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Hypeonic urine is excreted due to absorption of water in: | A i.e. Collecting DuctOsmolality of urine depends on the action of vasopressin on the collecting ductsQ. Alteration in water metabolism by vasopressinUrine isotonic to plasmaGFR (ml/min)% of filteredwaterreabsorbedUrine volume(L/d)Urine concentration(mosm /kg H20)Gain /Loss of water inexcess of solute (L/d)12598.72.4290 Vasopressin present12599.70.51400Q (almost 5 timeof plasma)1.9 gainNo vasopressin (Diabetesinsipidus)12587.123.33020.9 loss | 3,100 | medmcqa_train |
Impotent female is having - | Ref: Synopsis of Forensic medicine and Toxicology (Dr.K.S.Narayana Reddy) Pg 200 In females impotence is of an active nature , leading to vaganismus . vaginisumus is a spasmodic contraction of vagina due to hyperesthesia .it's a classical example of psychosomatic illness .anatomically, it may affect the perineal muscles exclusively or may felt as a constriction of the levator ani , right up to vaginal fornices .this a definite cramp like spasam of the adductor muscles .the vagainal hypersthesia stas at the vaginal introitus . the spastic contraction of the vaginal outlet is completely involuntary reflex, at vaginal penetration. In fully developed state, penetration by the penis is impossible.thus she becomes impontant. In case of Gonadal dysgenesis , Hermaphrodits and Absence of ovary ,it doesn't interfere with vaginal penetration and paicipation in coitus, those females are not impotent but may be infeile. | 3,101 | medmcqa_train |
Which among the following causes Malta fever? | Brucellosis, also called Bang's disease, Crimean fever, Gibraltar fever, Malta fever, Maltese fever, Mediterranean fever, rock fever, or undulant fever. The infection is transmitted from animals to humans. Brucella abous (cattle), B suis (hogs), and B melitensis (goats) are the main agents. Transmission to humans occurs by contact with infected meat (slaughterhouse workers), placentae of infected animals (farmers, veterinarians), or ingestion of infected unpasteurized milk or cheese. The incubation period varies from a few days to several weeks. Brucellosis is a systemic infection that may become chronic. B. melitensis infections tend to be more severe and prolonged, whereas those caused by B. abous are more self-limited. After an incubation period of 1 to 3 weeks, nonspecific symptoms such as fever, chills, fatigue, malaise, anorexia, and weight loss occur. The onset can be acute or gradual. The undulating (rising-and-falling) fever pattern that gives the disease its name occurs in a minority of patients. The treatment of choice is tetracycline plus rifampin. Prevention of brucellosis involves pasteurization of milk, immunization of animals, and slaughtering of infected animals. There is no human vaccine. Ref: Levinson W. (2012). Chapter 20. Gram-Negative Rods Related to Animal Sources (Zoonotic Organisms). In W. Levinson (Ed), Review of Medical Microbiology & Immunology, 12e. | 3,102 | medmcqa_train |
Rupture of the carotid artery in the neck region. Which of the following site pressure is applied | D. i.e. (C6 - vertebra ) (444 - Grey 14th)The bifurcation of the common carotid artery in to the internal and external carotid arteries can be palpated just beneath the anterior border of sterno cleidomastoid muscle at the level of the superior border of the thyroid cartilage. This is a convenient site to take the carotid pulse (748- Snell 8th) (C3 - C4 junction)The artery may be compressed against the prominent transverse process of the sixth cervical vertebra (chassaignac's tubercle) and above this level it is superficial and its pulsation can be easily fet (444 - Gray - anatomy 14th)* Best radiographic view for fracture of Cl C2 vertebra is odontoid view*** C7 has longest spinous process*** Subclavian Artery in patients with upper limb hemorrhage - compressed against the upper surface of the fist rib (third part of subclavian artery | 3,103 | medmcqa_train |
Daily maintanence fluid for a child weighing 10 kg is: | Ref: Nelson's Textbook of Pediatrics. 19th Edition.Explanation:The Holliday-Segar MethodIn the Holliday-Segar Method, fluid and electrolyte requirements are empirically based on the caloric needs of the average hospital patient.The same formula is used for calculating calorie requirement as well as fluid requirementRelation of Body Weight to Maintenance fluidsFor each kilogram in this rangeDaily fluid requirement per kilogramFirst 1-10 kg100 ml/kg/dayNext 11 -20 kg50 ml/kg/dayFor >20 kg20 ml/kg/dayFor 10kg child. Maintanence fluid for 24 hours = 10 x 100 = 1000 ml/dayFor 15 kg child, Maintanence fluid for 24 hours = 10 x 100 + 5x 50 = 1250 ml/dayFor 25 kg child, Maintanence fluid for 24 hours = 10 x 100 + lOx 50 + 5x 20 = 1600 mL/day | 3,104 | medmcqa_train |
Soft markers on ultrasonography are helpful in diagnosing? | Ans. is'b'i.e., Chromosomal anomaliesAntenatal soft ultrasound markers are fetal sonographic findings that are generally not abnormalities as such but are indicative of an increased age adjusted risk of an underlying fetal aneuploidic or some non chromosomal abnormalities. | 3,105 | medmcqa_train |
Baby born to DM have following except : | Ans. is a i.e. Hypercalcemia Neonatal complications of Maternal diabetes : Respiratory distress syndrome (RDS) Hypoglycaemiadeg Hypocalcemiadeg Hypomagnesemia Polycythemia Hyperbilirubinaemia Hyperviscosity syndrome Hyperophic cardiomyopathy Bih trauma - Erb's and Klumpke's paralysis and fractures of the clavicle and humerus due to large size Feeding problems. Late effects : Increased risk of diabetes in children if : If mother is diabetic Risk 1-3% If father is diabetic Risk 6% If both are diabetic - Risk 20% - Self Assessment & Review Obstetrics As far as Hypokalemia is concerned - It is not given anywhere that hypokalemia is seen in neonate of diabetic mother, but we all know that in neonate of diabetic mother hyperinsulinemia is seen. "Insulin causes potassium to shift in to the cells by Na' antipoer and Na' ATPase pump thereby lowers plasma potassium concentration". | 3,106 | medmcqa_train |
Oblitration of left cardiac shadow on PA view is due to: | A i.e. Lingular lesion | 3,107 | medmcqa_train |
There is spontaneous rupture of the Achilles tendon in an 18 year old male. It is most likely to be due to excess stress beyond - | ACHILLES TENDON RUPTURE: A ripping or popping sensation is felt, and often heard, at the back of the heel. This most commonly occurs in spos requiring an explosive push-off: squash, badminton, football, tennis, netball. The patient will often repo having looked round to see who had hit them over the back of the heel, the pain and collapse are so sudden.The typical site for rupture is at the vascular watershed about 4 cm above the tendon inseion onto the calcaneum. The condition is often associated with poor muscle strength and flexibility, failure to warm up and stretch before spo, previous injury or tendinitis and coicosteroid injection. REF:Apley&;s system of ohopaedics - 9th edn - pg no 615. | 3,108 | medmcqa_train |
