamideQ* CycloserineQ (WHO group 4)* TerizidoneQ (WHO group 5)* Third-line drugs (WHO group 5) include drugs that may be useful, but have doubtful or unproven efficacy.* RifabutinQ* ClarithromycinQ* LinezolidQ* ThioacetazoneQ* ThioridazineQ* Arginine* Vitamin D* BedaquilineQ* DeiamanidQ | 158,079 | medmcqa_train |
A most common cause of erythema multiforme – | Most of the cases of erythema multiforme are idiopathic, but amongst the known causes, HSV is the most important cause. | 158,080 | medmcqa_train |
Berkesonian bias is a type of | A special example of bias is berkesonian bias termed after doctor Joseph berkeson who recognized this problem. The bias arises because of different rates of admission to hospitals for people with different diseases (refer pgn:74 park 23 rd edition ) | 158,081 | medmcqa_train |
The daily extra calorie requirement in first trimester of pregnancy is - | For pregnant woman the extra energy requirement is 350kcal.REF.PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE.Editon-21.Page no.-588 table no.29. | 158,082 | medmcqa_train |
Best treatment for glioblastoma multiforme: | Ans. C. Excision with radiation* These are highly infiltrative tumors, and the areas of increased T2/FLAIR signal surrounding the main tumor mass contain invading tumor cells.* Treatment involves maximal surgical resection followed by partial-field external beam radiotherapy (6000cGy in thirty 200-cGy fractions) with concomitant temozolomide, followed by 6-12 months of adjuvant temozolomide | 158,083 | medmcqa_train |
Pentostatin inhibits | Pentostatin is a purine analogue that inhibits Adenosine deaminase. It is used in cases of Hairy cell leukemia (Doc: Uadiribine). | 158,084 | medmcqa_train |
All of the following are true about cold sterilization except | It destroys spores and vegetative cells but not effective against viruses. | 158,085 | medmcqa_train |
Drug used in irritable bowel syndrome with constipation is: | Ans. (A) Lubiprostone(Ref: Katzung 11/e p1080)Lubiprostone acts by stimulating Cl- channel opening in the intestine, increasing liquid secretion in gut and decreasing transit time, therefore used for chronic constipation. It has also been approved for constipation dominant irritable bowel syndrome in women. | 158,086 | medmcqa_train |
Polychromatic lusture is seen in : | A i.e. Complicated cataract Complicated cataract (i.e. cataract secondary to some intraocular disease) may be - Anterior coical Q in anterior segmental lesions as glaucoma, acute iritis, or, - Posterior coical Q in posterior segmental lesions as uveitis, RD, pigmentary retinal dystrophy. The second type of complicated cataract presents with posterior coical bread crumb appearance/ polychromatic lusture or rainbow cataract Q Complicated cataract occurs secondary intraocular disease e.g. Inflammatory conditions as uveitis. Degenerative conditions as retinitis pigmentosa, high myopia etc. Intraocular tumors Retinal detachment, Glaucoma etc. | 158,087 | medmcqa_train |
ROSE questionnaire is used for | The Rose Angina Questionnaire (RAQ) was developed in 1962 to detect ischemic hea pain (angina pectoris and myocardial infarction) for epidemiological field-surveys.1 Since then, the RAQ has been used in many countries to detect coronary hea disease (CHD) in epidemiological research . Ref Davidson edition23rd pg 460 | 158,088 | medmcqa_train |
Hand foot syndrome is seen with which anticancer drug? | Ans. B. 5-fluorouracilHand and foot syndrome is caused by 5-fluorouracil, capecitabine, doxorubicin. Cisplatin is highly emetic and nephrotoxic drug. Methotrexate is hepatotoxic. | 158,089 | medmcqa_train |
Coloured halos are seen in all, except –a) Mucopurulent conjunctivitis b) Acute anterior uveitisc) Tetracyclined) Glaucoma | Coloured halos are not seen in acute anterior uveitis and this is one of the differentiating points between acute anterior uveitis and acute angle closure glaucoma
Tetracycline does not cause coloured halos.
