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Valvulae conniventes are seen in | The valvulae conniventes, also known as Kerckring folds or plicae circulares, are the mucosal folds of the small intestine, staing from the second pa of the duodenum, they are large and thick at the jejunum and considerably decrease in size distally in the ileum to disappear entirely in the distal ileal bowel loops. p Ref - radiopedia.org | 2,000 | medmcqa_train |
A girl aged 20 yrs complains of headache while studying. Her vision is found to be normal. All
of the following should be further evaluated except | Family h/o headache is important in any headache to rule out organic cause of headache. Menstrual history
Menstrual history is important in any female presenting with headache to rule to premenstrual syndrome.
Detailed menstrual history should be taken to find out headache is due to hormonal imbalance. Interest in studies
The patient might not be interested in studies. Studies might be acting as stressors and she must be faking headache to avoid it.
Self esteem Self-worth or self-esteem is analyzed to rule out depression.
But with depression, headache won’t only occur during studies, it would be pervasive.
It the self-esteem of the girl is low it won 7 only manifest during studies; it would affect all her performances. | 2,001 | medmcqa_train |
Congenital hypertrophic pyloric stenosis usually presents – | The symptoms vomiting usually starts after 3 weeks of age but symptoms may develop as early as1st week of life and as late as 5 months of life. - Nelson
Congenital hypertrophic pyloric stenosis
Hypertrophic pyloric stenosis is the commonest surgical disorder of the stomach during infancy.
Pylorus is thickened and elongated and its lumen is narrowed due to hypertrophy of circular muscle fibers of pylorus.
More common in boys.
More common in infants of blood group 'B' and 'O'.
Associated congenital defects are → Tracheoesophageal fistula and hypoplasia or agenesis of inferior labial frenulum.
May be associated with Turner syndrome, Trisomy 18.
Symptoms are not present at birth.
The vomiting usually starts after 3 weeks of age. | 2,002 | medmcqa_train |
Prophylaxis against spontaneous bacterial peritonitis ( SBP) in case of cirrhosis with ascites is indicated in: | The risk factors for SBP are 1.Ascitic fluid protein < 1 g/dl 2.Variceal hemorrhage 3.Prior episode of SBP Acute variceal bleeding patients need prophylaxis against SBP & Drugs used for prophylaxis are: 1.Inj.Ceftriaxone 1 g/day 2. Oral. Ofloxacin 400 mg/day or Norfloxacin 400 OD Primary prophylaxis is indicated in patients with features of : Ascitic fluid protein < 1.5 g/dl With at least one of the following 1. Serum creatinine > 1.2 mg/dl 2. BUN > 25 mg/dl 3. Serum Na < 130 mEq/L 4. CTP > 9 points with bilirubin > 3 mg/dl 5. DRug is Norfloxacin 400 mg OD for long time. Ref: AASLD practice guidelines:Hepatology, Vol.49 ,No.6 ,2009. | 2,003 | medmcqa_train |
Radiation induced thyroid cancer is - | Radiation-induced thyroid cancer Authors: Section Editors: Deputy Editor: INTRODUCTION Radiation exposure of the thyroid during childhood is the most clearly defined environmental factor associated with benign and malignant thyroid tumors. The risk of thyroid cancer following irradiation is related to radiation dose and age (greater for children exposed early in life), and the risk persists throughout life. Radiation exposure during childhood also increases the risk of benign thyroid nodules and hypothyroidism. The purpose of this topic is to review the evaluation of a patient with a history of childhood radiation exposure and how such a history affects treatment of patients with thyroid tumors. Radiation injury to other organs is reviewed separately. (See and .) RADIATION EXPOSURE Type of exposure -- Radiation exposure may be external or internal. *External - The predominant types of external radiation are diagnostic radiographs, therapeutic radiation for the treatment of cancer, and historical use of external radiation to treat a wide variety of nonmalignant conditions. External radiation also includes brachytherapy, whereby a sealed radiation source is placed adjacent to a treatment area. *Internal - Internal radiation exposure includes ingestion of foods or liquids contaminated with radioactivity or by inhalation of radioactive gases or paicles. Internal radiation occurs after exposure to nuclear fallout (from testing and accidents at operating nuclear power plants or above ground nuclear explosive testing) or after ingestion of radioiodine for diagnostic tests and for therapy of hypehyroidism. | 2,004 | medmcqa_train |
Significant value of `p' is ? | Ans. is 'd' i.e., 0.05 P is the probability that the difference seen between 2 samples occurs due to chance". If p . .05 it is considered statistically significant. It means that There is 5% probability that the result could have been obtained by chance. or The investigator can be 95% sure that the result was not obtained by chance. | 2,005 | medmcqa_train |
Complications of Colles' fracture are all except | B i.e. Nonunion | 2,006 | medmcqa_train |
Lecithin/Sphingomyelin ratio is done to assess the maturity of: | Ref: Cloherty's Manual of Newborn Care. 6th edition, Page 323Explanation:THE LECITHIN -SPHINGOMYELIN (L/S) RATIOAssessment of fetal lung maturity (FLM) prenatally by testing amniotic fluid obtained by amniocentesis.It is performed by thin-layer chromatography.The risk of RDS is very low if the L/S ratio is >2.Exceptions to L/S ratio >2 are:o Infants of diabetic mothers (IDMs)o Intrapartum asphyxiao Erythroblastosis fetalis.Other possible exceptions are intrauterine growth restriction (IUGR), abruptio placentae, preeclampsia and hydrops fetalis.Blood and meconium tend to elevate an immature L/S ratio and depress a mature L/S ratio.OTHER METHODSThe TDx-FLM 11 measures the surfactant- albumin ratio.Measured using fluorescent polarization technology.A value of >45 mg/g indicates maturity.Lamellar body counts in the amniotic fluid.Lamellar bodies are '"packages" of phospholipids produced by type II alveolar cells.A count of >50,000 lamellar bodies/microliter predicted lung maturity. | 2,007 | medmcqa_train |
At which level sound is painful - | Intensity
Whisper - 30 dB
Normal conversation - 60 dB
Shout - 90 dB
Discomfort of ear - 120 dB
Pain in ear -130 dB
Ref. Dhingra, 6/e, p 19 | 2,008 | medmcqa_train |
All of the following are included as causes of maternal death except - | Maternal moality rate is total no.of female deaths due to complications of pregnancy,childbihor within 42 days of delivery from puerpeural causes.REF.PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE.Editon-21.Page no.-514 | 2,009 | medmcqa_train |
Trypsinogen to trypsin is conveed by | Trypsin, a proteinase, is secreted as an inactive zymogen form trypsinogen, which is activated to form active Trypsin, which has strong proteolytic activity and an inactive hexapeptide which is produced and liberated during the process of activation. Activation is brought about by * A glycoprotein enzyme called as enterokinase of the intestinal juice at a pH of 5.5 * Also by trypsin itself once it is formed, autocatalytically, at a pH of 7.9. *C a++ also is required for the activation. In the process of activation, the "active site" of the enzyme trypsin, which is histidylserine residue is unmasked. Hence trypsin belongs to the group of serine proteases. Trypsin acts in an alkaline medium pH 8 to 9 (optimum pH-7.9) and has low Michaelis constant.Ref: Textbook of medical biochemistry, MN Chatterji, 8th edition, page no: 464 | 2,010 | medmcqa_train |
Which of the following is used to represent continuous (quantitative) data ? | Ans. is `c' i.e., Histogram | 2,011 | medmcqa_train |
What is the most probable poal of entry for Aspergillus | Aspergillosis is caused by the inhalation of Aspergillus conidia or mycelial fragments which are present in the decaying matter, soil or air, resulting in aspergillus asthma, bronchopulmonary aspergillosis and aspergilloma. Ref: Textbook of Microbiology, Ananthanarayan and Paniker; 9th edition | 2,012 | medmcqa_train |
Obstruction to the flow of CSF at the aqueduct of Sylvius will most likely lead to enlargement of - | CSF is produced by choroid plexus in the lateral and III ventricles. Then it flows through the aqueduct of Sylvius into the 4th ventricle and from there into the subarachnoid space to be absorbed by the arachnoid
Obviously, any obstruction in the aqueduct of Sylvius will lead to enlargement of the proximal ventricles (i.e. both lateral and IIIrd ventricles). | 2,013 | medmcqa_train |
Dinner fork deformity is seen in - | Ans. is 'a' i.e., Colles fracture DeformityAssociated fracture / conditionGarden Spade DeformitySmiths FractureGun stock deformityCubitus varus commonly due supracondylar humerus fractureDinner fork deformityColles FractureGenu VarumBlounts disease | 2,014 | medmcqa_train |
Ministry covering ESI: | ESI act is an impoant measure of social security and health insurance in India. Administration: The Union Ministry of Labour is the Chairman of ESI corporation. Secretary to Govt. of India Ministry of Labour is Vice-Chairman of ESI. | 2,015 | medmcqa_train |
A 22yrs female was admitted in emergency with c/o nausea, vomiting, and watery diarrhoea since 4 days. He is also having low grade fever. He was hospitalised and treated symptomatically and was being relieved and discharged. His blood samples were sent for culture; repos of which pt. brought during his follow up - which showed the presence of clostridium perfringens. Being his physician what should be your next instruction to such patient - | Clostridia Spore bearing, obligate anaerobes and gram positive organisms. Reside normally in GI tract; although they have the propensity to cause fulminant bacteremia, but it is rare. In this question, pt. is well after an acute episode of illness; rules out fulminant course. So, a transient self-limited bacteraemia due to transient gut translocation could occur mostly during an episode of gastroenteritis and doesn't require treatment and fuher workup. So, among the given options returning for penicillin therapy is the best answer. | 2,016 | medmcqa_train |