A 10 month of child weighing 8kg has bitot spots in both eyes. Which of the following is the most appropriate schedule to prescribed vitamin A to this child - | Vitamin A deficiency treatment: Vitamin A on days 1,2 and 14 each Age >12 months - 200,000 IU Age 6-12 months - 100,000 IU for age 0-5 months - 50,000 IU Ref: Guidelines for the inpatient treatment of severely malnourished children, WHO Pgno : 23 | 3,109 | medmcqa_train |
All of the following drugs alter calcium hemostasis except- | drugs or Non hormonal substances altering calcium hemostasis are Calcium preparations Flouride Thiazides Bisphosphonates Vit D or Calcitriol Some antibiotics like mithramycin Ref - Harrisons internal medicine 20e p2945-2946 2911-12 | 3,110 | medmcqa_train |
Which of the following is NOT an adverse effect of cyclosporine? | (Ref: KDT 6/e p840) Cyclosporine causes hyper and not hypoglycemia | 3,111 | medmcqa_train |
Epithelium of cornea is | A. i.e. Stratified Squamous non Keratinizing | 3,112 | medmcqa_train |
Ligamentum teres is: | After bih, the left umbilical vein are obliterated and forms the ligamentum teres hepatisLigamentum teresIt is the obliterated fibrous remnant of the left umbilical vein of the fetus.It originates at the umbilicus.It passes superiorly in the free margin of the falciform ligament.From the inferior margin of the liver, it may join the left branch of the poal vein or it may be in continuity with the ligamentum venosumOther fetal remnantsUmbilical aeries forms medial umbilical ligamentDuctus venosus forms ligamnetum venosusmDuctus aeriosus forms ligamnetum aeriosum | 3,113 | medmcqa_train |
Structures passing through obturator foramen are all except - | Through the canal the obturator aery, obturator vein and obturator nerve pass out of the pelvis. | 3,114 | medmcqa_train |
The Earliest sign of male pubey is | In boys, the first visible sign of pubey and hallmark of SMR2 is testicular enlargement, beginning as early as 9 1/2 years. This is followed by penile growth during SMR3. Peak growth occurs when testis volumes reach approximately 9-10 cm3 during SMR4. Under the influence of LH and testosterone, and prostate enlarges. The left testis normally is lower than the right. Some degree of breast hyperophy, typically bilateral, occurs in 40-65% of boys during SMR2-3 due to a relative excess of estrogenic stimulationIn girls, the first visible sign of pubey and the hallmark of SMR2 is the appearance of breast buds, between 8 and 12 years of age. Menses typically begins 2-2 1/2 years later, during SMR3-4 (median age, 12 years; normal range, 9-16 years), around the peak height velocity. Less obvious changes include enlargement of the ovaries, uterus, labia, and clitoris, and thickening of the endometrium and vaginal mucosa | 3,115 | medmcqa_train |
Mechanism of action of Tetanospasmin:- | Mechanism of action of Tetanospasmin is Inhibition of GABA release. C. tetani produces:- Tetanolysin:heat labile, oxygen labile hemolysin. It plays no role in the pathogenesis. Tetanospasmin or tetanus toxin (TT) : neurotoxin responsible for the pathogenesis of tetanus: - It is oxygen stable but heat labile; coded by plasmid. - Mechanism of action: Toxin acts pre-synaptically at the inhibitory neuron terminals and prevents release of inhibitory neurotransmitter GABA and glycine - leads to spastic muscle contraction. -Strychnine poisoning has a similar mechanism except that it acts post-synaptically. - BT (Botulinum Toxin) blocks the release of acetylcholine in neuromuscular junction, which leads to flaccid paralysis. Options 2, 3 4: Mechanism of Action of some impoant Bacterial Toxins: Heat Labile toxin of E.coli Increase cAMP Heat stable toxin of E.coli Increase cGMP Botulism toxin Inhibit release of acetylecholine from peripheral nerves Tetanus toxin Inhibit release of glycine and GABA at presynaptic terminals Diphtheria toxin Inhibit protein synthesis by inactivating EF 2 | 3,116 | medmcqa_train |
Characteristic radiological feature of fibrous dysplasia- | Fibrous Dysplasia (FD) Asymptomatic, self-limiting developmental regional alteration of bone in which the normal architecture is replaced by fibrous tissue and nonfunctional trabeculae-like osseous tissue. It is self-limiting (thus it is not a true neoplasm) * Represents a group of disorders with variety of clinical patterns * Mutation in GNAS 1 gene Clinical forms of fibrous dysplasia of the jaws * Monostotic: localized to a single bone Juvenile and aggressive juvenile Adult * Polystotic: involves several bones Craniofacial McCune-Albright syndrome Jaffe syndrome ref " maheswari 9th ed | 3,117 | medmcqa_train |
A 9-year-old girl presents for evaluation of regular vaginal bleeding. History reveals the thelarche at the age of 7 years and adrenarche at the age of 8 years. The most common cause of this condition in girls is: | Pubeal changes before the age of 8 years in girls and 9 years in boys are considered as Precocious pubey Most common cause of precocious pubey in girls - Idiopathic Others causes: Congenital lesions of the hypothalamus-pituitary Acquired lesions--trauma, infection, neoplasm-- tuberculosis (TB) meningitis in childhood Pa of a specific syndrome--McCuneAlbright (5%), von Recklinghausen's neurofibrobromatosis Endocrine/metabolic disorders | 3,118 | medmcqa_train |
Frameshift mutation occurs due to: | A frameshift mutation is caused by a deletion or inseion in a DNA sequence that shifts the way the sequence is read. | 3,119 | medmcqa_train |
Not controlled directly by ACTH- | Ans. is 'D' i.e., Epinephrine o The question is very simple. o Adrenocorticotropin hormone ( ACTH), as the name indicates, stimulate adrenal cortex. o Epinephrine is secreted by adrenal medulla other three hormones (given in question) are secreted by adrenl cortex, o ACTH has its main and most important effect on secretion of glucocorticoids (cortisol). o The effect on secretion of mineralocorticoids (aldosterone) and androgens (DHEA : dehydroepiandrosterone) in minimal (but some effect is there, which is not major regulatory mechanism). o It should be remembered that, though ACTH does not have a direct effect on epinephrine secretion, it increases epinephrine secretion indirectly as epinephrine secretion is dependent on cortisol. | 3,120 | medmcqa_train |
True about berry-aneurysm is following except ? | Answer is 'c' i.e. Wall contains smooth muscle fibroblasts The wall of Berry aneurysm is made up of thickened hyalinized intima. The adventitia covering the sac is continuous with that of the parent aery. Berry aneurysm (or Saccular or congenital aneurysm) Are the most common type of intracranial aneurysm (other rarer type of aneurysms include atherosclerotic, mycotic, traumatic and dissecting aneurysms). About 90% of berry aneurysms occur in the anterior circulation and are found near the major aerial bifurcations. * Multiple aneurysms exist in 20% - 30% of cases, many at mirror sites bilaterally Etiology & Pathogenesis The etiology is unknown, the underlying congenital weakness of the wall is considered to be the cause. There is increased risk of berry aneurysms in following conditions : a) Autosomal Polycistic Kidney Ds. d) Marfans syndrome b) Ehlers-Danlos syndrome e) Fibromuscular dysplasia c) Neurofibromatosis type I f) Coarctation of aoa Predisposing factors a) Cigarette smoking b) Hypeension Rupture of aneurysm usually occurs at the apex (i.e. dome) of the sac, resulting in subarchnoid haemorrhage or intraparenchymal haemorrhage or both. Unruptured aneurysms are usually completely asymptomatic. | 3,121 | medmcqa_train |
