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Vogt Koyanagi Harada syndrome is - | Ans. is 'c' i.e., UveitisClinical manifestations of Vogt Kavanadi Harada syndromeOccular involvementC.N.S. involvementAuditory manifestationCutaneous manifestationOccular involvementB/L panuveitis ino Meningismuso Hearing losso VitiligoB/L panuveitis inassociation with serouso Headacheo Tinnituso Alopeciaassociation w'ith serousretinal detachmento C.S.F. Pleocytosis retinal detachmentAccording to American uveitis society the criteria for diagnosis of VKH syndromeo No history' of ocular trauma or surgery.o At least three of four of the following signsBilateral chronic iridocyclitis.Posterior uveitis, including exudative retina! detachment, disc hyperemia or edema and sunset glow fundus.Neurological sign of tinnitus, neck stiffness cranial nerve or CNS problems or CSF pleocytosis.Cutaneous finding of alopecia, poliosis or vitiligo. | 1,700 | medmcqa_train |
Which of the following ultrasound marker is associated with greatest increased risk for Trisomy 21 in fetus? | Ans. Nuchal edema | 1,701 | medmcqa_train |
Cyanide affects respiratory chain by | The toxicity of cyanide is due to its inhibitory effect on the terminal cytochrome which brings cellular respiration to a standstill. The inhibitor usually binds to a different domain on the enzyme, other than the substrate binding site. Since these inhibitors have no structural resemblance to the substrate, an increase in the substrate concentration generally does not relieve this inhibition.Ref: DM Vasudevan, Page no: 234 | 1,702 | medmcqa_train |
Mercury affects which part of the kidney - | Ans. (a) PCT(Ref: Robbins 9th/pg 928; 8th/pg 938)Nephrotoxic AKI*Caused by Gentamicin, radiographic contrast agents, heavy metals (eg mercury), organic solvents (eg CCl4 ).*Extensive necrosis along mainly proximal convoluted tubule (PCT) & ascending limb of Henle's loop.*On histologic examination, non-specific tubular necrosis, with some distinctive features:Mercuric chlorideSeverly injured cells contain large acidophilic inclusions, become totally necrotic, & may undergo calcification.Carbon tetrachlorideAccumulation of neutral lipids (fatty change), followed by necrosis.Ethylene glycolMarked ballooning & hydropic or vacuolar degeneration of proximal convoluted tubules. Ca oxalate crystals are often found in the tubular lumens in such poisoning. | 1,703 | medmcqa_train |
A 30 year old lady is to undergo surgery under intravenous regional anesthesia for her left 'trigger finger'. Which one of the following should not be used for patient? | B i.e. Bupivacaine | 1,704 | medmcqa_train |
One primary oocyte forms how many ovum/ova | Observe that whereas one primary spermatocyte gives rise to four spermatozoa, one primary oocyte forms only one ovumHuman embryology Inderbir Singh&;s Tenth edition Pg 23 | 1,705 | medmcqa_train |
The age by which most of the normal babies know their gender is | <p>. Developmental milestones:- GROSS MOTOR DEVELOPMENT: 2 months: Holds head in plane of rest of the body when held in ventral suspension. In prone position in bed, the chin lifts momentarily. 3 months:lift head above the plane of the body. Head control stas by 3 months and fully developed by 5 months. 4 months:Remain on forearm suppo if put in prone position, lifting the upper pa of the body off the bed. 5 months: Rolls over. 6 months:sit in tripod fashion. 8 months: sits without suppo., crawling 9 months: Takes a few steps with one hand held. Pulls to standing and cruises holding on to furniture by 10 months. 10 months: creeps 12 months:creeps well, walk but falls, stand without suppo. 15 months: walks well, walks backward/ sideways pulling a toy. May crawl upstairs. 18 months: Runs, walks upstair with one hand held. Explores drawers 2 years: walk up and downstairs, jumps. 3 years : rides tricycle, alternate feet going upstairs. 4 years: hops on one foot, alternate feet going downstairs. 5 years:skips FINE MOTOR DEVELOPMENT:- 2 months- eyes follow objects to 180 deg. 3 months-Grasp reflex disappears and hand is open most of the time. 4 months- Bidextrous approach( reaching out for objects with both hands). 6 months- Unidextrous approach( Reach for an object with one hand). 8 months- radial grasp sta to develop. Turns to sound above the level of ear. 9 months- immature pincer grasp, probes with forefinger. 12 months-Unassisted pincer grasp. Releases object on request.Uses objects predominantly for playing, not for mouthing. Holds block on each hand and bang them together. 15 months- imitate scribbling , tower of two blocks 18 months- scribbles, tower of 3 blocks.turn pages of a book, 2-3 at a time. 2 years- tower of 6 blocks, veical and circular stroke. 3 years-Tower of 9 blocks, dressing and undressing with some help, can do buttoning. 4 years- copies cross, bridge with blocks 5 years- copies triangle, gate with blocks. SOCIAL AND ADAPTIVE MILESTONES: 2 months: social smile(smile after being talked to).watches mother when spoken to and may smile. 3 months:Recognizes mother, anticipates feeds. 4 months: Holds rattle when placed in hand and regards it . Laughs aloud. Excited at the sight of food. 6 months:recognizes strangers, stranger anxiety . Enjoy watching own image in mirror, shows displeasure when toy pulled off. 9 months:waves bye bye 12 months:comes when called, plays simple ball game.kisses the parent on request. Makes postural adjustments for dressing. 15 months:jargon, stas imitating mother. 18 months: copies parents in tasking, dry by day, calls mother when he wants potty, points to three pas of body on request. 2 years: ask for food, drink, toilet, pulls people to show toys. 3 years:shares toys, know fullname and gender, dry by night. 4 years:Plays cooperatively in a group, goes to toilet alone, washes face, brushes teeth. Role play . 5 years:helps in household task , dresses and undresses. LANGUAGE MILESTONES: 1 month: Ales to sound. 2 month:respond to sound by stale or quitening to a smooth voice. 3 months: babbles when spoken to. Makes sounds (ahh,coos, ) laughs. 4 months: laughs aloud. 6 months: monosyllables 9 months: understands spoken words, bisyllables. 12 months: 1-2 words with meaning. 18 months: vocabulary of 10 words. Can name one pa of body. 2 years: 3 word simple sentences 3 years:asks questions, knows full name and gender. 4 years: says songs or poem, tells story, knows three colours. 5 years: ask meaning of words. {Reference: GHAI Essential pediatrics, eighth edition} | 1,706 | medmcqa_train |
True about nucleosome | In biology, histones are highly alkaline proteins found in eukaryotic cell nuclei that package and order the DNA into structural units called nucleosomes. They are the chief protein components of chromatin, acting as spools around which DNA winds, and playing a role in gene regulation. Without histones, the unwound DNA in chromosomes would be very long (a length to width ratio of more than 10 million to 1 in human DNA). For example, each human diploid cell (containing 23 pairs of chromosomes) has about 1.8 meters of DNA, but wound on the histones it has about 90 micrometers (0.09 mm) of chromatin, which, when duplicated and condensed during mitosis, resulting in about 120 micrometers of chromosomes | 1,707 | medmcqa_train |
A 64 year old hypertensive obsese female was undergoing surgery for fracture femur under general anaesthesia. Intra-operatively her end-tidal carbon dioxide decreased to 20 from 40 mm of Hg, followed by hypotension and oxygen saturation of 85%. What could be the most probable cause? | "Arterial blood gas analysis reveals hypoxemia and hypocapnia, with subsequent metabolic acidosis in severe pulmonary embolism. During anaesthesia, end tidal CO2 concentration may fall dramatically because of increased dead space and reduced cardiac output". _________ Anesthesia & Intensive care
Note : Fat embolism can present as pulmonary embolism when an extensive fat embolism of lung is present. | 1,708 | medmcqa_train |
