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Septic arthritis in a 2-year-old child is often caused by – | Bacteria are the most common pathogens in acute skeletal infections.
The microbial spectrum is diverse in suppurative arthritis, but Staphylococcus aureus infection is most common.
Salmonella is the most common cause of osteomyelitis in children with sickle cell anemia. | 159,500 | medmcqa_train |
Cell lining of small intestine - | Explainatin 2: The intestinal epithelium is the layer of cells that forms the luminal surface or lining of both the small and large intestine (colon) of the gastrointestinal tract. It is composed of simple columnar epithelium. It has two important functions: absorbing helpful substances and providing a barrier against harmful substances. Explainatin 1:Ans. is 'c' i.e., Simple columnar o Simple columnar epithelium : It is made up of tall columnar cells. Simple columnar cells may be :Simple columnar epithelium (without cilia and microvilli) : Lining of stomach, large intestine, collecting duct and cervical canal.Columnar epithelium with striated border (regularly arranged microvilli) : Lining of small intestine.Columnar epithelium with brush border (irregularly placed microvilli) : Lining of gall bladder.Ciliated columnar epithelium (presence of cilia) : Lining of uterus, fallopion tube, eustachian tube, tympanic cavity and central canal of spinal cord and ventricles.o Linining of gall-bladder is columnar epithelium with brush border (irregularly placed microvilli).Type of epitheliumTissue or organSimple squamousLung alveoliMesothelium lining serous surfacesEndocardium and endotheliumLoop of henle in nephronKeratinized stratified squamousEpidermis of skinDuct of sebaceous glandNon keratinized stratified squamousTongue, tonsil, pharynx, esophagusCorneaVaginaSimple columnar epithelium(without cilia and microvilli)Lining of stomach and large intestineCervical canalColumnar epithelium with striated border(regularly arranged microvilli)Lining of small intestineColumnar epithelium with brush border(Irregularly placed microvilli)Gall bladderCiliated columnar epithelium(cilia on surface for propulsion of fluid)Uterus and fallopian tubesEustachian tubeCentral canal of spinal cord and ventricles of brainRespiratory epitheliumSecretory columnar epithelium (with goblet cells)Stomach and intestinesTrachea and bronchiPseudostratified columnar epitheliumOlfactory epitheliumTracheaEustachian tubeVas + deferensUrethraCuboidal epitheliumDucts of glandsThyroid folliclesOvarian surface epitheliumTransitional epithelium (Crothelium)Renal pelvis, calyces, ureter, urinary bladder and part of urethra | 159,501 | medmcqa_train |
Patient with 37 week AOG, centrally located placenta previa presented with bleeding per vaginum. Management: | Ans. (a) Caesarean sectionRef : D.C. Dutta 8th ed. / 290-92; William's 23rd ed. Chapter 35.* Placenta previa-placenta located at LUS.* One of the most commoncause of APH.* In case of centrally located placenta previa -mode of delivery is always CS.Management of placenta previa depends on its type- 4 typesIndication for termination(by vaginal/CS)Indication for conservative management* POG-37 weeks or beyond* Pt continuosly bleeding* Fetal distress* Hemodynamically unstable mother* Pt is active labour* IUD* Congenital malformation of baby which are incompatible with lifeDone in patient who do not obey previous 7 ruleTermination by vaginal delivery or CS (depending on type of PPMa caffe's protocol for conservative mxBed restMonitor vitals-mother and babyBlood transfusion (if needed) Type 1(low lying-vaginal deliveryType 2 (marginal vaginal if placenta anterior, CS-if posteriorType 3 (incomplete/partial)- always CSType 4 (complete/central)- always CSIf POG<34 weeks-give betamethsone 12 mg IM 2 dose, 24 hrs apartm, for lung maturityMark CS as management option for placenta previa if any of following points give in Q-* Mother unstable* Fetal distress* Major degree of PP-type3 (incomplete/partial), type4 (complete/central) | 159,502 | medmcqa_train |
Which of the following techniques in the best for differentiating recurrence of brain tumour from radiation therapy induced necrosis? | Ans. is 'c' ie PET scan (Ref: Harrison, 16/e, p2460)."MRI or CT scans are often unable to distinguish radiation necrosis from recurrent tumor, but PET or SPECT scans may demonstrate that glucose metabolism is increased in tumor tissue but decreased in radiation necrosis." - Harrison. | 159,503 | medmcqa_train |
A 27 yr old boy has itchy, excoriated papules on the forehead and exposed pas of the arms and legs for 3 years. The disease was most severe in the rainy season and improved completely in winter. What is the most likely diagnosis? | In this case, diagnosis can be made by excluding each option. This patient is least likely to have scabies, as it does not produce lesions on the face in adults. Atopic dermatitis is unlikely since he is giving a history of similar lesions only since 3 years. In atopic dermatitis lesions first appears in infancy and then continues into childhood and adulthood. By this time lesions become more and more lichenified. Uicaria is characterised by the presence of evanescent wheals due to edema of dermis, and it last only for 24- 48 hours. So the most appropriate diagnosis would be insect bite hypersensitivity. In this condition the characteristic lesions are itchy persistent papules with a central punctum, seen mainly on exposed pas of the body and aggrevated during rainy season. | 159,504 | medmcqa_train |
Most important layer of a slow sand filter is - | This is confusing one because of the following statements of Park.
"The most important part of the filter is the sand bed" - Park
"The vital layer is the heart of the slow sand filter" - Park
Following statement may help in choosing the answer : -
"Vital layer is the layer that provides the effective purification in potable water treatment, the underlying sand layer providing the support medium for this biological treatment layer" - Water & Health 3rd/e 733.
Read the mechanism of action of slow sand filter and there will be no confusion.
Mechanism of action of slow sand filter
Slow sand filter work through the, formation of a gelatinous layer called vital layer or hypogeal layer or Schmutzdecke in the top few cm of sand layer.
This layer is formed in the first 10-20 days of operation.
The formation of vital layer is known as "Ripening of the filter".
This vital layer consists of bacteria, fungi, Protozoa, and a range of aquatic insect larvae.
As waste passes through vital layer, particles of foreign matter are trapped in the mucilaginous matrix and dissolved organic material is absorbed and metabolized by bacterial, fungi and protozoa → Vital layer has mechanical (physical) as well as biological action.
So, the vital layer acts as the heart of slow sand filter. | 159,505 | medmcqa_train |
A rickshaw is run over legs of a child making markings of tyre on the legs. Which type of injury is this? | Patterned abrasion. Patterning of abrasions The patterning of abrasions is clearer than that of bruises because abrasions frequently take a fairly detailed impression of the shape of the object causing them and, once inflicted, do not extend or gravitate; therefore, they indicate precisely the area of application of force. An abrasion (or a graze) is a superficial injury involving only the outer layers of the skin and not penetrating the full thickness of the epidermis. Patterned Abrasions: Patterned abrasions occur when the force is applied at or around right angle to the surface of skin. The classical example of this is seen in traffic accidents when tyre of a motor car passes over the skin leaving the pattern when the skin has been squeezed into the grooves of the rubber tread. Pressure Abrasions (Imprint Abrasions): When the impact is veical to the skin surface, the epidermis gets crushed and pressure type of abrasions result and the imprint of the impacting object may be produced. These may be seen in manual strangulation (abrasions produced by fingernails) and in hanging, where the weave of the ligature material may be reproduced. | 159,506 | medmcqa_train |
Asher man n syndrome is secondary to - | Ans. is 'a' i.e., Tuberculosis Asherman's syndrome (AS) or Fritsch syndromeo It is a condition characterized by adhesions and/or fibrosis of the endometrium most often associated with dilation and curettage of the intrauterine cavity:o Intrauterine adhesions can also form after infection with tuberculosis or schistosomiasis,o The adhesions may cause amenorrhea (lack of menstrual periods). repeated miscarriages, and infertility:o Pain during menstruation and ovulation is also sometimes experiencedo The history of a pregnancy event followed by a D&C leading to secondary amenorrhea or hypomenorrhea is typicalo Hysteroscopy is ihe gold standard for diagnosis.o Imaging by sonohysterography or hysterosalpingography will reveal the extent of the scar formation.o Treatment involves surgery to cut and remove the adhesions or scar tissue (adhesiolysis). This can usually be done with hysteroscopy:o Progesterone challenge test is negative.Sites of genital TB% involvementTubes90-100%Uterus50-60%Ovaries20-30%Vagina & vulva1-2%o Menstrual problems occurring in TB patients:-Hypomenorrhea/Amenorrhea due to Asherman s syndrome.Polym enorrhea/Menorrhagia | 159,507 | medmcqa_train |
What is the age of tendon transfer in post polio residual paralysis - | Ans. is 'd' i.e., > 5 years * The available musclepower is redistributed either to equalize an unbalanced paralysis, or to use the motorpower for a more useful function.* It is not done before 5 years of age, asthe child has to be manageable enough tobe taught proper exercises.* More commonlyperformed tendon transfers are as follows:i) Transfer of extensor hallucis longus (EHL)from the distal phalanx of great toe tothe neck of the first metatarsal (modifiedjones operation). This is done to correctfirst metatarsal drop in case of tibialisanterior muscle weakness.ii) Transfer of peronius tertious and brevismuscles (evertors of the foot) to thedorsum of the foot. The transfer isrequired in a foot with dorsiflexor weakness.Evertors can be spared for moreuseful function of dorsiflexion of the foot.iii) Hamstring (knee flexors) transfer to thequadriceps muscle to support a weak knee extensor. | 159,508 | medmcqa_train |