Earliest clinical indicator of sodium loss is | Ans. a (Altered sensorium) (Ref. Harrison's - 18th/pg. Ch. 45).Hyponatremia may be due to water excess, diabetes, lipidemia etc. Drugs known to release ADH will cause dilutional hyponatremia include morphine, tricyclics, nicotine, NSAIDs, etc. The individual present with confusion, anorexia, lethargy and cramps. When sodium drops abruptly, seizures, hemiparesis and coma can develop.CLINICAL FEATURES OF HYPONATREMIA# The clinical manifestations of hyponatremia are related to osmotic water shift leading to increased ICF volume, specifically brain cell swelling or cerebral edema.# The symptoms are primarily neurologic.# Patients may be asymptomatic or complain of nausea and malaise.# As the plasma Na+ concentration falls, the symptoms progress to include headache, lethargy, confusion, and obtundation.# Stupor, seizures, and coma do not usually occur unless the plasma Na+ concentration falls acutely below 120 mmol/L or decreases rapidly.# Loss of Na+ and K+, followed by organic osmolytes, from brain cells decreases brain swelling due to secondary transcellular water shifts (from ICF to ECF).# The net effect is to minimize cerebral edema and its symptoms.Composition of World Health Organization Oral Rehydration Solution (ORS) A,BConstituentConcentration, mmol/LNa+90K+20Cl-80Citrate10Glucose110Also know:*SLADH is characterized by hypotonic hyponatremia with euvolemia. Low plasma osmolality (<280 mOsm/Kg) with high urine osmolality (>100-150 mOsm/Kg) in suspected patients is diagnostic.* Pneumonia, hyponatremia and diarrhea are almost classic for Legionella.* Under most physiologic conditions, sodium, urea, and glucose generate the osmotic pressure of blood. Plasma osmolality is calculated according to the following expression: Posm = 2Na+ + Glu + BUN (all in mmol/L), or, using conventional laboratory values in which glucose and BUN are expressed in milligrams per deciliter: Posm = 2Na+ + Glu/18 + BUN/2.8. The calculated and determined osmolality should agree within 10-15 mmol/kg H20. When the measured osmolality exceeds the calculated osmolality by >15-20 mmol/kg H20, one of two circumstances prevails. Either the serum sodium is spuriously low, as with hyperlipidemia or hyperproteinemia (pseudohyponatremia), or osmolytes other than sodium salts, glucose, or urea have accumulated in plasma. | 3,122 | medmcqa_train |
Feature(s) of Allergic conjunctivitis is/are all except: | Ans: D (UsuaIly..) SIMPLE ALLERGIC CONJUNCTIVITISIt is a mild, non-specific allergic conjunctivitis characterized by itching, hyperaemia and mild papillary response. Basically, it is an acute or subacute urticarial reaction.EtiologyIt is seen in following forms:Hay fever conjunctivitis. It is commonly associated with hay fever (allergic rhinitis). The common allergens are pollens, grass and animal dandruff.Seasonal allergic conjunctivitis (SAC). SAC is a response to seasonal allergens such as grass pollens. It is of very common occurrence,Perennial allergic conjunctivitis (PAC) is a response to perennial allergens such as house dust and mite. It is not so common, results. However, a trial may be given in recurrent cases.PathologyPathological features of simple allergic conjunctivitis comprise vascular, cellular and conjunctival responses.Vascular response is characterised by sudden and extreme vasodilation and increased permeability of vessels leading to exudation.Cellular response is in the form of conjunctival Infiltration and exudation in the discharge of eosinophils, plasma cells and mast cells producing histamine and histamine-like substances.Conjunctival response is in the form of boggy swelling of conjunctiva followed by increased connective tissue formation and mild papillary hyperplasia.Clinical PictureSymptoms include intense itching and burning sensation in the eyes associated with watery discharge and mild photophobia.Signs (a) Hyperaemia and chemosis which give a swollen juicy appearance to the conjunctiva, (b) Conjunctiva may also show mild papillary reaction, (c) Oedema of lids.DiagnosisDiagnosis is made from : (1) typical symptoms and signs; (2) normal conjunctival flora; and (3) presence of abundant eosinophils in the discharge.TreatmentElimination of allergens if possible.Local palliative measures which provide immediate relief include:Vasoconstrictors like adrenaline, ephedrine, and naphazoline.Sodium cromoglycate drops are very effective in preventing recurrent atopic cases.Steroid eye drops should be avoided. However, these may be prescribed for short duration in severe and non- responsive patients.Systemic antihistaminic drugs are useful in acute cases with marked itching.Desensitization has been tried without much rewardingFig: (Khurana): Differentiating features of common types of conjunctivitis BacterialViralAllergicChlamydial(A) CLINICAL SIGNS 1. CongestionMarkedModerateMild to moderateModerate2. Chemosis+++- +-3. Subconjunctival haemorrhages++---4. DischargePurulent or mucopurulentWateryRopy/wateiyMucopurulent5. Papillae+-+++6. Follicles-+-++7. Pseudomembrane++--8.Pannus--- (Exceptvernai)+9. Pre-auricular lymph nodes+++-+(B) CYT0L0G1CAL FEATURES 1. Neutrophils++ (Early)-+2. Eosinophils--+-3. Lymphocytes-+-+4. Plasma cells---+5. Multi nuclear cells-+--6. Inclusion bodies: Cytoplasmic-+(Pox)-+Nuclear-+ (Herpes)--7. Micro-organisms+--- | 3,123 | medmcqa_train |
The combination of alcohol and disulfiram results in nausea and hypotension as a result of accumulation of: | Disulfiram is an aldehyde dehydrogenase inhibitor that can be used for de-addiction of chronic alcoholics. Due to inhibition of aldehyde dehydrogenase, there is accumulation of acetaldehyde that leads to several distressing symptoms (which strengthens the resolution of a person to quit alcohol). | 3,124 | medmcqa_train |
Lymph node biopsy of an AIDS patient shows: March 2009 | Ans. D: All of the above Histopathology of HIV Florid reactive hyperplasia-may be: - Collections of monocytoid B cells in sinuses - Neutrophils - Features of dermatopathic lymphadenopathy Often reactive germinal centers show 'follicle lysis':i.e. invagination of mantle lymphocytes into germinal centers associated with: - Disruption of centers ('moth-eaten appearance') - Distinctive clustering of large follicular center cells resulting appearance termed explosive follicular hyperplasia Occasional polykaryocytes: - Wahin-Finkeldey cells - May be multinucleated form of follicular dendritic cell Electron microscopy: - Sometimes prominent follicular dendritic cells exhibit alterations of their fine processes Interfollicular tissue may show prominent vascular proliferation: vague resemblance to Castleman's disease - These areas and subcapsular region may reveal earliest signs of Kaposi's sarcoma - Sometimes advanced lymphocyte depletion: may be abnormal (regressively transformed) germinal centers | 3,125 | medmcqa_train |
In oesophageal ca which Neoadjuvant chemotherapy is used - | Sabiston writes-"Since its introduction in 1980, cisplatin has emerged as the cornerstone of combination therapy in esophageal cancer.
