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A person is diagnoses with pulmonary embolism invasive modality for diagnosis is - | Ans. is 'b' i.e., Pulmonary angiography o The definitive diagnostic for pulmonary thromboembolism is pulmonary angiography.o It is the most specific investigation for pulmonary> thromboembolism but it is expensive time consuming and invasive,o Therefore chest CT with contrast has virtually replaced angiography as the diagnostic test.o Best investigation when there is clinical suspicion of pulmonary embolism - Contrast enhanced CT. | 159,100 | medmcqa_train |
Wof is an immunosuppressant that acts by inhibiting mTOR and is non nephrotoxic | mTOR INHIBITORS Sirolimus This new and potent immunosup-pressant is a macrolide antibiotic (like tacrolimus), which was earlier named Rapamycin. Mech of action:- It binds to immunophillin FKBP and the sirolimus-FKBP complex inhibits kinase called 'mammalian target of rapamycin' (mTOR). uses:- 1)For prophylaxis and therapy of graft rejection reaction, sirolimus can be used alone, but is generally combined with lower dose of cyclosporine/tacrolimus and/or coicosteroids and mycophenolate mofetil. It is paicularly suitable for patients developing renal toxicity with cyclosporine.( Sirolimus is non nephrotoxic). 2)sirolimus coated stents are being used to reduce the incidence of coronary aery restenosis, by inhibiting endothelial proliferation at the site. Adverse effects:- Significantly, sirolimus is not nephrotoxic, but it can suppress bone marrow, mainly causing thrombocytopenia. Rise in serum lipids is common. Other adverse effects are diarrhoea, liver damage and pneumonitis. Ref:- kd tripathi; pg num:-882 | 159,101 | medmcqa_train |
Paramesonephric duct develops into: | Ans. D. Uterus MaleFemaleMesonephric ductDuct of epididymisDuct of epoophoron(Wolffian duct)Ductus deferensPart of bladder and urethra Ejaculatory duct Part of bladder and prostatic urethra (Paramesonephric or Mullerian duct)Appendix of testisUterine tube Prostatic utricleUterus Vagina | 159,102 | medmcqa_train |
Toxin involved in the streptococcal toxic shock syndrome is: | Streptococcal TSS is caused by pyrogenic exotoxin. Ref: Text Book of Microbilogy By Ananthanarayan, 8th Edition, Page 208-209 ; Harrison's Principles of Internal Medicine, 14th Edition, Page 889, 15th Edition, Page 903 | 159,103 | medmcqa_train |
Radiopharmaceutical used for the liver scan is | Tc-99m sulphur colloid is used in liver scan.Tc-99m DTPA measurement of GFR.Tc99m-sestamibi is taken up by cells with a high concentration of mitochondria i.e. highly cellular/metabolically active tissues such as the hea but also abnormal tissues such as oxyphil cell parathyroid adenomas, myeloma and breast cancer. | 159,104 | medmcqa_train |
From which of the following routes absorption of local anaesthetic is maximum? | Ans. is 'a' i.e., Intercostal According to miller "The greater the blood supply to the area injected, the greater is the systemic absorptionSites of absorption from greatest to least include:-Intrapleural > intercostal > pudendal > caudal > epidural > brachial plexus > infiltration. | 159,105 | medmcqa_train |
Atypical pneumonia is caused by all except | Haemophilus influenza causes lobar pneumonia .it is one of the frequent cause of fatal pneumonia in the pandemic of influenza in 1918 _1919 where as atypical pneumonia is not as serious as typical pneumonia Ref:anantnarayan and paniker's microbiology 10th edition | 159,106 | medmcqa_train |
A 28 year female patient presented with history of bilateral hearing loss and tinnitus. She can hear better in noisy environment. Examination showed intract ear drums bilaterally and Rinne test is negative bilaterally. Pure tone audiometry given below. What is the most probable diagnosis? | Ans. (c) Stapedial otosclerosisRef: Logan Turners ENT 11th Ed; Page No-464Otosclerosis* Most commonly seen in third decade, i.e. 20-30 years of age.* Most commonly seen in females, with a ratio of 2:1.* It is most commonly seen in white peoples.* The most common site origin of otosclerosis is fissula ante fenestrum.* It is aggravated by any hormonal change, be it pregnancy or menopause.* It is an autosomal dominant disorder and positive family history.* Clinical features:# Patients presents with bilateral progressive conductive hearing loss (70-85%).# Otosclerosis is the most common cause of bilateral progressive conductive hearing loss in adults.# This patient gives the typical history of haring better in noisy surroundings, which is known as Paracusis willisii phenomenon. This is because the speaker raises his voice in noisy surroundings which now cross the hearings threshold of the patient.# Less commonly tinnitus can also occur in otosclerosis, particular in cochlear otosclerosis and active otosclerosis.# Sometimes otosclerosis is associated with Osteogenesis imperfecta and blue sclera, when it constitutes van dar Hoeve syndrome.* Investigation:# Tympanic membrane appears pearly white (normal) in 90% patients; it is called as mature otosclerosis.# 10% cases of otosclerosis are active. In these the active division is taking place on the medial wall of middle ear leading to increase vascularity. This appears pinkish through the intact tympanic membrane leading to flamingo pink appears of TM also known as Schwartz sign.# Audiometric test:Tuning fork testFindingsRinne'sNegativeWeber'sLateralized to the worst earABCSame as examinerSchwabachLengthenedGelle'sNegative (i.e. change in the pressure of EAC does not produce ant y change in hearings as ossicular chain is already fixed.* Pure tone Audiometry:# The audiogram of the patients shows anA-B gap > 15dB (Suggestive of conductive hearing loss). Complete fixation of foot plate leads to the maximum conductive hearing loss of 60dB.# There is typical dip at 2000Hz in the bone conduction curve. This dip is because of fixation of footplate of stapes, the natural frequency of which 2000Hz. Hence its fixation fails to transit this frequency sound.# This dip is known as "Carhart's notch". This dip disappears after the mobilization of footplate and stapes during the management of otosclerosis.TreatmentActive casesMature cases* Sodium fluoride (NaF):# Inactive cases i.e. when Scwartze sign is present, medial medical management with sodium fluoride is done.# NaF accelerates the maturation of the focus by increasing osteoblastic and decreasing osteolytic activity.# It also inhibits the proteolytic enzymes that release cytotoxic chemicals to Cochlea.* Surgery: In mature otosclerosis when the foot plate is fixed and active division has stopped the treatment consists of mobilization of foot plate of stapes. The surgical procedure s are:-* Stapedectomy:# Here the whole of the stapes is removed and the oval window is then covered with a fascia graft and prosthesis is placed over the graft with other end of prosthesis attached to the long process of incus.# The change of perilymph fistula, SN hearing loss and vertigo is higher in stapedectomy as compared to stapedotomy. Hence it is not preferred nowadays.# It is contraindicated in chronic nephritis, RA, pregnancy and lactation.* Bisphosphonates have also been used as they inhibit bone resorption.* Stapedotomy:# This is a more conservative and better procedure where the incudostapedial joint is separated; the Stapedial tendon is cut and the suprastructure of stapes (head, neck, anterior and posterior crura) is removed leaving the foot plate behind.# The most common prosthesis is used here Teflon piston.* Postoperative Complication:# Conductive hair loss.# Perilymph fistula# Facial nerve palsyHow to rule out other options?Meniere's disease# It is also known as endolymphatic hydrops. It is frequently a unilateral condition and seen in more commonly in young females (20-40 years).# It is largely idiopathic.Clinical features* Vertigo: It is the first symptoms of Meniere's disease and it lasts for at least 20 minutes till a maximum of up to 24 hours. This sudden onset of vertigo of Meniere's disease associated with vagal symptoms, i.e. nausea, vomiting, abdominal cramping, diarrhoea and bradycardia.* SN hearing loss and tinnitus can be seen.Investigations* Rinne Test: Positive* Weber test: Towards the normal ear* ABC: Shortened* Schwabach: Shortened* Recruitment: Positive* SISIS:70-100% (because of recruitment)Management* Salt and water restrictions* Labyrinthine sedatives* Vasodilators* Meniett deviceVestibular neuronitis* This condition is characterized by acute onset vertigo, nystagmus and tinnitus with nausea and vomiting lasting for days to weeks.* This is most likely because of viral infection involving the vestibular nave.* The cochlear part is not involved, so the hearing remains normal.* The caloric test shows diminished response.* It is managed by labyrinthine sedatives. | 159,107 | medmcqa_train |