Leukocytoclastic vasculitis as an extrahepatic manifestation is noticed in: | Extrahepatic complications of chronic hepatitis B Extrahepatic complications of chronic hepatitis B, is associated with deposition of circulating hepatitis B antigen-antibody immune complexes. They are; Ahralgias and ahritis - common, Purpuric cutaneous lesions (leukocytoclastic vasculitis) - Rare Immune-complex glomerulonephritis Generalized vasculitis (polyaeritis nodosa) Ref: Harrison, Edition-18, Page-2568. | 2,017 | medmcqa_train |
An antihelmenthic drug that is effective against blood fluke, liver fluke, lung fluke and cysticercus is: | - Drug of choice for treatment of flukes (except liver fluke) and tapeworms (except dog tapeworm) is praziquantal. - Drug of choice for treatment of liver fluke is triclabendazole. - Drug of choice for dog tapeworm (Echinococcus) is albendazole - Drug of choice for all nematodes (see exceptions below) is albendazole - Drug of choice for treatment of filariasis is diethylcarbamezine. - Drug of choice for treatment of onchocerca and strongyloides is ivermectin. | 2,018 | medmcqa_train |
All of the following are good prognostic factors for childhood Acute Lymphoblastic Leukemia, except: | Hyperdiploidy, Female sex and pre B cell ALL are associated with good prognosis. t (12 : 21) translocation may be associated with a poor prognosis and is the single answer of exclusion. Ref: Pediatric Oncology: A Comprehensive Guide By Paul Imbach, Thomas R. Kuhne, Robe Arceci, 2004, page 23. | 2,019 | medmcqa_train |
Radiological feature of Mitral stenosis is are | A, B, C i.e. Double contour of right hea border, Straightening of left hea border, Splaying of carinal angle | 2,020 | medmcqa_train |
Which of the following hormone doesn't use the adenylyl cyclase-cAMP as a second messenger ? | Hormones That Use the Adenylyl Cyclase-cAMP as Second Messenger System Adrenocoicotropic hormone (ACTH) Angiotensin II (epithelial cells) Calcitonin Catecholamines (b receptors) Coicotropin releasing hormone (CRH) Follicle-stimulating hormone (FSH) Glucagon Growth hormone releasing hormone (GHRH) Human chorionic gonadotropin (hCG) Luteinizing hormone (LH) Parathyroid hormone (PTH) Secretin Somatostatin Thyroid-stimulating hormone (TSH) Vasopressin (V2 receptor, epithelial cells) Insulin acts on tyrosine kinase receptor pathway. | 2,021 | medmcqa_train |
A 3 years old boy presented with fever with pain in the throat and difficulty in deglutition. On examination following findings are seen. What is the most likely diagnosis? | PERITONSILLAR ABSCESS(QUINSY) Collection of pus between the fibrous capsule of the tonsil, and the superior constrictor muscle of the pharynx. Condition is generally unilateral. Tonsil is swollen, red, hot & congested. Uvula and soft palate are pushed to opposite side. Uvula Points towards Normal side as shown in the image. Organism involved are Streptococcus, Staph aureus, anaerobic organism, more often mixed growth is seen. Parapharyngeal abscess (abscess of lateral pharyngeal space, pterygomaxillary, space, pharyngomaxillary space: Swelling is on lateral wall of Pharynx pushing tonsils towards midline. Patient may also have a swelling in neck, posterior to SCM muscle. Patient may also present with Trismus. Ludwig's angina is cellulitis of submandibular space. | 2,022 | medmcqa_train |
Brinzolamide is a | Ans is 'd' i.e. Highly specific reversible and noncompetitive carbonic anhydrase inhibitor o Carbonic anhydrase inhibitors act by a non-competitive, reversible inhibition of the enzyme carbonic anhydrase. o Brinzolamide is a highly .specific inhibitor of carbonic anhydrase II (CA II), which is the main carbonic anhydrase isoenzyme involved in the secretion of aqueous humour. o Inhibition caused by brinzolamide is reversible and non-competitive. | 2,023 | medmcqa_train |
Cholesteatoma commonly associated with: | (a) Atticoantral CSOM(Ref. Scott Brown, 8th ed. Vol 2; 989)Tympanosclerosis is hyalinisation and calcification of the fibrous layer of tympanic membrane. It is not associated with cholesteatoma. Foreign body in ear does not lead to cholesteatoma formation.Keratosis obturans is the collection of desquamated keratin debris in the external auditory canal. This keratin debris comes from the external auditory canal stratified squamous epithelium. | 2,024 | medmcqa_train |
A child presenting with localized patches of complete hair loss with normal appearance of scalp. Diagnosis is - | alopecia areata develops as single or multiple oval or round patches of hair loss on the scalp, beard area,eyebrows, eyelashes and other hairy areas of the body. Telogen effluvium- generalized and diffuse hair loss over scalp and body Cradle cap - infantile seborrhoeic dermatitis characterized by yellowish, patchy, greasy, scaly and crusty skin rash that occurs on the scalp of recently born babies. Tinea capitis-a dermatophytosis caused by trichophyton and microsporum fungi , can be either an ectothrix or endothrix type of infection. Ectothrix involves both inside and outside of hair shaft. Endothrix involves only inside of hair shaft. Page no.241,242,55,169 ref Harrison20th edition | 2,025 | medmcqa_train |
An 8-hour-old term infant develops increased respiratory distress, hypothermia, and hypotension. A complete blood count (CBC) demonstrates a white blood cell (WBC) count of 2500/mL with 80% bands. The chest radiograph is shown below. Which of the following is the most likely diagnosis? | (c) Source: (Hay et al, pp 1163-1166. Kliegman et al, pp 925-928. McMillan et al, pp 482-483, 501-506. Rudolph et al, pp 1097-1099.) The radiograph shows diffuse that infiltrates bilaterally; this can be seen with neonatal pneumonia or primary surfactant deficiency. The rapid onset of the symptoms, the low WBC count with left shift, and the depicted chest x-ray findings, however, are typical of a patient with group B streptococcus (GBS) pneumonia. Appropriate management would include rapid recognition of symptoms, cardiorespiratory support, and prompt institution of antibiotics. Despite these measures, mortality from this infection is not uncommon. The other infectious causes listed do not present so early, and the noninfectious causes listed do not cause elevations in the band count. GBS disease in the infant is decreasing in incidence with better prevention strategies in the perinatal period; early screening in pregnancy and treatment with antibiotics just prior to delivery to eliminate GBS colonization markedly decreases the risk to the infant. Congenital syphilis can cause pneumonia, but it is diagnosed at birth along with other features including hepatosplenomegaly, jaundice, rashes, hemolytic anemia, and others. Diaphragmatic hernia presents with early respiratory distress, but the diagnosis is confirmed clinically with bowel sounds heard in the chest and a radiograph that has loops of bowel located above the normal placement of the diaphragm. Transient tachypnea of the newborn (TTN) causes an increase in respiratory rate and occasionally a low oxygen requirement; the history is often positive for a cesarean delivery, and the radiograph shows retained fluid in the fissures. TTN does not cause temperature instability nor an abnormal CBC. Chlamydial pneumonia is not a condition that occurs in an 8-hour-old infant; it is generally a mild pneumonia that can develop in an exposed infant at several weeks of life. | 2,026 | medmcqa_train |
In the gr'cii circuit, the arc! flow pressure is 100 mm Hg and the outward flow pressure is 10 mm Hg. Each of the parallel circuit has a resistance of 5 mm Hg/mL/min. Calculate the flow across the circuit: | Ans. b. 90 mL | 2,027 | medmcqa_train |
Bochdalek hernia is related to - | Ans. is 'b' i.e., Pleuroperitoneal canal Bochdalek herniao Most Bochdalek hernia are on the left side (~80%) and may rarely be bilateral.o Compression of the lung results in pulmonary hypoplasia, involving both the lungs (ipsilateral > contralateral)o Pulmonary vasculature is also abnormal leading to pulmonary hypertension.o Thus the two main factors that affect morbidity and mortality are pulmonary hypoplasia and pulmonary hypertension.o The most frequent clinical presentation of CDH is respiratory distress due to severe hypoxemia,o The anteroposterior diameter of the chest may be large along with a scaphoid abdomen,o The diagnosis of CDH can be made prenatally by ultrasound.o The postnatal diagnosis is relatively straightforward because a plain chest radiograph demonstrates the gastric air bubbles or loops of bowel within the chest. There may also be a mediastinal shift away from the side of the hernia.o Historically, the surgical repair of a CDH was considered to be a surgical emergency' because it was believed that the abdominal viscera within the chest prevented the ability to ventilate. More recently with the recognition of the role of pulmnary hypertension and pulmonary hypoplasia and the adverse effects of early operative repair on the pulmonary function has caused a policy of delayed repair.o Thus most pediatric surgeons wait for a variable period (24 to 72 hrs) to allow for stabilization of the infant before doing surgical repair.Congenital diaphragmatic herniao It is the herniation of abdominal contents into the thoracic cavity through the diaphragmatic defecto The defect may be:Posterolateral (Bochdalek hernia)Retrosternal (Morgagni hernia)At the esophageal hiatus (hiatal hernia)Adjacent to the hiatus (paresophageal hernia)o Although all these defects are congenital, the term congenital diaphragmatic hernia is generally used for Bochdalek hernia. | 2,028 | medmcqa_train |