As a single agent, it has a response rate of 25% to 30%. Given in combination with 5-fluorouracil, a response rate of 50% may be achieved, and this is an established chemotherapeutic regimen for esophageal cancer." | 3,126 | medmcqa_train |
Choriocarcinoma commonly metastasize to:
a.Brain
b. Lung
c. Vagina
d. Ovary
e. Cervix | Most common sites of metastases in choriocarcinoma are:
Lung (80%) > Vagina (30%) > Pelvis (20%) > Liver (10%) and Brain (10%) | 3,127 | medmcqa_train |
In burns least useful is | We know that Ringer's lactate is the preferred agent during initial 24 hrs. Nasogastric intubation is done to decrease the risk of emesis and possible aspiration (as parlytic ileus develops in a pt. with significant burn) Dextran is a colloid and can be used in 2nd 24 hrs., however albumin is the preferred and most widely used colloid. Blood has also role in burn patient. The need for Blood replacement is significant in extensive burns. Besides injury to red blood cells and their decreased half-life resulting in their early destruction, many patients may be anaemic. Hence, repeated and frequent transmission to maintain a hematocrit around 35% is necessary. Ref Bailey and love 27e p625 , Srb`s manual of surgery p133 | 3,128 | medmcqa_train |
Alpha 1 antitrypsin deficiency is associated with- | Ans. is 'a' i.e., Panacinar-emphysema Pathogenesis of Emphysemao The most accepted theory in the pathogenesis of emphysema is protease - antiprotease mechanism which is responsible in the pathogenesis of two common forms of emphysema, i.e. centriacinar and panacinar.o The alveolar wall destruction results from an imbalance between proteases (mainly elastase) and antiproteases in the lung.o Proteases (elastase) cause destruction of alveolar wall, while antiproteases prevent this damage,o a1 antitrypsin is the major antiprotease (antieiastase) secreted by neutrophils during inflammation.A. Pathogenesis of panacinar emphysemao Panacinar emphysema is associated with congenital deficiency of a1.-antitrypsin.o This results in unchecked overactivity of neutrophil elastase that causes destruction of alveolar wall,o As a,-antitrypsin is deficient throughout the acinus, the acini are uniformly involved from the respiratoiy bronchiole to the terminal blind alveoli.o Neutrophils are the major cells in the pathogenesis of panacinar emphysemaB. Pathogenesis of centriacinar emphysemao Centriacinar emphysema is associated with smoking.o Nicotine acts as a direct chemoattractant for neutrophils and macrophages,o So, in centriacinar emphysema, both neutrophils and macrophages play central role,o Smoking enhances activity of neutrophil and macrophage elastase.o Macrophage elastase is not inhibited by a1-antitrypsin and indeed can proteolvticallv digest this antiprotease,o Beside protease - antiprotease mechanism, oxidant - antioxidant imbalance also plays an important role in the pathogenesis of smoking related emphysema.o Normally, the lung contains a healthy complement of antioxidants (superoxide dismutase, glutathione),o Tobacco smoke contains abundant reactive oxygen species (free radicals) which deplete these antioxidant mechanisms.o Free radicals cause tissue damage as well as they inactivate a(-antitrypsin, resulting in functional a,- antitrypsin deficiency even in patients without enzyme deficiency. | 3,129 | medmcqa_train |
Sternocleidomastoid is supplied by all of the following aeries, EXCEPT? | The Sternocleidomastoid muscle flap is used in reconstructive surgery of the neck. The exact knowledge of its blood supply helps to minimize the risk of flap necrosis after transposition.Blood supply of Sternocleidomastoid: Upper third - supplied by branches of the occipital aery. Middle third - supplied by a branch of the superior thyroid aery.Lower third - supplied by a branch arising from the suprascapular aery. (Suprascapular aery is a branch of thyrocervical trunk). | 3,130 | medmcqa_train |
Stereognosis will be lost in the lesion of: | Stereognosis is the ability to identify an object by its touch, texture. The object is placed in hands and is identified without seeing it. Fine touch sensation from the upper limb is carried toward coex in fasciculus cuneatus. The tract also carries the finer aspects of touch. Perception of touch occurs in the somatosensory coex I (areas 3, 1, 2); analysis and interpretation of the touch is done in the somatosensory coex II (areas 5, 7). | 3,131 | medmcqa_train |
Lateral boundary of cubital fossa is formed by: | Brachioradialis Boundaries of cubital fossa- Laterally - Medial border of brachioradialis. Medially - Lateral border of pronator teres. Base - It is directed upwards, and is represented by an imaginary line joining the front of two epicondyles of the humerus. Apex - It is directed downwards, and is formed by the area where brachioradialis crosses the pronator teres muscle. Ref: Gray&;s anatomy text book of anatomy BD chaurasia 21st Ed. | 3,132 | medmcqa_train |
Second gas effect is seen with - | Ans. is 'b' i.e., Nitrous oxide Second gas effecto If another inhalation agent is (eg Halothane) is being given at the same time with N2O2 it also will be delivered to lung from the cylinder (due to negative intraalveolar pressure).Also Remembero Concentration effect and secondary gas effect - during inductiono Diffusion hypoxia - during recovering.o All these occur with N2O only (Xenon also causes these effects). | 3,133 | medmcqa_train |
Example of electrical synapse: | (Refer: Ganong’s Review of Medical Physiology, 24th edition, pg no: 43-44)
Intercellular junctions
Connects the cell membranes of the neighboring cells also known as junctional complexes | 3,134 | medmcqa_train |
All are medically important streptococci except - | STREPTOCOCCI
Streptococci are gram-positive, nonmotile, non-spore-forming, catalase & oxidase negative medically important bacteria.
Many organisms of streptococcus genus cause human diseases. | 3,135 | medmcqa_train |
True about meningiomas- | Meningiomas are predominantly benign tumors that arise from arachnoid meningothelial cells. They usually occur in adults and are often attached to the dura. Meningiomas may be found along any of the external surfaces of the brain as well as within the ventricular system, where they arise from the stromal arachnoid cells of the choroid plexus.They usually come to attention because of vague nonlocalizing symptoms, or with focal findings referable to compression of the adjacent brain. Most meningiomas are easily separable from the underlying brain. Meningiomas (WHO grade I/IV) grow as well-defined dura-based masses that may compress the brain but do notinvade it. Among the varied histologic patterns are syncytial, named for whorled clusters of cells without visible cell membranes that sit in tight groups; fibroblastic, with elongated cells and abundant collagen deposition between them; transitional, which shares features of the syncytial and fibroblastic types; psammomatous, with numerous psammoma bodies ; and secretary, with gland-like PAS-positive eosinophilic secretions known as pseudopsammoma bodies. Atypical meningiomas (WHO grade II/IV) are recognized by the presence of ceain histologic features (prominent nucleoli, increased cellularity, pattern-less growth), and often have a higher mitotic rate. These tumors demonstrate more aggressive local growth and a higher rate of recurrence; they may require therapy in addition to surgery. Anaplastic (malignant) meningiomas (WHO grade III/IV) are highly aggressive tumors that may resemble a high-grade sarcoma or carcinoma, although there usually is some histologic evidence of a meningothelial cell origin. | 3,136 | medmcqa_train |
A 52-year-old alcoholic notices a skin rash on his chest, and also has symptoms of diarrhea and abdominal pain. On examination, he has a scaly and pigmented rash on the sun-exposed areas of his skin, the abdomen is soft, and his short-term memory is impaired. He has dermatitis, diarrhea, and dementia syndrome.For the patient with vitamin deficiency or excess, select the most likely diagnosis | Diarrhea, dementia, and dermatitis are the classic triad for pellagra (niacin deficiency). The diagnosis is based on clinical suspicion and response to therapy, and can be confirmed by demonstrating low levels of the urinary metabolites 2-methylnicotinamide and 2-pyridone. Small doses of niacin (10 mg/day) with adequate dietary tryptophan will cure pellagra secondary to nutritional deficiency. | 3,137 | medmcqa_train |
A 19-year-old man presents to the clinic complaining of early fatigue and muscle cramps while playing sports. He is fine when walking or doing less intense levels of work. On physical examination, he appears well and the vital signs are normal. Muscle bulk, tone and strength in the proximal muscles are normal. There is no muscle fatigue with repetitive arm grip exercises. After an exercise stress test, his serum creatine kinase (CK) is elevated and lactate level is normal. Which of the following is the most likely diagnosis? | There are many types of glycogen storage diseases, each caused by a different enzymatic abnormality. The best-known types of glycogen storage disease are those that have hepatic hypoglycemic pathophysiology (eg, von Gierke disease) or those that have muscle energy pathophysiology (McArdle disease). InMcArdle' symptoms usually develop in adulthood, and it is marked by cramps and muscle injury with strenuous exercise, but not with usual activities. Gaucher and Tay-Sachs disease are lysosomal storage diseases. | 3,138 | medmcqa_train |
A 36-year-old lady presents with a 20 yrs duration fluctuant and translucent swelling on right side of her neck. No other history available. No other findings on examination of neck. What is the most probable diagnosis? | The only swelling among the 4 options which will show translucency is Lymph cyst. | 3,139 | medmcqa_train |
Tumorogenesis in aging is due to - | After a fixed number of divisions, normal cells becomes arrested in a terminally nondividing state.
How does the normal cells count their divisions i.e. How, do the cells find out that now they do'nt need to divide further.
Cells achieve this through telomer shortening
Telomers are short repeated sequences of DNA present at the linear ends of chromosome that are important for ensuring complete replication of chromosome ends.
It consists of many arrays of TTAGGG repeats at tellninal of 3' ending strand. It confers stability to chromosomes. With each successive division there is some shortening of the telomers.
Once the telomers are shortened beyond a certain point the ends of the chromosome are seen as broken i1 NA, which signals cell cycle arrest.