Select the false statement about P. jiroveci? | Ans. is 'b' i.e., Frequently associated with CMV Lets see each option one by one. Robbin's Option 'a' - See following statements of Topley's mycology; "Pneumocystis are found in low number in the lungs of mammalian hosts with intact immune system and in more abundance in homeotherms with compromised immune status". "A decrease in cell mediated immunity is the single most impoant risk factor for the development of pneumocystis pneumonia". So, P. jiroveci may be seen both in immunocompromised individuals and individuals with intact immune system, but it causes pneumonia only in immunocompromised individuals. Option 'b' - P.jirovecii may be associated with CMV infection but it is not usually associated with CMV infection. Option 'c' - P.jirovecii may be associated with penumatocele formation but pneumatoceles are not associated in all cases of P.jirovecii pneumonia. Option 'd' - Option 'c' is paially correct. - Usually the diagnosis of pneumocystis pneumonia is confirmed by histopathologic staining of BAL fluid collected by bronchoscopy, but it can also be diagnosed by microscopic examination of induced sputum. Diagnosis | 159,108 | medmcqa_train |
Capacitance of sperms takes place in | Sperm is the male reproductive cell in the sexual reproduction. Capacitation is the penultimate step in the maturation of mammalian spermatozoa and is required to render them competent to feilize an oocyte. This step is a biochemical event; the sperm moves normally and looks mature prior to capacitation. In vivo, this step typically occurs after ejaculation, in the female reproductive tract. Ref: Ganong&;s review of medical physiology; 24th edition; page no:-422 | 159,109 | medmcqa_train |
Complication which commonly accompanies acute prostatitis - | • Acute inflammation of prostate associated with UTI
• Caused by ascending urethral infection or reflux of infected urine into prostatic ducts
• MC organism: E. coli
• Patients present with sudden onset high grade fever with chills and rigors, severe irritative symptoms and enlarged, tender and boggy prostate
• Catheterization and prostatic massage is contraindicated
• MC used antibiotics are: TMP-SMX and Ciprofloxacin (Both are having better concentration in prostatic tissue)
• Around 4-6 weeks of antibiotic therapy is used to avert chronic bacterial prostatitis.
Chronic Bacterial Prostatitis
• Due to persistent bacterial infection of prostate
• Insidious in onset, characterized by relapsing or recurrent UTI caused by persistence of pathogen in prostatic fluid despite of antibiotic therapy
• Diagnosis is made by microscopic examination and culture of prostatic expressate and culture of urine obtained before and after prostatic massage.
• Treated by chronic antibiotic suppression (3–4 months)
Prostatic Abscess
• Most cases result from complications of acute bacterial prostatitis
• Fluctuation is a very late sign
• Predisposing factors: Diabetes, renal insufficiency, immunosuppression, urethral instrumentation, chronic indwelling catheter
• Diagnosis: TRUS or pelvic CT scan is crucial for diagnosis and treatment
• Treated by transurethral drainage and antibiotics | 159,110 | medmcqa_train |
An 18-year-old female passenger injured in a rollover car crash was rushed to the emergency department. After the patient is stabilized she undergoes physical examination. She demonstrates considerable weakness in her ability to flex her neck, associated with injury to CN XI. Which of the following muscles is most probably affected by nerve trauma? | The iliocostalis thoracis muscle is found in the deep back and functions to maintain posture. It is not associated with neck flexion. The sternocleidomastoid muscle is innervated by CNXI and functions in contralateral rotation and bilateral flexion of the neck. Rhomboid major and minor are both innervated by the dorsal scapular nerve and serve to adduct the scapulae. Teres major is innervated by the lower subscapular nerve and serves to medially rotate and adduct the humerus. | 159,111 | medmcqa_train |
Which of the following statements about Cushing's disease is true? | Cushing's syndrome is due to increased adrenal coisol production, regardless of aetiology.Cushing's disease usually is caused by a pituitary microadenoma producing high adrenocoicotropin (ACTH) levels.In most patients, coisol levels would be suppressed as a result of the high-dose dexamethasone suppression test.Transsphenoidal microsurgical removal of the microadenoma is the treatment of choice in most centres. | 159,112 | medmcqa_train |
Intractable secondary glaucoma is seen in: | Ans. (a) Diffuse iris melanomaRef: Surgical Pathology of Head & Neck p. 1935Intractable secondary glaucoma may also occur in cases of blunt trauma due to anteriorly dislocated lens setting caught in the pupil.Iris melanoma(malignant neo plasms that arise from neuroectodermal melanocytes with in the Iris)Circumscribed/nodular iris melanoma* Present as pigmented spot on the iris* These tumors are usually localized, well circumscribed and nodular* These tumors usually tend to involve only a limited segment of the angle circumference and hence glaucoma is less common and usually treatableDiffuse iris melanoma* Present as a unilateral dark iris (hyperchromic heterochromia) Q* These tumors show a flat and diffuse infiltration pattern of growth* The infiltration invades the intertrabecular spaces and plugs the drainage mechanism, resulting in an intractable secondary glaucoma | 159,113 | medmcqa_train |
A normally developing 10 months old child should be able to do all of the following except _________ | the child is able to make tower of 2 blocks by 15 months and tower of 3 blocks by 18 months. Ref: OP GHAI - ESSENTIAL PEDIATRICS - 8 TH edition page no 50 | 159,114 | medmcqa_train |
A child with pyoderma becomes toxic and presents with respiratory distress. His CXR shows patchy areas of consolidation and multiple bilateral thin walled air containing cysts. The most likely etiological agent in this case is: | b. Staph aureus(Ref: Nelson's 20/e p 2088-2093, Ghai 8/e p 379-381)The given chest X-ray finding is suggestive of pneumonia with pneumatoceles, seen in infection due to Staph aureus. | 159,115 | medmcqa_train |
Locard’s principle is concerned: | Ref. Textbook of forensic medicine. Krishnan Vij. Page. 302
Locard Principle:
When any two objects come into contact, there is always a transfer of material from each object on the other.
Some examples are fingerprints, footprints,hair, tool marks etc. | 159,116 | medmcqa_train |
Most common ovarian tumor | Ans. (a) Serous cystadenoma(Ref: Robbins 9th/pg 1023)*Most ovarian tumors are surface epithelial (65-70%)*Serous cystadenoma is the most common surface epithelial tumor | 159,117 | medmcqa_train |
Best diagnostic aid in blunt trauma abdomen is - | Ans. is 'd' i.e., Ultrasound | 159,118 | medmcqa_train |
Which of the following lipids is found exclusively in mitochondria? | Cardiolipin Is a Major Lipid of Mitochondrial Membranes
Phosphatidic acid is a precursor of phosphatidylglycerol, which in turn gives rise to cardiolipin. This phospholipid is found only in mitochondria and is essential for the mitochondrial function. Decreased cardiolipin levels or alterations in its structure or metabolism cause mitochondrial dysfunction in aging and in pathological conditions including heart failure, hypothyroidism, and Barth syndrome (cardioskeletal myopathy).
