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Complications of cataract surgery –a) Endophthalmitisb) Optic neuropathyc) Retinal detachmentd) Vitreous losse) Lagophthalmos | Important complications of cataract surgery
After cataract (opacification of the capsule)
Vitreous prolapse & loss
Cystoid macular edema
Endophthalmitis
Aphakic glaucoma
Retinal detachment
Fibrous & endothelial growth
Neovascular glaucoma
Iris prolapse
Anterior uveitis (iridocyclitis)
Strait keratopathy & pseudophakic bullous keratopathy
Corneal endothelial damage | 2,600 | medmcqa_train |
The most common cause of malignant adrenal mass is | Ans. is 'd' i.e., Metastasis from another solid tissue tumor The most common cause of adrenal tumors is metastasis from another solid tumor like breast cancer and lung cancer. Malignant Percentage Adrenocoical carcinoma 2-5% Malignant pheochromocytoma <I% Adrenal neuroblastoma <0- 1% Lymphomas (incl. primary adrena lymphoma) <1% Metastases (most frequent : Breast, lung) 15% | 2,601 | medmcqa_train |
All are components of Sewer gas except - | When the sewage is highly concentrated and contains plenty of solids the anaerobic process is highly effective. The end products of decomposition are methane, ammonia, CO2, and H2S. Park's Textbook of Preventive and Social Medicine, 25th Edition, Pg 794 | 2,602 | medmcqa_train |
Incomplete uterine rupture is defined as? | Ans. is'd' i.e., Disruption of scar with peritoneum intact Incomplete rupture :In an Incomplete uterine rupture, the mother's peritoneum remains intact.The peritoneum is the membrane that lines the abdominal cavity to suppo abdominal organs.It also acts as a channel for blood vessels and nerves.An incomplete uterine rupture is significantly less dangerous with fewer complications to the delivery process.Complete rupture:During a Complete uterine rupture, the peritoneum tears and the contents of the mother's uterus can spill into her peritoneal cavity.The peritoneal cavity is the fluid-filled gap that separates the abdomen walls and its organs.It is suggested that delivery cesarean section (C- section) should occur within approximately 10 to 35 minutes after a complete uterine rupture occurs.The fetal morbidity rate increases dramatically after this period. | 2,603 | medmcqa_train |
Insufflation pressure during laparoscopy is? | ANSWER: (B) 11-15 mm HgREF: Maingot's 10th ed p. 243The intrabdominal pressure during laparoscopy is monitored by insufflator and it is set between 12-15 mm Hg. | 2,604 | medmcqa_train |
The teiary structure of protein is determined by | Three-Dimensional Structure is determined by X-ray Crystallography or by NMR SpectroscopyRef: Harper&;s Biochemistry; 30th edition; Chapter 5; Proteins: Higher Orders of Structure | 2,605 | medmcqa_train |
Along with succinyl CoA which of the following amino acid serve as staing material in heme synthesis? | The two staing materials of heme synthesis pathway are succinyl CoA and glycine. Pyridoxal phosphate is needed to activate glycine. ALA synthase catalyzes the conversion of succinyl CoA and glycine to delta aminolevulinate. This is the rate limiting enzyme in porphyrin biosynthesis in the mammalian liver. Synthesis of ALA occurs in mitochondria. Last 3 steps of heme synthesis occur in the cytoplasm. The 3 enzymes which catalyse the reactions in cytoplasm are ferrochelatase, protoporphyrinogen oxidase and coproporphyrinogen oxidase. Coproporphyrinogen oxidase catalyze conversion of coproporphyrinogen III to protoporphyrinogen III. Protoporphyrinogen oxidase catalyze conversion of protoporphyrinogen III to protoporphyrin III. Ferrochelatase catalyze conversion of protoporphyrin III to heme by incorporating heme into protoporphyrin. Ref: Murray R.K. (2011). Chapter 31. Porphyrins & Bile Pigments. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K. Murray, V.W. Rodwell (Eds),Harper's Illustrated Biochemistry, 29e. | 2,606 | medmcqa_train |
Latanoprost (PGF0 alf | ANSWER: (D) GlaucomaREF: Goodman and Gillmans 11TH edition page 1103, http://en.udkipedia.org/wiki/Latanoprost "Latanoprost ophthalmic solution is a topical medication used for controlling the progression of glaucoma or ocular hypertension by reducing intraocular pressure. It is a prostaglandin analogue (more specifically an analogue of Prostaglandin F2a)""The PGF2a analogs consist of Latanoprost, travoprost, bimatoprost, and unoprostone. PGF2a analogs appear to lower IOP by facilitating aqueous outflow" through the accessory uveoscleral outflow pathway. The mechanism by which this occurs is unclear" | 2,607 | medmcqa_train |
Renshaw cell inhibition is an example of: | Renshaw cells are inhibitory cells that transmit inhibitory signals to the surrounding motor neurons. This anterior motor neuron gets excitatory impulses from multiple sources, if all these excitatory inputs were sent to the muscles, muscle will fatigue early, so, there is some inherent check to reduce the excitability of these motor neurons & that is in form of Renshaw cell inhibition. This is recurrent type of inhibition. The inhibitory neurotransmitters Glycine and GABA are involved in Renshaw cell inhibition. | 2,608 | medmcqa_train |
Blood culture is positive in which infection of Staphylococcus aureus is | Infections caused by methicillin-sensitive S aureus, high-magnitude bacteremia (defined as >4 positive blood cultures ), and endocarditis. The most impoant test is a blood culture used to identify bacteria in the bloodstream. REFERENCE: www.mayoclinic.org | 2,609 | medmcqa_train |
Gonadotropin levels decline to prepubertal levels by age | Gonadotropin levels gradually decline to reach prepubertal levels by age 1 to 2 years. | 2,610 | medmcqa_train |
Which among the following surgery requires lithotomy position | Ans) a (Anal) Ref: http://en.wikipedia.orgThe lithotomy position refers to a common position for surgical procedures and medical examinations involving the pelvis and lower abdomen. References to the position have been found in some of the oldest known medical documents including versions of the Hippocratic oath. The position is named after the ancient surgical procedure for removing kidney stones, gall stones and bladder stones via the perineum. The position is perhaps most recognizable as the 'often used' position for childbirth: the patient is laid on the back with knees bent, positioned above the hips, and spread apart through the use of stirrups.Obvious benefits from the position is that it provides good visual and physical access to the perineal region. The position is used for procedures ranging from simple pelvic exams to surgeries and procedures involving, but not limited to reproductive organs, urology, and gastrointestinal systems. Used for perianal surgeries like haemorrhoidectomy, fistulectomy, lateral sphinc-terotomy; perineal surgeries like APR & vaginal hysterectomy. | 2,611 | medmcqa_train |