Which of the following drugs is taken during the first pa of the meal for the purpose of delaying absorption of dietary carbohydrates? | Acarbose is alpha glucosidase inhibitor. It inhibits the breakdown of complex carbohydrates to simple carbohydrates and thus they decrease the absorption. Glipizide is second generation sulphonylurea which helps in secretion of insulin. Metformin is biguanide which decrease the synthesis of glucose. Exenatide is GLP-1 analogue which delay in gastric emptying, decrease appetite and augment glucose secretion. | 1,709 | medmcqa_train |
Test for tight iliotibial band is | OBER&;S TEST:Used in physical examination to identify tightness of iliotibial band. During the test ,the patient lies on his side with the unaffected leg on the bottom with their shoulder and pelvis in line. The knee may extended or flexed to 90 or 30 degrees.The hip is maintained in slight extension.The test leg is abducted,then allowed to lower toward the table with the pelvis stabilized NORMAL: able to abduct parallel to the examining surface Inability to adduct to parallel indicates tightness of iliotibial band REF : MAHESWARI 9TH ED | 1,710 | medmcqa_train |
The antiepileptic drug effective in Lennox-Gastaut syndrome is: | Lamotrigine is the most effective drug among the given options. Ref: Harrisons principles of internal medicine, 18 th edition ; Page : 3263, Table : 369/9. | 1,711 | medmcqa_train |
Ten days after an exploratory laparotomy and lysis of adhesions, a patient, who previously underwent a low anterior resection for rectal cancer followed by postoperative chemoradiation, is noted to have succus draining from the wound. She appears to have adequate source control--she is afebrile with a normal white blood count. The output from the fistula is approximately 150 cc per day. Which of the following factors is most likely to prevent closure of the enterocutaneous fistula? | Factors that predispose to fistula formation and may prevent closure include foreign body, radiation, inflammation, epithelialization of the tract, neoplasm, distal obstruction, and steroids.Factors that result in unhealthy or abnormal tissue surrounding the enterocutaneous fistula decrease the likelihood of spontaneous resolution. For example, radiation therapy, such as used for treatment of pelvic gynecologic and rectal malignancies, can result in chronic injury to the small intestine characterized by fibrosis and poor wound healing. High-output fistulas, defined as those with more than 500 cc per day output, are usually proximal and unlikely to close. Treatment consists of source control, nutritional supplementation, wound care, and delayed surgical intervention if the fistula fails to close. | 1,712 | medmcqa_train |
All are causes of hypertension with hypokalemia except, | Ans. is 'b' i.e. End stage renal disease Hypertension with HypokalemiaHigh reninRenal artery stenosisAccelerated hypertensionRenin-secreting tumorEstrogen therapyLow reninPrimary aldosteronismAdenomaHyperplasiaCarcinomaAdrenal enzyme defects1 1b- Hydroxylase deficiency17a- Hydroxylase deficiencyCushing's syndrome or diseaseOtherLicoriceCarbenoxoloneChewer's tobaccoLydia Pinkham tabletsAlso know.Hypokalemia without hypertensionBARTER'S SyndromeGUELMAN'S Syndrome | 1,713 | medmcqa_train |
All are autosomal dominant except - | Phenylketonuria (PKU) is an inborn error of metabolism that results in decreased metabolism of the amino acid phenylalanine.] Untreated PKU can lead to intellectual disability, seizures, behavioral problems, and mental disorder. It may also result in a musty smell and lighter skin. Babies born to mothers who have poorly treated PKU may have hea problems, a small head, and low bih weight. Phenylketonuria is a genetic disorder inherited from a person's parents. It is due to mutations in the PAH gene which results in low levels of the enzyme phenylalanine hydroxylase. This results in the build up of dietary phenylalanine to potentially toxic levels. It is autosomal recessive meaning that both copies of the gene must be mutated for the condition to develop. There are two main types, classic PKU and variant PKU, depending on if any enzyme function remains. Those with one copy of a mutated gene typically do not have symptoms | 1,714 | medmcqa_train |
Primary structural defect of an organ is termed - | Ans. (a) Malformation(Ref: Robbins 9th/pg 452)Malformation refers to primary structural defect of an organ due to intrinsically abnormal developmental process (multifactorial); Eg Anencephaly, Congenital heart defects | 1,715 | medmcqa_train |
First investigation done for abnormal uterine bleeding in reproductive age group is _______ | The first investigation for abnormal uterine bleeding is Urine Beta HCG to rule ouut pregnancy. Abnormal Uterine Bleeding(AUB): is a common and debilitating condition. Chronic AUB was defined as &;bleeding from the uterine corpus that is abnormal in volume, regularity and/or timing that has been present for the majority of the last 6 months. AUB may affect females of all ages. Factors that influence incidence most greatly are age and reproductive status. A structured approach for establishing the cause using the FIGO PALM COEIN classification system will facilitate accurate diagnosis and inform treatment options. In the reproductive age group , the hypothalamic-pituitary-ovarian (HPO) axis matures, and anovulatory uterine bleeding is encountered less often. The diagnostic goal is exclusion of pregnancy and identification of the underlying pathology to allow optimal treatment. Miscarriage, ectopic pregnancies, and hydatidiform moles may cause life-threatening hemorrhage. Pregnancy complications are quickly excluded with determination of urine and serum Beta-human chorionic gonadotrophin (hCG levels). This is typically obtained on all reproductive-aged women. Other options: Pap smear evaluation is usually done for cervical and endometrial cancers which are commonly seen in peri and post menopausal women. Transvaginal sonography (TVS) typically offers greater patient comfo and suitable detection of postmenopausal endometrial hyperplasia and cancer compared to transabdominal ultrasonography. Ref: Shaw&;s textbook of Gynaecology 17th edition Pgno: 139 | 1,716 | medmcqa_train |
Female sterilization is absolutely contraindicated in: | There is no absolute medical contraindication for female sterilization. Also remember, : FEMALE STERILIZATION MALE STERILIZATION - Married - Married - 22-49 yrs old female - 22-60 yrs old male - >= 1 child - >= 1 child - No past history in self/ spouse sterilization - No past history in self/ spouse sterilization - MINILAP - Done by trained MBBS/ MD Gyn-obs/ DGO - Conventional vasectomy - Trained MBBS & above - Laproscopic sterilization- MD Gyn-obg /DGO - MS surgery - No scalpel vasectomy - Trained MBBS & above | 1,717 | medmcqa_train |
Causes of biliary tract carcinoma after ingesting infected fish - | In most cases the disease tends to remain low grade and chronic producing only minor symptoms of abdominal distress,intermittent diarrhea and liver pain or tenderness.C.sinensis has been linked to bile duct carcinoma.It is mostly observed in areas where chlonorchiasis is endemic (refer pgno:126 baveja 3 rd edition) | 1,718 | medmcqa_train |
Joint not involved in Rheumatoid ahritis according to 1987 modified ARA criteria? | Tarsometatarsal The 1987 Revised Criteria for the Rheumatoid ahritis 4 out of 7 criteria are required to classify a patient as having rheumatoid ahritis Patients with 2 or more clinical diagnoses are not excluded. 1.Morning stiffness: morning stiffness in and around joints lasting at least 1 hour before maximal improvement 2.Ahritis of 3 or more joint areas: soft tissue swelling (ahritis) of 3 or more joint areas observed simultaneously by a physician. The 14 possible joint areas involved are, right or left: - proximal interphalangeal metacarpophalangeal wrist elbow knee - ankle metatarsophalangeal Ahritis of hand joints: swelling (ahritis) of the proximal interphalangeal, metacarpophalangeal, or wrist joints Symmetric ahritis: simultaneous involvement of the same joint areas on both sides of the body Rheumatoid nodules: subcutaneous nodules over bony prominences, extensor surfaces, or juxtaaicular regions Serum rheumatoid factor: demonstration of abnormal amounts of serum rheumatoid factor Radiographic changes: radiographic erosions and/or periaicular osteopenia in hand and/or wrist joints Criteria 1 to 4 must be present, for at least 6 weeks. Criteria 2 to 5 must be observed by a physician. | 1,719 | medmcqa_train |