HARPERS ILLUSTRATED BIOCHEMISTRY30th ed, Page No:343 | 159,119 | medmcqa_train |
A 20 yr old girl presents with 9 month history of neck swelling with thyrotoxicosis symptoms. On investigation increased T4 and decreased TSH with palpable 2 cm nodule was found. Next investigation will be | In clinical cases of thyroid nodule, Thyroid profile (T3 T4 TSH) is done. If TSH is low, thyroid scan is done to see if nodule is hot or cold. If TSH is low or normal, ultrasound followed by FNAC is done Source :Sabiston 20 th edition Pg 890 | 159,120 | medmcqa_train |
Investigation of choice for Hydrocephalus in infants ? | Brain imaging Imaging tests can help diagnose hydrocephalus and identify underlying causes of the symptoms. These tests may include: Ultrasound. Ultrasound imaging, which uses high-frequency sound waves to produce images, is often used for an initial assessment for infants because it&;s a relatively simple, low-risk procedure. The ultrasound device is placed over the soft spot (fontanel) on the top of a baby&;s head. Ultrasound may also detect hydrocephalus prior to bih when the procedure is used during routine prenatal examinations. Magnetic resonance imaging (MRI) uses radio waves and a magnetic field to produce detailed 3D or cross-sectional images of the brain. This test is painless, but it is noisy and requires lying still. MRI scans can show enlarged ventricles caused by excess cerebrospinal fluid. They may also be used to identify underlying causes of hydrocephalus or other conditions contributing to the symptoms. Children may need mild sedation for some MRI scans. However, some hospitals use a very fast version of MRIthat generally doesn&;t require sedation. Computerized tomography (CT) scan is a specialized X-ray technology that can produce cross-sectional views of the brain. Scanning is painless and quick. But this test also requires lying still, so a child usually receives a mild sedative. Drawbacks to CT scanning include less detailed images than an MRI, and exposure to a small amount of radiation. CT scans for hydrocephalus are usually used only for emergency exams. Reference: GHAI Essential pediatrics, 8th edition | 159,121 | medmcqa_train |
A pt. presented with renal cell carcinoma invadving IVC and the renal vein. False statement is ? | Ans. is 'b' ie. IVC involvement indicates inoperability A renal cell carcinoma that has spread to renal vein, IVC or even upto the thorax (hea) is operable. A preop biopsy is not necessary as a RCC is the most common malignant neoplasm of kidney (90 - 95%) and any solid renal mass is considered to be RCC until unless proved otherwise. A chest x-ray should be done to rule out pulmonary metastasis as it will make the Ca of stage IV with worst prognosis and also decide the tit plan. Radiotherapy, Chemotherapy or Hormonal therapy have little role in RCC t/t. More about Renal cell carcinoma Its the MC malignant neoplasm of kidney (90 - 95%) MC site of origin is prox. convoluted tubules RCC originates in the coex and tends to grow out into perinephric tissue. Usually situated at poles (commonly at upper pole) Male female ratio is 2 : 1 Age - 5th to 6th decade Risk factors: i) Cigarette smoking ii) Obesity iii) Polycystic kidney ds iv) Tuberous sclerosis v) Von-Hippel lindau syndorme (Cerebellar hemangioblastoma, retinal angiomatosis and b/1 renal cell Ca) Histologically RCC is an adenocarcinoma. It has been reclassified into subtypes of which Clear Cell Ca is the MC type. Classical triad of RCC consists of Hematuria Flank pain Palpable flank mass Earliest and MC presenting feature is hematuria. Paraneoplastic syndormes i) Fever of unknown origin ii) Anemia iii) Erythrocytosis (d/t secretion of erythropoietin by RCC) (but anemia is a more common finding) iv) Hypeension v) Abnormal liver function (Stauffers syndrome ie non metastatic hepatic dysfunction) vi) Hypercalcemia vii) Neuromyopathy viii) Amyloidosis ix) Increased ESR (MC paraneoplastic syndrome) x) Dysfibrogenemia xi) Cushing's syndrome xii) Galactorrhoea xiii) Feminization and masculanization MC route of metastasis is hematogenous MC site of distant metastasis is lung (canon ball secondaries, secondaries may be pulsatile) Inv. of choice --> CT scan. | 159,122 | medmcqa_train |
Commonest neurological tumour associated with NF-2:- | NF is a type of genetic condition Gene Chromosome Protein Features NF 1 17 Neurofibromin - Cafe-au-lait-macules (CALM) NF 2 22 Merlin -Vestibular Schwannoma (Acoustic neuroma): commonest neurological tumour. -Giant Neurofibromas, Meningioma - Axillary Freckling | 159,123 | medmcqa_train |
Tumor seen exclusively in parotid: | Wahin Tumor: Viually restricted to the parotid gland More common in Male; Smoking is most impoant risk factor EXTRA EDGE: Most common salivary gland tumor - Pleomorphic Adenoma. Most common Benign salivary gland tumor - Pleomorphic Adenoma MC Primary malignant salivary gland tumor - Mucoepidermoid carcinoma. Adenoid cystic carcinoma - Most aggressive salivary tumor, can cause perineural invasion. Larger the size of salivary gland more likely it's benign. Smaller the size of salivary gland more likely it's malignant. MC salivary gland involved - parotid gland > submandibular gland. | 159,124 | medmcqa_train |
Hypochloremia, hypokalemia and alkalosis are seen in? | Ans is 'a' i.e. Congenital hyperophic pyloric stenosis Biochemical abnormality in congenital hyperophic pyloric stenosis is a regular feature of AIIMS and AI examinations it has been repeated several times. The biochemical abnormalities seen are: ( I ) Hypokalemia (3) Alkalosis and (2) Hypochloremia (4) Paradoxical aciduria | 159,125 | medmcqa_train |
Axillary abscess is safely drained by which approach | Axillary abcess should be incised through the floor of axilla, midway between the anterior and posterior axillary folds,and nearer to the medial wall in order to avoid injury to the main vessels running along the anterior,posterior and lateral walls. | 159,126 | medmcqa_train |
Anti HIV drug used for prevention of vertical transmission - | Ans. is 'a' i.e., Nevirapine Treatment during pregnancyo HIV infected mother can transmit the virus to fetus/infant during pregnancy, during delivery or by breast feeding,o Early diagnosis and antiretroviral therapy to mother and infant significantly decrease the rate of intrapartum and perinatal transmission (vertical transmission) of HIV infection,o Zidovudine treatment of HIV infected pregnant women from the beginning of second trimester through delivery and of infant for 6 weeks following birth decreases the rate of transmission from 22.6% to < 5%.o Single dose of nevirapine given to the mother at the onset of labor followed by a single dose to the newborn within 72 hours of birth decreased transmission by 50%. This is the prefered regimen now in developing countries. | 159,127 | medmcqa_train |
Thump print sign in the abdominal radiograph indicates which of the following conditions? | The thump print sign is seen in Inflamatory bowel disease (Ulcerative colitis, Crohns), infectious colitis (amoebic, pseudomembranous), ischaemic bowel disease and diveiculitis. The sign is a result of haustral mucosal thickening in most of the cases. | 159,128 | medmcqa_train |
Alcohol dependence is associated with all of the following except | Amotivational syndrome is seen with chronic cannabis abuse. | 159,129 | medmcqa_train |
A patient presented in casualty with a history of sudden paplitation, sensation of impending doom and constriction in his chest. This lasted for about 10-15 minutes after which he became all right. The diagnosis is likely to be: | D i.e. Panic attack Feeling of impending doom with sympathetic symptoms (chest discomfo/pain/constriction, anxiety apprehension, breathlessness, sweating, palpitations, tremors etc.) of sudden onset and lasting for few minutes are diagnostic of Panic attackQ. - In generalized anxiety disorder, there must be a period of atleast 6 monthsQ with prominent tension, worry & feeling of apprehension about every day events & problems. The onset is also insidious (not abrupt as in panic attack). Symptoms of anxiety are seen both in panic attack & generalized anxiety disorder; but panic attack is differentiated by sudden onset of symptoms of severe anxiety (like feeling of impending doom) lasting for few minutesQ. Panic Attack Episode (discrete period) of acute anxiety (i.e. intense fear or discomfo) of sudden (abrupt) onset like out of the blue, reaching a peak within 10 minutes and usually lasting for < 1-hour (most commonly diminished with in 30 minutes). The clinical picture is that of acute severe anxiety that builds up quckly and include various features of sympathetic stimulation because hyper ventilation caused by anxiety lit Paco2. >4 of the following symptoms developing abruptly and reaching a peak within 10 