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Age of closure of spheno-occipital synchondrosis: | Postnatally, the posterior cranial base becomes longer primarily due to growth at the spheno-occipital synchondrosis. Histologic studies have shown that the spheno-occipital synchondrosis fuses at approximately 16 to 17 years in females and 18 to 19 years in males.
Ref: Graber LW, Vanarsdall RL, Vig KW, Huang GJ. Orthodontics: current principles and techniques. Edition 6 page no 10 | 2,700 | medmcqa_train |
Disulphiram acts by competitive inhibition of which enzyme? | Ans. (b) Aldehyde dehydrogenaseRef KDT 6th ed. / 386EthanolAlcohol Dehydrogenase-------------------Acetaldehyde Aldehyde Dehydrogenase---------------------Acetate* Disulfiram is an anti-craving agent for alcoholics. It has been used as an aversion technique in alcoholics.* Disulfiram acts by inhibiting aldehyde dehydrogenase. If a person still takes alcohol while on disulfiram treatment, alcohol is metabolized as usual, but acetaldehyde accumulates.* This accumulation of acetaldehyde gives some distressing symptoms like flushing, burning sensation, throbbing headache, perspiration, dizziness, vomiting, confusion and circulatory collapse.* Therefore, it is recommended only for those alcoholics who are motivated and sincerely desire to leave the habit.* Drugs causing Disulfiram like reaction:# Metronidazole# Chlorpropamide# Cefoperazone# Cefotetan# Trimethorprim* Other drugs that decrease craving for alcohol and smoking: (remembered as NATO)# NALTREXONE# ACAMPROSATE# TOPIRAMATE# ONDANSETRONAlso Know* Drug which inhibit alcohol dehydrogenase - FOMEPIZOLE* Antidote for methanol poisoning: FOMEPIZOLE > ETHANOL* Antidote for ethelene glycol poisoning: FOMEPIZOLE | 2,701 | medmcqa_train |
Fast breathing in a 6-month old infant is taken as | Criteria for fast breathing AGE Respiratory Rate <2 months >60/minute 2-12 months >50/minute 12 months-5 years >40/minute | 2,702 | medmcqa_train |
Shivering" is observed in the early pa of postoperative period due to | Postoperative shivering (halothane shakes) and hypothermia is maximum with halothane among inhalational anesthetics. It can be used to sta or maintain anaesthesia. One of its benefits is that it does not increase the production of saliva, which can be paicularly useful in those who are difficult to intubate | 2,703 | medmcqa_train |
Malignant glaucoma is seen in –a) Anterior chamber normalb) Misdirected aqueous flowc) Pilocarpine is the drug of choiced) Management is medical onlye) Atropine is also given | In malignant glaucoma there is misdirection of aqueous posteriorly into the vitreous. It is characterized by markedly raised IOP and shallow or absent anterior chamber.
Treatment includes :- i) Medical :- Atropine (DOC), phenylephrine, osmotic agents, (β-blockers, α-agonists, carbonic anhydrase inhibitors; ii) YAG laser hyaloidotomy; iii) Surgery :- pars plana vitrectomy. | 2,704 | medmcqa_train |
Staph, epidermis has become important due to | * S. epidermis is a pathogenic organism which affects interventions like catheter, canula.* It is an organism which can form biofilm.* It is novobiocin sensitive. | 2,705 | medmcqa_train |
CRF is associated with? | ANSWER: (C) Metabolic acidosisREF: Harrison 17th ed chapter 274, Essentials of Pathophysiology: Concepts of Altered Health States by Carol Mattson Forth page 200Chronic kidney disease is the most common cause of chronic metabolic acidosis. The kidneys normally conserve HCO3-- and secrete H+ ions into the urine as a means of regulating acid-base balance. In chronic kidney disease, there is loss of both glomerular and tubular function with retention of nitrogenous waste and metabolic acids. In condition called renal tubular acidosis, glomerular function is normal, but tubular secretion of H+ or reabsorption of HC03~ is abnormal. | 2,706 | medmcqa_train |
All are dopaminergic agonists used for parkinsonism EXCEPT | Selegiline REF: KDT 6th Ed p. 415 DRUGS USED FOR PARKINSONISM Drugs affecting dopaminergic system Dopamine precursor Levodopa Peripheral decarboxylase inhibitors Carbidopa , benzaseride Dopaminergic agonists Bromocriptine , ropinerole , pramipexole MAO-B inhibitor Selegiline COMT inhibitor Entacapone , tolcapone Dopamine facilitator Amantadine Drugs affecting brain cholinergic system Central anticholinergics Trihexyphenidyl , procyclidine , biperidin Antihistamines Orphenadrine , promethazine | 2,707 | medmcqa_train |
Incestuous relationship between mother and son is called as? | Ans. is 'a' i.e., Oedipus complex * In psychoanalysis, the Oedipus complex is a child's desire, that the mind keeps in the unconscious via dynamic repression, to have sexual relations with the parent of the opposite sex (i.e. males attracted to their mothers, and females attracted to their fathers)* The Oedipus complex occurs in the third -- phallic stage (ages 3-6) of the psychosexual development.* Sigmund Freud coined the term "Oedipus complex"* Boys and girls experience the complex differently: boys in a form of castration anxiety & girls in a form of penis envy (Electra complex). | 2,708 | medmcqa_train |
Suspensory ligament of Lockwood encloses which pair of muscles | Suspensory ligament of Lockwood: A specialized lower pa of the fascial sheath of the eyeball is the suspensory ligament, which suppos the eyeball. This sling-like structure is made up of fascial sheath of the eyeball. It has contribution from these muscles : Inferior oblique & Inferior rectus. In an event of orbital floor fracture it protects drop down of eyeball . | 2,709 | medmcqa_train |
The major constituents in agar are | Agar, a polysaccharide extract of a marine alga, is uniquely suitable for microbial cultivation because it is resistant to microbial action and becauseit dissolves at 100degC but does not gel until cooled below 45degC; cells can be suspended in the medium at 45degC and the medium quickly cooled to a gel without harming them.Ref: Jawetz, Melnick, & Adelberg's Medical Microbiology; Twenty-Seventh Edition; Chapter 5; Cultivation of Microorganisms | 2,710 | medmcqa_train |
For optimum esthetics when setting maxillary denture teeth, the incisal edges of the maxillary incisors should follow the _____. | Maxillary teeth should contact the wet dry lip line when fricative sounds f, v, and ph are made. These sounds help to determine the position of the incisal edges of the maxillary anterior teeth. | 2,711 | medmcqa_train |
Osteosclerotic metastasis is common in cancer of: | Ans. A. Prostate cancerProstate cancer leads to osteosclerotic metastasis because of release of PTH like proteinsa. Prostate carcinoma cells secrete factors that directly and indirectly alter the osteoblastic function and express factors critical for normal bone development and remodeling, including bone morphogenetic proteins (BMPs), TGF-b, platelet- derived growth factor, adrenomedullin, insulin-like growth factor (IGF-1), fibroblast growth factor and vascular endothelial growth factor (VEGF).b. The osteolytic factor, PTHrP, is also abundantly expressed in Prostate carcinoma metastases, despite the fact that these lesions are primarily blastic. It has been demonstrated that PTHrP increases osteoblastic progenitor cell proliferation and induces early Osteoblastic differentiation.c. Another study says that Wants (a large family of proteins that promote bone growth) contribute to prostate cancer- mediated osteoblastic activity. Prostate cancer bone metastases have both an osteolytic and osteoblastic component, there is a shift in the balance from osteolytic to osteoblastic activity as prostate cancer progresses, which results in osteosclerotic (Osteoblastic) metastasis. | 2,712 | medmcqa_train |