Antibody transfer mother to fetus - | Ans. is 'a' i.e., IgG | 1,720 | medmcqa_train |
Hydrocephalus in infant is best diagnosed by | Ans. a (USG cranium). (Ref. Grainger, Diagnostic Radiology, 4th ed., 2469)Cranial ultrasound of Infants# USG cranium is best method to diagnose hydrocephalus through the anterior and posterior fontanalles.# Progression of hydrocephalus can be estimated by comparison with previous studies.# USG is also helpful in following ventricular decompression in patients treated for hydrocephalus.# Neonatal hydrocephalus can also be evaluated by Doppler to assess indirectly intracranial pressure and help to determine the need for shunt placement.Cranial CT# CT enable us to evaluate the brain structure and ventricular size by noninvasive highly reliable technique.# But due to the ionizing radiations hazard, CT as a screening investigation is less preferable.Qhstretk. (Fetal) Cranial ultrasound# Obstretic ultrasound study is one of the best methods for antenatal diagnosis of hydrocephalus as it is noninvasive & hazard free not only to fetus as well as to mother. However assessment prior to GA of 20 weeks may be difficult, as ventricles constitute a large portion of cranial vault.# Signs suggestive of fetal hydrocephalus on obstretic USG study are:- Atrial size > 10 mm- Dangling "Choroid plexus" sign- BPD > 95th percentile- +- PolyhydramniosEducational points:# Lemon sign:- Concave/linear frontal contour abnormality located at coronal suture strongly associated with spina bifida.# Banana sign:- Cerebellum wrapped around posterior brainstem + obliteration of cisterna magna secondary to small posterior fossa + downward traction of spinal cord in Chiari II malformation.# Key points about Obstetric color Doppler study:- Assessment of flow in MCA is important parameter to diagnose fetal anemia.- Assessment of flow in umbilical vessels is important parameter to diagnose fetoplacental insufficiency.- Reduced diastolic flow in umbilical artery is the earliest sign of fetoplacental insufficiency.- Reversal of flow in umbilical artery (as well as pulsatile flow in umbilical vein) is the most ominous sign and may indicate impending fetal death. | 1,721 | medmcqa_train |
TRUE/FALSE statements about radial nerve is/are: 1. Branch of posterior cord 2. Nerve of extensor compament of forearm 3. Arise from C5 - T1 4. Anterior interosseous nerve is a branch of it 5. Supply skin of extensor compament | Radial nerve is the largest branch of the posterior cord of the brachial plexus with a root value of C5 - C8 and T1. The radial nerve is commonly injured in the region of the spiral groove. this result in the wrist drop and sensory loss over a narrow strip on the back of forearm, and on the lateral side of the dorsum of the hand. Posterior interosseous nerve is the branch of radial nerve given off in the cubital fossa while anterior interosseous nerve is a branch of the median nerve given off in the upper pa of the forearm. Skin of the back of the forearm (i.e. extensor compament) is supplied by the posterior cutaneous nerve of the forearm which is a branch of radial nerve. | 1,722 | medmcqa_train |
Which is not a common enzyme for glycolysis and gluconeogenesis? | Seven of the reactions of glycolysis are reversible and are used in the synthesis of glucose by gluconeogenesis. Thus, seven enzymes are common to both glycolysis and gluconeogenesis : (i) Phosphohexose isomerase; (ii) Aldolase; (iii) Phosphotriose isomerase, (iv) Glyceraldehyde 3-phosphate dehydrogenase; (v) Phosphoglycerate kinase; (vi) Phosphoglycerate mutase; (vii) Enolase. Three reactions of glycolysis are irreversible which are circumvented in gluconeogenesis by four reactions. So, enzymes at these steps are different in glycolysis and gluconeogenesis. | 1,723 | medmcqa_train |
Hepatotoxic agent is - | Ans. is 'a' i.e., Halothane o Halothane is the most hepatotoxic anesthetic.o Hepatotoxic anaesthetic agents are :1. Chloroform2. Halothane3. Carbon tetrachloride4. Trichloroethylene5. MethoxyfluraneRemembero Nitric oxide is least potent inhalation agent (MAC - 105%).o Halothane is most potent inhalation agent-MAC - 0.75 (Methoxyflurane was the most potent inhalation agent hut it is not used now due to its nephrotoxic action).o Desflurane is fastest acting inhalation agent.o Diethyl ether is slowest acting (Previously it was methoxyflurane).o Ether has highest muscle relaxant action.o N2O has least muscle relaxant action.o N2O is least lipid soluble.o Halothane is most lipid soluble.o Most of the Inhaled anaesthetics are eliminated from lung, though some metabolism in liver may occur - In terms of the extent of hepatic metabolism, the rank of order is methoxyflurane > Halothane > enflurane > sevoflurane > isoflurane > desflurane > nitrous oxide. | 1,724 | medmcqa_train |
Which of the following is the "Least common" complication of measles- | <p>measles complications:- Most common complications are 1. Measles associated diarrhoea. 2. Pneumonia 3. Otitis media 4. Respiratory complications Pneumonia is the most life threatening complication. Pulmonary complications account for more than 90% of deaths due to measles. Neurological complications:- 1. Febrile convulsions 2. SSPE (subacute sclerosing pan encephalitis). This is a rare complication occuring after many years after measles infection. It is characterised by mental deterioration, paralysis, involuntary movements, muscle rigidity and coma. 3. Encephalitis Measles during pregnancy causes congenital anomalies in children. {Reference: park&;s textbook of preventive and social medicine, 23rd edition, pg no.148}</p> | 1,725 | medmcqa_train |
COX pathway is inhibited by : | Aspirin inhibits COX irreversibly by acetylating one of its serine residues; return of COX activity depends on synthesis of fresh enzyme. Other NSAIDS like indomethacin, diclofenac etc are competitive and reversible inhibitors of COX, return of activity depends on their dissociation from the enzyme which in turn is governed by the pharmacokinetic characteristics of the compound. Corticosteroids like betamethasone act by inhibiting phospholipase A2. | 1,726 | medmcqa_train |
Poor prognostic factor in chizophrenia is: | Past history of schizophrenia | 1,727 | medmcqa_train |
In ETC cmplex-4 is inhibited by all except - | Ans. is 'd' i.e., BAL o Rotenone inhibits complex I (NADH-CoQ reductase).Inhibitors of electron transport chain-o Inhibitors of respiratory chain may be divided into three groups : -Inhibitors of electron transport chain properThese inhibitors inhibit the flow of electrons through the respiratory chain. This occurs at following sites.Complex I (NADH to CoQ) is inhibited by: - Barbiturates (amobarbital), Piericidin A (an antibiotic), rotenone (an insectiside), chlorpromazine (a tranquilizer), and guanethidine (an antihypertensive). These inhibitors block the transfer of reducing equivalents from FeS protein to CoQ.Complex II is inhibited by : - Carboxin and TTFA inhibit transfer of electon from FADH2 to CoQ, whereas malanate competitively inhibit from succinate to complex II.Complex III (Cytochrome b to cytochrome Cl) is inhibited by : - Dimercaprol, antimycin A, BAL (British anti lewisite), Naphthyloquinone. These inhibitors block the transfer of electrons from cytochrome b to cytochrome C i.Complex IV (cytochrome C oxidase) is inhibited by : - Carbon monoxide, CN-, ITS and azide (N3). These inhibitors block the transfer of electrons from cytochrome aa3 to molecular oxygen and therefore can totally arrest cellular respiration.Inhibitors of oxidative phosphorylationThese compounds directly inhibit phosphorylation of ADP to .ATP. Oligomycin inhibits Fo component of F0F1 ATPase. Atractiloside inhibits translocase, a transport protein that transports ADP into mitochondria for phosphorylation into ATP.UncouplesAs the name suggests, these componds block the coupeling of oxidation with phosphorylation. These compounds allow the transfer of reducing equivalents in respiratory chain but prevent the phosphorylation of ADP to ATP by uncoupling the linkage between ETC and phosphorylation. Thus the energy instead of being trapped by phosphory lation is dissipated as heat. Uncouplers may be :- Natural :-Thermogenin, thyroxineSynthetic :- 2, 4-dinitrophenol (2, 4-DNP), 2, 4-dinitrocresol (2, 4-DNC), and CCCP (chlorocarbonylcyanidephenyl hydrazone). | 1,728 | medmcqa_train |