minutes are required. Sensation of shoness of breath or smothering (paradoxical feeling of breathlessness)Q Chocking sensation Chest pain or discomfo PalpitationQ, pounding hea, tachycardia (accelerated hea rate) Feeling dizzy, unsteady, light-headed or faint Paresthesias (numbness or tingling) Trembling or shaking or tremor Chills or hot-flushes SweatingQ Fear of dying (impending doom)Q Fear of losing control or going crazy (apprehension)Q Derealization (feeling of unreality) or depersonalization (being detached from oneself) Nausea or abdominal distress Recurrent, unexpected panic attack and at least one of the attack has been followed by >1 month of 1 of the following a) Persistent concern about having additional (fuher) attacks b)Worry about the implications of the attack or its consequences (eg because of physical symptoms patients are likely to fear that they are experiencing a hea attack, stroke or the like; or occasionally patients think they are going crazy or are out of control) c) A significant change in behavior related to attacks (because they think that attacks indicate a serious undiagnosed physical illness). Panic attacks should not be d/t medical disorder, social /specific phobia, OCD, PTSD, or seperation anxiety; but it may or maynot be associated with agoraphobia. Agoraphobia Anxiety about being in places or situations from which escape might be difficult(2 (or embarrassing) or in which help may not be available in the event of having an unexxpected or situationally predisposed panic attack or panic like symptoms. Agoraphobic fears typically involves characteristic clusters of situations that include | 159,130 | medmcqa_train |
The cough response caused while cleaning the ear canal is mediated by stimulation of: | Auricular branch of vagus nerve provide innervation of the external auditory canal. So mechanical stimulation of ear canal while cleansing it cause stimulation of this nerve branch of vagus nerve and may induce cough. The auricular branch of vagus nerve passes through the mastoid canaliculus and through a space between the mastoid process and the tympanic pa of the temporal bone to the external ear and external auditory canal. The ear canal receives sensory fibers from the glossopharyngeal nerve through its communicating branch with the vagus nerve. | 159,131 | medmcqa_train |
All of the following can cause methemoglobinemia except- | Methemoglobinemia is a rare but potentially life - threatening complication that may follow theadministration of ceain drugs that causes oxidation of hemoglobin to Methemoglobin. Drugs whichcause this - prilocaine benzocaine, rarely Lignocaine, nitroglycerine, Phenytoin sulphonamide. | 159,132 | medmcqa_train |
Amine hormone is ? | Ans. is 'd' i.e., Thyroxine | 159,133 | medmcqa_train |
Darkening of urine on standing is associated with | Alkaptonuria is caused by defect of the enzyme homogentisate 1,2-dioxygenase(homogentisic acid oxidase).The disorder comes to attention due to change in colour of urine to brownish black/ staining of diapers.The urine becomes dark on standing,especially if the pH of urine is alkaline,due to the presence of homogentisic acid.Excessive urine homogentisate results in positive reducing substances. Reference:Essential pediatrics-Ghai,8th edition,page no:653. | 159,134 | medmcqa_train |
Which of the following is most strongly associated with coronary hea disease? | Apolipoprotien B (major LDL protien) is better predictors of CHD. Ref-Park&;s textbook of Preventive and Social Medicine 24th edition. | 159,135 | 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 forearm | 159,136 | medmcqa_train |
Svere myopathy commonly is a side effect of | ESSENTIALS of medical PHARMOCOLOGY SEVENTH EDITION KD TRIPATHI Page :636,637 Impoant statins are :lovastatin Simvastain, pravastatin, rosuvastatin etc Rosuvastatin This is the latest and the most potent statin (10 mg rosuvastatin :::::. 20 mg atorvastatin), with a plasma tlh. of 18-24 hours. Greater LDL-CH reduction can be obtained in severe hypercholesterolaemia; paly due to its longer persistence in the plasma. In patients with raised TG levels, rosuvastatin raises HDL-CH by 15--20% (greater rise than other statins). Dose: Sta with 5 mg OD, increase if needed upto 20 mg/ day, (max 40 mg/ day) ROSUV AS, ROSYN 5, 10, 20 mg tabs. Adverse effects All statins are remarkably well tolerated; overall incidence of side effects not differing from placebo. Notable side effects are: * Headache, nausea, bowel upset, rashes. * Sleep disturbances (probably more with lipophilic drugs). * Rise in serum transaminase can occur, but liver damage is rare. * Muscle tenderness and rise in CPK levels occurs infrequently. Myopathy is the only serious reaction, but is rare ( < 1 per 1000). Few fatalities due to rhabdomyolysis are on record. Myopathy is more common when nicotinic acid/ gemfibrozil or CYP3A4 inhibitor- ketoconazole I erythromycin/ cyclosporine I HIV protease inhibitor is given concurrently. Gemfibrozil inhibits the hepatic uptake of statins by the organic anion traspoer OATP2.it must not be given to pregnant ladies. Uesd in primary hyperlipipidemias. | 159,137 | medmcqa_train |
In a young female of reproductive age with regular menstrual cycles of 28 days ovulation occurs around 14th day of periods. When is the first polar body extruded | A i.e. 24 hours prior to ovulationEvent In OogenesisTime periodMaximum number of germ cell (Oogonia & few oocyte) - 7 million are found by5th month (prenatal)All oogonia become atretic and only primary oocyte surrounded by follicular cell (k/a primordialfollicle) remain by7", month (prenatal)All primary oocyte have staed prophase of meiosis I, but instead of proceeding into metaphase,they enter diplotene stageNear the time of bihPrimary oocyte remain in prophase of meiosis I untilPubeyPrimordial follicle (with primary oocyte) grow to form primary/ preantral- follicle, which grows intosecondary / vesicular / Graffian- follicle. The 2deg follicle enters preovulatory stage - 36 hours beforeovulation (when LH surge occurs) resulting in completion of meiosis I and formation ofsecondary oocyte and 1st polar bodyQ- 36 hours before ovulation2deg oocyte enters meiosis 11 but arrests in metaphase- 3 hours before ovulationMeiosis II is completed with formation of ovulin and 2" polar body only ifFeilization occursWithout feilization 2deg oocyte degenerates with in- 24 hours after ovulation | 159,138 | medmcqa_train |
Basophilic stippling is seen with | i.e. (Thalassaemia) : (292-Harsh mohan 6th) (658-H17th/6th)Punctate basophilia or basophilic stippling is diffuse and uniform basophilic granularity in the cell which does not stain positively with Perl's reaction (in contrast to pappenhamer bodies which stain positively)Examples -* Aplastic anaemia* Thalassaemia* Myelodysplasia* Infections* Lead poisoning* Howell -Jolly bodies - present in Megaloblastic anemia and after splenectomy* Basophilic leucocytosis indicative of CML**PYRIMIDINE 5' - NUCLEOTIDASE (PSN) DEFICIENCY - Highly distinctive feature of this condition is a morphological abnormality of the red cells known as basophilic stippling. This condition is rare but it probably ranks third in frequency among red cell enzyme defects (after G6PD deficiency and pyruvate Kinase deficiency) (658-H17th) | 159,139 | medmcqa_train |
Thumb print sign is seen in: March 2011 | Ans. C: Ischemic colitis Earlier features of intestinal ischemia seen on abdominal radiographs include bowel wall edema, known as "thumb printing". Radiological signs in GIT: Thumb printing sign: Ischemic colitis Bird of prey sign: Sigmoid volvulus Double bubble sign (X-ray abdomen): - Annular pancreas - Duodenal atresia String sign: - Crohn's disease - Pyloric stenosis Single bubble sign: Pyloric stenosis Chain of lake appearance: Chronic pancreatitis Fox sign: Acute pancreatitis Widening of duodenal C loop: Carcinoma of head pf pancreas | 159,140 | medmcqa_train |
Endothelium activation refers to - | Ans. is 'd' i.e., Increased expression of adhesion molecules for leukocyte recruitment o Vascular endothelium in its normal, unactivated state does not bind circulating cells or impede their passage,o In acute inflammation, the endothelium is activated and can bind leukocytes as a prelude to their exit from the bloodvessels.o Inflammatory mediators like thrombin, IL - 1, Platelet Activating Factor, Histamine And TNFactivate endothelial cells by increasing expression of adhesion molecules which can bind leukocytes for leukocyte recruitment. | 159,141 | medmcqa_train |
An amoebic liver abscess can be diagnosed by demonstrating- | Exploratory puncture is one of the most practical methods for confirming the diagnosis of amboebic liver abscess. The aspirated pus may be examined for the demonstration of trophic forms (trophozoites) of E. histolytica.