The broken NA leads to activation of p53 dependent cell cycle check points causing proliferative arrest or apoptosis.
Thus telomere shortening functions as a clock that counts cell division.
How do the germ cells keep on dividing throughout their life???
In germ cells telomere shortening is prevented by the sustained function of the enzyme telomerase.
Telomerase is a reverse transcriptase and is responsible for telomer synthesis and maintaining the length of telomer.
It is RNA dependent DNA polymerase. It has one segment that is complimentary to TTAGGG repeat and is used as template for the replication of telomeric sequence.
This enzyme is absent from most somatic cells and hence they suffer progressive loss of telomers and they exit the cell cycle. Telomerase is present in Germ cells thus explaining the ability of these cells to self replicate extensively. If loss of telomere is the basis of finite life span then how do cancer cells continue to divide actively????
In cancer cells telomerase activity is reactivated. Telomerase activity has been detected in more than 90% of human tumours.
Thus telomerase activity and maintenance of telomere length are essential for the replicative potential in cancer cells. | 3,140 | medmcqa_train |
All are true regarding typhoid ulcer EXCEPT: September 2012 | C i.e. Stricture is common and causes obstruction Typhoid ulcers Longitudinal, Ulceration of Peyer's patches, Stricture is rare | 3,141 | medmcqa_train |
The lesion listed below that would most likely pursue a benign course is :- | Adenomyosis is a benign condition characterised by the presence of benign endometrial glands and stroma within the myometrium, Common cause of diffuse uterine enlargement and menstrual irregularities. Vaginal adenosis is a DES-related precursor lesion for clear cell adenocarcinoma. Extrammary paget's disease is an intraepithelial adenocarcinoma. Endometrial hyperplasia is a precursor lesion of endometrial carcinoma. | 3,142 | medmcqa_train |
Canakinumab is a monoclonal antibody against: | Canakinumab and Anakinra are IL-1 inhibitors used in the treatment of gout. | 3,143 | medmcqa_train |
Minimum amount of GI bleed to cause malena is | Melaena refers to the passage of typical black, tarry coloured foul smelling stool. It signifies upper GI bleed. At least 50-60 ml bleeding should be there to cause melaena. Reference : page 834 SRB's manual of surgery 5th edition | 3,144 | medmcqa_train |
Sympathetic innervation of heart is by - | Ans. is 'b' i.e., T1- T5 * Parasympathetic supply to heart - Vagus.* ympathetic supply to heart - T1- T5Innervation of Heart* Innervations of heart are :-A) Sympathetic innervation of heart:# All parts of the heart (SA node, atria, AV node and ventricles) recieve sympathetic innervations.# The sympathetic innervation on right side is distributed primarily to the SA node, while on the left side is distributed primarily to the AV node.# Sympathetic fibers are mostly distributed to the epicarium.# Sympathetic discharge has following effects :i) Positive ionotropic (Increase in force of contraction).ii) Positive chromotropic (Increased heart rate).iii) Positive dromotropic (Increased conduction).iv) Positive bathmotropic (increased automaticity).v) Decreased refractory period of all types of cardiac cells. -# The main neurotransmitter is nor-adrenaline.B) Parasympathetic innervation of heart:# Parasympathetic fibers to the heart reach through the vagus nerve.# The right vagus is distributed mainly to SA node while the left vagus mainly innervates the AV node. Vagal fibers are mostly endocardial in distribution.# Vagal stimulation has following effects :i) Negative chronotropic (decreased heart rate).ii) Negative dromotropic (decreased conduction).iii) Increased refractory period of all types of cardiac cells.# But vagal stimulation does not have a negative inotropic effect because vagal (parasympathetic) fibers do not innervate the myocardial cells of the ventricles in sufficient numbers; there is slight decrease in force contraction of atria only.# Major neurotransmitter is acetylcholine. | 3,145 | medmcqa_train |
All of the following can induce methemoglobinemia EXCEPT: | Drugs that may cause Methemoglobinemia includes- nitrates derivatives (nitrates salt, nitroglycerin), nitrites derivatives (nitroprusside, amyl nitrite, nitric oxide), sulfonamides, dapsone, phenacetin, phenazopyridine, local anesthetics such as prilocaine, topical anesthetics such as Emla cream, benzocaine etc Essential of medical pharmacology Sixth edition-KD Tripathi Page:405,406 | 3,146 | medmcqa_train |
Kamli Rani, 75-years -old woman present with post myocardial infarction after 6 weeks mild CHF. There was past H/O neck surgery for parathyroid adenoma 5 years ago, ECG shows slow atrial fibrillation. Serum Ca2+ 13.0 mg/L and urinary Ca2+ is 300 mg/24 hr. On examination there is small mass in the Para tracheal position behind the right clavicle. Appropriate management at this time is: | Patient is a case of recurrent hyperparathyroidism, as she was operated previously for parathyroid adenoma. In the setting of recent myocardial infarction, CHF and atrial fibrillation, any operation carries a high risk. Ultrasound-guided alcohol injection in the mass is preferred in this setting. | 3,147 | medmcqa_train |
All are true for transplanted kidney except | Answer- D. HLA identity similarity seen in 1:100 peopleWithin any paicular family, sibling's have a 7:4 chance of being HLA identical. In contrast among unrelatedpeople, the probabilities of HLA identity in several thousand depending upon phenotype involved' It is due to the fact thatHLA complex is inherited intact as two haplotypes. | 3,148 | medmcqa_train |
Non-coding RNAs are | A non-coding RNA (ncRNA) is a functional RNA molecule that is transcribed from DNA but not translated into proteins. Epigenetic related ncRNAs include miRNA, siRNA, piRNA, and lncRNA. In general, ncRNAs function to regulate gene expression at the transcriptional and post-transcriptional level. | 3,149 | medmcqa_train |
'Brush burns' are synonymous with | Ans. a (Graze abrasion) (Ref. Reddy FMT 23rd ed. 145)ABRASIONS (GRAZES, SCRATCHES, BRUSH BURNS)# Loss/crushing of outer skin layer due to impact with a rough surface- Tangential impact produces a moving abrasion:* Indicates direction.* Trace material (e.g., grit).- Direct impact produces an imprint abrasion:* Pattern of causative object.# All abrasions reflect site of impact (contact bruises).# Assessment of age difficult.# Postmortem abrasion - Brown, leathery. | 3,150 | medmcqa_train |
Cervical cone biopsy in a case of carcinoma cervix causes all, except : | Ans. is d i.e. Spread of malignancy Complications of Cone biopsy are : Hemorrhagedeg Sepsis (infection)deg Cervical stenosisdeg Pregnancy complications which include : Mid trimester aboionsdeg Preterm labourdeg -- Cervical dystociadeg Also Know : Cone biopsy should be done under general anaesthesia. The cone should include the entire outer margin and the endocervical lining but internal OS is spared. 1 A small cone is preferred in younger women to avoid pregnancy complications. | 3,151 | medmcqa_train |
A 57-year-old man arrives at the emergency room complaining of weakness, fatigue, and intermittent fever that has recurred for several weeks. The patient had a cardiac valvular prosthesis implanted 5 years ago. Blood cultures grew ceain gram-positive cocci on which catalase and coagulase test were done. The gram-positive organisms failed to ferment mannitol, and their growth was inhibited by novobiocin. CATALASE TEST SLIDE COAGULASE TEST Lesions seen on skin What is the most likely infectious agent? | Physical examination reveals petechiae (pinpoint, nonraised, purplish red spots caused by intradermal hemorrhage) on the chest and stomach. Catalase-positive and coagulase negative The patient is probably suffering from bacterial endocarditis caused by S. epidermidis infection of the prosthetic hea valve. S. epidermidis Coagulase-negative organism Unable to ferment mannitol Sensitive to novobiocin Resistant to penicillin. Patients with congenital hea malformations, acquired valvular defects (for example, rheumatic hea disease), prosthetic valves, and previous bacterial endocarditis show an increased incidence of bacterial endocarditis. Intravenous drug users also have a high risk for infection. S. viridans can be ruled out, because streptococci are catalase negative, which is a feature that distinguishes them from catalase-positive staphylococci. S. aureus is coagulase positive so it is ruled out. S. saprophyticus is coagulase negative but resistant to novobiocin, hence also ruled out here | 3,152 | medmcqa_train |
