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All of the following are pre-malignant except: | Ans. c. Peutz-Jegher's syndrome | 3,500 | medmcqa_train |
Condition not associated with bronchiectasis is? | Ans. is 'b' i.e., Lung Cancer * Important complications of bronchiectasis are massive hemoptysis, purulent pericarditis, lung abscess, empyema, amyloidosis, metastatic abscess (in brain, bones etc) , and cor pulmonale. It is not a premalignant condition. | 3,501 | medmcqa_train |
Lateral medullary syndrome or Wallenberg syndrome involves all, EXCEPT: | Ipsilateral cranial nerve involvement (spinal tract of Vth cranial nerve and IX, X, XI cranial nerve) is seen in Wallenberg syndrome. Clinical manifestations of involvement of these cranial nerves are, loss of taste from the posterior third of the tongue (nuclei or fibers of CN IX and X) and reduced corneal reflex, from damage to the descending spinal tract and nucleus of CN V. Ref: Clinical Medicine Made Easy By TV. Devarajan, 2008, Page 213 ; Harrison's Internal Medicine 17th ed Chapter 364 ; Cerebrovascular Diseases, Brainstemdisorders by Peter P Urban, Louis R Caplan page 205-207. | 3,502 | medmcqa_train |
Maximum equilibrium potential is for - | Ans. is 'b' i.e., K+ | 3,503 | medmcqa_train |
A 40 year old male had multiple blisters over the trunk & Extremities. Direct immuno fluoresce studies showed linear IgG deposits along the basement membrane, which of the following is the most likely diagnosis – | IgG deposits along basement membrane occurs only in bullous pemphigoid, amongst the given options. | 3,504 | medmcqa_train |
Allergic rhinitis is which type of hypersensitivity- | Ans. is 'a' i.e., Type -1 Pathogenesis of allergic rhinitiso Allergic rhinitis is a type I hypersensitivityIt occurs in two phases:-1) Initial response/Acute or early phase# After first antigen exposure, this antigen is presented to CD-4 helper T cells (TH, type) by antigen presenting cells. These primed TH, cells release IL-4 that acts on B-cells to form Ig E specific for that particular antigen. The antigen specific Ig E antibodies then bind to the surface receptors of mast cells and basophils. The process from first antigen exposure to the coating of mast cells by Ig E acts as sensitization (prior sensitization) and first exposure is also called priming or sensitizing exposure (dose). Subsequent exposure (shocking dose) to same antigen then results in activation of mast cells and basophils with release of inflammatory mediators : -i) Histamine (most important)ii) Hepariniii) Leukotriens (B4, C4> D4)iv) PGD2v) PAFvi) Cytokines (IL-1, 3, 4, 5, 6; INF)vii) Eosinophil chemolactic factor (ECF)viii) Neutrophil chemolactic factor (NCF)The release of these mediators result in : -Increased vascular permeability and vasodilatation which result in tissue edema - Nasal blockage and sneezing.Smooth muscle spasm - BronchoconstrictionHyperactivity of glands - RhinorrheaRecruitment of inflammatory cells.2) Late phase responseRecruited inflammatory cells of initial phase amplify and sustain the inflammatory response without additional exposure to the triggered antigen. PAF is the most important mediator in initiation of late phase response. Eosinophils are particularly important cells among the recruited cells which also include neutrophils, basophils, monocytes and T-cells. It causes symptoms like nasal congestion and post nasal drip. | 3,505 | medmcqa_train |
Myasthenia gravis is associated with | Some 60%of Myasthenia gravis are associated with a peculiar reactive hyperplasia of intrathymic B cells and another 20%are associated with thymoma, a tumor of thymic epithelial cells. Robbins basic pathology 9th edition page no 800,heading =Myasthenia gravis Option 4 is correct | 3,506 | medmcqa_train |
