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Gaisbock syndrome is better known as? | Gaisbock syndrome is characterised by secondary polycythemia. It occurs mainly in male sedentary individuals, on a high-calorie diet. Prevalence is unknown. The clinical picture includes mild obesity, hypeension and decrease in plasma volume with relative increase in hematocrit, blood viscosity, serum cholesterol, triglycerides and uric acid. The reduction in plasma volume seems related to the elevation of the diastolic blood pressure. Prognosis is impaired by the development of cardiovascular complications. | 3,200 | medmcqa_train |
After an incised wound, new collagen fibrils are seen along with a thick layer of growing epithelium. The approximate age of the wound is - | . 4-5 days | 3,201 | medmcqa_train |
Thyrotoxic periodic paralysis leads to extreme muscle weakness due to? | T3| T4| - Positive Na- K+ ATPase activity in the cells (3 Na outside 2 K+ inside) | K Influx | K| | Thyrotoxic Periodic Paralysis | 3,202 | medmcqa_train |
vitamin involved in 1 carbon metabolism | THFA is the carrier of One Carbon groups The folic acid is first reduced to 7,8-dihydrofolic acid and fuher reduced to 5,6,7,8-tetrahydrofolic acid (THFA) . Both reactions are catalyzed by NADPH dependent folate reductase. The THFA is the carrier of one-carbon groups. One carbon compound is an organic molecule that contains only a single carbon atom. The following groups are one carbon compounds: Formyl (-CHO) Formimino (-CH=NH) Methenyl (-CH=) Methylene (-CH2-) Hydroxymethyl (-CH2OH) Methyl (-CH3). One carbon groups bind to THF through N5 are Formyl, Formimino or methyl N10 are Formyl Both N5 and N10 are Methylene and Metheny Ref: DM Vasudevan - Textbook of Biochemistry, 8th edition, page no: 475 | 3,203 | medmcqa_train |
Snow blindness is caused by : | A i.e. Ultra violet rays | 3,204 | medmcqa_train |
Hyponatremia in multiple myeloma is | Pseudohyponatremia Patients with multiple myeloma also have a decreased anion gap because of the M component is cationic, resulting in retention of chloride This is often accompanied by hyponatremia that is felt to be aificial (pseudohyponatremia) because each volume of serum has less water as a result of the increased protein Ref: Harrison's 19th edition Pgno : 714 | 3,205 | medmcqa_train |
Schiller-Duval bodies are seen in- | Yolk sac tumor of the testis: Raised a-fetoprotein level (AFP). Schiller-Duval bodies. Schiller-Duval body: It is the characteristic feature of the endodermal sinus tumor. This is a glomerulus-like structure composed of a central blood vessel enveloped by germ cells within a space lined by germ cells. Endodermal sinus tumor: 1. Schiller-Duval body 2. PAS-positive hyaline droplets Ref: RAM DAS NAYAK EXAM PREPARATORY MANUAL FOR UNDERGRADUATES 2nd ed. pg no: 684 | 3,206 | medmcqa_train |
Which one of the following disorders is related to sense of unreality? | Ans. A. Depersonalization disorderDepersonalization:Depersonalization is a sense of unreality or strangeness concerning the self, manifested by feeling detached from and being an outside observer of one's mental processes or body.A patient who experiences depersonalization may describe feeling like things "I have stepped outside of myself and am watching myself doing things".Derealization:Derealization refers to feeling detached from one's environment so that the sense of the reality of the external world is lost.E.g, I feel as if everything is unreal and those around me are actors in a play or two dimensional cardboard figures. | 3,207 | medmcqa_train |
Floaters can be seen in following except | Black spots or floaters in front of the eyes may appear singly or in clusters. They move with the movement of the eyes and become more apparent when viewed against a clear surface e.g., the sky. Common causes of black floaters are: Vitreous hemorrhage Vitreous degeneration e.g., - senile vitreous degeneration, vitreous degeneration in pathological myopia Exudates in vitreous Lenticular opacity Reference : AK KHURANA COMPREHENSIVE OPHTHALMOLOGY, E4, Page-463 | 3,208 | medmcqa_train |
Term psychoanalysis was coined by? | Ans. is 'b' i.e., Freud * The credit for invention of psychoanalysis belong to Sigmund FreudImportant contributors in psychiatryTermCoined by* Demence precoce* Moral Emil* Dementia precox* Kraepelin* Catatonia, cyclotymia* Kahlbaum* Hebephrenia* Hecker* Schizophrenia* Eugen Bleuler* Ambivalence* Eugen Bleuler* Free association* Sigmund Freud* Psychoanalysis, Psychodynamics* Sigmunnd Freud* Id, ego, Superego* Sigmund Freud* Psychiatry* Johann christion Reil | 3,209 | medmcqa_train |
CSOM with Picket fence fever is seen in | Sigmoid sinus thrombosis/lateral sinus thrombosis is an inflammation of inner wall of lateral venous sinus with formation of an intra sinus thrombus It occurs as a complication of chronic suppuration of middle ear or acute coalescent mastoiditis, and cholesteatoma Picket fence fever temperature never comes back to normal baseline. Remittent fever. Complications of CSOM - Intra temporal Intracranial Mastoiditis Meningitis - m/c Petrositis Brain abscess Facial paralysis Extradural abscess Labyrinthitis Subdural abscess Lateral sinus thrombophlebitis Otitic hydrocephalus | 3,210 | medmcqa_train |
Which dietary deficiency of a vitamin can cause Pellagra. | Some amino acids (isoleucine, tryptophan, phenylalanine, and tyrosine) are both glucogenic and ketogenic because their degradation pathway forms multiple products.a. Amino acids that are converted to pyruvate (see Figure I).(1). The amino acids that are synthesized from the intermediates of glycolysis (serine, glycine, cysteine, and alanine) are degraded to form pyruvate.(a). Serine is converted to 2-phosphoglycerate, an intermediate of glycolysis, or directly to pyruvate and NH4+ by serine dehydratase, an enzyme that requires PLP.(b). Glycine, in a reversal of the reaction utilized for its synthesis, reacts with methylene-FH4 to form serine.1. Glycine also reacts with FH4 and NAD+ to produce CO2 and NH4+ (glycine cleavage enzyme).2. Glycine can be converted to glyoxylate, which can be oxidized to CO2 and H2 O or converted to oxalate.(c). Cysteine forms pyruvate. Its sulfur, which was derived from methionine, is converted to H2 SO4 , which is excreted by the kidneys.(d). Alanine can be transaminated to pyruvate.b. Amino acids that are converted to intermediates of the TCA cycle (see Figure II).(1). The carbons from the four groups of amino acids form the TCA cycle intermediates: a-ketoglutarate, succinyl-CoA, fumarate, and oxaloacetate.(a). Amino acids that form a-ketoglutarate (see Figure III).1. Glutamate can be deaminated by glutamate dehydrogenase or transaminated to form a- ketoglutarate.2. Glutamine is converted by glutaminase to glutamate with the release of its amide nitrogen as NH4+ 3. Proline is oxidized so that its ring opens, forming glutamate semialdehyde, which is oxidized to glutamate.4. Arginine is cleaved by arginase in the liver to form urea and ornithine. Ornithine is transaminated to glutamate semialdehyde, which is oxidized to glutamate.5. Histidine is converted to formiminoglutamate (FIGLU). The formimino group is transferred to FH4, and the remaining five carbons form glutamate.(b). Amino acids that form succinyl-CoA (see Figure IV)1. Four amino acids are converted to propionyl-CoA, which is carboxylated in a biotin requiring reaction to form methylmalonyl-CoA, which is rearranged to form succinyl-CoA in a reaction that requires vitamin B12 (seen previously in the metabolism of odd-chain number fatty acids).a). Threonine is converted by a dehydratase to NH4+ and a-ketobutyrate, which is oxidatively decarboxylated to propionyl-CoA.In a different set of reactions, threonine is converted to glycine and acetyl-CoA.b). Methionine provides methyl groups for the synthesis of various compounds; its sulfur is incorporated into cysteine; and the remaining carbons form succinyl-CoA.i. Methionine and ATP form S-adenosylmethionine (SAM), which donates a methyl group and forms homocysteine.ii. Homocysteine is reconverted to methionine by accepting a methyl group from the FH4 pool via vitamin B12 .iii. Homocysteine can also react with serine to form cystathionine. The cleavage of cystathionine produces cysteine, NH4+ , and a-ketobutyrate, which is converted to propionyl-CoA.c). Valine and isoleucine, two of the three branched-chain amino acids, form succinyl-CoA (see Figure IV).i. The degradation of all the three branched-chain amino acids begins with a transamination followed by an oxidative decarboxylation catalysed by the branched-chain a-keto acid dehydrogenase complex (Figure V). This enzyme, like pyruvate dehydrogenase and a-ketoglutarate dehydrogenase, requires thiamine pyrophosphate, lipoic acid, CoA, flavin adenine dinucleotide (FAD), and NAD+.ii. Valine is eventually converted to succinyl-CoA via propionyl-CoA and methyl malonyl-CoA.iii. Isoleucine also forms succinyl-CoA after two of its carbons are released as acetyl-CoA.(c). Amino acids that form fumarate1. Three amino acids (phenylalanine, tyrosine, and aspartate) are converted to fumarate (see Figure II).a). Phenylalanine is converted to tyrosine by phenylalanine hydroxylase in a reaction requiring tetrahydrobiopterin and O2 (Figure VI).b). Tyrosine, obtained from the diet or by hydroxylation of phenylalanine, is converted to homogentisic acid. The aromatic ring is opened and cleaved, forming fumarate and acetoacetate.c). Aspartate is converted to fumarate via reactions of the urea cycle and the purine nucleotide cycle.d). Aspartate reacts with IMP to form AMP and fumarate in the purine nucleotide cycle.