True statements about alpha -1 - anti-trypsin deficiency-a) Autosomal dominant diseaseb) Emphysemac) Fibrosis of Portal tractd) Diastase resistant positive hepatocytese) Orcein positive granules | Fibrosis of portal tract develop when there is cirrhosis. | 2,713 | medmcqa_train |
The age at which a child can make a tower of 9 cubes and draw a circle is | Key fine motor developmental milestones4mo - Bidextrous reach (reaching out for objects with both hands)6mo - Unidextrous reach (reaching out for objects with one hand); transfers objects9mo - Immature pincer grasp; probes with a forefinger12mo - Pincer grasp mature15mo- Imitates scribbling; tower of 2 blocks18 mo- Scribbles; tower of 3 blocks2 yr - Tower of 6 blocks; veical and circular stroke3 yr - Tower of 9 blocks; copies circle4 yr - Copies cross; bridge with blocks5 yr- Copies triangle; gate with blocks Ref:Ghai 8e pg:50 | 2,714 | medmcqa_train |
In chronic inflammation confined to poal tract with intact limiting membrane and normal lobular parenchyma, the histoapathological diagnosis would be - | Ans. is 'c' i.e., Chronic persistent hepatitiso Intact limiting membrae with inflammation confined to poal area is seen in chronic persistent hepatitis. | 2,715 | medmcqa_train |
Most common site of hypospadias: | Ans. (a) Proximal to GlansRef Page 1478, Bailey and Love 27th editionHypospadias:* Incidence- 1 in 200* MC congenital anomaly of urethra* External meatus opens on under side (Ventral surface)* Dorsal Hood and ventral chordee seen.* MC site of opening- proximal to the normal opening in Glans Penis (MC)* Others: Coronal, penile, Penoscrotal, Perineal.* Most severe type is perineal, luckily it is the rarest also.* Procedure of choice: Tabularized incised plate Urethroplasty for distal hypospadias for proximal hypospadias Foreskin is used.* As per Bailey Surgery done before 18 months (correct answer is 6 months) | 2,716 | medmcqa_train |
Per Rectal palpation of uterus is done in : | Virgins | 2,717 | medmcqa_train |
All of the followings are true about Sprengel's deformity, except: | ANS. DSprengel's deformity: It is congenital elevation of the scapula.Is a complex deformity of the shoulder and the most common congenital shoulder anomaly.Associations of Sprengel's deformity:* Klippel-Feil syndrome* Spina bifida* Diastematomyelia* Torticollis* Kyphoscoliosis# Klippel-Feil syndromeThe most common sign of the disorder is restricted mobility of the neck and upper spine. A short neck and low hairline at the back of the head may occur in some patients. | 2,718 | medmcqa_train |
The commonest cause of primary hyperparathyroidism is- | solitary adenoma ie a single abnormal gland is the cause in 80% of patients ( Harrison 17 pg 2380) | 2,719 | medmcqa_train |
Aminoglycoside affects ? | Ans. is 'a' i.e., Outer hair cells in basal area Cochlear damage with the use of aminoglycosides stas from the base and spreads to the apex; hearing loss affects the high frequency sound first, then progressively encompasses the lower frequencies. Outer hair cells are easily damaged by ototoxic drugs (aminoglycosides) and high intensity noise. Inner hair cells are more resistant. | 2,720 | medmcqa_train |
Which of the following statements about Histamine is true: September 2012 | Ans: D i.e. All of the above Histamine Histamine is formed by: Decarboxylation of histidine Function of histamine: Mediates triple response | 2,721 | medmcqa_train |
Accessory renal aery:- | The accessory renal aery is the precocious origin of a segmental aery which sometimes arises from the aoa and supplies upper or lower pole of the kidney. The accessory renal aery is the remnant of the degenerated mesonephric aery. The aery for the lower pole usually passes behind the pelvis of ureter and may cause obstruction to urine flow producing hydronephrosis. | 2,722 | medmcqa_train |
Blood pressure in right ventricle | Peak pressures in theright ventricles is about 25 mm HgRef: Ganong's Review of Medical Physiology Twenty-Third Edition Page No:508 | 2,723 | medmcqa_train |
Tzank smear helps in the diagnosis of : | A. i.e. Herpes | 2,724 | medmcqa_train |
Which of the following is the most common cataract in the newborn - | Answer: A The commonest cataract in childhood is Blue Dot cataract which presents without visual obstruction. And the commonest congenital cataract which presents with a visual defect is zonular cataract. | 2,725 | medmcqa_train |
Row of tombstone is seen in which skin disorder: | Ans. A. Pemphigus vulgaris* Pemphigus vulgaris is characterized by following signs:1. Bulla spread sign2. Perilesional, and distant Nikolsky sign3. Tzanck smear: Acantholytic cell* Histopathology shows suprabasal blister with row of tomb stone appearance of basal cells.* Direct immunofluorescence from perilesional skin demonstrated intra epidermal IgG deposits' in a fishnet pattern. | 2,726 | medmcqa_train |
A 25year old male presents with painless sudden loss of vision, ocular and systemic examination is not contributory. What is probable diagnosis | Ans is Eale's disease Both Eale's disease and Retinal detachment are causes of painless sudden loss of vision, however Eale's disease is a much more common cause than RD in a young male. Ocular and systemic examinations in both the conditions may be normal.Eale's diseaseIt is a disease of young adult males, who otherwise are healthy, in developing countries (especially India).It is an idiopathic inflammation of peripheral retinal veins; characterized by recurrent vitreous hemorrhage.(Periphlebitis leads to obliteration of the affected vessels. Hypoxia leads to neovascularization which lead to recurrent vitreous hemorrhage)The etiology is unknown. Hypersensitivity to tuberculin protein has been reported, however no clear relationship to tuberculosis has been found.Usually bilateral.The common presenting symptoms are sudden appearance of floaters or painless loss of vision.The vitreous hemorrhage clears spontaneously, but after a few recurrence the hemorrhage may organize, and may cause fractional retinal detachment or secondary glaucoma.Treatment:systemic steroids in early vasculitis stageLaser photocoagulation for abnormal vessels is used in neovascularization stagevitreoretinal surgery is required for marked vitreous traction threatening the macula.Causes of sudden, painless loss of visionUnilateralBilateralSubluxation or dislocation of lensVitreous hemorrhageRetinal hemorrhageRetinal detachmentRetinal vascular occlusionExudative age-related macular degenerationPosterior uveitis Diabetic retinopathyGrade IV hypertensive retinopathy with macular star Atypical optic neuritis Toxic optic neuropathy Bilateral occipital infarction | 2,727 | medmcqa_train |
