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Cause of death in Carcinoma penis is usually - | Inguinal lymph nodes erode the skin of the groin and the death of the patient may be due to involvement of the femoral or external iliac artery with torrential hemorrhage. | 158,600 | medmcqa_train |
All are true about levamisole EXCEPT: | Levamisole- Active against many nematodes, but use is restricted to ascariasis and ancylostomiasis because the action on other worms is poor. The ganglia in worms are stimulated causing tonic paralysis and expulsion of live worms. Interference with carbohydrate metabolism (inhibition of fumarate reductase)may also contribute. It is an immunostimulant, used for slow spreading vitiligo to be used for at least 6 weeks ESSENTIALs of MEDICAL PHARMACOLOGY SIXTH EDITION -KD TRIPATHI Page 812 | 158,601 | medmcqa_train |
In patients with osteoahritis of knee joint, atrophy occurs most commonly in which muscle : | Quadriceps only Met Maheshwari 3/e, p 253;Apley's 8/e, p 472] In osteoahritis of knee joint, the quadriceps muscle is usually wasted. | 158,602 | medmcqa_train |
All of the following are pyrogenic cytokines, Except- | Ans. is 'a' i.e., Interleukin 18 (IL-18) Interleukin 18 is not a pyrogenic cytokine. | 158,603 | medmcqa_train |
All of the following are known causes of recurrent aboion, except: | SLE is associated with antiphospholipid syndrome (anti cardiolipin antibodies) and is known to cause recurrent aboions. RH incompatibility is a known cause for spontaneous aboion and may lead to recurrent aboions if it remains unrecognized. Syphilis has also lead to recurrent aboion. TORCH is thus the single best answer of exclusion. Ref: Gynaecology for Postgraduates and Practitioners By Sengupta, Pages 187-92; Textbook of High Risk Pregnancy By Hemant Deshpande, Hemant, Pages 248-49 | 158,604 | medmcqa_train |
Pontaic, fever is caused by - | Ans. is 'a' i.e., Legionella | 158,605 | medmcqa_train |
A patient presents with fever, cough with sputum and weight loss. He has a history of not completing treatment for tuberculosis thrice in the past. XDR-TB is suspected. How is XDR-Tb defined? | XDR-TB (Extensively drug-resistant TB) is defined as MDR TB (Resistant to rifampicin and isoniazid) + Resistant to one fluoroquinolone (eg. ofloxacin) + resistance to one injectable second line drug (Amikacin or kanamycin or capreomycin). Reference: Ananthanarayan and Paniker&;s Textbook of Microbiology Tenth edition | 158,606 | medmcqa_train |
False about acute aluminium phosphate poisoning: | D i.e. Oesophageal stricture Aluminium (zinc) phosphide or celphos poisoning liberates phosphine gas which inhibits mitochondrial cytochrome oxidase, respiratory chain enzymes and electron transpo systemQ. It is a systemic poison and kills most of patients with in 24 hours secondry to cardiovascular collapse d/t direct myocardial toxic effect( 2. Oesophageal strictures and fistula occur in few survivors (which are already very few) in late stages. So this is late complication of least occurance (among other options) | 158,607 | medmcqa_train |
Injury occurs at C7 root, in what pa of arm, sensation will be lost ? | Ans. is 'd' i.e., None of the above | 158,608 | medmcqa_train |
A child having delayed separaion of umbilical cord with leukocytosis with Downs syndrome and recurrent infections. Diagnosis ? | Leukocyte adhesion deficiency (LAD) is a rare primary immunodeficiency. The clinical picture is characterized by marked leukocytosis and localized bacterial infections that are difficult to detect until they have progressed to an extensive level secondary to lack of leukocyte recruitment at the site of infection. Thus the infections in patients with leukocyte adhesion deficiency act similarly as those observed in patients with neutropenia. See the images below. Reference: GHAI Essential pediatrics, 8th edition | 158,609 | medmcqa_train |
False regarding Cytochrome P 450 is ? | Ans. is d i.e., They are non heme proteins CYTOCHROME P450 They CYP450 are essential for the production of cholesterols, steroids, prostacyclins and thromboxane A2. They are also essential for the metabolism of foreign chemicals and detoxification of drugs. CYP 450 enzymes are so named because they are bound to membranes within a cell (cyto) and contain a heme pigment (chrome and P) that absorbs light at a wavelength of 450 nm when exposed to carbon monoxide. There are more than 50 CYP450 enzymes, but the CYP1A2, CYP2C9, CYP2C19, CYP2D6, CYP3A4, and CYP3A5 enzymes metabolize 90 percent of drugs. | 158,610 | medmcqa_train |
The mode of inheritance of Incontinentia pigmenti is - | Ans- C X-linked dominant | 158,611 | medmcqa_train |
Ramu, presents with recurrent attacks of cholelithiasis, U/S examination shows a dilated CBD of 1 cm. The next line of management is ? | Ans. is A ie. ERCP The first inv. for any pt. with cholelithiasis or jaundice is U/S. Next inv. depends on U/S findings, If the intrahepatic ducts are dilated without any extrahepatic dilatation then the preferred inv. is ----> PTC* If the dilatation is in CBD ---> ERCP*. ERCP may provide direct diagnosis of the distal CBD pathology and may be therapeutic as well for a CBD stone or stricture. | 158,612 | medmcqa_train |
A 50 year old male patient came with the complaint of palpitations. Examination of pulse revealed irregular heabeat and advised ECG recording. Spread of cardiac impulse is fastest in which of the following structure | Conduction speed in cardiac tissue: Tissue Conduction Rate SA node 0.05 Atrial pathways 1 AV node 0.05 Bundle of His 1 Purkinje system 4 Ventricular muscle 1 Purkinje fibers also have the ability of firing at a rate of 15-40 beats per minute if upstream conduction or pacemaking ability is compromised. In contrast, the SA node in normal state can fire at 60-100 beats per minute. In sho, they generate action potentials, but at a slower rate than sinoatrial node. This capability is normally suppressed. Thus, they serve as the last reso when other pacemakers fail. When a Purkinje fiber does fire, it is called a premature ventricular contraction or PVC, or in other situations can be a ventricular escape. It plays a vital role in the circulatory system. Reference: Ganong's Review of Medical Physiology; 25th edition; Page no: 522 | 158,613 | medmcqa_train |
Golgi tendon apparatus conveys message to CNS, depends upon: | Golgi tendon organs are in series with the muscle fibers, they are stimulated by both passive stretch and active contraction of the muscle, when tension increases inside muscle. | 158,614 | medmcqa_train |
Best stimuli for secretin is- | B i.e. Acid | 158,615 | medmcqa_train |
Drugs used in congestive hea failure are All except | As a medication, adrenaline is used to treat a number of conditions including anaphylaxis, cardiac arrest, and superficial bleeding. Inhaled adrenaline may be used to improve the symptoms of croup. It may also be used for asthma when other treatments are not effective. It is given intravenously, by injection into a muscle, by inhalation, or by injection just under the skin. Common side effects include shakiness, anxiety, and sweating. A fast hea rate and high blood pressure may occur. Occasionally it may result in an abnormal hea rhythm. While the safety of its use during pregnancy and breastfeedingis unclear, the benefits to the mother must be taken into account Refer kDT 6/e p502 | 158,616 | medmcqa_train |