Alosetron is | . | 159,509 | medmcqa_train |
Vitamin A prophylaxis is given to children every:September 2007 | Ans. B: 6 monthsNational programme for prevention of nutritional blindness focuses onPromoting consumption of vitamin A rich foods by pregnant and lactating women and by children under 5 years of age.Administration of massive doses of vitamin A up to 5 years. First dose of 100,000 IU with measles vaccination at 9 months and subsequent doses of 200,000 IU each, every 6 months up to the age of 5 years should be given. | 159,510 | medmcqa_train |
In comparison to hyperplasia, hyperophy involves? | Ans. is 'b' i.e., Increase in cell size without increase in number Hyperplasia Increase in cell number without increasing in size o Occurs due to proliferation of cells Occurs only in cell capable of division DNA content in nuclei is same as normal cells o Example of tissues --> Breast, endometrium, liver, kidney Hyperophy Increase in cell size without increase in number Occurs due to increased synthesis of structural proteins Can occur both in cells with limited capacity of division as well as cells capable of division. DNA content is more than normal cells. Examples of tissues Myocardium, skeletal muscles, Breast, endometium, liver, kidney. Why do some tissues undergo hyperophy, while others undergo hyperplasia ? o The cells that have limited capacity of proliferation (e.g., myocardial cells & skeletal muscle cells) can not increase their number, So they are not able to undergo hyperplasia. But these cells can increase in size in response to increased demand, So they can undergo hyperophy. o The cells capable of division (hepatocytes, renal tubular epithelial cells, smooth muscles of uterus) have both the propeies, i.e., to increase the number as well as the size. So, tissues containing these cells can undergo hyperophy or hyperplasia or both. o For example, both hyperplasia and hyperophy occur in endometrium of pregnant uterus. | 159,511 | medmcqa_train |
This milestone is achieved by _________ | At 10 months Sits up alone and indefinitely without suppo Pulls to a standing position Walks holding furniture Grabs objects with thumb and forefinger Pokes at things with forefingers Uncovers hidden toy Mama, dada sounds (repetitive consonant sounds) Responds to the sound of a name Plays Peek-a-boo Waves bye-bye Ref : Nelson 20th edition pg no : 67 | 159,512 | medmcqa_train |
Which of the following is used for initial screening of auditory function in a neonate? | Most screening programmes for newborn hearing ability uses otoacoustic emission as the initial test. It this test fails then auditory brainstem response is used for screening. Otoacoustic emissions are low level sound emitted spontaneously by the cochlea on presentation of an auditory stimulus. Persons with normal hearing produce oatoacoustic emissions whereas those who have hearing loss of 30-40db HL or greater do not produce OAE. Auditory brainstem response testing is used with babies between the ages of bih and 5 months. It is the electrophysiological response to an acoustic stimulus and originates from the eight cranial nerve and auditory brain stem. It can be used to determine the degree of hearing loss at different audiometric frequencies. | 159,513 | medmcqa_train |
The recommended oral dose of vitamin A in pregnant females is: | Ans. c. 2,00,000 U style="font-size: 1.04761904761905em; font-family: Times New Roman, Times, serif; margin: 0 0 0 8px; text-indent: 0">'There was a previous recommendation by WHO on giving 2 lacs IU of Vitamin A to pregnant women immediately after delivery, which was withdrawn in 2011.' | 159,514 | medmcqa_train |
Not true regarding Sudden infant death syndrome | SIDS / COT DEATH / CRIB DEATH :- It is sudden & unexpected death of seemingly healthy infant whose death remains unexplained even after comp. autopsy. Factors associated with SIDS :- Age = 2 month to 2 years Sex = Male Time = early morning Twins Mother = smoking during pregnancy | 159,515 | medmcqa_train |
Which vitamin is given in type 2B familial hyperlipidemia? | Niacin or nicotinic acid is vitamin. Niacin is conveed to its coenzyme forms NAD and NADPTreatment of hyperlipidemia:Niacin (at doses of 1.5 g/day or 100 times the Recommended Dietary Allowance or RDA) strongly inhibits lipolysis in adipose tissue--the primary producer of circulating free fatty acids. The liver normally uses these circulating fatty acids as a major precursor for triacylglycerol synthesis. Thus, niacin causes a decrease in liver triacylglycerol synthesis, which is required for very-low-density lipoprotein (VLDL, see p.231) production. Low-density lipoprotein (LDL, the cholesterolrich lipoprotein) is derived from VLDL in the plasma. Thus, both plasma tri acylglycerol (in VLDL) and cholesterol (in VLDL and LDL) are lowered. Therefore, niacin is paicularly useful in the treatment of Type IIb hyperlipoproteinemia, in which both VLDL and LDL are elevated. Ref: Lippincott, 5th edition, page no: 380 | 159,516 | medmcqa_train |
Doxylamine used in management of nausea and vomiting is marketed with which vitamin ? | Ans. is'd'i.e., PyridoxineDoxylamineSedative H1 antihistamine with prominent anticholinergic activity. Marketed in combination with pyridoxine, it is specifically promoted in India for 'morning sickness' (vomiting of early pregnancy), although such use is not made in the UK and many other countries. | 159,517 | medmcqa_train |
Maximum tensile strength is recovered in wound area during what period after an injury? | Net collagen accumulation, however, depends not only on increased collagen synthesis but also on decreased degradation. When sutures are removed from an incisional surgical wound, usually at the end of the first week, wound strength is approximately 10% that of unwounded skin. Wound strength increases rapidly over the next 4 weeks, slows down at approximately the third month after the original incision, and reaches a plateau at about 70% to 80% of the tensile strength of unwounded skin. Lower tensile strength in the healed wound area may persist for life. Ref: Robbins 8th edition Chapter 3. | 159,518 | medmcqa_train |
Characteristic of acute inflammation is | Ref Robbins 8/e p 45 ,9/e p74 The acute inflammatory response rapidly delivers leuko- cytes and plasma proteins to sites of injury. Once there, leukocytes clear the invaders and begin the process of digesting and getting rid of necrotic tissues. Acute inflammation has two major components (Fig. 2-2): * Vascular changes: alterations in vessel caliber resulting in increased blood flow (vasodilation) and changes in the vessel wall that permit plasma proteins to leave the cir- culation (increased vascular permeability). In addition, endothelial cells are activated, resulting in increased adhesion of leukocytes and migration of the leukocytes through the vessel wall. * Cellular events: emigration of the leukocytes from the circulation and accumulation in the focus of injury (cel- lular recruitment), followed by activation of the leuko- cytes, enabling them to eliminate the offending agent. The principal leukocytes in acute inflammation are neu- trophils (polymorphonuclear leukocytes). Stimuli for Acute Inflammation Acute inflammatory reactions may be triggered by a variety of stimuli: * Infections (bacterial, viral, fungal, parasitic) are among the most common and medically impoant causes of inflammation. * Trauma (blunt and penetrating) and various physical and chemical agents (e.g., thermal injury, such as burns or frostbite; irradiation; toxicity from ceain environ- mental chemicals) injure host cells and elicit inflamma- tory reactions. * Tissue necrosis (from any cause), including ischemia (as in a myocardial infarct) and physical and chemical injury * Foreign bodies (splinters, di, sutures, crystal deposits * Immune reactions (also called hypersensitivity reactions) against environmental substances or against "self" tissues. Because the stimuli for these inflammatory responses often cannot be eliminated or avoided, such reactions tend to persist, with features of chronic inflam- mation. The term "immune-mediated inflammatory disease" is sometimes used to refer to this group of disorders. Although each of these stimuli may induce reactions with some distinctive characteristics, in general, all inflamma- tory reactions have the same basic features. In this section, we describe first how inflammatory stimuli are recognized by the host, then the typical reac- tions of acute inflammation and its morphologic features, and finally the chemical mediators responsible for these reactions. | 159,519 | medmcqa_train |
All are components of GCS EXCEPT: | ANSWER: (B) RespirationREF: Harrison 18t ed table 267-1GLASGOW COMA SCALE 123456EyesDoes not open eyesOpens eyes in response to painful stimuliOpens eyes in response to voiceOpens eyes spontaneouslyN/AN/AVerbalMakes no soundsIncomprehensiblesoundsUttersinappropriatewordsConfused,disorientedOriented,conversesnormallyN/AMotorMakes no movementsExtension to painful stimuli (decerebrate response)Abnormal flexion to painful stimuli (decorticate response)Flexion/ Withdrawal to painful stimuliLocalizespainfulstimuliObeyscommandsThe scale comprises three tests: eye, verbal and motor responses. The three values separately as well as their sum are considered. The lowest possible GCS (the sum) is 3 (deep coma or death), while the highest is 15 (fully awake person). | 159,520 | medmcqa_train |
Deficiency of the 'intrinsic factor of Castle' causes: | Answer is B (Pernicious Anemia) Deficiency of Intrinsic factor leads to a specific form of vitamin B12 deficiency megaloblastic anemia called `Pernicious Anemia'. Pernicious Anemia also known as Addison's Anemia is a megaloblastic anemia due to deficiency of intrinsic factor (secreted by parietal cells of gastric mucosa) that is essential for vitamic B12 absorption. Note: 'Intrinsic factor' was first described by castle & coworkers and hence intrinsic factor is also called Intrinsic factor of Castle. | 159,521 | medmcqa_train |
Urinary incontinence results from all except - | Rectovesical fistula doesn’t cause urinary incontinence, as the level of fistula is above the sphincter mechanism. | 159,522 | medmcqa_train |