(d). Amino acids that form oxaloacetate (see Figure II)1. Aspartate is transaminated to form oxaloacetate.2. Asparagine loses its amide nitrogen as NH4+ , forming aspartate in a reaction catalyzed by asparaginase.c. Amino acids that are converted to acetyl-CoA or acetoacetate (see Figure VI).(1). Four amino acids (lysine, threonine, isoleucine, and tryptophan) can form acetyl-CoA, and phenylalanine and tyrosine form acetoacetate. Leucine is degraded to form both acetyl-CoA and acetoacetate.Pellagra is caused by a dietary deficiency of niacin, beriberi is caused by a lack of thiamine (vitamin B-,), scurvy caused by a lack of vitamin C, and rickets from a lack of vitamin D.I. Amino acids derived from the intermediates of glycolysis. These amino acids can be synthesized from glucose and can be reconverted to glucose in the liver.II. The degradation of amino acids. A. Amino acids that produce pyruvate or the intermediates of the TCA cycle. These amino acids are considered glucogenic because their carbons can produce glucose in the liver. B. Amino acids that produce acetyl-CoA or ketone bodies. These amino acids are considered ketogenic. CoA, coenzyme A; HMG-CoA, hydroxymethylglutaryl-CoA; TCA, tricarboxylic acid.III. Amino acids related through glutamate. These amino acids contain carbons that can be converted to glutamate, which can be converted to glucose in the liver. All of these amino acids except histidine can be synthesized from glucose.IV. Amino acids that can be converted to succinyl-CoA. The amino acids methionine, threonine, isoleucine, and valine, which form succinyl-CoA via methyl malonyl-CoA, are all essential. Because succinyl-CoA can form glucose, these amino acids are glucogenic. The carbons of serine are converted to cysteine and do not form succinyl-CoA by this pathway. A defect in cystathionine synthase causes homocystinuria. A defect in cystathionase causes cystathioninuria. B12-CH3, methyl cobalamin; N5-CH3-FH4, N 5- methyl tetrahydrofolate; PLP, pyridoxal phosphate; SAM, S-adenosylmethionine; TCA, tricarboxylic acid.V. The degradation of the branched-chain amino acids. Valine forms propionyl-CoA. Isoleucine forms propionyl-CoA and acetyl-CoA. Leucine forms acetoacetate and acetyl-CoA. CoA, coenzyme A; FAD, flavin adenine dinucleotide; HMG-CoA, hydroxymethylglutaryl-CoA.VI. A. Ketogenic amino acids. Some of these amino acids (tryptophan, phenylalanine, and tyrosine) also contain carbons that can form glucose. Leucine and lysine are strictly ketogenic; they do not form glucose. B. A deficiency in various steps leads to the diseases indicated. CoA, coenzyme A; NAD, nicotinamide adenine dinucleotide; NADP, nicotinamide adenine dinucleotide phosphate; PKU, phenylketonuria; PLP, pyridoxal phosphate; TCA, tricarboxylic acid cycle. | 3,211 | medmcqa_train |
Good prognostic factor for schizophrenia is ? | Ans. is 'c' i.e., Presence of depression Good prognostic factors :- Acute onset; late onset (onset after 35 years of age); Presence of precipitating stressor; Good premorbid adjustment; catatonic (best prognosis) & Paranoid (2nd best); sho duration (< 6 months); Married; Positive symptoms; Presence of depression; family history of mood disorder; first episode; pyknic (fat) physique; female sex; good treatment compliance & good response to treatment; good social suppo; presence of confusion or perplexity; normal brain CT Scan; outpatient treatment. | 3,212 | medmcqa_train |
All drug inhibit bacterial cell wall synthesis EXCEPT | Spectinomycin is an aminocyclitol antibiotic that inhibits bacterial protein synthesis. The other drugs all inhibit bacterial cell wall synthesis. Vancomycin and bacitracin inhibit early steps in the biosynthesis of the peptidoglycan component of the cell wall, whereas 3-- lactams such as aztreonam (a monobactam), penicillins, cephalosporins, and carbapenems inhibit the cross-linking (transpeptidation) of the cell wall peptidoglycan polymers. | 3,213 | medmcqa_train |
Longest and thinnest extrocular muscle - | SO arises from the bone above and medial to the optic foramina. It runs forward and turns around a pulley- " the trochlea" and is inseed in the upper and outer pa of the sclera behind the equator. Ref;A.K.Khurana; 6th edition;Page no:336 | 3,214 | medmcqa_train |
Ribosomes has following enzymatic activity? | The formation of peptide bonds is catalysed by peptidyl transferase, an activity intrinsic to the 23 S r-RNA of 50 S subunit in prokaryotes and 28 S r-RNA of 60 S subunit in eukaryotes. So, it is referred to as ribozyme & indicates a direct role of r-RNA in protein synthesis. | 3,215 | medmcqa_train |
Inhibin inhibits the secretion of which hormone : | FSH | 3,216 | medmcqa_train |
True regarding traumatic facial nerve palsy is all, except | TRAUMA TIC FACIAL NERVE PARALYSIS 1. FRACTURES OF TEMPORAL BONE Fractures of temporal bone may be longitudinal, transverse or mixed. Facial palsy is seen more often in transverse fractures (50%). Paralysis is due to intraneural haematoma, compression by a bony spicule or transection of nerve. In these cases, it is impoant to know whether paralysis was of immediate or delayed onset. Delayed onset paralysis is treated conservatively like Bell palsy while immediate onset paralysis may require surgery in the form of decompression, re-anastomosis of cut ends or cable nerve graft. 2. EAR OR MASTOID SURGERY Facial nerve is injured during stapedectomy, tympanoplasty or mastoid surgery. Paralysis may be immediate or delayed and treatment is the same as in temporal bone trauma. Sometimes, nerve is paralyzed due to pressure of packing on the exposed nerve and this should be relieved first. Operative injuries to facial nerve can be avoided if attention is paid to the following: (a) Anatomical knowledge of the course of facial nerve, possible variations and anomalies and its surgical landmarks. Cadaver dissections should be an impoant pa of the training in ear surgery. (b) Always working along the course of nerve and never across it. (c) Constant irrigation when drilling to avoid thermal injury. Use diamond burr when working near the nerve. (d) Gentle handling of the nerve when it is exposed, avoiding any pressure of instruments on the nerve. (e) Not to remove any granulations that penetrate the nerve. (f) Using magnification; never to work on facial nerve without an operating microscope. 3. PAROTID SURGERY AND TRAUMA TO FACE Facial nerve may be injured in surgery of parotid tumours or deliberately excised in malignant tumours. Accidental injuries in the parotid region can also cause facial paralysis. Application of obstetrical forceps may also result in facial paralysis in the neonate due to pressure on the extratemporal pa of nerve. Ref : ENT textbook by Dhingra 6th edition Pgno : 96,97 | 3,217 | medmcqa_train |
Mean Hb values in two population groups are compared by | Ref:Park's Textbook of Preventive and Social Medicine 25th Ed | 3,218 | medmcqa_train |
A chest physician performs bronchoscopy in the procedure room of the out patient depament. To make the instrument safe for use in the next patient waiting outside, the most appropriate method to disinfect the endoscope is by - | Glutaraldehyde is especially effective against the tubercle bacilli, fungi, and viruses. It is less toxic and irritant to eyes and skin than formaldehyde. It has no deleterious effects on the cement or lenses of instruments such as cystoscope and bronchoscopy It can be safely used to treat corrugated rubber,nanestheticubes, face masks, plastic endotracheal tubes, metal instruments a, d polythene tubings REF:Ananthanarayan and Panicker's Textbook ofMicrobiology 8th Edition pg no:36 | 3,219 | medmcqa_train |
Most important amino acid for formation Neutrophilic extracellular trap (NET) is | Conversion of arginine residues to Citrulline in the histones is an essential step in the formation of neutrophill extracillular traps. | 3,220 | medmcqa_train |
All muscles of the pharynx are supplied by pharyngeal plexus, EXCEPT? | With the exception of stylopharyngeus, which is supplied by the glossopharyngeal nerve, the muscles are supplied by the cranial pa of the accessory nerve the pharyngeal plexus. | 3,221 | medmcqa_train |
Mauriac's syndrome is characterized by all except | Ans. is 'd' i.e., Cardiomegaly Mauriac Sydrome Children with poorly controlled type I diabetes may develop Mauriac syndrome. It is characterized by : - Growth attenuation Delayed pubey Hepatomegaly Abnormal glycogen storage and steatosis Cushingoid features Rare in modern era of insuling therapy but is occasionlly repoed. | 3,222 | medmcqa_train |
All of the following are true about Herpes group virus except- | Herpes viruses are susceptible to fat solvents like alcohilic ether chlorofirm and bike salts. REF:ANANTHANARAYAN AND PANIKER'S TEXTBOOK OF MICROBIOLOGY 9TH EDITION PAGE NO:466 | 3,223 | medmcqa_train |
The diabetes control and complication trial (DCCT) provided definitive proof that reduction In chronic hyperglycemia helps to improve - | The Diabetes Control and Complications Trial (DCCT) found definitive proof that a reduction in chronic hyperglycemia can prevent many of the complications of type 1 diabetes mellitus (DM). This multicenter randomized trial enrolled over 1400 patients with type 1 DM to either intensive or conventional diabetes management and prospectively evaluated the development of retinopathy, nephropathy, and neuropathy. The intensive group received multiple administrations of insulin daily along with education and psychological counseling. The intensive group achieved a mean hemoglobin A1C of 7.3% versus 9.1% in the conventional group. Improvement in glycemic control resulted in a 47% reduction in retinopathy, a 54% reduction in nephropathy, and a 60% reduction in neuropathy. There was a nonsignificant trend toward improvement in macrovascular complications. The results of the DCCT showed that individuals in the intensive group would attain up to 7 more years of intact vision and up to 5 more years free from lower limb amputation. Later, the United Kingdom Prospective Diabetes Study (UKPDS) studied over 5000 individuals with type 2 DM. Individuals receiving intensive glycemic control had a reduction in microvascular events but no significant change in macrovascular complications. These two trials were pivotal in showing a benefit of glycemic control in reducing microvascular complications in patients with type 1 and type 2 DM, respectively. Another result from the UKPDS was that strict blood pressure control resulted in an improvement in macrovascular complications Ref - pubmed.com | 3,224 | medmcqa_train |