All are transmitted by blood except - | Ans-CEpstein Barr Virus??? Viruses associated with blood transfusion:Hepatitis C virus:Hepatitis G virus:Hepatitis B virusHIV type IHTLV Type ICytomegalovirusParvovirus B-19HGVA recently discovered and identified non A-E hepatitis virus has been designated the name Hepatitis G virus (HGV) which is a member of Flaviviridae family.HGV is distinct from hepatitis C virus (HCV) and the newly discovered GBV-A and GBV-B agents.The structure of the HGV genome resembles that of HCV.HGV replicates in peripheral blood cells I while replication in liver cells has not been observed till date. It does not appear to cause liver disease.Epidemiological data indicates that virus is prevalent throughout the world and has clearly reestablished transmission modes which are: -Blood and Blood productsSexual transmissionEBV can also be transmitted by blood transfusion.- EBV os present in the transfused WBC.The leucocyte associated viruses are: -CMVEBVHHV-8 (Human herpes virus type 8)HTLV-1 &HTLV-IIHIVWe are not sure of the answer.Now we should look for the virus which is least commonly transmitted.There is confusion in this too because both EBV and Parvovirus are rare with transfusion.An important point * All the viruses mentioned in the question are not routinely screened for blood transfusion.The American Red Cross performs laboratory tests for multiple infectious disease markers on every unit of donated blood.These tests includes: -Chagas diseaseHepatitis B virus (HBV)Hepatitis C virus (HCV)HIV (1,2)HTLV-ISyphilisWest Nile virus (WNV) | 158,617 | medmcqa_train |
An adult patient presents with leg pain. On examination there is gangrene of his toe. What would be the ankle to brachial aerial pressure ratio in this patient ? | Since this patient has developed gangrene of the toe ankle to brachial presure ratio should be less than 0.3. Ratio of ankle to brachial systolic pressure (ankle brachial index) is obtained to determine the presence and magnitude of occlusive disease. The ankle brachial index of 0.9 - 1.0 indicates normalcy or minimal aerial occlusive disease. ABI of 0-5 -0.9 signifies claudication level. ABI less than 0.5 signifies presence of ischemic rest pain or severe occlusive aerial disease. ABI less than 0.3 is compatible with trophic changes over the lower extremity. | 158,618 | medmcqa_train |
The infection that is spreading to the newborn by caregivers? | Ans is (c) i.e Candida Paraspilosis Ref Clin MicroHol Rev. Oct 2008: 21(4): 606-625 Candida parapsilosis is an emerging major human pathogen that has dramatically increased in significance and prevalence over the past 2 decades, such that C. parapsilosis is now the second leading causes of invasive candidal disease. Individuals at the highest risk for severe infection include neonates and patients in intensive care units. C. parapsilosis infections are especially associated with hyperalimentation solutions, prosthetic devices, and indwelling catheters, as well as the nosocomial spread of disease through the hands of health care workers. Factors involved in disease pathogenesis include the secretion of hydrolytic enzymes, adhesion to prosthetics, and biofilm formation. Impoant Points about Candida parapsilosis Candida species are presently the fouh leading cause of nosocomial bloodstream infection. Candida albicans is the most frequent isolate from blood cultures followed by Candida parapsilosis C. parapsilosis does not form true hyphae and exists in either a yeast phase or a pseudohyphal form. C. parapsilosis is notorious for its capacity to grow in total parenteral nutrition and to form biofilms on catheters and other implanted devices, for nosocomial spread by hand carriage. C. parapsilosis is of special concern in critically ill neonates, causing more than one-quaer of all invasive fungal infections in low-bih-weight infants. Additionally, it is the predominant fungal organism isolated in many neonatal intensive care units (NICUs), where it is often associated with neonatal moality C. parapsilosis is also a normal human commensal, and it is one of the fungi most frequently isolated from the subungal space of human hands C. parapsilosis fungemia can lead to seeding of tissues, resulting in deep-seated infections, and has a moality rate ranging from 4% to 45% Compared to C. albicans, C. parapsilosis more frequently caused fungemia among neonates, in patients with intravenous lines or vascular catheters, who had received prior antifungal agents, were on parenteral nutrition, or had undergone transplantation. | 158,619 | medmcqa_train |
Hepatotoxic drugs are | Refer KDT 6/e p372 Massive liver necrosis following Halothane anaesthesia is seen in some cases If chloroform cos given for long period liver damage occurs | 158,620 | medmcqa_train |
Which of the following statement is false regarding phenobarbitone: September 2011 | Ans. D: N significant interaction with warfarin Barbiturates stimulates hepatic microsomal catabolism of warfarin Phenobarbital/ Phenobarbitone It is a barbiturate It is the most widely used anticonvulsant worldwide, and the oldest still commonly used. The World Health Organization recommends its use as first-line for paial and generalized tonic-clonic seizures (those formerly known as grand mal) in developing countries. It is still commonly used to treat neonatal seizures. Phenobarbital is indicated in the treatment of all types of seizures except absence seizures. Sedation and hypnosis are the principal side effects (occasionally, they are also the intended effects) of phenobarbital. Central nervous system effects like dizziness, nystagmus and ataxia are also common. In elderly patients, it may cause excitement and confusion while in children, it may result in paradoxical hyperactivity. Another very rare side effect is amelogenesis imperfecta Contraindication: Acute intermittent porphyria, oversensitivity for barbiturates, prior dependence on barbiturates, severe respiratory insufficiency and hyperkinesia in children The principal mechanism of action of barbiturates is believed to be their affinity for the GABAA receptor (Acts on GABA : BDZ receptor Cl- channel complex). GABA is the principal inhibitory neurotransmitter in the central nervous system (CNS). Barbiturates bind to the GABAA receptor at the alpha subunit, which are binding sites distinct from GABA itself. Like benzodiazepines, barbiturates potentiate the effect of GABA at this receptor. In addition to this GABA-ergic effect, barbiturates also block the AMPA receptor, a subtype of glutamate receptor. Phenobarbital has an oral bioavailability of approximately 90%. Peak plasma concentrations are reached 8 to 12 hours after oral administration. It is one of the longest-acting barbiturates available - it remains in the body for a very long time (half-life of 2 to 7 days) and has very low protein binding (20 to 45%). Phenobarbital is metabolized by the liver, mainly through hydroxylation and glucuronidation, and induces many isozymes of the cytochrome P450 system. Cytochrome P450 2B6 (CYP2B6) is specifically induced by Phenobarbital It is excreted primarily by the kidneys Phenobarbital markedly reduces effect of warfarin | 158,621 | medmcqa_train |
Optic tract fibers project to the superior colliculi for | Optic tract fibers project to the superior colliculi for reflex gazesPretectal area for the light reflexSuprachiasmatic nucleus of the anterior hypothalamus for generation of circadian rhythms | 158,622 | medmcqa_train |