A 4 yr old partially immunized boy came to OPD with history of bouts of coughing. On staining the sputum sample an organism with bipolar staining was seen. Which among the following organism it would be? | REF: (B) B. pertussisREF: Jawetz Microbiology, 24th Ed Ch. 19BORDETELLA PERTUSSIS:The organisms are minute gram-negative coccobacilli resembling H influenzae. With toluidine blue stain, bipolar metachromatic granules can be demonstrated. A capsule is present. After an incubation period of about 2 weeks, the "catarrhal stage" develops, with mild coughing and sneezing. During this stage, large numbers of organisms are sprayed in droplets, and the patient is highly infectious but not very ill. During the "paroxysmal" stage, the cough develops its explosive character and the characteristic "whoop" upon inhalation. This leads to rapid exhaustion and may be associated with vomiting, cyanosis, and convulsions. The "whoop" and major complications occur predominantly in infants; paroxysmal coughing predominates in older children and adults. The white blood count is high (16,000-30,000/ uL), with an absolute lymphocytosis. Among provided options, T. pestis and B. pertussis produce bipolar metachromatic appearance, but considering the partial immunization status and age of patient, b. pertussis is answer of choice. | 2,029 | medmcqa_train |
What is true in case of perforation of pars flaccida? | Ans. B Associated with cholesteatomaTympanic membrane can be divided in 2 pas:Parstensa : It forms most of the tympanic membrane. Its periphery is thickened to form fibro cailaginous ring called as annulus tympanicus.Pars Falccida : It is situated above the lateral process of malleus between the notch of Rivinus and the anterior and posterior malleolar folD. Perforation in tympanic membrane can be in Central* Occurs in tubotympanic type ofCSOM* Not associated with cholesteatoma* Considered safe Marginal (Perforation destroys even the annulus) theraby reaching sulcus tympanicusMost common is posterio superiormarqinal?- occur in attico antral type of CSOM- associated with cholesteatoma- considered unsafe / dangerous Attic perforation NoteMost common cause of perforation is chronic otitis mediaMnemonicFamousF - Perforation of Pars FlaccidA.A - Seen in Atticoantral/marginal perforationM - Associated with CSOM (of atticoantral type) or acute necrotizing otitis mediao - Associated with CholesteatomaU - Unsafe typeS - Surgery is TOe. | 2,030 | medmcqa_train |
Adam's apple seen in boys is because of: | Prominance of Thyroid cailage (because of sharp angle) in males is called Adam's apple. Thyroid cailage with right and left lamina both meet at midline and form an angle of 90deg in males, 120deg in females. At rest it lies at level of C3 | 2,031 | medmcqa_train |
Site of placement of tension free vaginal tapes in stress urinary incontinence | Tension-free vaginal tape A knitted 11 mm x 40 cm polypropylene mesh tape is inseed transvaginally at the level of the midurethra Complications: Sho term Voiding difficulties , Bladder perforation, de novo Urgency and Bleeding Ref: SHAW&;S TEXTBOOK OF GYNAECOLOGY; 15th edition; Pg no:194 | 2,032 | medmcqa_train |
The amount of water absorbed in the intestine in a day is : | D i.e. 8 lit | 2,033 | medmcqa_train |
Most impoant from of carbon-dioxide transpo in the blood | The route by which most of the carbon dioxide is carried in the bloodstream. Once dissolved in the blood plasma, carbon dioxide combines with water to form carbonic acid, which immediately ionizes into hydrogen and bicarbonate ions. The bicarbonate ions serve as pa of the alkaline reserve.Ref: Ganong&;s Review of Medical Physiology; 24th edition; page no: 644 | 2,034 | medmcqa_train |
A patient presents to the emergency department with uniocular diplopia. Examination with oblique illumination shows golden crescent while examination with coaxial illumination show a dark crescent line. Which of the following is the most likely diagnosis – | Presence of uniocular diplopia together with the finding of the golden crescent on oblique illumination (edge of subluxated lens) or black crecent line on coaxial illumination (edge of subluxated lens) suggests a diagnosis of `subluxation' of the crystalline lens. Ectopic lens refers to the displacement of shows lens from its normal position (subluxation, dislocation). | 2,035 | medmcqa_train |
All of the following statements about Lupus Anticoagulant are true, EXCEPT: | Catastrophic Life threatening Antiphospholipid Syndrome results from rapid onset thrombosis and ischemia in multiple organ systems and not from severe bleeding. However such bleeding episodes are rare after thrombotic spells even with severe thrombocytopenia, not leading to life threatening hemorrhage and occur as a result of consumptive thrombocytopenia. Hemorrhage is rarely associated with Lupus anticoagulant. Ref: Hematological Complications in Obstetrics, Pregnancy and Gynecology By Rodger. L. Bick, Pages 150-152; Quality in Laboratory Hemostasis and Thrombosis By Steve Kitchen, Chapter 16;The Lupus Book: A Guide for Patients and Their Families By Daniel J. Wallace, 4th Edition, Chapter 21 | 2,036 | medmcqa_train |
CT scan abdomen at the level of the twelfth thoracic veebra in a pt., Which structure provides an attachment of the suspensory muscle of the duodenum (ligament of Treitz)? | The duodenojejunal flexure is suppoed by a fibromuscular band called the suspensory ligament of the duodenum (ligament of Treitz), which is attached to the right crus of the diaphragm. C. - The pancreas is an endocrine and exocrine gland; is retroperitoneal in position and receives blood from the splenic, gastroduodenal, and superior mesenteric aeries. E - The spleen lies in the left hypochondriac region, is hematopoietic in early life, and later functions in worn-out red blood cell destruction. It filters blood, stores red blood cells, and produces lymphocytes and antibodies. D - The splenic aery is a branch of the celiac trunk, follows a touous course along the superior border of the pancreas, and divides into several branches that run through the lienorenal ligament. A -. The common hepatic aery is divided into the proper hepatic and gastroduodenal aeries. | 2,037 | medmcqa_train |
Best method of treatment of ulner never abscess in case of leprosy is - | Best method to treat ulnar nerve abscess is incision and drainage. folowed by treatment with coicosteroids and mbmdt iadvl textbook of dermatology page 2091 | 2,038 | medmcqa_train |
Most common cause of sho stature is: | Ans. A: Constitutional The causes of sho stature can be divided into 3 broad categories: Chronic disease (including undernutrition genetic disorders) Familial sho stature Constitutional delay of growth and development (commoner) Endocrine diseases are rare causes of sho stature. The hallmark of endocrine disease is linear growth failure that occurs to a greater degree than weight loss. | 2,039 | medmcqa_train |
Frozen section is/are used for all except | Frozen section Biopsy Biopsy technique in pathology laboratories for making urgent on-table diagnosis Frozen section biopsy is a procedure done in a pathological setup existing adjacent to the operation theatre Surgeons are the main users of this service Procedure An unfixed fresh tissue is frozen (using CO2 to - 25degC) and section are made and stained Uses of Frozen section Biopsy It is quick and surgeon can decide the fuher steps of procedure in the same sitting like nodal clearance /type of resection to be done During surgery after resection of the tumor to look for (on table) the clearance in margin and depth, also to study the lymph nodes for their positivity. Used for demonstration of ceain constituents which are lost in processing with alcohol or xylene, eg: Fat, enzyme Ref: Bailey and love 25th edition Pgno : 169-170 | 2,040 | medmcqa_train |
Which of the following condition is associated with Osmotic diarrhoea? | Clinical causes of osmotic diarrhea that causes an osmolar gap greater than 50 includes lactase deficiency, sorbitol foods, saline cathaics and antacids. Osmotic diarrhea occur when water soluble molecules are poorly absorbed, remain in the intestinal lumen and retain water in the intestine. It usually follows ingestion of osmotically active substances. In this, Stool volume is less than 1 litre /day Diarrhea stops with fasting Stool has an osmolar gap (normal stool osmolar gap is less than 50) Ref: Mayo Clinic Internal Medicine Review, Eighth Edition edited by M. Habermann Thomas, page 262. | 2,041 | medmcqa_train |
WHO recommended regime for the treatment of Brucella infection is ? | Ans. is 'b' i.e., Rifampin with doxycyclinelRef : Harrison 18n/e p. 1299,1672 & I4/e p. 1268).The gold standard for the treatment of brucellosis in adults is IM streptomycin (0.75-1 g daily for 14-21 days) together with doxycycline (100 mg twice daily for 6 weeks).In both clinical trials and observational studies, relapse follows such treatment in 5-10 % of cases.The usual alternative regimen (and the current World Health Organization recommendation) k rifampin (600-9{n mg/it) plus doxycycline (100 mg twice daily) for 6 weeks. | 2,042 | medmcqa_train |