. True about polio is all except: | Vaccine induced polio" is usually due to Type 2 virus | 3,225 | medmcqa_train |
Bleomycin toxicity is characterized by destruction of: | Ans. b. Type I pneumocytes Bleomycin toxicity is characterized by destruction of Type I pneumocytes.Histopathotogy of Lung in Bleomycin Toxicity* Endothelial cell edema and blebbing* Necrosis of type 1 pneumocytes* Proliferation of fibroblast and fibrosis* Hyperplasia and metaplasia of type II pneumocytes* Inflammatory infiltrate with PMNBleomycin* Bleomycin is well known to cause pulmonary toxicity.* Incidence of bleomycin induced pulmonary toxicity is 5% for a total cumulative dose of 450 units and 15% for higher dosages.* Bleomycin is concentrated preferentially in the lung and is inactivated by hydrolase enzyme. This enzyme is relatively deficient in lung tissue. This may explain relative sensitivity of bleomycin to lung tissue.Type I pneumocytes are more vulnerable to bleomycin toxicity' and are destroyed by bleomycinPathological Features of Bleomycin Toxicity* Early endothelial cell damage* Destruction uf type 1 pneumocytes* Migration of type II pneumocytes into alveolar spaces inducing interstitial changesFollowing destruction of type I pneumocytes repair is characterized by hyperplasia and dysplasia of type II pneumocytes. Fibro- blast proliferation with subsequent pulmonary fibrosis is probably the basis for irreversible changes induced by Bleomycin. | 3,226 | medmcqa_train |
A policemen foo..a a person ln ing unconscious in iglu lateral position on the road with superficial injury to the face, bruises on the right arm, and injury to the lateral aspect of right knee. Nerve most probably injured: | Ans. c. Common peroneal nerve Common peroneal nerve (L4, L5, Sl, S2) is the smaller terminal branch of sciatic nerve. The larger terminal branch of sciatic nerve is the tibial nerve. The common peroneal nerve is relatively unprotected as it traverses the lateral aspect of the head of fibula and is easily compressed at this site.' Common Peroneal Nerve Injury Common peroneal nerve (L4, L5, Sl, S2) is the smaller terminal branch of sciatic nerve. The larger terminal branch of sciatic nerve is the tibial nerve. The common peroneal nerve is relatively unprotected as it traverses the lateral aspect of the head of fibula and is easily compressed at this site. Common Modes of Injury Fracture of neck of fibula Plaster on the leg Lathi injury on the lateral side of knee joint Clinical Features: Injury to common peroneal nerve results in paralysis of all muscles in the anterior and lateral compament of the leg (dorsiflexors of the ankle and eveors of the foot) which results in: Loss of eversion of foot and dorsiflexion of the ankle causes foot drop Foot drop and toes drags on the floor while walking Foot comes down suddenly producing a distinctive plop Variable loss of sensation on the anterolateral aspect of the leg and dorsum of the foot Aicular loss the lateral side of the knee joint In common peroneal nerve injury, only eversion and dorsiflexion is lost, while inversion and plantar flexion remains normal, therefore ankle reflex is intact. | 3,227 | medmcqa_train |
HLA B27 histocompatibility antigen is correlated With | REF:HARRISONS PRINCIPLE&;S OF INTERNAL MEDICINE 18TH EDITION | 3,228 | medmcqa_train |
Dileufloy's lesion is seen in - | Ans. is 'a' i.e., Stomach Dieulafoy's lesion* Dieulafoy's lesion is a medical condition characterized by a large tortuous arteriole most commonly in the stomach wall (submucosal) that erodes and bleeds.* It can cause gastric hemorrhage but is relatively uncommon. It is thought to cause less than 5% of all gastrointestinal bleeds in adults* Dieulafoy's lesions are characterized by a single large tortuous small artery in the submucosa which does not undergo normal branching or a branch with caliber of 1-5 mm (more than 10 times the normal diameter of mucosal capillaries). The lesion bleeds into the gastrointestinal tract through a minute defect in the mucosa which is not a primary ulcer of the mucosa but an erosion likely caused in the submucosal surface by protrusion of the pulsatile arteriole.* Approximately 75% of Dieulafoy's lesions occur in the upper part of the stomach within 6 cm of the gastroesophageal junction, most commonly in the lesser curvature. | 3,229 | medmcqa_train |
All the following are complications of streptokinase, except | Ref Harrison 19 th ed pg 1605 Allergic reactions to streptokinase occur in ~2% of patients who receive it. While a minor degree of hypotension occurs in 4-10% of patients given this agent, marked hypotension occurs, although rarely, in association with severe allergic reactions. | 3,230 | medmcqa_train |
A 40-year-old patient is suffering from carotid body tumor. Which of the following is the best treatment for him? | Best treatment for a 40-year-old patient who is suffering from carotid body tumor is excision of tumor. CAROTID BODY TUMOR TREATMENT Because these tumors rarely metastasizeQand their overall rate of growth is slow, the need for surgical removal must be considered carefully as complication of surgery are potentially serious. Operation is best avoided in elderly patientsQ. Preoperative embolization is performed for tumors >3 cm. Tumors >5 cm are associated with a need for concurrent carotid aery replacement. | 3,231 | medmcqa_train |
Following may be seen in the exit wound: DNB 10; NEET 14 | Ans. Abrasion collar | 3,232 | medmcqa_train |
Substance which is not absorbed in the loop of Henle: March 2005 | Ans. B: Urea The descending pa of the thin segment of the loop of Henle is highly permeable to water and moderately permeable to most solutes and little or no active reabsorption. The thick ascending limb of the loop of Henle reabsorbs about 25% of the filtered loads of sodium, chloride and potassium as well as large amount of calcium, bicarbonate and magnesium. It also secretes hydrogen ions into the tubular lumen | 3,233 | medmcqa_train |
A 28 year old woman, suffers from emotional liability and depression, about 10 days prior to her menses. She repos that once she begins to bleed, she feels back to normal. She also gives a history of premenstrual fatigue, bloating and breast tenderness. What would be the best treatment for the patient? | Fluoxetine is a selective serotonin Reuptake Inhibitor (SSRI) and SSRIs have shown the greatest efficiency in PMS treatment. Premenstrual syndrome (PMS), also called Premenstrual Tension (PMT), is a symptom complex, recognised primarily by cyclic changes, associated with ovulatory cycles. It occurs 7 to 14 days prior to menstruation and spontaneously resolves after menses. It always occurs in the luteal phase of the cycle. Symptoms include: Pain: Headache, breastpain, abdominal cramps, muscle stiffness, backache and generalise body ache. Water retention: Breast volume increase, bloating and weight gain. Behavioural changes: Low performance, difficulty in concentration, irritability, depression, forgetfulness, low judgement, anxiety, loneliness, feeling like crying, hostility, increased appetite and cravings and sleeplessness. Autonomic changes: Dizziness, faintness, nausea, vomiting and hot flushes Treatment: Psychosomatic symptoms: SSRIs, Vitamin B1, B6 and E Breast pain: Danazol, Bromocriptine and GnRH analogues Pelvic pain and bloatedness: OCP and Mirena IUCD General measures: Excercise, relaxation and hobbies like Meditation and Yoga Ref: Shaw&;s textbook of Gynaecology 17th edition PGno: 127 | 3,234 | medmcqa_train |
Which of the following statements about 'Multiple Pregnancies' is TRUE? | Twin peak or Lambda sign is seen in dichorionic diamniotic twin gestation. In this the chorion and amnion for each twin reflect away from the fused placenta to form an inter twine membrane. A space that exist in the intewine membrane is filled by proliferating placental villi giving rise to twin peak sign. Twin peak sign appear as a triangle with the base at the chorionic surface and apex in the inter twin membrane. Ref: Textbook of Obstetrics By Dutta, 6th Edition, Page 207; Ultrasound in Obstetrics and Gynecology By Meyz, 2004, Page 422, 423; Ultrasound and Multifetal Pregnancy, 1998, Pages 74, 75, 73; Textbook of Perinatal Medicien By Kurjak, 2nd Edition, Page 499, 500, 501. | 3,235 | medmcqa_train |
In hyponatremia following renal failure, serum sodium should be maintained at what levels ? | Hyponatremia in CKD population is associated with increased moality, but the effect on renal outcome was unknown.. Hyponatremia (serum sodium <120 mEq/L) was associated with excessive volume and volume depletion, measured as total body water by bioimpedance analysis, in diuretic users, but not in diuretic non-users Ref Davidson 23rd edition pg 366 | 3,236 | medmcqa_train |
True about VSD are all except – | Hemodynamics of VSD
A VSD results in shunting of oxygenated blood from left to right because left ventricle has more pressure than right → Left to right shunt.