Traid of Bulgar urethral injury includes all except | Pelvic hematoma occurs in membranous urethral injury not bulbar urethral injury. | 158,623 | medmcqa_train |
Which of the following deals with section 377, I.P.C? | Voluntary sexual intercourse against the order of nature with any man, woman, or animal is an unnatural sexual offence (Section 377 I.P.C). Penetration is sufficient to constitute the offence. These offences are punishable with imprisonment for life or upto ten years and also with fine. Ref: The Essentials of Forensic Medicine and Toxicology, 27th edition, Page 363. | 158,624 | medmcqa_train |
A 60-year man had undergone cardiac bypass surgery 2 days back. Now he staed forgetting things and was not able to recall names and phone numbers of his relatives. What is the probable diagnosis? | The history of cardiac surgery 2 days prior followed by behavioral changes is suggestive of delirium. The question here is stressing on "disturbances of memory" which can be seen in delirium, however are usually restricted to sho term memory loss. The other impoant features such as clouding of consciousness and attention impairment have not been provided. Nonetheless, the most likely diagnosis appears to be delirium. As delirium has prominent cognitive dysfunction, that is the correct answer. Alzheimer disease does not have such sudden onset. | 158,625 | medmcqa_train |
Striatum damage affects priming | Implicit memory is subdivided into 4 types. Procedural memory includes skills and habits, which one acquired become unconscious and automatic. Priming is facilitation of recognition of words or objects by prior exposure to them. Ganong&;s review of medical physiology; 23rd edition; pg: 290 | 158,626 | medmcqa_train |
In facial palsy, food accumulated in the mouth due to paralysis of | (D) Buccinator > The facial nerve contributes to the oropharyngeal phase of deglutition via the buccinator, perioral, digastricus posterior, and stylohyoid muscles. The gustatory and salivatory functions of the facial nerve are also known to contribute to swallowing.> The relation between peripheral facial nerve palsy (PFP) and swallowing dysfunction has never been studied systematically | 158,627 | medmcqa_train |
Glycogen phosphorylase coenzyme associated is? | ANSWER: (D) Pyridoxal phosphateREF: Lehninger Principles of Biochemistry 4th edition page 562Pyridoxal phosphate is an essential cofactor in the glycogen phosphorylase reaction; itsphosphate group acts as a general acid catalyst, promoting attack by Pi on the glycosidic bond. (This is an unusual role for this cofactor; its more typical role is as a cofactor in amino acid metabolism)Flavin mononucleotide (FMN), or riboflavin-5'-phosphate, is a biomolecule produced from riboflavin (vitamin B2) by the enzyme riboflavin kinase and functions as prosthetic group of various oxidoreductases including NADH dehydrogenase as well as cofactor in biological blue- light photo receptors | 158,628 | medmcqa_train |
The minimum number of feeding days in a year recommended, under Mid-day meal programme is | Recommended norms of 450 Kcal and 12 g protein for a minimum of 200 days Ref : Park 23rd edition Pgno :661 | 158,629 | medmcqa_train |
Most characteristic eye lesion in diabetes is | Most characteristic - Capillary aneurysm. | 158,630 | medmcqa_train |
A 24-year-old female complains of suicidal ideation. She lost her family in a car accident earlier this year. Since then, she had problems with focusing on her work. She was laid off from her work as she was making many errors due to false judgment. She was rescued from suicidal attempts a couple of times. She was prescribed electroconvulsive therapy. The intravenous anesthetic of choice for electroconvulsive therapy is: | Answer: c) MethohexitalMethohexital has minimum interference with therapeutic induction of seizures. Hence, it is the drug of choice for electroconvulsive therapy (ECT).Propofol can be used as an alternative if methohexital is contraindicated.Therapeutic seizures induced by ECT typically last for 15-70s.The steps involved in the anesthesia for ECT are as follows:Pre-oxygenation: Should be maintained at near 100%. It decreases post-seizure hyperventilation and prevents increased intensity of seizures.Anesthetic medication: Drug of choice is methohexital.Anticholinergic medication: It prevents vagally mediated bradycardia and reduces excess respiratory and oral secretions.Skeletal muscle relaxant: It prevents musculoskeletal injury. | 158,631 | medmcqa_train |
40 yr old with koilonychias, iron deficiency & dysphagia, diagnosis is - | Ans. is 'a' i.e., Plummer Vinson syndrome Plummer-Vinson syndromeo Plummer-Vinson syndrome, also known as Brown-Kelly-Paterson syndrome or sederopenic dysphagia, seen in middle aged edentulous women.o The plummer Vinsion Paterson Brown Kelly Syndrome is characterized by: -DysphagiaChronic iron deficiency anemiaAtrophic oral mucosa and glossitisBrittle, spoon-shaped fingernails (Koilonychia)o The cause of dysphagia is usually a cervical esophageal web, but abnormal pharyngeal and esophageal motility may play a role.o The syndrome characterstically occurs in middle aged edentulous (without teeth) women, o It is a premalignant lesion. Approximately 10% of patient develop squamous cell Ca of esophagus, oral cavity or the hypopharynx.o As iron-deficiency anemia is a common finding, it is also known as sideropenic dysphagia. o Carcinoma develops in post-cricoid region. | 158,632 | medmcqa_train |
The most common site of perforation in tympanic membrane is | Perforations. They may be central, attic or marginal and are associated with chronic otitis media The most common site of Tympanic membrane perforation is antero-inferior quadrant. Ref : Diseases of ENT by Dhingra 6th edition Pgno : 56,71 | 158,633 | medmcqa_train |
A carrier who gets infected from another carrier is known as:- | Paradoxical carrier - A person gets infected from another carrier and himself becomes Carrier. Carriers are of 6 major types: Content carrier - Carrier gets infection from a case Paradoxical carrier - Carrier gets infection from another carrier Chronic carrier - Carrier for duration of more than 6 months Incubatory carrier - can transmit the agent during the incubation period before clinical illness begins. Convalescent carrier - can transmit the agent during recovery phase Pseudo carrier - asymptomatic carrier with avirulent organismsm.( no need to worry about it) | 158,634 | medmcqa_train |
Which is the treatment of choice for CA head of pancreas | Answer- C. Whipple's SurgeryWhipples operation (Pancreaticoduodenectomy) is the most commonly performed operation for carcinoma of head of Pancreas. | 158,635 | medmcqa_train |
Kartagener's syndrome increase risk of - | Ans. is 'c' i.e., Bronchieactasis | 158,636 | medmcqa_train |
An accused in a case of sodomy is brought for Medical Examination. On detailed questioning, he reveals that he is an active agent and is a regular participant. Which of the following will not be seen during the examination of the accused - | Presence of thick uniform coating of smegma under prepuce and around corona glandis is suggestive of absence of inter course (vaginal or anal) within the last 24 hours since it gets rubbed off during the sexual act.