Stool investigation of a child who presented with anemia revealed worm infestation. Which of the following worm infestation is associated with iron deficiency anemia? | The common human hookworms are Ancylostoma duodenale and Necator americanus. The larger A duodenale is more pathogenic because it consumes more blood, up to 0.5 mL per worm per day. The adult worms attach with their mouthpas to the mucosa, from which they suck blood. Blood loss is the major sequel of infection which leads to iron-deficiency anemia. Chronic hookworm infection is a common cause of moderate and severe hypochromic microcytic anemia, and heavy infection can cause hypoproteinemia with edema. Chronic hookworm infection in children may lead to growth delay, deficits in cognition, and developmental delay. Ref: Dominguez S.R., Levin M.J. (2012). Chapter 43. Infections: Parasitic & Mycotic. In W.W. Hay, Jr., M.J. Levin, R.R. Deterding, J.J. Ross, J.M. Sondheimer (Eds), CURRENT Diagnosis & Treatment: Pediatrics, 21e. | 2,612 | medmcqa_train |
Homonymous hemianopsia is associated with lesion at | (C) Optic tract > It is difficult to localize a postchiasmal lesion accurately, because injury anywhere in the optic tract, lateral geniculate body, optic radiations, or visual cortex can produce a homonymous hemianopia, i.e., a temporal hemifield defect in the contralateral eye and a matching nasal hemifield defect in the ipsilateral eye | 2,613 | medmcqa_train |
Tumor that follows rule of 10 is | Pheochromocytomas are neoplasms composed of chromaffin cells. They follow rule of 10: - 10% of pheochromocytomas are extra adrenal - 10% of sporadic adrenal pheochromocytomas are bilateral - 10% of adrenal pheochromocytomas are biologically malignant. -10% of adrenal pheochromocytomas are not associated with hypeension. Ref: Robbins and cotrans 9e | 2,614 | medmcqa_train |
Cystic hygroma may be associated with: March 2005 | Ans. D: All of the above Karyotypic abnormalities are present in 25-70% of children with Cystic Hygroma. CH has been noted to be more common in persons with: Turner's syndrome Klinefelter's syndrome Down's syndrome In addition, several nonchromosomal disorders, including Noonan syndrome, Fryns syndrome, multiple pterygium syndrome, and achondroplasia, are associated with an increased incidence of CH. Intrauterine alcohol exposure has been associated with the development of lymphangiomas. Dissolution of bone caused by either lymphangiomas or hemangiomas is termed Gorham-Stout syndrome | 2,615 | medmcqa_train |
False regarding electron transport chain is: | (Refer: DM Vasudevan, Textbook of Biochemistry, 7th edition, pg no: 266)
Inhibitors of electro transport chain and Oxidative phosphorylation | 2,616 | medmcqa_train |
During laryngoscopy and intubation procedure, all of these are true, except: | Ans: D. After inseion of laryngoscope, it is levered on the upper incisor to pull up the tongue and visualize the vocal cords(Ref: Miller 81c, p I 666-7667. 71e p1587).The laryngoscope should never be hinged on the teeth to lift up the epiglottis.The patient is aligned in a "sniffing" position, i.e. neck (atlanto-axial joint) flexion and face extension (atlanto-occipital joint), at around 35deg and 15deg respectively | 2,617 | medmcqa_train |
In Refeeding syndrome, all the given lab valves are monitored except | In Refeeding syndrome, hypocalemia, hypophosphatemia, hypomagnesemia occurs. Hence, they are monitored. Ammonia levels are not altered. | 2,618 | medmcqa_train |
At how many weeks of gestation can Hegar's sign be elicited? | Hegar's sign refers to widening and softening of of the body or isthmus of the uterus. It usually occurs at 6-8 weeks of gestation. Softening and dilatation at the external os is caused by estrogen and progesterone. Chadwick's sign: It refers to bluish discoloration of cervix caused by congestion of pelvic vasculature. It is a presumptive sign of pregnancy. Jacquemier's sign: It refers to congested appearance of vaginal mucosa. Osiander's sign: It refers to increased pulsations felt in the lateral fornices at 8 weeks of gestation. Goodell's sign: It refers to softening of the cervix. Palmer's sign: refers to intermittent contractions of the uterus. Ref: Bernstein H.B., VanBuren G. (2013). Chapter 6. Normal Pregnancy and Prenatal Care. In A.H. DeCherney, L. Nathan, N. Laufer, A.S. Roman (Eds),CURRENT Diagnosis & Treatment: Obstetrics & Gynecology, 11e. Manual Of Obstretics, 3/e By Daftary page 54 | 2,619 | medmcqa_train |
The major initiating response for peristalsis is | The major initiating response for peristalsis is local stretching of the gut. Peristalsis is a reflex that is initiated when the gut wall is stretched by the contents of the lumen. It occurs in all pas of the gastrointestinal tract from the esophagus to the rectum. The stretch initiates a circular contraction behind the stimulus and an area of relaxation in front of it. The wave of contraction then moves in an oral-to-caudal direction. This propels the contents of the lumen forward at rates that vary from 2 to 25 cm/s Ref: Ganong&;s Review of Medical Physiology 26th edition Pgno: 485 | 2,620 | medmcqa_train |
Semicircular canal perceives ___________ | They respond to angular acceleration and deceleration. The three canals lie at right angles to each other but the one which lies at right angles to the axis of rotation is stimulated the most. Thus horizontal canal will respond maximum to rotation on the veical axis and so on. Due to this arrangement of the three canals in three different planes, any change in position of head can be detected. | 2,621 | medmcqa_train |
Fetal tachycardia is defined as heart rate more than___ | Ans. B. 160. (Ref Williams obstetrics 20th/pg. 1428; Danforth9s obstetrics and gynecology - pg.157)Fetal bradycardia is defined as fetal heart rate <110 bpm; fetal tachycardia is defined as fetal heart rate >160 bpmThe normal FHR baseline ranges from 120 to 160 beats per minute.Foetal tachycardia is defined as a baseline heart rate greater than 160 bpm and is considered a nonreassuring pattern.Fetal Bradycardia is defined as an abnormally low baseline FHR (<110 beats per minute). Bradycardia is a baseline fetal heart rate under 120 beats/min that lasts 15 minutes or longer. Bradycardias are defined as 80 to 100 beats/min, and severe bradycardias are less than 80 beats/min, | 2,622 | medmcqa_train |
Angina pectoris and syncope are most likely to be associated with | Ref Harrison 19 th ed pg 1530 patients with pure or predominant AS have gradually increas- ing obstruction over years but do not become symptomatic until the sixth to eighth decades. Adult patients with BAV disease, however, develop significant valve dysfunction and symptoms one to two decades sooner. Exeional dyspnea, angina pectoris, and syncope are the three cardinal symptoms. | 2,623 | medmcqa_train |
Organ of coi is situated in ? | Scala media (cochlear duct or membranous labyrinth) has 3 walls : -i) The basilar membrane, which suppos the organ of coi.ii) The Reissner's membrane which separates it from the scala vestibuli.iii) The stria vascularis which contains vascular epithelium and is concerned with secretion of endolymph. | 2,624 | medmcqa_train |
All of the following statements are true regarding warfarin toxicity except | Refer Harrison 18/e p433 Common sites of warfarin -induced skin necrosis are breasts, thighs and buttocks | 2,625 | medmcqa_train |
Frequent blushing ("erethism") is associated with poisoning of | Mechanism of toxicity:Mercury reacts with sulfhydryl (SH) groups, resulting in enzyme inhibition and pathologic alteration of cellular membranes.Clinical presentation:Severe chemical pneumonitis and noncardiogenic pulmonary edema.Acute gingivostomatitis may also occur.Chronic intoxication:Classic triad Tremor Gingivostomatitis. Metallic tasteFrequent blushing ("erethism")Pain in the extremities, often accompanied by pinkish discoloration and desquamation ("pink disease") | 2,626 | medmcqa_train |
