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Non specific esterase is positive in all the categories of AML except | Non specific esterase on cytochemistry is strongly positive in M5(acute monocytic leukemia- Schilling type) and M4(acute myelomonocytic leukemia -Naegeli type) which have monocytic component.It is also positive in M3(acute promyelocytic leukemia).But non specific esterase is negative in M6(acute erythroleukemia-Di Guglielmo's syndrome),which shows positive for Periodic acid-Schiff. Reference:Textbook of pathology-Harsh Mohan,6th edition,page no:362. | 158,400 | medmcqa_train |
A young patient presents with enlargement of costocondral junction and with the white line of fraenkel at the metaphysis. The diagnosis is- | *Enlargement of costochondral junction and white line of Frankel are seen both in scurvy and rickets. *However, best answer here is scurvy as white line frankel is seen in healing rickets, not in active rickets. And rickets refers to active disease. ref : maheswari 9th ed | 158,401 | medmcqa_train |
A 54-year-old woman presents with prominent scattered erythematous papules on the right side of her forehead. She had "burning" pain and hypersensitivity in that area for the past 2 days. Her pain is localized to the right supraorbital area and the right aspect of the dorsum of her nose. She denies headaches, mental status changes, or recent infections. What is the most plausible diagnosis? | Woman is suffering from herpes zoster, or "shingles" - a late complication of prior infection with varicella zoster virus. The virus remains latent in the ganglia of sensory nerves after the primary infection. The characteristic shingles rash is always confined to a dermatome and does not cross the midline. Specifically, the area described by the patient is the right V1 dermatome. | 158,402 | medmcqa_train |
Atropine is used in organophosphate poisoning because of its | Refer kDT 6/e p 106 atropine acts as antagonist in muscarinic receptors. It has no activity on nicotinic receptors and do not interfere with the release of acetylcholine | 158,403 | medmcqa_train |
Most "Radiosensitive" Tissue is: | Bone-marrow | 158,404 | medmcqa_train |
Which of the following drugs is associated with the untoward side effect of renal tubular damage? | Cisplatin is a highly emetic and nephrotoxic agent.
Streptozocin causes the destruction of β-cells of the pancreas and may result in hyperglycemia.
Methysergide can cause retroperitoneal fibrosis on long-term use.
Cyclophosphamide can result in hemorrhagic cystitis. | 158,405 | medmcqa_train |
If urine sample darkens on standing, the most likely condition is : | Alkaptonuria a condition d/t defective homogentisate 1, 2- dioxygenase (1/t defective tyrosine degradation) usually presents after age of 40 with characteristic triad of Homogentisic aciduria (which blacken/darkens on exposure to air /standing and is strongly Benedict's positive), Ochronosis (i.e black pigmentation of cailage & collagenous connective tissue), and Ahritis of large joints | 158,406 | medmcqa_train |
The different semen in case of gang rape is identified by:- | Single photon fluorimetry has been used to differentiate between different semen in a gang rape case TESTS FOR SEMINAL STAINS Creatine phosphokinase test Acid phosphatase testQ Florence testQ (Choline iodide crystals) Barberio's test (crystals of spermin picrate) | 158,407 | medmcqa_train |
Submucosal fibroid is detected by : | Ans. is a, b and c i.e. Hysteroscopy; Hysterosalpingography; and USG (Transabdominal) USG * Ultrasound is the main diagnostic tool in case of fibroid.deg It checks the numberdeg, locationdeg and sizedeg of fibroids and helps to reduce overlooking small fibroids during surgery (which might lead to persistence or recurrence of symptoms). USG findings in case of Fibroid Enlarged and distoed uterine contour Depending on connective tissue amount -- fibroid may have varying echogenecity (hypoechoic or hyperechoic. Vascularisation is seen at periphery. Hysteroscopy or hysterosalpingography : These methods are useful to detect submucous fibroid in unexplained infeility and repeated pregnancy wastage. The presence and site of submucous fibroid can be diagnosed by direct visualization during hysteroscopy or indirectly as a filling defect on HSG. Hysteroscopy also allows its excision under direct vision. Uterine Curettage : It can also help in diagnosis of submucous fibroid by feeling of a bump during curettage.deg Laparoscopy : is helpful if uterine size is less than 12 weeks, for detection of a subserous fibroid. It can also differentiate a pedunculated fibroid from an ovarian tumour not revealed by clinical examination and ultrasound. Investigation which can be done is MRI.deg Role of Doppler in diagnosis of Fibroid : Leiomyomas have characteristic vascular patterns which can be identified by color flow doppler. A peripheral rim of vascularity from which a few vessels arise and penetrate into the centre is seen. Doppler imaging can be used to differentiate an extrauterine leiomyoma from other pelvic masses or a submucous leiomyoma from an endometrial polyp or adenomyosis. Also know : Best investigation for submucous fibroid - Hysteroscopydeg Best investigation to detect fibroid (in general)deg -- USG (Pt choicer -- MRI (2f'd choicer | 158,408 | medmcqa_train |
The tumor causing polycythemia due to erythropoietin production is - | <p>The tumors causing inappropriate rise in erythropoietin are renal cell caarcinoma,hepatocellular carcinoma ,cerebellar hemangioblastoma.</p><p>Reference :Harsh mohan textbook of pathology sixth edition pg no 359.</p> | 158,409 | medmcqa_train |
A female with IUCD develops pelvic inflammatory disease. which of the following should be done: | Ans. is 'a' i.e., Keep the IUCD, give antibiotic, follow up for antibiotic response & then take decision regarding IUCDremoval If an IUD user receives a diagnosis of PID, the IUD does not need to be removed. However, the woman should receive treatment according to these recommendations and should have close clinical follow-up no clinical improvement occurs within 48-72 hours of initiating treatment, providers should consider removing the IUD.PID treatment regimens must provide empiric, broad spectrum antibiotic coverage of likely pathogens | 158,410 | medmcqa_train |
Which of the following culture medium is made by adding Agar: | Ans. (a) Solid mediumRef: Microbiology by Ananthanarayan and Paniker 8th ed. / 39-40GROWING BACTERIAL CULTURES IN LIQUIDNUTRIENT BROTH* Nutrient broth is a liquid bacterial growth medium made of powdered beef extract and short chains of amino acids that have been dissolved in water.* Liquid medium is convenient to use for growing bacteria in test tubes, and can reveal information about the oxygen requirements of bacteria growing within.* Bacteria that require oxygen will grow close to the water s surface, and bacteria that cannot tolerate the presence of oxygen will grow at the bottom of the test tube.B GROWING BACTERIAL CULTURES ON SOUP MEDIA* Broth media can be made solid by adding agar, a gel like polysaccharide extracted from red algae.* Broth with about 1.5% agar added will be liquid when heated, but solid at room temperature, making it easy to pour into a vessel, such as a Petri dish or test tube when hot.* The solution then becomes solid once cooled. | 158,411 | medmcqa_train |
Amphiphatic helices are | Many α helices have predominantly hydrophobic R-groups projecting from one side of the axis of the helix and predominantly hydrophilic R-groups projecting from the other side. These amphipathic helices are well adapted to the formation of interfaces between polar and nonpolar regions such as the hydrophobic interior of a protein and its aqueous environment. Clusters of amphipathic helices can create channels, or pores, through hydrophobic cell membranes that permit specific polar molecules to pass.
Note: Clusters of twisted strands of β sheet are called β barrels.