Which cranial nerve(s) is/are not involved in "Locked in syndrome"? | Locked-in Syndrome: A pseudo-coma state in which an awake patient has no means of producing speech or volitional movement Retains voluntary veical eye movements and lid elevation Pupils are normally reactive. Aphonic because of the involvement of pyramidal fibers Involvement of medulla leads to 9th, 10th, 12th nerves. Conscious, ale and awake as the tegmental Ascending Reticular Activating System (ARAS) is intact. Veical eye movements are intact as it is controlled by the interstitial nucleus of Cajal and the rostral pa of the M.L.F Horizontal movements are lost ,basalis pontis is involved- 6th cranial nerve involvement | 1,729 | medmcqa_train |
True regarding scrum pox is all except | Serum pox is caused by HSV - type I. | 1,730 | medmcqa_train |
All of the following syndromes are seen with obesity except: | Cohen syndrome - Cohen syndrome is Paternal inheritance always associated with obesity Carcinoid syndrome - Excess of 5 HT derivatives : Serotonin increase leads to secretory diarrhea & will Result in weight loss Prader willi syndrome - caused by deletion of chromosome 15 Sho stature, obesity, inappropriate laugh so called as happy puppets and intellectual disability. | 1,731 | medmcqa_train |
A case of injury to right brow due to a fall from scooter present with sudden loss of vision in the right eye.The pupil shows absent direct reflex but a normal consensual pupillary reflex is present. The fundus is normal. The treatment of choice is- | Sudden loss of vision, absent Ipsilateral direct light reflex and normal ipsilateral consensual light reflex suggest the diagnosis of optic nerve injury.
Within 8 hours of injury megadose of iv steroid (methylprednisolone) should be given. If there is no response or deterioration, optic canal decompression should be done. If vision is improving, steroids should be tapered gradually. If on tapering steroids, vision deteriorates, optic canal decompression is indicated. | 1,732 | medmcqa_train |
Cauliflower ear is associated with: | A patient with an auricular hematoma usually presents with an edematous, fluctuant, and ecchymotic pinna, with loss of the normal cailaginous landmarks. Failure to evacuate the hematoma may lead to cailage necrosis and permanent disfigurement known as "cauliflower ear." | 1,733 | medmcqa_train |
True statements regarding epilepsy in pregnancy is: | Ans. is b, i.e. Monotherapy is preferred to polydrug therapy --Dutta Obs 7/e, p 291As discussed earlier, seizure frequency remains unchanged in majority during pregnancy."Frequency of convulsions is unchanged in majority (50%) and is increased in some." --Dutta 7/e, p 291"The risk of developing epilepsy to the offspring of an epileptic mother is 10%." --Dutta 7/e, p 291So, option c is incorrect."There is no contraindication for breastfeeding." --Dutta 7/e, p 291so option d is incorrect.We have read time and again that monotherapy is preferred in pregnant epileptic patient. | 1,734 | medmcqa_train |
Spinal cord in an infant terminates at | In premature & term neonates- it lies b/w 1st & 3rd lumbar veebrae. In children between ages of (1-7yrs)- it lies between 12th thoracic and 3rd lumbar veebra. In adults, it terminates at the level of middle 3rd of body of 1st lumbar veebra which corresponds approximately to transpyloric plane. Spinal cord occupies superior 2/3rd of veebral canal It continues cranially with medulla oblongata, just below the level of foramen magnum, at the upper border of atlas and terminates caudally as conus medullaris. During development, veebral column elongates more rapidly than spinal cord, so there is increasing discrepancy b/w anatomical level of spinal cord segments & their corresponding veebrae. | 1,735 | medmcqa_train |
A 67 yr male with history of chronic smoking hemoptysis with cough. Bronchoscopic biopsy from centrally located mass shows undifferentiated tumor histopathologically. Most useful I.H.C. (immunohistochemical) marker to make a proper diagnosis would be: | The presence of chronic smoking, cough and hemoptysis in old man is a pointer towards a diagnosis of bronchogenic cancer. The central location suggests the possibility of a squamous cell cancer. Histologically, this tumor is characterized by the presence of keratinization and/or intercellular bridges. HMB (melanoma), Hep par1 (liver cancer) and parvalbumin (schizophrenia). | 1,736 | medmcqa_train |
Malignant cold nodule in thyroid diagnostic on USG by all EXCEPT | (A) No cystic lesion > USG can also be used to aid in the differentiation between benign and malignant nodules. The following criteria can be used by USG, and favor a diagnosis of malignancy:1) Absence of a halo sign2) Uniformly solid tumor with occasional central necrosis3) Irregular margins4) Fine calcifications5) Heterogenous echos and large size6) Surrounding tissue invasion | 1,737 | medmcqa_train |
Most common type of germinal cell tumor in testis is? | Ans. is 'c' i.e., Seminoma * Testicular tumors are divided into two major categories : (i) Germ cell tumors, and (ii) Sex cord tumors.A) Germ cell tumors# More than 95% of testicular tumors are germ cell tumors. They are further divided into -i) Seminoma* It is the most common germ cell tumor of testis. Female counterpart of seminoma is dysgerminoma of ovary.ii) Non-seminoma germ cell tumors (NSGCT)* These are spermatocytic seminomay embryonal carcinoma, Yolk sac tumor (also called endodermal sinus tumor or infantile embryonal carcinoma), teratoma, and choriocarcinoma.# Risk factors for germ cell tumors of testis are -i) Cryptorchidism (abdominal > inguinal, i.e. higher the undescended testis more the chances of malignancy).ii) Testicular feminization syndrome and Klinefelter syndrome.iii) Excess 12P copy number either in the term of i(12P) or increased 12P an aberranthy banded marker chromosome.B) Non-germ cell tumors (sex cord tumors)# These are ley dig cell tumor and sertoli cell tumor.# Leydig (interstitial) cell tumors are positive for Reinke crystalloids. | 1,738 | medmcqa_train |
An order for exhumation can be given by: Maharashtra 08 | Ans. Any of the above | 1,739 | medmcqa_train |
Langerhans cells in skin are : | A i.e Antigen presenting cells | 1,740 | medmcqa_train |
In hyperkalemia with bradycardia treatment is: - | The treatment for hyperkalemia can be thought of in 3 distinct steps. First, antagonize the effects of hyperkalemia at the cellular level (membrane stabilization). Second, decrease serum potassium levels by promoting the influx of potassium into cells throughout the body.(insulin,beta2 agonist) Third, remove potassium from the body.(k+resins) In cells with calcium-dependent action potentials, such as SA and atrioventricular nodal cells, and in cells in which the sodium current is depressed, an increase in extracellular calcium concentration will increase the magnitude of the calcium inward current and the Vmax by increasing the electrochemical gradient across the myocyte. This would be expected to speed impulse propagation in such tissues, reversing the myocyte depression seen with severe hyperkalemia. The effects of intravenous calcium occur within 1 to 3 minutes but last for only 30 to 60 minutes. Therefore, fuher, more definitive treatment is needed to lower serum potassium levels. Calcium gluconate is the preferred preparation of intravenous calcium. The dose should be 10 mL of a 10% calcium gluconate solution infused over 2 to 3 minutes. | 1,741 | medmcqa_train |