Morbid jealousy is most often seen in patients taking | Some Complications of Alcohol Dependence Medical Complications Central Nervous System: i. Peripheral neuropathy ii. Delirium tremens iii. Rum fits (Alcohol withdrawal seizures) iv. Alcoholic hallucinosis v. Alcoholic jealousy vi. Wernicke-Korsakoff psychosis vii. Marchiaa-Bignami disease viii. Alcoholic dementia ix. Suicide x. Cerebellar degeneration xi. Central pontine myelinosis xii. Head injury and fractures. Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no. 39 | 159,523 | medmcqa_train |
Most common subtype of thyroid cancer is? | ANSWER: (B) Papillary carcinomaREF: Sabiston 18th ed chapter 36, Schwartz 9th ed chapter 38Papillary carcinoma is the most common of the thyroid neoplasms and is usually associated with an excellent prognosis, particularly in female patients younger than 40 years. About 70% to 80% of patients in the United States in whom thyroid carcinoma is newly diagnosed have papillary carcinoma.Thyroid malignancy PapillarycarcinomaFollicularcarcinomaHurthle cell carcinomaMedullarycarcinomaAnaplasticcarcinomaLymphomaPrevalence80%10%3%5%1%<1%Cell typeFollicularFollicularFollicular,oxyphiliccellsParathyroid C cellswide variety of cell typesNon Hodgkin's B cell type | 159,524 | medmcqa_train |
A 35 yr old P 3+0 is observed to have CIN grade III on colposcopic biopsy. Best treatment will be | LEEP Repeat All India 2009 "Although CIN can be treated with a variety of techniques, the preferred treatment for CIN 2 and 3 has become LEE?" - Novak's Gynecology p582 Though the patient is 35 yrs old and has completed her family, still hysterectomy won't be treatment of choice as-"Hysterectomy is currently considered too radical .for treatment of CIN"Novak's Gynecology p.585 Following are some situations in which hysterectomy remains a valid and appropriate method of treatment for CIN Microinvasion CIN 3 at limits of conizution specimen in selected patients Poor compliance with follow-up Other gynecologic problems requiring hysterectomy, such as fibroids, prolapse, endometriosis, and pelvic inflammatory disease Cervical intraepithelial neoplasia(CIN) Invasive squamous cell cervical cancers are preceded by a long phase of preinvasive disease, collectively referred to as cervical intraepithelial neoplasia (CIN). Histopathologically a pa or the full thickness of cervical squamous epithelium is replaced by cells showing varying degree of dysplasia, with intact basement membrane. CIN may be suspected through cytological examination using the Pap smear test or through colposcopic examination. Cervical cytology is the most efficacious and cost-effective method for cancer screening. Final diagnosis of CIN is established by the histopathological examination of a cervical punch biopsy or excision specimen. Additionally, human papilloma virus (HPV) testing can be performed in order to better triage women with early cytologic changes. Cervical Cytology Screening (American College of Obstetricians and Gynecologists Guideline) Initial screening Age 21 or 3 y after vaginal sex Interval Every year Every 2-3 y after age 30 with 3 consecutive normals Discontinue No upper limit of age Comparison of Cytology Classification Systems (in simplified form) Bathesda CIN llysplasia Limit of histologic changes *LSIL CIN 1 Mild Basal 1/3rd of sq. epithelium HSIL ON 2 Moderate Basal 1/2 to 2/3rd CIN3 Severe Whole thickness except one or two superficial layers CIS Whole thickness LSIL - Low grade squamous intraepithelial lesion HSIL - High grade squamous intraepithelial lesion CIS - Carcinoma in situ *LSIL incorporates HPV changes (koilocytotic atypia) along with CIN I. Role of HPV HPV infection is found in approx. 90% cases of intraepithelial neoplasia. Type H&18 are most commonly associated. HPV-18 is more specific than HPV-16 for invasive tumors. In most women, the HPV infection clears in 9 to 15 months. Only a minority of women exposed to HPV develop persistent infection that may progress to CIN. Type-16 is the most common HPV type found in women with normal cytology. Treatment CIN 1 Spontaneous regression of CIN 1 is seen in 60% to 85% of cases, typically within 2yrs. So patients who have biopsy diagnoses of C1N 1 are kept under observation with: Pap testing performed at 6 and 12 months Or HPV DNA testing at 12 months After two negative test results or a single negative HPV DNA test, annual screening may be resumed. Women with persistent CIN 1 after 24 months should be treated with a local ablative method. CIN 2 and3 CIN 2&3 carries a much higher probability of progressing to invasive cancer. All CIN 2 and 3 lesions require t reatment. LEEP ( loop electrosurgical excision procedure) is the preferred treatment for CIN 2 and 3. Because all therapeutic modalities carry an inherent recurrence rate of upto 10%. cytologic follow-up at about 3-month intervals for 1 year is necessary. Cryotherapy Considered acceptable therapy when the following criteria are met: - Cervical intraepithelial neoplasia, grade 1 to 2 - Small lesion Ectocervical location only - Negative endocervical sample - No endocervical gland involvement on biopsy Laser Ablation It has been used effectively for the treatment of CIN .But because of the expense of the equipment as well as necessity for special training, laser ablation has fallen out of or. Laser has been widely replaced by LEEP. Laser Excisional Conization Rather than using laser for vaporization leading to ablation, it can be used to excise a conization specimen. The ease of LEEP conization has significantly reduced the indications of laser conization. Loop electrosurgical excision( LEEP) LEEP, variably known as simply loop excision or LLETZ (large loop excision of the transformation zone), is a valuable tool for the diagnosis and treatment of CIN. It uses low-voltage, high-frequency, thin wire loop electrodes to perform a targeted removal of a cervical lesion, an excision of the transformation zone, or a cervical conization. This technique can be used in the outpatient setting Cold knife conization (scalpel) Conization is both a diagnostic and therapeutic procedure and has the advantage over ablative therapies of providing tissue for fuher evaluation to rule out invasive cancer. Conization is indicated for CIN 2&3 in following conditions: - Limits of the lesion cannot be visualized with colposcopy. - The squat-no-columnar junction (SCE) is not seen at colposcopy. - Endocervical curettage (ECC) histologic findings are positive for CIN 2 or CIN 3. - There is a substantial lack of correlation between cytology, biopsy, and colposcopy results. - Microinvasion is suspected based on biopsy, colposcopy, or cytology results. - The colposcopist is unable to rule out invasive cancer. | 159,525 | medmcqa_train |
Lipschutz inclusion bodies are seen in infects caused by- | Herpes Simplex Viruses Infection Laboratory Diagnosis 1. Light Microscopy - cells from the base of the lesion, or wiped from a mucous surface, or biopsy material, may reveal intranuclear inclusions (Lipschutz inclusion bodies). Infected cells may show ballooning and fusion. 2. Electron Microscopy - Electron microscopy is not a sensitive tool for the detection of HSV, except in the case of vesicle fluids which often contain 108 or more paicles per milliliter. However, like light microscopy, electron microscopy cannot distinguish between the different viruses. 3. Direct examination by antigen detection - cells from specimens is treated in ice-cold acetone. FITC is generally used for staining of fixed material. It is more sensitive and specific than light and electron microscopy (90% sensitive, 90% specific), but cannot match virus culture. In terms of cost and technical expeise, it is very much more demanding. Cytopathic effect of HSV in cell culture, note the ballooning of cells (Couesy of Linda Stannard, University of Cape Town, S.A.) and positive immunofluorescence test for HSV antigen in the epithelial cell (Virology Laboratory, Yale-New Haven Hospital) Ref: mayo clinic | 159,526 | medmcqa_train |
Which of the following antibodies is the most specific for the diagnosis of rheumatoid arthritis? | Ans. d. Anti-CCP (Ref: Harrison 19/e p2136, 18/e p2745; CMDT 09/727)Anti-CCP antibodies are the most specific blood test for the diagnosis of rheumatoid arthritis."Anti CCP antibodies are the most specific blood test for rheumatoid arthritis (specificity ~95%)."- CMDT 09/727"Anti-cyclic citrullinated peptide (anti-CCP) antibody testing is particularly useful in the diagnosis of rheumatoid arthritis,with high specificity, presence early in the disease process, and ability to identify patients who are likely to have severe disease and irreversible damage. Anti-CCP antibodies have not been found at a significant frequency in other diseases to date, and are more specific than rheumatoid factor for detecting rheumatoid arthritis."- Oxford Journal of Medicine\Rheumatoid ArthritisIt is a chronic systemic inflammatory disease of unknown cause characterized by persistent involvement of synovial membrane of multiple joints and variety of systemic manifestations.More common in femalesQRA is best diagnosed by Anti-CCP antibodiesQ.Pathology:Pathology is not limited to articular cartilage alone and arthritis is typically 'erosive'QThe potential of the synovia! inflammation to cause cartilage damage and bone erosions and subsequent changes in joint integrity is the hallmark of the diseaseQ.RA is most strongly associated with the Class IIQ MHC allele HLA DR4Qand related alleles.Characteristic Features:RA most often causes symmetric arthritis with characteristic involvement of certain specific joints such as the proximal interphalangeal and metacarpophalangeal jointsQ.DIP joints are typically sparedQAxial skeleton involvement is usually limited to upper cervical spineQExtra articular manifestations are seen in up to 40% of patientsQRheumatoid nodules are seen in approximately 20% of patientsQTypically the pleural fluid contains very low levels of glucoseQRA is associated with nurmocytic normochromic anemia of chronic diseaseQAnti CCP antibodies arc the most specific blood test for RA (specificity ~95%)Felty's syndrome is seen in association with RAFelty's syndrome consists of chronic rheumatoid arthritisQ, splenomegalyQ and neutropeniaQDiagnostic criteria for Rheumatoid arthritisMorning stiffness* Stiffness in and around joints lasting 1 hour before maximal improvement.