Aspirations from the center of amoebic liver abscess do not show trophozoites, while aspirates from the margins show trophozoites
About other options
Option 'a'
"Cysts are never seen in extraintestinal lesions"
Option 'c & d'
In extraintestinal amoebiasis, often stool examination is negative | 159,142 | medmcqa_train |
Carboxylases requires - | Ans. is 'd' i.e., Biotin o Biotin is a coenzyme for carbon dioxide fixation reactions.o It serves as prosthetic group of ATP-dependent carboxylase, i.e., in carboxylation reactionQ,o It acts as coenzyme tor acetyl-CoA carboxylaseQ, propionyl-CoA carboxylaseQ, pyruvate carboxylaseQ and metbylcartonyl-CoA carboxylase. | 159,143 | medmcqa_train |
Mechanism of action of sulfonamide is? | Ans. is 'c' i.e., Inhibits folate synthesis Sulfonamides are bacteriostatic and act by inhibiting folic acid synthesis by inhibiting enzyme folate synthatase. | 159,144 | medmcqa_train |
All are true about Net protein utilization (NPU) except | • 1 gram of proteins is equivalent to: 6.25 grams Nitrogen
• NPU of India diets: 50-80 | 159,145 | medmcqa_train |
Following vasectomy for family planning, a patient should be advised to use some other method of contraception, till : | None | 159,146 | medmcqa_train |
The structures passing posterior to diaphragm are all except: | D i.e. Greater splanchnic nerve | 159,147 | medmcqa_train |
True about acid phosphatase is ? | Acid phosphataseAcid phosphatase (ACP) hydrolyzes phosphoric acid esters at pH 5-6.It is found in different isoforms in prostate, spleen, liver, erythrocytes, platelets and bones. Prostatic and erythrocyte isoform can be differentiated by ?i) Prostatic isoform is inhibited by taarate (taarate sensitive), whereas erythrocyte isoform is not.ii) Erythrocyte isoform is inhibited by formaldehyde and cupric ions, whereas prostatic isoform is not.Acid phosphatase, paicularly prostatic enzyme, is unstable at room temperature above 37degC and at pH above 7.0 and more than 50% of the acid phosphatase activity may be lost in 1 hour at room temperature. | 159,148 | medmcqa_train |
Which is not a dietary fiber ? | Ans. is 'b' i.e., LactuloseDietary fibres (Review) Dietary fibre consists of unabsorbable cell wall and other consititutents of vegetable food like celluloseQ, lignin, hemicellulosee, gums, pectinsdeg, aliginates and other polysaccharides.In herbivorous animals, intestinal microoganism breakdown these polysaccharides into acetate, propionate and butyrate.These polysaccharides contain 13-glycosidic linkages.Therefore, they cannot be digested by a-amylase present in human saliva and pancreatic juice because a-amylase breaks a-glycosidic bond (especially 1-4 a linkage).So, dietary fibers are not digested or hydrolyzed but are fermented by colonic bacteria except for lignin, which is neither digested nor fermented by intestinal microorganismsdeg.Dietary fibre absorbes water in the intestine, swells, increase bulk of stool by increasing water content of faeces and soften it, decreases transit time by facilitating colonic tansit."The presence of fibre shoens the transit timese and increases the stool bulk".Dietary fibre is of two types : -Soluble fibree : - These are pectin, aliginates, and gums. These absorb upto 15 times its weight in water as it moves through GIT, producing softer stools. Its good sources are oat, flaxseeds, peas, beans, apple, citrus fruits, carrots, bareley and psyllium.Insoluble fibredeg : - These are cellulose, hemicellulose and lignin. These promote movement of material through digestive system and increases stool bulk. Its good sources are wheat flour, wheat bran, nuts and vegetables. | 159,149 | medmcqa_train |
RNA polymerase does not require : | D i.e. Primer | 159,150 | medmcqa_train |
The protein in the GBM responsible for charge dependent filtration is | Glomerular basement membrane contains: a. Collagen type IV b. Laminin c. Polyanionic proteoglycans (responsible of charge-dependent filtration) d. Entactin e. Fibronectin f. Sialoglycoprotein coating on endothelial and visceral epithelial cells. Ref: ROBBINS BASIC PATHOLOGY 10th ed Pg no: 551 | 159,151 | medmcqa_train |
Which is the most impoant prognostic marker in ALL? | Response to treatment is the most impoant prognostic marker in ALL. Leucocyte count> 50000/ul Poor prognosis Hyperploidy Favorable prognostic factor Response to treatment Remission status at 14 days of chemotherapy is best guide to prognosis. Organomegaly Poor prognosis. Lymph node, liver, spleen and testis enlargement indicate spread of cancer Unorable prognostic factors for ALL: Extreme age group: <1 year or >10 years Black males TLC>1 lac/cu.mm Organomegaly CNS Leukemia L2 ALL, pre B cell and mature B cell ALL Hypoploidy t(9:22) and t(4:11) Remission> 14 days | 159,152 | medmcqa_train |
A patient complains of knee pain. Routine investigations are unremarkable and still, the patient is unsatisfied. Urine turns black on standing, what is the enzyme involved? | Alkaptonuria - Due to deficiency of Homogentisate dioxygenase/ oxidase (requires Iron) Fresh urine is normal in colour On standing or on exposure to air - turns Black - Homogentisic acid accumulated - get oxidised - gives rise to Black urine - Homogentisic acid gets polymerized in body forming ALKAPTON BODIES, which gets accumulated in: Cailages - Nose, ear pinna, interveebral disc Connective tissue has bluish black colour. Patient develops ahralgia & ahritis. - This condition is known as Ochronosis. Ahritis is also known as ochronotic ahritis - Benedict 's test is positive due to homogentisic Acid, which is a Reducing substance - Treatment drug is NITISINONE | 159,153 | medmcqa_train |
Minimum pneumothorax is best seen in which of the following view (chest x-ray)? | A pneumothorax is, when looked for, usually easily appreciated. Typically they demonstrate: visible visceral pleural edge is seen as a very thin, sharp white line. no lung markings are seen peripheral to this line. | 159,154 | medmcqa_train |
Calculate GCS of 25 old head injury patient with following parameters confused,opening eyes in response to pain ,localising pain response to pain | Glasgow coma scale: Eye opening Best verbal response Best motor response Response Score Response Score Response Score Spontaneously 4 Oriented and Converses 5 Obeys commands 6 To verbal stimuli 3 Disoriented and converses 4 Localises pain 5 To pain 2 Inappropriate words 3 Flexion- withdrawal to pain 4 Never 1 Incomprehensible words 2 Abnormal flexion (decoicate rigidity) 3 No response I Abnormal extensive obsturing 2 No response 1 Maximum score is : 15 Minimum score is :03 RE: BAILEY AND LOVE 27TH ED | 159,155 | medmcqa_train |
The nerve supply to pronator muscle of distal radioulnar joint is : | Pronator of proximal radioulnar joint - Pronator teres (median nerve).