'Rosette cataract' is caused by: | Ans. c (Trauma) (Ref: Parson's Disease of Eye 19th/pg. 283; Basak Ophthalmology 2nd/pg. 82, 305).CATARACTContusion cataractContusion of the eyeball will produce a rosette-shaped subcapsular opacity on the anterior surface of the lens. It will normally remain unchanged but will migrate into the deeper cortex over time due to the apposition of new fibers.Lamellar (Zonular) cataractIt is the most common developmental cataract.Opacities are located in one layer of lens fibers, often as "riders" only in the equatorial region.Nuclear cataractIn the fourth decade of life, the pressure of peripheral lens fiber production causes hardening of the entire lens, especially the nucleus. The nucleus takes on a yellowish brown color (brunescent nuclear cataract). This may range from reddish brown to nearly black discoloration of the entire lens (black cataract). Nuclear cataracts develop very slowly. Due to the lenticular myopia, near vision (even without eyeglasses) remains good for a long time.Cortical cataractNuclear cataracts are often associated with changes in the lens cortex. It is interesting to note that patients with cortical cataracts tend to have acquired hyperopia in contrast to patients with nuclear cataracts, who tend to be myopic.# Berlin's edema (commotio retinae) is a condition caused by blunt injury to the eye. Berlin's edema is an acute traumatic maculopathy characterized by retinal opacification. Histopathologic studies have shown that it is characterized by disruption of photoreceptor outer segments and retinal pigment epithelial damage. OCT an effective tool for management of patients with posterior segment trauma. OCT is more comfortable for the traumatized patient than other imaging techniques because it is a non-contact method utilizing infrared illumination. OCT is also highly sensitive in identifying subtle anatomic changes.Educational points: CataractFeatureAfter-cataract (Post cap opacity)Elschnig pearl & Rings of SoemerringsBrown/Cataract brunescensNuclear/hard cataractBlack cataract/Cataract nigransNuclear/hard cataractBlue dot cataract (Punctate)Most common congenital cataractComplicated cataract'Bread crumb' appearanceConcussion cataract'Rossete-shaped' cataractCoronary cataractDevelopmental cataract at pubertyChalcosisSunflower cataractDiabetic cataract'Snow flake/storm' appearanceHypermature senile cataractMorgagnian cataractLamellar/ZonularRidersMyotonic dystrophyCataract with polychromatic dots ("Christmas-tree") | 2,043 | medmcqa_train |
Cork screw esophagus in barium swallow is seen in: | Ans: C (Diffuse esophageal spasm) Ref: Sc ibis ion Textbook of Surgery, 19th Edition 1028Explanation:Diffuse Esophageal spasmHyper motili ty di sorderRepetitive, simultaneous, and of high amplitude esophageal contractionsMotor abnormality of the esophageal body that is more in the lower two thirds.Muscular hypertrophy and degeneration of the branches of the vagus observed.Clinical featuresChest pain and dysphagiaSqueezing pressure in the chest that may radiate to the jaw, arms, and upper back mimicking anginaSymptoms are more during times of emotional stress.Regurgitation of esophageal contents and saliva common.DiagnosisBy esuphagraphy and manometric studiesBarium swallow - Corkscrew esophagus or pseudodiverticulosis due to the presence of tertiary contractionManometrySimultaneous multipeaked contractions of high amplitude (>120 mm Hg> or long duration (>2.5 seconds)Due to spontaneous contractions and intermittent normal peristalsis, standard manometry mayNot be enough to identify DES.An ambulatory manometry has sensitivity of 90% and a specificity of 100% and is preferred.ManagementPharmacologic or endoscopic treatment preferredAll patients require psychiatric evaluationPharmacotherapyNitrates,Calcium channel blockersAnticholinergicsRelative efficacy of each of the drugs not clearEndoscopic managementBougie dilation of the esophagus up to 50 or 60 Fr provides relief for severe dysphagia and is 70% to 80% effective.Botulinum toxin injections have also been triedSurgeryIndicationsPatients with incapacitating chest pain or dysphagia who have failed medical and endoscopic therapyPresence of a pulsion diverticulum of the thoracic esophagus.ProcedureA long esophagomyotomy is performed through a left thoracotomy or a left video-assisted technique.Dor fundoplication - to prevent healing of the myotomy site and provide reflux protectionNote:Barium Swallow appearance of Carcinoma esophagus - Rat tail appearaneeBarium Swallow appearance of Achalasia - Bird's Beak appearance due to dilated esophagus with a distal narrowingGold standard for diagnosing Achalasia - Esophageal manometry. | 2,044 | medmcqa_train |
Infant with cystic fibrosis (CF) are likely to develop | The common clinical presentations include meconium ileus in neonatal period,recurrent bronchiolitis in infancy and early childhod,recurrent respiratory tract infections ,chronic lung disease , bronchiectasis, steatorrhoea,with incresing age pancreatitis and azoospermia. Ref : Essential pediatrics,O.P.Ghai,7 th edition ,pg no:36 | 2,045 | medmcqa_train |
Which of the following indicates radiograph contrast induced nephropathy? | Ans.Increased creatinine levels | 2,046 | medmcqa_train |
In postductal coarctation of aoa, collaterals may be formed by all of the following, except | In post-ductal coarctation of the aoa, an extensive collateral circulation develops involving the branches of subclan & axillary aeries with the distal aeries given by aoa Veebral aery does not play a significant role in this collateral circulation. Ref: Gray's 40e/p984 | 2,047 | medmcqa_train |
Which of the following is not a true association of thymoma ? | The usual association is hypogamaglobuthemia not hyperglobulinemia. | 2,048 | medmcqa_train |
Which of the following statements about the pathology in Alzheimer's disease is not true: | Answer is C (NFTs appear extracellularly before intracellular appearance):NFTs are typically seen intracellularly within the soma and proximal dendrites of neurons. Neurofibrillary Tangles (NFTs) are intracellular accumulations of hyperphosphorylated 'tau' proteins.Neurofibrillary Tangles are Intracellular AccumulationsNeurofibrillary Tangles are intracellular accumulations of hyperphosphorylated microtubule binding protein 'tau'.Paired helical filaments of tau protein (NFTs) form intracellularly within the soma and proximal dendrites of neurons.These cytoskeletal protein tangles (NFTs), initially impede cellular metabolism and axosplasmic transpo leading to impaired synaptic function and eventually to neuronal death.These neurofibrillaty tangles may be seen as extracellular tangles after degeneration of the neuron as evidence of the neuronal cell's demiseNeurofibrillary Tangles are intracellular accumulations that may appear extracellularly alter degeneration of neuron (neuronal death)Histopathological Hallmarks of Alzheimer's DiseaseAmyloid Plaques (Extracellular)Amyloid Neuritic Plaques are formed by extracellular accumulation of beta amyloid deposits within the neutropil'Neuritic' or 'Senile' I3-amyloid plaques are an early histopathological sign of Alzheimer's disease (that occur rarely in healthy subjects)The amyloid 13-protein accumulated in single neuritic plaques is toxic to surrounding structures and adjacent neurons.Clinicopathological studies have shown that amy/aid burden does not directly correlate with severity or duration of dementia.Neurofibrillary Tangles (Intracellular)Neurofibrillary tangles arc formed by intracellular accumulation of hyperphosphorylated microtubule binding protein 'tau'.NFT's occur in many neurodegenerative diseases and /or a group of diseases called laupathies'.These include Frontotemporal dementia, Pick's disease etc. The cooccurance of fi-amyloid plaques with NFT's suggests a diagnosis of AD.The NFT's are toxic to the neurons and neurons with NFT's eventually die and degenerate leaving a residual `ghost tangle', in the extracellular space reminding of the pyramidal cell body in which it was initially formed.Clinicopathological studies have shown that dementia correlates more strongly with NFT's than with senile plaques (3-amyloid) | 2,049 | medmcqa_train |
Senescent RBC's are mainly attacked in- | P. malariae which attacks mainly senescent (old) RBC’s: Agent of Quartan malaria
P. ovale and P. vivax: attack younger RBCs and reticulocytes: Agent of benign tertian malaria
P. falciparum: attacks RBC of all ages: Agent of malignant tertian malaria. | 2,050 | medmcqa_train |
Which of the following is spared in modified radical mastectomy (MRM)? | Ans. a (Pectoralis major). (Ref. Bailey & Love Surgery, 25th ed., 842)MASTECTOMY is now only strictly indicated for large tumors, central tumor beneath or involving nipple, multifocal disease, and local recurrence or for patient preference.Simple mastectomyRadical mastectomy (Halsted)Modified radical Mastectomy (Patey's)# Only breast & Axillary tail of breast# Breast# Axillary lymph nodes# Pectoralis major# Pectoralis minor# Whole breast# Large portion of skin including nipple# Dissection of axilla# All fat, fascia & lymph nodes of axilla.# Pectoral minor either divided or retracted# Intercostal brachial nerves divided.STRUCTURES SPARED IN MRM1. Pectoralis major2. Axillary vein3. Nerve to serratus anterior & latissimus dorsiEducational points:# Conservative breast cancer surgery is QUART (Quadrantectomy Axillary Dissection & RT).# Sentinel node biopsy localized by radionuclide scan or by injection of patent blue dye.# Reconstruction materials:- Silicone gel,- Musculocutaneous Flaps {TRAM gives best cosmetic results) | 2,051 | medmcqa_train |
Painless effusion in congenital syphilis is called | Skeletal manifestations of congenital syphilis Clutton's joints - Painless sterile effusions in the knees or elbows Parrot's joints - Effusion with epiphysitis and epiphyseal separation Erosion of the nasal boneThickening and expansion of the finger phalanges (dactylitis) Higoumenaki's sign - Bilateral enlargement of sternal end of the clavicle Saber tibia, Scaphoid scapula (Refer: Mohindra's Fundamentals of Ohopedics, 2nd edition, pg no. 291) | 2,052 | medmcqa_train |
