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Testicular Feminization syndrome is characterised by all except | Karyotype in testicular feminization syndrome is 46 XY. Barr body is therfore absent. | 159,900 | medmcqa_train |
Facial nerve exits the skull through | Facial nerve enters the temporal bone through - Internal acoustic meatus Facial nerve exits the skull through - Stylomastoid foramen. Ref: PL Dhingra, Diseases of Ear, Nose & Throat, 7th edition, pg no. 99 | 159,901 | medmcqa_train |
A child presenting with clinical features of an endocrine abnormality showed epiphyseal dysgenesis in imaging studies. Epiphyseal dysgenesis is a pathognomonic feature of: | Epiphyseal dysgenesis is radiological finding of hypothyroidism which is characterized by centers of ossification, especially of the hip, may show multiple small centers or a single stippled, porous, or fragmented center. Other radiological findings of hypothyroidism: Delayed bone age Cardiomegaly Thyrotrophic hyperplasia characterized by an enlarged sella or pituitary gland Ref: Zeitler P.S., Travers S.H., Nadeau K., Barker J.M., Kelsey M.M., Kappy M.S. (2012). Chapter 34. Endocrine Disorders. In W.W. Hay, Jr., M.J. Levin, R.R. Deterding, J.J. Ross, J.M. Sondheimer (Eds), CURRENT Diagnosis & Treatment: Pediatrics, 21e. | 159,902 | medmcqa_train |
All of the following statement regarding stones in the submandibular gland are true except: March 2008 | Ans. B: Majority of submandibular stones are radio-lucent | 159,903 | medmcqa_train |
A 90-year-old woman with mild diabetes and Alzheimer's disease die in her sleep. At autopsy, hepatocytes are noted to contain golden cytoplasmic granules that do not stain with Prussian blue. Which of the following best accounts for pigment accumulation in the liver of this patient? | The answer is A: Advanced age. Substances that cannot be metabolized accumulate in cells. Examples include:- (1) endogenous substrates that are not processed because a key enzyme is missing (lysosomal storage diseases) (2) insoluble endogenous pigments (lipofuscin and melanin) (3) exogenous paiculates (silica and carbon) Lipofuscin is a "wear and tear" pigment of aging that accumulates in organs such as the brain, hea, and liver. None of the other choices are associated with lipofuscin accumulation.Diagnosis: Aging, lipofuscin | 159,904 | medmcqa_train |
The following statements are related to clear cell carcinoma of the vagina except : | clear cell adenocarcinoma of vagina: Found in adolescent girls who have a history of intrauterine exposure to diethylstilbestrol Incidence following DES exposure is 1:1000 may develop vaginal adenosis lesion usually involves upper third of anterior vaginal wall and cervix may be involved Treatment: radical hysterectomy,vaginectomy with pelvic lymphadenectomy. D.C.DUTTA'S TEXTBOOKOF GYNECOLOGY,Pg no:339,6th edition | 159,905 | medmcqa_train |
A 55 years old smoking presents with history of five episodes of macroscopic hematuria each lasting for about 4-5 days in the past five years. Which of the following investigations should be performed to evaluate the suspected diagnosis? | Ans. (a) Urine microscopy and cytologyRef: Smith 17th Edition, Pages 308-315Diagnosis of Urinary bladder carcinoma:* Cystoscopy and transurethral resection is the IOC for obvious lesions.* Urinary cytology is the IOC for carcinoma in situ.* Cytological examination of exfoliated cells from tumor is useful in detecting cancer in symptomatic patients and assessing the response to treatment.* Cytological examination is also most useful to detect early recurrence* CT and MRI are used in stagingExfoliative markers:* NMP22 (Nuclear matrix protein 22)* Hyaluronidase* Lewis X ag* Telomerase activity | 159,906 | medmcqa_train |
Right shift of oxygen dissociation curve is caused by? | Ans. is `b' i.e., Hypoxia | 159,907 | medmcqa_train |
The most common manifestation of congenital toxoplasmosis | *Congenital toxoplasmosis is caused by toxoplasma gondi .The transmissibility increases but the risk of feral disease decreases with advancing pregnancy * The classical triad of toxoplasmosis includes intracranial calcification, hydrocephalus and chorioretinitis. Diagnosis is confirmed by demonstrating IgM in serum of the baby Image : Severe, active retinochoroiditis. Reference : Ghai essential pediatrics, 9 th edition, pgno :264 | 159,908 | medmcqa_train |
The diagnostic procedure not done in case of ph eochromoc ytoma. | FNAC "Percutaneous fine-needle aspiration of chromallin tumors is contraindicated; indeed, pheochronwcytoma should be considered before adrenal lesions are aspirated." -Harrison "Catastrophic hypeensive crisis and fatal cardiac arrhythmias can occur spontaneously or may be triggered by intravenous contrast dye or glucagon injection, needle biopsy of the mass, anesthesia, and surgical procedures." - | 159,909 | medmcqa_train |
Which of the following necrosis occurs characteristically in brain infarcts? | CNS parenchymal infarcts organize an influx of macrophages into the area of necrosis. The macrophages ingest the lipid-rich, necrotic parenchyma, ultimately conveing the area to a fluid-filled cavity (liquefactive necrosis). This process is usually complete by about 6 months after the development of the infarct. | 159,910 | medmcqa_train |
In deltoid paralysis, which nerve is involved : | C. i.e. Axillary nerve | 159,911 | medmcqa_train |
A 41 year old woman presented with a history of aches and pains all over the body and generalized weakness for four years. She cannot sleep because of the illness and has lost her appetite as well. She has a lack of interest in work and doesn't like to meet friends and relatives. She denies feelings of sadness. Her most likely diagnosis is - | This is a case of somatized (masked) depression which is a form of major depression in which the depressed patients may present their distress as somatic symptoms, e.g. chronic pain, anorexia (loss of appetite), insomnia (cannot sleep), paresthesia, atypical facial pain, and generalized weakness. Depressive mood is not easily apparent as it is usually hidden behind the somatic symptoms, (e.g. in this question she denies the feeling of sadness). | 159,912 | medmcqa_train |
'Tentative cuts' are seen with | Ans. b (Suicide) (Ref. FMT by N. Reddy 5th/pg.93)TENTATIVE (preliminary cuts) CUTS# Hesitation cuts derive their name from the hesitation with which these incisions are made by a person intending to commit suicide by a cutting instrument.# He or she usually makes preliminary cuts before gathering sufficient courage to make final deep incision.# These are generally small, multiple, superficial, and usually skin deep.# They are seen with commencement of the incised wound and merge with the main incision. | 159,913 | medmcqa_train |
Which of the following is FALSE about SOMATIZATION Syndrome - | Ans. is 'a' i.e., Involves 2 sexual disturbance Symptomso For diagnostic criteria at least 1 sexual symptom should be there (not two),o All other diagnostic criteria (other three options) are true.Somatization disordero The essential features of somatization disorder are multiple recurrent somatic symptoms of long duration (chronic) that are caused by psychological basis and no physical illness can be found,o The disorder begins before the age of 30 years and then has a chronic course (over a period of several years).Diagnostic criteria for somatization disordero Each of the following should be present: -Four pain symptoms: - Pain, at least at four different sites or functions - Head (headache), abdomen, back, joint, extremites, chest, rectum, during mensturation or sexual intercourse or urination.Two gastrointestinal symptoms : - Nausea, bloating, vomiting, diarrhea.One sexual symptom : - Erectile dysfunction ( Impotence), ejaculatory dysfunction, irregular menses, excessive menstural bleeding.One pseudoneurological symptom : - Conversion symptoms (impaired coordination or balance, paralysis, weakness, blindness, deafness, glove & stocking anesthesia. Paresthesia, seizure, aphonia); Dissociative symptoms (amnesia); loss of consciousness. | 159,914 | medmcqa_train |