Pronator of distal radioulnar joint - Pronator quadratus (anterior interosseous nerve). | 159,156 | medmcqa_train |
Acquire IgA deficiency may occur in ? | Severe Congenital toxoplasmosis Block in B cell differentiation due to defective interaction between T and B cells. Naive B cells are not able to differentiate into IgA - producing cells. | 159,157 | medmcqa_train |
Which category of ICD is associated with mood disorders? | Ans. is 'd' i.e., F3 International classification of disease-10 (ICD-10)o ICD -10 is WHO classification for all diseases and health problems (and not only psychiatric disorders). ICD-10 uses alpha numeric code made of an alphabet (in contrast DSM-IV uses numerical coding) - 'F' is for mental disorders. There are 10 main categories denoted by digits 0 to 9.CodeCategoryF0Organic, including symptomatic mental disorders.FIMental and behaviuor disorders due to psychoactive substance useF2Schizophrenia, schizotypal and delusional disordersF3Mood (affective) disordersF4Neurotic, stress-related and somatoform disorders.F5Behavioral syndromes associated with physiological disturbances and physical factorsF6Disorders of adult personality and behaviourF7Mental retardationF8Disorders of psychological developmentF9Behavioural and emotional disorders with onset usually occuring in childhood or adolescence. | 159,158 | medmcqa_train |
Influenza is caused by which virus - | Ans. is 'b' i.e., Orthomyxovirus DNA virusesPoxviridaeVariola, vaccinia, cowpox, monkeypox, tanapox, molluscum contagiosumHerpesviridaeHSV-1, HSV-2, varicella-zoster, EBV, CMV, HTLV-1, RK-virusAdenovirideAdenovirusParvoviridaeParvovirus, Adenosatellovirus, DensovirusPapovaviridaePapilloma \4rus (HPV), PolyomavirusHepadnaviridaeHepatitis-B virus RNA VirusesPicornaviridaePoliovirus, Coxsackievirus, Echovirus, Enterovirus, Rhinovirus, Hepatitis A virusCaliciviridaeNorwalk virus, Hepatitis E virusTogaviridaeRubella virus, Eastern equine encephalitis virus, Western equine encephalitis virusFlaviviridaeYellow fever virus, Dengue virus, St. Louis encephalitis virus, West nile virus, Hepatitis C virus, Hepatitis G virusCoronaviridaeCoronavirusesRhabdoviridaeRabies virus, Vesicular stomatitis virusFiloviridaeMarburg virus, Ebola virusParamyxoviridaeParainfluenza virus, Respiratory syncytial virus, Newcastle disease virus, Mumps virus, Rubeola (measles) virusOrthomyxoviridaeInfluenza virus | 159,159 | medmcqa_train |
'Whip-lash' Injury is caused due to- | * Whiplash Injury is caused by sudden unexpected hyperextension of cervical spine followed immediately by flexion. <img alt="" src=" /> Ref: Apley's 9th/e p.820 | 159,160 | medmcqa_train |
Increase in height in first year is by – | At birth, the average height of a child is 50 cm.
During first year height increases about 50% of birth height (25 cm). | 159,161 | medmcqa_train |
The pre-malignant condition with the highest probability of progression to malignancy is | Incidence of malignant change in erythroplakia is 17- fold higher than in leukoplakia. | 159,162 | medmcqa_train |
Hemoglobin unlike myoglobin showsa) Sigmoid curve of oxygen dissociationb) Positive cooperativityc) Hills coefficient of oned) None of above | Hb-O2 dissociation curve- Sigmoid shape
Co-operativity- Hb is a tetramer. If one molecule of O2 binds to the tetramer more easily if other O2 is already bound.
Hills coefficient of Hb- 2.8 | 159,163 | medmcqa_train |
Not an Ideal Candidate for inseion of IUCD | The Ideal IUCD candidateThe planned parenthood federation of America has described the ideal IUCD candidate as a woman:who has born at least one childhas no history of pelvic diseaseis willing to check the IUCD tailhas access to follow up and treatment of potential problems, andis in a monogamous relationshipRef: Park pg no: 497 | 159,164 | medmcqa_train |
A 32 year old male with painless lymph node in cervical region. Lymph node biopsy shown normal thyroid gland features. The thyroid is normal on palpation clinically. The diagnosis is | Thyroid tissue present in cervical lymph nodes in the face of a clinically normal thyroid gland is a metastasis from an occult primary thyroid carcinoma Occasionally, a metastatic papillary thyroid cancer manifests as a painless lateral neck mass that is clinically detected before detecting the primary thyroid lesion. Comment: Normal thyroid tissue is a trap by examiner, remeber in young people papillary thyroid cancer mostly is well differentiated. Well differentiated cells look like normal cells and tend to grow .and spread more slowly than poorly differentiated cells (anaplastic carcinoma). Sabiston 20th edition pg 926 | 159,165 | medmcqa_train |
Tourette is a disorder of | Tourette's disorder(Gilles de la Tourette) - combined vocal and multiple motor tic disorder. presence of both multiple motor and one or more vocal tics (>1 year) Onset <18 years involuntary, spasmodic, stereotyped movement of small groups of muscles; seen most predominantly in moments of stress or anxiety Ex: Nose twitching, Shoulder shrugging, Sustained eye closure, Tensing of abdominal or limb muscles Etiology- Neurotransmitter dysregulation in basal ganglia, striatum, and frontal lobes. Rx- Haloperidol , pimozide(first line) , Risperidone , olanzapine comorbidity- ADHD, OCD AUTO IMMUNE-PANDAS( Peadiatric Auto immune NeuroPsychiatric disorders assosiated with Streptococcus) Akathisia* Motor restlessness (unpleasant need to move), usually in the lower extremities Ballismus* Intermittent, coarse, large-amplitude, jerking, shaking, flinging movements Chorea* Irregular, spasmodic movements, usually affecting the limbs or face Tic* Non-rhythmic, Stereotyped, rapid, recurring movement, involuntary or semivoluntary, and sudden in onset. TYPES: (motor tic) or vocalization (phonic or vocal tic) Tremor* Unintentional, somewhat rhythmic, muscle movement involving oscillations of one or more pas of the body Stereotypy* Repetitive, usually meaningless, gestures, habits, or automatisms Reference: P 3617: chap 46.Tic Disorders(Kaplan & Sadock's Comprehensive Textbook of Psychiatry, 9th Edition)P 81 DSM-5 | 159,166 | medmcqa_train |
All of the following radiologic features are seen in patients with chronic cor pulmonale, except | Diagnosis of Chronic cor pulmonale:Chest X-rayECGECHORight ventricular hyperophyRight atrial dilatationProminent pulmonary aeryPeripheral lung fields show reduced vascular markingsFeatures of hyperinflation: Widened intercostal space, increased translucency of lung and flattened diaphragm. Right ventricular hyperophy Right axis detionProminent R wave in lead V1 & inveed T waves in right precordial leadsLarge S in Lead I, II and IIILarge Q in lead IIITall Peaked P waves (P pulmonale) in lead II, III and aVF.Right ventricular dilatation and tricuspid regurgitation(Refer: Harrison's Principles of Internal Medicine, 18th edition, pg no: 1913-1915) | 159,167 | medmcqa_train |
Osgood schlatter disease is osteochondritis of ? | Ans. is 'a' i.e., Tibial tuberosity | 159,168 | medmcqa_train |
A male neonate is born with an omphalocele (shown in Figure below). This entity can be distinguished from gastroschisis, because in an omphalocele, the protrusion is:Giant omphalocele in a newborn male. | In omphalocele (see figure below), the swelling is covered by a membrane formed by the peritoneum, Wharton's jelly, and amnion. The membrane is transparent, and underlying intestine can be seen. The other features listed are characteristic of gastroschisis. In gastroschisis, the protrusion is not covered by a membrane and the other features listed apply.Radiograph shows large swelling due to gastroschisis. (Multiple loops of bowel lying on the right side and outside of the abdomen)Radiograph shows large swelling due to gastroschisis. (Bowel loops wrapped in synthetic bag to reduce bowel sequentially.) | 159,169 | medmcqa_train |
Xeroderma pigmentosum is caused due to defect in: (Repeat) | Ref: Chapter 7. Neoplasia; page: 275; Robbins and Cot ran Pathologic Basis of Disease: 8t>? editionExplanation:* Defective DNA - repair syndromes are set of syndrome due to defect in DNA repair genes and resultant DNA instability.* These are autosomal recessive in inheritance and include:Xeroderma pigmentosumBloom syndromeAtaxia telangiectasia.* Whereas, HNPCC is associated with inactivation of DNA mismatch repair gene, resulting in increased susceptibility to colon cancer, and cancers of Endometrium, ovary etc.,* Example for Base pair defect is Sickle cell anemia; example for Translocation defect is Philadelphia chromosome in CML - t (9:22). | 159,170 | medmcqa_train |