Jumping gene is known as? | * Transposons, also called jumping genes, are pieces of DNA that move readily from one site to another.* They move either within or between the DNAs of bacteria, plasmids and bacteriophages in a manner, that plasmid genes can become part of the chromosomal complement of genes.* Interestingly, when transposons transfer to a new site, it is usually a copy of the transposon that moves, while the original remains in situ (like photocopying).* Transposons can code for metabolic or drug resistance enzymes and toxins. They may also cause mutations in the gene into which they insert or alter the expression of nearby genes.* In contrast to plasmids or bacterial viruses, transposons cannot replicate independently of the recipient DNA. More than one transposon can be located in the DNA for example, resistance genes. Thus, transposons can jump from:# The host genomic DNA to a plasmid# One plasmid to another# A plasmid to genomic DNA.* An insertion sequence is a short DNA sequence that acts as a simple transposable element. Insertion sequences have two major characteristics: they are small relative to other transposable elements (generally around 700 to 2500bp in length) and only code for proteins implicated in the transposition activity (they are thus different from other transposons, which also carry accessory genes such as antibiotic resistance genes. | 2,728 | medmcqa_train |
Which of the following X-ray should be advised for age determination between 1-13 years of age | A bone age study helps doctors estimate the maturity of a child&;s skeletal system. It&;s usually done by taking a single X-ray of the left wrist, hand, and fingers. It is a safe and painless procedure that uses a small amount of radiation. ... The bone age is measured in years . Reference: GHAI Essential pediatrics, 8th edition | 2,729 | medmcqa_train |
Plague epidemic in Surat in 1995 has occurred after a 'silence period' of | The last case of plague in India was repoed in 1966 and after that there was a 'silence period' of 28 years till the reappearance of the disease in September 1994, when there was an outbreak of bubonic plague in Beed district of Maharashtra and pneumonic plague in Surat (Gujarat). | 2,730 | medmcqa_train |
Vitamin D analogue calcitriol is useful in the treatment of ? | Ans. is 'b' i.e., Psoriasis | 2,731 | medmcqa_train |
Radiation protector drug in clinical use among the following is | Amifostine is used therapeutically to reduce the incidence of neutropenia-related fever and infection induced by DNA-binding chemotherapeutic agents including alkylating agents and platinum-containing agents . It is also used to decrease the cumulative nephrotoxicity associated with platinum-containing agents. Amifostine is also indicated to reduce the incidence of xerostomia in patients undergoing radiotherapy for head and neck cancerReference: Perez and Brady&;s textbook of radiation oncology; 6th edition | 2,732 | medmcqa_train |
Biochemical etiology of Alzheimer's disease relates to | Neurotransmitters, which are decreased in Alzheimer's disease:- Acetylcholine (most important), norepinephrine, somatostatin, corticotropin. | 2,733 | medmcqa_train |
Max risk of stroke after TIA: | Ans. a. First 48 hoursTransient ischemic attack (TIA) is sudden, transitory loss of neurologic function that comes on without headache and resolves spontaneously within 24 hours (but usually lasts less than 1 hour), leaving no neurologic sequelae.The specific symptoms depend on the area of the brain affected, which is in turn related to the vessels involved. The most common origin is high-grade stenosis (>=70%) of the internal carotid, or ulcerated plaque at the carotid bifurcation.Stroke may be indistinguishable from a TIA at the time of presentation: Duration of symptoms is the determining difference.Symptoms are transient with a TIA because reperfusion occurs, either because of collateral circulation or because of the breaking up of an embolus.The blockage in blood flow does not last long enough to cause permanent infarction.Once a patient has a TIA, there is a high risk of stroke in 10-15% in the first 3 months, with most events occurring in the first 2 days. The risk of a stroke in a patient with a history of TIA is about 10% per year. TIAs carry a 30% 5-year risk of stroke. Therefore, cardiac risk factors should be closely investigated and, if possible, eliminated in a patient who has had a TIA.Cases may present only with transient loss of vision in one eye, known as amaurosis fugax. This happens during a transient ischemic attack because the first branch of the internal carotid artery is the ophthalmic artery.Note:TIAs are never due to hemorrhage; hemorrhages do not resolve in 24 hours.The importance of TIAs is that they are predictors of stroke, and timely elective carotid endarterectomy may prevent or minimize that possibility.Workup starts with.noninvasive Duplex studies.Carotid endarterectomy is indicated if the lesions are found in the location that explains the neurologic symptoms.Angioplasty and stent can be performed in high risk surgical patients | 2,734 | medmcqa_train |
'Cloudy cornea' is a feature of? | Ans. D. All of the above. (Ref Essential Paediatrics by OP Ghai 7th/pg. 637)'Cloudy cornea' is known to be a feature of Hurler's disease/IH, Scheie's disease/IS, Morquio's disease/IV and Maroteaux Lamy disease/VI.C/f of mucopolysaccharidoses:Eponyms/MPS numbersMentalretardationCoarse faciesHepatospleno-megalyDysostosismultiplexCorneal clouding1. Hurler/IH+++++2. Scheie's/IS----+3. Hunter/U++++-4. Sanfilipo/lll+----5. Morquio/IV---++6. Maroteaux-Lamy / VI---++7. Sly/VII--++-Features of Hurler Syndrome:# H: Hepatosplenomegaly# U: Ugly facies# R: Recessive (AR)# L: L-iduronidase deficiency# E: Eyes (Cornea) clouded# R: Retarded mentally# S: Short stubby fingers | 2,735 | medmcqa_train |
Painful are syndrome is seen in all except - | Painful are syndrome is seen in incomplete tear of supraspinatus tendon (not in complete tear). | 2,736 | medmcqa_train |
In Thyrotoxicosis, B-blockers do not control - | Beta blockers ameliorate the symptoms of hypehyroidism that are caused by increased beta-adrenergic tone. These include palpitations, tachycardia, tremulousness, anxiety, and heat intolerance. n many tissues, hypehyroidism is associated with an increased number of beta-adrenergic receptors . The ensuing increase in beta-adrenergic activity is responsible for many of the symptoms associated with this disorder. It also explains the ability of beta blockers to ameliorate rapidly many of the symptoms, including palpitations, tachycardia, tremulousness, anxiety, and heat intolerance. Ref - pubmed.com | 2,737 | medmcqa_train |
Arousal response is mediated by | Arousal response in cerebral cortex is activated by stimulation of Reticular activating system. | 2,738 | medmcqa_train |
Lymphoplasmacytoid lymphomas may be associated with | Ans. (b) IgM(Ref: Robbins 9th/pg 598-602)Lymphoplasmacytic cell proliferation in marrow (Lymphoplasmacytic lymphoma) with secretion of IgM | 2,739 | medmcqa_train |
Massive edema in body in a patients of burns is due to | Massive edema in burns is due to altered pressure gradient because of injury to basement membrane. | 2,740 | medmcqa_train |
True about Fibrolamellar carcinoma of Liver is all,except- | Fibrolamellar carcinoma -
It is a distinctive variant of hepatocellular carcinoma
It is seen in young adults (20-40 yrs of age)
It has equal sex incidence
It has a better prognosis
It has no association with HBV or cirrhosis
It is grossly encapsulated mass.