In human body, methionine is synthesized from ? | Ans. is 'd' i.e., None Methionine is an essential amino acid, cannot be synthesized in body. | 1,742 | medmcqa_train |
Not a common cause of night blindness: | Cataract is not a common cause of night blindness. Other causes are more recognized causes. Causes of Night Blindness Vitamin A deficiency (first symptom is red-green differentiation anomaly) Pathological myopia Tapetoretinal degenerations{eg. Retinitis pigmentosa(RP)} Familial congenital night blindness Oguchi's disease | 1,743 | medmcqa_train |
In recent surveillance reports cases of diphtheria are reducing. This is due to - | Ans. is 'c' i.e., Vaccination o The reduced incidence of diphtheria in India is primarily due to the high coverage of appropriate immunization in children and to an apparent reduction in toxin-producing strains of the bacterium. | 1,744 | medmcqa_train |
Total lung capacity depends on: | Ans. C. Lung compliancea. TLC is the maximum volume to which the lungs can be expanded with the greatest possible inspiratory effort.b. TLC=IRV+TV+ERV+RV=IC+RVc. Compliance (stretch ability) of lungs: D is increased in Emphysema (obstructive lungs dis) and decreased in Interstitial pulmonary fibrosis (Restrictive lung disease). Compliance of lung is change in lung volume per unit change in airways pressure.d. TLC is increased in obstructive lung disease (eg. emphysema, COPD) and decreased in the restrictive lung disease (Interstitial pulmonary fibrosis). | 1,745 | medmcqa_train |
A 65-year-old man suffers a sudden fall in mean aerial pressure, 4 hours after his CABG surgery. Other findings include elevated JVP. What is the best next step in the management of this case? | This clinical presentation points towards a likely diagnosis of Cardiac tamponade. It is a common complication post CABG. It can be confirmed on an Echocardiography. It is a life-threatening condition hence it should be managed by immediate return to the OT for exploration and drainage of mediastinal hematoma. | 1,746 | medmcqa_train |
Type IV complex of ETC is inhibited by | Cyanide is probably the most potent inhibitor of ETC (Complex IV). It binds to Fe3+ of cytochrome oxidase blocking mitochondrial respiration leading to cell death. Cyanide poisoning causes death due to tissue asphyxia (mostly of the central nervous system) In Acute cyanide poisoning Amyl nitrite is given followed by sodium thiosulphate. This is an example of Chemical antagonism i.e. one drug binding to other making it unavailable in body. | 1,747 | medmcqa_train |
A 60 yr old smoker came with a history of painless gross hematuria for one day. Most logical investigation would be | In this case, we should suspect bladder carcinoma ( transitional cell carcinoma ) . Smokers are at a higher risk of developing TCC.Other risk factors being chemical .industry workers in western countries and schistosomiasis in endemic regions . It is more common in males -3:1. They usually presents with painless gross hematuria. Thus the best option here is urine microsopy for RBC's and malignant cells.urine cytology even though not a good screening test because of lack of sensitivity is highly specific . Mainstay of diagnosis is cystourethroscopy. investigations include imaging ( CT , MRI ,USG ,IVU ) and blood investigations for HB , electrolytes and urea . Bailey and Love 27th edition.chapter 77.pg no 1449. | 1,748 | medmcqa_train |
Which Ca has best prognosis: | Oral malignancy with best prognosis is carcinoma lips. Oral cancer with worst prognosis is floor of mouth carcinoma. | 1,749 | medmcqa_train |
Net reproduction rate is : | Total Fertility Rate(TFR) : Number of babies born to a woman
Gross Fertility Rate(GFR) : Number of girl babies born to a woman
Net reproduction rate(NRR) : Number of girl babies born to a woman and taking into account only alive once. | 1,750 | medmcqa_train |
What is the common change in cell death associated with both apoptosis and necrosis ? | Answer- C. Chromatin condensationBoth form of cell death, finally lead to nuclear changes i.e. chromatin condensation (pyknosis). | 1,751 | medmcqa_train |
Drug the choice for hyperthyroidism in first trimester of pregnancy is | Propylthiouracil is the only thioamide which is least teratogenic and hence it is the drug of choice to hyperthyroidism in pregnancy and lactation. | 1,752 | medmcqa_train |
Which of the following coagulation factors causes cross-linking and stabilization of clot? | The loose aggregation of platelets in the temporary plug is bound together and conveed into definitive clot bg fibrin. Fibrin is initially a loose mesh of interlacing strands. It is conveed by the formation of covalent cross-linkages to a dense tight aggregate. The latter reaction is catalyzed by activated factor 13 and requires calcium. Ref: Ganong&;s Review of medical physiology, 24th edition.Pg no. 566 | 1,753 | medmcqa_train |
The first step when doing a pneumonectomy for cancer of the bronchus is to: | Pneumonectomy Pneumonectomy is anatomically more straightforward than lobectomy (in carcinoma bronchus): The pulmonary aery is first dissected, divided and sutured. The pulmonary veins are then isolated divided and sutured. The main bronchus is divided so that no blind stump remains. The technique of stump closure is impoant if a bronchopleural fistula is to be avoided. The tissues are carefully handled and the stump is usually stapled. | 1,754 | medmcqa_train |
All are true about DOTS, except ? | Ans. is 'd' i.e., Daily treatment is recommended Directly observed treatment sho course (DOTS) In the Revised National Tuberculosis Control Programme (RNTCP), patients are provided sho course chemotherapy as DOTS. All patients are provided sho-course chemotherapy free of charge. During the intensive phase of treatment a health worker watches as the patient swallows the drug in his presence. o During continuation phase, the patient is issued medicine for one week in a multiblister combipack of which the first dose is swallowed by the patient in the presence of health worker. The consumption of medicine in the continuation phase is also checked by return of empty multiblister combipack when the patient comes to collect medicine for the next week. In this programme, alternate day treatment is given. Under RNTCP, active case finding is no longer pursued. Case finding is passive. Patients presenting themselves with symptoms suspicious of tuberculosis are treated with DOTS therapy. The colour of boxes (containing the drugs for full course of treatment) is according to the category of regimen? Category I patients - Red Category II patients - Blue Category III patients - Green | 1,755 | medmcqa_train |
A patient on warfarin was given phenobarbitone, The result would have been - | Ans. is 'a' i.e., Increase the dose of warfarin | 1,756 | medmcqa_train |
Which of the following dings is not used for anxiety? | Ans. is 'd' i.e., Haloperidol | 1,757 | medmcqa_train |
True about carotid body receptors ? | Ans. is 'b' i.e., Dopamine is neurotransmitter Peripheral chemoreceptors The peripheral chemoreceptors which regulate respiration are located in the carotid body and aoic bodies. These bodies are located in the connective tissue associated with the vessel wall, at the bifurcation of the common carotid, and on the arch of aoa, respectively. The characteristic cells of both these structures are called glomus cells. Type I glomus cells have a high dopamine content, which they possibly employ as a neurotransmetter. Peripheral chemoreceptors convey information to the DRG of neurons in medulla, for which purpose the afferent neurons from the carotid bodies pass through glossopharyngeal nerve and from the aoic bodies pass through vagus nerve. The most potent natural stimulus for peripheral chemoreceptors is low aerial P02 (hypoxic hypoxia). The other stimuli which activate peripheral chemoreceptors are high aerial PCO2, and an increase in aerial hydrogen ion concentration (acidosis or low pH). The response to activation of peripheral chemoreceptors is an increase in pulmonary ventilation through an increase in the rate and depth of breathing. The blood flow to peripheral chemoreceptors, on per unit mass basis, is the highest to any tissue in the body. With a blood flow of 2000 ml/min/100 gm tissue, the carotid and aoic bodies, inspite of their high metabolic rate, hardly remove any oxygen from the blood supplies to them. That is why the aeriovenous oxygen difference is negligible in these bodies. Thus these structures are idealy built to sense change in aerial P02. It is good to keep in mind that stimulation of peripheral chemoreceptors not only stimulates medullary respiratory centers but also medullary vasomotor center. Therefore, the response to their stimulation is tachycardia, vasoconstriction and increase BP along with hyperventilation. | 1,758 | medmcqa_train |