Port wine stain of the face, seizures, hemiparesis, intracranial calcification and glaucoma are features of? | Ans. c (Sturge-Weber syndrome) (Ref. Harrison's medicine 17th/Chapter 379; IADVL 2nd/ pg l68)PHAKOMATOSES (NEUROCUTANEOUS SYNDROMES = NEUROECTODERMAL DYSPLASIAS)# Autosomal dominant:- Neurofibromatosis (von Recklinghausen synd)# Not autosomal dominant:- Encephalotrigeminal angiomatosis (Sturge-Weber synd)- Tuberous sclerosis (Bourneville synd)- Retinocerebellar hemangioblastoma (VHL synd)- Neurocutaneous melanosis- Ataxia-telangiectasiaSTURGE-WEBER SYNDROME (ENCEPHALOTRIGEMINAL ANGIOMATOSIS)# Classical triad:- Facial portwine stain in distribution of VI (trigeminal nerve), present at birth and unilateral; may cross midline.- Mentral retardation- Seizures# Ocular features:- Ipsilateral glaucoma,- Buphthalmos,- Strabismus and- Loss of vision,# CT SCAN:- "Tram-track" or S-shaped intracranial calcifications, seen after the age of 2 years.- Ipsilateral Choroid plexus and venous angiomas with leptomeningeal angiomatoses over the parietoccipital lobes.VON HIPPEL-LINDAU DISEASE# Mutation of the von Hippel-Lindau (VHL) gene on chromosome 3p, a tumor-suppressor gene, causes this disorder.# Associated tumors:- Hemangioblastomas (Erythropoietin producing) - cerebellum, retina, medulla, spinal cord- Renal cysts 60%; Pancreatic, epididymis, or liver cysts- Renal cell carcinoma 45%- Pheochromocytoma (NIH Type 2a or 2b)- Islet cell tumors; Endolymphatic sac tumors; Serous adenomasTUBEROUS SCLEROSIS (BOURNEVILLPS DISEASE)# Autosomal dominant# Classical clinical triad of = EPIlepsy, LOw IQ, Adenoma sebaceum (EPDLOIA).# 'Ash leaf' macule - the earliest cutaneous sign & results in poliosis (circumscribed patch of gray-white hair)# Hamartomas involving many organs# Cardiac rhabdomyomas# Angiomyolipomas of kidneys, liver, adrenals, and pancreas (Angiomyolipomas are the most common renal abnormality, occur bilaterally, are often multiple, and are usually asymptomatic)# Brain -- periventricular subependymal nodules- Cortical tubers- 15% develop subependymal giant cell astrocytoma (SEGA) - the foramen Munro tumor# Lungs - LAM (Lymphangioleomyomatosis) and pulmonary interstitial fibrosisNEUROFIBROMATOSIS TYPE 1 (VON RECKLINGHAUSEN'S DISEASE)# NF1 is characterized by cutaneous neurofibromas, pigmented lesions of the skin called cafe au lait spots, freckling in non-sun-exposed areas such as the axilla, hamartomas of the iris (Lisch nodules), and pseudoarthrosis of the tibia.# Neurofibromas present as multiple, palpable, rubbery, cutaneous tumors.# Aqueductal stenosis (hydrocephalus), scoliosis, short stature, hypertension, epilepsy, & mental retardation may occur.# Patients with NF1 are at T risk of developing nervous system neoplasms, including plexiform neurofibromas, optic pathway gliomas, ependymomas, meningiomas, astrocytomas, and pheochromocytomas.# Mutation of NF1 gene on chromosome 17 causes von Recklinghausen's disease. The NF1 gene is a tumor-suppressor gene; it encodes a protein, neurofibromin, which modulates signal transduction through the ras GTPase pathway.NEUROFIBROMATOSIS TYPE 2 (MISME Complex)# bilateral vestibular schwannomas in >90% of individuals who inherit the gene.# Predisposition for the development of Meningiomas, gliomas, and Schwannomas of cranial and spinal nerves.# In addition, a characteristic type of cataract, juvenile posterior subcapsular lenticular opacity, occurs in NF2.# Multiple cafe au lait spots and peripheral neurofibromas occur rarely.# This syndrome is caused by mutation of the NF2 gene on chromosome 22q; NF2 encodes a protein called neurofibromin 2, schwannomin, or merlin, with homology to a family of cytoskeletal proteins that includes moesin, ezrin, and radixin. | 2,053 | medmcqa_train |
Cis atracurium is better then atracurium because:- | Atracurium Cis-atracurium Mixture of cis-isomers Pure cis-isomer Histamine release No / minimal release CVS unstable CVS stable Less potent Dose - 0.5-0.6mh/kg More potent Dose - 0.1-0.2 mg/kg - Cis-atracurium and atracurium are dependent on Hoffman elimination - Cis-atracurium's duration of action is more predictable because of spontaneous breakdown. Although atracurium undergoes similar elimination, it is less potent than cis-atracurium, so its breakdown product, laudanosine, is found in higher concentrations | 2,054 | medmcqa_train |
Kanagawa's phenomenon is seen in ? | Ans. is 'b' i.e., Vibrio parahemolyticus Strains of vibrio parahemolyticus isolated from patients are always hymolytic on Wagatsuma agar, while strains from environmental sources are always non-hemolytic. This linkage of enteropathogenicity to ability of hemolysis on Wagatsuma agar is called Kanagawa's phenomenon. | 2,055 | medmcqa_train |
The following are attributes of hepatitis B infection except - | Hepatitis B may cause an acute viral hepatitis; however, acute infection is often asymptomatic, paicularly when acquired at bih. Many individuals with chronic hepatitis B are also asymptomatic. The risk of progression to chronic liver disease depends on the source and timing of infection . Veical transmission from mother to child in the perinatal period is the most common cause of infection worldwide and carries the highest risk of ongoing chronic infection. In this setting, adaptive immune responses to HBV may be absent initially, with apparent immunological tolerance. Several mechanisms contribute towards this: Firstly, the introduction of antigen in the neonatal period is tolerogenic. Secondly, the presentation of such antigen within the liver, as described above, promotes tolerance; this is paicularly evident in the absence of a significant innate or inflammatory response. Finally, very high loads of antigen may lead to so-called 'exhaustion' of cellular immune responses. The state of tolerance is not permanent, however, and may be reversed as a result of therapy, or through spontaneous changes in innate responses, such as interferon alpha (IFN-a) and NK cells, accompanied by host-mediated immunopathology. Chronic hepatitis can lead to cirrhosis or hepatocellular carcinoma, usually after decades of infection . Chronic HBV infection is a dynamic process that can be divided into five phases ; these are not necessarily sequential, however, and not all patients will go through all phases. It is impoant to remember that the virus is not directly cytotoxic to cells; rather, it is an immune response to viral antigens displayed on infected hepatocytes that initiates liver injury. This explains why there may be very high levels of viral replication but little hepatocellular damage during the 'immune-tolerant' phase. Hepatitis B core antigen Hepatitis B core antigen (HBcAg) is not found in the blood, but antibody to it (anti-HBc) appears early in the illness and rapidly reaches a high titre, which subsides gradually but then persists. Anti-HBc is initially of IgM type, with IgG antibody appearing later. Anti-HBc (IgM) can sometimes reveal an acute HBV infection when the HBsAg has disappeared and before anti-HBs has developed Ref Davidson edition23rd pg 874 | 2,056 | medmcqa_train |
MMR. vaccination is given at- | Ans. is 'd' i.e., 11/2 years o See IAP vaccination schedule. | 2,057 | medmcqa_train |
Which of the following inducing agent produces cardiac stability? | Etomidate
It is another induction anaesthetic (0.2- 0.5 mg/kg) which has a briefer duration of action (4-8 min).
than thiopentone; produces little cardiovascular and respiratory depression, but motor restlessness and rigidity is more prominent as are pain on injection or nausea and vomiting on recovery. It is a poor analgesic and has not found much favour ,except for patients with compromised cardiovascular status.
Reference: Essentials of Medical Pharmacology Eighth Edition KD TRIPATHI page no 410 | 2,058 | medmcqa_train |
Weight range of adrenal glands in most of cases of cushing's disease is - | Ans. is 'd' i.e., 25-40 gm o The weight of adrenal gland depends on the cause of cushing syndrome : ? Due to ACTH production by pituatory microadenoma (cushing disease) or by ectopic ACTH production. o ACTH stimulates the zona reticularis and zona fasciculata which results in either diffuse hyperplasia (25-40 gm) or nodular hyperplasia (30-50 gm) of adrenal. Primary pituitary adenoma Weight is less than 30 gm. Primary pituitary carcinoma -4 Weight is 200-300 gm. Exogenous glucocoicoid administration o Exogenously administered glucocoicoids inhibit the release of ACTH from pituitary by negative feed back mechanism. o So, there is no stimulatory signal on zona fasciculata and zona reticularis --> Both these layers undergo atrophy. o As zona glomerulosa function is independent of ACTH, its thickness remains normal. o Due to atrophy the weight of the gland is less than normal, i.e., < 4 gm. | 2,059 | medmcqa_train |
Which of the following aery is not a terminal branch of coeliac trunk ? | The coeliac trunk arises from the front of the abdominal aoa just below the aoic opening of the diaphragm at the level of the disc between veebrae thoracic twelve and first lumbar. The trunk is only about 1.25 cm long. It ends by dividing into its three terminal branches, namely the left gastric, hepatic and splenic aeries. Ref : B D Chaurasia's Human Anatomy ,seventh edition , volume 2 , pg. no., 302 ( fig. 21.3 to 21.5 ). | 2,060 | medmcqa_train |
Most reliable method of diagnosing pulmonary embolism is: September 2004 | Ans. D i.e. Angiography Pulmonary angiography has been now replaced by CT and MR angiography | 2,061 | medmcqa_train |
One of the earliest symptoms of Vit. A deficiency is: | Deficiency manifestations of Vitamin A:
Night blindness (nyctalopia) is one of the earliest symptoms of vitamin A deficiency.
The individuals have difficulty to see in dim light since the dark adaptation time is increased.
Prolonged deficiency irreversibly damages a number of visual cells.
Severe deficiency of vitamin A leads to xerophthalmia. This is characterized by dryness in conjunctiva and cornea, and keratinization of epithelial cells.