Blood flow from left to right ventricle due to high pressure gradient → Pansystolic murmur and systolic thrill.
Because left ventricle starts contracting before Right ventricle, pansystolic murmur starts early → Masking of Si.
This pressure gradient is maintained throughout the systole pansystolic murmur lasts long → Masking of S2.
Towards the end of systole, the declining left ventricular pressure becomes lower than aortic → Early closure of A2.
Left to right shunt occurs during systole at a time when the right ventricle is also contracting, therefore left to right shunt streams to pulmonary artery more or less directly → No volume overload > Right ventricle size remains normal.
Increased blood flow through pulmonary valve → Pulmonary ejection systolic murmur and delay & accentuated P2.
Early closure of A2 and delayed closure of P2 cause → Widely split S2 (But this is usually masked by pansystolic murmur).
Larger volume reaches the left atrium → Left atrial hypertrophy
Increased blood flow through mitral valve → Accentuated S1 (But it is masked by pansystolic murmur) and delayed diastolic murmur.
Note :
Ejection systolic murmur of pulmonary valve can not be separated from pansystolic murmur.
The effect of ejection systolic murmur is a selective transmission of pansystolic murmur to the upper left sternal border (pulmonary valve area) → In this area ejection characteristic of this murmur can be recognized since it does not mask the aortic component of S2. For the same reason second heart sound (S2) can be heard in the pulmonary area where it is not masked by pansystolic murmur. | 3,237 | medmcqa_train |
Rapid change of presbyopic glass is a feature of | D i.e. Open angle glaucoma Conditions associated with altered refraction Feature Found in Frequent change of presbyopic glasses Open angle glaucoma Q Second sight/ Myopic Shift/Improvement in near vision Senile immature nuclear cataract Fluctuation of refractory error Diabetic cataract Frequent change of glasses Coical or nuclear cataract Primary Open Angle Glaucoma/ Chronic Simple Glaucoma It is chronic, slowly progressive, bilateral disease characterized by - adult onset, 10P > 21 mmHg at some point in the course of disease, an open angle, glaucomatous optic nerve head damage and visual field loss. It presents with painless progressive loss of vision Q, frequent change in presbyopic glasses Q and difficulty in near work owing to accommodative failure. | 3,238 | medmcqa_train |
Alopecia areata is not associated with which of the folllowing condition? | Alopecia areata may be associated with atopy, downs syndrome, vitiligo, pernicious anemia, myxedema , diabetes or hypeension in the family. Sho,1-2 mm fractured hairs can frequently be seen at the active margins of alopecia areata. These hairs are described as exclamation mark hairs because these characteristic hairs fracture at their distal end and taper proximally to a pencil point giving them appearance of an exclamation mark . nail pitting is a common finding in alopecia areata . Ref Harrison20th edition pg 1236 | 3,239 | medmcqa_train |
Risk of mother to child HIV transmission in pregnant woman at the time of delivery, and after delivery in non breast feeding woman is | HIV transmission in absence of intervention:
MTCT of HIV in developed countries: 20% (15-25%)
MTCT transmission of HIV in developing countries: 30% (25-35%) | 3,240 | medmcqa_train |
True about receptor potential is? | ANSWER: (D) Is a graded changeREF: Textbook of Medical Physiology by Khurana page 1032-1033, Physiology - Prep Manual for Undergraduates, 4th Edition by Vijaya D Joshi page 562, Ganongs 22nd ed p. 123-125When a stimulus excites the receptor, it changes the potential across the membrane of the receptors. This change in the potential is called receptor or generator potential.The change in membrane potential in a receptor is caused by a change in permeability of membrane of the unmylelinated terminals to Na+. The resultant influx of Na+ causes development of generator or receptor potential. Since the receptor potential may generate the action potential it is also called as generator potential.The larger the receptor potential, the greater the frequency of action potential generated in the afferent neuron. A larger receptor potential can not bring about a larger action potential (because of all or none phenomenon), but it can induce more rapid firing of action potential.DIFFERENCE BETWEEN RECEPTOR POTENTIAL AND ACTION POTENTIAL:Receptor potentialAction potentialReceptor potential is a graded response i.e. amplitude of receptor potential increases with increase velocity of stimulus application and increase strength of stimulusAction potential obeys all or none law i.e. further increase in stimulus above threshold do not bring any change in amplitudeCan be added together if second stimulus arrives before the first stimulus is overCan not be added togetherHas no refractory periodHas a refractory period of 1 msMostly it is local and can not be propagatedIt can be propagated without loss in the amplitude along the nerve fibreDuration is greater (approximately 5-10 ms)Duration is small (approximately 1-2 ms) | 3,241 | medmcqa_train |
Condition required for autoclave is? | Autoclave: Recommended condition- 121–124°C temperature for 15 min at 1.1 bar pressure
Alternate: 134–138°C temperature for 3 min at 2.2 bar pressure
Hot air oven: 160°C temperature for 120 min or 180°C temperature for 30 min | 3,242 | medmcqa_train |
An obese, diabetic patient with hypertension who is also a smoker, currently on anti-hypertensive and OHA drugs presents with complains of apnea during night. Polysomnography reveals 5 apneic episodes and 1 hypoapneic episode in one hour. What will be best next line of management is: (E. REPEAT 2007) | Ref: Harrison's Principles of Internal Medicine. 18th edition, Page 2188Explanation:OSAHS is defined as the coexistence of unexplained excessive daytime sleepiness with at least five obstructed breathing events (apnea or hypopnea) per hour of sleep.EPWORTH SLEEPINESS SCOREHow often are you likely to doze off or fail asleep in the following situations, in contrast to feeling just tired'* This refers to your usual way of life in recent times.Even if you have not done some of these things recently, fry to work out how they would have affected you.Use the following scale to choose the most appropriate number for each situation:= would never doze.= slight chance of dozing.= moderate chance of dozing.= high chance of dozing.* Sitting and reading--* Watching TV--* Sitting, inactive in a public place (e.g., a theater or a meeting)--* As a passenger in a car for an hour without a break--* Lying down to rest in the afternoon when circumstances permit--* Sitting and talking to someone--* Sitting quietly after lunch without alcohol--* In a car, while stopped for a few minutes in traffic--TOTAL--DiagnosisSleep history from the patient and partner, with both completing.Sleep questionnaires.Epworth Sleepiness Score.Assessment of:o Obesity.o Jaw structureo Upper airwayo Blood pressureo Hypothyroidismo Acromegaly.Polysomnography.The apnea-hypopnea index or apnoea-hypopnoea index (AHI)It is an index of sleep apnea severity that combines apneas and hvpopneas.The apneas (pauses in breathing) must last for at least 10 seconds and are associated with a decrease in blood oxygenation.Combining these gives an overall sleep apnea severity score that evaluates both number sleep disruptions and degree of oxygen desaturation (low blood level).The AHI is calculated by dividing the number of events by the number of hours of sleep.AHI values are typically categorized as:o Mild = 5-15/hro Moderate = 15-30/hro Severe = > 30/hTREATMENT: OBSTRUCTIVE SLEEP APNEAWhom to Treat-Indications for TreatmentGroup IPatients who have an:o Epworth Score >1Lo Troublesome sleepiness while driving or working.o >15 apneas + hypopneas per hour of sleep.Treatment is definitely indicated in this group- Maximum benefit.Treatment improves:o Symptomso Sleepinesso Drivingo Cognitiono Moodo Quality of lifeo Blood pressure.Group 2Patient who have:o Similar degrees of sleepiness as Group Io 5-15 events per hour of sleep.Treatment is indicated-But benefit is less than Group 1.Treatment improves:o Symptomso Subjective sleepiness.No significant improvement in cognition and quality of life.No improvements in Blood pressure.Group 3Patients who are/have:o Nonsleepy subjects.o Less than 5 events per hour of sleep.Treatment is not indicated.No benefit with treatment.Life style modifications advised.MANAGEMENT OPTIONSLifestyle ModificationsWeight loss.Alcohol Reduction-Alcohol acutely decreases URT dilating muscle tone.CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP)Blowing the airway open during sleep, usually with pressures of 5-20 mmllg.CPAP improves the following in patients with OSAHS:o Breathing during sleepo Sleep qualityo Sleepinesso Blood pressureo Vigilanceo Cognitiono Driving abilityo Moodo Quality of life.The main side effect of CPAP is airway drying (decreased by using heated humidifier).CPAP is effective for both Moderate and Severe disease.Most common treatment modality used in OS A.MANDIBULAR REPOSITIONING SPLINT (MRS)Also called oral devices.Holds lower jaw and tongue forward causing widening the pharyngeal airway.MRSs improve the follow ing in OSAHS patients:o Breathing during sleep.o Daytime somnolenceo Blood pressure.There are many devices with differing designs with unknown relative efficacy.Self-reports of the use of devices long-term suggest high dropout rates.SurgeryBariatric surgery can be curative in the morbidly obese.Tonsillectomy can be highly effective in children but rarely in adults.Tracheostomy is curative but rarely used because of the associated morbidity rate but should nor be overlooked in severe cases.Jaw advancement surgery--particularly maxillomandibular osteotomy--is effective in young and thin patients with retrognathia (posterior displacement of the mandible).There is no clear evidence that pharyngeal surgery , including uvulopalatopharyngoplasty (whether by scalpel, laser, or thermal techniques) helps OSAHS patients.DrugsNo drugs are clinically useful in the prevention or reduction of apneas and hypopneas.In CPAP refractory patients. Modafinil can be tried with limited success.Choice of TreatmentCPAP and MRS are the two most widely used and best evidence-based therapies.CPAP is the current treatment of choice.MRSs are evidence-based second-line therapy in those who fail CPAP.In younger. thinner patients, maxillomandibular advancement should be considered.Note:In the given case, patient has 5 events/hour of sleep. He is also obese, diabetic, smoker and hypertensive. So the next step in management is to advocate life style modifications to treat obesity advise smoking cessation and follow-up. | 3,243 | medmcqa_train |