* Constitutional features indicative of the inflammatory nature of disease such as morning stiffness "support the diagnosis"Arthritis* SymmetricalQ, involving same joint areas on both sides of body simultaneously* MultipleQ: It commonly involves three or more joint areas, predominantly of the joint areas in hand (peripheral)* * Typical picture of bilateral symmetrical inflammatory polyarthritis involving small and large joints in both upper and lower extremity with sparing of axial skeleton except the cervical spineQRheumatoid nodulesQ* Demonstration of subcutaneous nodules is helpful diagnostic featureSerum Rheumatoid factorQ* An IgM antibody directed against the Fc fragment of IgG is present in sera of >75% of patientsQ.RadiographicchangesQ* Juxta articular osteoporosisQ* Joint erosion with narrowing of joint spacesQ.Rheumatoid Factor and Rheumatoid Arthritis:Rheumatoid factor in RA belongs to the igM class0 (directed against Fc fragment of IgG)QIgM Rheumatoid factor is positive in about 75-80% of patients with RAPresence of RA factor is not specific for RAQPresence of Rheumatoid factor does not establish the diagnosis of RAQRheumatoid factor is only of prognostic significance because patients with high titers tend to have more severe and progressive disease with extra-articular manifestationsQ.Causes of False Positive Rheumatoid factor* SLE (Associated with a positive Coomb's test)* Sjogren syndrome* Chronic liver disease* Sarcoidosis* Interstitial pulmonary fibrosis* Infectious mononucleosis* Hepatitis B (Associated with HbsAg)* Tuberculosis* Leprosy* Syphilis (Associated with a positive VDRL)* Subacute bacterial endocarditis* Visceral Leishmaniasis* Schistosomiasis* MalariaTreatment:DMARD's include agents that appear to have the capacity to alter the course of Rheumatoid Arthritis.Methotrexate is the DMARD of choice.DMARDs (Disease Modifying Anti-Rheumatoid Drugs)1. MethotrexateQ2. Gold compoundsQ3. D-PenicillamineQ1. Anti-malarials e.g. ChloroquinesQ2. SulfasalazineQ | 159,527 | medmcqa_train |
Glomus tumour invading the veical pa of the carotid canal. It is | FISCH classification is used for glomus tumours based on the extension into surrounding anatomic structures. Type A tumour - Tumour limited to the middle ear cleft (glomus tympanicum) Type B tumour - Tumour limited to the tympanomastoid area with no infralabyrinthine compament involvement Type C tumour - Tumour involving the infralabyrinthine compament of the temporal bone and extending into the petrous apex; Type C1 tumour - Tumor with limited involvement of the veical poion of the carotid canal; Type C2 tumour - Tumour invading the veical poion of the carotid canal; Type C3 tumour - Tumour invasion of the horizontal poion of the carotid canal Type D1 tumour - Tumour with an intracranial extension less than 2 cm in diameter; Type D2 tumour - Tumour with an intracranial extension greater than 2 cm in diameter | 159,528 | medmcqa_train |
An elective surgery is to be done in a patient taking heavy doses of Aspirin. Management consists of : | Ans. is 'b' i.e., Stop aspirin for 7 days and then do surgery "Aspirin should be stopped 1 week before elective surgery." - KDT Aspirin, even in small doses, irreversibly inhibits Thrombooxane A2 (TXA2) synthesis by platelets. Thus it interferes with platelet aggregation and increase the bleeding time. This effect lasts for a week, the turnover time of platelets. | 159,529 | medmcqa_train |
A point that falls on horopter excites: | Ans. Corresponding retinal points | 159,530 | medmcqa_train |
Xerophthalmia is considered a problem in a community if:- | Prevalence criteria for determining the Xerophthalmia problem in a community: Criteria Prevalence Night blindness >1.0% Bitot's spots >0.5% Corneal xerosis / corneal ulceration / keratomalacia >0.01% Corneal ulcer >0.05% Serum retinol >5.0% | 159,531 | medmcqa_train |
Nerve supplying Gemellus inferior | Nerve to Obturator internus supplies obturator internus and Gemellus superior.
Nerve to Quadratus femoris supplies Quadratus femoris and Gemellus inferior | 159,532 | medmcqa_train |
Ca-wheel appearance of tympanic membrane in ASOM is due to | In the stage of presuppuration of ASOM, there is congestion of pars tensa. A leash of blood vessels appears along the handle of malleus and at the periphery of tympanic membrane impaing it a ca-wheel appearance. (Ref: Textbook of diseases of ENT, Dhingra 7th edition; pg no 67) | 159,533 | medmcqa_train |
Regarding Case Control Study true is | (A) Useful for rare diseases # CASE-CONTROL STUDY: Both exposure & outcome have occurred before the start of the study the study proceeds backwards from effect to cause; & it uses a control or comparison group to support or refute an inference.ADVANTAGES AND DISADVANTAGES OF CASE CONTROL STUDIESADVANTAGESDISADVANTAGES1. Relatively easy to carry out1. Problems of bias relies on memory or past records, the accuracy of wh'ch may be uncertain; validation of information obtained is difficult or sometimes impossible2. Rapid and inexpensive (compared with cohort studies)2. Selection of an appropriate control group may be difficult3. Require comparatively few subjects3. We cannot measure incidence, and can only estimate the relative risk4. Particularly suitable to investigate rare diseases or diseases about which little is known. But a disease which is rare in the general population (e.g., leukaemia in adolescents) may not be rare in special exposure group (e.g. prenatal X-rays).4. Do not distinguish between causes and associated factors5. No risk to subjects5. Not suited to the evaluation of therapy or prophylaxis of disease6. Allows the study of several different aetioiogical factors (e.g., smoking, physical activity and personality characteristics in myocardial infarction)6. Another major concern is the representativeness of cases and controls7. Risk factors can be identified. Rational prevention and control programmes can be established 8. No attrition problems, because case control studies do not require follow-up of individuals into the future9. Ethical problems minimal | 159,534 | medmcqa_train |
Laboratory evaluation for the differential diagnosis of chronic myeloproliferative disorders includes all the following evcepr : | Answer is C (Flow cytometry) respective myeloproliferative disorde Myeloproliferative disorder Useful tests Polycythemia vera Elevated Red cell mass / with normal erythropoetin levels Chronic myeloid leukemia Chromosomal demonstration of Philadelphia chromosome or bcr /abl translocation Chronic idiopathic Myelofibrosis Dry tap on bone marrow aspiration alongwith characteristic peripheral blood picture Essential thrombocytosis Elevated Platelet count with cytogenetic evaluation to rule out CML or other myelodysplastic disorder | 159,535 | medmcqa_train |
Scabies, an infection of the skin caused by Sarcoptes scabiet, is an example of: | D i.e. Water related disease Scabies is water washed (category II) water related disease. | 159,536 | medmcqa_train |
A VDRL reactive mother gave bih to an infant. All of the following would help in determining the risk of transmission to the infant, Except | Positive TPHA mother is responsible for transmission of infection to the infant In infants, no test (even TPHA) can show the difference between asymptomatic infected and noninfected. VDRL -- detect antibody titer raised in both infants and mother suggests the transmission 4 weeks before delivery treatment should be completed so time interval is the impoant factor. Ref: Ananthanarayana textbook of Microbiology 9th edition Pgno : 374 | 159,537 | medmcqa_train |
The components of the respiratory control pattern generator is responsible for automatic respiration. Pacemaker regulating the rate of respiration is: | Rhythmic respiration is initiated by a small group of synaptically coupled pacemaker cells in the pre-Botzinger complex (pre-BOTC) on either side of the medulla between the nucleus ambiguus and the lateral reticular nucleus. These neurons discharge rhythmically, and they produce rhythmic discharges in phrenic motor neurons that are abolished by sections between the pre-Botzinger complex and these motor neurons. They also contact the hypoglossal nuclei, and the tongue is involved in the regulation of airway resistance. Ref: Barrett K.E., Barman S.M., Boitano S., Brooks H.L. (2012). Chapter 36. Regulation of Respiration. In K.E. Barrett, S.M. Barman, S. Boitano, H.L. Brooks (Eds), Ganong's Review of Medical Physiology, 24e. | 159,538 | medmcqa_train |
Mizuo phenomenon is seen in: | Ans. b. Oguchi's disease Mizuo phenomenon is seen in Oguchi \ disease."In Oguchis disease the characteristic golden yellowish metallic sheen (color) of posterior pole (fundus) in light adapted state reverts to normal after prolonged dark adaptation, a phenomenon described by and named after Japanese ophthalmologist Mizuo Re-exposure to light results in the return of golden yellow metallic sheen.** Female carriers of X-linked (XL) retinitis pigmentosa may have normal fundi or show a golden metallic (tapetal) reflex at macula and/or small peripheral patches of hone spicule pigmentation. The inverse Mizuo phenomenon seen in XL-RP is characterized by appearance of golden sheen in dark (hut no golden sheen in light)."Oguchi's Disease* Oguchi's disease is a rare autosomal recessive trait characterized by congenital stationary night blindness and a unique morphological and functional abnormality of the retina.* Show Mizuo phenomenon^* Mizuo phenomenon: Fundus is golden yellow in light adapted state which becomes normal after prolonged dark adaptation. Reexposure to light results in the return of the metallic y ellow sheeny.* Rod function is absent after 30-minutes of dark adaptation but recovers to a near normal level after a long period of dark adaptation (i.e. -- normal rod thresholds reached only after 4 hours or longer instead of normal 30 minutes).Etiopathogenesis:* A null allele in genes for each of rhodopsin kinase and arrestin (proteins responsible for terminating phototransduction cascade) is responsible for Oguchi's disease.* Therefore, the persistent low level of light may desensitize the rods continually.* Mizuo phenomenon suggest an abnormality in rod pigment, rhodopsin.* Cone function is normal because cone adaptation, final cone thresholds and photopicERG response are normal.* Rod function is abnormal with delayed dark adaptation and scotopic ERG showing only a small electronegative response, even when the rod threshold have reached normal.Clinical Features:* Patients have non-progressive night blindness since young childhood writh normal day vision, but they often claim improvement of light sensitivities w hen they remain long in the dark environment* The fundus oculi presents a most peculiar appearance. | 159,539 | medmcqa_train |