Excretory poion of kidney is formed by? | DERIVATIVES OF MESONEPHRIC DUCT Both in Males and a Females Collecting tubules Minor and major calyces Pelvis Ureter Trigone of bladder In Males Epidydymis Vas derferens Seminal vesicles Mesoderm of prostate Ejaculatory duct In Females Ganers duct | 2,627 | medmcqa_train |
Fear of open spaces is: NIMHANS 07; Kerala 11 | Ans. Agoraphobia | 2,628 | medmcqa_train |
Treatment of systemic or disseminated variant of sporotrichosis is | Sporotrichosis:- Treatment:- : * Lymphocutaneous disease:- itraconazole, terbinafine, saturated solution of potassium iodide (SSKI) * Disseminated infection:- Amphotericin B (AMB). Ref:- Dermatology review by Asra Ali; pg num:-364 | 2,629 | medmcqa_train |
Which is not a finding in viral encephalitis? | Ans. is 'a' i.e., Astroglial proliferation The pathologic Changes in viral encephalitis are : Parenchymal infiltrate chiefly in perivascular location, of mononuclear cells consisting of lymphocytes, plasma cells, macrophages. o Microscopic clusters of MICROGLIAL cells and presence of Neuronophagia. o Viral infection can lead to : - i) Intranuclear inclusions Herpes infection (Cowdry body 'A') ii) Cytoplasmic inclusions --> Rabies (Negri body) iii) Both intranuclear & --> Cytomegalovirus. cytoplasmic inclusions | 2,630 | medmcqa_train |
Oblique view in XRAY of hand is required for diagnosis of | Oblique view of the wrist is required for scaphoid fracture * Most common fractured bone in the wrist * Peanut shaped bone that spans both row of carpal bones * Does not require excessive force and often not extremely painful so can be delayed presentation * Pain over the anatomic snuff box * Pain is not usually severe * Often present late Scaphoid Fracture Treatment * Cast 6-12 weeks * Sho arm vs. long arm * Follow patient every 2 weeks with x-ray * CT and clinical evaluation to determine healing * Consider screwing early Ref: Maheshwari and Mhaskar 9th ed pg 367. | 2,631 | medmcqa_train |
The pa of the broad ligament giving attachment and suppo to the uterine tube is the: | The mesosalpinx is the pa of broad ligament that suppos the uterine tube. The mesosalpinx extends inferiorly to meet the root of the mesovarium; it attaches the uterine tube to the mesometrium. The mesometrium is the pa of the broad ligament below the junction of the mesosalpinx and the mesovarium; it attaches the body of the uterus to the pelvic wall. The mesovarium is the pa of broad ligament that forms a shelf-like fold suppoing the ovary. It attaches the ovary to the mesometrium and mesosalpinx. The round ligament of the uterus is a connective tissue band that attaches the uterus to the inner aspect of the labium majus. It is found in the broad ligament, and it traverses the inguinal canal. Ref: Hoffman B.L., Schorge J.O., Schaffer J.I., Halvorson L.M., Bradshaw K.D., Cunningham F.G., Calver L.E. (2012). Chapter 38. Anatomy. In B.L. Hoffman, J.O. Schorge, J.I. Schaffer, L.M. Halvorson, K.D. Bradshaw, F.G. Cunningham, L.E. Calver (Eds), Williams Gynecology, 2e. | 2,632 | medmcqa_train |
Koplik spot is pathognomic of which infection ? | Ans. is 'd' i.e., Measles | 2,633 | medmcqa_train |
All the following are features of Anorexia Nervosa except : | Ans.is C (Amenorrhea is rare):Anorexia nervosa often referred to simply as anorexia, is an eating disorder, characterized by low weight, food restriction, fear of gaining weight, and a strong desire to be thin.Complications may include osteoporosis, infeility, and hea damage, among others. Women will often stop having menstrual periods.Amenorrhea is associated with almost a hundred percent of cases of Anorexia Nervosa. | 2,634 | medmcqa_train |
Most likely diagnosis ? | CT scan of chest showing enlarged pulmonary aeries In interstitial lung diseases HRCT shows bilateral subpleural reticular changes,with traction bronchiectasis and honeycombing(idiopathic pulmonary fibrosis).and varies according to cause of ILD. In bronchiectasis CT shows: tram tracts and signet ring sign. | 2,635 | medmcqa_train |
Type II respiratory failure best relates to which of the following? | TYPE II RESPIRATORY FAILUREThis type of respiratory failure is a consequence of alveolar hypoventilation and results from the inability to eliminate carbon dioxide effectively. Mechanisms are categorized by Impaired central nervous system (CNS) drive to breathe (drug overdose, brainstem injury, sleep-disordered breathing, and severe hypothyroidism), Impaired strength with failure of neuromuscular function in the respiratory system. Reduced strength can be due to impaired neuromuscular transmission (e.g., myasthenia gravis, Guillain-Barre syndrome, amyotrophic lateral sclerosis) or respiratory muscle weakness (e.g., myopathy, electrolyte derangements, fatigue).Increased load(s) on the respiratory system. The overall load on the respiratory system can be subclassified into Resistive loads (e.g., bronchospasm), Loads due to reduced lung compliance (e.g., alveolar edema, atelectasis, intrinsic positive end-expiratory pressure --see below), Loads due to reduced chest wall compliance (e.g., pneumothorax, pleural effusion, abdominal distention), and ads due to increased minute ventilation requirements (e.g., pulmonary embolus with increased dead-space fraction, sepsis).Ref: Harrison 19e pg: 1732 | 2,636 | medmcqa_train |
Muscle that does not arises from the common tendinous ring at the apex of orbit is? | The four recti arise from a common annular tendon or tendinous ring of zinn. This ring is attached to the orbital surface of the apex of the orbit. It encloses the optic canal and the middle pa of the superior orbital fissure.The lateral rectus has an additional small tendinous head which arises from the orbital surface of the greater wing of the sphenoid bone lateral to the tendinous ring. The inferior oblique arises from the orbital surface of the maxilla, lateral to the lacrimal groove. The muscle is situated near the anterior margin of the orbit. Refer BDC sixth edition volume 3 page no: 266 ,267 Refer table 17.2 | 2,637 | medmcqa_train |
Which of glial cell is mesodermal in origin - | Ans. is 'b' i.e., Microglial cellso Microglial cells are derived from mesenchymal (mesodermal) cells.Development of cells in CNSCells of originDeveloped mature cellsNeuroepithelial cellso Neuronso Glial cells (Macroglial cells)# Oligodendrocytes# Astrocytes# Ependymal cellsMesenchymal (mesodermal) cellso Microglial cells | 2,638 | medmcqa_train |
Which muscle is most resistant to neuromuscular blockage? | ANSWER: (A) DiaphragmREF: Lee synopsis of anesthesia 13th e p. 182, Morgan 4th e p. 206-15Diaphragm is the most resistant muscle to muscle relaxants. | 2,639 | medmcqa_train |
Fibroid with a typical "Lantern on top of St Paul's cathedral" appearance is | Cervical Fibroid is compared to "Lantern on dome of st Paul's catherdral". | 2,640 | medmcqa_train |