Important drugs causing coloured halos
Amiodarone
Amyl nitrite
Chloroquine
Chlorpromazine
Cortisone
Digoxin
Fluphenazine
Hydrocortisone
Oral contraceptives
Trimethadione
Prednisolone
Promethazine
Sildenafil
Triflupromazine
Water (sterile) | 158,090 | medmcqa_train |
Uses of tumor marker are all except : | Tumor markers are not specific, so, cannot be used for confirmation of diagnosis. Confirmation is done by biopsy Examples: PSA Prostate cancer Ig Multiple myeloma hCG Choriocarcinoma Calcitonin Medulaary thyroid cancer Catecholamines Pheochromocytoma CEA Colon ca, Pancreatic ca CA 15.3 Breast cancer CA 19-9 Pancreatic cancer CA 125 Ovarian ca NSE Neuroblastoma | 158,091 | medmcqa_train |
Titration of the dose of a drug with the response can be done with which of the following routes of administration: | - Titration of drug dosage can be done only with the inhalational route of administration among the given options. | 158,092 | medmcqa_train |
Urban malaria is caused by | Anopheles Mosquito There are over 55 species of anopheline mosquitoes in India causing malaria An.culicifacies - Vector of rural malaria An.stephensi - Vector of urban malaria; Breed in overhead tanks An.flutilis- Efficient vector, highly anthrophilic, breed in moving water An.sundaicus : Breed in brackish water An.dirus An.minimus An.philippines An.maculates Ref: Park 25th edition Pgno : 281 | 158,093 | medmcqa_train |
Procedure to be performed in the case of arrest of after-coming head due to contracted pelvis in breech: | Ans is c, i.e. Zavanelli maneuverRef Williams, 24/e, p 567The last rescue for entrapped fetal head in term fetus is replacement of the fetus higher into the vagina and uterus followed by cesarean delivery. This is called as Zavanelli maneuver.In preterm babies, last resort for entrapment of after-coming head of breech is-to give Duhrssen Incisions. | 158,094 | medmcqa_train |
Glanzmann thrombasthenia is due to | Glanzmann thrombasthenia is an autosomal recessive disorder. There is a failure of primary platelet aggregation with ADP or collagen due to inherited deficiency of two platelets membrane glycoproteins. It is caused due to deficiency of glycoprotein IIb- IIa. | 158,095 | medmcqa_train |
A patient with conjunctival infection, which lead to corneal perforation, was positive for Gram-negative coccoid appearance on Gram stain. Fuher investigation showed small translucent colourless organism which is oxidase positive. What could be the most probable causative organism- | Ans. is 'b' i.e., Neisseria gonorrhea | 158,096 | medmcqa_train |
Pseudohyponatremia can be seen in - | Ans. is 'a' i.e., Multipe myeloma Causes of Hyponatremia* Pseudohyponatremia# Hyperlipidemia# Hyperproteinemia (multiple myeloma, macroglobulinemia)* Dilutional# Hyperglycemia* Hypovolemic hyponatremia : decreased total body sodium with a relatively greater increase in total body water# Heart failure# Chronic renal failure# Hepatic failure or cirrhosis* Euvolemic hyponatremia : Increased Total body water with nearly normal total body sodium# SIADH# Drugs causing DIADH (diuretics, barbiturates, carbamazapine, chlopropamide, clofibrate, opioids, tolbutamide, vincristine psychogenic polydipsia# Beer potomaria# Hypothyroidism# Adrenal insufficiency# MDMA (ecstasy)# Accidental or intestional water intoxication# MDMA, N-methyl-3,4 methylenedioxy amphelamine; SIADH, syndrome of inapproprfate secretion of antidiuretic hormone.# Hyperglycemia is retened by some as pseudohyponumia, but hyperglycemia is acrually a dilutional hyperglycemia. | 158,097 | medmcqa_train |
Most common parotid gland tumor is: | Ans. (c) Pleomorphic adenomaRef: Bailey & Love 26th ed. / 732PLEOMORPHIC ADENOMA* Overall most common tumor of salivary gland* MC benign salivary gland tumor* MC tumor of major salivary glands* MC site is parotid tail (superficial lobe).Also Know* 2nd MC benign tumor of parotid gland: Warthin's tumor* MC malignant tumor of parotid gland: Mucoepidermoid CA* 2nd MC malignant tumor of parotid gland: Adenoid cystic CA | 158,098 | medmcqa_train |
Metabolic alkalosis is seen in- | Mineralocoicoid excess increases net acid excretion and may result in metabolic alkalosis, which may be worsened by associated K+ deficiency. ECFV expansion from salt retention causes hypeension. The kaliuresis persists because of mineralocoicoid excess and distal Na+ absorption causing enhanced K+ excretion, continued K+ depletion with polydipsia, inability to concentrate the urine, and polyuria. | 158,099 | medmcqa_train |
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