However, its an unreliable sign with no medicolegal value as its presence or absence depends on personal hygiene. | 158,637 | medmcqa_train |
30 yea raid female comes with acute breathelessness, neck vein distension, absent breath sounds and mediastinal shift. Which of the following should be done immediately: (PGI June 2008) | Ans.: D {Large bore needls puncture of thorax) (Ref Harrison 17th/1660; Oxford Textbook of Surgery'/1932}The young lady from the case history is suffering from tension pneumothorax.The immediate management of such patient should be large bore neelds punctureQ of thorax through second anterior intercostals space to save the life- Oxford Textbook of Surgery/1932X-ray is used for confirmation of diagnosis, but urgent order is not requiredABC & HRCT is not necessaryFig.: Needle Insertion & thoracostomy tubeTension Pneumothorax Harrison I7th/1660# This condition usually occurs during mechanical ventilation or resuscitative efforts.The positive pleural pressure is life-threateningQ both because ventilation is severely compromised and because the positive pressure is transmitted to the mediastinum, which results in decreased venous return to the heart and reduced cardiac output.Difficulty in ventilation during resuscitation or high peak inspiratory pressures during mechanical ventilation strongly suggests the diagnosis.The diagnosis is made by physical examinationQ showing an enlarged hemithorax with no breath sounds, hvperresonance to percussion, and shift of the mediastinum to the contralateral side.Tension pneumothorax must be treated as a medical emergencyQIf the tension in the pieural space is not relieved, the patient is likely to die from inadequate cardiac output or marked hypoxemia.A large-bore needleQ should be inserted into the pleural space through the second anterior intercostal space. If large amounts of gas escape from the needle after insertion, the diagnosis is confirmed. The needle should be left in place until a thoracostomy tube can be inserted | 158,638 | medmcqa_train |
All are true statements about Conversion disorder except | Conversion Disorder Conversion disorder is characterised by the following clinical features: 1. Presence of symptoms or deficits affecting motor or sensory function, suggesting a medical or neurological disorder. 2. Sudden onset. 3. Development of symptoms usually in the presence of a significant psychosocial stressor(s). 4. A clear temporal relationship between stressor and development or exacerbation of symptoms. 5. The patient does not intentionally produce the symptoms. 6. There is usually a ' secondary gain' (though not required by ICD-10 for diagnosis). 7. Detailed physical examination and investigations do not reveal any abnormality that can explain the symptoms adequately. 8. The symptom may have a 'symbolic' relationship with the stressor/conflict. There can be two different types of disturbances in conversion disorder; motor and sensory. Autonomic nervous system is typically not involved, except when the voluntary musculature is involved, e.g. vomiting, globus hystericus. Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no. 99 | 158,639 | medmcqa_train |
HLA gene for abacavir hypersensitivity is? | Drug allergies are the most significant allergic reactions occurring in HIV-infected patients and appear to become more common as the disease progresses. Anaphylaxis is extremely rare in patients with HIV infection, and patients who have a cutaneous reaction during a single course of therapy can still be considered candidates for future treatment or prophylaxis with the same agent. The one exception to this is the nucleoside analog abacavir, where fatal hypersensitivity reactions have been repoed with rechallenge. This hypersensitivity is strongly associated with the HLA-B5701 haplotype, and a hypersensitivity reaction to abacavir is an absolute contraindication to future therapy. Ref: Harrison&;s Principles of Internal Medicine; 19th edition; Chapter 226; Human Immunodeficiency Virus Disease: AIDS and Related Disorders; Page no: 1260 | 158,640 | medmcqa_train |
Major Pyrogenic cytokine: | Ans. D. IL-1. (Ref Robbins Basic Pathology 8th/ Table 2-6).IL-1: fever.IL-2: stimulates T cells.IL-3: stimulates bone marrow.IL-4: stimulates IgE production.IL-5: stimulates IgA production.IL-6: stimulates acute-phase protein production.IL-8: recruites Neutrophils. Tumor Necrosis Factor and Interleukin-1# TNF and IL-1 are producedby activated macrophages, as well as mast cells, endothelial cells, and some other cell types.# Their secretion is stimulatedby microbial products, such as bacterial endotoxin, immune complexes, and products of T lymphocytes generated during adaptive immune responses.# The principal role of these cytokines in inflammation is in endothelial activation.# Both TNF and IL-1 stimulate the expression of adhesion molecules on endothelial cells, resulting in increased leukocyte binding and recruitment, and enhance the production of additional cytokines (notably chemokines) and eicosanoids.# TNF also increases the thrombogenicity of endothelium and causes aggregation and activation of neutrophils, and# IL-1 activates tissue fibroblasts, resulting in increased proliferation and production of ECM.- Although TNF and IL-1 are secreted by macrophages and other cells at sites of inflammation, they may enter the circulation and act at distant sites to induce the systemic acute-phase reaction that is often associated with infection and inflammatory diseases.- Components of this reaction include fever, lethargy, hepatic synthesis of various acute-phase proteins, metabolic wasting (cachexia), neutrophil release into the circulation, and release of adrenocorticotropic hormone (inducing corticosteroid synthesis and release). Role of Mediators in Different Reactions of InflammationVasodilationProstaglandins. Nitric oxide, HistamineIncreased vascular permeabilityHistamine and serotonin, C3a and C5a (by liberating vasoactive amines from mast cells, other cells), Bradykinin, Leukotrienes C4, D4, E4, PAF, Substance PLeukocyte recruitment and activationTNF, IL-1, Chemokines, C3a, C5a, Leukotriene B4 (Bacterial products, e.g., N-formyl methyl peptides)Fever0IL-1, TNF, ProstaglandinsPainProstaglandins, Bradykinin, NeuropeptidesTissue damageLysosomal enzymes of leukocytes, Reactive oxygen species, Nitric oxide CytokineCellular sourceTraget cellsBiologic effectsIL-1Monocytes and macrophagesT cells, B cells neuronsCostimulator pyrogenIL-2Tumor cells T cells (TH1)Endothelial cells T cellsB cellsNK cellsGrowthActivation and antibody productionActivation and growthIL-3T cellsImmature hemopoietic stem cellGrowth and differentiationIL-4T cells (TH2)B cellsActivation and growth; isotype switch to IgE; increased MHCII expression T cellsGrowthIL-6Monocytes and macrophages T cells, B cells Ovarian cancer cells Other tumors tumor cellsB cellsT cellsHepatocytesStem cell Autocrine/paracrine growth and viability-enhancing factorDifferentiation, antibody productionCostimulatorInduction of acute-phase responseGrowth and differentiationIL-10T cells (TH2)Monocytes and macrophagesT cells (Th1)Monocytes and macrophagesInhibition of cytokine synthesisInhibition of Ag presentiation and cytokine production B cellsAcivationIL-12MonocytesNK cells, T cells (TH1)InductionIL-13T cells (TH2), mast cells, NK cellsBcells, TH2 cells, macrophagesRegulates IgE secretion by B cell TH2developmentMacrophage activityIL-15Dendritic cells, monocytes, placenta, kidney, lung, heart, TcellsMast cellsNK cell development and functionMast cell proliferation11-16CD4+ and CD8+ T cells, eosinophils, mast cells, dendritic cellsT cells, monocytes, dendritic cells, eosinophilsPrevent antigen-induced T-cell death, chemotactic factor for CD4= T cells, monocytes, eosinophils, dendritic cellsIL-17Acivated CD4+ T cellsT cell, fibrobiastsT-cell activation Induces secretion ofcytokiness by fibroblastsIL-27Monocytes, macrophagesCD4+ T cellsProliferation of naive CD4+ T cells, synergizes with IL-12IFN-YT cells (TH1) NK cellsMonocytes/ macrophagesNK cells, T cells, B cellsActivationAcivation Enhanves responsesTNF-aMonocytes and macrophages T cellsMonokine productionCostimulator pyrogenMonocytes/ macrophages T cells, B cells Neurons Endothelial cells Muscle and fat cellsActivation, inflammationCatabolism/cachexiaAdditional Educational points:# The major cytokines in acute inflammation are TNF and IL-1, as well as a group of chemoattractant cytokines called chemokines. Other cytokines that are more important in chronic inflammation include interferon-? (IFN-?) and IL-12.