Ref: Harper’s illustrated biochemistry. 30th edition page no: 37 | 158,412 | medmcqa_train |
Maximum density of goblet cells is seen in | Goblet cells form the mucus layer of the tear film They are maximum nasally and least superiorly REF:Refer Khurana 6th edition page number 59 | 158,413 | medmcqa_train |
Which is the most common cytogenetic abnormality in myelodysplastic syndrome (MDS)? | Monosomy 7 is most common cytogenetic abnormality in children whereas 5q - is seen frequently in adults and is very rare in children. Although 5q may be commoner than monosomy 7 in some settings, overall monosomy 7 appears more common. Myelodysplastic syndromes are a group of stem cell disorders with altered hematopoesis causing anemia. It is the most common hematologic cancer in the older adult. Course may be indolent or rapidly progress to an AML. They are characterized by the constellation of cytopenias, usually hypercellular marrow, and a number of morphologic and cytogenetic abnormalities. Ref: The Myelodysplastic Syndromes: Pathobiology and Clinical Management By John M. Bennett, Page 264 ; Wintrobe's Clinical Hematology, 10th Edition ; Neoplastic Diseases of the Blood, Issue 439, Edited By Peter H. Wiernik, 4th Edition, Page 114 ; Neoplastic Hematopathology By Daniel M. Knowles, 2nd Edition, Page 397 | 158,414 | medmcqa_train |
Appendicitis-like syndrome is caused by | Yersinia enterocolitica: Type 1- Enterocolitis and gastroenteritis; Type 2- mesenteric adenitis and inflammatory terminal ileitis that may mimic appendicitisYersinia pseudotuberculosis: also mimics appendicitisRef: Ananthanarayan 9th edition, p324 | 158,415 | medmcqa_train |
Which of the following parameters adds predictive information regarding cardiovascular risk stratification and the measurement of serum cholesterol? | Recent studies have demonstrated that markers of inflammation correlate with coronary risk and that inflammation plays a role in atheromatous plaque instability. Elevations of C-reactive protein, (CRP) identify patients at increased risk of myocardial infarction (MI) and poor outcome of acute coronary syndromes. Measurement of CRP adds information regarding risk stratification to standard risk factor such as hypeension, diabetes, smoking, and lipids. Elevations in homocysteine, lipoprotein A, and plasminogen activator factor I have all been associated with an increased risk at cardiovascular events; however, at the time none have been shown to be useful in populations to improve risk stratification. | 158,416 | medmcqa_train |
Side effects of oxygen therapy are all except: | B i.e., Increased pulmonary compliance Hyperoxia (oxygen toxicity) may lead to hypoventilation, hypercapnia (but not necessarily hypoxia), absorption atelectasis, decreaed vital capacity, deterioration of pulmonary compliance & blood gasesQ, interstitial edema, pulmonary fibrosis, tonic clonic seizure & retinopathy of prematurity d/t free radicle induced damage of sulfhydryl group enzymes, endotheliumQ, epithelium and surfactant systems | 158,417 | medmcqa_train |
Irresistible urge to do a thing repeatedly is seen in | An obsession is defined as an idea, impulse or image which intrudes into the conscious awareness repeatedly, patient tries to resist against it but is unable to . an obsession is usually associated with compulsion and a compulsion is defined as a form of behaviour which usually follows obsessions,the behaviour is not realistic and is either irrational or excessive compulsion may diminish the anxiety associated with obsession (Ref: a sho textbook of psychiatry, Niraj Ahuja, 7th edition, pg no 95) | 158,418 | medmcqa_train |
Duret haemorrhage is/are seen in: | D i.e. Brain Whiplash injury results from acute hyperextension of cervical spineQ in the region of C4 - C6 veebrae. Coup & Count-re coup lesions are most commonly seen in brainQ. Lucid interval is seen in insanity & epidural haemorrhageQ Fracture - ala - signature / signature fracture is also known as depressed fracture of skull vaultQ. Depressed/ Signature fracture are caused by heavy weapon with small striking surface eg. hammerQ. Pond or Indented fracture occur in childrenQ due to elasticity of their skull bones. -Duret haemorrhages are small areas of bleeding in anterior & paramedian upper brain stem (midbrain & pons)Q produced due to progressive rise of intracranial pressure 1/t coning or downward herniation of brainstem into foramen magnum. This results in stretching & shearing of perforators of basilar aery causing duret hemorrhage , tractional damage of pituitary stalk causing diabetes insipidus; Cushing triad (bradycardia, hypeension & respiratory irregularities), mid size non reacting pupil and brainstem death. | 158,419 | medmcqa_train |
CD 19 positive, CD22 positive, CD103 positive monoclonal B-cells with bright kappa positivity were found to comprise 60% of the peripheral blood lymphoid cells on flow cytometric analysis in a 55 year old man with massive splenomegaly and a total leucocyte count of 3.3 x 109/L. Which one of the following is the most likely diagnosis? | Answer is D (Hairy cell leukemia) Presence of massive splenomegaly, and granulocytopenia, alongwith characteristic immunophenotypic features (specially CD103) suggests the diagnosis of Hairy cell leukemia. CD103 is exclusively positive in Hairy cell leukemia and thus leaves no doubt as regards the correct diagnosis. | 158,420 | medmcqa_train |
Most specific marker for myeloid series is | The markers for myeloid series are CD13, CD33, CD 11b, CD15, CD117 and cMPO. c MPO is the most lineage specific marker amongst these. Regarding other options, CD 34 - Myeloid and lymphoid blasts, stem cells, CD 45 - Leukocyte common antigen (nonerythroid hematopoietic cells), CD 99 - Ewing's sarcoma/primitive neuroectodermal cells. | 158,421 | medmcqa_train |
Which surgical procedure has the highest incidence of ureteric injury? | The Weheim type of radical hysterectomy for cancer of the cervix is notorious for ureteric injury for which over-dissection of the ureter or accidental injury is most often responsible. Ref: Shaw's Gynaecology, 13th Edition, Pages 180-81; Dutta Gynecology, 4th Edition, Pages 391-92; Management of Common Problems in Obstetrics and Gynecology By T. Murphy Goodwin, Main N. Montoro, Laila Muderspach, Subir Roy, 2010, Page 325; Clinical Gynecology By Bhasker Rao, 4th Edition, 1998, Page 239. | 158,422 | medmcqa_train |
An 18 year old student complains of lack of interest in studies for last 6 months. He has frequent quarrels with his parents and has frequent headaches. The most appropriate clinical approach would be: | B i.e. Rule out depressionLet us consider the options one by one. This can be a normal behaviour but use definitely need to rule out of few disorders before reaching this conclusion. Recent studies have suggested a possible correlation b/w migraine and behavioural problems. There is nothing in the question to point out towards migraine as a cause of the headache, not there are any specific behavioural problems that can be linked to migraine.Diagnostic criteria for appositional defiantdisorder (ADD) A. A pattern of negativistic, hostile, and defiant behaviour lasting for atleast 6 months, during which four (or more) of the following are present?Often loses temperOften argues with adultsOften actively defies or refuses to comply with adults' requests or rules.Often deliberately annoys peopleOften blames others for his or her mistakes or misbehaviourIs often touchy or easily annoyed by othersIs often spiteful and resentfulIs often spiteful or vindictiveNote: Consider a criterion met only if the behaviour occurs more frequently than is typically observed in individuals of comparable age and developmental level.B. The disturbance in behaviour causes clinically significant impairment in social, academic, or occupational functioning.C. The behaviours do not occur exclusively during the course of a psychotic or mood disorder.D. Criteria are not met for conduct