'Inveed fir tree' appearance is characteristic of? | B anthracis has a tendency to form very long chains of rods and in culture it is nonmotile and nonhemolytic. Colonies are characterized by a rough, uneven surface with multiple curled extensions at the edge resembling a "Medusa head." B anthracis has a D-glutamic acid polypeptide capsule of a single antigenic type that has antiphagocytic propeies. B anthracis endospores are extremely hardy and have been shown to survive in the environment for decades. On gelatin stab culture a characteristic inveed fir tree appearance is seen, with slow liquefaction commencing from top. Ref: Ray C.G., Ryan K.J. (2010). Chapter 26. Corynebacterium, Listeria, andBacillus. In C.G. Ray, K.J. Ryan (Eds), Sherris Medical Microbiology, 5e. | 2,641 | medmcqa_train |
Ranula is a: March 2013 (a, d, e) | Ans. A i.e. Retention cystBailey & Love (Surgery) states that ranula is an extravasation cyst, but CSDT (Surgey), Dhingra (ENT) & even internet references describe it as retention cyst. | 2,642 | medmcqa_train |
Which cerebral layer is referred as "Internal granule cell layer"? | Layer/Lamina IV of cerebral coex. Layer/Lamina IV - "Internal granule cell layer" Contains predominately granule cells & nerve fibers. Specific sensory input through thalamocoical fibers terminate primarily in coical layer IV on stellate (granule cells). Diffuse non-specific sensory afferents are distributed through layer I-IV. OTHER LAYERS OF CEREBRAL COEX: Composed of 6 layers - Layer/Lamina I - "Molecular layer" Contains nerve fibers. Mainly dendrites of pyramidal cells & axons of granular cells. Layer/Lamina II - "External granule cell layer" Contains mainly granule cells. Layer/Lamina III - "External pyramidal cell layer" Contains mainly small to medium size pyramidal cells Some granular cells also present Layer/Lamina V - "Internal pyramidal cell layer" Contains large pyramidal cells. Descending tracts, i.e. projection fibers from coex (coicospinal tract, coicobulbar tract) are the axons of these pyramidal cells of Layer V Layer/Lamina VI - "Multiform layer" Contains all types of cells | 2,643 | medmcqa_train |
Periodic acid schiff stain shows Block positivity | Lymphoblast contain cytoplasmic aggregates of periodic acid-schiff (PAS)-positive material. | 2,644 | medmcqa_train |
Pataus syndrome due to ? | Ans. is 'd' i.e., Trisomy 13 | 2,645 | medmcqa_train |
Which of the following inherited neutropenias show a self limited course? | Answer- D. Autoimmune neutropenia of infancyIt is recognized as a fairly specific syndrome of early childhood.Low neutrophil numbers are often discovered during the course ofroutine investigation for benign febrile illness.The illness abates but the neutropenia persists, sometimes for months and occasionally for years.The prognosis is good and neutropenia is self-limited albeit protracted, and patients seldom develop serious bacterial infections. | 2,646 | medmcqa_train |
What is true about Salter-Harris type IV epiphyseal injury: | Ans: C (Fracture occur through growth plate, metaphysic & epiphysis) SALTER~HARRIS FRACTURES http://wwwlbpt.bridgeport.edu/-gwl/salter-barrisdassification.htmThere are nine types of Salter-Harris fractures; types 1 to V as described by Robert B Salter and W Robert Harris in 1963, and the rarer types V! to IX which have been added subsequently:Type I - A transverse fracture through the growth plate (also referred to as the "physis"): 6% incidenceType II - A fracture through the growth plate and the metaphysis, sparing the epiphysis: 75% incidence, takes approximately 2-3 weeks to heal.Type III - A fracture through growth plate and epiphysis, sparing the metaphysis: 8% incidenceType IV - A fracture tb rough all three elements of the bone, tbegrowth plate, metaphysis, and epiphysis: 10% incidenceType V - A compression fracture of the growth plate (resulting in a decrease in the perceived space between theepiphysis and diaphysis on x-ray): 1% incidenceType VI -Injury to the peripheral portion of the physisand a resultant bony bridge formation which may produce an angular deformity (added in 1969 by Mercer Rang)Type VII - Isolated injury of the epiphyseal plate (VII--IX added in 1982 by JA Ogden)Type VIII - Isolated injury of the metaphysis with possible impairment of endochondral ossificationType IX - Injury of the periosteum which may impair intramem bra nous ossificationThe mnemonic "SALTR" can be used to help remember the first five types: This mnemonic requires the reader to imagine the bones as long bones, with the epiphyses at the base,I - S = Slip (separated or straight across), Fracture of the cartilage of the physis (growth plate)II - A = Above. The fracture lies above the physis, or Away from the joint.III - L = Lower. The fracture is below the physis in the epiphysis.IV - TE = Through Everything. The fracture is through the metaphysis, physis, and epiphysis.V - R = Rammed (crushed). The physis has been crushed, (alternatively SALTER can be used for the first 6 types - as above but adding Type Vr 'E' for Everything or Epiphysis and Type VI'R' for Ring)Fig: Types of Salter-Harris fractures | 2,647 | medmcqa_train |
The daily requirement of Vitamin C is- | Ans. is 'a' i.e., 40 mgo The daily requirement for vitamin C --> 40 mg. | 2,648 | medmcqa_train |
Diseases caused by coxsackievirus are all except: | In oral cavity CV causes:
Herpangina
Hand foot and mouth disease
Acute lymphonodular pharyngitis. | 2,649 | medmcqa_train |
True about Wilsons disease is? | Ans. is 'c' i.e., Increased urinary copper excretion | 2,650 | medmcqa_train |
The chyle from intestine is rich with chylomicrons. Which of the following form the protein core of chylomicrons? | The triacylglycerol, cholesterol ester and phospholipid molecules along with apoproteins B48, and apo-A are incorporated into chylomicrons. Four major groups of lipoproteins: Chylomicrons, derived from intestinal absorption of triacylglycerol and other lipids. Very low density lipoproteins (VLDL, or pre--lipoproteins), derived from the liver for the expo of triacylglycerol. Low-density lipoproteins (LDL, or -lipoproteins), representing a final stage in the catabolism of VLDL. High-density lipoproteins (HDL, or -lipoproteins), involved in cholesterol transpo and also in VLDL and chylomicron metabolism. Triacylglycerol is the predominant lipid in chylomicrons and VLDL, whereas cholesterol and phospholipid are the predominant lipids in LDL and HDL, respectively. Ref: Botham K.M., Mayes P.A. (2011). Chapter 25. Lipid Transpo & Storage. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K. Murray, V.W. Rodwell (Eds), Harper's Illustrated Biochemistry, 29e. | 2,651 | medmcqa_train |
Which of the following is known as monkey fever - | Ans. is 'b' i.e., KFDo White disease- AIDSo Poverty disease - Cholerao Hundred day cough: Pertussis (Whooping cough)o 5 day fever: Trench fevero 8th day disease: Tetanuso Black sickness: Kala azaro Black death: Plagueo Cerebrospinal fever: Meningococcal meningitiso Kochs phenomenon: Tuberculosiso Hansen s disease: Leprosyo Break-bone fever: Dengueo Slim disease: AIDSo Monkey fever: KFDo First disease/ Rubeolla: Measleso Second disease: Scarlet fevero Third disease/ German Measles: Rubellao Fourth disease: Duke's diseaseo Fifth disease: Erythema infectiosum (Parvovirus)o Sixth disease/Baby Measles/3-day fever: Exanthem subitum/ Roseola infantumo Barometer of Social Welfare (India): Tuberculosiso Father of Public Health: Cholerao River Blindness: Onchocerciasis | 2,652 | medmcqa_train |