Hypophosphatemia is seen in all except: | Answer is A (Acute renal failure): Renal insufficiency is associated with hyperphosphatemia due to impaired renal phosphate excretion. Acute renal failure: 'Mild Hyperphosphatemia is an almost invariable complication of Acute Renal Failure. Severe hyperphosphatemia may develop in highly catabolic patients or following rhabdomyolysis, hemolysin or tumor lysis.' -- Harrison 16th / 1650 Diabetic ketoacidosis or Metabolic acidosis from any other causes may be associated with hyperphosphatemia from transcellular phosphatic shifts. However resolving phases of diabetic ketoacidosis are associated with hypophosphatemia and not hyperphosphatemia. This is a result of insulin therapy for diabetic ketoacidosis. Causes of hyperphosphatemia Causes of hypophosphatemia Metabolic acidosis Insulin therapy of diabetic ketoacidosis or prolonged (Lactic acidosis / Diabetic Ketoacidosis) hyperglycemia. Laboratory values in DKA / Harrison 6th / 323 - 324 Phosphate values are : decreased (large changes occurs during treatment of DKA Also note that total body stores of phosphorus (Also potassium, sodium, chloride, magnesium) are reduced in DKA, but are not accurately reflected by their levels (serum values may be increased) because of dehydration and hyperglycemia. -- Harrison Respiratory alkalosis is associated with hypophosphatemia by causing intracellular shift of phosphorus into cells. Hypophosphatemia * Hyperphosphatemia Metalbolic alkalosis * Metabolic acidosis Respiratory alkalosis * Respiratory acidosis Chronic alcoholism / Alcoholism is known to cause hypophosphatemia. -- Harrison 16th / 881 Severe hypophosphatemia is common and multifactorial in alcoholic patients. Chronic alcohol use results in a decrease in the renal threshold of phosphate excretion.' -- CMDT Patients with COPD and Asthma commonly have hypophosphatemia. This is attributed to xanthine derivatives causing shifts of phosphate intracellularly and the phosphaturic effects of beta -- adrenergic agonists, loop diuretics, xanthine derivatives and coicosteroids. -- CMDT 2006 / 88 | 159,540 | medmcqa_train |
Crepitus over skin of the swollen limb should ale on possibility of: KCET 13 | Ans. Gas gangrene | 159,541 | medmcqa_train |
Mutation seen in malignant melanoma is | CDKN2A is a complex locus that encodes three different tumor sup- pressors, p15/INK4b, p16/INK4a, and p14/ARF. Of these, loss of p16/INK4a is clearly implicated in human melanoma, and experimental evidence also suppos a role for loss of p14/ARF. As already mentioned, p16/ INK4a inhibits cyclin-dependent kinase 4 (CDK4) and cyclin-dependent kinase 6 (CDK6), thus reinforcing the ability of the RB tumor suppressor to block cells in the G1 phase of the cell cycle. By contrast, p14/ARF enhances the activity of the p53 tumor suppressor by inhibiting MDM2, an oncoprotein that stimulates p53 degradation. CDKN2A is mutated in approximately 10% of sporadic melanomas, and these mutations uniformly abolish the production of p16/INK4a and more variably affect p14/ ARF. However, it is suspected that these mutations are the tip of the "oncogenic iceberg" with respect to molec- ular lesions affecting the G1 checkpoint. For example, 30% to 70% of melanomas show loss of p16/INK4a expression though varied mechanisms, and other famil- ial and sporadic melanomas have mutations in CDK4 | 159,542 | medmcqa_train |
Sample registration is done | Sample registration system (SRS) SRS is taken once every 6 months It is a dual record data collection system of India Therefore, it is the most accurate data collection system of India | 159,543 | medmcqa_train |
Renal osteodystrophy differs from nutritional osteomalacia by having______. | Ans. a (Increased phosphates) (Ref. H-17th/2694)In addition to measuring serum calcium, it is useful to determine albumin, phosphorus, and magnesium levels. As for the evaluation of hypercalcemia, determining the PTH level is central to the evaluation of hypocalcemia. A suppressed (or "inappropriately low") PTH level in the setting of hypocalcemia establishes absent or reduced PTH secretion (hypopar- athyroidism) as the cause of the hypocalcemia. Further history will often elicit the underlying cause (i.e., parathyroid agenesis vs. destruction). By contrast, an elevated PTH level (secondary hyperparathyroidism) should direct attention to the vitamin D axis as the cause of the hypocalcemia. Nutritional vitamin D deficiency is best assessed by obtaining serum 25-hydroxyvitamin D levels, which reflect vitamin D stores.PRINCIPAL SYSTEMIC MANIFESTATIONS OF CHRONIC RENAL FAILURE AND UREMIAFluid and ElectrolytesCalcium Phosphate and Bone# Dehydration# Hyperphosphatemia# Edema# Hypocalcemia# Hyperkalemia# Secondary hyperparathyroidism# Metabolic acidosis# Renal osteodystrophy | 159,544 | medmcqa_train |
True or false
1. Bronchoscopy with BAL is mainstay of diagnosis for pneumocystic pneumonia
2. Pneumatoceles are seen in all cases of pneumocystic pneumonia
3. CD4 count < 350 /µL is indication for prophylaxis against pneumocyctis carini pneumonia
4. Trimethoprim - sulfamethoxazole is drug of choice for prophylaxis. | CD4 count <200 /µL is indication for prophylaxis.
Pneumatoceles may be seen, but not in all cases. | 159,545 | medmcqa_train |
All are ture about innate immunity except ? | Ans. is 'c' i.e., Not affected by genetic affected | 159,546 | medmcqa_train |
68-year-old male with hypeension presents for annual examination. On review of systems he repos urinary hesitancy and nocturia. Your examination reveals a nontender but enlarged prostate without nodules. On review of his blood pressure logs and clinic readings he is averaging values of 150/80 mm Hg. Wof medication offer treatment of HTN and prostatic symptoms | a-ADRENERGIC BLOCKERS Terazosin, Doxazosin These are long-acting congeners of prazosin with similar propeies but suitable for once daily dosing. advantages include * Does not impair carbohydrate metabolism; suitable for diabetics, but not if neuropathy is present, because postural hypotension is accentuated. * Has a small but ourable effect on lipid profile: lowers LDL cholesterol and triglycerides, increases HDL. * Affords symptomatic improvement in coexisting benign prostatic hyperophy. Ref:- kd tripathi; pg num:-564,565 | 159,547 | medmcqa_train |
Which of the following is not capsulated - | Ans. is 'd' i.e., Proteus Capsuleo Many bacteria secrete a viscid material around the cel! surface,o When this is organized into a sharply defined structure, it is known as capsule,o Capsules are protective and protect the bacteria from phagocytosis and from lytic enzymes.o Some bacteria loose their capsules on repeated subcultures.Cansulated oroanismso Pneumococcuso Yersiniao Bacillus anthraxo V. parahemolyticuso Bordetellao H. influenzaeo Meningococcio Fresh strains of staphylococci, streptococci and E coli.o CL perfringens and CL butyricumo Bacteroideso Klebsiellao Cryptococcus. | 159,548 | medmcqa_train |
In osteogenic sarcoma predominant histological finding is - | Ans. is 'b' i.e.. Osteoid forming tumor ceils [Ref: Apley's 9th/e p. 208}Histologic appearance of osteosarcomao It appears pale and extending through the cortex on gross cut section examination,o On histological sections it consists of malignant stromal tissue showing osteoid formation.o Osteoid bone formation by tumor cells is diagnostic of OGS. | 159,549 | medmcqa_train |
Word substitute used for alginate is: | Euphemisms | 159,550 | medmcqa_train |
A 55-year-old female presents to the surgeon with breast symptoms. Her right breast is swollen, red and tender. The physician palpates a firm area in the breast and suspects inflammatory breast cancer. Which of the following best describes the histological changes observed in this disorder? | Inflammatory breast cancer is a pattern of invasive breast cancer in which the neoplastic cells infiltrate widely through the breast tissue. The cancer involves dermal lymphatics and therefore has a high incidence of systemic metastasis and a poor prognosis. If the lymphatics become blocked, then the area of skin may develop lymphedema and "peau d'orange" or orange peel appearance. The overlying skin in inflammatory breast cancer is usually swollen, red, and tender. Acute inflammation is a rare finding in breast cancer and may be associated with secondary infection or abscess. Chronic inflammation in breast cancer is a non-specific finding. In medullary breast cancer, a type of invasive ductal carcinoma, there are a large number of lymphocytes around the tumor and a desmoplastic reaction is often absent in the surrounding tissue. This type of cancer carries a somewhat better prognosis. Epidermal invasion by cancer cells is a poor prognostic indicator. Intraepidermal malignant cells are called Paget cells. Paget's disease of the nipple is a type of ductal carcinoma that arises in large ducts and spreads intraepidermal to the skin of the nipple and areola. There is usually an underlying ductal carcinoma. | 159,551 | medmcqa_train |
The poor prognostic factor associated with ALL in children is | The standard features are age and WBC at diagnosis, with infants (less than one year), adolescents (greater than nine years), and children with WBC above 50,000/ml being at higher risk. Ceain chromosomal abnormalities are also strong predictors; in paicular, the Philadelphia chromosome and MLL gene rearrangements (especially in infants) are adverse features, while TEL-AML1 is orable. It is impoant to note, however, that even the most impoant known predictors explain only a small propoion of the variability in outcome. Testicular involvement Is a poor prognostic factor for ALL Reference: GHAI Essential pediatrics, 8th edition | 159,552 | medmcqa_train |