disorder, and if the individual is 18 years or older, criteria are not met for antisocial personality disorder.Clinical manifestations of depression in children and adolescents AnhedoniaLoss of interest andenthusiasm in play,socializing, school, andusual activities; boredom;loss of pleasureDysphoric moodTearfulness; sad, downturned expression; slumpedposture; quick temper;irritability; angerFatigabilityLethargy and tiredness; noplay after schoolMorbid ideationSelf-deprecating thoughts,statements; thoughts ofdisaster, abandonment,death, suicide, orhopelessness.Somatic symptomsChanges in sleep or appetitepatterns; difficulty inconcentrating; bodilycomplaints, paicularlyheadache and stomachache.QFrequent quarrels with parents and lack of interest in studies for last 6 months are both consistent with a diagnosis of oppositional defiant disorder. However, children with oppositional disorder typically present to the clinic by the age of 8 years. Also headache has not been mentioned as a manifestation in this disorder. The presence of frequent headaches and age of presentation (18 years) make the diagnosis of appositional delusional disorders unlikely. So symptoms of the patient here are not enough to be diagnosed as ADD.Depression can occur at any age including adolescents and young adults. Lack of interest in school is a known feature (anhedonia). Restlessness & irritability are pa of dysphoric mood & explain frequent quarrels with parents. Also somatic symptoms like headache/ heaviness of head are known associations | 158,423 | medmcqa_train |
Which of the following is FALSE regarding Kishori Shakti Yojana? | It is a scheme for adolescent girls and is being implemented using the ICDS infrastructure. It targets girls between 11 - 18 years of age. It addresses their needs of self development, nutrition and health state's, literacy and numerical skills, vocational skills etc. Ref: Park, Edition 21, Page - 545. | 158,424 | medmcqa_train |
All of the following statements about synovial fluid are true. Except- | synovial fluid is plasma transudate from synovial capillaries, modified by secretory activities of type-B synovial lining cells. | 158,425 | medmcqa_train |
ln which of the following transmission, meiosis occurs : | Primary to secondary spermatocyte | 158,426 | medmcqa_train |
Copper-T is preferably inseed postnatal, after: | Timings of IUD inseion During menstruation or within 10 days of begining of menstrual period: Best time for IUD inseion Cervical canal diameter greatest, lesser expulsive, least risk of pregnancy. Immediate post-paum inseion: During 1st week after delivery before woman leaves hospital. High chance of perforation High chance of expulsion Post-puerperal inseion: 6-8 weeks after delivery Can be combined with follow up visit of mother and child. Not recommended after 2nd trimester aboion. Ref: Park 25th edition Pgno: 531 | 158,427 | medmcqa_train |
Consider the following statements regarding thyroid hormones- | Thyroid Hormones physiology The thyroid secretes predominantly thyroxine (T4) and only a small amount of triiodothyronine (T3); approximately 85% of T3 in blood is produced from T4 by a family of monodeiodinase enzymes that are active in many tissues, including liver, muscle, hea and kidney. Selenium is an integral component of these monodeiodinases. T4 can be regarded as a prohormone, since it has a longer half-life in blood than T3 (approximately 1 week compared with approximately 18 hours), and binds and activates thyroid hormone receptors less effectively than T3. T4 can also be conveed to the inactive metabolite, reverse T3. T3 and T4 circulate in plasma almost entirely (> 99%) bound to transpo proteins, mainly thyroxine-binding globulin (TBG). It is the unbound or free hormones that diffuse into tissues and exe diverse metabolic actions. Some laboratories use assays that measure total T4 and T3 in plasma but it is increasingly common to measure free T4 and free T3free hormone measurements is that they are not influenced by changes in the concentration of binding proteins. For example, TBG levels are increased by oestrogen (such as in the combined oral contraceptive pill) and this will result in raised total T3 and T4, although free thyroid hormone levels are normal. Ref - davidson 20e p656 | 158,428 | medmcqa_train |
who gave the concept of la belle indiffernce | 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 | 158,429 | medmcqa_train |
Vitamin A is stored in:- | HSCs (Hepatic Stellate Cells) are: Pericytes which exist in the space between parenchymal cells and liver sinusoidal endothelial cells of the hepatic lobule. Also called Vitamin A-storing cells, Lipocytes, Interstitial cells, Fat-storing cells or Ito cells, Perisinusoidal cells Store 50-80% of vitamin A in the whole body as Retinyl Palmitate. Extra information: Vitamin A - The fat-soluble vitamin A, as such is present only in foods of animal origin. However, its provitamins carotenes are found in plants Retinol, retinal and retinoic acid are regarded as vitamers of vitamin A. Function of vit A - Vitamin A is necessary for a variety of functions such as vision, proper growth and differentiation, reproduction and maintenance of epithelial cells. Deficiency manifestations of the eyes - nyctalopia is one of the earliest symptoms of vitamin A deficiency. | 158,430 | medmcqa_train |
The best parameter for assessment of chronic malnutrition is - | parks textbook of preventive and social medicine 23rd edition * height is a stable measurement of growth as opposed to body weight .whereas the weight reflects only the present health status of the child,height indicate the events in the past also. *low height for age also knownn as nutritional stunting or drawfting.it reflects past or chronic mal nutrition. | 158,431 | medmcqa_train |
True about the basic structure of atherosclerosis plaque is ? | Ans. is 'c' i.e., Convex pa formed by fibrous cap | 158,432 | medmcqa_train |
Right border of heart is formed by all except - | Ans. is 'b' i.e., Right ventricle o Dont get confused with above question. Most probably this question has been framed by a radiologist. Read following factsi) Right border of heart is formed by (anatomically) - Right atrium.ii) Right border of heart is formed by (on X-ray PA view) - Right atrium (majority), SVC, I VC. o Similiarly-i) Left border of heart is formed by (anatomically) - Left atrium (mainly), left auricle.ii) Left border of heart is formed by (on X-ray PA view) - Aortic knucle, Pulmonary trunk, left auricle, left atrium, left ventricle. | 158,433 | medmcqa_train |
Rao and Singh's index is? | RAO & SINGH'S INDEX: - It is calculated as Weight (in kg) x 100/height2 (in cm) - Normal value: 0.14 - In children with malnutrition: 0.12 - 0.14 | 158,434 | medmcqa_train |
Adult scabies is characterized by? | A i.e. Involve palm & soles | 158,435 | medmcqa_train |
All are elevators of the larynx except - | Elevators : Primary elevators act directly as they are attached to the thyroid cartilage and include stylopharyngeus, salpingopharyngeus, palatopharyngeus and thyrohyoid. Secondary elevators act indirectly as they are attached to the hyoid bone and include mylohyoid (main), digastric, stylohyoid, geniohyoid.
Depressors : They include sternohyoid, sternothyroid and omohyoid. | 158,436 | medmcqa_train |
Leukemia associated with Disseminated Intravascular Coagulation is: | Major Disorders Associated With Disseminated Intravascular Coagulation (DIC)
Obstetric Complications
Abruptio placentae
Retained dead fetus
Septic Abortion
Amniotic fluid embolism
Toxemia
Infections
Sepsis (gram-negative and gram-positive)
Meningococcemia
Rocky Mountain spotted fever
Histoplasmosis
Aspergillosis
Malaria
Neoplasms
Carcinomas of pancreas, prostate, lung and stomach
Acute promyelocytic leukemia
Massive Tissue Injury
Trauma
Burns
Extensive surgery
Miscellaneous
Acute intravascular hemolysis, snakebite, giant hemangioma, shock, heatstroke, vasculitis, aortic aneurysm, liver disease.