A mother calls you on the telephone and says that her 4-year-old son bit the hand of her 2-year-old son 2 days ago. The area around the injury has become red, indurated, and tender, and he has a temperature of 39.4degC (103degF). Which of the following is the most appropriate response? | Human bites can pose a significant problem. They can become infected with oropharyngeal bacteria, including S aureus, Streptococcus viridans, Eikenella corrodens, and anaerobes. A patient with an infected human bite of the hand requires hospitalization for appropriate drainage procedures, Gram stain and culture of the exudate, vigorous cleaning, debridement, and appropriate antibiotics. The infected wound should be left open and allowed to heal by secondary intention (healing by granulation tissue rather than closure with sutures). Empiric antibiotic therapy for an infected bite should be penicillinase-resistant; amoxicillin-clavulanate orally, or ticarcillin-clavulanate or ampicillin-sulbactam IV are good choices. Antibiotic prophylaxis for noninfected bite wounds remains controversial, but some experts recommend prophylaxis for all significant human bites. | 1,759 | medmcqa_train |
Most common malignancy in children is – | Most common childhood tumor → Leukaemia
Most common childhood leukemia → ALL
Most common solid tumor of childhood → Brain tumor
Most common tumor in infancy → Neuroblastoma
Most common abdominal tumor in child → Neuroblastoma | 1,760 | medmcqa_train |
A factory worker presents with excessive salivation, blue lines on gums, tremors, disturbed personality, insomnia, and loss of appetite. The most likely poisoning is - | Excessive salivation, blue line on gums, tremors (i.e. Hatter's shake), disturbed personality (i.e. erethism) and loss of appetite (anorexia) suggest the diagnosis of mercury poisoning. | 1,761 | medmcqa_train |
Role of carnitine in lipid metabolism - | Ans. is 'd' i.e.. Transfer of activated long chain FFA into mitochondria o Activated long chain fatty acid (acyl CoA) cannot penetrate inner mitochondrial membrane.o Acyl group of acyl CoA is transferred to carnitine, resulting in formation of acylcarnitine.o Acylcarnitine is then transported across the inner mitochondrial membrane into the mitochondrial matrix by translocase.o Once inside the mitochondrion, acyl group of acylcarnitine is transferred back to CoA, resulting in formation of acvl-CoA which undergoes b-oxidation. | 1,762 | medmcqa_train |
CAMP reaction is shown by which streptococci? | Ans. b (Group B). (Ref. Textbook of microbiology by Ananthanarayan 6th ed. 187).Serological or Lancefield classification system for streptococci1Group A streptococciCatalase -,Beta-hemolysis,Bacitracin sensitive,PYR test +,Ribose not fermented.Includes Streptococcus pyogenes.2Group B streptococciCAMP + and Beta-hemolysis +.CAMP reaction (Christie, Atkins and Munch Peterson reaction) due to their ability to hydrolyze hippurate, which can be demonstrated as accentuated zone of hemolysis when streptococcus agalactiae is inoculated perpendicular to streak of staph aureus grown on blood agar.Includes only one bacterium, S. agalactiae.Currently, it has been found to be a cause of sexually transmitted urogenital infections in females.3Group C streptococciRibose and trehalose fermentation4Group D streptococciGrow in 6.5% NaCI and are optochin sensitive.Hydrolysis of bile esculin (dark brown medium)-this indicates the ability of the bacteria to tolerate bile from the liver and growth in high salt cone.Includes Enterococcus and non-Enterococcus.The Enterococci include E. faecalis, a cause of urinary tract infections, and E. faecium, a bacterium resistant to many common antibiotics. Diseases such as septicemia, endocarditis, and appendicitis have also been attributed to group D Strep. Once identified, Group D Strep can be treated with ampicillin alone or in combination with gentamicin. Viridans GroupThe Viridans Streptococci, consisting of S. mutans and S. mitis, are alpha-hemolytic bacteria.These bacteria inhabit the mouth.In fact, a large percentage of tooth decay can be attributed to S. mutans.5Group F streptococciMinute streptococci;streptococcus MG. | 1,763 | medmcqa_train |
One gram of smokeless gunpowder produces: Karnataka 11 | Ans. 12,000-13,000 cc of gas | 1,764 | medmcqa_train |
Cranial pa of accessory nerve supplies | Sternocleidomastoid and trapezius develop from branchial arch mesoderm and are supplied by spinal pa of the accessory nerve. Levator scapulae are supplied by a branch from dorsal scapular nerve and branches from C3, C4. BD Chaurasia 7th edition Page no: 65 | 1,765 | medmcqa_train |
Marcus Gunn pupil is due to - | The Relative Afferent Pupillary Defect (RAPD), or Marcus-Gunn Pupil is an extremely significant and highly objective clinical finding in the examination of the visual system. The "swinging flashlight test" is probably the best test for identifying an RAPD. In this test, a strong, steady light is used. The light is shined into one eye, and then quickly switched to the other. This is repeated back and foh, until one of four conclusions is reached (listed below). Since light in one pupil causes both pupils to constrict, quickly switching from one eye to the other will give a "relative" indication of the functioning of each eye and optic nerve. If both eyes are equally dysfunctional, no "relative" defect would be found. | 1,766 | medmcqa_train |
The adverse effect of clozapine - | Side effects of clozapine
Agranulocytosis
Urinary incontinence
Unstable BP & Tachycardia
Hypersalivation (sialorrhoea)
Worsening of diabetes
Weight gain
Seizures
Sedation | 1,767 | medmcqa_train |
Most common cause of death in criminal abortion is? | ANSWER: (B) SepsisREF: Forensic Medicine and Toxicology By R.N.Karmakar page 230, Textbook of Forensic Medicine and Toxicology, Krishan Vij 5th ed fig 26.2The most common complication from illegal abortion is retained product of conception; the most frequent cause of death is infection and sepsis.NATURAL VS CRIMINAL ABORTION Natural abortionCriminal abortionCauseSpontaneousInducedPrecipitating factorMaternal or fetal diseaseUnwanted pregnancyEvidence of genital violenceAbsentPresentForeign body from genitalsAbsentMay be presentToxic effect of drugAbsentMay be presentFetal injuryAbsentRarely present | 1,768 | medmcqa_train |
Most potent statin - | Ans. is 'c' i.e., Rosuvastatin o Two most potent statins are Pitavastatin (most potent) and rosuvastatin most potent). | 1,769 | medmcqa_train |
Contraception of choice for a post paum village woman with one child : | Copper T | 1,770 | medmcqa_train |
A 33-year-old male immigrant from Taiwan presents with increasing right upper quadrant (RUQ) pain. The pain is dull, and it does not radiate or change with eating. On examination the abdomen is soft, there is a mass in the RUQ, and no ascites is clinically detected. He has a prior history of hepatitis B. His laboratory investigations reveal hepatitis B surface antigen (HBsAg) positive, hepatitis B surface antibody (HBsAb) negative, aspartate amino transferase (AST) 60 U/L, alanine amino transferase (ALT) 72 U/L, and an elevated alpha-fetoprotein level. Which of the following is the most likely diagnosis? | (b) Source: (Devita, pp. 533-534) Only the chronic carrier state increases HCC risk, not previous infection. The majority, but not all, of HCC associated with HBV occurs in the setting of cirrhosis (60-90%). Because the latency period of HBV infection is 35 years, before HCC supervenes, early-life infection is strongly correlated with HCC. The chronic carrier state of HBsAg in endemic areas, such as Taiwan, is associated with a relative risk of over 100 for the development of HCC. Over half the chronic carriers of HBsAg in such a population will die of cirrhosis or HCC. In Taiwan, where childhood vaccination was introduced in 1984, the death rate from childhood HCC has already declined. | 1,771 | medmcqa_train |