Red degeneration most commonly occurs in | Ans. is 'b' i.e. 2nd Trimester Red degeneration of the myomasRed degeneration of uterine myomas develops most frequently during pregnancy. It typically occurs during 2nd trimester (20-22) weeks of pregnancy.During red degeneration, the myomas become tense, tender and causes severe abdominal pain with constitutional upset and fever.Although the patient is febrile with moderate Leucocytosis and raised E.S.R., the condition is an aseptic one.It needs to be differentiated from appendicitis, twisted ovarian cyst, pyelitis and accidental hemorrhage.During the red degeneration, the tumour itself assumes a peculiar purple red colour and develops a fishy odour. If the tumour is carefully examined, some of the large veins in the capsule and the small vessels in the substance of the tumour will be found thrombosed. The discoloration is possibly caused by diffusion of blood pigments from thrombosed vessels.Conservative treatment with analgesia, reassurance and supportive therapy is almost always adequate.Also knowAnother complication of myoma which is seen during pregnancy is torsion of the myoma.Torsion of the myoma is also characterized by acute abdominal pain with point tenderness over the site of leiomyoma.Conservative t/t is adequate. | 3,507 | medmcqa_train |
Which one of the following is a conjugated vaccine- | Ans. is 'c' i.e., Hemophillus influenzae HIB PRP vaccine (conjugate vaccine) is available for H. influenzae type b. o Currently no vaccine is available for non typable strains. | 3,508 | medmcqa_train |
Echoencephalography is most useful in detecting: | Ans. Ventricular dilatation | 3,509 | medmcqa_train |
Vidian neurectomy is done in? | Ans. (b) Vasomotor rhinitisRef: Dhingra's 4th ed p-160 | 3,510 | medmcqa_train |
Vasanti 45 years, was brought to casualty with abnormal movements which induced persistent detion of neck to right side. One day before she was prescribed Haloperidol 5mg three times daily from the psychiatry OPD. She also had an alternation with her husband recently. Which of the following is the most likely cause for her symptoms. | C i.e. Acute drug dystonia | 3,511 | medmcqa_train |
Which of the following statistics should be adjusted for age to allow comparisons - | Crude Mortality Rate (Crude Death Rate) is not a correct parameter to compare death rates of two populations since each population is likely to have different age compositions. Age adjustment or Age standardization is required to compare crude death rates from two different populations.
Infant Mortality Rate; Perinatal Mortality rate; and Age Specific Fertility Rate all compare populations within a narrow/similar age range and hence these statistics do not require to be adjusted for age. | 3,512 | medmcqa_train |
In postmenopausal women, estrogen is metabolized mostly into | . | 3,513 | medmcqa_train |
Pain-sensitive intracranial structure is | Intracranial structures sensitive to pain are scalp, anponeurotica, duramater around venous sinuses & vessels, falx & tentorium cerebri, cranial venous sinuses, some arteries. Intracranial structures insensitive to pain are brain parenchyma, ventricular ependyma, duramater over convexity of skull, piameter, pial veins, arachnoidmater and choroids plexus. | 3,514 | medmcqa_train |
Auer rods are seen in: | Some of the commonly employed cytochemical stains, as an aid to classify the type of acute leukemia, are-
Myeloperoxidase: positive in immature myeloid cells containing granules and Auer rods but negative in M0 myeloblasts.
Sudan black: Positive in immature cells in AML.
Periodic acid Schiff (PAS): Positive in immature lymphoid cells and in erythroleukemia (M6).
Non-specific esterase (NSE): Positive in monocytic series (M4 and M5).