Antiparkinsonian drug activating D2 receptors directly | Direct D2 activators are bromcriptine , pergolide,pramipexole,ropinirole. ENtcapone and tolcapone are COMT inhibitors and selegiline is a MAO inbibitor used in PD.In PD there is decrease of dopamine in the substansia nigra. Ref:KDT 6/e p419 | 2,653 | medmcqa_train |
Treatment of atropine toxicity - | Ans. is 'd' i.e., Physostigmine o Atropine blocks cholinergic receptors. So, for atropine overdose, we require a drug that increases cholinergic action. o Physostigmine increases the concentration of Ach. Physostigmine counteracts central (because it crosses BBB) as well as peripheral symptoms of atropine toxicity (other anticholinesterases like neostigmine and pyridostigmine counteract only peripheral symptoms as they cannot cross BBB) --> Physostigmine is the DOC. | 2,654 | medmcqa_train |
76 year old man presents with lytic lesion in the vebrae. X-Ray skull showed multiple punched out lesions. The diagnosis is | B i.e. Multiple Myeloma Old age, male sex & veebral involvement (lytic lesion) indicate towards diagnosis of Metastasis & Multiple myeloma. But Absence of primary and characterestic multiple punched out lesions on X-Ray skull is diagnostic of Multiple myelomaQ. Osteomalacia: - Looser's zoned or PseudofractureQ (Hallmark) Mnemonic - "Losse Pencilin Fish" - Pencilling-in- of veebral bodies - Cod - fish (marked biconvex) veebraeQ Hyper parathyroidism : - Brown tumorQ Mnemonic - - Sub periosteal ErosionQ "Brown Erosed Salt Basket" - Salt & Pepper or Pepper - Pot skullQ - Basket work appearanceQ of coex Renal Osteodystrophy(d/t CRF): - It combines findings of ostemalacia, hyperparathyroidism and bone sclerosis - Osteomalacia lit Looser's zone - Hyper PTH 1/t Subperiosteal Erosion of bone - Osteosclerosis Vt Rugger Jersey spineQ (End plate sclerosis with alternating bands of radiolucency) In children with CRF, the combination of rickets & hyperparathyroidism leads to Rotting Fence Post appearance.Q Multiple Myeloma: Two cardinal features are: Generalized reduction of bone density (Osteopenia) Localized areas of radiolucency (Punched outQ/Rain drop lesionsQ) in red marrow areas i.e. axial skeletal - spine & skull. In multiple Myeloma lytic lesions of spine are usually associated with some collapse & soft tissue extension i.e. paraveebral soft tissue shadows (differentiation from Metastasis). Differentiation from inflamatory lesions can be made as the interveebral disc space & aicular surfaces are not affected. | 2,655 | medmcqa_train |
All the following increase insulin release except | Glitazones -insulin sensitizers.they will not produce insulin from beta cells.a cells of pancreas There are insulin sensitizers and insulin secretogogues. insulin secretogogues increase the insulin secretion from the beta cells of pancreas.where as insulin sensitizres help in secsitizing the tissue to already present insulin. which include GLP 1 analogue,glinides,sulfonylureas. Ref: Katzung 12th ed. | 2,656 | medmcqa_train |
Observe the following curves. What will happen to Sensitivity and Specificity if curve changes from Blue to Red? | (a) Both Sensitivity & Specificity increase* If Blue color curve changes to Red color curve (see Photograph in Question), then- FN will reduce, Sensitivity will increase (see Photograph given in Answer)- FP will reduce, Specificity will increase (see Photograph given in Answer). | 2,657 | medmcqa_train |
Vegetable fat differs from animal oil in being – | Vegetable fats are more unsaturated than animal fats, PUFA is found mostly in vegetable fats.
However, there are exceptions, as for example coconut and palm oils although vegetable oils, have an extremely high percentage of saturated fatty acids. On the other hand , fish oil contain good percentage of PUFA
Vegetable fats are less stable.
They contain high no. of unsaturated bonds which undergo spontaneous oxidation at the double bond forming aldehydes,ketones and resins.
Vegetable fats are less atherosclerotic;
In fact PUFA have a favorable effect on serum lipid profile. They decrease LDL and increase HDL ( good cholesterol ).Essential fatty acids ( high percentage in vegetable fat) decrease the platelet adhesiveness.
Vegetable fat contains less fat soluble vitamins (A,D,E & K vitamin).
For this reason Vanaspati Ghee is fortified with vit. A *& D by government regulation (DALDA) | 2,658 | medmcqa_train |
Sympathetic stimulation increases blood flow except: | Ans. a. Skin Sympathetic stimulation decreases blood flow in skin. Sympathetic Stimulation Stimulation of sympathetic fibers causes vasoconstriction but it is not impoant, as the vasocontricor system is not well developed in cerebral vascular bed. Sympathetic stimulation increases myocardial blood flow through an increased metabolic demand and a predominance of beta-receptor activation. | 2,659 | medmcqa_train |
Amount of blood loss in class II circulatory failure/Haemorrhagic shock? | -Hemorrhagic shock has been divided into 4 classes according to ATLS course. Class 1 Class2 Class 3 Class 4 Blood volume lost as % of total < 15 % 15-30% 30-40% >40% Four Classes of Hemorrhagic Shock (According to the ATLS course) Parameter I II III IV Blood loss (%) 0-15% 15-30 30-40 >40 CNS Slightly anxious Mildly anxious Anxious or confused Confused or lethargic Pulse (beats/ min) <100 >100 >120 >140 Blood pressure Normal Normal Decreased Decreased Pulse pressure Normal Decreased Decreased Decreased Respiratory rate 14-20/min 20-30/min 30-40/min >35/min Urine (mL/hr) >30 20-30 5-15 Negligible Fluid Crystalloid Crystalloid Crystalloid + blood Crystalloid + blood Base deficit 0 to -2 mEq/L -2 to 6 mEq/L -6 to -10 mEq/L -10 mEq/L or less -Please refer to the above table as many such questions are asked from the table. | 2,660 | medmcqa_train |
An adult hypeensive male presented with sudden onset severe headache and vomiting. On examination, there is marked neck rigidity and no focal neurological deficit was found. The symptoms are most likely due to: | Ans. d. Subarachnoid hemorrhage Most likely diagnosis in an adult hypeensive male with sudden onset severe headache, vomiting with marked neck rigidity without focal neurological deficit would be subarachnoid hemorrhage. | 2,661 | medmcqa_train |
Down's syndrome is due to: | Ans: c (21 trisomy)Ref: Nelson Pediatrics, 19th ed., Pg. 384Trisomy 21, Down's syndrome seen in 1/600-800 births. Please note the clinical features which are often asked Hypotonia Dysplasia of the pelvis Flat face, cardiac malformations Speckled irises Simian crease (Brushfield spots) Varying degrees of mental Short, broad hands and growth retardation Hypoplasia of middle Upward slanted palpebral phalanx of 5th finger fissures and epicanthic folds Intestinal atresia, and high arched palate | 2,662 | medmcqa_train |
Man is the only reservoir for | Entamoeba histolytica is predominantly found in primates (including humans) and occasionally in dogs, cats, cattle and pigs.
The parasite has a worldwide distribution and is prevalent in tropical and subtropical countries.
Salmonella - The most common are animal reservoirs are chickens, turkeys, pigs, and cows; dozens of other domestic and wild animals also harbor these organisms.