Blue sclera is seen in - | Ans. is 'b' i.e., Osteogenesis imperfect * Blue scleral discoloration is caused by thinning or transparency with resultant visualization of the underlying uvea.* Causes of blue sclera are: Osteogenesis imperfecta, Marfan syndrome, Ehler - Danlos syndrome, Pseudoxanthoma elasticum. | 3,244 | medmcqa_train |
A 3 year graduate MBBS programme was suggested by which committee? | HLEG Recommendations
High Level Expert Group (HLEG, Planning Commission, GOI) on Universal health Coverage has suggested 3½ year MBBS course for serving rural population
HLEG was developed for XII Five Year Plan
Rural doctors will be called as ‘Community Health Officers’
3½ Degree given: B.Sc. Community Health | 3,245 | medmcqa_train |
Quinidine exes action on hea by | Refer katzung 11e p 237 * Mechanism of action Like all other class I antiarrhythmic agents, quinidine primarily works by blocking the fast inward sodium current (INa). ... The effect of blocking the fast inward sodium current causes the phase 0 depolarization of the cardiac action potential to decrease (decreased Vmax). | 3,246 | medmcqa_train |
In the beginning of resuscitation effos, 0.5 mg of epinephrine is administered subcutaneously. Which adrenergic receptors, in which tissues, are responsible for the beneficial effect of epinephrine in this patient? | Epinephrine is a non selective adrenergic agonist and a valuable resuscitative drug because of its effects at multiple adrenergic receptor subtypes. In the treatment of anaphylaxis, epinephrine increases myocardial contractility, accelerates hea rate, causes constriction of vascular smooth muscle, and causes relaxation of bronchial smooth muscle. The principal pharmacologic effects of epinephrine that are beneficial in anaphylaxis are mediated : alpha-1 receptors in vascular smooth muscle, resulting in vasoconstriction, beta-1 receptors in the hea, resulting in increased contractility, and beta-2 receptors in bronchial smooth muscle, resulting in relaxation and relief of bronchoconstriction. (One simple mnemonic for the respective locations of beta1 and beta2 receptors is "one hea, two lungs.") Beta-2 receptors are also found, however, in vascular smooth muscle (especially in skeletal muscle beds), were, just as in bronchial smooth muscle, they promote relaxation. (Epinephrine dilates skeletal muscle vascular beds to maximize oxygen delivery for the "fight-or-flight" response.) The resulting vasodilation in skeletal muscle vascular beds would, by itself, tend to decrease blood pressure, which might tend to worsen the effects of anaphylactic shock, but this effect is mitigated by the intense alpha-1 receptor stimulation, causing vasoconstriction in multiple beds. The principal action of alpha-2 receptors is at the presynaptic nerve terminal, where receptor stimulation reduces the release of norepinephrine from the nerve terminal. Epinephrine does stimulate these receptors, but it does not really contribute to the beneficial actions of epinephrine in resuscitation. Alpha-2 receptors are not located in the hea (except at presynaptic nerve terminals), alpha-2 receptors do not have a significant beneficial effect in resuscitation, and beta-1 receptors are not located in bronchial smooth muscle, but are located in the hea. Beta-1 receptors are located in the hea, not in bronchial smooth muscle. The adrenergic receptor that produces bronchial smooth muscle relaxation is beta-2. Alpha-2 receptors are located primarily at presynaptic nerve terminals, and because the beta-2 receptors in vascular smooth muscle cause vasodilation, this not a helpful effect of epinephrine in this case. Also Know: Epinephrine is indicated for the treatment of anaphylactic reactions and acute asthma exacerbations. It is considered a first-line agent in the treatment of cardiac arrest (i.e., pulseless ventricular tachycardia/ventricular fibrillation, asystole, and pulseless electrical activity). Epinephrine also causes bronchodilation and antagonizes the effects of histamine. Epinephrine significantly increases myocardial oxygen consumption and thus can exacerbate ventricular irritability in the setting of myocardial ischemia. Extravasation causes necrosis and sloughing, and requires prompt infiltration of the affected area with phentolamine. Ref: Miller B.A., Clements E.A. (2011). Chapter 24. Pharmacology of Vasopressor Agents. In J.E. Tintinalli, J.S. Stapczynski, D.M. Cline, O.J. Ma, R.K. Cydulka, G.D. Meckler (Eds), Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e. | 3,247 | medmcqa_train |
Residul lung volume increased in | (B) Emphysema# FACTORS AFFECTING FRC> FRC Increases with: Increased height Erect position (30% more than in supine) Decreased lung recoil (E.g. emphysema)> FRC Decreases with: Obesity, Muscle Paralysis (especially in supine) Restrictive lung disease (E.g. Fibrosis, Pregnancy) Anaesthesia FRC does not change with age> Emphysema is a condition of the lung characterized by abnormal permanent enlargement of the airspaces distal to the terminal bronchiole, accompanied by destruction of their walls and without obvious fibrosis.> Principal antielastase activity in serum and interstitial tissue is alpha 1 -AT (others are secretory leukoprotease inhibitor in bronchial mucus and serum alphal -macroglobulin), and the principal cellular elastase activity is derived from neutrophils (other elastases are formed by macrophages, mast cells, pancreas, and bacteria). Neutrophil elastase is capable of digesting human lung, and this digestion can be inhibited by alphal-antitrypsin.> The most plausible hypothesis to account for the destruction of alveolar walls is the protease-antiprotease mechanism. This hypothesis is based on two important observations, one clinical and one experimental. The first is that homozygous patients with a genetic deficiency of the protease inhibitor alphal -AT have a markedly enhanced tendency to develop pulmonary emphysema, which is compounded by smoking.# Emphysema is classified into distinct pathologic types:> The most important types being centriacinar and panacinar.# Centriacinar emphysema, the type most frequently associated with cigarette smoking, is characterized by enlarged airspaces found (initially) in association with respiratory bronchioles.> Centriacinar emphysema is most prominent in the upper lobes and superior segments of lower lobes and is often quite focal.# Panacinar emphysema refers to abnormally large airspaces evenly distributed within and across acinar units.> Panacinar emphysema is usually observed in patients with a1 AT deficiency.> Pulmonary function testing shows airflow obstruction with a reduction in FEV1 and FEV1/FVC With worsening disease severity, lung volumes may increase, resulting in an increase in total lung capacity, functional residual capacity, and residual volume.> In patients with emphysema, the diffusing capacity may be reduced, reflecting the parenchymal destruction characteristic of the disease. | 3,248 | medmcqa_train |
What is the most probable diagnosis for on the x-ray of a 20 year old female who came with knee swelling | Sunburst appearance of Osteosarcoma Sunburst appearance is a type of periosteal reaction giving the appearance of a sunburst secondary to an aggressive The sunburst appearance occurs when the lesion grows too fast and the periosteum does not have enough time to lay down a new layer and instead the It is frequently associated with or osteoblastic metastases Ref: Maheshwari 6e pg 239. | 3,249 | medmcqa_train |
Which among the following is true about atrial myxoma? | Atrial myxomas are the most common primary hea tumors, and 75-85% occurs in the left atrial cavity. The most common site of attachment is at the border of the fossa ovalis in the left atrium. Although atrial myxomas are typically benign, local recurrence due to inadequate resection or malignant change has been repoed. Two-dimensional echocardiography is the diagnostic procedure of choice. Most atrial myxomas are benign and can be removed by surgical resection. | 3,250 | medmcqa_train |
For the following statements, select whether it is applicable to any or all of the below medications.Inhibition of angiotensin converting enzyme I (ACE I) | Enalapril may exert its effect by inhibiting formation of angiotensin II. This lowers systemic vascular resistance. In addition, ACE inhibitors have a natriuretic effect by inhibition of aldosterone secretion. They have been shown to improve mortality and decrease hospitalization in patients with CHF. | 3,251 | medmcqa_train |
Lesion of optic tract causes? | Ans. (d) Homonymous hemianopiaRef.: Harrison's 19th ed. /198-199* Unilateral optic nerve lesion: Unilateral blindness* Binasal hemianopia: Bitemporal optic chiasma lesion. Two different lesions compressing the chiasma from the lateral parts.* Bitemporal hemianopia: Binasal retinal damaged optic chiasmal lesion. Commonest lesion is pituitary adenoma.* Homonymous hemianopia: lesion at optic tract AND optic radiation* Homonymous superior quadrantonopia: All superior quadrantonopia goes to the temporal lobe (pie in the sky).* Homonymous inferior quadrantonopia: All inferior quadrantonopia goes to the parietal lobe (Pie on the floor).* Homonymous hemianopia w/ macular sparing: Lesion in occipital cortex les | 3,252 | medmcqa_train |