Coagulation defect associated with increased coagulation are seen in | Ref Harrison 16/e p1491 ,9/e p123 Protein C and protein S are two vitamin K-dependent proteins that act in a complex to proteolytically inacti- vate cofactors Va and VIIIa. Protein C activation by thrombomodulin was described earlier; protein S is a cofactor for protein C activity Resistance to activated protein C due to the factor V R506Q (Leiden) mutation is the most common clotting abnormality in patients with venous thromboembolism | 159,915 | medmcqa_train |
Patient with leprosy, smear sample taken show 10 - 100 bacilli in one field. Bacterial index is ? | Ans. is 'd' i.e., 4+ Bacteriological Index For Leprosy It is a rough index expressing probable number of acid fast bacilli for standardized microscopic field in skin smear. It is indicative of the load of bacteria at the site from which smear is taken. It does not differentiate between live and dead bacilli. It is not an indication of total bacillary load in the body. Ridleys scale is followed to calculate the bacterial index. = no bacilli in 100 fields 1+ = 1 - 10 bacilli in 100 fields 2+ = 1 - 10 bacilli in 10 fields 3+ = 1 - 10 bacilli in 1 fields 4+ = 10 - 100 bacilli in 1 field 5+ = 100 - 1000 bacilli in 1 field 6+ = >1000 bacilli in 1 field. Our patient has 10 - 100 bacilli in 1 field thus the bacteriological index is - 4+ | 159,916 | medmcqa_train |
Enteroviruses are associated with all of the following, EXCEPT: | Acute hemorrhagic fever is not caused by the enteroviruses. It usually causes non specific febrile illness, hand foot mouth disease, Herpangina, coryza, conjunctivitis, pericarditis, myocarditis, gastrointestinal symptoms and neurological symptoms. Ref: Kliegman, Behrman, Jenson, Stanton (2008), "Nelson Textbook of Pediatrics", Chapter 247, "Nonpolio Enteroviruses", Volume 1, Page 1350; Medical Microbiology By Jawetz , 24th Edition, Page 494; Harrison's Principle of Internal Medicine, 17th Edition, Page 1208 | 159,917 | medmcqa_train |
The commonest type of Pemphigus is | Pemphigus vulgaris is the most common form of pemphigus and occurs when antibodies attack Desmoglein 3. Usually begins with painful blisters in your mouth and then on the skin or genital mucous membranes. Ref Harrison20th edition pg 1334 | 159,918 | medmcqa_train |
Under-running may involve: | Under-running/ tail gating Tail-gating occasionally occurs with cars driving into the back of large trucks. In such case, the windscreen and front of the passenger compament are smashed with severe injuries to the head and in some cases decapitation of the occupants of the front seat. Also seen where the motorcyclist drives under the rear of the truck, causing head injuries and even decapitation. | 159,919 | medmcqa_train |
A young tourist presents with a skin lesion after being to Rajastan. He presents with an erythematous lesion on the cheek with central crusting. What is the likely dermatological condition? | A typical lesion of Acute Cutaneous Leishmaniasis is papule at the site of the sand fly bite which enlarges and breaks down in the centre. The ulcer usually has a rolled border. When the lesion heals in a year's time it leaves a distinctive depressed hyper pigmented scar. The typical sites are cheeks and arms (exposed areas). Localised Cutaneous Leishmaniasis (LCL) is seen in India in the forests of Rajastan, caused mostly by Leishmania tropica. Himachal Pradesh is repoed as a recent focus. Ref: Thieme Clinical Companions Dermatology By Wolfram Sterry, Ralf Paus, Walter H. C. Burgdo; Leishmania: After the Genome By Peter J. Myler, Nicolas Fasel, Pages 2-3. | 159,920 | medmcqa_train |
Which of the following association is true regarding facial nerve palsy in temporal bone fractures? | Longitudinal fractures of Temporal bone are more common than transverse fracture but, facial nerve injury is most commonly associated with Transverse fracture of the temporal bone. | 159,921 | medmcqa_train |
A 1-year-old female infant has failure to thrive, poor neurologic development, and poor motor function. Physical examination shows a "cherry red" spot on the macula of the retina. The infant's muscle tone is poor. Both parents and a brother and sister are healthy, with no apparent abnormalities. One brother with a similar condition died at the age of 18 months. This genetic disorder most likely resulted from a mutation involving a gene encoding for which of the following? | The findings listed suggest a severe inherited neurologic disease, and the pattern of inheritance (e.g., normal parents, an affected sibling) is consistent with an autosomal recessive disorder. This inheritance pattern and the cherry red spot in the retina are characteristic of Tay-Sachs disease, caused by mutations in the gene that encodes a lysosomal enzyme hexosaminidase A. Mitochondrial genes have a maternal pattern of transmission. Mutations in genes affecting receptor proteins and structural proteins typically give rise to an autosomal dominant pattern of inheritance. | 159,922 | medmcqa_train |
In prolactinoma most common symptom other than galactorrea is? | Pituitary tumors 1.Eosinophil (Acidophil) adenomas: Tumour is usually small. Rarely it causes compressive features. It secretes excess growth hormone causing acromegaly in adults and gigantism in children. 2. Chromophobe adenomas are common in females and in the age group--20-50 years. Initially, it is intrasellar and after sometime becomes suprasellar. Later, it extends intracranially often massively, causing features of intracranial space occupying lesion. It presents with myxoedema, amenorrhoea, infeility, headache, visual disturbances, bitemporal hemianopia, blindness, intracranial hypeension, epilepsy. Differential diagnosis: Meningiomas, aneurysms. CT scan, angiogram, X-ray skull are diagnostic. Treatment is surgical decompression by craniotomy through subfrontal approach or trans-sphenoidal approach. Deep external radiotherapy and steroids are also used. 3. Basophil adenomas are usually small. They secrete ACTH and presents as Cushing's disease with all its features. 4. Prolactin-secreting adenomas causes infeility, amenorrhoea and galactorrhoea. Ref: SRB's Manual of Surgery 5th Pgno : 1105 | 159,923 | medmcqa_train |
Lens develops from. | Ans. (b) Surface ectodermSurface EctodermNeural EctodermMesodermNeural Crest* Conjunctival Epithelium* Corneal Epithelium* Lacrimal gland* Tarsal gland* Lens* Smooth muscle of Iris* Iris Epithelium* Ciliary Epithelium* Retina & its pigment epithelium* Optic nerve fibre* Part of vitrous* EOM* Sclera* Iris* Vascular endothelium* Choroid* Part of vitrous* Corneal stroma* Ciliary ganglion* Schwann cell* Uveal and conj melanocytes* Meningeal sheath of ON* Part of vitrous | 159,924 | medmcqa_train |
Manoeuvre carried out for diagnosing medial meniscus injury is: March 2010, March 2013 (c, d) | Ans. A: McMurray's Test McMurray's test is performed for meniscus injury For medial meniscus: Patient lying flat (non-weight bearing), the knee is completely flexed. The foot is rotated externally and the leg abducted. The joint is now slowly extended keeping the leg externally rotated and abducted. As the torn cailage gets caught during this manoeuvre, the patient will experience pain or a click may be heard and felt. | 159,925 | medmcqa_train |
A young boy came with dyspnea and was found to have a mediastinal mass. Which of the following is known to produce mediastinal lymphadenopathy? | mediastinal lymphadenopathy ,sternal tenderness and mediastinal mass are seen with ALL. | 159,926 | medmcqa_train |