Robbins BASIC PATHOLOGY T E N T H E D I T I O N page no.487 | 158,437 | medmcqa_train |
The effect of morphine which has least tolerance is? | ANSWER: (C) ConstipationREF: KDT 6th edition page 457Tolerance is exhibited to all actions except meiosis and constipation | 158,438 | medmcqa_train |
Stability of denture can be increased by | V-Y plasty procedure or Z plasty procedure is used for frenectomy procedure to increase the stability of denture. | 158,439 | medmcqa_train |
'Meralgia paresthetica' is due to the compression of which off the follwoing nerves? | Meralgia Paraesthetica results from compression neuropathy of the lateral cutaneous nerve of thigh. It is also called Bernhardt-Roth syndrome. This nerve can be compressed as it runs through the inguinal ligament, just medial to the Anterior superior Iliac spine. Pain, numbness, tingling and paresthesia localised to anterolateral aspect of thigh. Metabolic disorder most notably diabetes is identified as the potential cause of this condition. Ref: Apley's System of Ohopedics and Fractures 8th Edition, Page 252; Lippincott's Primary Care Ohopedics, 2008, Page 87. | 158,440 | medmcqa_train |
Example of secondary active transport- | Ans. is 'd' i.e., Na+-amino acid transport Transport mechanismExamplesSimple diffusionMovement of fats, oxygen, CO2 through lipid portion of membraneFacilitated diffusionMovement of glucose and some amino-acidsOsmosisMovement of water into and out of the cellPrimary active transportIons K+, Na+, Ca++, H+Secondary active transportGlucose or amino-acid into the cell along Na+ (Symport or cotransport) Ca+2, H+ out of the cell against Na+ (Antiport or countertransport) | 158,441 | medmcqa_train |
Microscopic examination of a specimen shows 'Schiller-Duval bodies'. This most probably will have: | Yolk sac tumor only occurs as a pure tumor in young males (at about 3 years of age). In adults, yolk sac tumors are pa of mixed germ cell tumors. One characteristic feature of yolk sac tumor is Schiller-Duval bodies, which resemble endodermal sinuses. Schiller-Duval bodies have a capillary at the core and are surrounded by a visceral and a parietal layer (i.e., resemble primitive glomerulus). Ref: Wyatt C., Butterwoh IV J.F., Moos P.J., Mackey D.C., Brown T.G. (2008). Chapter 17. Pathology of the Male and Female Reproductive Tract and Breast. In C. Wyatt, J.F. Butterwoh IV, P.J. Moos, D.C. Mackey, T.G. Brown (Eds), Pathology: The Big Picture. | 158,442 | medmcqa_train |
Pre-anaesthetic medication is given to ? | Ans. is 'd' i.e., All of the above Preanaesthetic medication Premedication (Preanaesthetic medication) refers to the use of drugs before anaesthesia to make it more pleasant and safe. The aims are : Relief of anxiety and apprehension preoperatively and to facilitate smooth induction. Amnesia for preoperative and postoperative events. Supplement analgesic action of anaesthetics and potentiate them. Decrease secretions and vagal stimulation (undesirable reflex). Antiemetic effect extending into postoperative period. Decrease acidity and volume of gastric juice so that it is less damaging if aspirated. Drugs used in premedication 1. Sedative - antianxiety - Diazepam / Lorazepam / Midazolam. Lorazepam is used most commonly. Midazolam is used for day care surgery. 2. Opioids - Morphine / pethidine 3. Anticholinergics -. Atropine / Hyoscine / Glycopyrrolate. 4. Neuroleptics Haloperidol / chlorpromazine / triflupromazine. 5. H2 blocker or proton pump inhibitor Ranitidine / Famotidine, omeprazole / Pantoprazole. 6. Antiemitics - Metoclopramide / Domperidone / Ondansetron. | 158,443 | medmcqa_train |
Rate limiting step in facilitated diffusion? | Ans. is'b'i.e., Conformational change in transpoer(Ref: Essentials of membrane Biophysics p. 25I).The relative slowness of the rate constant for conformational change reorienting the Solute-unoccupied transpoer (Step-4) makes it the rate-limiting step in the process of facilitated diffusion. | 158,444 | medmcqa_train |
Fixed performance device is – | Ventimask (venturi mask) is a fixed performance (high flow) oxygen delivery device.
Nasal cannula, non-rebreathing mask (Hudson mask) and simple mask are variable performance (low flow) devices. | 158,445 | medmcqa_train |
Hemivertebra is a defect of: | Ans. A. Bodya. Vertebral bodies mainly develop from ventral sclerotome (VS) and thus hemivertebra is a defect of VS.b. Hemivertebra can lead to defects in the vertebral column - scoliosis.c. Posterior vertebral arches (PVA) contribute mainly to the lamina & spines. PVA are contributed by the dorsal sclerotome. | 158,446 | medmcqa_train |
Not a metabolic product of urea cycle- | Biosynthesis of urea occurs in five steps.
1) Carbamoyl phosphate synthase-I (CPS-I), a mitochondrial enzyme, catalyzes the formation of carbamoyl phosphate by condensation of CO2 and ammonia.
Two molecules of ATP are required for the reaction. CPS-I is the rate-limiting enzyme of the urea cycle. It is an allosteric enzyme and allosterically activated by N-acetyl glutamate.
2) Ornithine transcarbamylase catalyzes the formation of citrulline from carbamoyl phosphate and ornithine.
3) Argininosuccinate synthase catalyzes the formation of argininosuccinate from citrulline and aspartate.
This reaction requires 1ATP, but 2 high energy phosphate bonds are consumed as ATP is converted to AMP + PPi.
The amino group of aspartate provides one of the two nitrogen atoms that appear in urea (The other one is provided by ammonia NH4).
4) Argininosuccinate lyase (argininosuccinase) catalyzes the cleavage of argininosuccinate into arginine and fumarate.
Fumarate enters in TCA cycle.
5) Arginase catalyzes the formation of urea from arginine by hydrolytic cleavage of arginine to yield urea and ornithine.
Ornithine is thus regenerated and can enter mitochondria to initiate another round of the urea cycle. | 158,447 | medmcqa_train |
A patient was operated for forearm fracture under general anesthesia under tourniquet. Following surgery, he was unable to move his fingers and there was sensory loss over the whole hand. Most common type of injury is: | Ans. A. NeuropraxiaTourniquet paralysis is usually Neuropraxia. Application of tourniquet may press on all the nerves passing beneath it, resulting in mostly neuropraxia. | 158,448 | medmcqa_train |
Most common source of error in a false positive finding of dental caries is: | Although this can be caused by a variation in the morphology of the tooth, the most common source of error is the misinterpretation of cervical burnout as dental caries. Cervical burnout produces an artifact that mimics a carious lesion near the cementoenamel junction (CEJ) area of the tooth.
As the X-ray beam meets the convex proximal surface of the tooth, those X-ray photons that pass almost tangentially through the tooth surface “see” less tooth structure than those photons that pass deeper through the tooth. This area of convexity is commonly located apical to the CEJ, near the normal height of the alveolar crest.
The thinner tooth structure here absorbs fewer X-rays; consequently the area appears relatively more radiolucent on an image. Cervical burnout can also be seen in multirooted teeth, when roots that are more buccally positioned do not overlap perfectly with a lingual or palatal root in a mesiodistal direction.