Who coined term anaesthesia | Oliver Wendell Holmes coined the term anesthesia. In 1846, Holmes coined the word anesthesia. In a letter to dentist William T. G. Moon, the first practitioner to publicly demonstrate the use of ether during surgery, he wrote: "Everybody wants to have a hand in a great discovery. All I will do is to give a hint or two as to names--or the name--to be applied to the state produced and the agent. The state should, I think, be called "Anaesthesia." This signifies insensibility--more paicularly ... to objects of touch." Ether was used for frivolous purposes ("ether frolics"), but not as an anesthetic agent in humans until 1842, when Crawford W. Long and William E. Clark independently used it on patients for surgery and dental extraction, respectively. However, neither Long nor Clark publicized his discovery. Four years later, in Boston, on October 16, 1846, William T.G. Moon conducted the first publicized demonstration of general anesthesia for surgical operation using ether. The dramatic success of that exhibition led the operating surgeon to exclaim to a skeptical audience: "Gentlemen, this is no humbug!" Joseph Priestley produced nitrous oxide in 1772, and Humphry Davy first noted its analgesic propeies in 1800. Gardner Colton and Horace Wells are credited with having first used nitrous oxide as an anesthetic for dental extractions in humans in 1844. Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e | 3,253 | medmcqa_train |
A 55-year-old man presents with recurrent epigastric pain. Upper GI endoscopy and gastric biopsy reveal a neoplastic, lymphocytic infiltrate invading glandular tissue. Giemsa staining is positive for Helicobacter pylori. Which of the following is the most likely diagnosis? | Diagnosis: Marginal zone lymphoma, MALT lymphoma Marginal Zone Lymphoma is an indolent tumor develop due to chronic B cell stimulation either by H.pylori or Auto immune disorders Translocation (11:18) involved | 3,254 | medmcqa_train |
Maintenance of high urinary pH is important during methotrexate treatment because: | Methotrexate is a weak acid and is reabsorbed in acidic urinary pH. Higher plasma concentration may result in toxicity. Therefore, to decrease the reabsorption through renal tubules, high urinary pH must be maintained. | 3,255 | medmcqa_train |
Which of the following statement is true regarding Atazanavir:- | Atazanavir is effective against both against HIV 1 and HIV 2 but NNI are effective only against HIV 1. They do not decrease cholesterol and triglyceride levels. Combination with ritonavir have an advantage due to the phenomenon of Ritonavir boosting. The resistance is due to mutation in codon 50 isoleucine to valine substitution. | 3,256 | medmcqa_train |
Cerebrosides consist mostly of this | Both glucocerebrosides and galacto cerebrosides are present however galactocerebrosides are most commonly seen on neural cells and are abundant | 3,257 | medmcqa_train |
Bence Jone's Protein is: March 2005 | Ans. B: Monoclonal light chains A Bence Jones protein is a monoclonal globulin protein found in the blood or urine, with a molecular weight of 22-24 kDa. The proteins are immunoglobulin light chains (paraproteins) and are produced by neoplastic plasma cells. They can be kappa (most of the time) or lambda. The light chains can be immunoglobulin fragments or single homogeneous immunoglobulins. They are found in urine due to the kidneys' decreased filtration capabilities due to renal failure, often induced by hypercalcemia from the calcium released as the bones are destroyed. The light chains can be detected by heating or electrophoresis of concentrated urine. Light chains precipitate when heated to 50 - 60 degrees C and redisolve at 90 -100 degrees C. There are various rarer conditions that can produce Bence Jones proteins, such as Waldenstrom's macroglobulinemia. | 3,258 | medmcqa_train |
Risk factors for gonococcal infection is all except | Age < 24 years is a risk factor. | 3,259 | medmcqa_train |
Which of the following best defines the "Saccade"- | Saccades are sudden, jerky conjugate eye movements that occur as the gaze shifts from one object to another. Supranuclear eye movement systems include : Saccadic system Smooth pursuit system Vergence system Vestibular system Optokinetic sysytem Position maintenance system Ref;A.K.Khurana;6th edition; Page no: 341 | 3,260 | medmcqa_train |
Inclusion conjunctivitis is caused by- | Ans. is 'a' i.e., Trachoma Adult inclusion conjunctivitiso It is a type offollicular conjunctivitis caused by serotypes D to K of chlamydia trachomatis-in sexually active young adults.o The primary source of infection is urethritis in males and cervicitis in females.o Transmission may occur either through contaminated fingers or through contaminated water of swimming pools (Swimmingpool granuloma).o Presentation is similar to other acute follicular conjunctivits with mucopurulent discharge,o The disease runs a benign course and often evolves into the chronic follicular conjunctivitis. | 3,261 | medmcqa_train |
A 25 years old male smoker presents with high grade fever with chills and severe right sided pleuritic chest pain and cough with expectoration physical examination of the patient is likely to show | This is the case of pneumonia shows signs of consolidation lung :
Reduced thoracic movements.
Increased vocal fremitus and vocal resonance.
Dull note on percussion.
Bronchial breath sounds. | 3,262 | medmcqa_train |
All except one is continued prior to elective caesarean section in an hypertensive diabetic term gestation, obese female who is a case of chronic aorto iliac obstruction. | Heparin is stopped 6 hours priorly. Rest all drugs need to be continued till day of surgery. | 3,263 | medmcqa_train |
Triple bonds are found between which base pairs | Adenine is always paired with thymine by the formation of two hydrogen bonds. Guanine is always paired with cytosine by the formation of three hydrogen bonds.
Thus, the C-G bonds are more resistant to denaturation. | 3,264 | medmcqa_train |
Which is not an effect of atropine? | ANSWER: (C) BradycardiaREF: KDT 4th Ed p. 94EFFECTS OF ATROPINE:CNS* Stimulates medullary , vasomotor and respiratory center* Depresses vestibular excitation , hence anti motion sickness* Suppresses cholinergic activity in basal ganglia, hence decreases tremor.* High doses may cause cortical excitation , restlessness , disorientation and hallucinationsCVS* Tachycardia* Abbreviates A-V refractory period* Facilitates A-V conduction* No consistent effect on BPEYE* Mydriaisis* Abolition of light reflexes* Cycloplegia* Rise of IOTSmooth musdes* All visceral smooth muscles are relaxed* Constipation* Bronchodilation* Urinary retention* Urinary bladder and ureter relaxation* Effect on uterus is minimal* Effect of biliary tract is less markedGlands* Decrease sweat, salivary , tracheobronchial and lachrymal secretions* Decreases secretion of acid and pepsinBody temperature* riseLocal anesthetic* effect present | 3,265 | medmcqa_train |
An expectant mother feels quickening at: | Ans. is b, i.e. 16-20 weeksRef. Dutta Obs 9/e, p 63: Reddy 27/e, p 434"Quickening (feeling of life) denotes the perception of active fetal movements by the women. It is usually felt about the 18th week Q, 2 weeks earlier in multiparae. Its appearance is a useful guide to calculate the expected date of delivery with reasonable accuracy" Ref. Dutta Obs, 9/e, p 63"Quickening is felt between 16th to 20th week Q" --Reddy 27/e, p 343PhenomenonTimePalpation of fetal part20 weeksActive fetal movement felt by placing a hand on abdomen20 weeksExternal ballottement20 weeksInternal ballottement16-28 weeksFHS audible by Stethoscope18-20 weeksFetal movement can be detected by Doppler10 weeksLightening38 weeks | 3,266 | medmcqa_train |
All of the following are causes of Renal Vein Thrombosis, Except: | Answer is D (PSGN): Post streptococcal Glomerulonephritis has not been mentioned as a cause of Renal Vein thrombosis Nephrotic Syndrome: Common Renal pathologies causing Renal Vein Thrombosis Membranous Glomerulonephritis (strongest association) Membranoproliferative Glomerulonephritis Amyloidosis Lupus Nephritis (Thrombosis & hemorrhage 3rd/724) Nephrotic syndrome due to diabetic mellitus, minimal change disease andfbcal segmental sclerosis are rarely associated with renal vein thrombosis | 3,267 | medmcqa_train |
Drug which do not cause hyperprolactinemia: | Ans. A. BromocriptineAll of the drugs listed are D2 blockers which are associated with hyperprolactinemia except bromocriptine which is D 2 agonist. | 3,268 | medmcqa_train |
All of the following are indicators of air pollution except | Soiling index or smoke index is used to monitor air pollution. Best indicators of air pollution are sulfur dioxide, smoke index, grit and dust measurement, coefficient of haze and Air pollution index. Smoking index is measured by multiplying the number of cigarettes smoked per day by the number of years the person has smoked. Park's Textbook of Preventive and Social Medicine, 25th Edition, Pg 796 | 3,269 | medmcqa_train |
Sex determination in early pregnancy Is done by: | Ultrasound | 3,270 | medmcqa_train |
What is the rate of release of levonorgestrel into the uterus from Mirena, a progestin releasing intrauterine device? | Mirena is a progestin releasing device, it releases levonorgestrel into the uterus at a rate of 20 microgm/d. It has a T-shaped radiopaque frame, with its stem wrapped with a cylinder reservoir, composed of a polydimethylsiloxane-levonorgestrel mixture. Cu T 380A is another progestin releasing device. It has a polyethylene and barium sulfate, T-shaped frame wound with copper. Ref: Cunningham F.G., Leveno K.J., Bloom S.L., Hauth J.C., Rouse D.J., Spong C.Y. (2010). Chapter 32. Contraception. | 3,271 | medmcqa_train |