Only male are affected in | Hunter's syndrome belongs to Type II mucopolysaccharidoses in which mucopolysaccharides accumulate in the lysosomes causing disorganization of the cell structure & function.This syndrome is characterised by mild mental retardation;marked skeletal changes like thickening of the skull,marked deformity of sella tursica,broad spatula like ribs,beak shaped veebrae(around L1 veebra) and proximal tapering of metacarpals-these abnormalities are referred to as dysostosis multiplex;coarse facies & hepatosplenomegaly. Reference:Essential pediatrics-Ghai,8th edition,page no: 660,661. | 159,927 | medmcqa_train |
Adoptive immunity is by? | Aadoptive immunity: a special type of immunisation is the injection of immunologically competent lymphocytes. - instead of whole lymphocytes, an extract of immunologically competent lymphocytes, known as the transfer factor can be used. Reference: Anathanarayan & paniker's 9th edition, pg no:84 <\p> | 159,928 | medmcqa_train |
A 41 y/o male presents with complaints of inability to achieve proper erections during sexual intercourse. He repos that there were no abnormalities till last month, when on one occasion he tried having sex with wife while he was drunk. He was not able to achieve a proper erection at that time and since than, on four other occasions , he was not able to have an erection during attempted sex. He repos that his morning erections are fine and erection during masturbation was also normal. He is a diabetic, and the blood repos show, FBS-103 mg/dl, HbA1C- 6.6. His BP was 138/88 mm Hg What is the likely cause of erection disturbances? | History of sudden onset, normal morning erections and normal erection during masturbation is suggestive of Psychogenic Erectile dysfunction. The cause is usually performance anxiety. To differentiate between psychogenic and organic erectile dysfunction best test is ask for nocturnal / early morning erections as patient is relaxed in these conditions. So in the above case it rules out all organic causes. | 159,929 | medmcqa_train |
All of the following can cause hypersecretion of prolactin, except? | The function of dopamine is to supress the prolactin secretion. Prolactin agonists reduce secretion of prolactin and antagonists increase the secretion of prolactin. Cabergoline is a long acting dopamine agonist. The drug suppresses prolactin secretion. Used to treat prolactinoma. All others can cause increased secretion. High prolactin levels are also associated with Hypothyroidism. | 159,930 | medmcqa_train |
A 10 years boy presented with sensory neural deafness not benefited with hearing aid, Next treatment is | A. i.e. (Cochlear implant) (125- Maqbool 11th) (121- Dhingra 4th)COCHLEAR IMPLANT - is indicated in patients with bilateral severe sensorineural deafness who do not respond to amplified sound stimuli* Cochlear implants are more useful in post lingually deaf patients i.e. who lost their hearing after acquisition of language* Stapedectomy with prosthesis replacement is the treatment of choice for otosclerosis*** Pathway for extension of the infection from meninges to labyrinth - Cochlear aqueduct*** **Cochlear implants electrodes are most commonly placed at cochlea to directly stimulate the fibre of VIII. nerve | 159,931 | medmcqa_train |
A 15-year-old boy complains of right-sided weakness and gait impairment. A CT scan shows a large, non-enhancing cyst in the posterior cranial fossa, with an enhancing tumor nodule in the left cerebellum. What is the most likely diagnosis? | Cystic astrocytoma's are neoplasms of the CNS. They usually consist of a large, non-enhancing cyst on the wall of which is an enhancing tumor nodule. They are most commonly found within the substance of the cerebellar hemispheres of children and young adults. A Rathke's cleft cyst is a remnant of the embryologic Rathke's pouch. These are found within the sella turcica. | 159,932 | medmcqa_train |
Ketamine produces ? | Ans. is 'a' i.e., Emergence delirium Ketamine The primary site of action is in the coex and subcoical areas; not in the reticular activating system (site of action of barbiturates). It acts on NMDA receptors. Sho duration of action (10-15 minutes) is due to redistribution from brain and blood to other tissues of the body. Ketamine is different from most other anaesthetic induction agents in that it has significant analgesic action. Ketamine increases IOT and cerebral metabolism --> contraindicated in head injury. It causes sympathetic stimulation with elevation of HR, CO & BP --) contraindicated in hypeension and ischemic hea disease. It also raises IOT --> contraindicated in glaucoma. It relieves bronchospasm --> intravenous anaesthetic of choice in asthmatics (inhalation anaesthetic of choice in asthmatic is halothane). Injection is not painful (All other inducing agents cause pain on injection). It is i.v. anaesthetic of choice in children (Sevoflurane is inhalation agent of choice). Because it causes sympathetic stimulation it is intravenous anaesthetic of choice in patients with shock and hypovolumia. It has no muscle relaxant propey rather muscle tone is increased. Airway reflexes (pharyngeal and laryngeal) are not depressed --> intravenous anaesthetic of choice for emergency anaesthesia (no starvation is required). Ketamine produces emergence reaction during awakening from anaesthesia --> vivid dreaming, illusions, extracorporeal experiences, excitment, confusion, fear and euphoria --> contraindicated in psychiatric illness like schizophrenia. | 159,933 | medmcqa_train |
Splenectomy is done to tide over the acute crises of uncontrollable: | Indications of splenectomy in ITP: Failure of medical therapy Prolonged use of steroids with undesirable effects Most cases of first relapse Splenectomy provides a permanent response without subsequent need for steroids in 75-85% of patients. Laparoscopic splenectomy has become the gold standard for ITP patients. Responses usually occur within the first postoperative week. | 159,934 | medmcqa_train |
Osteoahritis not seen in ? | Ans. is 'a' i.e., Ankle joints OA affects ceain joints, yet spares others. Commonly affected joints include the cervical and lumbosacral spine, hip, knee, and first metatarsal phalangeal joint (MTP). In the hands, the distal and proximal interphalangeal joints and the base of the thumb are often affected. Usually spared are the wrist, elbow, and ankle. Our joints were designed, in an evolutionary sense, for brachiating apes, animals that still walked on four limbs. We thus develop OA in joints that were ill designed for human tasks such as pincer grip (OA in the thumb base) and walking upright (OA in knees and hips). Some joints, like the ankles, may be spared because their aicular cailage may be uniquely resistant to loading stresses. | 159,935 | medmcqa_train |
Compared with cow's milk, mother's milk has more- | Ans. is 'a' i.e., Lactose Lactose (g) Cow's milk 4.4 Human milk 7.4 Proteins (g) 3.2 1.1 Fat (g) 4.1 3.4 Calcium (mg) 120 28 Iron (mg) 0.2 1.0 Water (g) 87 Energy (Kcal) 67 65 | 159,936 | medmcqa_train |
Characteric finding in restrictive lung disease is: | Ans. c (Normal FEV, /Vc). (Ref. Harrison, Principles of Medicine, 18th/1448)OBSTRUCTIVE PATTERNRESTRICTIVE PATTERN (Al 2005)EXTRAPARENCHYMAL PATTERN (INSPIRATORY DYSFUNCTION)Decreased expiratory flow rates (hallmark)Normal forced expiratory flow ratesExpiratory flow rates not affectedDecreased FEV1/VC (in fully established disease)-FEVl/FVC variableTLC normal or increased (Minor change)Decreased lung violume (TLC and VC)TLC not predictableIncreased residual volume (striking)Decreased residual volumeIncreased RVIncresed ratio of RV/TLC--Decreased VC-Decreased MIP | 159,937 | medmcqa_train |