Which of the following is not done before ABG? | Done Before ABG Allen test: integrity of palmer arch. Heparin: to rinse the syringe Poking the aery at 45-degree angle. Extend wrist joint: Radial Aery tent. | 1,772 | medmcqa_train |
Focal lesion in liver is best detected by | MRI in Liver lesions MRI had emerged as the best imaging test for liver lesion detection and characterization MRI provides high lesion-to-liver contrast and does not use radiation Liver-specific contrast media, such as mangofodipir trisodium (taken up by hepatocytes) and ferrumoxides (taken up by kupffer cells) demonstrate selective uptake in the liver and primarily used for lesion detection These two contrast agents are also useful in characterising specific liver tumors, such as FNH, hepatic adenoma and HCC Ref: Shackelford 7th edition Pgno : 1560 | 1,773 | medmcqa_train |
A patient presents with LMP 8 weeks ago. She has history of delayed cycles in the past. Which of the following is the most accurate way of dating the pregnancy? | CRL is the best USG parameter to determine gestational age in first trimester Crown rump length - it is the longest straight line measurement of the embryo from the other margin of cephalic pole to rump mid-sagittal plane with fetus in neutral , non fixed position - Best seen on TVS - Overall best USG parameter to assess the fetal age - Ideal time to measures CRL is 7 - 10 weeks - can be done upto 14 weeks | 1,774 | medmcqa_train |
Pectinate line is an impoant landmark because? | All of the above | 1,775 | medmcqa_train |
A lady used to repeatedly wash her hands due to the fear of acquiring AIDS is due to | (A) OCD # Obsessive-compulsive disorder (OCD) is a psychiatric anxiety disorder most commonly characterized by a subject's obsessive, distressing, intrusive thoughts and related compulsions (tasks or "rituals") which attempt to neutralize the obsessions.# Obsessions are defined by:> Recurrent and persistent thoughts, impulses, or images that are experienced at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress.> Thoughts, impulses, or images are not simply excessive worries about real-life problems.> Person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action.> Person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind, and are not based in reality.> Tendency to haggle over small details that the viewer is unable to fix or change in any way. This begins a mental pre-occupation with that which is inevitable.# Compulsions are defined by:> Repetitive behaviors or mental acts that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly.> The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive. | 1,776 | medmcqa_train |
A 5-year-old boy is brought to the emergency room with a fever of 103degF (38.7degC), chest pain, and productive cough. The patient has a history of recurrent pulmonary disease and respiratory distress. What microorganism recovered from the lungs of this child is virtually diagnostic of cystic fibrosis? | Cystic fibrosis is the most common lethal autosomal recessive disorder in the white population. The disease is characterized by (1) chronic pulmonary disease, (2) deficient exocrine pancreatic function, and (3) other complications of inspissated mucus in a number of organs, including the small intestine, the liver, and the reproductive tract. It results from abnormal electrolyte transport caused by impaired function of the chloride channel of epithelial cells. The pulmonary symptoms of CF begin with cough, which eventually becomes productive of large amounts of tenacious and purulent sputum. Episodes of infectious bronchitis and bronchopneumonia become progressively more frequent, and eventually shortness of breath develops. Respiratory failure and the cardiac complications of pulmonary hypertension (cor pulmonale) are late sequelae. The most common organisms that infect the respiratory tract in CF are Staphylococcus and Pseudomonas species. As the disease advances, Pseudomonas may be the only organism cultured from the lung. In fact, the recovery of Pseudomonas sp., particularly the mucoid variety, from the lungs of a child with chronic pulmonary disease is virtually diagnostic of CF.Diagnosis: Cystic fibrosis | 1,777 | medmcqa_train |
Conduction velocity in AV node 8c SA node- | Ans. is 'a' i.e., 0.05 meter/sec Cardiac tissueConduction velocity (meter/second)SA node0 [?] 05Inteatrial pathways1Atrial muscle0 [?] 30AV node0 [?] 05 (minimum)Bundle of His1Purkinje system4 (maximum)Ventricular muscle1 | 1,778 | medmcqa_train |
Which of the following cells do Natural killer cells attack? | . Cells which are not able to express MHC 1 | 1,779 | medmcqa_train |
Continues scrutiny of factors that affect the occurence of a disease is - | Surveillance has been defined as the continuous scrutiny of all aspects of occurrence and the spread of diseases that are peinent to effective control. Surveillance goes beyond the passive repoing of cases Ref: 25th edition, Park's Textbook of Preventive and Social Medicine, Page no. 138 | 1,780 | medmcqa_train |
Most common site of tear in Mallory-weiss syndrome is in | MALLORY WEISS syndrome is seen in adults with severe prolonged vomiting, causing a longitudinal tear in the mucosa of the stomach at and just below the cardia leading to severe hematemesis.violent vomiting may be due to a migraine or veigo or following a bout of alcohol.common in 1 o' clock position.investigations include Hb%, PCV.treatment includes blood transfusion, IV fluids, sedation and hemostatic agents such as vasopressin. Ref: SRB&;s manual of surgery,3 rd ed, pg no 734 | 1,781 | medmcqa_train |
A patient presented with 2 months history of increased ICP, with massive parietal edema, CT/MRI shows single and were circumscribed region lesion | (A) Granuloma > Granuloma usually presents with increased ICP, with massive parietal edema. CT/MRI shows single circumscribed region lesion. Gliomas include astrocytomas, oligodendrogliomas and mixed tumours. Common sites include the cerebellum, optic nerve and chiasma, hypothalamus and brainstem. Diffuse astrocytomas (WHO grade II) are most common in the fourth decade of life and often present with seizures or are incidental findings. CT scan shows enhancement which is often irregular around a centre of low density which may represent necrosis calcification may be present. Cerebral metastases are by far the most common intracranial tumours and will affect approximately one in every four cancer sufferers. They tend to occur in the fifth to seventh decades. The majority of patients with cerebral metastases have multiple lesions. Metastatic tumours show isodense on unenhanced CT and enhance vividly on intravenous contrast. | 1,782 | medmcqa_train |
Incineration is done for waste category ? | Ans. is 'c' i.e., Category 6 | 1,783 | medmcqa_train |
Pathognomic factors involved in foot ulcers in DM include all, Except: | Answer is C (Microangiopathic changes in blood vessels): Macroangiopathic changes in blood vessels in the form of peripheral aerial disease contribute to the generation of foot ulcers and non microangiopathic changes. Pathogenic Factors in generation of foot ulcers in DM Neuropathy (Peripheral Sensory neuropathy): Trophic changes Abnormal Foot Biomechanics (d/t disordered propioception and sensorimotor neuropathy) Peripheral Aerial disease (Macroangiopathy) and poor wound healing Autonomic neuropathv (anhidrosis and altered superficial blood flow in ,foot) | 1,784 | medmcqa_train |