Acid phosphatase: Focal positivity in leukemic blasts in ALL and diffuse reaction in monocytic cells (M4 and M5). | 3,515 | medmcqa_train |
A 5-day-old male infant is diagnosed with Hirschsprung disease. CT scan examination reveals an abnormally dilated colon. Which of the following is the most likely embryologic mechanism responsible for Hirschsprung disease? | Congenital megacolon (Hirschsprung disease) results from the failure of neural crest cells to migrate into the walls of the colon. Incomplete separation of the cloaca would result in anal agenesis either with or without the presence of a fistula. The failure of recanalization of the colon results in rectal atresia, wherein both the anal canal and rectum exist but are not connected due to incomplete canalization or no recanalization. Defective rotation of the hindgut can cause volvulus or twisting of its contents. Oligohydramnios is a deficiency of amniotic fluid, which can cause pulmonary hypoplasia but would not cause Hirschsprung disease. | 3,516 | medmcqa_train |
Winging of the scapula is seen in injury to which nerve? | Ans. is 'a' i.e., Long thoracic nerve of Bell * Winging of scapula is caused most commonly by serratus anterior palsy. This is typically caused by damage to long thoracic nerve (nerve to serratus anterior). | 3,517 | medmcqa_train |
A 16-year-old boy suffering from drug abuse presents with cross-over of sensory perceptions, such that, sounds can be seen and colors can be heard. Which of the following is the most likely agents responsible for drug abuse: | B i.e. (LSD) - Lysergic acid diethylamide (LSD) has potent psychedelic & hallucinogenic effects and produce a variety of bizarre and offer conflicting perceptual and mood changes, including visual illusions, synesthesias (reflex hllucination = sensory modalities cross over) extreme lability of moodQ. and sometimes bad trip (panic episode). It also produces tachycardia, hypeension, pupillary dilation, tremor, and hyperpyrexia. Phencyclidine (PCP) or angel dust, a NMDA receptor blocker, is widely used in veterinary medicine to briefly immobilize large animals (dissociative anesthesia). It produces agitation, excitement, impaired motor coordination, dysahria and analgesia at low doses; whereas signs of intoxication include horizontal or veical nystagmus, flushing, diaphoresis, and hyperacusis; higher doses (5-10 mg) produce profuse salivation , vomiting, myoclonus, fever, stupur, coma, convulsions, opisthotonus and decerebrate posturing. Behavioral changes include distoion of body image, disorganization of thinking, and feeling of estrangementQ - Flunitrazepam (Rohypnol), a benzodiazepine used for insomnia has strong hypotic, anxiolytic and amnesia producing effects. It is also k/a date - rape drug or roofies and overdose can be treated with flumazenil. GHB (Gamma hydroxy butyric acid = Xyrem) is FDA approved treatment for narcopepsy with abuse potential producing euphoria & disinhibition. GABAB antagonists can reverse its sedating effects and opioid antagonists (naloxone, naltrexone) can attenuate GHB effects on dopamine release. | 3,518 | medmcqa_train |
Monoclonal antibody used in Head and neck cancer is:- | Drug Mechanism of action Uses Pembrolizumab Monoclonal antibody against PD 1 * Multiple myeloma * Non small cell lung cancer * Head and neck cancer * Any cancer containing mismatch repair Trastuzumab Monoclonal antibody against her-2/neu Breast cancer, gastroesophageal junction cancer Rituximab Monoclonal antibody against CD20 Non hodgkin's lymphoma(NHL), chronic lymphocytic leukemia(CLL) Ocrelizumab Monoclonal antibody against CD20 Primary progressive multiple sclerosis(PPMS) | 3,519 | medmcqa_train |
Numerator in negative predictive value - | Ans. is 'c' i.e., True negative o The results of a screening test can be arranged in following table : -Screening test resultsDiagnosisTotalDiseasedNot diseasedPositiveNegativeTrue positive (a)False negative (c)False positive (b)True negative (d)a + bc + dTotala + cb + d From this table following measure can be obtained : -i) Sensitivityo It is the percentage of diseased people that wrho are diagnosed as having disease,o Total number of diseased people = True positive + False negative.o Number of people (among diseased people) diagnosed as having disease = True positives,o So, percentage of truely diagnosed people : -Number of true positiveSensitivity = ---------------------------------------------------------------------------------Number of true positives - Number of false negative.Specificityo It is the percentage of healthy people who are identified as healthy.o Total number of healthy people = True negatives + False positiveso