# Chemokines are classified into four groups based on the arrangement of highly conserved cysteine residues. The two major groups are the CXC and CC chemokines:- CXC chemokines have one amino acid separating the conserved cysteines and act primarily on neutrophils.* IL-8 is typical of this group; it is produced by activated macrophages, endothelial cells, mast cells, and fibroblasts, mainly in response to microbial products and other cytokines such as IL-1 and TNF.- CC chemokines have adjacent cysteine residues and include:* monocyte chemoattractant protein 1 (MCP-1) and macrophage inflammatory protein 1? (MIP-1?) (both chemotactic predominantly for monocytes),* RANTES (regulated on activation normal T expressed and secreted) (chemotactic for memory CD4+ T cells and monocytes), and* eotaxin (chemotactic for eosinophils). | 158,641 | medmcqa_train |
True about Gaucher disease | This is an inborn error of metabolism due to failure of degradation of glucocerebrosides. The enzyme beta-glucosidase is deficient in this condition.Ref: DM Vasudevan, 7th edition, page no: 192 | 158,642 | medmcqa_train |
Stages of pneumonia are all except:- | The stages of pneumonia/consolidation are:-
i. Stage of Exudation
ii. Stage of Red hepatisation
iii. Stage of Grey hepatisation
iv. Stage of Resolution | 158,643 | medmcqa_train |
Most common Complication of TIPSS procedure | Since systemic blood is shunted toxins ( NH3) travel to brain
causing encephalopathy. Hence TIPSS is contra indicated in
encephalopathy patients. | 158,644 | medmcqa_train |
Schirmer's test detects abnormality of which nerve? | (Refer: AK Khurana Comprehensive Ophthalmology, 6th edition, pg no. 389)*Schirmer's test is used for the production of tear by lacrimal glands*Preganglion secretory fibers for lacrimal gland arise from the lacrimatory nucleus and pass through the facial nerve, then to its greater petrosal branch. Greater petrosal nerve forms nerve to the pterygoid canal to reach pterygopalatine ganglion. Postganglionic fibers supply lacrimal gland*Thus, lesion in any structure of this pathway will have positive Schirmer's test | 158,645 | medmcqa_train |
All except one is required for the diagnosis of obesity hypoventilation syndrome | Repeated | 158,646 | medmcqa_train |
OCP are associated with which of the following complication (Repeat 2009) | Ans b (Optic neuritis)Ophthalmic complication of OCP central retinal artery occlusion prethrombosis of central retinal vein perivasculitis, inflammation of anterior segment of the eye ' macular hemorrage Papillitis & lesions of optic nerve causing variable degree of visual loss | 158,647 | medmcqa_train |
Hydrogen sulphide acts on which complex of cytochrome oxidase | Complex IV inhibitors i. Carbon monoxide, inhibits cellular respiration ii. Cyanide (CN-) iii. Azide (N3-) iv. Hydrogen sulphide (H2S)Ref: DM Vasudevan Textbook of Medical Biochemistry, 6th edition, page no: 234 | 158,648 | medmcqa_train |
Which structure lies midway between the ASIS & pubic symphysis : | A. i.e. Femoral aery Femoral aery traverses the femoral triangle from its base (which is formed by inguinal ligament - attached between ASIS and Pubic tubercle) at midinguinal pointQDeep inguinal ring lies 1/2 inch above midinguinal pointQ; Superficial inguinal ring lies I/2 inch bellow midinguinal point; and Saphenous opening lies 4 cm below & lateral to the pubic tubercle. | 158,649 | medmcqa_train |
First antibody to appear in hepatitis - | Anti-HBV appears in serum a week or two after the appearance of HBsAg. It is therfore the earliest antibody marker to be seen in blood? long before anti-HBe or anti-HBs. REF:ANANTHANARAYAN AND PANIKER'S TEXTBOOK OF MICROBIOLOGY 9TH EDITION PAGE NO-546 | 158,650 | medmcqa_train |
In which of the following vasculitis lung involvement does not occur: | Answer- B. Polyaeritis nodosa (PAN)Microscopic polyangiitis (microscopic polyaeritis, hypersensitivity, or leukocytoclastic vasculitis): This type of necrotizing vasculitis generally affects aerioles, capillaries, and venule.Wegener granulomatosis (Granulomatosis with polyangitis)- is a necrotizing vasculitis characterized by th e triad ofacute necrotizing granulomasnecrotizing or granulomatous vasculitisrenal disease in the form of focal necrotizing often crescentic, glomerulitis"Churg- Strauss syndrome(allergic granulumatosis and angiitis) is a multisystem diseases with cutaneous involvement gastrointestinal tract bleeding, and renal disease. | 158,651 | medmcqa_train |
Which of the following drug is commonly used in narcoanalysis? | Ans. (B) Scopolamine hydrochloride(Ref: J Psychiatry and Law 1993:3:447-471)Controlled administration of intravenous hypnotics to obtain information from subjects who are unable or unwilling to provide it otherwise, is known as Narcoanalysis or Narcosynthesis.Drugs used for narcoanalysis are:[?]Ethanol[?]Scopolamine[?]Temazepam[?]Barbiturates like Thiopentone and AmobarbitalThese drugs are also known as truth drug or truth serum.Phenobarbitone is not used, rather amobarbital is used for narcoanalysis. | 158,652 | medmcqa_train |
The function common to neutrophils, monocytes, and macrophages is: | Phagocytic cells are: neutrophils monocytes macrophages | 158,653 | medmcqa_train |
Which of the following enzyme is involved in rejoining sho fragments of DNA on the lagging strand? | The okasaki fragments that are sho segments of DNA formed on the lagging strand of DNA in the 5'-3' direction are joined by DNA ligase. Ref: Textbook of Biochemistry By D M Vasudevan, 3rd Edition, Pages 347-8 | 158,654 | medmcqa_train |
Ototoxicity caused by: | Ans. (b) StreptomycinRef : KDT 6th ed. / 743-44* Streptomycin has been assigned to pregnancy category D by the FDA.* Streptomycin crosses the placenta; reported cord concentrations have been equal to or less than the mothers serum concentration.* There are reports of fetal eighth cranial nerve damage with subsequent bilateral deafness. Most authorities, including the Centers for Disease Control and the American Thoracic Society, discourage the use of streptomycin during pregnancy due to the risk of fetal ototoxicity. | 158,655 | medmcqa_train |
The instrument below is used for | This is used for monitoring temperature, core temperature monitoring. | 158,656 | medmcqa_train |
Alkalinization of urine is required to treat toxicity of all except: | Changes in urinary pH affect tubular reabsorption of drugs that are paially ionized - * Weak bases are ionize more and are less reabsorbed in acidic urine.* Weak acids ionize more and are less reabsorbed in alkaline urine. Urine is alkalinized in barbiturate, methotrexate and salicylate poisoning. | 158,657 | medmcqa_train |
Which of the following is the feature of vegetations in Libmann Sacks endocarditis? | Mitral and tricuspid valvulitis with small, sterile vegetations, called Libman-Sacks endocarditis, is occasionally encountered in systemic lupus erythematosus. The lesions are small (1 to 4 mm in diameter), single or multiple, sterile, pink vegetations with a way (verrucous) appearance. They may be located on the undersurfaces of the atrioventricular valves, on the valvular endocardium, on the chords, or on the mural endocardium of atria or ventricles. | 158,658 | medmcqa_train |
Permanent impairment of fingerprints occurs in all except | Permanent impairment of fingerprints occurs in: Leprosy Electrical injuries Radiation injuries Ridge alteration occur in: Acanthosis nigricans Scleroderma | 158,659 | medmcqa_train |