A patient aged 63 years, is diagnosed to have severe aplastic anemia. HLA compatible sibling is available. The best option of treatment is : | Answer is A (Antithymocyte globulin followed by cyclosporine) Tor adults over age 50 years or those without HLA matched siblings, the treatment of choice for severe Aplastic anemia is immunosupression with antithymocyte globulin (A TG) plus Cvclosporine' | 3,153 | medmcqa_train |
Cobblestone appearance is seen in | Cobblestone appearance is severe papillary hyperplasia in upper palpebral conjunctiva Refer: Khurana 6th edition page number 73 | 3,154 | medmcqa_train |
Not a molecular motor: | Motor proteins: Molecular motors include the proteins: myosin kinesin dynein They move along a track- microtubules or microfilaments - and pull larger structures such as vesicles, fibers, or paicles. Such movement can be used for intracellular transpo or movement of the cell's entire framework. | 3,155 | medmcqa_train |
True about anaplastic thyroid carcinoma:a) Common in elderlyb) Well encapsulatedc) Will not invade surrounding structuresd) Distant metastasis commone) Some degree of differentiation to Papillary and Follicular types seen | About option 'e' Schwartz writes:
"On gross inspection, anaplastic tumors are firm and whitish in appearance. Microscopically, sheets of cells with marked heterogeneity are seen. Cells may be spindle-shaped, polygonal, or large, multinucleated cells. Foci of more differentiated thyroid tumors, either follicular or papillary, may be seen, suggesting that anaplastic tumors arise from more well-differentiated tumors." | 3,156 | medmcqa_train |
Recommended Dietary allowance in pregnancy are - | Requirements in pregnancy Pregnancy Proteins +23 g/day Calcium 1200 mg/day Iron 35 mg/day Vitamin A 800mcg/day Ref: Park 25th edition Pgno : 674 | 3,157 | medmcqa_train |
Which of the following is not a feature of chronic tonsillitis? | Ans. is 'a' i.e., Fever(ref Dhingra 6h/e p. 258]Fever is a symptom in case of acute tonsillitis, not chronic tonsillitis.Chronic tonsillitis is characterized by:- Recurrent attacks of sore throat or acute tonsillitis. | 3,158 | medmcqa_train |
Which of the following muscle relaxants causes maximal pain on injection – | Pain during injection is an important and common feature of Rocuronium Injection. | 3,159 | medmcqa_train |
Steroids are indicated in all of the following forms of tuberculosis except: | Steroids are contraindicated in intestinal tuberculosis because silent perforation can occur. (REF.Essential of medical pharmacology K D TRIPATHI 6 Edition, Page No - 778) | 3,160 | medmcqa_train |
Which of the following is false about viral thyroditis? | Viral thyroditis has initial hyperthroid state due to release of harmones due to gland destruction. | 3,161 | medmcqa_train |
Expansible pulsating secondary metastasis is a feature of | B i.e. Renal Cell carcinoma | 3,162 | medmcqa_train |
Most common cause of bleeding for massive hemothorax in blunt trauma to chest is from | Answer- A. Intercostal vesselsThe most common cause of massive haemothorax in blunt injury to chest is continuing bleeding from torn intercostal vexels or occasionallyfrom the internal mammary aety. | 3,163 | medmcqa_train |
The main clinical significance of sliding type hiatus hernia is: | Four types of hiatus hernia are present. Type I, or sliding hiatal hernia comprising at least 95% of total. Pathology is the weakening of the phrenoesophageal ligament attaching the gastroesophageal junction to the diaphragm at the hiatus. Incidence of sliding hernias increases with Age and conceptually, results from wear and tear Intraabdominal pressure Hereditary factors The main significance of sliding hernias is the propensity of affected individuals to have GERD. Ref: Harrison, E-18, P- 2429 | 3,164 | medmcqa_train |
The fascia of Denonvilliers - | The posterior surface of prostate is separated from the rectum by the fascia of Denonvilliers which is the obliterated rectovesical pouch of the peritoneum. | 3,165 | medmcqa_train |
How many items are there in Mini mental state examination (MMSE)? | Ans.D.30ExplanationMMSE or Folstein test is a simplified form of routine cognitive status examination. It is routinely used to track improvement and deterioration. It includes following points:Orientation to time-5Orientation to place-5Registration-3Attention and calculation-5Recall-3Language-2Repetition-1Complex commands-6Total score-30, score less than 24 indicates cognitive impairment. | 3,166 | medmcqa_train |
According to Lecompte (1987), the following are the recommendations for topical application of high potency fluoride products EXCEPT- | According to Lecompte (1987), the following are the recommendations for topical application of high potency fluoride products:
1. No more than 2 g of gel per tray or approximately 40 % of tray capacity should be dispensed. Even more conservative amounts should be considered for small children.
2. Because patient may have the need to swallow during a 4 minute topical application procedure, the use of a saliva ejector during the procedure is recommended.
3. Following the 4 minutes application procedure, the patient should be instructed to expectorate thoroughly for from 30 sec to one minute, regardless of whether high speed suction is utilized or not. Expectoration is probably the single most effective way of reducing orally retained fluoride.
4. When utilizing custom individually fitted trays for patients requiring daily or weekly application of a high fluoride concentration product, utilize only 5-10 drops of products per tray. | 3,167 | medmcqa_train |
Ion required for exocytosis is - | (C) (Calcium) (4.8 Ganong 24th edition, 18 A.K. Jain 5th)Exocytosis is the Ca^ dependant process.Exocytosis: here-substances secreted by the cell are trapped within vesicles or granules which fuse with the cell membrane and release their contents to the ECF. This leaves the contents of the vesicles or granules outside the cell and cell membrane intact.It requires Ca++ and energy. Hormones, digestive enzymes and synaptic transmitters are examples of substances transported out of the cell by this process.Endocytosis: includes phagocytosis, pinocytosis, clathrin mediated endocytosis, caveolate-dependant uptakeand nonclathrin/noncaveolae endocytosis. | 3,168 | medmcqa_train |
Essential radiological feature of acute mastoiditis is: | (b) Clouding of air cells of mastoid(Ref. Cummings, 6th ed., 2161)X-ray mastoid and CT scan shows clouding of air cells because of the collection of exudates in them. Later on mastoid pneumatisation is lost and a single mastoid cavity may be seen. | 3,169 | medmcqa_train |
All the following are features of Wilson's disease except: | Answer is B (Increased Ceruloplasmin) In Wilson's disease, Ceruloplasmin levels are decreased (not increased). In Wilson's disease excess Cu saturates liver and spills in the plasma thereby decreasing ceruloplasinin levels. | 3,170 | medmcqa_train |
Pelvic exentration is known as ? | Ans. is 'd' i.e., Brunschwig's operation | 3,171 | medmcqa_train |
What is the latest reference to body length in ICD-10 to call it perinatal moality rate? | parks textbook of preventive and social medicine 23rd edition * ninth revision of international classification of diseases (ICD) added that :(1) babies choosen for inclusion in perinatal statistics should be tjose above a minimum bih weight ie1000g at bih. (2)if bihweight is not available ,a gestational period of atleast 28weeks should be used if (1)&(2)is not available ,body length of atleast 35cm should be used . | 3,172 | medmcqa_train |