In certain areas of conjunctiva, white triangular plaques known as Bitot's spots are seen.
lf xerophthalmia persisits for a long time, corneal ulceration and degeneration occur.
This results in the destruction of cornea ,a condition referred to as keratomalacia, causing total blindness
Vitamin A deficiency blindness is mostly common in children of the developing countries
Key Concept:
Night blindness (nyctalopia) is one of the earliest symptoms of vitamin A deficiency.
Ref : Textbook of Biochemistry, Satyanarayana | 2,062 | medmcqa_train |
Chediak-Higashi syndrome is characterized by | Ans. a (Defects in phagolysosome function) (Ref. H - 17th/pg. Table 61-4)CHRONIC GRANULOMATOUS DISEASEChronic Granulomatous Disease presents before the age of 2 and can be transmitted through X-linked or autosomal pattern of inheritance. The defect lies in the inability to generate oxidative burst to kill organisms after being phagocytosed. The neutrophils lack enzyme NADPH oxidase, which plays an important role in production of microbicidal oxygen radicles. In the lab, the diagnosis can be confirmed through Nitro blue Tetrazolium reduction dye test, which will be negative. B cell and T cell functions are normal. Recurrent infections with catalase producing organisms are common. The NBT test is a measure of the respiratory burst in neutrophils and is used to screen for CGD. Neutrophils will reduce the dye NBT, a clear yellow water-soluble compound, to formazan upon stimulation of the respiratory burst. Formazan thus forms precipitates as a dark blue granular substance, which remains trapped in the cytoplasm. Patients with CGD lack a component of the oxidase system, which produces super oxide anion and thus cannot reduce NBT to formazan. Results are interpreted as follows: Normal (positive test) - cells with an orange-red nucleus and blue cytoplasm; Abnormal (negative test) - cells with an orange-red nucleus and colorless cytoplasm.Phagocytic cell deficiency:Leukocyte adhesion deficiency syndrome (type 1): Defect in LFA-1 integrin proteins on phagocytes. Presents early with recurrent bacterial infections, absent pus formation, and delayed separation of umbilicus.Chediak-Higashi disease:Autosomal recessive. Defect in microtubular function and lysosomal emptying of phagocytic cells. Presents with recurrent pyogenic infections by staphylococci and streptococci, partial albinism, and peripheral neuropathy.Chronic granulomatous disease:Defect in phagocytosis of neutrophils owing to lack of NADPH oxidase activity or similar enzymes. Presents with marked susceptibility to opportunistic infections with bacteria, especially S. aureus, E. coli, and Aspergillus. Diagnosis confirmed with negative nitroblue tetrazolium dye reduction test. Rx:Gamma Interferon.Inherited Disorders of Phagocyte Function: Differential FeaturesClinical manifestationsCellular or molecular defectsDiagnosisChronic Granulomatous Diseases (70% X-linked, 30% Autosomal Recessive)Severe infections of skin, ears, lungs, liver, and bone with catalase-positive microorganismsSuch as S. aureus, BurkholderiaChromobacterium violaceum; often hard to culture organism; excessive inflammation with granulomas, frequent lymph node suppuration; granulomas can obstruct GI or GU tracts; gingivitis, aphthous ulcers, seborrheic dermatitisNo respiratory burst due to the lack of one of four NADPH oxidase subunits in neutrophils, monocytes, and eosinophilsNBT or DHR test; no superoxide and H2O2 production by neutrophils; immunoblot for NADPH oxidase components; genetic detectionChediak-Higashi Syndrome(Autosomal Recessive)Recurrent pyogenic infections, especially with S. aureus; many patients get lymphoma-like illness during adolescence; periodontal disease; partial oculocutaneous albinism, nystagmus, progressive peripheral neuropathy, mental retardation in some patientsReduced chemotaxis and phagolysosome fusion, increased respiratory burst activity, defective egress from marrow, abnormal skin window; defect in LYSTGiant primary granules in neutrophils and other granule-bearing cells (Wright's stain); genetic detectionSpecific Granule Deficiency(Autosomal Recessive)Recurrent infections of skin, ears, and sinopulmonary tract; delayed wound healing; decreased inflammation; bleeding diathesisAbnormal chemotaxis, impaired respiratory burst and bacterial killing, failure to upregulate chemotactic and adhesion receptors with stimulation, defect in transcription of granule proteins; defect in C/EBPLack of secondary (specific) granules in neutrophils (Wright's stain), no neutrophil- specific granule contents (i.e., lactoferrin), no defensins, platelet granule abnormality; genetic detectionMyeloperoxidase Deficiency(Autosomal Recessive)Clinically normal except in patients with underlying disease such as diabetes mellitus; then candidiasis or other fungal infectionsNo myeloperoxidase due to pre- and posttranslational defectsNo peroxidase in neutrophils; genetic detectionLeukocyte Adhesion DeficiencyType 1: Delayed separation of umbilical cord, sustained neutrophilia, recurrent infections of skin and mucosa, gingivitis, periodontal diseaseImpaired phagocyte adherence, aggregation, spreading, chemotaxis, phagocytosis of C3bi-coated particles; defective production of CD18 subunit common to leukocyte integrinsReduced phagocyte surface expression of the CD18-containing integrins with monoclonal antibodies against LFA-1 (CD18/CD11a), Mac-1 or CR3 (CD18/CD11b), pl50,95 (CD1S/ CD11c); genetic detectionType 2: Mental retardation, short stature, Bombay (hh) blood phenotype, recurrent infections, neutrophiliaImpaired phagocyte rolling along endotheliumReduced phagocyte surface expression of Sialyl-Lewisx, with monoclonal antibodies against CD15s; genetic detectionPhagocyte Activation Defects(X-linked and Autosomal Recessive)NEMO deficiency: mild hypohidrotic ectodermal dysplasia; broad based immune defectrpyogenic and encapsulated bacteria, viruses, Pneumocystis, mycobacteria; X-linkedImpaired phagocyte activation by IL-1, IL-18, TLR, CD40 TNF-leading to problem with inflammation and antibody productionPoor in vitro response to endotoxin;lack of NF-B activation; genetic detectionClinical manifestationsCellular or molecular defectsDiagnosisIRAK4 deficiency: susceptibility to pyogenic bacteria such as staphylococci, streptococci, Clostridia; resistant to mycobacteria; autosomal recessiveImpaired phagocyte activation by endotoxin through TLR and other pathway; TNF-signaling preservedPoor in vitro response to endotoxin; lack of NF-B activation by endotoxin; geneticdetectionHyper IgE-Recurrent InfectionSyndrome (Autosomal Dominant)(Job's Syndrome)Eczematoid or pruritic dermatitis, "cold" skin abscesses, recurrent pneumonias with S. aureus with bronchopleural fistulae and cyst formation, mild eosinophilia, mucocutaneous candidiasis, characteristic facies, restrictive lung disease, scoliosis, delayed primary dental deciduationReduced chemotaxis in some patients, reduced suppressor T cell activityClinical features, involving lungs, skeleton, and immune system; serum IgE > 2000 IU/mL | 2,063 | medmcqa_train |
Safety valve mechanism is: | There is little change in the width of the dental arch anterior to the first permanent molars after the fifth or sixth year of life.
In the mandibular dentition, mandibular intercanine width is relatively complete by 9–10 years of age in both boys and girls.
In the maxilla, intercanine width is essentially completed by 12 years of age in girls, but continues to grow until 18 years of age in boys.