Down beat nystagmus is seen in? | Ans. is 'a' i.e., Arnold chiari malformation Down-beat nystagmus are seen in cerebellar lesion and Arnold-chiary malformation | 159,938 | medmcqa_train |
Which of the following is not true for ZollingerEllison syndrome: September 2008 | Ans. B: Reduced BAO : MAO ratio Zollinger-Ellison syndrome (ZES) is a rare condition characterized by peptic ulcers that are refractory to conventional medical therapy. Gastrin-producing tumors or gastrinomas cause excessive gastric acid secretion, leading to ulcers of the upper GI tract, as well as diarrhea and severe abdominal pain. Laboratory studies to confirm the diagnosis of ZES include the following: Measurements of fasting serum gastrin levels - Gastrin levels higher than 100 pg,/mL are highly suggestive of ZES. If the gastric pH level is less than 2.5, a gastrin level of higher than 1000 pg/mL is diagnostic of ZES. If the patient is not receiving acid-suppressing medication and the gastric pH levels are higher than 2, ZES can be ruled out. Secretin stimulation test After blood to measure the basal gastrin level is obtained, 2 IU/kg of secretin is intravenously administered. Blood is obtained at 2.5 minutes, 5 minutes, 10 minutes, 15 minutes, and 30 minutes. An increase of serum gastrin levels to higher than 200 pg/mL is diagnostic of ZES. - It is the most impoant diagnostic test to exclude other conditions with increased acid secretion, hypergastrinemia, or both. - Clinical conditions in which patients present with hypergastrinemia, such as gastric outlet obstruction, pernicious anemia, renal failure, and achlorhydria due to atrophic gastritis, must be excluded with secretin provocative testing. Measurement of basal acid output - Before measurement of the basal acid output (BAO), acid-inhibitory agents must be discontinued: 24 hours for H2 receptor antagonists and 7 days for proton pump inhibitors (PPIs). - In the 24 hours prior to the test, the patient receives antacids. - In an unoperated stomach, a BAO of more than 15 mEq/h is diagnostic of Zollinger-Ellison syndrome. If the patient underwent gastric resection for acid reduction, a BAO of more than 10 mEq/h is diagnostic for Zollinger-Ellison syndrome. If the patient has multiple endocrine neoplasia type 1 (MEN-1), other laboratory abnormalities may be suggestive of Zollinger-Ellison syndrome. - High plasma calcium levels High parathyroid hormone (PTH) levels - High prolactin levels | 159,939 | medmcqa_train |
Edman's reagent is - | Ans. is 6c' i.e., Phenyl-isocyanateo Determination of amino acid sequence (sequence analysis) is performed by Edman degradation method on automatic mechines, called cyclic sequentors. Edman's reagent is phenyl-isothiocyanate, and forms a covalent bond to N- terminal of amino-acid. This can be identified.o Sanger's reagent (l-fluoro-2,4-dinitrobenzene) can be used in place of Edman's reagent. | 159,940 | medmcqa_train |
Farmer presents with the features of high fever, painful inguinal lymphadenopathy, vomiting and diarrhea and 'Ivpotension. Which stain will help in the diagnosis | Ans. b. Wayson's stain Farmer presents with the features of high fever, painful inguinal lymphadenopathy, vomiting and diarrhea and hypotension. This clinical picture is suggestive of Bubonic plague. Bubonic plague Bubonic plague symptoms can occur within two to six days of being infected by the bacteria Yersinia pestisdeg. If left untreated, symptoms, such as vomiting, abdominal pain, and diarrhea, can progress rapidly to septicemic plaguedeg. Approximately 10 to 20 percent of people with bubonic plague symptoms will also develop symptoms in the lungs. This is called pneumonic plague, and is often fataldeg. Plague Caused by bacteria Yersinia pestisdeg. Animal reservoir for Yersinia pestis: Rodentsdeg Vector: Rat flea (Xenopsylla cheopsisdeg) carries infection from rat to rat and rat to humans Characterized by rapid onset of fever and other systemic manifestations of Gram (-)ve bacterial infections. It is of Bubonic Plague Incubation period 2-7 daysdeg MC type of plague and almost always caused by bite of infected fleadeg. MC site of bubo- femoral, inguinal regiondeg >axillary, cervical. Distinguished from lymphadenitis by its rapid onset, its extreme tenderness, accompanying signs of toxemia and absence of cellulites or obvious ascending lymphadenitis DIC is common and may lead to gangrenedeg. Y. pestis can also be cultured from blood of most bubonic plague patientdeg. Septicemic Plague: Often present with GI symptoms, DIC, multiorgan failuredeg Incubation period 2-7 days Pneumonic Plague Most infectious, most fatal type of plague with incubation period of 1-3 daysdeg Primary pneumonia: Cyanosis is very prominent, with bloody mucoid sputumdeg Secondary pneumonia: Diffuse interstitial pneumonia, less infectious. Diagnosis Yersinia pestis is best demonstrated by polychromatic stains (Wayson, Wright-Giemsadeg). These polychromatic stains accurately highlight bipolar stainingdeg characteristics of these gram negative bacilli | 159,941 | medmcqa_train |
Area of Cornea indented in Goldman Applanation tonometer for measuring IOP | Area of Cornea indented in Goldman Applanation tonometer for measuring IOP is 3.06mm. | 159,942 | medmcqa_train |
The commonest extradural spinal tumour is ? | Ans. is 'd' i.e., Metastasis | 159,943 | medmcqa_train |
A 45 year old woman presents with a hard and mobile lump in the breast. Next investigation is - | Ans. is 'a' i.e., FNAC In any patient with a breast lump or other symptoms suggestive of carcinoma, diagnosis should be made by a combination of : 'Triple Assessment' : a. Clinical assessment b. Radiological imaging c. Tissue sampling for either cytological or histological examination. FNAC is more than often the first investigation for a tissue assessment. Bailey writes ? "FNAC is the least invasive technique for obtaining a cell diagnosis and is very accurate if both operator and cytologists are experienced. However false negatives do occur, mainly through sampling error, and invasive cancer cannot be distinguished from 'in situ' disease. A histological specimen taken by core biopsy allows a definitive preoperative diagnosis, differentiates between duct carcinoma in situ (DCIS) and invasive disease and also allows the tumor to be stained for receptor status. This is impoant before commencing neoadjuvant therapy." | 159,944 | medmcqa_train |
Primary Regulator for central chemoreceptor - | Ans. is 'c' i.e., H+ Central chemoreceptors o These receptors are located in a chemosensitive area on the ventral surface of the medulla near the exit of the ninth and tenth cranial nerves. The primary stimulus for the central chemoreceptors is an increase in the hydrogen ion concentration. Stimulation of central chemoreceptors by increased hydrogen ion concentration leads to excitation of the respiratory neurons, thereby producing an increase in the rate and depth of respiration o Although the primary stimulus for central chemoreceptors is an increase in hydrogen ion concentration, in actual practice the physiological stimulus is an increase in PCO2. The reason is that hydrogen ions cannot cross the blood-brain barrier. Therefore, a change in the blood hydrogen ion concentration does not change the hydrogen ion concentration in the immediate vicinity of the chemosensitive neurons (i.e., in CSF and brain interstitial fluid). On the other hand, CO2 being lipid soluble can easily cross the blood-brain barrier. It enters the brain, where it is hydrated to give rise to H+ and HCO2 ions. Now these H+ directly stimulate the central chemoreceptors. o Thus, central chemoreceptors are directly stimulated by an increase in H+ concentration in CSF and brain interstitial tissue, which is brought about by the change in arterial PCO2 (PaCO2). o Change in CSF & Brain interstitial tissue - | H+ concentration (Primary direct stimulus) o Change in Blood - | PCO2 (Actual physiological stimulus). o Central chemoreceptors are not stimulated by hypoxia; rather like any other cells, they are depressed by hypoxia. | 159,945 | medmcqa_train |