Campylobacter jejuni - C. jejuni is carried by most of these animal reservoirs and is the predominant species isolated from chickens and cattle.
Y. Enterocolitica - dogs, sheep, wild rodents, and environmental water may also be a reservoir of pathogenic Y. enterocolitica strains.
Ref : http://parasite.org.au/para-site/text/entamoeba-text.html#:~:text=Host%20range%3A%20Entamoeba%20histolytica%20is,in%20tropical%20and%20subtropical%20countries | 2,663 | medmcqa_train |
All of the following effects can occur if vagus is stimulated, except: March 2009 | Ans. D: Bronchial musculature relaxation | 2,664 | medmcqa_train |
Denosumab is used in:- | Denosumab is a monoclonal antibody against RANK - ligand which inhibits binding to RANK receptor and inhibits the activation of osteoclasts and inhibits bone resorption so it is used in treatment of Osteoporosis. | 2,665 | medmcqa_train |
When information memorized afterward is interfered by the information learned earlier, it is called : | Earlier learning interferes with retrieval of new information → proactive interference.
Newly acquired information interferes with the retrieval of previously learnt information → retroactive inhibition. | 2,666 | medmcqa_train |
Viral Conjunctivitis is most commonly caused by | Viral Conjunctivitis is most commonly caused by Adenovirus. | 2,667 | medmcqa_train |
About retinitis pigmentosa all are true, EXCEPT: | In retinitis pigmentosa rods are involved first followed by cones. As the disease progresses there is loss of night vision and peripheral field of vision. Only in the later stages of the disese there is loss of central vision. Retinitis Pigmentosa is a group of hereditary retinal degenerative disorder characterized by progressive dysfunction of photoreceptors, associated with progressive cell loss and atrophy of several retinal layers. Hallmark symptoms are: night blindness, progressive loss of peripheral field of vision and coalescing ring scotomas. Characteristic fundoscopic findings are: attenuated retinal aerioles, waxy pale optic disc, mottling of retinal pigment epithelium, and peripheral retinal pigment clumping (bone spicule formation). ERG shows reduced/absent retinal function. EOG lacks usual light rise. | 2,668 | medmcqa_train |
Common peroneal nerve is related to which of the following structures | B i.e., Neck of fibula Common peroneal nerve winds around neck of fibula to enter peroneus longus muscle. Because of its subcutaneous position it can be easily palpated here & is very prone to injury. So fracture neck of fibula may cause foot drop. | 2,669 | medmcqa_train |
Chromosomal mutation can be identified by all except: | Chromosomal mutation can't be identified by Agarose gel electrophoresis Agarose Gel electrophoresis Used to separate the DNA by charge or by size. The smaller the fragment, the more rapid the migration. Overall rate of migration and optimal range of size for separation are determined by the chemical nature of the gel and by the degree of its crosslinking. Highly cross-linked gels optimize the separation of small DNA fragments. The dye ethidium bromide forms a brightly fluorescent color as it binds to DNA, and so small amounts of separated DNA fragments can be photographed on gels. Specific DNA fragments can be recognized by probes containing complementary sequences. Usually performed to visualize the amplified DNA after PCR, but may be used as a preparative technique prior to use of other Just a method of visualizing the DNA after separating by size. So it is always used as a pa of any molecular method to visualize the DNA. But alone it cannot be used to detect any mutations. | 2,670 | medmcqa_train |
Upper limb deformity in Erb's palsy - | Ans. is 'b' i.e., Adduction and medial rotation of arm Clinical features of Erb's palsy A) Muscles paralyzed: Mainly biceps brachii, deltoid, brachialis and brachioradialis. Partly supraspinatus, infraspinatus and supinator. B) Deformity (position of the limb) i) Arm : Hangs by the side; it is adducted and medially rotated. ii) Forearm : Extended and pronated. The deformity is known as 'policeman's tip hand' or 'porter's tip hand'. C) Disability: The following movements are lost. o Abduction and lateral rotation of the arm (shoulder). o Flexion and supination of the forearm. o Biceps and supinator jerks are lost. o Sensations are lost over a small area over the lower part of the deltoid. | 2,671 | medmcqa_train |
In angle closure glaucoma, obstruction to outflow of aqueous humour mainly due to the involvement of: September 2007 | Ans. C: Iris | 2,672 | medmcqa_train |
Which one of the following bacteria ois oxidase positive? | Oxidase test: The test is used to identifying bacteria containing cytochrome oxidase. I t is useful in differentiating the oxidase negative Enterobacteriaceae from the oxidase positive Pseudomonas organisms and the oxidase positive group of vibrios and related bacterias (Aeromonas, Plesiomonas). Neisseria organisms also test positive. the presence of cytochrome oxidase can is detected through the use of an oxidase disc which acts as an electron donor to cytochrome oxidase. if the test bacterium oxidizes the disc, the disk turns pin indicating a positive test. If there is no change in color the test is negative for the bacterium REF:Ananthanarayan & Panicker's Textbook of Microbiology 8th Edition pg no: 675 | 2,673 | medmcqa_train |
Dose of rifampicin in RNTCP is - | Ans. is 'b' i.e., 450 mg TREATMENT REGIMEN SPUTUM EXAMINATIONS FOR PULMON ARY TBCategory of treatmentType of patientRegimentPre treatment sputumTest at monthIf result isTHEN -Start continuation phase, test sputum 6 monthsNew casesNew sputum smear-positive2(HRZE)3+-2 Category 1New sputum semar-negative+ +Continue intesive phase for one more montfRed BoxNew extra-pulmonaryNew others4 (HR)3 Complete the treatment in 7 monthsPreviouslySputum smear-positive Relapse2(HRZES}3 -Start continuation phase, test sputum again 6 months, completion of treatmentTreatedSputum smear-positive Fa ilure+ Category IISputum smear-positive1 (HRZE)3+3+Continue intensive phase for one more monthBlue Boxtreatment after default Others+5 (HRE)3 again at 4 months if sputum is positive sene sputum for culture and drug sensitivity as might be a case of MDR-TBo The number before the letters refers to the number of months of treatment. The subscript after the letters refers to the number of doses per week- H : Isomazid (600 mg), R : Rifampicin (450 mg), Z : Pyrazinamide (1500 mg), E : Ethambuiol (1200 mg), S : Streptomycin (750 mg). Patients who weight more than 60 kg receive additional Rifampicin 150 mg. Patients more than 50 years old receive streptomycin 500 mg- Patient in categories I and 11, Who have a positive sputum smear at the end of the initial intensive phase, receive