AFP elevation is not seen in Fibrolamellar Ca | 2,741 | medmcqa_train |
Cocospinal tract lesion leads to: | A, B, C i.e. Spaticity, Extensor plantar response, Exaggerated tendon reflexes | 2,742 | medmcqa_train |
An attack of migraine can be easily terminated by: | SPECIFIC ANTIMIGRAINE DRUGS
Ergotamine: It is the most effective ergot alkaloid for migraine. Given early in attack, lower doses generally suffice, and relief is often dramatic. However, when pain has become severe-larger doses are needed and control may be achieved only after few hours. Oral/sublingual route is preferred. 1 mg is given at half hour intervals till relief is obtained or a total of 6 mg is given. Parenteral administration, though rapid in action is more hazardous.
Ergotamine acts by constricting the dilated cranial vessels and/or by specific constriction of carotid A-V shunt channels. Ergotamine and DHE have also been shown to reduce neurogenic inflammation and leakage of plasma in duramater that occurs due to retrograde stimulation of periascular afferent nerves. These actions appear to be mediated through partial agonism at 5-HTID/IB receptors in and around cranial vessels.
Reference: Essentials of Medical Pharmacology Eighth Edition KD TRIPATHI page no 193 | 2,743 | medmcqa_train |
In trauma, which of the following is increased - | Answer is 'a' i.e. Epinephrine; 'b' i.e. ACTH ; 'c' i.e. Glucagon As already mentioned in one of the previous questions, the neuroendocrine response to injury is an impoant pa of the stress response. The release of various hormones, creates an altered metabolic state which helps the individual to survive through the injury or the adverse circumstances. The neuroendocrine response begins with activation of the hypothalamic-pituitary-adrenal axis hypothalmic activation leads to - ADH (or vasopressin) release from the neurohypophysis epinephrine secretion from the adrenal medulla norepinephrine release from sympathetic nerve endings - CRH travels to adenohypophysis, stimualting ACTH production. ACTH acts on adrenal coex, producing coisol release (ACTH also stimulates release of aldosterone from the adrenal coex) About other hormones Insulin - hormones and inflammatory mediators associated with stress response inhibit insulin release. This is required to achieve the hyperglycemic state after injury. Glucagon - increased Aldosterone - increased Thyroid hormones : Thyroxine-no change; T3 - decreased 3 - increased Sex hormones - decreased | 2,744 | medmcqa_train |
A liver biopsy reveals following findings. What is true about this condition | This is a classical picture of nutmeg liver seen in chronic passive venous congestion on the liver.
The dark congested areas consist of necrotic hepatocytes while the surrounding paler and brownish appearing regions are viable hepatocytes.
"The combination of hypoperfusion and retrograde congestion acts synergistically to cause centrilobular hemorrhagic necrosis.
The liver takes on a variegated mottled appearance, reflecting haemorrhage and necrosis in the centrilobular regions.
This finding is known as nutmeg liver due to its resemblance to the cut surface of a nutmeg. ”
— Robbins 9/e p864
Passive Congestion and Centrilobular Necrosis Hepatic manifestations of systemic circulatory compromise-passive congestion & centrilobular necrosis can be seen in both left & right-sided heart failure.
Pathology
Right-sided cardiac decompensation leads to passive congestion of the liver.
The liver is slightly enlarged, tense, and cyanotic, with rounded edges.
Microscopically there is congestion of centrilobular sinusoids.
With time, centrilobular hepatocytes become atrophic, resulting in markedly attenuated liver cell plates.
Left-sided cardiac failure or shock may lead to hepatic hypoperfusion & hypoxia, causing ischemic coagulative necrosis of hepatocytes in the central region of the lobule (centrilobular necrosis). Combination of hypoperfusion & retrograde congestion acts synergistically to cause centrilobular hemorrhagic necrosis.
The liver takes on a variegated mottled appearance, reflecting hemorrhage & necrosis in the centrilobular regions.
This finding is known as nutmeg liver due to its resemblance to the cut surface of a nutmeg. | 2,745 | medmcqa_train |
A patients complains of occasional vomiting of food paicles eaten a few days ago. His wife repos that his breath smells foul. The most likely diagnosis is ? | Ans. is 'd' i.e., Achalasia cardia | 2,746 | medmcqa_train |
An 80 year old male presents to OPD with c/o rapidly enlarging neck mass and Hoarseness of voice . He gives a history of untreated papillary carcinoma of thyroid . What would be the likely diagnosis? | Anaplastic carcinoma - Seen in 7th-8th decade -C/F Sudden increase in the size of swelling Severe pain over the swelling Most common route of spread- Direct invasion Evidence of compression of Trachea - Dyspnea Esophagus - Dysphagia Recurrent laryngeal nerve - Hoarseness of voice Most common site of metastasis - Lungs - Investigations IOC for Diagnosis- FNAC - Treatment For resectable tumor - Total thyroidectomy For unresectable tumor - Tracheostomy (lifesaving procedure when tumor is obstructing trachea) - Poor prognosis. | 2,747 | medmcqa_train |
True statement about Korsakoff's psychosis is - | Korsakoff syndrome has sever antegrade amnesia and less severe retrograde amnesia. | 2,748 | medmcqa_train |
Which of the following acts by inhibition of 30 S ribosome - | Ans. is 'a' i.e., Tetracycline | 2,749 | medmcqa_train |
Male comes with acute scrotal pain. To differentiate between testicular torsion and epididymo-orchitis which is the best way | Angel sign and prehn sign are not reliable.color Doppler is investigation of choice | 2,750 | medmcqa_train |
NaF preservative is added in suspected cases of poisoning by ? | Ans. is 'b' i.e., Alcohol | 2,751 | medmcqa_train |
V asomotor eentre of medulla is associated with: | Ans, a. Acts with the cardiovagal centre to maintain BPVasomotor centre (VMC) controlling sympathetic outflow acts along with cardiovagal centre (CVC) controlling parasympathetic out flow to maintain blood pressure."Vasomotor centre (VMC) controlling sympathetic outflow acts along with cardiovagal centre (CVC) controlling parasympathetic out flow to maintain blood pressure. Baroreceptors, chemoreceptors and cortico hypothalamic inputs influence VMCG. Baroreceptors are tonically active stretch receptors located in walls of aortic arch and carotid sinus. Discharge from baroreceptors cause inhibition of Cl neurons of vasomotor center (VMC) situated in upper (rostral) half of ventrolateral medullaQ andfacilitation of cardiovagal centre (CVC) or nucleus ambiguous. "Medullary Centres regulating Blood PressureVasomotor Centre (VMC)Cardiovagal Centre (CVC)* Collection of glutaminergic neurons in superficial medullary reticular formation, known as C1 neurons, serves as pressure area of VMC. Cell bodies of C1 cells lie in ventrolateral region of upper half of medulla.* These neurons are spontaneously active day and night, tonically discharging impulses (in rhythmic manner) to the heart and blood vessels through lateral reticulospinal tract* It refers to nucleus ambiguous which lies lateral to VMC (medullary reticular neurons)* It receives afferents via Nucleus tractus solitaries (NTS) and in turn sends parasympathetic impulses to heart via the vagus, so named cardiovagal centre* The neurons in CVC do not discharge rhythmically (i.e. are not tonically active) Medullary Centres regulating Blood PressureVasomotor Centre (VMC)Cardiovagal Centre (CVC)* These reticulospinal tracts synapse with preganglionic neurons of sympathetic nervous system located in intermediolateral grey column of spinal cord (thoraoo lumbar sympathetic out flow)* Post ganglionic sympathetic neuron secrete nor adrenaline thereby increasing sympathetic activity and causing tonic vasoconstrictor and cardio accelerator activity resulting in:* The discharge increases parasympathetic activity there by resulting in: * Vasodilation* BP* Cardiac output* Heart rate * Vasoconstriction* BP* Cardiac output* Stroke volume | 2,752 | medmcqa_train |
Usual time for symptoms to appear in Rabid animal - | Post exposure prophylaxis may be discontinued if the suspected animal is proved by appropriate laboratory examination to be free of rabies or in the case of domestic dogs, cats or ferrets, the animal remains healthy throughout a 10 day observation period staing from the date of bite Reference ; Park&;s Textbook of preventive and social medicine,24th edition.Pg no. 297 | 2,753 | medmcqa_train |