The commonest cause of primary Amenorrhoea is: | Most common cause of Primary Amenorrhea = Gonadal dysgenesis/ovarian dysgenesis
2nd most common cause of Primary Amenorrhea = Mullerian agenesis (Mayer Rokitansky Kuster Hauser Syndrome)
“Mullerian agenesis is a relatively common cause of primary amenorrhea, more frequent than congenital androgen insensitivity and second only to gonadal dysgenesis”
3rd most common cause is testicular feminizing syndrome. | 159,946 | medmcqa_train |
All the following types of hypersensitivity reactions can be demonstrated by skin test except ? | Ans. is 'b' i.e., Type II Has been explained | 159,947 | medmcqa_train |
All of these hormones use cAMP as second messenger except: | Ans. (D) Vasopressin(Ref: Katzung 11/e p301, Gationg 22/e p41-43)Vasopressin acts via V1 and V2 receptors. V1 receptors use IP3 -DAG-Ca2+ pathway whereas V2 use cAMP as second messenger. All other drugs mentioned in the question act by cAMP pathway only. Thus, all of these use cAMP as second messenger, but if we need to choose one option we can answer vasopressin as it is acting through IP3 -DAG-Ca2+ pathway also. | 159,948 | medmcqa_train |
An elderly multigravida female presents in labor. She has multiple fibroids in lower uterine segment. Management is: | Ans. is d, i.e. Classical cesarean section followed by hysterectomySince this female is multigravida with multiple fibroids in lower uterine segments - vaginal delivery is not possible as multiple fibroids are present in lower uterine segment. We will have to do cesarean - but LSCS is also not feasible due to fibroids in lower segment (a lot of bleeding will occur if we cut through fibroid). Hence classical cesarean section should be done. The treatment of multiple fibroids in a multipara is hysterectomy, so classical cesarean section should be followed by hysterectomy). | 159,949 | medmcqa_train |
Microfalaria in Culex depicts what kind of Biological transmission? | Microfalaria in culex is an example of cyclo-developmental transmission. In Culex mosquito, it undergoes only development. stages will change There is no multiplication taking place in it. TYPES OF BIOLOGICAL TRANSMISSION- Propogative transmission Cyclo-developmental Cyclo-propogative | 159,950 | medmcqa_train |
All extra-ocular muscles are supplied by the oculomotor nerve except | The superior oblique is supplied by the trochlear nerve The lateral rectus is supplied by abducent nerve The superior rectus, inferior rectus, medial rectus and inferior oblique are supplied by occulomotor nerve Ref BDC volume 3,sixth edition pg 208 | 159,951 | medmcqa_train |
Which of the following chemical mediator of inflammation is an example of a C-X-C or alpha chemokine | Ref Robbins 9/e p87 IL-8, also known as neutrophil chemotactic factor, has two primary functions. It induces chemotaxis in target cells, primarily neutrophils but also other granulocytes, causing them to migrate toward the site of infection. IL-8 also stimulates phagocytosis once they have arrived. IL-8 is also known to be a potent promoter of angiogenesis. In target cells, IL-8 induces a series of physiological responses required for migration and phagocytosis, such as increases in intracellular Ca2+, exocytosis (e.g. histamine release), and the respiratory burst. IL-8 can be secreted by any cells with toll-like receptors that are involved in the innate immune response. Usually, it is the macrophages that see an antigen first, and thus are the first cells to release IL-8 to recruit other cells. Both monomer and homodimerforms of IL-8 have been repoed to be potent inducers of the chemokine receptors CXCR1 and CXCR2. The homodimer is more potent, but methylation of Leu25 can block the activity of homodimers. | 159,952 | medmcqa_train |
Epidural anaesthesia is preferred over spinal anaesthesia because: September 2006 | Ans. A: Prolonged duration of effect Epidural anaesthesia, a form of regional anaesthesia involving injection of drugs through a catheter placed into the epidural space. The injection can cause both a loss of sensation (anaesthesia) and a loss of pain (analgesia), by blocking the transmission of signals through nerves in or near the spinal cord The anaesthetist may use epidural analgesia in addition to general anaesthesia. This may reduce the patient's requirement for opioid analgesics. This is suitable for a wide variety of surgery, for example gynaecological surgery (e.g. hysterectomy), ohopaedic surgery (e.g. hip replacement), general surgery (e.g. laparotomy) and vascular surgery (e.g. open aoic aneurysm repair) which are longer duration surgeries. Other features of epidural anaesthesia: Expensive compared to spinal anaesthesia More incidence of intravascular injection (epidural space has venous plexus of Batson) More incidence of epidural hematoma Level of block can be changed by increasing the dose through the catheter | 159,953 | medmcqa_train |
Which of the following drugs cause relaxation of LES? 1. Nitrates 2. Histamine blockers 3. Morphine 4. Atropine 5. Calcium channel blockers | Factor causing relaxation of LES Factor increasing LES pressure Pharmacological agents:nitrates, anticholinergics, barbiturates, calcium channel blockers, caffeine, theophylline, diazepam, dopamine, prostaglandin E1 and E2 and meperidine Pepperdine Chocolate Coffee Alcohol Smoking Fat Antacids Cholinergics Domperidone Metoclopramide Prostaglandin F2 Also know: LES pressure is higher in the supine position than in the upright position. Ref: Schwarz 9/e, Page 812; Harrison 17/e, Page 1741. | 159,954 | medmcqa_train |
Plasma membrane is freely permeable to - | Ans. is 'd' i.e., Alcoholo As the major middle portion of membrane (core of the membrane) is formed by hydrophobic region of phospholipids, this portion is impermeable to the usual water-soluble substances, such as ions, glucose and urea.o Conversely, fat-soluble substances, such as oxygen, carbon dioxide, and alcohol, can penetrate this portion of the membrane with ease.o Permeability coefficient and permeability of some important molecules in increasing order of frequency are Na+ < K+ < Cl- < Glucose < Tryptophan < Urea = Glycerol< Indole < H2O. | 159,955 | medmcqa_train |
Which of the following drugs is not useful in the management of Postpaum Hemorrhage(PPH)? | Mifepristone is a progestin analogue and it blocks the effects of progesterone. It is used as a medical termination of pregnancy in the first trimester and as a post-coital contraceptive. While misoprostol, oxytocin and ergotamine are oxytocics and as uterine stimulants are used in the management of postpaum hemorrhage. Ref: Dutta textbook of Obstetrics 6th edition, Pages 175, 550, 411-22 | 159,956 | medmcqa_train |
Which is not a alkylating agent? | 5-FU is an metabolite | 159,957 | medmcqa_train |
100% Oxygen is not effective in: March 2005 | Ans. C: Tetralogy of fallot | 159,958 | medmcqa_train |
The lymph nodes first involved in cancer of the skin of the scrotum are - | • Squamous cell carcinoma of scrotumQ, most commonly resulted from exposure to environmental carcinogens including chimney soot, tars, paraffin and petroleum products.
• Superficial inguinal lymph nodes are the first lymph nodes involved.
Risk Factors
• Most cases results from poor hygiene and chronic inflammation.
Diagnosis
• Diagnosis is established by biopsy of scrotal skin.
Treatment
• Wide excision with 2 cm margins should be performed for malignant tumors.