Which of the following transmits the Internal Carotid aery? | ForamensStructuresCribriform plate of ethmoidOlfactory nervesOptic foramenOptic nerve, ophthalmic aery, meningesSuperior orbital fissureOculomotor, trochlear, and abducens nerves; ophthalmic division of trigeminal nerve; superior ophthalmic veinForamen rotundumMaxillary division of trigeminal nerve, small aery and veinForamen ovaleMandibular division of trigeminal nerve, veinForamen lacerumInternal carotid aery, sympathetic plexusForamen spinosumMiddle meningeal aery and veinInternal acoustic meatusFacial and vestibulocochlear nerves, internal auditory aeryJugular foramenGlossopharyngeal, vagus, and spinal accessory nerves; sigmoid sinusHypoglossal canalHypoglossal nerveForamen magnumMedulla and meninges, spinal accessory nerve, veebral aeries, anterior and posterior spinal aeries | 159,171 | medmcqa_train |
Which of the following compounds acts as a benzodiaz epine antagonist? | A specific BZD antagonist flumazenil is used for BZD poisoning ,it is a BZD analogue which has little intrinsic activity (no effect on normal subject), but competes with BZD agonist as well as inverse agonist for BZD receptor &reverse its effect . Ref: KD tripathi 8th ed. | 159,172 | medmcqa_train |
Structures Passing Through The Foramen Marked in the Diagram are all EXCEPT? | The Structure Marked is Foramen Magnum Lower pa of medulla oblongata (not the spinal cord) passes through posterior pa of foramen magnum, and veebralaeries are transmitted through the subarachnoid space in foramen magnum Ref : BD chaurasia | 159,173 | medmcqa_train |
70 year old man with cervical lymphadenopathy.What can be the cause - | Ans. is 'a' i.e., Nasopharyngeal carcinoma o Among the given options only nasopharyngeal carcinoma is a common cause of cervical nodes in 70 years male,o Information in this question :i) Cervical adenopathy (Neck node) Most common presentation of nasopharyngeal carcinoma.ii) Type B tympanogram Indicates serous otitis media, which may be a complication of nasopharyngeal carcinoma due to eustachian tube blockade.o Thus, among the given options, nasopharyngeal carcinoma is the answer of choice.Clinical features of nasophary ngeal carcinomao Symptomatology of nasopharyngeal carcinoma is divided into five main groupsNasal symptomsNasal obstruction, nasal discharge, denasal speech (rhinolalia clausa), episiaxis.Otologic symptomsOtologic symptoms are due to obstruction of eustachian tube.This results in serous or suppurative otitis media. Which causes conductive deafness.Presence of unilateral serous otitis media in adult should raise the suspicion of nasopharyngeal carcinoma.Tinnitus and dizziness may occur.OphthalomoneuroLogical symptomsThese symptoms occur due to spread of tumor to the surrounding regions.Squint and diplopia due to involvement of VP cranial nerve.Ophthalmoplagia due to involvement of IIIrd. IVth &. VIth cranial nerve.Facial pain & reduced corneal sensations due to Vth nerve involvementExophthalmos and blindness due to direct extension into the orbit.Jugular foramen syndrome (IXth, Xth, XIth cranial nerve involvementj due to pressure by enlarged lateral retropharyngeal lymph nodes.Cranial nerve XIth involvement due to extension of growth to hypoglossal canal.Horner's syndrome due involvement of cervical sympathetic chain.Neckmass:-Itisthemnstcommonpresentation(60-90%)Due to cervical lymphadenopathy.Distant metastasisInvolve bone, lung, liver and other sites. | 159,174 | medmcqa_train |
Vi antigen is present in all except- | Vi antigen is present in all except S.paratyphi A. Vi Antigen: It is the surface polysaccharide envelope or capsular antigen covering the O antigen. Expressed in :- S.typhi, S. paratyphi C, S. dublin and some strains of Citrobacter freundii. When Vi antigen is present, it renders the bacilli inagglutinable with the O antiserum. Poorly immunogenic and antibody titres are low, not helpful in diagnosis , hence not employed in the Widal test. Complete absence of the Vi antibody in a proven case of typhoid fever- Poor prognosis. Note: Vi Antibodies are not seen in normal population. | 159,175 | medmcqa_train |
Child having long history of hemoglobin 5 gm% next step? | Ans. is 'b' i.e., CBC,reti count with peripheral smear In above question, if child is stable, then no need to give blood transfusion. Before staing Iron, we have to rule out types of anemia as Iron is indicated only in nutritioral anemia. Hb ele ctrophoresis is indicated if there is featuer of hemolytic anemia (thalassemia) so over all our next step is complete hemogram with manual peripheral smear examination. (obtion b). | 159,176 | medmcqa_train |
Serum alkaline phosphatase levels increases in: | Ans. C. HyperparathyroidismSerum alkaline phosphatase is increased in hyperparathyroidism, rickets, obstructive jaundice and Paget's disease. | 159,177 | medmcqa_train |
Which of the following is true regarding the trophozoite of E. histolytica? | Ans. (d) Shows erythrophagocytosis Differntial features of intestinal entamoede Features E. histolytica E. hamanni E. coli Trophozoite Size (pm) 12-60 4-12 20-50 Motility Motility Active Sluggish Pseudopodia Finger shaped, rapidly extruded Finger shaped, rapidly extruded Sho, blunt, slowly extruded Cytoplasm Clearly defined into endoplasm and ectoplasm Clearly defined into ectoplasm and endoplasm Not defined Inclusions Red blood cells present, no bacteria Bacteria and other paicles, no red blood cells Bacteria and other paicles, no red blood cell Nucleus Not clearly visible in unstained films; It is eccentric Not clearly visible in unstained films Visible in unstained films Karyosome Small, central Small, eccentric Large, eccentric Differntial features of intestinal entamoede Features E. histolytica E. hamanni E. coli Nuclear membrane Delicate, with fine chromatin dots Coarse chromatin granules Thick, with coarse chromatin Cyst Size (pm) 10-15 5-10 10-30 Nuclei in mature cyst 4, central karyosome 4 8, eccentric karyosome Glycogen mass Seen in uninucleate, but not in quadrinucleate stage Seen in uninucleate, but not in quadrinucleate stage Seen upto quadrinucleate stage Chromatidial bars 1-4, with rounded ends Often numerous, shape irregular Splinter like with angular ends | 159,178 | medmcqa_train |
You have diagnosed intrinsic asthma in a patient and is explaining to him regarding his illness. He has no family history of asthma. All the following are true regarding intrinsic asthma, EXCEPT: | Intrinsic asthma is a non atopic condition and so no allergen is detected. The onset in during adulthood and family history may be absent. No preceding allergic illness may be evident and unlike extrinsic asthma it has no association with chronic bronchitis or nasal polyp. Ref: Harsh Mohan Pathology Quick Review, 4th Edition, Page 652 | 159,179 | medmcqa_train |
Root Value of Pudendal Nerve is: | Ans. B. S2 S3 S4 The pudendal nerve (Root Value S2 S3 S4 ) is the main nerve of the perineum. It carries sensation from the external genitalia of both sexes and the skin around the anus and perineum, as well the motor supply to various pelvic muscles, including the male or female external urethral sphincter and the external anal sphincter. If damaged, most commonly by childbirth, lesions may cause sensory loss or fecal incontinence. | 159,180 | medmcqa_train |
Budd chiari syndrome can be caused by - | Ans. is 'd' i.e., AllBudd-chiari syndrome o Budd-chiari syndrome is the clinical picture caused by occlusion of the hepatic vein or inferior vena cava.o It presents with classical triad of abdominal pain, ascites and hepatomegaly.Causes of Budd-chiari syndromeHepatic vein thrombosisMyeloproliferative disorders (Polycythemia)Inherited disorder of coagulation --> deficiency of antithrombin, protin 'C' & 'S'.o Antiphospholipid syndromeo Paroxysmal nocturnal hemoglobinuriao Intraabdominal cancers, paicularly hepatocellular carcinoma.Pregnancyo Oral contraceptives (estrogen + Progesteron) 2. Membranous web in inferior vena cova. I am not sure about option 'c' | 159,181 | medmcqa_train |