True about ascent to high altitude: | Respiratory alkalosis occurs Polycythemia is due to increased erythropoietin Acute mountain sickness develops 8-24 hr after arrival at altitude and lasts 4-8 days. Acute altitude illness: 3 forms Acute mountain sickness (AMS) The pathophysiology of AMS is not well understood. The essential factor responsible for this condition is hypoxemia High altitude cerebral edema (HACE) High altitude pulmonary edema (HAPE) | 158,660 | medmcqa_train |
Phenol test or Reidel Walker test is done to determine: | Ans. d. Efficacy of a disinfectants | 158,661 | medmcqa_train |
Goodpasture syndrome has antibodies against: | (Refer: Robbins Pathologic Basis of Disease, 8thedition, pg no: 709) | 158,662 | medmcqa_train |
Zygote is dependent on which of the following for its nutrition - | Ans. is 'd' i.e., All the above While zygote is passing down the fallopian tube and after a brief period as it enters the uterus, it depends for its nutrition on the yolk sac granules (deutoplasm) embedded in its cytoplasm and on the fluid medium surrounding it which is secreted by the walls of the uterine tube and uterus.It also derives its energy from the stored carbohydrate in sperm, whichfeilized the ovum, | 158,663 | medmcqa_train |
Urine is collected for examination in a pregnant female by : | Early morning sample | 158,664 | medmcqa_train |
Okazaki fragments are found during | DNA synthesis is always into 5&; to 3&; direction in both strands The strand which is discontinuously synthesized is referred to as the &;lagging strand &; otherwise called the retrograde strand The small DNA molecules attached to its own primer RNA are called Okazaki fragments The synthesis along the lagging strand is in 5&; to 3&; directionRef: DM Vasudevan, 7th edition, page no: 580, 581 | 158,665 | medmcqa_train |
Which type of pelvis is associated with increased incidence of 'face to pubis' delivery: | As discussed in the text in Table 1.1 face-to-pubis delivery is common in anthropoid pelvis. | 158,666 | medmcqa_train |
HIV primarily replications in which cells - | Ans. is 'a' i.e., CD4 T-cells * The receptor for the virus is the CD4 antigen on surface. The cells affected are :# CD4 T Cells (major target)# B lymphocytes# Monocytes and macrophages# Langerhans cells in dermis# Glial cells and microglia in the CNS# Follicular dendritic cells from tonsils can be infected by HIV without the involvement of CD4 | 158,667 | medmcqa_train |
According to The Workmen's Compensation Act, 1923, which of the following is considered an occupational disease? | Ans. b. Anthrax (Ref: style="font-size: 1.04761904761905em; font-family: Times New Roman, Times, serif; margin: 0 0 0 8px; text-indent: 0">According to The Workmen's Compensation Act, 1923, Anthrax is considered an occupational disease.List of Occupational Diseases as per Employee Compensation Act 1923 (Workmen Compensation Act, 1923)Part APart BPart C* Infectious and parasitic diseases contracted in an occupation where there is a particular risk of contamination (Anthrax)* Diseases caused by work in compressed air* Diseases caused by lead or its toxic compounds* Poisoning by nitrous fumes* Poisoning by organophosphorus compounds.* Diseases caused by phosphorus or its toxic compounds.* Diseases caused by mercury or its toxic compounds* Diseases caused by benzene or its toxic homologues.* Diseases caused by nitro and amido toxic derivatives of benzene or its homologues.* Diseases caused by chromium, or its toxic compounds* Diseases caused by arsenic or its toxic compounds.* Diseases caused by radioactive substances or radiations.* Primary epitheliomatous cancer of the skin, caused by tar, pitch, bitumen, mineral oil, anthracence, or the compounds, products or residues of these substances.* Disease caused by the toxic halogen derivatives of hydrocarbons (of the aliphatic and aromatic series).* Diseases caused by carbon disulphide.* Occupational cataract due to infrared radiations.* Diseases caused by manganese or its toxic compounds.* Skin diseases caused by physical, chemical or biological agents not included in other items.* Hearing impairment caused by noise.* Poisoning by dinitrophenol or a homologue or by substituted or by the salts of such substances.* Diseases caused by beryllium or its toxic compounds.* Diseases caused by cadmium or its toxic compounds.* Occupational asthma caused by recognized sensitizing agents inherent to the work process.* Diseases caused by fluorine or its toxic compounds.* Diseases caused by nitroglycerine or other nitro acid esters.* Diseases caused by alcohols and ketones.* Diseases caused by asphyxiant carbon monoxide, and its toxic derivatives, hydrogen sulphide.* Lung cancer and mesotheliomas caused by asbestos.* Primary neoplasm of the epithelial lining of the urinary bladder or the kidney or the ureter.* Snow blindness in snow bound areas.* Disease due to effect of cold in extreme cold climate.* Pneumoconiosis caused by sclerogenic mineral dust silicosis, anthracosilicosis, asbestosis) and silicotubercuiosis provided that silicosis is an essential factor in causing the resultant incapacity or death.* Bagassosis* Bronchopulmonary diseases caused by cotton, flax hemp and sisal dust (Byssinosis).* Extrinsic allergic alveolitis caused by the inhalation of organic dusts.* Bronchopulmonary disease caused by hard metals.* Acute pulmonary edema of high altitude. | 158,668 | medmcqa_train |
Radiological factors indicating an unstable pelvis are all except: | Radiographic factors indicating unstable pelvis are: Posterior sacroiliac complex displacement >1cm Avulsion fracture of sacral or ischial end of the sacrospinous ligament. Avulsion fractures of the L5 transverse process Disruption of pubic symphysis with pubic diastasis of 2 cm with posterior pelvic injury or injury to anterior/ posterior sacroiliac ligament or sacrospinous ligaments. Presence of gap rather than impaction in the posterior pelvic ring. | 158,669 | medmcqa_train |
Xiphoid process fuses with body of sternum by: | 40 years | 158,670 | medmcqa_train |
Uveitis is caused by –a) TBb) Staphylococcusc) Streptococcusd) Klebsiellae) E.Coli | TB causes chronic granulomatous uveitis.
Staphylococcus and streptococcus cause acute non-granulomatous pyogenic uveitis. | 158,671 | medmcqa_train |
A young female presented to you with primary amenorrhea. Examination reveals normal breast development and absent axillary hairs. Pelvic examination shows a normally developed vagina with clitoromegaly. On ultrasound, gonads are visible in the inguinal region. What is the most likely diagnosis? | Ans. is b, i.e. Partial androgen insentivity syndromeIn the question patient has 1deg amenorrhea:* Breast development is normal and absent axillary hair. (This means it cannot be Mayer Rokitansky kiister hauser syndrome --where Breast and pubic as well as axillary hair are well developed and it cannot be Gonadal dysgenesis as none of the secondary sexual characteristics are developed in it).We are left with 2 options:Option a --Complete androgen insensitivityOption b --Partial androgen insensitivityIn both these conditions --Breast development will be normal and pubic hair and axillary hair will be absent but clitoromegaly will be seen in partial androgen insensitivity only. | 158,672 | medmcqa_train |
A patient presents with thrombocytopenia, eczema and recurrent infections. What is the most probable diagnosis? | Wiskott-Aldrich syndrome (WAS) is an X-linked platelet/immunologic disorder caused by mutations in the WASP gene. The triad of eczema, recurrent infections, and microthrombocytopenia that characterizes WAS only occurs in 27% of the cases. The immunologic defects include low serum concentrations of IgM, while IgA and IgG are normal and IgE is frequently increased. Ref: The Elements of Immunology By Fahim Halim Khan, 2009, Page 413 ; Harrison's 17th ed chapter 310 | 158,673 | medmcqa_train |
A baby presents with refusal to feed, skin lesions, seizures, ketosis organic acids in urine with normal ammonia; likely diagnosis is: | Baby in the above mentioned case scenario is showing signs and symptoms of multiple carboxylase deficiency such as dermatitis severe metabolic acidosis, organic acid excretion. Ref: Essentials of Pediatrics By Nelson, 16th Edition, Pages 356 ; The Embryo: Scientific Discovery and Medical Ethics By Shraga Blazer, Page 246 ; NORD Guide to Rare Disorders: National Organization for Rare Disorders, Page 483 | 158,674 | medmcqa_train |