The diagnostic characteristics of Plasmodium falciparum are best described by which one of the following statements? | P. Falciparum infection Distinguished by the appearance of ring forms of early trophozoites and gametocytes, both of which can be found in the peripheral blood. The size of the RBC is usually normal.Double chromatin dots in the rings are common. Schuffner stippling is routinely seen in RBC's that harbor P.vivax. | 2,754 | medmcqa_train |
Hypercalcemia is seen in which cancer | Ref:Textbook of pathology (Harsh mohan) 6th edition,page no.695 CLINICAL FEATURES. Renal cell carcinoma is generally a slow-growing tumour and the tumour may have been present for years before it is detected. The classical clinical evidence for diagnosis of renal cell carcinoma is the triad of gross haematuria, flank plain and palpable abdominal mass. The most common presenting abnormality is haematuria that occurs in about 60% of cases. By the time the tumour is detected, it has spread to distant sites haematogenous route to the lungs, brain and bone, and locally to the liver and perirenal lymph nodes. Systemic symptoms of fatiguability, weight loss, cachexia and intermittent fever unassociated with evidence of infection are found in many cases at presentation. A number of paraneoplastic syndromes due to ectopic hormone production by the renal cell carcinoma have been described. These include polycythaemia (by erythropoietin), hypercalcaemia (by parathyroid hormone and prostaglandins), hypeension (by renin), effects of feminisation or masculinisation (by gonadotropins) and Cushing's syndrome (by glucocoicoids). | 2,755 | medmcqa_train |
Which is the only nearly pure metal used for dental casting purposes? | CP titanium, which is classified in four different grades, can technically be considered as an alloy because small percentages of other impurity elements are allowed as specified by a standard that has been established by the American Society for Testing and Materials (ASTM) for each grade. Although it is classified as commercially pure, grade 2 CP-Ti may contain up to 0.10% C, 0.30% Fe, 0.015% H, 0.03% N, 0.25% O, and 0.40% of other elements.
Phillips 12th edition page 71 | 2,756 | medmcqa_train |
Drug used in triple drug therapy of H. Pylori: | Ans. A. MetronidazoleH pylori have triple and 4 drug therapy for H. Pylori where 4 antibiotics can be given like amoxicillin, clarithromycin, Metronidazole and tetracycline. Other drugs are PPI like omeprazole and bismuth sub citrate. | 2,757 | medmcqa_train |
Selective serotonin reuptake inhibitors are drugs of choice for all of the following conditions except: | Ref: KDT 6/e p448,449 *SSRIs are drug of choice for depression,sustained treatment of panic disorder and generalized anxiety disorder, obsessive compulsive disorder, post-traumatic stress disorder, social and other phobia and bulimia. *In acute panic attacks and for acute treatment of generalized anxiety disorder, benzodiazepines are preferred. | 2,758 | medmcqa_train |
Complete regression of which of the following veins causes this anomaly in the development of IVC (Figure). | Ans: (c) Right supra-cardinal veinRef: Essentials of Human Embryology, A.K.Datta, 5th edition, 2005, Page 205-208 4The anomaly shown in picture is Retrocaval ureter (right ureter) passes at first behind the IVC, and then appears in front of it after winding the medial margin of IVC.Retrocaval ureter occurs when the post-renal segment of the IVC is developed from the right posterior cardinal vein and the right supra-cardinal vein regress entirely.Development of IVCIVC developed from the following sources from below upwards1. Persistent caudal part of the right posterior cardinal vein2. Right supra-cardinal vein (this part receives 3rd and 4th pairs of lumbar veins)3. Anastomosis between right supra-cardinal and right sub-cardinal veins (this part receives the right gonadal vein).4. Upper part of the right sub-cardinal vein (this part receives both renal veins and right supra-renal vein).5. A new vessel grows dorsal to the liver and communicates the right sub-cardinal vein with the common hepatic vein (intrahepatic part of IVC).6. Common hepatic vein-which is developed from the suprahepatic part of the right vitelline vein (terminal part of IVC).Anomalies of IVC1. Double IVC - IVC persist on both sides below the level of renal veins. This occurs when the left common iliac vein fails to develop and the infra-renal segment of the left supra-cardinal vein fails to regress.2. Retro-caval ureter (as explained earlier). | 2,759 | medmcqa_train |
Compute the median for the following set of data, 1,2,3,4,5,6: | If the number of samples is an even number, the median is midway between the two middle scores. (3+4)/2=3.5 Ref : Medical biostatistics, 1st edition pg: 111 | 2,760 | medmcqa_train |
A 50-years-old male Raju, presents with occasional dysphagia for solids, regurgitation of food and foul smelling breath. Probable diagnosis is: | Clinical feature Usually seen in patients over 50 years MC symptom is dysphagia Undigested food is regurgitated into the mouth, especially when the patient is in the recumbent position Swelling of the neck, gurgling noise after eating, halitosis, and a sour metallic taste in the mouth are common symptoms Cervical webs are seen associated in 50% of patients with Zenker's diveicula, can cause dysphagia post-operatively if not treated. | 2,761 | medmcqa_train |
Which of the following is not seen in pseudogout | Small joints affected Pseudogout commonly involves the larger joints.Knee joint is most commonly involved; other sites are wrist, elbow, shoulder, ankele. Involvement of small joints is uncommon. Pseudogout It is one of the forms of "Calcium pyrophosphate dehydrate" (CPPD) ahropathy Age group is > 60 yrs. In CPPD ahropathy, CPPD deposition occurs in aicular tissues. It can present in any of the following three forms 1)Asympatoinatic chonclrocalcinosis 2)Acute synovitis - Pseudogout 3)Chronic pyrophosphate ahropathy The radiologic hallmark of CPPD is "Chondrocalcinosis" Chondrocalcinosis is seen as punctate and/or linear radiodense deposits in fibroc:ailaginous joint menisci or aicular hyaline cailage. Definitive diagnosis is made by synol fluid polarised light microscopy which shows weakly positive, birefringent, rhomboid crystals of CPPD. In acute synovitis form, leucocytosis (thousands to 1 lac cells/g1) is seen in synol fluid examination. It may be associated with ceain underlying disease such as ? - Primary hyperparathyroidism - Hemochromatosis - Hypomagnesemia - Hypophosphatasia - Hypothyroidism Pseudogout can be differentiated from gout as follows - Gout Pseudogout Smaller joints Large joints Intense pain Moderate pain Joint inflammed Swollen joint Hyperuricemia Chondrocalcinosis Uric acid crystals Calcium pyrophosphate dehydrate crystal Treatment The treatment of pseudogout is the same as that of acute gout: rest and high dose anti-inflammatory therapy. In elderly patients, joint aspiration and infra-aicular caicosteroid injection is the treatment of choice as these patients are more vulnerable to the side effects of NSAIDs. Urate lowering therapy is ineffective in CPPD | 2,762 | medmcqa_train |
The neurosurgeon had removed a portion of the dense tissue (dura mater) covering the brain of the patient when she removed the tumor that had invaded the skull. To replace this important tissue covering of the brain, she took a band of the aponeurotic tissue of the lateral aspect of the thigh, covering the vastus lateralis muscle. What muscle, supplied by the inferior gluteal nerve, inserts into this band of dense tissue as part of its insertion? | The tensor fasciae latae (which is innervated by the superior gluteal nerve) and the iliotibial tract are dense, wide aponeurosis that receives the insertion of the tensor fasciae latae and about 75% of the gluteus maximus. The gluteus maximus is the only one of the muscles listed that is supplied by the inferior gluteal nerve; in fact, it is the only muscle innervated by the inferior gluteal nerve. Gluteus medius and minimus insert on the greater trochanter and are innervated by the superior gluteal nerve. The rectus femoris, supplied by the femoral nerve, inserts via the quadriceps tendon on the patella and tibial tuberosity. | 2,763 | medmcqa_train |
Which of the following does not supply the palate- | Blood supply of soft palate
Arterial supply of soft palate is as follows:-
Greater palatine branch of the descending palatine artery, which in turn is a branch of the maxillary artery.