Finding on histopathological examination in liver in case of malaria is : | Ans. is 'b' i.e. Kupffer's cell hyperplasia with macrophage infiltration around periportal area laden with pigments * In severe infections with plasmodium falciparum, the vital organs are packed with erythrocytes containing mature form of the parasite.* There is abundant intra and extraerythrocytic pigment and organs such as liver, spleen and placenta may be grey black in colour.Also know * Durck's granuloma are pathognomic of malignant cerebral malaria.Histopathological features in liver due to falciparum malariaReticuloendothelial cell proliferation i.e., Kupffer cell hyperplasia.Malarial pigmentation i.e., haemoglobin pigmentation.CongestionPortal infiltration of the macrophageSinusoidal infiltration and sinusoidal dilatationCholestasisNuclear vacuolationLiver cell necrosisFatty changeBallooning of hepatocytesVacuolated cytoplasm's | 1,785 | medmcqa_train |
Which of the following is true about sickle cell red blood cells? | HbA/S heterozygotes (sickle cell trait) have a sixfold reduction in the risk of dying from severe falciparum malaria. This decrease in risk appears to be related to impaired parasite growth at low oxygen tensions and reduced parasitized red cell cytoadherence. Parasite multiplication in HbA/E heterozygotes is reduced at high parasite densities. Ref: White N.J., Breman J.G., Osler W. (2012). Chapter 210. Malaria. 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. | 1,786 | medmcqa_train |
Drug of choice for pneumocystis carinii ? | Ans. is 'a' i.e., Cotrimoxazole | 1,787 | medmcqa_train |
A 26-year-old man is admitted through the casualty of the hospital for a heroin overdose. His hea rate is 45 beats/min, and his blood pressure is 75/40 mm Hg. Which of the following best depicts the results from an aerial blood sample? | This man has a respiratory acidosis. Overdose with drugs that suppress ventilation (e.g., heroin, morphine, barbiturates, methaqualone, and "sleeping pills") often causes hypercapnia. In patients with an intact renal response, the respiratory acidosis causes a compensatory rise in plasma HCO3-, which lessens the fall in pH. However, the renal response requires several days to develop fully. The plasma HCO3- of 26 mEq/L (normal: 22-28 mEq/L) for this man is typical of acute respiratory acidosis with little or no renal compensation. pH 7.34, PaCO2 (mm Hg) 29, HCO3- (mEq/L) 15 reflects metabolic acidosis. pH 7.40, PaCO2 (mm Hg) 40, HCO3- (mEq/L) 24 is normal. pH 7.47, PaCO2 (mm Hg) 20, HCO3- (mEq/L) 14 reflects respiratory alkalosis. | 1,788 | medmcqa_train |
Most common bone fracture in body is: | Ans: b (Clavicle)Ref: Maheshwari Ortho, 3rd ed, p. 73 | 1,789 | medmcqa_train |
Drug treatment for laryngeal stenosis is | Mitomycin-C is an antineoplastic antibiotic that acts as an alkylating agent by inhibiting DNA and protein synthesis. ... Topical application of mitomycin-C (0.4 mg/mL) was used as an adjuvant treatment in the endoscopic laser management of laryngeal and tracheal stenosis Ref: Internet sources | 1,790 | medmcqa_train |
A 40 year old presenting with dizziness on standing with systolic reduction of BP of 50mm Hg; appropriate treatment | Graduated compression stockings (GCS) help prevent the formation of blood clots in the legs by applying varying amounts of pressure to different pas of the leg. Thigh or waist-high stockings help reduce pooling of blood in the legs and help prevent lightheadedness or falling when you stand up (ohostatic hypotension). Stockings that rise to just below the knee help limit lower leg swelling due to fluid buildup Ref Davidson 23rd edition pg 450 | 1,791 | medmcqa_train |
A child aged 24 months was brought to the Primary Health Centre with complaints of cough and fever for the past 2 days. On examination, the child weighed 11kg, respiratory rate was 38 per minute, chest indrawing was present. The most appropriate line of management for this patient is ? | Ans. is `c' i.e., Classify as severe pneumonia, sta antibiotics and refer urgently | 1,792 | medmcqa_train |
A 40-year-old female have a right hypochondriac pain. USG is taken. What is the inference? | USG shows highly reflective echogenic focus within the gallbladder lumen, with prominent posterior acoustic shadowing, characteristic of Cholelithiasis. If there is associated cholecystitis, gallbladder wall thickening along with the pericholecytic fluid. Murphy&;s sign might be elicited with probe over gallbladder. | 1,793 | medmcqa_train |
All of the following are known predisposing factors for Alzheimer's disease except : | Answer is C (Smoking):Smoking has not been mentioned as a risk factor, for Alzheimer's disease. | 1,794 | medmcqa_train |
Action of alpha subunit of G-protein is: | Ans. (C) Breakdown of GTP to GDP(Ref: KDT 8th/e p54)Alpha subunit of G protein contains GTPase activity and thus dissociates GTP to form GDP. This result in re-uniting a subunit with b and g subunit | 1,795 | medmcqa_train |
A 50 year old with history of jaundice in the past has presented with right upper quadrant abdominal pain. Examination and investigations reveal chronic calculous cholecystitis. The liver functions tests are within normal limits and on ultrasound examination, the common bile ducts is not dilated. Which of the following will be the procedure of choice? | In the given question there was an episode of jaundice, but LFT is normal and CBD is not dilated. The best option is laparoscopic cholecystectomy only Management of CBD stones associated with GB stones * Pre-operatively detected stones:- * Unsuspected stones found at the time of cholecystectomy:- Experienced laparoscopic surgeon Experienced laparoscopic surgeon Cholecystectomy and choledochotomy in same sitting Laparoscopic CBD exploration and stone retrieval through the cystic duct * Laparoscopic choledochotomy and stone extraction Inexperienced laparoscopic surgeon Inexperienced laparoscopic surgeon Pre-op ERCP with stone removal and laparoscopic cholecystectomy later Conve to open procedure and remove CBD stone Complete the cholecystectomy and refer the patient for ERCP | 1,796 | medmcqa_train |
Which muscle paralysis can cause ‘Winging of scapula’? | LONG THORACIC NERVE
■ Arises from ventral rami of C5, C6, and C7.
■ Descends behind the brachial plexus on the lateral surface of the serratus anterior, to which it supplies.
■ The serratus anterior muscle can be examined by asking patient to push against a wall with both hands. Winging of scapula will be typically noted | 1,797 | medmcqa_train |
True about proximal fragment In supratrochantric fracture is | The peritrochanteric fracture is one of the most serious causes of mortality and morbidity in the elderly.
Subtrochanteric fractures account for approximately 10-30% of all peritrochanteric fractures, and they affect persons of all ages.
1,2 The subtrochanteric region of the femur is generally recognized to be the area of the femur below the inferior border of the lesser trochanter, extending distally 7.5 cm to the junction of the proximal and middle third of the femur.3 Most frequently, these fractures are seen in two patient populations, namely older osteopenic patients after a low-energy fall and younger patients involved in high-energy trauma.1-3 In elderly patients, minor slips or falls that lead to direct lateral hip trauma are the most frequent mechanism of injury.
This age group is also susceptible to metastatic disease that can lead to pathologic fractures.
In younger patients, the mechanism of injury is always high-energy trauma, either direct or from axial loading (e.g., a fall from height), which often creates a comminuted fracture. | 1,798 | medmcqa_train |
The BEST method for teaching mothers about using ORS is: | A demonstration is a carefully prepared presentation to show how to perform a skill or procedure. Here a procedure is carried out step by step before an audience. Demonstration is found to have high education value in programmes like teaching a mother the use of oral rehydration therapy at home. Ref: Park 21st edition, page: 803. | 1,799 | medmcqa_train |
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