Carbamoyl phosphate intermediates the synthesis of | (B) Urea & Pyrimidine # Biosynthesis of urea begins with the condensation of CC>2, NHs and ATP to form carbamoyl phosphate, a reaction catalyzed by carbamoyl phosphate synthase I which is a mitochondrial enzyme, and rate limiting or pacemaker enzyme and the enzyme is active only in the presence of its allosteric activator N-acetylglutamate, which enhances the affinity of synthase for ATP. | 158,675 | medmcqa_train |
Which of the following is not true about Diplococcus pneumoniae | Streptococcus pneumoniae is optochin sensitive. Optochin sensitivity: the sensitivity of Streptococcus pneumoniae to optochin is useful in differentiating it from other streptococci. When a disc impregnated with optochin is applied on a plate of blood agar inoculated with Streptococcus pneumoniae, a wide zone of inhibition appears on incubation. Reference: Textbook of Microbiology; Anathanarayan and panicker's; 10th edition; Page no: 225 | 158,676 | medmcqa_train |
A patient on Bilonatumomab for refractory B cell All is now resistance to the drug. Which drug to be used:- | Drug Mechanism Use Vorinostat HDAC inhibitor Cutaneous T cell lymphoma Brentuximab Man against CD30 Hodgkin lymphoma Pembrolizumab PD-1 Melanoma Lung Cancer Head and neck cancer Tisagenlecleucel Ca therapy ALL Blinatumomab Bispecific t-cell engages ( targets CD19 and CD3) ALL | 158,677 | medmcqa_train |
Horizontal semicircular canal responds to | The three canals lie at right angles to each other but the one which lies at right angles to the axis of rotation is stimulated the most.Thus horizontal canal will respond maximum to the rotation on the veical axis. (Ref: Diseases of EAR, NOSE and THROAT by PL Dhingra; 6th edition; page no.17) | 158,678 | medmcqa_train |
Roof of the Anatomical snuff box is formed by the | Anatomical snuff box boundaries: Lateral wall Abductor pollicis longus Extensor pollicis brevis Medial wall Extensor pollicis longus Roof Cephalic vein Sup branch of radial nerve Floor Radial styloid, scaphoid, trapezium,1st meta carpal Content Radial Aery Ref: Gray's Anatomy The Anatomical Basics of Clinical Practice 41 e pg 893. | 158,679 | medmcqa_train |
Which of these differentiates between ante moem and post moem burns? | SPECIFIC FINDINGS IN ANTEMOEM BURNS 1.SOOT PAICLES UPTO THE LEVEL OF TERMINAL BRONCHIOLE. 2. PRESENCE OF CARBOXYHEMOGLOBIN IN BLOOD. 3. Cyanide IN BLOOD 4. CURLING ULCER IN FIRST PA OF DUODENUM. NON SPECIFIC FINDINGS IN BURNS( ANTEMOEM + POSTMOEM BURNS) 1. PUGILISTIC ATTITUDE OR HEAT STIFFENING. 2. HEAT RUPTURE 3. HEAT HEMATOMA 4. HEAT FRACTURE. | 158,680 | medmcqa_train |
Arrange the following in sequential order of their involvement in estrogen synthesis: A. Progesterone B. Androgen in granulosa cell C. Androgen in theca cell D. Aromatase | Interaction of follicular theca and granulosa cells for production of estrogens. The theca cells, under the control of luteinizing hormone (LH), produce androgens that diffuse into the granulosa cells. In mature follicles, follicle-stimulating hormone (FSH) acts on granulosa cells to stimulate aromatase activity, which conves the androgens to estrogens. AC - Adenylate cyclase; ATP - Adenosine triphosphate; cAMP - Cyclic adenosine monophosphate; LDL - Low density lipoproteins. | 158,681 | medmcqa_train |
Left bundle branch block (LBBB) on ECG can suddenly develop in all of the following except: | Ans. b. Ashman phenomenon (Ref: Harrison 18/e p1835) style="font-size: 1.04761904761905em; font-weight: bold; font-family: Times New Roman, Times, serif; margin: 0 0 0 8px; text-indent: 0">Ashman phenomenon:Ashman phenomenon is an intraventricular conduction abnormality caused by a change in the heart rate.Wide QRS complex) on the surface ECGA RBBB pattern is more common because of the longer refractory period of the right bundle branch, although association with LBBB has been documentedCauses of Left Bundle Branch Block (LBBB)* Aortic stenosis* Dilated cardiomyopathy* Acute myocardial infarction* Extensive coronary artery disease* Primary disease of the cardiac electrical conduction system* Long standing hypertension leading to aortic root dilatation and AR* Hypokalemia* Hyperkalemia | 158,682 | medmcqa_train |
Treatment of latent TB infection in Tuberculin positive, HIV positive patients: | Ans. is 'a' i.e., 1NH biweekly for 9 month Dosing regimens for treatment of latent tuberculosis* AdultsChildren <12IsoniazidStandard regimen:o 300 mg PO daily for nine months Alternate regimens:o 300 mg PO daily for six months900 mg PO twice weeklyD for nine months900 mg PO twice weeklyD for six monthsStandard regimen:o 10 to 15 mg/kg PO daily for nine months; not to exceed 300 mg/dayAlternate regimen:o 20 to 30 mg/kg PO twice weekly for nine months; not to exceed 900 mg/dayIsoniazid and rifapentineIsoniazid (orally once weekly for 12 doses, given by direct observation):o 15 mg/kg, rounded up to the nearest 50 or 100 mg; 900 mg maximumRifapentine (orally once weekly for three months, given by direct observation):o 10 to 14 kg: 300 mgo 14.1 to 25 kg: 450 mgo 25.1 to 32 kg: 600 mgo 32.1 to 49.9 kg: 750 mg o >50 kg: 900 mg maximumSee noteYIsoniazid (orally once weekly for 12 doses, given by direct observation):o 15 mg/kg, rounded up to the nearest 50 or 100 mg; 900 mg maximumRifapentine (orally once weekly for three months, given by direct observation):o 10 to 14 kg: 300 mgo 14.1 to 25 kg: 450 mgo 25.1 to 32 kg: 600 mgo 32.1 to 49.9 kg: 750 mgo >50 kg: 900 mg maximumRifampin600 mg PO daily for four months10 to 20 mg/kg PO daily for four months; not to exceed 600 mg/dayIsoniazid and rifampinIsoniazid 300 mg PO daily for three monthsIsoniazid 10 to 15 mg/kg PO daily for three months; not to exceed 300 mg/day Rifampin 600 mg PO daily for three monthsRifampin 10 to 20 mg/kg PO daily for three months; not to exceed 600 mg/day | 158,683 | medmcqa_train |
In MI, which enzyme is raised in 4 to 6 hrs. & decreases in 3 to 4 days : | Answer is C (Creatinine phosphokinase) Creatinine phosphokinase is seen at 4 to 8 hours (May be seen at 2-4 hours), peaks at 24 hours and return to normal by 72 hours. Creatinine phosphokinase MB (CPKMB) Very sensitive (CPK MB isoenzyme increases the specificity) 'Absence in change in levels of CPK and CPKMB during the 1st 2 days essentially excludes the diagnosis of MI' -Chandrasoma CK elevation used to be test of choice in First 24 hours. ('Cardiac troponins are now preferred'). CKMB is still the test of choice for detecting recurrent ischaemic event. | 158,684 | medmcqa_train |
The most impoant factor in fracture healing is: | D i.e. Immobilization | 158,685 | medmcqa_train |
Rubella causes all except | Rubella: Rubella/ german measles is caused by RNA virus of togavirus family. Rubella inhibits cell division and this is the reason for congenital malformations. Congenital Rubella syndrome refers to infants born with defects secondary to intrauterine infections sometime after bih. It consists of triad of symptoms of deafness, cardiac malformation and cataract . Other defects include glaucoma , retinopathy, microcephalus, cerebral palsy , intrauterine growth retardation, hepatosplenomegaly, mental and motor retardation. Reference: GHAI Essential pediatrics, 9 th edition | 158,686 | medmcqa_train |
Optical urethroplasty is done in:(Internet) | (Congenital stricture of urethra) (1388-89-Baily & Love 24th) (Internet) (1362-Baily & Love 25th)Hypospadias - surgical plastic repair of hypospadias is currently accomplished by a variety of highly successful one stage operations and is routinely performed between 6 and 19 months of age (1008-CSDT 12(tm))Epispadias - Treatment consist of correction of penile curvature reconstriction of the bladder neck in incontinent patients.Congenital urethral stricture - commonly these strictures are thin diaphragms that may respond to simple dilation onto direct vision internal urethrotomy.A single treatment by optical urethrotomy or dilatation is usually effective (1388-Bailey & Love 24th)* A one stage dorsal free graft urethroplasty for bulbar urethral structure to reduce the incidence of urethrocele. | 158,687 | medmcqa_train |