Ascending palatine branch of the facial artery.
Palatine branch of ascending pharyngeal artery.
Lesser palatine artery a branch of descending palatine artery, which is a branch of the maxillary artery. | 2,764 | medmcqa_train |
Millard's 'Rule of Ten' includes all except - | Ans- D Rule often is the criteria used to judge the "readiness" of an infant for surgical repair of a cleft lip. The infant must weigh 10 Ib; be 10 weeks old; have a hemoglobin value of 10gm/dl and have a WBC count < 10,000. | 2,765 | medmcqa_train |
Which is the preferred incision for abdominal exploration in blunt abdominal injury ? | The preferred incision for emergency abdominal exploration in blunt injury abdomen is midline laparotomy. This type of incision is preferred as it provides adequate exposure, associated with minimal blood loss, minimal nerve and muscle injury. Ref: Current Surgical Diagnosis & Treatment, 12th Edition, By Gerard M. Dohey, Page 230,31; Bailey and Love's Sho practice of surgery , 24th Edition, Page 288 | 2,766 | medmcqa_train |
Molten wax appearance is seen in | Motten wax or Flowing candle wax appearance feature of Melorheostosis. | 2,767 | medmcqa_train |
Golden hour of fracture femur is? | Ans. is 'a' i.e., 1 hr after injury Golden Hour It is the first hour from the time of trauma. It is the most critical for life and for the limb bility following fracture femur. Best prognosis is for the patients with fracture femur are for those who reach the OR in the golden hour. The emergency medical team should not take more than 10 minutes from the time of trauma in patients with fracture femur to decide and sta shifting the patient. This is described as "Platinum Ten". Thus, Golden hour -1 hour from the time of injury. Platinum hour - ten minutes from the time of injury. | 2,768 | medmcqa_train |
Most common malignancy in AIDS is: March 2011 | Ans. A: Kaposi sarcoma The neoplastic diseases clearly seen with an increased frequency in patients with HIV infection are Kaposi sarcoma and non-Hodgkin's lymphoma | 2,769 | medmcqa_train |
Brachytherapy is used in : | Ans. is a i.e. Stage lb Ca cervix Radiotherapy is recommended in advanced stages of Ca cervix i.e. stage IIB onwards.deg Brachytherapy is commonly used. For larger tumours initially external radiation then brachytherapy is given In small tumours brachytherapy is given first followed by external radiation. For stage IB and IIA - both surgery and radiotherapy yield similar results. There is very little scope of radiotherapy in ovary tumors. Only Granulosa cell tumour and dysgerminoma are radiosensitive and external radiotherapy is instituted for elderly woman. Vaginal Squamous cell Ca is only moderately sensitive to irradiation. In all advanced cases exenteration operation is done. Fallopian tube carcinoma -Total hysterectomy with Bilateral Salpingo-oophorectomy along with omentectomy followed by external pelvic radiation is the Treatment of Choice in Ca of Fallopian Tube. | 2,770 | medmcqa_train |
Child begins to sit with suppo, able to transfer objects from one hand to another hand and speak monosyllabic babbles at the age of - | Ans. is 'b' i.e., 6 months | 2,771 | medmcqa_train |
Maximum increase in prolactin level is caused by:- | Prolactin is inhibited by dopamine, so, any drug which blocks D2 recptor will lead to increase in prolactin. Anti-psychotics are D2 blocking drugs. They are of two types: * Typical anti-psychotic drug are amily D2 blocker. * Atypical anti-psychotics are mainly 5HT2 blocker but among them the maximum D2 blocking action is caused by Resperidone. So, Resperidone has the maximum chance of causing hyerprolactinema and also the maximum chance of causing EPS(Extra pyramidal symptoms) among the atypical anti-psychotics. Clozapine and Olanzapine are 5HT2 and D2 blocker. Aripiprazole is D2 paial agonist so, no chances of hyper-prolactinemia. | 2,772 | medmcqa_train |
Ramkali bai, a 35-year-old female presented with a one-year history of menstrual irregularity and galactorrhoea. She also had off and on headache, her examination revealed bitemporal superior quadrantanopia. Her fundus examination showed primary optic atrophy. Which of the following is a most likely diagnosis in this case - | A 35 year old woman complaining of amenorrhoea — galactorrhoea syndrome along with visual field defects confirms the diagnosis of pituitary macrodenoma (prolactinoma)
Amenorrhoea and galactorrhoea results due to increased secretion of prolactin.
Headache and visual field defects are seen due to mass effect of the tumours on the optic nerve.
Now, the closest d/d of prolactinoma i.e. craniopharyngioma
Bimodal age of incidence with one peak in childhood and the other in old age at 60 years.