an additional month of intensive phase treatment.o Examples of seriously ill extra-pulmonary TB cases are meningitis, disseminated TB, tuberculous pericarditis, peritonitis, bilateral or extensive pleurisy, spinal TB with neurological complications and intestinal and genito-urinary TB.o In rare and exeptional cases, patients who are sputum smear-negative or who have extra-pulmonary disease can have relapse or failure. This diagnosis in all such cases should always be made by an MO and should be supported by culture or histological evidence of current, active tuberculosis. In these cases, the patient should be categorized as 'other' and given category II treatment.o Any patient treated writb category I who has a positive smear at 5 months of treatment should be considered a Failure and started on category II treatment, afresh. If category I sputum smear-ve case fails to improve or if patient develops pulmonary signs and positive smear at the end of intensive phase, it is considered treatment failure. Start category II treatment and confirm failure by culture and perform DST. | 2,674 | medmcqa_train |
Fasciculations are caused by | Ans. a (Scoline). (Ref. KD Tripathi, Pharamacology, 6th ed., 150)SUXAMETHONIUM CHLORIDE OR SUCCINYL CHOLINE (SCOLINE)Introduction- It is a short acting muscle relaxant.- It is a phase II blocker.- Depolarising muscle i.e. depolarising block at motor end-plate.- It is dichlor ester of succinic acid.- The action lasts for 3-5 minutes.- Action is prolonged in liver disease.- Metabolised by pseudocholinesterase.- It gives good intubating condition in shortest time (less than one minute).Uses- Endotracheal intubation in dose of 1 to 2 mg/kg body weight.- To modify electroconvulsive therapy.- For procedures requiring short duration relaxation.- Excellent for operative abet and caesaerian section.Side effects(Mnemonic=ABRHAM on FTV)- Apnoea (Prolonged),- Bradycardia,- Raised intraocular pressure- Hyperkalemia- Ache (Myalgia/ Post-operative muscle ache)- Malignant hyperpyrexia- Fasciculation,- Tachyphylaxis- Ventricular fibrillationIts S/E can be prevented by- Self-taming with 10 mg suxamethonium given a minute before induction of an anaesthesia.PrecurarizationAlso remember:# Malignant hyperpyrexia:- It is due to release of Ca++ from sarcoplasmic reticulum in sensitive person- It can be caused also bya) Halothane,b) Methoxyflurane andc) Isoflurane- Rx- dantrolene.- Dantrolene is muscle relaxant acting directly on muscle. {MH 2006) | 2,675 | medmcqa_train |
Which of the following conditions cause congestive hea failure in neonates ? | In TAPVR can produce CHF in neonate. Ghai essential of pediatrics, eighth edition, p.no:397 | 2,676 | medmcqa_train |
Which of the following statements is true about diaphragm? | The Diaphragm This thin fibromuscular paition between thoracic and abdominal cavities is an impoant muscle of respiration.When it contracts,it increases the veical extend of thoracic cavity by paially flatenning its dome and displacingthe abdominal contents downwards.The firous,central pa of the diapgragm(central tendon)is slightly depressed by the hea and thus it has right and left domes.The right dome,suppoed by the liver,lies at slightly at a higher level(a little inferior to the nipple in the male)than the left. REF.Cunningham's manual of practical anatomy,Vol.2,PG.172 | 2,677 | medmcqa_train |
What is the S.I. unit of effective dose? | The effective dose (E) is used to estimate the risk in humans. It is hard to compare the risk from a dental exposure with, for example, the risk from a radiographic chest examination because different tissues with different radiosensitivities are exposed.
The unit of effective dose is the Sv. | 2,678 | medmcqa_train |
Type II Respiratory failure is characterised by (Davidson) | (Low PaO2/High PaCO2) (1684 -H17th)Respiratory failure - PaO2 <8.0 kPa (60mmHg) and PaCO2 > 6.5 kPa (50 mmHg)Type 1 - PaO2 low, PaCO2 normal or lowType II - PaCO2 raised, PaO2 low - Ventilatory failure* Most important - cause in chronic type II respiratory failure is - chronic bronchitis | 2,679 | medmcqa_train |
In post-hepatic jaundice, the concentation of conjugatedbilirubin in the blood is higher than that ofunconjugated bilirubin because : | . The conjugation process of bilirubin in liver remains operative without any interference. | 2,680 | medmcqa_train |
Zone of HOHL refers to: | 1. Cell-free zone (Zone of weil)
Width approx. 40 µm
Not always present
Absent in young pulp (Active secretion of primary dentine) and older pulp (tertiary dentine)
CONTENTS
Capillaries
Unmyelinated nerve fibers
Cytoplasmic process of fibroblasts
2. Cell Rich Zone (Zone of HOHL)
Most numerous cells are fibroblasts
Fibroblasts secrete Type I and Type III collagen
Also contains undifferentiated mesenchymal stem cells.
Vascular supply is extensive and more than cell free zone and odontoblast zone. | 2,681 | medmcqa_train |
Hernia into pouch of Douglas is __________ hernia : | Beclard's hernia → is the femoral hernia through the opening of the saphenous vein (named after Pierre Augustin Beclard). | 2,682 | medmcqa_train |
True about primary aldosteronism | Answer is C (Increased Na+) Primary Aldosteronism (Conn's syndrome) is associated with Hypeension, Hypernatremia ( tNa+) and Hypokalemia (iK+) | 2,683 | medmcqa_train |
A patient is found to have a duodenal ulcer by upper endoscopy. The likelihood of this patient having H. pylori in the gastric antrum is? | . | 2,684 | medmcqa_train |
A community has a population of 10,000 and a bih rate of 36 per 1000. 6 maternal deaths were repoed in the current year. The Maternal Moality Rate (MMR) is: | Total no.of female deaths due to complication of pregnancy, childbih or within 42 days of delivery from puerperal causes in an area during a given year. ---------------------------------------------------------------------------------------------------- x 1000 Total no. of live bihs in the same area and year. 6/360 x 1000= 0.0166 x 1000 = 16.6 Ref: Park, 20th Edition, Page 479. | 2,685 | medmcqa_train |
Acute infectious purpura fulminans is caused by | Purpura fulminans is an acute, often fatal, thrombotic disorder which manifests as blood spots, bruising and discolouration of the skin resulting from coagulation in small blood vessels within the skin and rapidly leads to skin necrosis and disseminated intravascular coagulation caused by Neisseria meningitidis and varicella Ref Harrison20th edition pg 1078 | 2,686 | medmcqa_train |
Not a component of Brain stem | Brainstem
1. Medulla:responsible for regulating and/ or coordination of:
- Blood pressure.
- Breathing.
- Swallowing.
- Coughing.
- Vomiting.
2. Pons : participates in respiratory regulation and the relay of information from cerebral hemispheres to the cerebellum.