The presence of a shallow furcation on either the mesial or distal surface of the tooth can make the area appear more radiolucent. However, the presence of two overlapping roots can be confirmed by identifying the periodontal ligament spaces of each root. | 158,449 | medmcqa_train |
Tophi in gout found in all regions except | Ans. is 'b' i.e., Muscle Location of Tophi They are classically located along the helix of the ear. Can also be seen in :- Fingers Toes Prepattelar bursa Olecranon Although gout typically cuases joint inflammation, it can also cause inflammation in other synol-based structures, such as bursae and tendons. Tophi are collections of urate crystals in the soft tissues. They tend to develop after about a decade in untreated patients who develop chronic gouty ahritis. Tophi may develop earlier in older women, paicularly those receiving diuretics. | 158,450 | medmcqa_train |
A mother comes with her 3 year old female child with complain of that child is not eating anything. Her weight is 11 kg (50th percentile) and height is 88 cm. (75th percentile). What should be done next – | "Allowable normal range of variation in observation, is conventionally taken between 3'd and 97th percentile curves" -Ghai
This female child has weight (50 th percentile) and height (75th percentile) in normal range of variation (3rd-97th percentile).
So, nothing should be done actively and the parent should be assured that weight and height of the child are within normal range. | 158,451 | medmcqa_train |
Fornication and delusion of persecution, both are together seen in - | This question is tricky one as tactile hallucination (fornication) and delusion of persecution are seen both in cocaine as well as amphetamine abuse.
Read the question carefully, examiner has asked about the presence of fornication and delusion of persecution together.
In amphetamine abuse these two do not occur together → fornication (tactile hallucination) is seen in chronic abuse, where as paranoid ideation (delusion of persecution) occurs in acute intoxication.
On the other hand both delusion of persecution and fornication are seen together in chronic cocaine abuse. "Cocaine abuse can present with auditory hallucinations, tactile hallucination including fornication and paranoid delusion (delusion of persecution)" . | 158,452 | medmcqa_train |
IUCD must not be used in a woman with- | Pelvic tuberculosis is an absolute contraindication for IUD inseion. Absolute contraindications for IUD Relative contraindications for IUD Suspected Pregnancy PID Vaginal Bleeding of undiagnosed etiology Ca Cervix,Uterus or Adnexa and other pelvic tumours Previous Ectopic Pregnancy Anaemia Menorrhagia History of PID since last pregnancy purulent cervical discharge Congenital uterine malformations Unmotivated person | 158,453 | medmcqa_train |
All enveloped helical RNA viruses belong to one large group, which includes all of the following except: | Ans. d. Herpes | 158,454 | medmcqa_train |
Which toll like receptors are involved in action of bacterial endotoxins - | Ans. is 'b' i.e., II o Ten different mammalian Toll like receptors (TRRs) have been identified --> TLR 1 to 10. o TLRs are involved in responses to widely divergent types of molecules that are commonly expressed by microbial but not mammalian cells. TLR Microbial ligand molecules Peptidoglycan of Gram (+)ve bacteria zymosan of fungi GPI anchor of Trypanosomes Lipoarabinomannan of mycobacteria LPS (endotoxin) of Leptospira Lipoproteins of bacteria Double - stranded DNA of viruses LPS (endotoxin) of all other gram (-)ve bacteria HSF 00 of chlamydia Flagellin of bacteria CpG DNA of bacteria and protozoa Note ? o Bacterial endotoxin of all gram (-)ve organisms, bind to TLR-4, except Leptospira. o Endotoxin of leptospira binds to TLR-2. | 158,455 | medmcqa_train |
Mucocelr is commonly seen in sinus: | A mucocele is an epithelial lined,mucus containing sac completely filling the sinus and capable of expansion: Mucocele are most commonly formed in frontal sinus followed by Ethmoid,sphenoid and maxillary sinuses. Mucocele of frontal sinus presents as a swelking in the floor of frontal sinus above the inner canthus.Itbdisplaces the eyeball forward,downward and laterally. Ref Dhingra 6/e,p 198;Tuli 1/e,p 196. | 158,456 | medmcqa_train |
Investigation of choice for Entrapment Neuropathy is? | ANSWER: (B) MRIREF: Surgical management of pain by Kim Burchiel Page 658, Neurology by Jon Brillman 8f Scott Khan page 110EMG and nerve conduction studies are done to identity the site of entrapment. Imaging is done to rule out any occult fracture and MRI for visualization of entrapped nerve in the tunnel. MRI is the imaging investigation of choice as it demonstrated soft tissue like nerve, muscle and tendon. MRJ is sensitive for changes in compressed or entrapped nerves | 158,457 | medmcqa_train |
Graham Cole test refers to | Oral cholecystography (Graham Cole Test) Once considered the diagnostic test of choice for gallstones, oral cholecystography has been replaced by ultrasonography It involves oral administration of a Radiopaque compound that is absorbed, excreted by the liver, and passed into the gallbladder Successful visualisation of GB in oral cholecystography depends on Blood flow to liver Ability of the liver cells to excrete dye into the bile (functioning liver) Patency of hepatic and cystic duct system Ability of GB to concentrate to excreted dye (by absorbing water) Ref: schwaz's principle of surgery 10th edition Pgno : 1141 | 158,458 | medmcqa_train |
Node of Ranvier is seen in - | Ans. is 'c' i.e., Axons o Nodes of Ranvier are periodic gaps in the myelin sheath on the axon.o Neuron is the functional unit (basic unit of nervous tissue).o It is specialized for the function of reception, integration and transmission of information in the body,o The basic structure of neuron is best studied in a spinal motor neuron,o This cell has a 'cell body (soma)' with 5-7 small processes called 'dendrites'.o There is a long process called 'axon' that originate from "axon hillock (A thickned area of cell body from which axon originates)".o The first portion of the axon is called "initial segment".o In a motor neuron, the axon hillock and the initial segment of axon have the low est threshold for excitation0o Functionally speaking, the neuron can be divided into four zones : -Dendrides and Soma (cell body) - Receptor zoneAxon hillock of body & initial segment of axon - Generator area (Nerve impulse is generated) QAxon (main length) : - Transmitter zone (Transmits nerve impulse).The nerve terminals (Terminal knobs or buttons) : - Release zone (release neurotransmitters). | 158,459 | medmcqa_train |
Parasympathetic stimulation of nerves innervating the islets of the pancreas will: | The pancreatic islets receive innervation from both the sympathetic and parasympathetic nervous system. Stimulation of the parasympathetic system increases secretion of insulin from the B cells. Stimulation of the sympathetic system increases glucagon secretion from the A cells. Insulin is inhibited by sympathetic stimulation. Ref: Molina P.E. (2013). Chapter 7. Endocrine Pancreas. In P.E. Molina (Ed),Endocrine Physiology, 4e. | 158,460 | medmcqa_train |
A 25 yr old man presents for a routine examination The patient is tall and on examination was found to have an early diastolic murmur Family pedigree given what is the mode of inheritance of the disease in this patient | HISTORY SUGGESTIVE OF MARFANS SYNDROME . WHICH IS AD. REF : ROBBINS 10TH ED | 158,461 | medmcqa_train |
Rhinophyma is a slow growing tumour with the following pathology: | Rhinophyma or potato tumour is a slow growing benign tumour due to hyperophy of the sebaceous glands of the tip of nose. | 158,462 | medmcqa_train |
Best indicator of protein quality:- | Best indicator of protein quality: DIAAS (Digestible indispensable amino acid scores) > PDCAAS (Protein digestibility-corrected amino acid score) >NPU (Net protein utilization). DIAAS =100 x . NPU = 100 x (Nitrogen retained by the body) / (Nitrogen intake) Other indicators: Amino acid score, Biological value, Protein efficiency ratio. Amino acid score = 100x (mg of amino acid per gm of test protein)/(mg of same amino acid per gm of reference protein) Also remember, protein quantity is measured by protein energy ratio = 100 x energy from protein / total energy in diet. | 158,463 | medmcqa_train |