Which of the following can be givenorally - | Ans. is 'd' i.e., Mesna o MESNA is given alongwith alkylating agents to prevent nephrotoxicity due to cyclophosphamide. o It can be administered intravenously or orally. Cytarabine Cytarabine (Ara C) is degraded by the enzyme cytidine deaminase. Cytidine deaminase is present in high concentrations in g.i. tract therefore only about 20% of the drug reaches the circulation after oral Ara-C administration. Thus the drug must be given intravenously. Dactinomvcin or Actinomvcin D o It is administered by intravenous route. Doxorubicin It is administered intravenously and are cleared by complex pattern of hepatic metabolism and biliary excretion. | 3,272 | medmcqa_train |
Which of these is true regarding CML - | Ans. is 'a' i.e., Size of splenomegaly indicates prognosis SOKAL INDEX is used for assessing the prognosis in CML. It includes 1. % of circulating blasts 3. platelet count 5. cytogenetic clonal evaluation 2. spleen size 4. age o The cytogenic hallmark of CML is presence of philadelphia chromosome (9:22). It is present in all the cell lines. Whether erythroid series, myeloid series or megakaryocytes. Also know o Other index used for assessing the prognosis of CML is HASFORD SYSTEM. It was developed based on IFN-alpha treated patients. It includes:- i) % of circulating blasts iii) Spleen size v) Age % of eosinophils & basophils iv) Platelet count | 3,273 | medmcqa_train |
Disulfiram like reaction is commonly caused by which of the following: March 2005 | Ans. B: Metronidazole Drugs causing Disulfiram like reaction Metronidazole Cefamandole Cefoperazone Chlorpropamide Sulfonylureas Quinacrine Griseofuvin Chloramphenicol Tinidazole Procarbazine Ritonavir Nitrofurantoin Chloramphenicol Chloral hydrate | 3,274 | medmcqa_train |
Best Prognostic factor for head injury ? | Glassgow Coma Scale (GCS) Maximum score - 15, minimum score - 3 Best predictor of outcome : Motor response Patients scoring 3 or 4 have an 85% chance of dying or remaining vegetative, while scores above 11 indicate only a 5-10% likelihood of death Table given as image Ref : Harrison's 19th edition Pgno :1777 | 3,275 | medmcqa_train |
Urea cycle components are all except | l-Ornithine transcarbamoylase (EC 2.1.3.3) catalyzes transfer of the carbamoyl group of carbamoyl phosphate to ornithine, forming citrulline and ohophosphate. Argininosuccinate synthase (EC 6.3.4.5) links aspaate and citrulline the amino group of aspaate (reaction 3, Figure 28-16) and provides the second nitrogen of urea Hydrolytic cleavage of the guanidino group of arginine, catalyzed by liver arginase (EC 3.5.3.1), releases urea. Urease is not involved in the urea cycleRef: Harpers Illustrated Biochemistry, 30th edition, page no: 294 | 3,276 | medmcqa_train |
A 36-year-old woman with pneumococcal pneumonia develops a right pleural effusion. The pleural fluid displays a high specific gravity and contains large numbers of polymorphonuclear (PMN) leukocytes. Which of the following best characterizes this pleural effusion? | -The pleural effusion encountered in this patient represents excess fluid in a body cavity. Transudate-Edema fluid with low protein content Exudate-Edema fluid with high protein content. Purulent exudate or effusion contains a prominent cellular component (PMNs). Serous exudate or effusion is characterized by the absence of a prominent cellular response and has a yellow, straw like color. Fibrinous exudate (choice A) does not contain leukocytes. Serosanguineous exudate (choice D) contains RBCs and has a red tinge. Diagnosis: Bacterial pneumonia, pleural effusion | 3,277 | medmcqa_train |
Which of the following type of cell is concerned with the production of surfactant? | Pulmonary surfactant composed of myelin and lecithin is mainly secreted continuously by Type II pneumocyte beginning from 20th week of gestation. Also Know: Surfactant has both lipid (90%) and protein (10%) component. About half of the lipids are dipalmitoylphosphatidylcholine and the remaining are phosphatidylglycerol, cholesterol and other lipids. Half of the proteins are apoproteins and other half is composed of proteins normally found in blood plasma. Function of surfactant: The surfactant greatly reduces the surface tension allowing easier expansion and collapse of alveoli during during respiration and the resulting changes in pressure. It also helps the alveoli to expand and shrink at the same rate thereby reducing the chance for isolated overexpansion and total collapse of alveolar sacs. Ref: The Big Picture: Medical Biochemistry by Lee W. Janson, chapter 17 | 3,278 | medmcqa_train |
Gene responsible for FAP is located at | Familial adenomatous polyp(FAP) is inherited as an autosomal dominant neoplastic condition (chromosome 5q21). It has a high potential for malignant transformation. It presents in younger age group- 15-20 yrs; equal in both sexes. It commonly involves the large intestine but can also occur in stomach, duodenum and small intestine. Reference : page 899 SRB's manual of surgery 5th edition | 3,279 | medmcqa_train |
The most impoant function of epithelioid cells in tuberculosis is - | Epithelioid cells. These are so called because of their epithelial cell-like appearance, are modified macrophages/ histiocytes which are somewhat elongated, having a vesicular and lightly-staining slipper-shaped nucleus, and pale staining abundant cytoplasm with hazy outlines so that the cell membrane of adjacent epithelioid cells is closely apposed.Epithelioid cells are weakly phagocytic. It is suggested that epithelioid cells could play an impoant role in fibrosis possibly by the secretion of a fibroblast activating factor. Ref:Harsh Mohan - Textbook of Pathology, 6th Edition.page no.148 &Immunobiology,elsevier,Volume 221, Issue 12, Pages 1329-1432. | 3,280 | medmcqa_train |
Developmental depressions on both mesial and distal sides of roots are seen in: | Deep concavities on distal surface are present in – Maxillary 1st premolar
Deep concavities on distal surface are present in – Maxillary 1st molar
Developmental depressions on both mesial and distal sides of roots are seen in – Mandibular central incisors, upper canines, mesial root of mandibular 1st molar. | 3,281 | medmcqa_train |
Biological Methods of Treatments in Psychiatry include all except | (D) Aversion therapy # Biological Methods of Treatments in Psychiatry include:> Older methods (no longer used in clinical practice): Malarial treatment for general paralysis of insane Insulin coma therapy Atropine coma therapy Continuous sleep treatment Sub-convulsive ECT Chemical convulsive therapy Sleep deprivation Mega vitamin therapy; Hallucinogens> Presently Used Biological Methods: Electroconvulsive therapy; Psychosurgery# Psychological Treatments (Psychosocial therapies): Psychoanalysis Psychoanalytical Psychotherapy -- Aversion therapy Transactional analysis Others: Hypnosis; Group therapy; Cognitive therapy; Behaviorism; Classical conditioning; Operant conditioning; Dual sex therapy; Psychodrama; Primal therapy; Rational emotive therapy; Primal therapy; will therapy; Gestalt therapy; Existenlial logotherapy; Reciprocal inhibition; Progressive muscular relaxation; Character analysis; Token economy. | 3,282 | medmcqa_train |
Cardiomyopathy is/are due to deficinency of: | Ans.: A (Selenium) ' Selenium deficiency causes Keshan disease(endemic cardiomyopathy)"Shinde 7th/594Possible causes of cardiomyopathy include; www.may- odinic.com/heaith/cardiomyopa thy/DS00519/DSECTION# Long-term high blood pressure# Defects in heart valve# Heart tissue damage from a previous heart attack# Chronic rapid heart rate# Metabolic disorders, such as thyroid disease or diabetes# Nutritional defdencies of essential vitamins or minerals, such as thiamin (vitamin B-l), selenium, calcium and magnesium# Pregnancy# Excessive use of alcohol over many years# Abuse of cocaine or antidepressant medications, such as tricyclic antidepressantsUse of some chemotherapy drugs to treat cancerSome viral infections, which may injure the heart and trigger cardiomyopathyIron buildup in your heart muscle (hemochromatosis)Genetic conditionsReversible cardiomyopathy due to carnitine deficiency from renal tubular wasting.Table (Harrison 18th/595): Deficiencies of MetalsElementDeficiencyBoronNo biologic function determinedCalciumReduced bone mass, osteoporosisCopperAnemia,, growth retardation, defective keratinization and pigmentation of hair, hypothermia, degenerative changes in aortic elastin, osteopenia, mental deteriorationChromiumimpaired glucose toleranceFluoride| Dental cariesIodineThyroid enlargement, |T4, cretinismIronMuscle abnormalities, koilonychia, pica, anemia, 4work performance, impaired cognitive development, premature labor, Tperinatal maternal mortalityManganeseImpaired growth and skeletal development, reproduction, lipid and carbohydrate metabolism; upper body rashMolybdenumSevere neurologic abnormalitiesSeleniumCardiomyopathy, heart failure, striated muscle degenerationPhosphorusRickets (osteomalacia), proximal muscle weakness, rhabdomyolvsis, paresthesia, ataxia, seizure, confusion, heart failure, hemolysis, acidosisZincGrowth retardation, !taste and smell, alopecia, dermatitis, diarrhea, immune dysfunction, failure to thrive, gonadal atrophy, congenital malformations | 3,283 | medmcqa_train |