3. Midbrain : participates in coordination of visual and auditory systems. | 2,687 | medmcqa_train |
Urinary tract infection exists when the bacterial count in 1 ml. of midstream specimen of urine is ? | Ans. is 'd' i.e., 105 or over | 2,688 | medmcqa_train |
Both APTT and PT are prolonged in which conditions? | ANSWER: (A) Factor II deficiencyREF: Mastery of Surgery by Josef E. Fischer, K. I. Bland, 5th edition Part I page 90, Saint-Frances guide: clinical clerkship in outpatient medicine. Page 434 8; 235, Harrison 17th ed table 59-4See APPENDIX-50 below for "BLE EDIN G/C O AG U L ATI ON DISORDERS" and APPROACH TO A PATIENT WITH BLEEDING DISORDER APPENDIX - 50BLEEDING/COAGULATION DISORDERSTable from Mastery of Surgery by Josef E. Fischer, K. I. Bland, 5th edition Part I page 90, http://en.uikipedia.org/wiki/ Bleeding_diathesisConditionProthrombinTimePartialThromboplastinTimeBleedingTimePlateletCountAspirinNormalNormalProlongedNormalCongenital afibrinogenemiaProlongedprolongedProlongedNormalDisseminated intravascular coagulationProlongedprolongedprolongedDecreasedEarly Liver failureProlongedNormalNormalNormalEnd-stage Liver failureProlongedprolongedprolongedDecreasedHaemophilia A (Factor 8}NormalProlongedNormalNormalHaemophilia B (Factor 9) Christmas diseaseNormalProlongedNormalNormalParahemophelia (factor 2,5,10)ProlongedProlongedNormalNormalFactor 7 deficiencyProlongedNormalNormalNormal! ThrombocytopeniaNormalNormalProlongedDecreasedBernard-Soulier syndromeNormalNormalProlongedDecreasedGlanzmann s thrombastheniaNormalNormalProlongedNormalUremiaNormalNormalProlongedNormalVitamin K deficiency or warfarinProlongedProlongedNormalNormalVon Willebrand diseaseNormalNormalProlongedNormalAPPROACH TO A PATIENT WITH BLEEDING DISORDER Obtain PT/ PTT and Platelet count Increased PT, Normal PTTNormal PT,Both PT &Both PT & PTT normalIncreased PTTPTT increasedPlatelet count* Early DIC* Liver disease* Warfarin therapy* Mild Vitamin K deficiency* Factor 7 deficiency* Coagulation factor deficiency* Coagulation factor inhibitor* Antiphospholipid antibody* Heparin therapy* Severe DIC* Severe liver disease* Warfarin overdose* Severe vitamin K deficiency* Factor 2, 5,10 deficiency* Heparin therapy> 90,000/pL Do Bleeding time< 90,000/uL ThrombocytopeniaSee extension of table below Do bleeding timeNormal bleeding timeIncreased bleeding time* Deficiency of inhibitors of fibrinolysis* Dysfibrinogenemia* Factor 13 deficiencyPlatelet dysfunctionAcquiredInherited* Severe renal disease* Severe liver disease* Myeloploreferative disorder* Autoantibodies* Paraprotenemia* DIC* vWD* Bernard Soulier disease* Glanzmann thrombasthenia | 2,689 | medmcqa_train |
The greatest volume of gastric secretion occurs during: | B: The gastric phase is the period of greatest gastric secretion. This phase is responsible for the greatest volume of gastric secretions, and it is activated by the presence of food in the stomach.
A: The cephalic phase of stomach secretion is anticipatory and prepares the stomach to receive food. In the cephalic phase, sensations of taste, the smell of food, stimulation of tactile receptors during the process of chewing and swallowing, and pleasant thoughts of food stimulate centers within the medulla oblongata that influence gastric secretions.
C: The intestinal phase of gastric secretion primarily inhibits gastric secretions. It is controlled by the entrance of acidic chyme into the duodenum. The presence of chyme in the duodenum initiates both neural and hormonal mechanisms.
D: Deglutition the action or process of swallowing. | 2,690 | medmcqa_train |
A 38-year-old gentleman repos of decreased hearing in the right ear for the last two years. On testing with a 512 Hz tuning fork, the Rinne&;s test without masking is negative in the right ear and positive on the left ear. With Weber&;s test, the tone is perceived as louder in the right ear. The most likely diagnosis in the patient is | The characteristics of conductive hearing loss are: 1. Negative Rinne test, i.e. BC > AC. 2. Weber lateralized to poorer ear. 3. Normal absolute bone conduction. 4. Low frequencies affected more. 5. Audiometry shows bone conduction better than air conduction with air-bone gap. Greater the air-bone gap, more is the conductive loss 6. Loss is not more than 60 dB. 7. Speech discrimination is good. Ref: Dhingra 7e pg 31. | 2,691 | medmcqa_train |
Structure superficial to mylohyoid in anterior digastric triangle are: | Deep pa of submandibular gland & hypoglossal neve are deep to mylohyoid muscle.Structures passing superficial to mylohyoid in anterior pa of digastric triangle are submandibular gland (superficial pa), facial vein, facial aery, mylohyoid nerve & vessels, hypoglossal nerve & submandibular nodes. | 2,692 | medmcqa_train |
Treatment of Acute pancreatitis includes all except | Oral administration of food and TPN is not recommended.
Patient is fed via NGT to jeyunum. | 2,693 | medmcqa_train |
A 78-year-old woman has an acute anterior wall MI with hypotension and pulmonary congestion. Her blood pressure is 90/70 mm Hg, pulse 110/min, JVP at 8 cm, and the heart sounds are normal. The lungs have bibasilar crackles, and her extremities are cool and diaphoretic. What would central hemodynamic monitoring reveal?For the above patient, select the hemodynamic parameters that are most likely to apply. | Cardiogenic shock is characterized by high right atrial pressure (although it can be normal at times), high PA wedge pressure, high systemic vascular resistance, and low cardiac output. | 2,694 | medmcqa_train |
Which of the following physiological change take place by Bainbridge reflex? | Atrial A and B receptors are located at the venoatrial junctions and have distinct functions. Type A receptors react primarily to hea rate but adapt to long-term changes in atrial volume. Type B receptors increase their discharge during atrial distension. C fibers arise from receptors scattered through the atria; these discharge with a low frequency and respond with increased discharge to increase in atrial pressure. The A and B receptors are thought to mediate the increase in hea rate associated with atrial distension (such as can occur with intravenous infusions) known as the Bainbridge reflex. In contrast, activation of atrial C fibers generally produces a vasodepressor effect (bradycardia and peripheral vasodilation). Ref: Hoit B.D., Walsh R.A. (2011). Chapter 5. Normal Physiology of the Cardiovascular System. In V. Fuster, R.A. Walsh, R.A. Harrington (Eds), Hurst's The Hea, 13e. | 2,695 | medmcqa_train |
The heme portion of the hemoglobin molecule consists of: | Structurally, porphyrin consists of four pyrrole rings (five-membered closed structures containing one nitrogen and four carbon atoms) linked to each other by methine groups (−CH=).
The iron atom is kept in the centre of the porphyrin ring by interaction with the four nitrogen atoms. | 2,696 | medmcqa_train |
Palpable purpura could occur in the following conditions, except: | Answer is A (Thrombocytopenia) Thrombocytopenia is associated with non palpable purpura'. Causes of Non palpable pupura: Primary cutaneous disorders Systemic diseases Clotting disturbance Vascular fragility Thrombosis 1 Emboli Possible immune complex Trauma Thrombocytopenia Amyloidosis Disseminated Cholesterol Gardner-Diamond syndrome Solar purpura (including ITP) Ehlers-Danlos intravascular Fat Waldenstrom's Steroid purpura Abnormal platelet syndome coagulation hypergammaglobulinemic Capillaritis Livedoid vasculitis function Clotting factor defects . Scurvy Monoclonal cryoglobulinemia Thrombotic thrombocytopenic purpura purpura Warfarin reaction | 2,697 | medmcqa_train |
The maneuver shown below helps specifically in | The image shows 4th leopold maneuverThe first maneuver assesses the uterine fundus. It permits identification of fetal lie and determination of which fetal pole--that is, cephalic or podalic--occupies the fundus. The second maneuver is accomplished as the palms are placed on either side of the maternal abdomen, and gentle but deep pressure is exeed.. By noting whether the back is directed anteriorly, transversely, or posteriorly, fetal orientation can be determined.The third maneuver aids confirmation of fetal presentation. The thumb and fingers of one hand grasp the lower poion of the maternal abdomen just above the symphysis pubis. If the presenting pa is not engaged, a movable mass will be felt, usually the head. The fouh maneuver helps determine the degree of descent.Reference: William's Obstetrics; 25th edition; Chapter 22; Normal Labor | 2,698 | medmcqa_train |
Carpal tunnel contains all except - | Ans-D | 2,699 | medmcqa_train |
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