A 78-year-old man with advanced renal disease has the ECG(lead II). What is the diagnosis? | (a) Source: (Fuster, p. 313)No atrial activity is detected. The ventricular rate is slightly irregular. Beat number 4 is a ventricular premature contraction. The T waves are tall and markedly peaked. This type of T wave is characteristic of hyperkalemia, as is absence of visible atrial activity. The potassium level was 8.2 mmol/L. | 158,688 | medmcqa_train |
Acute changes in brain due to wernicke's encephalopathy in chronic alcoholics is most frequently seen in: | Acute changes are most frequently seen in the 1. Mamillary bodies And also seen in 2. Around the third and fouh ventricles and 3. Aqueduct of the midbrain. Ref: Thorarinsson BL, S C I E N T I F I C P A P E R O V E R V I E W | 158,689 | medmcqa_train |
Secondary oocyte consists of | Ans. d (23 X)Secondary oocyte consist of 23 X chromosomes.The chromosomal complement of a primary oocyte is 46 XX and that of secondary oocyte is 23 X.Sequence of maturation of ovarian primordial follicle after primary follicle stage:Primordial follicle(Single layered ovarian follicle)Spermatogonium (diploid, 2N) ||Primary Spermatocyte (diploid, 2N)Primordial follicle ||Secondary Spermatocyte (haploid, N)Secondary follicle (Antral follicle) ||Spermatid (haploid, N)(Spermatogenesis begins with Spermatogonia.Full development takes 2 months.It occurs in seminiferous tubules)Graffian follicle|Corpus luteum| Corpus albicans # While majority of oogonia divide, some enter into prophase of first meiotic division and are primary oocytes. These are surrounded by flat cells, which are called primordial follicles, and are present in cortex of the ovary.# At birth, there is no more mitotic division and all the oogonia are replaced by primary oocytes, which have finished prophase of first meiotic division and remain in resting phase between prophase and metaphase.# The first stage of maturation occurs with full maturation of ovarian follicle just prior to ovulation but the final maturation occurs only after fertilization.# The primary oocyte undergoes first meiotic division giving rise to secondary oocyte and one polar body.# Secondary oocyte has haploid number of chromosomes.# Ovulation occurs soon after formation of secondary oocyte.# The secondary oocyte completes the second meiotic division only after fertilization by the sperm in the fallopian tube. | 158,690 | medmcqa_train |
True about mucosa associated lymphoma | Gastric lymphoma This is a rare tumour, accounting for less than 5% of all gastric malignancies. The stomach is, however, the most common site for extranodal non-Hodgkin lymphoma and 60% of all primary gastrointestinal lymphomas occur at this site. Lymphoid tissue is not found in the normal stomach but lymphoid aggregates develop in the presence of H. pylori infection. Indeed, H. pylori infection is closely associated with the development of a low-grade lymphoma (classified as extranodal marginal-zone lymphomas of MALT type). EUS plays an impoant role in staging these lesions by accurately defining the depth of invasion into the gastric wall. The clinical presentation is similar to that of gastric cancer and endoscopically the tumour appears as a polypoid or ulcerating mass. While initial treatment of low-grade lesions confined to the superficial layers of the gastric wall consists of H. pylori eradication and close observation, 25% contain t(11:18) chromosomal translocations. In these cases, additional radiotherapy or chemotherapy is usually necessary. High-grade B-cell lymphomas should be treated by a combination of rituximab, chemotherapy , surgery and radiotherapy. The choice depends on the site and extent of tumour, the presence of comorbid illnesses, and other factors, such as symptoms of bleeding and gastric outflow obstruction. The prognosis depends on the stage at diagnosis. Features predicting a ourable prognosis are stage I or II disease, small resectable tumours, tumours with low-grade histology, and age below 60 years. Ref Davidson edition23rd pg805 | 158,691 | medmcqa_train |
Which is not Glucogenic? | The glucogenic amino acids are: Alanine Arginine Asparagine Aspaic Cysteine Glutamic Glutamine Glycine Histidine Methionine Proline Serine ValineRef: DM Vasudevan, 7th edition | 158,692 | medmcqa_train |
The gene for folic acid transpoer is located on which chromosome: | C i.e. 21Folic acid transpoer gene (SLC 19 AI solute carrier family 19) is located on long arm of chromosome 21 (21q) Q at band 22.3. Transpo of folate occurs by potocytosis which functionally couples folate receptor, folate transpoer and V- type h+ pump. | 158,693 | medmcqa_train |
The best treatment for class V lesion on a tooth along with extensive class II caries is: | With class V lesion and extensive class II cavity in the same tooth the remaining enamel surface with the supported healthy dentin will be much less hence in such situation full crown restoration will be long lasting. | 158,694 | medmcqa_train |
Which has maximum nicotinic effect- | Ans. is 'b' i.e., Carbachol o Amongst the given options carbachol has maximum nicotinic actions. It has nicotinic as well as muscarinic action. | 158,695 | medmcqa_train |
Indications for cesarean hysterectomy are all except: | Cesarean hysterectomy refers to an operation where cesarean section is followed by removal of the uterus.
Peripartum hysterectomy is the surgical removal of the uterus either at the time of cesarean delivery or in the immediate postpartum period (even following vaginal delivery).
Some indications for peripartum hysterectomy
Uterine atony
Abnormal placentation
– Bleeding
– Accrete syndromes
Uterine extension
Uterine rupture
Cervical laceration
Postpartum uterine infection
Leiomyoma
Invasive cervical cancer
Ovarian neoplasia
M/C cause of cesarean/peripartum hysterectomy is PPH. | 158,696 | medmcqa_train |
The parasympathetic secretomotor nerve supply to the nose is | The nerve of the pterygoid canal passes through the pterygoid canal to reach the pterygopalatine ganglion. The parasympathetic fibres relay in this ganglion. Postganglion are parasympathetic fibres arising in the ganglion ultimately supply the lacrimal gland and the mucosal glands of the nose, palate, and pharynx. The gustatory or taste fibres do not relay in the ganglion and are distributed to the palate. Ref: BD Chaurasia's HUMAN ANATOMY, Volume 3, 4th edition. | 158,697 | medmcqa_train |
Foot process effacement is seen on EM in ? | Ans. is All 'a' i.e., Minimal change disease, 'b' i.e., Focal segmental GN, 'c' i.e., IgA nephropathyo Foot process effacement is noted in patients with nephrotic syndrome.o A variety of injurious stimuli may cause the podocyte to react with flatteninng or simplification of the foot process architecture.While most commonly noted in lipoid nephrosis (minimal change disease), foot process effacement can also be seen in focal segmental glomerulosclerosis, membranous glomerulonephropathy and in other glomerulonephritis.So, keep in mind that foot process efffacement is seen most commonly in minimal change disease, but can also occur in other glomerulonephropathies causing nephrotic syndrome (FSGS, IgA nephropathy, MPGN) o For option IgA nephropathy is a type of mesangioproliferative GN. | 158,698 | medmcqa_train |
Which of the following drug is category B (adequate studies in pregnant woman have failed to demonstrate a fetal risk)? | Category B drugus are the one that have shown no risks in animal studies, but human studies do not exist or also if adverse effect have been seen in animal studies with no such effect im well controlled human trials. eg.ranitidine,paracetamol. TEXT BOOK OF OBSTETRICS,Sheila Balakrishnan,2nd edition,page no.564 | 158,699 | medmcqa_train |
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