Number of healthy people who are identified as healthy = True negatives,o So, percentage of true healthy people : -Number of true negativesSpecificity = ------------------------------------------------------------------------------------Number of true negative + number of false positives.Predictive valve of a positive test (positive predictive value of secreening test)o It is the percentage of truely diseased people among those who show positive test results,o Total number of people showing positive test results = True positive + False positiveo Numbers of truely diseased people showing positive test = true positive,o So, the percentage of truely diseased people : -True positivePositive predictive value = ------------------------------------------------------------------------True positive + False positiveiv) Predictive value of a negative of test (negative predictive value)o It is the percentage of healthy people among those who show negative test results,o Total number of people showing negative test results = True negative + False negativeo Number of healthy people showing negative test = True negativeo So, percentage of healthy people showing negative results.True negativeNegative predictive value = ---------------------------------------------------------------------------True negative +- False negative | 3,520 | medmcqa_train |
Increased BP & decreased heart rate is seen in | Raised intracranial pressure initiates Cushing’s reflex. Cushing’s reflex leads to a rise in arterial pressure, which restores the blood supply to the brain. At the same time, the raised BP causes reflex Bradycardia through the baroreceptors. | 3,521 | medmcqa_train |
Ether is still used as a general anaesthetic in lndia, specially in peripheral hospitals because: | (Ref: KDT 6/e p371) Ether is the only complete anaesthetic agent. It is highly inflammable and explosive. It has good analgesic and muscle relaxant action. It can be delivered by open method. It is a pungent smelling liquid. Induction of anaesthesia with ether is quite slow. All the four stages can be seen. | 3,522 | medmcqa_train |
A patient presents 12 hours following a Myocardial infarction. Which of the following enzymes will be elevated at this period - | Ref: R Alagappan - Manual of Practical Medicine 4th Edition.pg no:184 Cardiac Enzymes a. CPK-MB: This cardiac isoenzyme stas rising within 4-6 hrs after development of acute MI, peaks during the 2nd day (4 fold rise) and disappears in 2-3 days. Other causes of total CK elevation: 1. Skeletal diseases - Polymyositis, Muscle dystrophy, Myopathies 2. Electrical cardioversion 3. Skeletal muscle damage - trauma, convulsions, immobilisation 4. Hypothyroidism 5. Stroke 6. Surgery b. AST: Stas rising on the 1st day, peaks in 2-3 days (3 fold rise) and disappears by 3rd day. c. LDH1: Stas rising by second day, peaks around 3- 4 days ( 3 fold rise) and disappears in 10 days. d. Troponin T: Cardiac troponin T is a regulatory contractile protein not normally found in blood. Its detection in the circulation has been shown to be a sensitive and specific marker for myocardial cell damage. Troponin T and I reach a reliable diagnostic level in plasma by 12-16 hrs, maximal activity by 24-32 hrs, returns to normal in 10-12 days. Troponin I : 0-0.4 ng/ml Troponin T: 0-0.1 ng/ml Cardiac troponins are detected in the serum by using monoclonal antibodies. These antibodies have negligible cross reactivity to skeletal muscle. Cardiac troponins I and T sta to rise within 3-4 hours after myocardial infarction and remain raised for 4-10 daysOther causes of elevated cardiac troponins: Cardiac causes: * Cardiac contusion/surgery * Myocarditis * Cardiomyopathy * Hea failure * Cardioversion * Percutaneous coronary intervention * Cardiac amyloidosis * Radiofrequency ablation * Supraventricular tachycardia * Post-cardiac transplantation Non-cardiac causes: * Primary pulmonary hypeension * Pulmonary embolism * Cerebrovascular stroke * High dose chemotherapy * Sepsis and septic shock * Renal failure * Critically ill patients * Scorpion envenomation * Ultra-endurance exercise (marathon) e. Myoglobin It is increased within 2 hrs of onset of symptoms and remains increased for at least 7-12 hrs. Normal level is 20-100 mg/L. | 3,523 | medmcqa_train |