Multiple intrahepatic bile duct dilation with bile lakes and concurrent sepsis is suggestive of | Caroli's disease Clinical features : Symptoms include cholangitis (64%), poal hypeension (22%) and abdominal pain(18%) More common in males Septa containing poal veins protrude into the lumen of the ecstatic bile ducts (central dot sign) The main and often the only symptom of bacterial cholangitis secondary to caroli's disease is fever without abdominal pain and jaundice Frequent episodes of cholangitis indicates poor prognosis Most stones are pigmented in caroli's disease Ref: Sabiston 20th edition Pgno :1511 | 159,553 | medmcqa_train |
Vitamin that acts like a hormone | (D) Vitamin D # Vitamin D is a fat-soluble vitamin that acts as a steroid hormone.> Several hormones, including adrenal and gonadal steroid hormones, thyroid hormones, retinoid hormones, and vitamin D, bind with protein receptors inside the cell rather than in the cell membrane. Because these hormones are lipid soluble, they readily cross the cell membrane and interact with receptors in the cytoplasm or nucleus.> The activated hormone-receptor complex then binds with a specific regulatory (promoter) sequence of the DNA called the hormone response element, and in this manner either activates or represses transcription of specific genes and formation of messenger RNA (mRNA) | 159,554 | medmcqa_train |
Rivastigmine & donepezil are drugs used predominantly in the management of - | Ans. is 'd' i.e., Dementia o Rivastigmine, Donepezil, Galantamine and tacrine all are central cholinesterase inhibitors and are used in senile dementia of Alzheimer's desease. | 159,555 | medmcqa_train |
Zellweger syndrome is due to | Zellweger syndrome is due to absence of peroxisomes in all most all tissues, as a result of which long chain fatty acids are not oxidized and accumulated in live and brain. So this syndrome is also called as cerebrohepatorenal syndrome. | 159,556 | medmcqa_train |
Which of the following is a VEGF inhibitor? | Cetuximab, Bevacizumab, Sunitinib, Sorafenib acts as VEGF inhibitors inhibiting angiogenesis.Ref: Sharma and Sharma 3rd ed/pg 875 | 159,557 | medmcqa_train |
One virus particles prevents multiplication of 2nd virus. This phenomena is: | Viral interference
Interference in which infectionof a cell by one virus inhibits simultaneous or subsequent infection by another virus.
Most important mediator of interference is interferon.
Interference produced by destruction of cell receptors is seen with myxoviruses and enterovirus.
It is applied in the field in controlling poliomyelitis outbreaks by in controlling poliomyelitis outbreaks by introducing into the population, the live attenuated poliovirus vaccine. | 159,558 | medmcqa_train |
'Presacral fascia' is derivative of | . | 159,559 | medmcqa_train |
Which are first order neuron in optic pathway- | in visual sensation first order neurons lies in the bipolar cell layer of retina. Reference: textbook of comprehensive Opthalmology by AK Khurana. | 159,560 | medmcqa_train |
Which is more common in primigravida than multigravida : | Hyperemesis | 159,561 | medmcqa_train |
Local anaesthesia causing metheaEUR' moglobinemia | Prilocaine | 159,562 | medmcqa_train |
What is the name of this retractor? | Ans. (a) Deavers retractorDeavers retractor* Used to retract liver without any damage to liver parenchyma.* Used during Cholecystectomy to retract liver.* Used during Pancreatico jejunostomy to retract Stomach* Used in places where a careful retraction without organ damage is needed.Other RetractorsThompson Self Retaining Liver Retractor* Thompson retractor has multiple arms which can be fixed to a rod which is attached to the Operating table.* Adjustable and Self retaining in nature.Balfours Abdominal Self Retaining retractor:* It's used to retract the lateral abdominal walls.* The third limb-used to retract the bladder downwards. Joll's self retaining Thyroid retractor:* Used during thyroidectomy to retract the platysma.* It's a self retaining retractor.Doyen's Mouth gag:* Used to open mouth during intra oral operations like glossectomy, Cleft palate operations and Ranula surgery.* Used to retract tissues during hernia surgery, Appendectomy etc,* Available in various sizes.Morris retractor:* Used to retract the abdominal wall in a wide manner.* It is the instrument of choice for retraction in left subcostal region because it avoids the risk of splenic injuryCzerny retractor:* Serves the same purpose of a Langenback retractor, but has another limb with a double hook with space in between.* Sutures can be made in the tissues between the gap of hooks.Volkmann's Retractor: (Cat Paw retractor)* Has multiple hooks on one limb* Used to retract the skin flaps and fascia during operations on the surface level- Eg. Sebaceous cyst, Lipoma and Dermoid cyst. | 159,563 | medmcqa_train |
FK 506 is a type of: | Tacrolimus (FK506)- structurally a macrolide antibiotic which is a newer immunosuppressant chemically different from cyclosporine, but having the same mechanism of action, and is -100 times more potent. It binds to a different cytoplasmic immunophilin protein labeled 'FKBP', but the subsequent steps are the same, i.e. inhibition of helper T cells calcineurin. Tacrolimus is administered orally as well as by i.v. infusion. Oral absorption is variable and decreased by food. It is metabolized by CYP3A4 Section 14 and excreted in bile with a longer tlh of 12 hour. Therapeutic application, clinical efficacy as well as toxicity profile are similar to cyclosporine. It is paicularly valuable in liver transplantation because its absorption is not dependent on bile. Because of more potent action, itis also suitable for suppressing acute rejection that has set in. Hypeension, hirsutism and gum hyperplasia are less marked than cyclosporine, but tacrolimus is more likely to precipitate diabetes, cause neurotoxicity, alopecia, and diarrhea. Dose-limiting toxicity is renal. ESSENTIALS of MEDICAL PHARMACOLOGY SIXTH EDITION -K. D TRIPATHI Page:853 T | 159,564 | medmcqa_train |
A potent inhibitor of protein synthesis that acts as an analogue of aminoacyl t-RNA is | Puromycin is an aminonucleoside antibiotic, derived from the Streptomyces alboniger bacterium, that causes premature chain termination during translation taking place in the ribosome. Pa of the molecule resembles the 3&; end of the aminoacylated tRNA. It enters the A site and transfers to the growing chain, causing the formation of a puromycylated nascent chain and premature chain release. The exact mechanism of action is unknown at this time but the 3&; position contains an amide linkage instead of the normal ester linkage of tRNA. That makes the molecule much more resistant to hydrolysis and stops the ribosome.Puromycin is selective for either prokaryotes or eukaryotes.Also of note, puromycin is critical in mRNA display. In this reaction, a puromycin molecule is chemically attached to the end of an mRNA template, which is then translated into protein. The puromycin can then form a covalent link to the growing peptide chain allowing the mRNA to be physically linked to its translational product.Antibodies that recognize puromycylated nascent chains can also be used to purify newly synthesized polypeptides and to visualize the distribution of actively translating ribosomes by immunofluorescence.Ref: https://en.wikipedia.org/wiki/Puromycin | 159,565 | medmcqa_train |
All of the following are true of Reye's syndrome, except - | Reye's syndrome , a serious complication in children that is associated with influenza B and to a lesser extent with influenza A virus infection as well as with varicella-zoster virus infection. An epidemiologic association between Reye's syndrome and aspirin therapy for the antecedent viral infection has been noted, and the syndrome's incidence has decreased markedly with widespread warnings regarding aspirin use by children with acute viral respiratory infections. (Harrison's Principles of internal medicine, 20th edition) | 159,566 | medmcqa_train |
Along a pleasant stimulus, noxious stimuli are given in treatment of alcohol dependence or sexual disorder is which of the following type of behaviour therapy | Aversion TherapyAversion therapy is used for the treatment of conditions which are pleasant but felt undesirable by the patient, e.g. alcohol dependence, transvestism, ego-dystonic homosexuality, other sexual detions. The underlying principle is the pairing of the pleasant stimulus (such as alcohol) with an unpleasant response (such as brief electrical stimulus), so that even in absence of unpleasant response (after the therapy is over), the pleasant stimulus becomes unpleasant by association. The unpleasant aversion can be produced by electric stimulus (low voltage), drugs (such as apomorphine and disulfiram) or even by fantasy (when it is called as cove sensitization). Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no. 215 | 159,567 | medmcqa_train |
Which of the following is the etiological agent for the given case below: | Ans. (A) Congenital(Ref: Apley's System of orthopedics and Fracture 9th Ed; Page No- 465-66)Presence of a hemivertebra- Congenital Scoliosis.Neurofibromatosis: It is associated with scoliosis. The scoliotic curve is typically 'short and sharp and is associated with skin lesions.Idiopathic: It usually resolves spontaneously, measurement of the rib-vertebra angles at the curve apex in the early stages of the deformity is a good prognostic factor.Neuromuscular: The typically paralytic curve is long, convex towards the side with weaker muscles (spinal, abdominal, or intercostal), and at first is mobile. An X-ray obtained with traction would show the extent to which the deformity is correctable. | 159,568 | medmcqa_train |
Avascular necrosis of which of the following bone result in Kohler's Disease? | Osteochondritis of Navicular bone is known as Kohler's Disease. It results in avascular necrosis of Navicular bone. | 159,569 | medmcqa_train |
All of the following drains into coronary sinus, EXCEPT? | The coronary sinus receives blood mainly from the small, middle, great and oblique cardiac veins. It also receives blood from the left marginal vein and the left posterior ventricular vein. It drains into the right atrium. The anterior cardiac veins do not drain into the coronary sinus but drain directly into the right atrium. Some small veins known as smallest cardiac veins drain directly into any of the four chambers of the hea. | 159,570 | medmcqa_train |
Gates Glidden drill is used to: | The Gates-Glidden drill is used to:
Remove the lingual shoulder during access preparation of the anterior teeth
Enlarge root canal orifices.