The following is lure for Mycoplasmas except: | GENERAL CHARACTERISTICS OF MYCOPLASMAS: Very small(0.2-0.3 um) . Can pass through bacterial filters. Lack a rigid cell wall. Bound by a single trilaminar cell membrane that contains a sterol. Extremely pleomorphic varying in shape from coccoid to filamentous to other bizzare forms. Mycoplasma, Ureaplasma, Spiroplasma and Anaeroplasma cannot synthesize their own cholesterol and require it as a growth factor in culture medium. Acholeplasma synthesizes carotenol as a substitute for cholesterol, but will incorporate cholesterol if it is provided. Insensitive to cell-wall active antibiotics such as penicillins and cephalosporins. Limited biosynthetic capabilities due to a small genome. Multiply by binary fission. However, cytoplasmic division may lag behind genome division. This results in the formation of multinucleate filaments and other shapes. Do not possess flagellae or pili, but some mycoplasmas including M. pneumoniae, exhibit gliding motility on liquid-covered surfaces. This is attributed to specialized tip structures that also help the organisms in the attachment to the cell. Non sporing Stain poorly with Grams stain. Can be stained with Giemsa and Dienes methods. Are considered as stable L forms by some researchers but this hypothesis is still not fully accepted. Aerobes and facultative anaerobes except Anaeroplasma which is strictly anaerobic. For primary isolation, an atmosphere of 95% Nitrogen and 5% Carbon dioxide is preferred. They can grow within a temperature range of 22-41degC, the parasitic species growing optimally at 35-37degC. For fermentative organisms, the initial pH of the medium is adjusted to 7.3-7.8, for arginine metabolizing organisms it should be around 7 and for ureaplasmas, range of pH should be 6-6.5. PPLO broth/agar and SP4 media are used for isolation of mycoplasmas. Fried egg colony morphology is obtained on culture media. Ref : Textbook of Microbiology by Dr. D.R. Arora; 3rd edition & Mackie McCaney Practical Medical Microbiology; 14th edition | 3,284 | medmcqa_train |
The most common cause of Anovulation is: | WHO Classification for Anovulation Hypothalamic pituitary failure: Hypogonadotropic Hypogonadism Hypothalamic pituitary dysfunction/PCOS: Normogonadotropic Hypogonadism Ovarian failure: Hypergonadotropic Hypogonadism Hyperprolactinemia Anovulation and ovulatory dysfunction can be caused by a number of factors. The most common cause of ovulatory dysfunction is PCOS. Other potential causes of irregular or absent ovulation: Obesity Underweight Extreme exercise Hyperprolactinemia Premature ovarian failure Perimenopause, or low ovarian reserves Thyroid dysfunction Extremely high levels of stress | 3,285 | medmcqa_train |
Which of the following Artery supplies the thyroid gland? | Arterial Supply of thyroid gland:-
Mainly supplied by:
Superior thyroid arteries (this is branch of external carotid artery)
Inferior thyroid arteries (this is a branch of the thyrocervical trunk that arises from the subclavian artery) | 3,286 | medmcqa_train |
Which of the following inhibits rate limiting step of Norepinephrine synthesis | Metyrosine inhibits tyrosine hydroxylase enzyme, which mediates the rate limiting step of norepinephrine synthesis (i.e conversion of Tyrosine to Dopa). | 3,287 | medmcqa_train |
Dye is injected in one of the extremities in a child and is followed by pain and swelling of upper limb, paraesthesias of fingers, stretch pain and normal peripheral pulses, management is: | (d) Fasciotomy- As patient is clinically a case of compartment syndrome -pain on passive stretch and he has paraesthesias so fasciotomy is indicated.- Remember Pulses can be normal in compartment syndrome. | 3,288 | medmcqa_train |
Number of holes per square inch of a standard mosquito net is? | ANSWER: (B) 150REF: Park 20th edition page 678"The size of the opening of mosquito net is of utmost importance- the size should not exceed 0.0475 inch in any diameter. The number of holes in one square inch is usually 150" | 3,289 | medmcqa_train |
Bronchial secretion secretes - | In its secretory form, IgA is the main immunoglobulin found in mucous secretions, including tears, saliva, sweat, colostrum, and secretions from the genitourinary tract, gastrointestinal tract, prostate, and respiratory epithelium. It is also found in small amounts in the blood Ref: Ananthanarayan & Parker's textbook of microbiology 9th edition pg:97 | 3,290 | medmcqa_train |
Primary' Health Care includes all, except - | Ans. is 'a' i.e., Proper housing Primary heath careo "Primary health care is essential health care made universally accessible to individuals and acceptable to them, through their full participation and at a cost the community and country: can afford."o There are 4 main principles of primary health care :Equitable distributionCommunity participationIntersectorial coordinationAppropriate technologyo Primary health care involves: health care of mother and child, immunization, prevention and control of locally endemic diseases, as well as appropriate treatment of common diseases and injuries. However, it is not essential to deliver these elements throught the agencies of doctors under the primary health care. Root level workers, such as village health guides, are appropriately trained to deliver these elements, at the village level. | 3,291 | medmcqa_train |
All of the following are attached to the greater trochanter of femur, EXCEPT? | The greater trochanter provides attachment for the smaller gluteal muscles. Gluteus minimus is attached to its rough anterior impression and gluteus medius to its lateral oblique strip. The bone is separated from the tendon of gluteus medius by a bursa. The area behind is covered by deep fibres of gluteus maximus, with pa of its trochanteric bursa interposed. The tendon of piriformis is attached to the upper border of the trochanter and the common tendon of obturatorinternus and the gemelli are attached to its medial surface. The trochanteric fossa receives the tendon of obturatorexternus. | 3,292 | medmcqa_train |
16-year-old girl with sho height, amenorrhea with widely spaced nipple. Karyotyping is; | Given features suggests the diagnosis of Turner's syndrome. Turner's syndrome Most common sex chromosomal disorder in phenotypic females. Results from complete or paial loss of one X chromosome (45, XO) Features: Sho stature Coarctation of aoa Cubitus valgus Streak ovaries, infeility, amenorrhea Peripheral lymphedema at bih Low posterior hairline Webbing of neck Broad chest and widely spaced nipples | 3,293 | medmcqa_train |
A person presented with swelling of the right 3rd toe. X ray shows deposition of multiple crystals. A defect in which of the following pathway caused the problem. | The probable diagnosis is gout . Gout is the most common inflammatory ahritis in men and in older women. It is caused by deposition of monosodium urate monohydrate crystals in and around synol joints due to abnormal purine metabolism . Ref Davidsons 23e p1013 | 3,294 | medmcqa_train |
Following are the major symptoms of obsessive compulsive disorders - | Ans. is 'd' i.e., All the above o OCD has four major symptom patterns1) Contamination:- Contamination is the most common pattern of an obsession followed by washing (washer). Patients may literally rub the skin of their hands by excessive hand washing. The most common emotional response is anxiety.2) Pathological doubts:- Doubts is the second most common pattern of an obsession, followed by a compulsive checking (checkers). The obsession often implies some danger of violence (e.g., forgetting to turn off the stove or not locking a door). The compulsion (checking) may involve multiple trips back into the house to check the stove or door.3) Intrusive thoughts (Pure obsessions):- In this third most common pattern, there are intrusive obsessional thoughts without a compulsion. Such obsessions are usually repetitious thoughts of a sexual or aggressive act that is reprehensible to the patient.4) Symmetry:- This is the fourth most common pattern in which there is obsession for symmetry or precision, which can lead to compulsion of slowness. Patients can literally take hours to shave their faces or to eat a meal. | 3,295 | medmcqa_train |
True about vertebral artery -a) Enter skull through condylar canal.b) Branch of internal carotid arteryc) Branch of subclavian arteryd) Accompany sympathetic ganglione) Passes through foramen transversarium of cervical vertebrae | Vertebral artery enters skull (posterior cranial fossa) through foramen magnum.
Vertebral artery is a branch of subclavian artery.
It is accompanied by sympathetic peri-arterial plexus, inferior cervical (stellate) sympathetic ganglion and ventral rami of 7th and 8th cervical spinal nerves.
Vertebral artery passes through foramina transversaria of upper six cervical vertebrae. | 3,296 | medmcqa_train |
Bristol cha is used fore | Answer- A. Stool consistencyThe Bristol stool scale(Bristol stool cha (BsC)) is a diagnostic medical tool designed to classifr the form of human feces into seven categories.The seven types ofstcol areType 1 Separate hard lumps, like nuts (hard to pass); also known as goat faecesType 2: Sausage-shaped but lumpyType 3: Like a sausage but with cracks on its surfaceType 4: Like a sausage or snake, smooth and softType 5: Soft blobs with clear cut edges (passed easily)Type 6: Fluft pieces with ragged edges, a mushy stoolType 7: Watery, no solid pieces, entirely liquid | 3,297 | medmcqa_train |
2 yrs child weighing 6.7 Kg presents in the casualty with history of vomiting and diarrohea for last 2 days. On examination skin pinch over the anterior abdominal wall go quickly to its original position. Interpretation of skin-pinch test in this child will be: | Skin pinch is less useful in infants or children with marasmus (wasting) or kwashiorkor (severe malnutrition with edema), or obese children. Ref: Kliegman, Behrman, Jenson, Stanton, (2007), Chapter 85, "Fluid and Electrolyte Treatment of Specific Disorders", In the book, "Nelson's Textbook of Pediatrics", Volume 1, 18th Edition, New Delhi, Page 317 | 3,298 | medmcqa_train |
Middle superior alveolar nerve is a branch of which of the following nerve? | Middle superior alveolar nerve arise from infra orbital branch of maxillary nerve in the infra orbital groove and canal.Course of superior alveolar nerve:It is given off from the maxillary nerve just before its exit from the infra orbital foramen. It descends in a canal in the anterior wall of the maxillary sinus, and divides into branches which supply the incisor and canine teeth. It communicates with the middle superior alveolar branch, and gives off a nasal branch and supplies the mucous membrane of the anterior pa of the inferior meatus and the floor of the nasal cavity. Ref: Essentials of Anatomy By I. B. Singh, 2nd Edition, Page 391 | 3,299 | medmcqa_train |
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