Amniocentesis for aneuploidy detection is best done at: | AMNIOCENTESIS Amniocentesis is the most commonly performed procedure used to diagnose fetal aneuploidy and other genetic conditions. Indications Diagnosis of fetal genetic disorders Congenital infections Alloimmunization Assessment of fetal lung maturity Therapeutic for polyhydramnios The most common types of prenatal diagnostic tests are: Chromosomal Micro Array to assess copy-number gains or losses karyotype analysis to test for aneuploidy, Fluorescent In Situ Hybridization ( FISH ) to identify gain or loss of specific chromosomes or vchromosome regions It is ideally done at 16-18 weeks.Early amniocentesis can be done between 13-15 weeks. | 158,464 | medmcqa_train |
What is the treatment modality for the following fracture? | Image shows patellar fracture. Tension band wiring is also used for: Patellar fracture Olecranon fracture Medial malleolus fracture Tension band wire are loop of wires passed around two bony fragments and then tightened to compress the fragments together. External fixation is done by using screws and is applicable to the tibia and pelvis. Indications of TBW: Fracture patella Fracture olecranon Fracture medial malleolus Fracture greater tuberosity Fracture greater trochanter | 158,465 | medmcqa_train |
Which of the following is true for Klinefilter's syndrome? | Klinefelter syndrome Rare disorder, Karyotype 47 XXY, Externally resembles a male in general body conformity, Penis small or normal, Testes small, Gynaecomastia, Appearance eunuchoid, Mentally retarded, Azoospermia,Infeility, Tall stature, Testosterone may help in Rx Breasts may need surgical excision. | 158,466 | medmcqa_train |
Endometrial cancer involving 50% of endometrium, extending to vagina, lymph nodes negative with positive peritoneal cytology is staged as | 3b FIGO STAGING OF ENDOMETRIAL CANCER STAGE I Cancer confined to corpus uteri IA --> Limited to endometrium IB --> < 1/2 myometrial thickness IC > 1/2 myometrial thickness STAGE II Tumour involves cervix but does not extend beyond uterus (la --> Cervical glandular involvement llb --> Cervical stromal involvement STAGE III Local and/or regional spread Ilia --> Uterine serosa, positive peritoneal washings Adnexal involvement Ilib -4 Vaginal involvement (lymph node absent) 111c --> Positive lymph node no pelvis and paraaoic lymph node STAGE IV Tumour widespread IVa - Bladder or bowel mucosa IVb --> Distant metastasis | 158,467 | medmcqa_train |
Mucopolysaccharide having anticoagulant action is? | Ans. is 'a' i.e., Heparin Heparin It is a parenteral indirect thrombin inhibitor. It is a on uniform mixture of straight chain polysaccharides with molecular weight 10, 000 - 20, 000. It contains polymers of two sulfated disaccharide units D glucosamine L iduronic acid and D glucosamine D glucuronic acid. Heparin is the strongest organic acid present in the body. | 158,468 | medmcqa_train |
Patients suffering from multidrug resistant tuberculosis can be treated with all the following drugs EXCEPT: | Multidrug-resistant (MDR) TB: is defined as resistance to both H and R and may be any number of other(1ST LINE) anti-TB drugs. MDR-TB has a more rapid course (some die in 4-16 weeks). Treatment of these cases is difficult, because one or more second line drugs are to be given for 12-24 months. If sensitivity of the TB bacilli is known, the drug/ drugs to which they are resistant is /are excluded and other first line drugs are prescribed along with 1-3 second line drugs. A total of 5-6 drugs are given. One of the FQs is generally included. ln case streptomycin is not being given, one out of kanamycin/ amikacin/ capreomycin should be added, because they are tuberculocidal. TOBRAMYCIN It was obtained from S. tenebrarius in the 1970s. The antibacterial and pharmacokinetic propeies, as well as dosage are almost identical to gentamicin, but it is 2-4 times more active against Pseudomonas and Proteus, including those resistant to gentamicin. However, it is not useful for combining with penicillin in the treatment oi enterococcal endocarditis. It should be used only as a reserve alternative to gentamicin. Serious infections caused by Pseudomonas and Proteus are its major indications. Ototoxicity and nephro toxicity is probably lower than gentamicin. ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:724,748 | 158,469 | medmcqa_train |
A 19 year old boy fell from the motorbike on his shoulder. The doctor diagnosed him as a case of Erb's paralysis. All of the following signs and symptoms will be observed in this boy, EXCEPT: | Due to Erb's paralysis there is damage of biceps brachii and supinator due to which there is loss of pronation of forearm. It is associated with loss of abduction at shoulder joint, loss of lateral rotation and loss of flexion at elbow joint and is not associated with loss of pronation at radioulnar joint.Erb's paralysis occur from damage at the Erb's point which is the meeting point of 6 nerves such as ventral rami of C5 and C6, suprascapular and nerve to subclavius of upper trunk and two divisions of upper trunk. Muscles paralysed are supraspinatus, deltoid, teres minor, infraspinatus, biceps brachii, brachialis, brachioradialis and supinator. PositionParalysis ofOveraction of Adduction of armSupraspinatus and deltoidAdductors of the shoulderMedial rotation of the armTeres minor and infraspinatusMedial rotators of the shoulderExtension of forearmBiceps brachii, brachialis and brachioradialisExtensors of elbowPronation of forearmBiceps brachii and supinatorPronators of forearmRef: Clinical Anatomy for Students: Problem Solving Approach By Neeta V. Kulkarni page 20. | 158,470 | medmcqa_train |
Cut off duration for diagnosis of Priaspism is: | Priapism: It is defined as a persistent painful erection lasting longer than 4 hours irrespective of any sexual stimulation & beyond reaching of orgasm. It is an emergency situation It is of two types: Ischemic priapism Non-ischemic priapism | 158,471 | medmcqa_train |
Most common cause of biliary stricture is:- | MC cause of benign biliary stricture is laparoscopic cholecystectomy (operative trauma). | 158,472 | medmcqa_train |
A patient gives history of recurrent episodes of pain and swelling in Mandibular posterior region.He is diagnosed to have pericoronitis.The partially erupted 3rd molar was vital.On radiographical examination a well defined radiolucency was found with distal aspect of the respected tooth. What could be the daignosis: | Paradental Cyst
Aka:
Baccal bifurcation Cyst
Craig’s cyst
Collateral cyst
Mandi 3rd molar – Association.
Associated with VITAL TOOTH and recurrent pericoronitis DISTAL Aspect of mandi 3rd molar | 158,473 | medmcqa_train |
Warm antibody in autoimmune hemolytic anemia | Warm antibody is IgG. | 158,474 | medmcqa_train |
A 35-year-old coal worker presents with difficulty in breathing on exeion for last 2 years. CXR was performed. What does it show? | The CXR of Coal worker patient shows the presence of hyperinflation in lungs with a tubular appearance of the hea. Lungs appear relatively blacker with flattening of the diaphragm on both sides. The hea appears smaller as lungs are hyper-inflated. These findings are suggestive of emphysema. | 158,475 | medmcqa_train |
Which of the following is not a direct route for transmission of communicable diseases? | Ref. Foundations of Community medicine. Page. 393 | 158,476 | medmcqa_train |
Which is not associated with diabetes mellitus? | Coisol, growth hormone and catecholamines increase the blood sugar levels leading to impaired glucose tolerance or diabetes mellitus. whereas hypothyroidism is not associated with the blood sugar levels or diabetes mellitus | 158,477 | medmcqa_train |
Which of the following anaesthetic agents causes a rise in the Intracranial pressure – | All inhalational agents increase ICT.