• Prognosis correlates with presence or absence of nodal involvement. | 159,959 | medmcqa_train |
The primary therapy to prevent oesophageal varices is : | The treatment of patients with varices that have never bled is usually referred to as prophylactic therapy (eg, prophylactic sclerotherapy or prophylactic propranolol). By convention, procedures performed on patients who have bled previously are referred to as therapeutic (eg, therapeutic shunts). Prophylactic therapy is of value, since the moality rate of variceal bleeding is high (25%), the risk of bleeding in patients with varices is relatively high (30%), and varices can often be diagnosed before the initial episode of bleeding. Ref :Jarnagin W.R. (2010). Chapter 24. Liver & Poal Venous System. In G.M. Dohey (Ed), CURRENT Diagnosis & Treatment: Surgery, 13e. | 159,960 | medmcqa_train |
The followng does not occur with asbestosis - | Ref:Textbook of pathology (Harsh mohan) 6th edition,page no.492 Overexposure to asbestos is associated with 3 types of lesions: asbestosis, pleural disease and ceain tumours. A. ASBESTOSIS. The gross pulmonary fibrosis caused by asbestos exposure and histologic demonstration of asbestos bodies on asbestos fibres is termed asbestosis. Grossly, the affected lungs are small and firm with cailage-like thickening of the pleura. The sectioned surface shows variable degree of pulmonary fibrosis, especially in the subpleural areas and in the bases of lungs . The advanced cases may show cystic changes. Histologically, the following changes are observed: 1. There is non-specific interstitial fibrosis. 2. There is presence of characteristic asbestos bodies in the involved areas . These are asbestos fibres coated with glycoprotein and haemosiderin and appear beaded or dumbbell-shaped. The coating stains positively for Prussian blue reaction. 3. There may be changes of emphysema in the pulmonary parenchyma between the areas of interstitial fibrosis. 4. The involvement of hilar lymph nodes in asbestosis is not as significant as in silicosis. B. PLEURAL DISEASE. Pleural disease in asbestos exposure may produce one of the following 3 types of lesions: 1. Pleural effusion. It develops in about 5% of asbestos workers and is usually serious type. Pleural effusion is generally accompanied by subpleural asbestosis. 2. Visceral pleural fibrosis. Quite often, asbestosis is associated with dense fibrous thickening of the visceral pleura encasing the lung. 3. Pleural plaques. Fibrocalcific pleural plaques are the most common lesions associated with asbestos exposure. Grossly, the lesions appear as circumscribed, flat, small (upto 1 cm in diameter), firm or hard, bilateral nodules. They are seen more often on the posterolateral pa of parietal pleura and on the pleural surface of the diaphragm. Microscopically, they consist of hyalinised collagenous tissue which may be calcified so that they are visible on chest X-ray. Asbestos bodies are generally not found within the plaques. C. TUMOURS. Asbestos exposure predisposes to a number of cancers, most impoantly bronchogenic carcinoma and malignant mesothelioma . A few others are: carcinomas of oesophagus, stomach, colon, kidneys and larynx and various lymphoid malignancies. 1. Bronchogenic carcinoma is the most common malignancy in asbestos workers. Its incidence is 5 times higher in non-smoker asbestos workers than the nonsmoker general population and 10 times higher in smoker asbestos workers than the other smokers. 2. Malignant mesothelioma is an uncommon tumour but association with asbestos exposure is present in 30 to 80% of cases with mesothelioma. The exposure need not be heavy because mesothelioma is known to develop in people living near asbestos plants or in wives of asbestos workers. | 159,961 | medmcqa_train |
True about phobia are all, except: NIMHANS 08; NEET 13 | Ans. Generalized anxiety | 159,962 | medmcqa_train |
An adolescent is brought to the emergency depament following an episode of myoclonic jerks at morning after waking up. His consciousness was not impaired. His EEG shows generalized 3-4 Hz spike and slow wave complexes. Most probable diagnosis is? | Juvenile myoclonic epilepsy is a subtype of idiopathic generalized epilepsy with onset usually between 8 and 20 years of age. Myoclonic jerks, especially in the morning, are of variable intensity ranging from simple twitching ("flying saucer syndrome") to falls; consciousness is not impaired in it. It is precipitated by alcohol and sleep deprivation. Patients will have normal intelligence. The typical interictal EEG abnormality consists of a generalized 4- to 6-Hz spike or polyspike and slow-wave discharges lasting 1-20 seconds. Usually, 1-3 spikes precede each slow wave. Also know: In Generalized tonic clonic seizure EEG shows a normal background with generalized epileptiform discharges such as spike or polyspike wave complexes at 2.5 to 4 Hz. During absence seizures there is an abrupt onset of bilaterally synchronous and symmetrical 3 Hz spike-wave discharge, irrespective of whether typical absences are simple or complex. Ictal recordings from patients with typical temporal lobe epilepsy usually exhibit 5-7 Hz, rhythmic, sharp theta activity, maximal in the sphenoidal and the basal temporal electrodes on the side of seizure origin. Ref: A-Z of Neurological Practice: A Guide to Clinical Neurology By Andrew J. Larner, Alasdair J Coles, Neil J. Scolding, Roger A Barker, 2011, Page 368 ; Clinical Electroencephalography by Misra,2005, Page 188 | 159,963 | medmcqa_train |
Thiopentone is not used in? | Ans. is 'd' i.e., As antidepressant | 159,964 | medmcqa_train |
True about tracheal bifurcation - | Trachea
The trachea is 10-15 cm long tube formed by C-Shaped hyaline cartilaginous rings and fibromuscular membrane.
It extends from the lower border of cricoid cartilage (at C6 level) to lower border of T4 or upper border of T5 vertebra (T4-T5 disc space) where it bifurcates.
Its external diameter is about 2 cm in males and about 1.5 cm in females.
It has 16-20 cartilaginous rings.
The first tracheal ring is the broadest. The last ring at tracheal bifurcation shows carina, a triangular hoop-shaped process separating the bronchi, i.e.
Carina is a bifurcation of the trachea.
The trachea is lined by ciliated columnar epithelium.
It is supplied by the inferior thyroid artery and is drained by left brachiocephalic vein.
Sensory and motor supply to the trachea is provided by the parasympathetic system through vagi and recurrent laryngeal nerve.
Vasomotor supply is by sympathetic fibres through middle cervical ganglion along inferior thyroid arteries. | 159,965 | medmcqa_train |
How does hyperammonemia inhibit TCA cycle? | Build up of cummonemia which occurs in urea cycle disorder or advanced liver disease, inhibits TCA cycle by depleting alpha ketoglutarate. | 159,966 | medmcqa_train |
The most common cause of painful pericarditis is | The cause of pericarditis is believed to be most often due to a viral infection. Other causes include bacterial infections such as tuberculosis, uremic pericarditis, following a hea attack, cancer, autoimmune disorders, and chest trauma Ref: guyton and hall textbook of medical physiology 12 edition | 159,967 | medmcqa_train |
Most common site of ectopic salivary gland is? | Ans is 'c' i.e. Angle of mandible * An accessory salivary gland is ectopic salivary gland tissue with a salivary gland duct system. The most common location of accessory salivary gland tissue is an extra major salivary gland in front of the parotid gland.* Salivary gland heterotopia is where salivary gland acini cells are present in an abnormal location without any duct system. The most common location is the cervical lymph nodes.* Most common ectopic salivary gland tissue is Stafne bone cyst.* It presents as asymptomatic, clearly demarcated radiolucency of the angle of mouth, characteristically, below inferior dental neurovascular bundle. | 159,968 | medmcqa_train |
An eight-year-old boy had abdominal pain, fever with bloody diarrhea for 18 months. His height is 100 cm and weight is 14.5 kg. Stool culture was negative for known entero-pathogens. The sigmoidoscopy was normal. During the same period child had an episode of renal colic and passed urinary gravel. The Mantoux test was 5 x 5 mm. The most probable diagnosis is: | The boy in question is obviously malnourished (Expected weight is 20-25 kg and expected height is 125-130 cm) A normal sigmoidoscopy rules out ulcerative colitis as it extends in a continuous fashion proximally from the rectum. A negative Mantoux test goes against active tuberculosis and a negative stool culture also rules out strongyloidiasis. Interpretation of Mantoux test: If the width of the induration is: >= 10 mm: Positive (tuberculin reactors) 6-9 mm: Equivocal/doubtful reaction <=5 mm: Negative reaction Hence, the obvious choice left is option '2', i.e. Crohn's disease. | 159,969 | medmcqa_train |