Palpatory thud audible slap is seen in: | A foreign body in trachea may move up and down the trachea between the carnia and the undersurface of vocal cords causing "audible slap" and "palpatory thud." | 3,173 | medmcqa_train |
Pseudogestational sac is seen in | The gestational sac --an anechoic fluid collection that represents the exocoelomic cavity--may be seen by 4.5 weeks.A caveat is that a gestational sac may appear similar to other intrauterine fluid accumulations--the so-called pseudogestational sac. This pseudosac may be seen with ectopic pregnancy and is easier to exclude once a yolk sac is seen. Typically, the yolk sac is visible by 5.5 weeks and with a mean gestational-sac diameter of 10 mm. Thus, the diagnosis of a uterine pregnancy should be made cautiously if the yolk sac is not yet seen.Ref: William&;s Obstetrics; 24th edition; chapter 19 | 3,174 | medmcqa_train |
A 50 years old patient presented to the skin OPD with erythematous scaly plaques over trunk and extremities for last l0 years. Lesions are occasionally itchy. There is history of remission and relapse with exacerbation during winters. Most likely diagnosis is? | Ans: B. Psoriasis vulgaris(Ref: Neena Khanna 4'h/e p. 40-48; Roxburg lVh/e p. 128-42; Venkataram 1"'/e p. 491)Psoriasis (psoriasis vulgaris):Psoriasis is chronic dermatosis characterized by unpredictable course of remission and relapse and presence of well defined silvery white scaly papules and plaques on erythematous base.Aggravated in winter.Lesions are mildly pruritic or non-pruritic. | 3,175 | medmcqa_train |
Child with primary amenorrhoea with negative progesterone challenge test but positive combined progesterone and estrogen test. Diagnosis may be : | Ans. is d i.e. Prolactinoma This child is presenting with - Primary amenorrhea with : Negative progesterone challenge test - which rules out PCOD - (otherwise too, PCOD is a cause of secondary amenorrhea). When next step was done i.e., estrogen, progesterone combined test - It comes out to be positive i.e., compament I system (uterus, endometrium and outflow tract) is normal if properly stimulated by estrogen which rules out mullerian agenesis and ashermann syndrome. Positive estrogen progesterone combined test means the defect is in the production of estrogen i.e., either ovaries, pitutary or hypothalmus. So from the given options we have to look for a cause which involves either of the above sites. which in this case is prolactinoma. | 3,176 | medmcqa_train |
The average whey/casein ratio in breast milk is: | a. 60:40(Ref: Nelson's 20/e p 286-290, Ghai 8/e p 150-161)Human milk contains two types of proteins 60% is: whey and 40% is casein; helps in quick & easy digestion. | 3,177 | medmcqa_train |
All of the following agents act by intracellular receptors EXCEPT: | The insulin receptor is located at outer membrane Pg.no.261KD TRIPATHI SEVENTH EDITION | 3,178 | medmcqa_train |
Initial amino acid in prokaryotic protein synthesis ? | Ans. is 'c' i.e., Formyl-methionine | 3,179 | medmcqa_train |
"Tear drop" sign on X-ray PNS is seen in | Ans. a (Blow out fracture of the floor of the orbit) (Ref. Grainger Diagnostic Rad 4th/2527; Ref . Q. 159. Of MH-2207)BLOW-OUT FRACTURE is caused by fracturing of the orbital walls with herniation of orbital contents and subsequent tethering of the globe, resulting in pain and diplopia. It usually involves the orbital floor with 'trap-door deformity' on skull AP view or characteristic "Tear drop" sign on X-ray PNS.Also Know:# Tripod Fracture: zygomaticomaxillary fracture# "pyramidal" fracture = Le Fort II fracture (fracture medial orbital and lateral maxillary walls).# Bare orbit sign: Neurofibromatosis# Coke-bottle sign: thyroid ophthalmopathy# "Mushroom-shaped" posterior segment mass: choroidal melanoma# Calcification is pathognomonic of: Retinoblastoma# Most common intraorbital tumor in adults: Cavernous hemangioma. | 3,180 | medmcqa_train |
Which classification is used to divide the liver into segments? | Ans. (a) Couinaud'sRef: Bailey and Love 26th edition page 1066* Couinaud divided the liver into multiple segments- 8 segments* He is a French Anatomist | 3,181 | medmcqa_train |
In a patient with compensated liver cirrhosis presented with history of variceal bleed. The treatment of choice in this patient is - | When a cirrhotic patient presents with upper GI bleed, the single most impoant diagnostic as well as therapeutic procedure to be performed is endoscopy (although after intravenous fluid resuscitation and correction of coagulation abnormalities) If varices are found they are treated by either Endoscopic variceal ligation or Endoscopic Sclerotherapy Endoscopic variceal ligation is now the t/t of choice (has replaced sclerotherapy) Ref : Schwaz 9/e p1113 | 3,182 | medmcqa_train |
During an emergency thoracotomy, the incision is made > 1cm lateral to the sternal margin. This will preserve which of the following structures? | In case of anterolateral thoracotomy, which is usually a transverse or a veical incision staing from fouh intercostal space, incision is made lateral to sternal in order to avoid injury to the adjacent vessels which include internal mammary aery. Superficial epigastric aery is the terminal branch of internal mammary aery and hence not at a risk in emergency thoracotomy. Intercostal vessels lie parallel to rib margin and hence not injured near sternal margin. Ref: General Thoracic Surgery, Volume 1 edited by Thomas W. Shields, Joseph LoCicero, Carolyn E. Reed, Richard H. Feins, Volume 1, Page 394 | 3,183 | medmcqa_train |
Causative organism of rheumatic fever - | Ans. is 'a' i.e., Group A Streptococci Rheumatic fevero Rheumatic fever (RF) is an acute, inununologically mediated, multisystem inflammatory disease classically occurring a few weeks after an episode of group A streptococcal pharyngitis; occasionally, RF can follow streptococcal infections at other sites, such as the skin. | 3,184 | medmcqa_train |
Kliiver-Bucy syndrome is associated with lesion in the following area of brain | (A) Amygdala # Kliiver-Bucy syndrome is a behavioral disorder that occurs when both the right and left medial temporal lobes of the brain malfunction. People with lesions in their temporal lobes show similar behaviors.> They may display oral or tactile exploratory behavior (socially inappropriate licking or touching); hypersexuality; bulimia; memory disorders; flattened emotions (placidity)-, and an inability to recognize objects or inability to recognize faces.> The full syndrome rarely, if ever, develops in humans. However, parts of it are often noted in patients with extensive bilateral temporal damage caused by herpes or other encephalitis and dementias of degenerative or post-traumatic etiologies.> This disorder may be caused by many conditions, including facial or cerebral trauma; infections; Alzheimer's disease; Niemann Pick disease of the brain; or cerebrovascular disease. | 3,185 | medmcqa_train |
Surest sign of brain stem death | B i.e. Fixed dilated pupil not responding to light Cooling of body & rigor mois is a sign of molecular or cellular death. - Somatic (systemic, clinical or brain) death is cessation of spontaneous breathing, circulation and brain activity (as indicated by flat isoelectric EEG, deep unconsciousness with no response to external stimuli or internal need). Surest sign of brain stem death is fixed dilated pupil not constricting (responding) to light.Q | 3,186 | medmcqa_train |
Stereoanesthesia is due to lesion ofa) Nucleus Gracilisb) Nucleus cuneatusc) Cerebral cortexd) Spinothalamic tract | Astereognosis/Stereoanaesthesia- Loss of ability to recognize size and shape of an object.
Seen in- lesion of somatosensory cortex, lesion of tractus cuneatus, lesion of tractus gracilis.
Somatosensory cortex lesion- proprioception and tactile sensations are lost while pain and temperature sensations are preserved.
Tractus cuneatus- formed by fasciculus cuneatus (spinal cord) and nucleus cuneatus (medulla). Pass through lateral portion of dorsal column. Carries sensations of dorsal column- proprioception and tactile sensations from upper part of the body.