Amongst intravenous agents only ketamine increases ICT. Propofol, etomidate, and barbiturates (thiopentone, methexitone) decrease ICT.
Lidocaine decreases ICT. | 158,478 | medmcqa_train |
A study is looking at breast cancer of women compared cases with non-cases, and found that 75/100 cases used calcium supplements compared with 25/100 of the non-cases. Calculate Cross product ratio | Odds ratio = ad/bc Breast cancer cases Non-cases Used Ca supplements 75 (a) 25 (b) Did not use Ca supplements 25 (c) 75 (d) 100 100 Odds ratio = ad/bc = 75*75/25*25 = 9 | 158,479 | medmcqa_train |
Oculomotor nerve palsy show all of the following except - | Ans. is 'b' i.e., Inability of lateral gaze Features of 3rd (occulomotor) nerve palsy* Paralysis of superior rectus, inferior rectus, medial rectus and inferior oblique. Eye is down and out due to unopposed action of superior oblique and lateral rectus. Medial 8c upward gaze is not possible.* Paralysis of sphinctor pupillae - Loss of ipsilateral direct and consensual pupillary light reflex and there is mydriasis.* Paralysis of ciliary muscle - Paralysis of accommodation.* Two extraocular muscles are sparedi) Superior oblique :- Intorsion, abduction and depression remain active.ii) Lateral rectus :- Abduction remains active. So eye is deviated lateraly.* Paralysis of levator palpabrae superioris -> Ptosis. | 158,480 | medmcqa_train |
True about tropomysin is? | ANSWER: (B) Lies on top of actinREF: Guyton 12th ed page 72-76SLIDING FILAMENT THEORY OF MUSCLE CONTRACTION:In resting muscle, the ends of the actin filaments extending from two successive Z discs barely begin to overlap one another. Troponin I is tightly bound to actin and tropomyosin covers the sites where myosin heads bind to actin i.e the tropomyosin molecules lie on top of the active sites of the actin strands, Thus, the troponin-tropomyosin complex constitutes a "relaxing protein" that inhibits the interaction between actin and myosin filaments to cause contractionIn contracted state, these actin filaments have been pulled inward among the myosin filaments, so their ends overlap one another to their maximum extent. Also, the Z discs have been pulled by the actin filaments up to the ends of the myosin filaments. Thus, muscle contraction occurs by a sliding filament mechanism.Actin filaments slide inward among the myosin filaments by forces generated by interaction of the cross-bridges from the myosin filaments with the actin filaments. Under resting conditions, these forces are inactive. But when an action potential travels along the muscle fiber, this causes the sarcoplasmic reticulum to release large quantities of calcium ions that rapidly surround the myofibrils. When the Ca2+ released by the action potential binds to troponin C, the binding of troponin I to actin is presumably weakened, and this permits the tropomyosin to move laterally. This movement uncovers binding sites for the myosin heads. ATP is then split and contraction occurs. Seven myosin-binding sites are uncovered for each molecule of troponin that binds a calcium ion. But energy is needed for the contractile process to proceed. This energy comes from high-energy bonds in the ATP molecule, which is degraded to adenosine diphosphate (ADP) to liberate the energy.Molecular Basis of ContractionThe process by which the shortening of the contractile elements in muscle is brought about is a sliding of the thin filaments over the thick filaments. The width of the A bands is constant, whereas the Z lines move closer together when the muscle contracts and farther apart when it is stretched. The sliding during muscle contraction occurs when the myosin heads bind firmly to actin, bend at the junction of the head with the neck, and then detach. This "power stroke" depends on the simultaneous hydrolysis of ATP. Myosin-II molecules are dimers that have two heads, but only one attaches to actin at a time. The process by which depolarization of the muscle fiber initiates contraction is called excitation-contraction coupling.Steps in contractionDischarge of motor neuron.Release of transmitter (acetylcholine) at motor end-plate.Binding of acetylcholine to nicotinic acetylcholine receptors.Increased Na+ and K+ conductance in end-plate membrane.Generation of end-plate potential.Generation of action potential in muscle fibers.Inward spread of depolarization along T tubules.Release of Ca2+ from terminal cisterns of sarcoplasmic reticulum and diffusion to thick and thin filaments.Binding of Ca2+ to troponin C, uncovering myosin-binding sites on actin.Formation of cross-linkages between actin and myosin and sliding of thin on thick filaments, producing movementSteps in relaxationCa2+ pumped back into sarcoplasmic reticulum.Release of Ca2+ from troponin.Cessation of interaction between actin and myosin. | 158,481 | medmcqa_train |
A male neonate is born with an omphalocele. This entity can be distinguished from gastroschisis, because in an omphalocele, the protrusion is: | Abdominal wall defects Omphalocele- Intestine fails return to the intra-abdominal cavity- Covered by 2 layers* Amnion* Peritoneum- For Small defect - Protrusion of small amounts of bowel- For Large defect - Protrusion of small bowel along with liver- Associated with Trisomy 13, 18, 21- Associated with congenital malformations - CVS > Musculoskeletal system >Gastrointestinal system > Genito urinary system- MC cause of death - congenital malformations- Associated with BECKWITH - WEIDMAN SYNDROME (variant of Wilms tumour)* Hemi hyperophy* Macroglossia* Visceromegaly* Omphalocele* Hepatoblastoma- Poor prognosis (associated with congenital malformations) Gastroschisis- Splitting of abdominal wall from right side with herniation of bowel.- Bowel is exposed, not covered and becomes thickened,matted and edematous- Associated with Intestinal atresiaRisk factors- If mother has history of intake of* Alcohol* Smoking* Aspirin during first trimester* Ibuprofen* Pseudoephedrine- Age of mother - < 20 years age- Not associated with congenital anomalies - so good prognosis | 158,482 | medmcqa_train |
Following grows in the cell free medium except -a) Rickettsiab) M lepraec) Bartonellad) Syphilis | Obligate intracellular organisms
To grow in a medium which does not contain cells (cell free medium), organism should be capable of ATP synthesis.
Obligate intracellular organisms are not capable of the metabolic pathways for ATP synthesis.
So, these organisms are dependent on the ATP of host cells.
As they require host cell ATP, they can not grow in the media which do not contain cells (cell free media).