All are autosomal recessive EXCEPT: September 2004 | Ans. C i.e. Marfan's syndrome Marfan syndrome is a disorder of connective tissue, manifested principally by changes in the skeleton, eyes, and cardiovascular system. It is transmitted by autosomal dominant inheritance. | 159,970 | medmcqa_train |
A 17-year-old girl with amenorrhea, atrophied breast, hypoplastic uterus : | Turner's syndrome Phenotype is female Karyotype is 45,XO Sho stature,webbed neck underdeveloped uterus and vagina ovaries lack graffian follicles breasts are not developed,axillary and pubic hair is scanty or absent SHAW'S TEXTBOOK OF GYNAECOLOGY,pg no:111,115th edition | 159,971 | medmcqa_train |
All are fibrinolytic, except - | Ans. is 'd' i.e., Epsilon amino caproic acid | 159,972 | medmcqa_train |
Which of the following statement is false about drugs used in rheumatoid ahritis? | Drug ending with inib - JAK inhibitor and given orally.- Tofacitinib- Beracitinib Drug ending with Mab: - Monoclonal antibody and IL-6 inhibitor.- Tocilizumab- SarilumabSix : IL-6A-AhritisR-RheumatoidI - InterleukinL - InterleukinUMAB: Monoclonal Antibody.All above mentioned drugs are used for Rheumatoid ahritis. Tocilizumab: is also use for cytokine release syndrome. | 159,973 | medmcqa_train |
Which of the following cell types are specific to a latent genital infection with HSV-2 | Latent infection by HSV-2 has been shown to occur primarily in the sacral ganglia, whereas HSV-1 latency has been demonstrated in trigeminal, superior cervical, and vagal nerve ganglia. Varicella- zoster virus remains latent in neural sensory ganglia. Ref:- Baveja textbook of Microbiology | 159,974 | medmcqa_train |
If a body is left undisturbed, for how long does post moem staining persists : | D i.e. Persists till merges with discolouration of putrefaction | 159,975 | medmcqa_train |
Phage typing is useful as an epidemiological tool in all, except ? | Ans. is 'd' i.e., Shigella dysenteriae | 159,976 | medmcqa_train |
Multifactorial inheritance is most likely to play a role in | Cleft lip and cleft palate, also known as orofacial cleft, is a group of conditions that includes cleft lip (CL), cleft palate (CP), and both together (CLP).] A cleft lip contains an opening in the upper lip that may extend into the nose. The opening may be on one side, both sides, or in the middle. A cleft palate is when the roof of the mouth contains an opening into the nose. These disorders can result in feeding problems, speech problems, hearing problems, and frequent ear infections. Less than half the time the condition is associated with other disordersMultifacorial inheritance is the type of inheritance followed by traits that are determined by multiple factors both environmental and genetic. Environmental factors interact with many genes to generate a normally distributed susceptibiity.Some diseases for example myocardial infarction, congenital bih defects, cancer, diabetes, mental illnesses and Alzheimer diseases cause along with morbidity, premature moality in two out of three individuals during their lifetime. Many show clustering among families. However their inheritance pattern does not follow that of single gene disorders (Mendelian pattern of inheritance). These kind of diseases are thought to result from complex interactions between genetic and environmental factors, i.e. multifactorial inheritance pattern. | 159,977 | medmcqa_train |
Which of the followign drugs require dose adjustment in renal failure? | Ans. (C) Streptomycin(Ref: Katzung 10/e p835 KDT 8/e p746)Streptomycin is an aminoglycoside and require dose adjustment in renal failure whereas doxycycline, rifampicin and cefoperazone are secreted in bile and do not require dose adjustment in renal failure. | 159,978 | medmcqa_train |
The learning theory of digit sucking was proposed by | The learning theory: Davidson (1967)
This theory advocates that non-nutritive sucking stems from an adaptive response.
The infant associates sucking with such pleasurable feelings as hunger. These events are recalled by sucking the suitable objects available, mainly thumb or finger. | 159,979 | medmcqa_train |
Which aery dilatation causes compression of 3rd pa of duodenum | Superior mesenteric aery: - Aery of mid gut Origin - L1 veebrae level . Regional anatomy of SMA: - It is crossed anteriorly by the splenic vein & the neck of pancreas. Posterior to it is the renal vein, the uncinate process & the inferior pa of duodenum (3rd pa). - This D3 pa can be compressed b/w two aeries: - Anterior - SMA Posterior - Abdominal aoa SMA dilatation can lead to compression of 3rd pa of duodenum. | This is called as superior Mesenteric aery syndrome. | 159,980 | medmcqa_train |
The surgery for hyperophic pyloric stenosis of infancy is | After laparotomy hyperophied muscle is cut along the whole length adequately until mucosa bulges out, then pyloromyotomy is done. in Heller&;s operation muscle of the cardiac are cut to allow passage of food ,and is done in achalasia cardia Truncal vagotomyis done by denervating the main branch which is supply in pylorus as in cases like peptic ulcerarltion Delorme&;s operation is done for repairing a external rectal prolapse Reference: SRB 5th edition page no. 821 & internet | 159,981 | medmcqa_train |
Testamentary capacity is the ability to: | Testamentary capacity (testament = will) is the mental ability to make a valid will. Will denotes any testamentary document. The requirement for a valid will are as follows. A written and properly signed and witnessed document must exist. The testator must be a major and of sound disposing mind at the time of making the will. Force undue influence or dishonest representation of facts, should not have been applied by others. Ref: The Essentials of Forensic Medicine and Toxicology 29th Ed Page 431 | 159,982 | medmcqa_train |
Uveitis with raised intraocular tension is best managed by – | Keep in mind that:-
Treatment of uveitis in hypertensive uveitis (uveitic glaucoma) is topical steroid along with mydriatic-cycloplegics.
Treatment for reducing IOP in hypertensive uveitis (uveitic glaucoma) is antiglaucoma drugs (Timolol is the drug of choice). | 159,983 | medmcqa_train |
Pin point pupil is seen in A/E : | D i.e. Barbiturate All are causes of constricted pupils but in? Barbiturate poisoning the pupils are usually slightly constricted & react to light by alternate contraction & dilation and dilate during terminal asphyxiaQ | 159,984 | medmcqa_train |
All are morbidity indicators execpt - | Ans. is `b' i.e., Doctor : population ratio Health change cannot be measured in specified unit. o So, different indicators have been defined which reflect health change in a community. o These indicators are called health indicators e.g. moality indicators, morbidity indicators, Disability rates. | 159,985 | medmcqa_train |
False positive fistula test is associated with | False positive fistula test seen in: Congenital syphilis - Stapes footplate is hypermobile Meniere's disease - fibrous bands connecting uricular macula to Stapes footplate. Ref : Dhingra 7e pg 43. | 159,986 | medmcqa_train |
NOT a feature of ligature strangulation: Kerala 08 | Ans. Incomplete ligature mark | 159,987 | medmcqa_train |
A 32-year-old female is brought by his family with history of gradual onset of suspiciousness, muttering and smiling without clear reason, decreased socialization, and violent outbursts. Mental status examination revealed a blunt affect, thought insertion, impaired judgement and insight. The most likely diagnosis would be: | Ans. C. SchizophreniaSchizophrenia is a disorder characterized by delusions, hallucinations, negative symptoms, aggressive behavior in clear consciousness. Altered sensorium is seen in organic conditions like delirium. | 159,988 | medmcqa_train |
In which of the following condition is Ground glass appearance of maxillary sinus seen? | Extra oral film taken in a case of maxillary fibrous dysplasia shows ground glass appearence. Intraoral film taken in this condition shows orange peel appearence. Fibrous dysplasia is an idiopathic skeletal disorder in which medullary bone is replaced by poorly organized structurally unsound fibro osseous tissue. Most commonly involved site is the posterior maxilla. In this condition, the normally radiolucent maxillary antrum may be paially or totally replaced by the radio-opaque lesion. | 159,989 | medmcqa_train |