Hence, the maxillary intercanine dimension serves as a ‘safety valve’ for this basal discrepancy. | 2,064 | medmcqa_train |
Which of the following drugs is useful in prophylaxis of motion sickness? | Ans. (A) Hyoscine(Ref: KDT 8th/e p132)Hyoscine is used for the prophylaxis of motion sickness whereas other drugs listed in the question are used for the treatment of vomiting. | 2,065 | medmcqa_train |
Middle meningel vessel damage results in - | Ans-D | 2,066 | medmcqa_train |
Most common mode of transmission of HIV world wide is - | most common mode of transmission of HIV virus is through hetrosexual REF:ANANTHANARAYANAN TEXT BOOK OF MICROBIOLOGY 9EDITION PGNO.570 | 2,067 | medmcqa_train |
Annexin V is associated with which of the following? | Annexin V is a calcium-dependent phospholipid binding protein that has a high affinity for the phophatidylserine (PS), a plasma membrane phospholipid. One of the earliest features of apoptosis is the translocation of PS from the inner to the outer leaflet of the plasma membrane, thereby exposing PS to the external environment. Annexin V binds to PS exposed on the cell surface and identifies cells at an earlier stage of apoptosis than assays based on DNA fragmentation. The Annexin V Assay, a classical technique for detecting apoptosis, is the most commonly used method for detecting apoptosis by flow cytometry. | 2,068 | medmcqa_train |
Black gun pow der composition - | Ans. is 'c' i.e., Charcoal 15% + Potassium nitrate 75% + sulphur 10% The classical gun powder is known as black powder, consists of charcol (15%), Sulphur (10%), and potassium nitrate (75%). Depending on fineness, the black gun powder is designated as FG, FFG, FFFG. etc. (F = fineness). Pyrodex is another gun powder with same components, but with different ratios.Black gun powder produces smoke, i.e. It is smoke producing pow der. Smokeless powder, in addition to black powder, has nitrocellulose (single base), or nitrocellulose plus nitroglycerine (double base), or nitrocellulose plus nitroglycerine plus nitroguanidine (triple base). Semi smokeless pow der has 80% black pow der and 20% smokeless powder (nitrocellulose). | 2,069 | medmcqa_train |
Ultrasound scanning of a fetus shows asymmetric growth retardation. It may be associated with the following pathology: | Asymmetric intrauterine growth retardation (IUGR) is seen in chronic placental insufficiency due to inadequate substrate transfer. The fetus is affected in later months during the phase of cellular hyperophy. The placental pathology includes, Placenta prae Abruption Circumvallate Infarction Mosaicism Poor placentation Symmetric IUGR is seen in genetic disease or infection. The fetus is affected from the noxious effect very early in the phase of cellular hyperplasia. Ref: Textbook of Obstetrics by DC Dutta, 6th edition, Page 463-464. | 2,070 | medmcqa_train |
Which of the following is not a heterophile reaction? | HETEROPHILE REACTION :- Similar antigens on dissimilar organisms are called heterophile antigens Closely related antigens can occur on a wide variety of organisms. Antibodies reacting with such antigens are called heterophile antibodies. Serologic tests employing such antigens are called heterophile tests. Frie's test is used in the diagnosis of LGV. Antigen made from sterile pus aspirated from previously unruptured LGV abscesses, produces a reaction in patients with lymphogranuloma inguinale when injected intradermally. | 2,071 | medmcqa_train |
Tumor commonly seen in the area marked below | Most sporadic gastrinomas are located in the first and second pa of the duodenum. The anatomical area comprising the head of the pancreas, the superior and descending poion of the duodenum and the relevant lymph nodes has been called the 'gastrinoma triangle' because it harbours the vast majority of these tumoursRef: Bailey and Love 27e pg: 851 | 2,072 | medmcqa_train |
Most of the incidentalomas are | An incidentaloma is an adrenal mass, detected incidentally by imaging studies conducted for other reasons, not known previously to have been present or causing symptomsMore than 75% are non-functioning adenomas but Cushing's adenomas, phaeochromocytomas, metastases, adrenocoical carcinomas and Conn's tumours can all be found this wayRef: Bailey and Love 27e pg: 839 | 2,073 | medmcqa_train |
A patient presented with neck swelling. Cytology showed showed parafollicular cells along with clusters of plasmacytoid and few spindle shaped cells. What investigation should be done to follow up the patient? | Ans. (a) CalcitoninCytology showed showed parafollicular cells along with clusters of plasmacytoid and few spindle shaped cells are suggestive of medullary ca thyroid and so should be followed up by its tumor marker calcitonin. | 2,074 | medmcqa_train |
Treatment of choice of small preputial Penile carcinoma is | Wide local excision with 2 cm margin is done for small preputial penile carcinoma. | 2,075 | medmcqa_train |
All are impoant laboratory features of hereditary spherocytosis, EXCEPT: | Laboratory diagnosis of hereditary spherocytosis The anemia is usually normocytic. Increase in mean corpuscular hemoglobin concentration (MCHC)- (The only condition in which an increased MCHC is seen.) The diagnosis is on the basis of red cell morphology and osmotic fragility, a modified version called the pink test. Ref: Harrison, E-18, P-875. | 2,076 | medmcqa_train |
All are transmitted by blood except aEUR' | Epstein Barr Virus ??? Viruses associated with blood transfusion: Hepatitis C virus: Hepatitis G virus: Hepatitis B virus HIV type I HTLV Type Cytomegalovirus Parvovirus 13-19 HGV A recently discovered and identified non A-E hepatitis virus has been designated the name Hepatitis G virus (HGV) which is a member afflaviviridae HGV is distinct.from hepatitis C virus (HCV) and the newly discovered GBVA and GBV-B agents. The structure of the HGV genome resembles that of HCV. The structure of the HGV genome resembles that of HCV. HGV replicates in peripheral blood eels! while replication in liver cells has not been observed till date. It does nor appear to cause liver disease. Epidemiological data indicates that virus is prevalent throughout the world and has clearly resblished transmission modes which are: ? - Blood abd Blood products - Sexual transmission EBV can also be transmitted by blood transfusion. EBV as present in the transfused WBC. The leucocyte associated viruses are : ? CMV EBV HHV-8 (Human herpes virus type 8) HTLV-1 & HTLV-11 HIV We are not sure of the answer. Now we should look for the virus which is least commonly transmitted. There is confusion in this too because both EBV and Parvovirus are rare with transfusion. An impoant point All the viruses mentioned in the question are not routinely screened for blood transfusion. The America' Red cross performs laboratory tests for multiple infectious disease markers on every unit of donated blood. These tests includes: ? - Chagas disease - Hepatitis B virus (HBV) - Hepatitis C virus (HCV) - HIV (1,2) - HTLV-I - Syphilis - West nile virus (WNV) | 2,077 | medmcqa_train |
Drug of choice for treatment of epiglottitis is | Ampicillin or third generation cephalosporins are effective against H. influenzae and are given by parenteral route (i.m. or i.v.) without waiting for results of throat swab and blood culture. Ref: PL Dhingra 7th edition of Ear, Nose and Throat; Pg no 328 | 2,078 | medmcqa_train |
APRV stands for: | APRV - Airway Pressure Release Ventilation Mode of mechanical ventilation that is less common than pressure control or volume control, APRV was described initially by Stock and Downs in 1987 as a continuous positive airway pressure (CPAP) with an intermittent release phase. APRV applies CPAP (P high) for a prolonged time (T high) to maintain adequate lung volume and alveolar recruitment, with a time-cycled release phase to a lower set of pressure (P low) for a sho period of time (T low) or (release time) where most of ventilation and CO2 removal occurs Using high-flow (demand valve) CPAP circuit, unrestricted spontaneous breathing can be integrated and can happen any time regardless of the ventilator cycle. If the patient has no spontaneous respiratory effo, APRV becomes typical to 'inverse ratio pressure'-limited, 'time cycle'-assisted mechanical ventilation (pressure-controlled ventilation). | 2,079 | medmcqa_train |
Which of the following is an ocular emergency ? | Ans. is 'd' i.e., All of the above Ocular emergencies include those conditions that result in acute, severe pain in association with sudden vision loss, or that may lead to vision loss if left untreated; and traumatic conditions that affect globe or adnexa. Comon ophthalmic emergencies are :- Acute congestive glaucoma Ruptured globe Ulcerative or traumatic corneal diseases Optic neuritis Hyphema Endophthalmitis Acute blindness Orbital cellulitis Eyelid or conjunctival laceration Central retinal aerial occlusion (CRAG) Anterior lens subluxation Retinal detachment | 2,080 | medmcqa_train |
Most sensitive diagnosis test for ectopic pregnancy | Transvaginal ultrasound Diagnosis of Ectopic pregnancy Pregnancy is definitely diagnosed by demonstrating intrauterine sac. - A normal intrauterine sac appears regular and well defined on ultrasound. So ectopic pregnancy can be diagnosed by demonstrating the absence of the intrauterine sac. In a woman in whom ectopic pregnancy is suspected because of pain, bleeding and positive pregnancy test, performance of vaginal sonography is the logical first step. If the sonography demonstrates live intrauterine fetus then ectopic pregnancy is extremely unlikely. Alternatively if the uterus is empty, an ectopic pregnancy can be diagnosed based on the visualization of an adnexal mass separate from the ovaries. 