Such organisms are -
Rickettsiae
Chlamydiae
Viruses
M.leprae
Pathogenic treponemes (syphillis) | 158,483 | medmcqa_train |
Stage X3B refers to the following in the classification of vitamin A deficiency: | d. Keratomalacia(Ref: Nelson's 20/e p 3 IB-320, Ghai B/e p 111-112)WHO classification of Vitamin A deficiency:IndicatorCategoryNight blindnessXNConjunctival xerosisX1ABitot's spotsX1BCorneal xerosisX2Corneal ulcerationX3AKeratomalaciaX3BXerophthalmia-related corneal scarsXS | 158,484 | medmcqa_train |
Clue cell is seen in aEUR' | Bacterial vaginosis Clue cells are seen in bacterial vaginosis -Clue cells are vaginal epithelial cells coated with coccobacillary organisms which have granular appearance and indistinct borders, on a wet mount prepared by mixing vaginal secretions with normal saline in a ratio of -1:1. Amsel criteria for the diagnosis of bacterial vaginosis Includes any three of the following four clinical abnormalities i) Objective signs of increased white homogenous vaginal discharge. ii) Vaginal discharge pH of >4.5 iii) Liberation of distinct .fishy odour (attributable to volatile amines such as trimethylamine) immediately after vaginal secretions are mixed with a 10% solution of KOH. iv) Microscopic demonstration of clue cells. | 158,485 | medmcqa_train |
When ICF and ECF of child becomes equal to adult person - | Ans. is 'a' i.e., 1 year o In fetus, ECF is much larger than ICF. o By the age of 1 year, ratio of ICF to the ECF volume approaches adult level. | 158,486 | medmcqa_train |
The most important function of the microcirculation is: | Ans. A. The exchange of nutrients and wastes between blood and tissueEach of the choices is a function of the microcirculation, but its most important function by far is to provide tissue with nutrients and remove the wastes. | 158,487 | medmcqa_train |
Altitudnal Field Defects are seen in | Non aeritic AION Impoant Points on Visual Pathway Lesions 1. Optic nerve lesion I/l direct and c/ L consensual reflex gone Causes *Optic atrophy/ optic neuritis, Avulsion optic nerve 2. Middle Chiasmal syndrome/ Central Chiasmal lesion Saggital chiasma lesion Bitemporal hemianopia | 158,488 | medmcqa_train |
What is the treatment for headache in a case of peptic ulcer disease? | Propoxyphene binds primarily to opioid receptors and produces analgesia and other CNS effects that are similar to those seen with morphine-like opioids. It is likely that at equianalgesic doses the incidence of side effects such as nausea, anorexia, constipation, abdominal pain, and drowsiness are similar to those of codeine. All other choices produce gastric ulceration. Ref: Yaksh T.L., Wallace M.S. (2011). Chapter 18. Opioids, Analgesia, and Pain Management. In L.L. Brunton, B.A. Chabner, B.C. Knollmann (Eds), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e. | 158,489 | medmcqa_train |
Which of the following is not estrogen dependant carcinoma | Refer Robbins page no 1095 | 158,490 | medmcqa_train |
Vogt Koyanagi - Harada (VKH) syndrome is - | (Ref: Khurana 7th/e p.175 & 4th/e p.156) VKH syndrome is a multisystem disorder characterized by chronic granulomatous uveitsi with exudative retinal detachment that is often associated with neurological and cutaneous manifestations. | 158,491 | medmcqa_train |
Gallstones do not contain: | Gallstones In the USA and Europe, 80% are cholesterol or mixed stones, whereas in Asia, 80% are pigment stones Cholesterol or mixed stones - 51-99% pure cholesterol Pigment stone contains <30% cholesterol Black stones - Insoluble bilirubin polymer + calcium phosphate + calcium bicarbonate Brown pigment stones- calcium bilirubinate+ calcium palmitate + calcium stearate+ cholesterol | 158,492 | medmcqa_train |
Typical CECT finding to suggest the diagnosis of pseudomyxoma peritonei is: | CT-scan findings may be pathognomonic for pseudomyxoma peritonei, Typical CT appearance 1. Areas of low attenuation, with islands of higher attenuation due to solid elements within mucinous material. 2. Classically scalloping of visceral surfaces, paicularly of the liver and spleen Ref: World J Gastrointest Oncol 2010 January 15; 2(1): 44-50. | 158,493 | medmcqa_train |
The given ECG shows | Ans. B. Pulmonary embolism* The given ECG shows changes corresponding with pulmonary embolism.* Changes are- Sinus tachycardia- S1Q3T3 pattern (T-wave inversion in III)- Incomplete RBBB- Right precordial T-wave inversions* Consistent with acute RV overload in a patient with pulmonary emboli | 158,494 | medmcqa_train |
Which of the following is not an effect of cholinergic muscarinic receptor stimulation: | Stimulation of muscarinic receptors decreases BP. | 158,495 | medmcqa_train |
Branched chain aminoacid is used in: | Ans: d (Isolated hepatic failure)Ref: Various internet sitesBranched chain amino acids are used in hepatic encephalopathy to improve mental function and muscle control.They have been tried in burns, sepsis and trauma but without much success.Eg of branched chain amino acid -valine, leucine and isoleucine. | 158,496 | medmcqa_train |
All are true about in pubey menorrhagia Except: | Endometrial biopsy confirms diagnosis REF: Novak's gynecology 13' edition - page 152 Causes of mennorhagia in adoloscese Anovulatory bleeding Pregnancy-related Bleeding Exogenous Hormones Hematologic Abnormalities Infections Anatomic Causes Obstructive or paially obstructive genital anomalies typically present during adolescence. mUllerian abnormalities, such as obstructing longitudinal vaginal septa or uterus didelphisolycystic ovarian syndrome Diagnosis Any adolescent with abnormal bleeding should undergo sensitive pregnancy testing, regardless of whether she states that she has had intercourse. Laboratory Testing In addition to a pregnancy test, laboratory testing should include a complete blood count with platelets, coagulation studies, and bleeding time. Thyroid studies also may be appropriate. A complete pelvic examination is appropriate if the patient has been sexually active, is having severe pain, or an anomaly is suspected. Cultures for gonorrhea and testing for chlamydia infection are appropriate if the patient has been sexually active. Some young teens who have a history that is classic for anovulation, who deny sexual activity, and who agree to return for follow-up evaluation may be managed with a limited gynecologic examination and pelvic ultrasonography Imaging Studies If the pregnancy test is positive, pelvic imaging using ultrasonography may be necessary to confirm a ble intrauterine pregnancy and rule out a spontaneous aboion or ectopic pregnancy. If a pelvic mass is suspected on examination, or if the examination is inadequate (more likely to be the case in an adolescent than an older woman) and additional information is required, pelvic ultrasonography may be helpful Management Management of bleeding abnormalities related to pregnancy, thyroid dysfunction, hepatic abnormalities, hematologic abnormalities, or androgen excess syndromes should be directed to treating the underlying condition. Oral contraceptives can be extremely helpful in managing androgen excess syndromes. After specific diagnoses have been ruled out by appropriate laboratory testing, anovulation or dysfunctional bleeding becomes the diagnosis of exclusion. | 158,497 | medmcqa_train |
'Murphy sign' is associated with: March 2004 | Ans. A i.e. Acute cholecystitis | 158,498 | medmcqa_train |
Schneiderian First rank symptoms are found in : | A >> B, C The presence of one of these Schneider's first rank symptoms (SFRS) in the absenc of intoxication, brain injury or clear affective illness, was sometimes taken as sufficient for making diagnosis of schizophrenia (Kaplan). SFRS are not specifc for schizophrenia and may be seen in other psychiatric disorders such as mood disorderQ and organic psychiatric disordersQ (Ahuja)/affective psychosis (New oxford) Schneider first rank symptoms, which he believed were pathognomic of schizophrenia (& became the forerunner of notion of positive signs & symptoms ), are now known not to be specific for schizophrenia, for they may also occur in mania, drug induced states, other disordersQ (CDTP) Classification of schizophrenia like disorders include cases that resemble schizophrenia in some respects and yet do not meet the criteria for diagnosis. These include ICD-10 DSM - IV Schizoaffective disorder Schizo affective disorder Persistent delusional disorders Induced delusional disorder Delusional disorder Shared psychotic disorder Acute & transient psychotic disorder Acute schizophrenia like psychotic disorder Brief psychotic disorders Schizophreniform disorder Unspecified non organic psychosis Psychotic disorder not otherwise specified Schizotypal disorder, Other non organic psychotic disorders ? | 158,499 | medmcqa_train |
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