These tumours are suprasellar in location and the symptoms are produced due to mass effect of tumour either on the pituitary or optic chiasm. (It does not secrete any hormone)
"Craniopharyngioma will never produce the Amenorrhoea galactorrhoea syndrome. Craniopharyngioma does not secrete any hormone."
| 2,773 | medmcqa_train |
Ceain sign of onset of labor: March 2013 | Ans. D i.e. Formation of bag of waters The first symptom to appear is intermittent painful uterine contractions followed by expulsion of blood stained mucus (show) per vaginum But formation of 'bag of membranes' is almost a ceain sign of onset of labor | 2,774 | medmcqa_train |
Linear accelerator produces? | ANSWER: (A) X raysREF: Oxford oncology 2nd edition page 398, O P Tondon's Inorganic chemistryRepeat from December 2009Linear accelerator and Betatron are used to produce X Rays by accelerating electronsCyclotron is used to produce Gamma rays. | 2,775 | medmcqa_train |
During normal inspiration diaphragm goes down by? | Ans. is 'a' i.e., 1-2 cmIn normal inspiration, the diaphragm descends 1-2 cm into the abdominal cavity producing a pressure difference of 1-3 mm hg and the inhalation of about 500 ml of air. | 2,776 | medmcqa_train |
Gene therapy is most commonly targeted against: | a. SCID(Ref: Nelson's 20/e p 584-586)FDA-approved gene therapy is used for ADA-SCID, Leber's congenital amaurosis, multiple myeloma & Adrenoleukodystrophy | 2,777 | medmcqa_train |
A 50 years old male with type 2 diabetes mellitus is found to have 24-hour urinary albumin of 250 mg. Which of the following drugs may be used to retard progression of the renal disease? | Antihypeensive drugs in Diabetes MellitusACE inhibitors (enalapril) or angiotensin receptor blockers are the first line of therapy in hypeensive individuals with type 2 DM.They have no known adverse action on glucose or lipid metabolism.Minimize the development of diabetic nephropathy (by reducing renal vascular resistance and renal perfusion pressure-the primary factor underlying renal deterioration in these patients).(Refer: Harrison's Principles of Internal Medicine, 18th edition, pg no: 2054-2058) | 2,778 | medmcqa_train |
Teeth bite marks are a type of: March 2011 | Ans. B: Pressure Abrasion Teeth marks in biting and ligature marks in hanging and strangulation are example of imprint, pressure or contact abrasion Abrasion It as also known as - Graze or Scratch or Impression. An abrasion is a superficial injury to the skin which involves the loss of superficial epithelial layer (Uppermost layers of the cells of skin) of skin. Abrasions are produced by ? - Blow - Fall on some rough and hard substance - Dragging as in vehicular accidents. - Scratching with finger nails, bites and thorns etc. - Friction on some hard substance. Pressure of rope or cord as is found in strangulation and hanging etc. - Rubbing. - Indenting of the objects. Varieties of Abrasions Scratches- They are due to a sharp or a pointed object pressing across the skin, moving the surface layers in front of it and causing the heaping up of layers of skin. Grazes- They are modified scratches. - In this, the broader surface of skin comes in contact with the uneven rough object. - In this, the depth may vary at different places. - The direction is indicated by presence of clean commencement and tag at the finishing end. Impact Abrasions/Pressure Abrasions - They are also known as "Imprint abrasions". - They are caused by the stamping of some object against the skin like radiators of cars in vehicular accidents or - They may be caused by pressure on the skin which is accompanied by movements as found in? Ligature in cases of hanging or strangulation. Injuries caused by lashes with whip Sites of Abrasions ? The abrasions resulting from friction against rough surface during a fall are generally found on the bony pas and are accompanied with contusions or lacerations The abrasions caused by finger nails are seen on the exposed of body like - Face near forearm, hands, thighs etc. They are cresentric in shape, when finger nails are used. Ecchymosis is a common accompaniment. The abrasions caused by teeth bite are elliptical or circular in shape and often present separate marks. Typical impression of teeth by different sets of teeth (Deciduous or permanent) is marked. The intervening area is only a bruised area. The abrasions from radiators are honey-comb in appearance and are .commonly found in vehicular accidents Difference between Antemoem and Postmoem Bruise Antemoem abrasions will show signs of inflammation and repair whereas these will be absent in postmoem abrasions. | 2,779 | medmcqa_train |
Drug (s) used in the treatment of multiple myeloma is/are- | Drugs used as first line treatment of multiple myeloma include boezomib(proteasome inhibitor) & thalidomide( anti- angiogenic effects against tumour blood vessels & immunomodulatory effects).Reference :Davidson's principles &practice of medicine 22nd edition pg no 1047. | 2,780 | medmcqa_train |
The following can be associated with fatty liver except - | Amiodarone-induced liver damage may present as Reye's syndrome in kids and may present as asymptomatic elevation of liver enzymes in adults. Asymptomatic liver enzyme elevation occurs in 25% of the population treated with amiodarone and is usually reversible upon discontinuation of therapy zidovudine-induced myopathy and hepatotoxicity in patients Valproic acid may cause serious or life-threatening damage to the liver that is most likely to occur within the first 6 months of therapy Chlorpropamide doesn't cause fatty liver Ref Davidson edition23rd pg774 | 2,781 | medmcqa_train |
Immunostimulant used for the treatment of malignant melanoma is : | It is a recombinant IL-2 used for the treatment of renal cell carcinoma and malignant melanoma. | 2,782 | medmcqa_train |
Nucleosome consist of | A nucleosome is a basic unit of DNA packaging in eukaryotes, consisting of a segment of DNA wound in sequence around eight histone protein cores. This structure is often compared to thread wrapped around a spool. Nucleosomes form the fundamental repeating units of eukaryotic chromatin, which is used to pack the large eukaryotic genomes into the nucleus while still ensuring appropriate access to it (in mammalian cells approximately 2 m of linear DNA have to be packed into a nucleus of roughly 10 um diameter). Nucleosomes are folded through a series of successively higher order structures to eventually form a chromosome; this both compacts DNA and creates an added layer of regulatory control, which ensures correct gene expression. Nucleosomes are thought to carry epigenetically inherited information in the form of covalent modifications of their core histones. | 2,783 | medmcqa_train |
Niacin deficiency causes all except | The classic triad of pellagra is dermatitis, diarrhea, and dementia. Ref: Page 182; Nelson textbook of pediatrics; 17th edition | 2,784 | medmcqa_train |
Larynx extends from - | The larynx is situated in front of hypopharynx opposite third to sixth cervical vertebrae. | 2,785 | medmcqa_train |
Apple jelly nodules on the nasal septum are found in cases of ? | Ans. is 'c' i.e., Lupus vulgaris Lupus vulgaris It is an indolent and chronic form of tuberculous infection. Female to male ratio is 2:1. Most common site is the mucocutaneous junction of the nasal septum, the nasal, vestibule and the ala. Characteristic Feature is the presence of apple- jelly nodules (Brown gelatinous nodules) in skin. Lupus can cause perforation of cailaginous pa of nasal septum. Confirmation is by Biopsy | 2,786 | medmcqa_train |
For clinically detectable ascites, the minimal amount of fluid should be | This is a direct pick from National Boards. | 2,787 | medmcqa_train |
Which statements is not true regarding acute starvation? | In starvation: Increased Lipolysis Increased gluconeogenesis in liver andIncreased glycogenolysis in liverIn fasting and starvation, glucose must be provided for the brain and red blood cells; in the early fasting state, this is supplied from glycogen reserves.In order to spare glucose, muscle and other tissues do not take up glucose when insulin secretion is low; they utilize fatty acids (and later ketone bodies) as their preferred fuelRef: Harper 27e pg: 149 | 2,788 | medmcqa_train |
Which of the following is a diagnosis? | Ans. (a) Klatskin tumor.Imagesource- style="font-family: Times New Roman, Times, serif"> | 2,789 | medmcqa_train |
A young girl presents with primary amenorrhoea, grade V thelarche, grade II pubarche and no axillary hair. The most probable diagnosis is | Testicular feminization syndrome - complete androgen resistance, presents as phenotypic young woman without sexual hair but with normal breast development and primary amenorrhoea Complete testicular feminization is a common form of male pseudohermaphroditism. It is the 3rd most common cause of primary amenorrhea after gonadal dysgenesis and congenital absence of the vagina. The features are characteristic. Namely, a ''woman" is asceained either because of inguinal hernia (prepubeal) or primary amenorrhea (postpubeal). The development of the breasts, the habitus, and the distribution of body fat are female in character so that most have a ''truly" feminine appearance. Axillary and pubic hairs are absent or scanty, but some vulval hairs are usually present. Scalp hairs are that of a normal woman, and facial hairs are absent. The external genitalia are unambiguously female, and the clitoris is normal. The vagina is sho and blind-ending and may be absent or rudimentary. All internal genitalia are absent except for testes that contain normal Leydig cells and seminiferous tubules without spermatogenesis. The testes may be located in the abdomen, along the course of the inguinal canal, or in the labia majora. | 2,790 | medmcqa_train |
An 8 days old male infant is brought to the emergency department with vomiting, lethargy, dehydration and features of shock. Clinical examination reveals hyperpigmentation of the genital skin and normal external genitalia. Abdominal examination is unremarkable. blood tests revealed sodium of 124 mecill, potassium of 7 meq/1 and hypoglycemia. Which of the following is the most likely diagnosis: | Presence of vomiting, lethargy, dehydration, hyponatremia, hyperkalemia, hypoglycemia and shock in this eight-year-old male infant suggest a diagnosis of neonatal adrenal insufficiency/crisis.