The most important investigation in the given case to diagnose if the condition is a neoplasm? | Ans. (a) JAK-2The figure shows increased platelets in smear and increased megakaryocytes in bone marrow. To diagnose this as essential thrombocythemia (neoplasm); JAK-2 mutation analysis should be done. | 159,182 | medmcqa_train |
World diabetes day is celebrated on - | Ans. is 'c' i.e., 14th November* 8th may - world red cross day* 8th march - international womens day* 14th november - world diabetes day* 1st december - world AIDS day | 159,183 | medmcqa_train |
An anesthetic agent with boiling temperature more than 75 C is | Refer Anesthesiology by Longnecker 2008/777 Boiling point of methoxyflurane is 104,7 degree Celsius whereas other flurrinated anesthetics have boiling point between 50 C and 60 C | 159,184 | medmcqa_train |
Takayam test is used for? | Ans. is 'a' i.e. To know the nature of stain o It is a microchemical test to know the nature of stain.Microchemical tests: These tests are based on property of haem part of hemoglobin to form characteristic coloured crystals.1) Teichmann's haemin crystal test2) Takayama hemochromogen crystal test3) Luminal spray test: It is especially useful in old obscure blood stains | 159,185 | medmcqa_train |
A small Ca2+ binding protein that modifies the activity of many enzymes and other proteins m response to changes in Ca2+ concentration, is known as | Calmodulin is a calcium-binding regulatory protein, with a molecular weight of 17,000 daltonsIt can bind with 4 calcium ionsCalcium binding leads to activation of enzymes. It is a pa of various regulatory kinasesRef: DM Vasudevan, 7th edition, page no: 503, 504 | 159,186 | medmcqa_train |
Dead space is reduced in tracheostomy by | Airflow resistance of the normal upper airway is substantial, constituting up to 80% of total airway resistance during nose breathing and 50% during mouth breathing.Theoretically, tracheostomy tubes should decrease airflow resistance, but in fact, this does not occur because of the smaller radius (inner diameter 7-8 mm) of the tubes. Tracheostomy tubes may reduce dead space by up to 100 mL -150 mL, 30-50% when compared to spontaneous breathing. This occurs because the tubes are small and bypass the glottic and supraglottic spaces. | 159,187 | medmcqa_train |
S/E of diethyl stilbesterol when used in pregnant woman- | Ans. is 'c' i.e., Infeility and development vaginal carcinoma in female offspring Stilbestrol given to pregnant women Increased risk of vaginal and cervical carcinoma in the female offspring in childhood or early adulthood. | 159,188 | medmcqa_train |
ASA -3 is | ASA grade 3 is when comorbidities are present and make patient symptomatic often. | 159,189 | medmcqa_train |
Lesion not seen in Lepromatous leprosy is:- | Lepromatous leprosy The first clinical manifestations are usually dermal (because early nerve involvement is usually asymptomatic) Leonine facies occur due to diffuse involvement of the facial skin Early symptoms Nasal symptoms of stuffiness, discharge and epistaxis, and oedema of legs and ankles due to increased capillary stasis and permeability. Eyebrows and eyelashes become thinned or lost (madarosis) Ear lobes are thickened Nose becomes misshapen, and may collapse due to septal perforation and loss of the anterior nasal spine Dermal signs comprise macules, diffuse papules, infiltration or nodules, Hair growth and sensation are not initially impaired over the lesions. | 159,190 | medmcqa_train |
The conversion of optically pure isomer (enantiomer) into a mixture of equal amounts of both dextro and levo forms is called as | Depending on the rotation, molecules are called dextrorotatory (+) (d) or levorotatory (-) (l). Thus D-glucose is dextrorotatory but D-fructose is levorotatory. Equimolecular mixture of optical isomers has no net rotation (racemic mixture) or Racemization Ref: Textbook of Biochemistry for Medical Students, 7E (DM Vasudevan)(2013) Pg no.70 & 71. | 159,191 | medmcqa_train |
When a homicide case comes to a doctor, he has to inform police. This comes under which section? | Every person, aware of the Commission of ceain offences shall give information to the nearest Magistrate or police officer.This comes under 39 Crpc section. Examples of such offences are: Offences relating to adulteration of food and drugs, etc Offences affecting life (302, 303, 304 IPC) Offence relating to kidnapping for ransom (364AIPC) Offences of robbery and dacoity | 159,192 | medmcqa_train |
Post-dural puncture headache is typically ? | Ans is 'c' i.e. Bifrontal or occipital Characteristics of post lumbar puncture Headache Cause - There is loss of C.S.F which decreases the brains suppoive cushion so that when a patient is upright there is dilatation and tension placed on brain's anchoring structures and the pain sensitive dural sinuses, resulting in pain. Nature - Usually a dull ache but may be throbbing Location - Occipito frontal * Accompanying symptoms -Nausea, stiff neck, blurred vision, photophobia, tinnitus and veigo Onset - Pain usually begins within 48hrs., but may be delayed for upto 12 days. Precipitating factors It is dramatically positional, it begins when the patient sits or stands upright Also worsened by head shaking or jugular venous compression Relief is obtained on reclining or with abdominal compression Treatment Post-LP headache usually resolves without specific treatment, and care is largely suppoive with oral analgesics and antiemetics. Patients may obtain relief by lying in a comfoable position. For some patients beverages with caffeine can provide temporary pain relief. For patients with persistent pain, - Treatment with I.V. caffeine may be effective. Epidural blood patch : an epidural blood patch accomplished by injection of 15m1. of autologus whole blood is almost successful in those who do not respond to caffeine. | 159,193 | medmcqa_train |
The glomus tumor invasion of jugular bulb is diagnosed by | MRI - gives soft tissue extent of tumor; Magnetic Resonance Angiography (MRA) shows compression of the carotid aery whereas magnetic resonance venography shows invasion of jugular bulb by the tumor. | 159,194 | medmcqa_train |
Chemically steroids are derivatives of | Cholesterol is first acted upon by desmolasw and a 6 carbon unit is cleaved off, forming pregnenoloneProgesterone is the first steroid hormone formed from pregnenoloneProgesterone is fuher conveed in to glucocoicoids, mineralocoicoids and sex steroids Ref: DM Vasudevan, 7th edition, page no: 664, 665 | 159,195 | medmcqa_train |
Toxin production by Corynebacterium diphtheria is due to ? | Ans. is 'c' i.e., Lysogenic conversion o The toxigenicity of the diphtheria bacilli depends on the presence in it of corynephages (tox +). Nontoxigenic strains may be rendered toxigenic by infecting them with beta phage or some other larger phage. This is known as lysogenic conversion or phage conversion. | 159,196 | medmcqa_train |
Azoospermia is seen in which syndrome - | Young's syndrome, also known as azoospermia sinopulmonary infections, sinusitis-infertility syndrome and Barry-Perkins-Young syndrome, is a rare condition that encompasses a combination of syndromes such as bronchiectasis, rhinosinusitis and reduced fertility. In individuals with this syndrome, the functioning of the lungs is usually normal but the mucus is abnormally viscous. The reduced fertility (azoospermia) is due to functional obstruction of sperm transport down the genital tract at the epididymis where the sperms are found in viscous, lipid-rich fluid. | 159,197 | medmcqa_train |
Which is the rarest type of von Willebrand disease? | Type III vWD is the rarest type of von Willebrand disease. It result from the inheritance of a mutant vWF gene from both parents. TYPES OF vBD: Condition Defect vWD type 1 Mild to moderate quantitative deficiency of vWF (i.e., about 20-50% of normal levels). vWD type 2A The most common qualitative abnormality of vWF selective loss of large and medium-sized multimers vWD type 2B Loss of only large multimers vWD type 2N Characterized by a defect residing within the patient's plasma vWF that interferes with its ability to bind F VIII. vWD type 2M Involves qualitative variants with decreased platelet-dependent function vWD type 3 A severe, quantitative deficiency associated with very little or no detectable plasma or platelet vWF, have a profound bleeding disorder | 159,198 | medmcqa_train |
chelioscopy is the study of - | Lip prints | 159,199 | medmcqa_train |
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