Textbook of Endodontics Nisha GARG 3rd ED | 159,571 | medmcqa_train |
MCARDLE's maximum allowable sweat rate for 4 hours is | Mc Ardle's maximum allowable sweat rate:4.5 litre/ 4 hours. Predicted 4 hr sweat rate (P4SR) in comfo zone is 1-3 L Park's Textbook of Preventive and Social Medicine, 25th edition, Page No. 792 | 159,572 | medmcqa_train |
A 50-year-old lady presented with a 3-month history of pain in the lower third of the right thigh. There was no local swelling; tenderness was present on deep pressure. Plain X-rays showed an ill-defined intra medullary lesion with blotchy calcification at the lower end of the right femoral diaphysis, possibly enchondroma or chondrosarcoma. Sections showed a cailaginous tumor. Which of the following histological features (if seen) would be most helpful to differentiate the two tumours? | Ans. is 'b' i.e., Tumour permeation between bony trabeculae at periphery Chondroma (enchondroma) Vs Chondrosarcoma o The term chondroma is used for benign neoplasm composed of cailage. It is of two types : - i) Enchondroma : - Cailage tumors occuring within the bone. ii) Periosteal chondroma : - Cailage tumors occuring on the surface of the bone. o Chondrosarcoma is the malignant tumor of cailage. Growth potential of chondroma is limited and mostly remain stable, but they have a potential to undergo malignant (sarcomatous) change to become chondrosarcoma. lnfact, enchondromas are considered to be a low grade chondrosarcoma. o A painful chondroid neoplasm in a large bone in an adult patient can be either enchondroma or chondrosarcoma o The differentiation between a low grade chondrosarcoma and an enchondroma can be difficult. o To make distinction between these two neoplasms, one has to make use of Cytological changes Myxoid quality of stroma Permeative characteristics Among these permeation, maifested as marrow spaces filled with the neoplasm and entrapment of preexisting bony trabeuculae is the most impoant sign of malignancy. | 159,573 | medmcqa_train |
Diagnostic criteria for ARDS include all except | Diagnostic Criteria for ARDSSeverity: OxygenationMild: Pao2/Fio2 300-2 00 mmHgModerate: Pao2/Fio2 200-100 mmHgSevere: Pao2/Fio2 <= 100 mmHgOnsetAcuteChest RadiographBilateral alveolar or interstitial infiltratesAbsence of Left Atrial HypeensionPCWP <=18 mmHg or no clinical evidence of increased left atrial pressureRef: Harrison 19e pg: 1736 | 159,574 | medmcqa_train |
Which of the following is true about Rotavirus - | rota virus are the commonest cause of diarrhea in infants and children the world over and account for half of the cases of children hospitalised for diarrhea REF:ANANTHANARYANAN TEXT BOOK OF MICROBIOLOGY 9EDITION PGNO.561 | 159,575 | medmcqa_train |
Severe chronic MR is associated with - | Even in people with severe MR, there may be no signs or symptoms until the left ventricle fails, an abnormal hea rhythm develops (atrial fibrillation), or pulmonary hypeension occurs. Pulmonary hypeension occurs when the blood pressure in the pulmonary aery is increased Ref Davidson 23rd edition pg 455 | 159,576 | medmcqa_train |
Oligohydramnios causes include - | Ans-Di.e., Renal agenesis Oligohydramnioso In this condition, liquor amnii is deficient in an amount to the extent of fewer than 200 ml at term,o Sonographically it is defined as when the max vertical pocket of liquor amnii is less than 2 cm or when the amniotic fluid index is less than 5 cm (< 10 centiles). With AFI < 8 cm (below 5th centile) or> 24 cm (above 95 centile) was considerd abnormal at gestational age. from 28-40 weeks.Etiologyo Fetal causesFetal chromosomal or structural anomaliesRenal AgenesisObstructed uropathySpontaneous rupture of membraneIntrauterine infectionsDrugs:- PG inhibitors, ACE inhibitorspostmaturity1UGRAmnion nodosum ( failure of secretion by the cells of the amnion covering the placenta)o Maternal causesHypertensive disordersUteroplacental insufficiencyDehydrationIdiopathic | 159,577 | medmcqa_train |
Which of the following disorder is characterised by intense nihilisim, somatization and agitation in old age? | Involutional melancholia refers to manic depressive disorder occuring during old age. Age of first presentation is 50 for women and 55 for men. Early symptoms include weight loss, insomnia, lack of interest in activities, poor concentration and low spirits. They also experience dejection, agitation, nihilistic delusions, hypochondriacal delusions and paranoid features.Ref: Abnormal Psychology By Page Mn page 279; Kaplan & Sadock's Comprehensive Textbook of Psychiatry, 9th edition page 1707. | 159,578 | medmcqa_train |
A 35 year old female, with post coital bleeding, next step : | Ans. is a i.e. Clinical examination and pap smear Well friends first I want you to read what Williams has to say on Postcoital bleeding. "Bleeding following intercourse most commonly develops in women aged 20 to 40 years and in those who are multiparous. No underlying pathology is identified in up to two thirds. If an identifiable lesions is found, however, it typically is benign. In a review of 248 women with postcoital bleeding. Selo-Ojeme and co-workers (2004) found that a fouh of cases were caused by cervical eversion. Other causes included endocervical polyps, cervicitis, and less commonly, endometrial polyps. In the cases of cervicitis. Chlamydia trachomatis is a frequent cause. In some women, postcoital bleeding may be from cervical or other genital tract neoplasia. The epithelium associated with cervical intraepithelial neoplasia (CIN) and invasive cancer is thin and friable and readily detaches from the cervix. In women with postcoital bleeding. CIN was found in to 10 percent, invasive cancer in about 5 percent, and vaginal or endometrial cancer in <1 percent. In another study, Jha and Sabharwal (2002) repoed that a number of women with postcoital bleeding had pathologic lesions identified at colposcopic evaluation that had been missed by Pap smear screening. Thus, most women with unexplained postcoital bleeding should undergo colposcopic examination if no other obvious souce of bleeding is identified." So after reading the above text it is clear that - Colposocopy is the most definitive procedure for diagnosis of postcoital bleeding. But here question is specifically saying - a 35 years old female is coming with postcoital bleeding, what is the next step - so obviously in this age group we will first examine the patient, rule out other causes, perform a pap's and still if no diagnosis is made we will go for colposocpy to rule out CIN and Ca cervix. | 159,579 | medmcqa_train |
Which of the following is NOT an alpha-adrenoceptor agonist? | Clonidine, apraclonidine, brimonidine are selective alpha 2 agonists. Guanfacine and guanabenz are central alpha 2 agonists. Isoxsuprine is a selective beta-2- receptor agonist used to relax uterus. From medical pharmacology Padmaja 4th edition page no 101 | 159,580 | medmcqa_train |
Female patient with injury on her scalp, hair was shaved and sutures were put. On which day sutures should be removed? | Ans. (a) 8-10 daysRef Sabiston 18th ed. 12134Scalp suture should be removed on 6th to 8th day. Given these options, 8-10 days is the best choice.Day of suture removal from different body areasBody areaSuture removal on* Scalp6-8 days* Face3-5 days* Chest, Abdomen8-10 days* Ear10-14 days* Extremities, back12 -14 days | 159,581 | medmcqa_train |
A lady with 8 wks pregnancy presented with random blood glucose of 177mg/dl. The treatment is : | Ans. is 'c' is insulin (Ref Dutta 6/e, p 288 (5/e, p. 304); Holland and Brews, 16/e, p. 107).Insulin is the only antidiabetic drug given in pregnancy to control increased blood sugar.Oral hypoglycemics are contraindicated in pregnancy because they cross placenta and have teratogenic effect on fetus.They cause fetal hypoglycemia and increase m fetal bilirubin.Moreover the increase demand in pregnancy cannot be met by oral hypoglycemics. | 159,582 | medmcqa_train |
Preferred drug for alcohol withdrawal seizures is: | Benzodiazepines (Chlordiazepoxide,diazepam) are the preferred drugs due to long duration of action and can be gradually withdrawn later. Ref KD Tripati 8th ed. | 159,583 | medmcqa_train |
Estimated mean Hemoglobin (Hb) of 100 women is 10g%. Standard detion is 1 gm%. Standard error of estimated will be - | <p>standrad error of mean= standard detion/[?]n =1/[?]100 =1/10 =0.1 Parks textbook of preventive and social medicine.K Park. Edition 23.Pg no: 850 </p> | 159,584 | medmcqa_train |
HLA associated with psoriasis | Psoriasis is a long-lasting autoimmune disease which is characterized by patches of abnormal skin.] These skin patches are typically red, itchy, and scaly. They may vary in severity from small and localized to complete body coverage. Injury to the skin can trigger psoriatic skin changes at that spot, which is known as the Koebner phenomenonType 1 has a positive family history, stas before the age of 40, and is associated with the human leukocyte antigen, HLA-Cw6. Conversely, type 2 does not show a family history, presents after age 40, and is not associated with HLA-Cw6. Type 1 accounts for about 75% of persons with psoriasis. | 159,585 | medmcqa_train |
Which of the following is a cause of unilateral hyperlucent lung on chest radiography? | Poland's syndrome (unilateral congenital absence of pectoral muscles) causes unilateral hypertranslucency.