3-hCG hormones also play an impoant role in the diagnosis of pregnancy. fi HCG is a hormone secreted during pregnancy. It is positive in viually 100% of ectopic pregnancies. However, a positive test only confirms pregnancy and does not indicate whether it is intrauterine or extrauterine. In normal pregnancy pHCG should double up every 2 days but in ectopic pregnancy the rate of increase of fl hCG is slow. 13 hCG litres and ultrasound complement one another in detecting ectopic pregnancy and have led to earlier detection. By correlating fl hCG titres with ultrasound .findings an ectopic pregnancy can often be differentiated.from intrauterine pregnancy. An intrauterine sac should be visible by transvaginal ultrasound when the p hCG is approximately 1000 ml p/m1 and by transabdominal ultrasound approximately 1 week later when the fi hCG is 1800-3600 ?nip/int. Thus when an empty uterine cavity is seen with a 13 hCG litre above this threshold, the patient is likely to have an ectopic pregnancy. An empty cavity is less of a concern when a fihCG below this threshold is obtained. Serum progesterone measuremen A single measurement of serum progesterone may sometimes clarify the diagnosis when ectopic pregnancy is suspected, but Its accuracy is crude and the customary thresholds are < 5 ng/m and > 25 'tend. i.e.a value exceeding 25 ng/m1 excludes ectopic pregnancy with 97.5% sensitivity, value below 5 ng/ml occur in only .3 percent of normal regnancies. So normal pregnancies can be excluded if the progesterone level is below 5%. Surgical diagnosis of ectopic pregnancy :- Laparoscopy Direct visualization of the ,fallopian tubes and pelvis by diagnostic laparoscopy offers a reliable diagnosis in most cases of suspected ectopic pregnancy and a ready transition to definitive operative therapy. At times, identification of an early unruptured tubal pregnancy may be difficult even if the tube is .fully visualized. Inspite of the low morbidity and quick recovery time, laparoscopy usually is performed when, on the basis of noninvasive test or curettage results, the diagnosis of ectopic pregnancy is fairly ceain and medical therapy is not planned. In these cases laporoscopy is used both for therapeutic and diagnostic purpose. Laparotomy Open abdominal surgery is preferred when the woman is hemodynamically unstable or when laparoscopy is not feasible. Laparotomy should not be delayed while laparoscopy is performed in a woman with obvious abdominal hemorrhage that required immediate definitive treatment. Culdocentesis Culdocentesis is the transvaginal passage of a needle into the posterior cul-de-sac in order to determine whether free blood is present in the abdomen. This procedure is useful in the diagnosis of intraperitoneal bleeding. This procedure will reveal nonclotting blood if intra-abdominal bleeding has occurred. If culdocentesis is positive, laparoscopy or laparotomy should be performed immediately. Indeed, some argue that the main purpose of culdocentesis is, not in diagnosis but to better prioritize patients so that those with positive culdocentensis are taken immediately to the operating room. More on imaging procedures used in the diagnosis of ectopic pregnancy Vaginal sonography There has been much improvement in the early diagnosis of ectopic pregnancy using vaginal sonography. Its use results in earlier and more specific diagnosis of uterine pregnancy than abdominal sonography and it has become the imaging method of choice in early pregnancy. Abdominal sonography:- Id entification of pregnancy products in the fallopian tube. | 2,081 | medmcqa_train |
Maternal mortality rate (MMR) is defined as - Number of maternal deaths per | (B) 1,00,000 live births # Maternal mortality rate (MMR) - number of maternal deaths per 1,00,000 women of reproductive age per year. In India it is about 120 as compared to 0.5 of United States. | 2,082 | medmcqa_train |
A 10-mm calculus in the right lower ureter associated with proximal hydroureteronephrosis is best treated with: | Answer is D (Ureteroscopic Retrieval) : The patient in question has a small calculus (1.0 cm) in size, which is located in the distal ureter and hence is amenable to ureteroscopic removal. The presence of proximal hydroureteronephrosis indicates obstruction and forms- the indication for clone removal. Indications and mahods for removal of stone Indications for stone removal Repeated attacks of colic Stone is too large to pass Stone is enlarging Stone is not moving Stone is causing complete obstruction of the kidney Urine is infected Ureteroscopic Removal Small stone Stone in lower pa of ureter within 5-6 cm of ureteric orfice Extracorporal shock wave Lithotripsy Best for proximal stones that can be identified by the imaging system of Lithotriptor Stones in miduretor can be pushed up in the pelvis and then exposed to shock waves Not appropriate if complete obstruction is present Stones < 2.0 to 2.5 cm can be removed Percutaneous Nephrolithotripsy It is done for proximal ureteric cacluli Stones > 2.5 cm, those that are resistant to shock waves Open Surgery is done very rarely nowadays when all methods have failed, Urethrolithotomy is done for long standing calculi not accessible by instruments and ESWL. | 2,083 | medmcqa_train |
Mother to child transmission of HIV - | HIV may pass from infected mother to foetus through placenta or to her infant during delivery. In absence of any intervention rate of this vary from 20-25%. Reference; Park&;s Textbook of preventive and social medicine, 24th edition.Pg no. 364 | 2,084 | medmcqa_train |
False statement regarding xenon is_____ | Xenon is Non- teratogenic.Option A: Xenon has a very low blood-gas solubility coefficient (0.115) and produces rapid induction of and emergence from anaesthesia.Option B: Xenon produces no green house effect or ozone depletion and is environmentally safe, unlike the other inhaled anaesthetics.Option D: Does not trigger malignant hypehermia Other advantages of xenon:IneMinimal cardiovascular effects- It produces minimal cardiovascular depression, and it is not arrhythmogenic.Non explosiveHas Analgesic activity - reduces intraoperative opioid requirements Disadvantages of Xenon High costLow potency (MAC = 70%)Xenon gas has a very high density (5.9 g/L) resulting in increased flow resistance and work of breathing. Thus, it may be a poor choice for patients wicompromised respiratory function | 2,085 | medmcqa_train |
Androgenic alopecia in female is caused by: | Ans. C. Stein-Leventhal syndromeAndrogenetic Alopecia (Male pattern; Female pattern): AssociationsIn women, features of hyperandrogenism may be present inthe form of hirsutism, acne & clitoromegaly.Always rule out polycystic ovary disease (PCOD).Stein-Leventhal syndrome, also called polycystic ovary syndrome (PCOS)Myxedema:Hair texture may become fine, and a diffuse alopecia occurs in up to 40% of patients, persisting for months after restoration of euthyroidism. | 2,086 | medmcqa_train |
True about Burkitt's lymphoma are: | Burkitt's lymphoma is associated with t(8:14). It has an increased MYC and BCL6 protein expression. Characteristic "starry sky" pattern is seen. | 2,087 | medmcqa_train |
Singers Alkali denaturation test is done with : | Ans. is b i.e. Fetal Hb Ref. Dutta Obs. 6/e, p 247-248: Williams Obs. 23/e, p 583, 584; Text book of Ohs. by Sheila Balakrishnan, p 167-168 Fetal hemoglobin can be distinguished from Adult hemoglobin by : Wright stain : On staining blood with wright stain if RBC's appear nucleateddeg the blood is of fetal origindeg. Singers alkali denaturation test : It is based on the fact that fetaldeg hemoglobin is more resistant to alkali denaturationdeg. Test -- Blood + Sodium hydroxide/ Potassium hydroxide | 2,088 | medmcqa_train |
NOT a feature of Atrial Septal defect among the
following | Left Atrial hypertrophy is never seen in ASD. | 2,089 | medmcqa_train |
Which of the following drug causes Pseudotumour cerebri - | Ans. is 'b' i.e., Tetracycline Drugs causing Pseudotumour cerebri o A miodarone o Mineralocoicoids (withdrawl) o Oral contraceptives o Glucocoicoids (withdrawl) o Hypervitaminosis A o Tetracyclines o Quinolones | 2,090 | medmcqa_train |
Last taste sensation discovered is- | Ans. is 'a' i.e., Umami o Umami a savory taste s one of the five basic tastes (together with sweetness, sourness, bitterness, and saltiness)o People taste umami through receptors specific to glutamate. Glutamate is widely present in savory foods, such as meat broths and fermented products, and commonly added to some foods in the form of monosodium glutamate (MSG) Since umami has its own receptors rather than arising out of a combination of the traditionally recognized taste receptors, scientists now consider umami to be a distinct taste | 2,091 | medmcqa_train |
All can cause peripheral neuropathy except | All other options are commonly associated with peripheral neuropathy except hypothyroidism | 2,092 | medmcqa_train |
Estimation of serum levels is impoant for which of the following drug: September 2009 | Ans. C: LithiumLithium has been the drug of choice for the treatment of maniac episode (acute phase) as well as for prevention of fuher episodes in bipolar mood disorder.It has also been used in the treatment of depression with less success.Lithium needs to be closely monitored by repeated blood levels, as the difference between the therapeutic (0.8-1.2 mEq/ L) and lethal blood levels (more than 2.5-3.0 mEq/1) is not very wide (narrow therapeutic index). | 2,093 | medmcqa_train |
Curie is the unit for – | Units of Activity .
The activity of radioactive material is the number of nuclear disintegration per unit of time.
The units of activity.
Bacquerel
Curies | 2,094 | medmcqa_train |
Linitus plastic is the type of - | Stomach cancer Ca stomach may be divided into five morphological subtypes, that correlate loosely with the natural history and outcome.
Ulcerang Ca
Polypoidal Ca
Superficial spreading Ca Also known as early gastric cancer, superficial ca is confined to mucosa and submucosa.
These cancers have an excellent prognosis (-90% 5-year survival rate) are resection 4 Lins plasma or Scirrhous Ca These tumors infiltrate the entire thickness of the stomach and cover a very large surface area, commonly involve the entire stomach. The marked desmoplastic reason is noted, the stomach loses its pliability. It has the worst prognosis of all types as the spread is early.
Advanced carcinoma This largest category' contains the big tumors that are found partly within and partly outside the stomach.
They may originally have qualified for inclusion in one of the preceding groups but have outgrown that early stage | 2,095 | medmcqa_train |
. In the fed state, major fate of Glucose 6-PO4 in tissues is : | D i.e. Storage as glycogen | 2,096 | medmcqa_train |
Which of the following disease shows autosomal dominant pattern of inheritance? | Best's disease is an autosomal dominant disorder with variable penetrance and expressivity. Bassen-Kornzwig disease is an autosomal recessive inherited disorder of lipoprotein metabolism. Gyrate atrophy is an autosomal recessive dystrophy with peripheral choroidal degeneration. Laurence-Moon-Biedle syndrome is also inherited in autosomal recessive manner. Best's disease: It is caused by a mutation in the BEST1 (VMD2) gene, which encodes a transmembrane calcium-sensitive chloride channel (bestrophin) expressed in retinal pigment epithelium. Fundus examination ranges from a mild pigmentary disturbance within the fovea to the typical vitelliform or "egg yoke" lesion located in the central macula. Visual acuity is good and electro retinogram is normal. An abnormal electro-oculogram (EOG) is the hallmark of the disease. Ref: Vaughan & Asbury's General Ophthalmology, 18 Edition, Chapter 10 | 2,097 | medmcqa_train |
Non-absorption of fat-soluble vitamins is due to | Steatorrhoea is an increase in stool fat excretion of >6% of dietary fat intake seen in malabsorption syndromes.Steatorrhoea may lead to weight loss, it is often associated with fat-soluble vitamin deficiency.Elevated alkaline phosphatase and reduced calcium levels suggest vitamin D deficiency and elevated prothrombin time suggests vitamin K deficiency.The gold standard test for steatorrhoea is quantitative stool fat estimation and the qualitative test is done using Sudan III stain, best used as a preliminary screening test.Chronic pancreatitis causes steatorhoea due to lipase deficiency(exocrine defect).Ref: Harrison's 18th e p2460, 2466 | 2,098 | medmcqa_train |
Speed of rabies virus progress in axon is | Speed of rabies virus progress in axon is 250 mm/day. | 2,099 | medmcqa_train |
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