Tractus gracilis- formed by fasciculus gracilis (spinal cord) and nucleus gracilis (medulla). Pass through medial portion of dorsal column. Carries sensations of dorsal column- proprioception and tactile sensations from lower part of the body. | 3,187 | medmcqa_train |
A 70-years old male presented with asymptomatic white patch on oral cavity following application of the denture. Treatment of choice is | Leukoplakia regress spontaneously after stopping alcohol or tobacco consumption or correction of underlying cause | 3,188 | medmcqa_train |
Radiological hallmark of primary tuberculosis in childhood is- | Ans. is 'c' i.e., Lymph adenopathy Primary tuberculosis in childhoodo Primary' tuberculosis in childhood can present in 4 major ways in addition to the normal chest radiography. These are:LymphadenopathyLobar or segmental parenchymal diseasePleural effusionMilitary involvemento Lymphadenopathy with or without parenchymal abnormality' is the radiological hallmark of primary tuberculosis in childhood. | 3,189 | medmcqa_train |
Positive shick's test indicates that person is ? | Ans. is 'c' i.e., Susceptible to diphtheria Shick test . Shick test is no longer in use. It was used for the susceptibility of for diphtheria. . It was an intradermal test, in which after intradermal injections of diphtheria toxin in one forearm (usually left) and toxoid in other forearm two readings were taken one at 24-48 hrs and second at 5-7 days. . Interpretation of the test : - Reaction in control arm indicates hypersensitivity - Reaction in test arm : at 24 - 48 hrs --> Hypersensitivity at 5 - 7 days --> Susceptibility Type of reaction Observation inference Negative reaction No reaction on either arm, (toxin neutralized by circulating antitoxin) No susceptibility No hypersensitivity Positive reaction No reaction on control arm, Circumscribed erythematous reaction caused by toxin on the test arm that persists. No hypersensitivity Susceptibility present Pseudoreaction Diffuse erythematous reaction on both areas, appearing with in 24 hrs and fading by 4 days. Combined reaction Both areas initially show Hypersensitivity present pseudoreaction followed by positive reaction on test arm Susceptibility present | 3,190 | medmcqa_train |
Dependency' ratio includes - | Ans. is 'a' i.e.. Less than 15 years Dependency ratiooThe proportion of persons above 65 years of age and children below 15 years of age are considered to be dependent on the economically productive age group {15-64 years).o The ratio of combined age group 0-14 years plus 65 years and above to the 15-65 years age group is known as total dependency ratio.o It is also referred to as the societal dependency ratio and reflects the need for a society to provide for their younger and older population groups. | 3,191 | medmcqa_train |
All the following are indications for termination of pregnancy in APH patient except: | Ans. is c, i.e. Transverse lieRef. Dutta Obs. 7/e, p 249In these questions, there is no confusion about any option except for 'lie of the fetus'.As far as lie is concerned:Friends, why would you terminate pregnancy just because of unstable lie or transverse lie, unless and until there is some other complication associated with it. Transverse lie/unstable lie in a patient of placenta previa simply means that whenever termination of pregnancy is considered cesarean section has to be done. | 3,192 | medmcqa_train |
An eight-month-old female infant presented with recurrent episodes of hypoglycemia, especially if time interval of feeding is increased. Dicarboxylic acid is present in the urine. Urine ketone bodies is negative. The child responded well to IV Glucose, less fat and more carbohydrate diet, frequent feeding. The child was diagnosed to be MCAD deficiency. What is the reason for hypoglycemia? | Ans. B. Lack of ATP to support gluconeogenesis* This is a case of MCAD deficiency.* Identifying features are:* Recurrent episodes of hypoglycaemia is time interval of feeding increased* Dicarboxylic acids in urine* Absence of ketone bodies in urine* Reasons for hypoglycemia are:* Due to MCAD deficiency, beta oxidation is affected. This is the source of ATP for gluconeogenesis, when glycogen stores are depleted. So lack of ATP is one reason* Due to lack of acetyl-CoA, which is released by beta oxidation. Acetyl-CoA is the activator of pyruvate carboxylase, one of the key enzymes of gluconeogenesis | 3,193 | medmcqa_train |
Hypersensitivity vasculitis usually involve | Refer robbins 9/e p510, 8/e 515 Harrison 7/2128 Direct quote from Harrison 18th /2798; Postcapillary venules are most commonly involved vessels. Capillaries and aerioles are less frequent involved | 3,194 | medmcqa_train |
Amino acid absorption is by: | Ans. C. Active TransportFree amino acids are absorbed across the intestinal mucosa by sodium-dependent active transport. There are several different amino acid transporters, with specificity for the nature of the amino acid side-chain.Transporters of Amino AcidsFor Neutral Amino acidsFor Basic Amino acids and Cysteine.For Imino Acids and GlycineFor Acidic Amino acidsFor Beta Amino Acids (Beta-Alanine)Meister's CycleFor absorption of Neutral Amino acids from Intestines, Kidney tubules and brain.The main role is played by Glutathione (GSH).For transport of 1 amino acid and regeneration of GSH 3 ATPs are required.Disorders associated with Meister's Cycle Oxoprolinuria5 Oxoprolinase deficiency leads to OxoprolinuriaDisorders associated with absorption of amino acidsHartnup's DiseaseMalabsorption of neutral amino acids, including the essential amino acid tryptophan SLC6A19, which is the major luminal sodium-dependent neutral amino acid transporter of small intestine and renal tubules, has been identified as the defective proteinBlue Diaper Syndrome or Drummond Syndrome IndicanuriaTryptophan is specifically malabsorbed and the defect is expressed only in the intestine and not in the kidney. Intestinal bacteria convert the unabsorbed tryptophan to indican, which is responsible for the bluish discoloration of the urine after its hydrolysis and oxidationCystinuriaDibasic amino acids, including cystine, ornithine, lysine, and arginine are taken up by the Na-independent SLC3A1/ SLC7A9, in the apical membrane which is defective incystinuri(a).Most common disorder associated with Amino acid malabsorptionLysinuric Protein Intolerance(SLC7A7) carrier at the basolateral membrane of the intestinal and renal epithelium is affected, with failure to deliver cytosolic dibasic cationic amino acids into the paracellular space in exchange for Na+ and neutral amino acidsOasthouse Urine Disease (Smith Strang Disease)A methionine-preferring transporter in the small intestine was suggested to be affected. Cabbage-like odor, containing 2-hydroxybutyric acid, valine, and leucineIminoglycinuriaMalabsorption of proline, hydroxyproline, and glycine due to the proton amino acid transporter SLC36A2 defectDicarboxylic AciduriaExcitatory amino acid carrier SLC1A1 is affected.Associated with neurologic symptoms such as POLIP (polyneuropathy, ophthalmoplegia, leukoencephalopathy, intestinal pseudo-obstruction | 3,195 | medmcqa_train |
Hyponatremia in multiple myeloma is - | • Patients with multiple myeloma also have a decreased anion gap because the M component is cationic, resulting in retention of chloride.
• This is often accompanied by hyponatremia that is felt to be artificial (Pseudohyponatremia) because each volume of serum has less water as a result of the increased protein. | 3,196 | medmcqa_train |
Index case is the - | Ans. is 'd' i.e., First case defected by investigator [Ref: Park 22nd/e d. 92 & 21st/e p. 9/1o Primary caseo Index case--First case of communicable disease introduced into the population.First case to come to attention of the investigator.o It is not always necessary that primary case will be index case : -When the first case noticed by the investigator is also the first case of the population - Primary case and index case are the same.When the first case nociced by the investigator is not the first case of the population (primary case) - Index case and primary case are different.o Secondary cases - Cases those developing from contact with primary case. | 3,197 | medmcqa_train |
Gastrojejernostomy surgery belongs to | Clean contaminated surgery :
Wound is exposed to not only skin but also GI tract / Respiratory tract / Urinary tract organism in controlled enviroment.
Hence Gastrojejunostomy surjery belongs to this category. | 3,198 | medmcqa_train |
Hand and foot syndrome is due to ? | Ans. is 'c' i.e., 5 FU | 3,199 | medmcqa_train |
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