Congenital Adrenal Hyperplasia is the most prevalent cause of adrenal insufficiency in neonates (typically 7-14 days post delivery) and the single best answer amongst the options provided,
Clinical features of CAH (21 hydroxylase deficiency)
Symptoms of classical CAH due to 21 hydroxylase deficiency are:
Clinical: Lethargy, vomiting, Anorexia, weight loss, dehydration, hypotension, shock
Mineralocorticoid deficiency: Hyponatremia, hyperkalemia, hypotension
Cortisol deficiency: Hypoglycemia, Hyperpigmentation of areolar and scrotal areas in males and genital creases in females (due to ↑ ACTH secretion)
Excess Androgen
Males: Phenotypically normal for some years, precocious puberty
Females: Virilization (female pseudohermaphrodite) | 2,791 | medmcqa_train |
Incidence of undescended testis in term infants is: | The incidence of undescended testes is approximately 30% in preterm infants and 1 to 3% in term infants. Ref: Schwaz's principle of surgery 9th edition, chapter 39. | 2,792 | medmcqa_train |
Irregular and infrequent menstruation is known as: | Oligomenorrhoea - Infrequent and irregularly timed episodes of bleeding usually occuring at intervals of more than 35 days Polymenorrhoea - Frequent episodes of mentruation usually occurring at intervals of 21 days or less Menorrhagia - Increased menstrual flow/Increased duration at regular cycles Hypomenorrhoea - Scanty bleeding and shoer days of bleeding Metrorrhagia - Irregular bleeding in between the cycles Menometrorrhagia - Increased menstrual flow as well as irregular bleeding between the cycles | 2,793 | medmcqa_train |
All are true about Xeroderma Pigmentosum except | (A) It is autosomal dominant inheritance # XERODERNA PIGMENTOSUM (XP)> Is an autosomal recessive genetic disease.> The clinical syndrome includes marked sensitivity to sunlight (ultraviolet) with subsequent formation of multiple skin cancers and premature death.> The risk of developing skin cancer is increased 1000- to 2000-fold.> The inherited defect seems to involve the repair of damaged DNA, particularly thymine dimers.> Cells cultured from patients with xeroderma pigmentosum exhibit low activity for the nucleotide excision-repair process.> Seven complementation groups have been identified using hybrid cell analyses, so at least seven gene products (XPA-XPG) Are involved.> Two of these (XPA and XPC) are involved in recognition and excision.> XPB and XPD are helicases and, interestingly, are subunits of the transcription factor TFIIH. | 2,794 | medmcqa_train |
Exposure of a female fetus to androgen in early embryogenesis may arrest differentiation of : | Sholy after the tip of para mesonephric ducts reach the urogenital sinus two solid evaginations grow out from the pelvic pa of the sinus.From these evaginations the sinovaginal bulbs proliferates to form the vaginal plates. The androgen exposure may arrest the differentiation of urogenital sinus LANGMAN'S MEDICAL EMBRYOLOGY, Pg no:229,12th edition | 2,795 | medmcqa_train |
In obstruction of second pa of axillay aery, theanostomosis between the following aery will maintain the blood supply of upper limb: | Deep branch of transverse cervical aery & subscapular aery [Ref: BDC 4/e, Vol 1, p 56, 82; Snell's Clinical Anatomy 6/e, p 412-413, 657; Moore Clinical Anatomy 5/a, p 766-7671Axillary aery is the continuation of the subclan aery. It is crossed by pectoralis minor muscle which devides it into three pas.A rich anastomosis exists around the scapula between branches of subclan aery (first pa) & the axillary aery (third pa).This anastomosis provides a collateral circulation through which blood can flow to the limb when the distal pa of subclan aery or the proximal pa of axillary aery is blocked.Anastomosis around the scapula :Formed by branches of-Subclan aery - first pa- Suprascapular aery- Deep branch of transverse cervical aeryAxillary aery - third pa- Subscapular aery & its circumflex scapular branchThere are other smaller anastomoses over the acromion process, which also helps to maintain .flow to arm. (BDC Vol I, 4/e, p 82)Anastomoses over the acromion processFormed by -a)Acromial br. of thoraco-acromial aeryb)Acromial br. of suprascapular aeryc)Acromial br. of posterior circumflex humeral aeryThe subscapular aery also forms anastomoses with intercostal aeries | 2,796 | medmcqa_train |
Drug of choice for surgically unresectable renal cell carcinoma is ? | . | 2,797 | medmcqa_train |
Which of the following markers in the blood is the most reliable indicator of recent hepatitis B- infection? | Ans. is 'c' i.e. IgM anti-HBc You are sure to get questions on serological marker of Hepatitis in every PG exams (particularly AIIMS & AI). This topic has been thoroughly discussed.See Q. No 58 of Nov. 2001.Coming to the question; Hbs Ag is also present in recent hepatitis B infection but it is not a reliable marker because it can also be seen in carriers, whereas IgM anti- HBc is seen only in acute or recent hepatitis and is replaced by IgG anti Hbc in chronic infections. | 2,798 | medmcqa_train |
After a leisure trip, a patient comes with gritty pain in eye, and joint pain following an episode of urinary infection. What is the most probable diagnosis? | Reiter 's syndrome now referred to as reactive ahritis (ReA), is a classic triad of ahritis, nongonococcal urethritis and conjunctivitis. Reactive ahritis is triggered following enteric or urogenital infections. Reactive ahritis is associated with human leukocyte antigen (HLA)-B27. Bacteria associated with reactive ahritis are generally enteric or venereal. Reactive ahritis falls under the rheumatic disease category of seronegative spondyloahropathies, which includes ankylosing spondylitis, psoriatic ahritis, the ahropathy of associated inflammatory bowel disease, juvenile-onset ankylosing spondylitis, juvenile chronic ahritis, and undifferentiated spondyloahritis. | 2,799 | medmcqa_train |
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