Asthma & acute bronchiolitis cause bilateral hypertranslucency. | 159,586 | medmcqa_train |
PGs in semen is secreted by | The seminal vesicles secrete a significant propoion of the fluid that ultimately becomes semen. Lipofuscin granules from dead epithelial cells give the secretion its yellowish color. About 50-70% of the seminal fluid in humans originates from the seminal vesicles, but is not expelled in the first ejaculate fractions which are dominated by spermatozoa and zinc-rich prostatic fluid.Ref: Ganong&;s review of medical physiology; 24th edition; page no:-419 | 159,587 | medmcqa_train |
During examination of parotid gland, parotid duct can be palpated at the following except: | Parotid Duct (Stenson’s Duct)
Parotid duct, about 5 cm long, emerges from the middle of the anterior border of the gland and opens into the vestibule of the mouth opposite the crown of upper second molar tooth. | 159,588 | medmcqa_train |
Which is a glycoprotein, produced by many mammalian cells, and used in the treatment of hepatitis, papillomaviruses, hairy-cell leukemia and AIDS-related Kaposi's sarcoma? | All the above agents are synthetic analogues, except Interferon which is a glycoprotein produced by many types of mammalian cells. It has been shown to be useful in treatment of hepatitis, papillomaviruses, hairy-cell leukemia and AIDS-related Kaposi's sarcoma. Idoxuridine, as its name implies, is a synthetic pyrimidine analog, which inhibits viral DNA polymerase. Zidovudine and zalcitabine are also synthetic pyrimidine analogs but they inhibit reverse transcriptase and act as chain terminators. Ref: Baden L.R., Dolin R. (2012). Chapter 178. Antiviral Chemotherapy, Excluding Antiretroviral Drugs. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e. | 159,589 | medmcqa_train |
The most likely cause of bihilar lymphadenopathy is | Sarcoidosis Chronic multisystem disorder of unknown cause characterized by accumulation of TH 1 lymphocytes and mononuclear phagocyte in various tissuesof body.Non-caseating sarcoid Granuloma in affected organsLungs (90%)Lymph nodesSkinOthersInterstitial lung disease (fibrosis of lung parenchyma)Pleura is involved, in 1-5% cases unilateral pleural effusion Cavitation is rare B/L hilar lymphadenopathy is the hallmark of Sarcoidosis B/L parotid enlargement Erythema nodosum Lupus pernio (purple blue shiny swollen lesion on nose, cheeks, lips, ears)UveitisRenal hypercalcemia with or without hypercalciuriaAhritisPeripheral neuropathyCor-pulmonale(Refer: Harrison's Principles of Internal Medicine, 18th edition, pg no: 2805-2813) | 159,590 | medmcqa_train |
In a surgical post-op ward, a pt. developed wound infection. Subsequently 3 other pts. developed smilar infections in the ward. What is the most effective way of preventing the spread of infection - | Ans. is 'b' ie. Proper hand washing of all ward personnels "Given the prominence of cross infection, hand washing is the single most impoant preventive measure in the hospital" - Harrison 15/e Harrison 17/e writes- "Given the prominence of cross-infection, hand hygiene is the single most impoant preventive measure in hospitals. Use of alcohol hand rubs between patient contacts is now recommended for all health care workers except when the hands are visibly soiled, in which case washing with soap and water is still required." | 159,591 | medmcqa_train |
Cold spot is seen in all the following except: | Eosinophilic granuloma - shows osteoblastic activity - hotspot. | 159,592 | medmcqa_train |
False about short bowel svndrome- | Ans. is 'c' i.e., Hirsutism Short bowel syndrome -o Presence of less than 200 cm of residual small bowrel in adult patients.o Insufficient absorptive capacity of small intestine results in diarrhea, dehydration and malnutition.Causes - Small intestine resection (massive) due toMassive resection in singleCumutative effect of multipleoperation as in acute mesentericoperations of small intestineischemia, malignancyresected as in Crohn's diseaseo In pediatric patients, MC etiologies are intestinal atresia, volvulus and necrotizing enterocolitis. Resection of less than 50% of small intestine is generally well tolerated.o Clinically significant malabsorption occurs when more than 50 to 80% of small intestine has been resected.o Resection ofjejunum is better tolerated than resection of ileum.o Presence of healthy colon, intact ileocecal valve and healthy residual small bowel are factors associated with decreased severity of malabsorption.o Malabsorption in short bowel syndrome is exacerbated by a characteristic hypergastrinemia associated gastric acid hypersecretion which persists for 1 to 2 years post operatively.Management -1. Medical- a)TPNHigh dose H-, reseptor antagonist/PPLAntimotility agents - Loperamide.Octreotide - reduces volume of GI secretions.o Levels of Iron, Magnesium, Zinc, Copper and vitamins must be monitored closely and deficienc ies prevented.1 Surgery -Non transplant surgery : Goal is to increase nutrient and fluid absorption by slowing intestinal transit or increasing intestinal length.Segmental reversal of small bowel.Colon interpositionSmall intestinal valves construction.Electrical pacing of small intestine.Bianchi's Intestinal lengthening operation (generally used in pediatric patients with dilated small bowel).Serial transverse enteroplasty (2003).Intestinal transplantation : Indicated for life threatening complications of intestinal failure or chronic TPN therapy -Impending/overt liver failure.Thrombosis of major central veins.Frequent cathater related sepsis.Frequent episodes of severe dehydration. | 159,593 | medmcqa_train |
antipsychotic which has anti suicidal propey is | CLOZAPINE * Impoance * First SGA * TREATMENT FOR TREATMENT RESISTANT SCHIZOPHRENIA * TOC for TD * Anti suicidal * Psychosis in parkinsonian patients Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, 935 | 159,594 | medmcqa_train |
Which is not a minor diagnostic criteria for multiple myeloma? | . Plasmacytoma on biopsy | 159,595 | medmcqa_train |
A 17 year old boy presented with total count of 138 x 109 /L with 80% blasts on the peripheral smear. Chest X-ray demonstrated a large mediastinal mass. Immunophenotyping of this patient's blasts would most likely demonstrate: | . An immature I$? cell phenotype (Tdt/D34/CD7 positive) | 159,596 | medmcqa_train |
Drug of choice of typhoid - | Ans. is 'd' i.e., Ciprofloxacin o The older agents used for the treatment of typhoid were;ChloramphenicolAmpicilinTrimethoprim Sulfamethoxazoleo These drugs are not used nowdays because o f widespread resistance.o Nowdays the drug of choice for Typhoid all over the world is a "Fluroquinolone" (Ciprofloxacin, ofloxacin).An important point to remembero High level of fluoroquinolone resistance (ciprofloxacin) have been reported from India and other parts of South East Asia in S, paratyphi and S.typhi infection.# Nalidixic acid resistant S.typhi (NARST) have decreased ciprofloxacin sensitivity-1 and are less effectively- treated with fluoroquinolones.# The fluroquinolones should not be used as first line treatment for typhoid fevers in patients from India and other parts of South Asia with high rates offluroquinolone resistance unless antibiotic susceptibility data demonstrates fluoroquinolone or nalidixic acid sensitivity>.Alternative drugs for patients with fluoroquinolone resistance are : -o Beta lactam Parenteral - Ceftriaxone Oral - Cefiximeo Azithromycino ChloramphenicolAntibiotic Therapy for Enteric Fever in AdultsIndicationAgentEmpirical treatmento Ceftriaxoneo AzithromycinFully susceptibleo Ciprofloxacinb (first line)o Amoxicillin (Second line)o Chloramphenicolo Trimethoprim-sulfamethoxazoleMutlidrng-Resistanto Ciprofloxacino Ceftriaxoneo AzithromycinNalidixic Acid-Resistanto Ceftriaxoneo Azithromycino High-dose ciprofloxacin | 159,597 | medmcqa_train |
Retrobulbar injection is given in - | It is given in the central space Central space : also called, muscular cone or retrobulbar space. It is bounded anteriorly by the Tenon's capsule lining back of the eyeball and peripherally by the four recti muscles and their intermuscular septa in the anterior pa. In the posterior pa, it becomes continuous with the peripheral space. Tumors lying here produces axial proptosis. Ref:AK Khurana 6thE pg 403 | 159,598 | medmcqa_train |
Which of the following is not a tumor marker for hepatocellular carcinoma | CEA is raised in colon ca. | 159,599 | medmcqa_train |
Subsets and Splits