Peptidoglycans are found in large quantities in cell wall of: March 2009 | Ans. B: Gram positive bacteria The Bacteria (eubacteria), with the exception of the Chlamydias have a semirigid cell wall containing peptidoglycan. Gram negative bacteria's peptidoglycan layer is much thinner than in Gram-positive bacteria In general, the walls of gram positive bacteria have a simpler chemical nature than those of gram negative bacteria. The mycoplasmas are the only bacteria that naturally lack a cell wall. Mycoplasmas maintain a nearly even pressure between the outside environment and the cytoplasm by actively pumping out sodium ions. Their cytoplasmic membranes also contain sterols that most likely provide added strength. All other bacteria have a cell wall Peptidoglycan prevents osmotic lysis. Under the cytoplasmic membrane, bacteria concentrate dissolved nutrients (solute) through active transpo. As a result, the bacterium's cytoplasm is usually hypeonic to its surrounding environment and the net flow of free water is into the bacterium. Without a strong cell wall, the bacterium would burst from the osmotic pressure of the water flowing into the cell. | 159,990 | medmcqa_train |
Coincidental malignancy in the upper respiratory tract with inveed papillomas seen in | Coincidental malignancy in the upper respiratory tract with inveed papilloma is seen in 4%Malignant transformation of the tumor itself is seen in 8% | 159,991 | medmcqa_train |
Hepatic encephalopathy is aggravated by all except? | Hypokalemia is seen with overzealous use of diuretics and this will lead to dehydration and increased hepatic encephalopathy. Anemia associated with Gl bleeding worsens hepatic encephalopathy Constipation in hypothyroidism will worsen hepatic encephalopathy by increasing bacterial load. Drugs like barbiturates and antipsychotics worsen hepatic encephalopathy | 159,992 | medmcqa_train |
A female aged 30, presents with an episodic throbbing headache for past 4 yrs. It usually involves one half of the face and is associated with nausea and vomiting. There is no aura. Most likely diagnosis is | Migraine 2nd most common cause of a headache.Affects 15% of women and 6% of men over a one year period.Usually an episodic headache and associated with ceain features such as sensitivity to light, sound, or movement. Nausea and vomiting often accompany a headache.May be associated with other symptoms of neurologic dysfunction in varying admixtures.Paresthesias are seen in 33% of people affected by a migraine.Ref: Harrison; 19th edition | 159,993 | medmcqa_train |
What is the type of voice in antrochoanal polyp- | Ans. is 'a' i.e., Hyponasal voice Clinical features of antrochoanal polypo Unilateral Nasal blockage (more on expiration than on inspirationo Obstruction may become bilateral when polyp grows into nasopharynx and starts obstructing opposite choana.o Hyponasal voiceo Mucoid nasal dischargeo Conductive deafness due to eustachian tube dysfunction.o On examination polyp may not be visible on anterior rhinoscopy as it grows posteriorlyo On posterior rhinoscopy - smooth, greyish white, spherical mass is seen in choana. | 159,994 | medmcqa_train |
Deep white matter lesion with bilateral deep bright thalamic appearance is suggestive of | Ans. is 'c' i.e. Krabbe's disease Deep white matter lesion along with the involvement of thalamus suggests Krabbe's disease.Krabbe's disease is a leukodystrophy.LeukodystrophyIt is a term commonly used to refer to demyelination disorders.They are mainly due to genetic defects in the formation and maintenance of myelin.They usually present in infants and children with increasing development delay, progressive dementia and neurological deficit.These disorders are inherited as autosomal recessive trait and are associated with lysosomal enzyme deficiencies.They include the following disorders:-Metachromatic leukodystrophyGloboid leukodystrophy (Krabbe's disease)Spongiform degeneration (Canavan's disease)T. scan of leukodystrophies:-C. T. scan of the leukodystrophies shows low density areas in the white matter which are bilateral but not necessary symmetric and becomes more extensive as the disease process progresses.Krabbe's diseaseIt occurs due to deficiency of the enzyme P-galactocerebroside.It presents in infancy with retardation and spasticity.CT scan appearance of Krabbe's diseaseB/L symmetrical hypodensities in both frontoparietal and occipital regions in the white matter zone.Both thalamus and basai ganglia are hyperdenseCerebellum unaffected, ventricles normal, septum midlineMetachromatic leukodystrophyIt is a common leukodystrophy which commences in infancy.It occurs due to deficiency of the enzyme Arylsulphatase A.C. T. shows diffuse symmetric attenuation of the cerebellar and cerebral white matter.Alexander's diseaseIt is one of the few leukodystrophies that occurs sporadically and is characterized histopathologically by the abundant presence of Rosenthal fibres in the affected brain.Definitive diagnosis thus depends on brain biopsy.It occurs due to mutation in glial fibrillary acidic protein (GFAP).C. T. scan demonstrates degeneration of the white matter most prominent in the frontal lobes.Canavan's diseaseIt occurs due to deficiency of the enzyme aspart acylase leading to accumulation of N-Acetyl aspartic acid in the brain.C. T. scan shows diffuse white matter degeneration primarily in the cerebral hemispheres with less involvement in the cerebellum and brainstem. | 159,995 | medmcqa_train |
What changes in GFR is expected in a 30-year-old lady with pre-eclampsia? | Pre-eclampsia is a state of hypeension in pregnancy associated with proteinuria but with or without pathological edema. It is defined as a multi-system disorder of unknown etiology characterised by development of hypeension to the extent of 140/90 mm Hg or more with protienuria after the 20th week of pregnancy in a previously normotensive and a normoproteinuric patient. The typical pathological features are endothelial dysfunction and intense vasospasm. In pre-eclampsia, the glomerular filtration rate decreases. The decrease in glomerular filtration rate is as a result of the following physiological changes: Afferent glomerular aeriolar vasospasm Occlusion of the lumen of the glomerulus resulting from glomerular endotheliosis and fibrin deposits in the basement membrane Decreased renal blood flow Ref: Textbook of Obstetrics By D.C. Dutta, 6th Edition, Pages 221-3131 | 159,996 | medmcqa_train |
Adies aegpti index at airport - | (C) (< 1) (258 - Park 22nd)AEDES AEGYPTI INDEX: This is a house index and is defined as "the percentage of houses and their premises in a limited well-defined area, showing actual breading of Aedes - aegypti larvae"* This index should not be more than 1 percent in towns and seaports in endemic areas to ensure freedom from yellow fever.* Airports and seaports are kept free from the breeding of insect vectors over an area extending at least 400 meters** around their perimeters.* The "aedes aegypti index" is kept below 1 **YELLOW - FEVER* It is a exotic zoonotic disease in India.* Causative agent - Group B Arbovirus (Flavivirus fibricus) (Togavirus family)* Reservoir - Monkey in forest areas and Man in urban area.* Vector - Aedes aegypti* Incubation Period - Intrinsic 3-6 days, Extrinsic 8-12 days.* Immunity - One attack confers life long Immunity. Infants bom of immune mothers have antibodies up to 6 months of life.* Clinical features - Haemorrhagic fever (black vomit, epistaxis, malena) with severe hepatic and renal manifestations. Spectrum of disease varies from clinically indeterminate to severe cases.* Case fatality rate - May reach 80% in severe cases.* Period of communicability: Blood of patients is infective during the first 3 to 4 days of illness.* Vaccine - 17 D vaccine Live attenuaed, Freeze dried. Immunity apperrs on 7th day and lasts >35 years. Rapid immunization of population at risk is the most effective control strategy.* International certificate of vaccination - Valid 10 days after date of vaccination and extends up to 10 years. WHO recommends re-vaccination after 10 years.* All travellers (including infants) exposed to risk of yellow fever or passing through endemic zones of yellow fever must poses a valid International certificate of vaccination.* Quarantine - A traveller without a valid international certificate of vaccination' is placed on quarantine in a mosquito proof ward for 6 days. | 159,997 | medmcqa_train |
Following are the mature mineralized matrix marker of the periodontal ligament except: | Markers for Periodontal Ligament Stem Cells
1. Bone Marrow Markers
STRO-1
2. Perivascular Cell Markers
CD146
αSMA
Pericyte associated antigen 3G5
CD106
3. Mature Mineralized Matrix Markers
Alkaline phosphatase
Osteonectin
Osteopontin
Osteocalcin
Bone sialoproteins
4. Connective Tissue Protein Markers
Type I and III collagen | 159,998 | medmcqa_train |
Strongest attachment of Zonule is at - | The lens is suspended in the eye by zonules which are inseed on the anterior and equatorial lens capsule and attached to the ciliary body. REF IMG | 159,999 | medmcqa_train |
Subsets and Splits