IPC 314 deals with ? | Ans. is 'b' i.e., Death of patient caused by miscarriage Offences related to aboion and child bih 312 , 313, 314 and 315 IPC : For causing voluntary miscarriage (criminal aboion). 312 IPC : Causing miscarriage with consent (3 years of imprisonment +- fine). 313 IPC : Causing miscarriage without consent of lady (10 years of imprisonment which can extend up to life +- fine). 314 IPC : Death of patient caused by miscarriage (10 years of imprisonment + fine). 315 IPC : Death of child during miscarriage (10 years imprisonment + fine). 316 IPC : Death of quick unborn child by act amouting to culpable homicide (10 years imprisonment + fine). 317 IPC : Abandoning a child (7 years imprisonment +- fine). 318 IPC : Concealment of bih by secret disposal of dead body (2 years imprisonment + fine). | 3,524 | medmcqa_train |
Which of the following is not true about hypoxanthineguanine phosphoribosyl transferase? | "SALVAGE REACTIONS" CONVE PURINES & THEIR NUCLEOSIDES TO MONONUCLEOTIDES Conversion of purines, their ribonucleosides, and their deoxyribonuc]eosides to mononucleotides involves so- called "salvage reactions" that require far less energy than de novo synthesis. The more impoant mechanism involves phosphoribosylation by PRPP of a free punine (Pu) to form a purine 5'-mononucleotide (Pu-RP). Three processes contribute to purine nucleotide biosynthesis. These are, in order of decreasing impoance: (1) Synthesis from amphibolic intermediates (synthesis de novo), (2) Phosphoribosyltion of purines, and (3) Phosphorylation of purine nucleosides. Lesch-Nyhan Syndrome * X-linked recessive. * Overproduction hyperuricemia. * Purine salvage problem owing to absence of HGP, which conves hypoxanthine to IMP and guanine to GMP. * C/f: o Mental retardation, o Self-mutilation, aggression, o Hyperuricemia, gout, and o Choreoathetosis. * Reflects a defect in hypoxanthine-guanine phosphoribosyl transferase (HGPase), an enzyme of purine salvage. * The accompanying rise in intracellular PRPP results in purine overproduction. * Mutations that decrease or abolish hypoxanthine-guanine phosphoribosyl transferase activity include deletions, frame-shift mutations, base substitutions, and aberrant mRNA splicing. | 3,525 | medmcqa_train |
Mercury affects which pa of the kidney ? | Ans. is 'a' i.e., PCT | 3,526 | medmcqa_train |
Primary amenorrhoea is a feature of all EXCEPT: September 2012 | Ans. B i.e. Stein Leventhal syndrome | 3,527 | medmcqa_train |
A 45 year old female presents with symptoms of acute cholecystisis . On USG there is a solitary gall stone of size 1.5 cm. Symptoms are controlled with medical management. Which of the following is the next most apppropriate step in the management of this patient. | Laparoscopic cholecystectomy is the gold standard treatment for gallstones,especially with symptoms or complications like acute cholecystitis.Some surgeons advocate urgent operation on a routine measure in cases of acute cholecystitis..Good results are obtained when the operation is undeaken within 5-7 days of the onset of the attack.If an early operation is not indicated,one should wait for approximately 6 weeks for the inflammation to subside before proceeding to operation. Reference:Bailey & Love's sho practise of surgery,25th edition,page no:1121,1122. | 3,528 | medmcqa_train |
Prognosis of breast carcinoma is best determined by ? | .Treatment of breast cancer depends on clinical stage of disease and stagings involves assessing the most common lymph node draining the breast:ie axillary lymph node. according to TNM staging, the nodes are scored on 1 to 3 score 1 :no nodal involvement score 2: one to three nodes involved score 3:four or more nodes involved Reference: BAILEY & LOVE&;S 24th edition , (P,no:839 ) | 3,529 | medmcqa_train |
A 57-year-old man presents with hemoptysis and generalized weakness. His symptoms began with small-volume hemoptysis 4 weeks ago. Over the past 2 weeks, he has become weak and feels "out of it." His appetite has diminished, and he has lost 10 lb of weight. He has a 45-pack-year history of cigarette smoking. Physical examination is unremarkable. Laboratory studies reveal a mild anemia and a serum sodium value of 118 mEq/L. Chest x-ray shows a 5-cm left, mid-lung field mass with widening of the mediastinum suggesting mediastinal lymphadenopathy. MR scan of the brain is unremarkable. What is the most likely cause of his symptoms? | Hyponatremia in association with a lung mass usually indicates small cell lung cancer (SCLC) with inappropriate antidiuretic hormone (ADH) production by the tumor. About 10% of lung cancers present with a paraneoplastic syndrome. Tumors producing ADH or adrenocorticotropic hormone (ACTH) are overwhelmingly SCLCs, which arise from hormonally active neuroendocrine cells. SCLC is a rapidly growing neoplasm; early mediastinal involvement, as in this case, is common. Tumor staging for SCLC differs from non-small cell cancers. SCLCs are simply classified as limited (confined to one hemithorax) or extensive. Limited tumors are usually managed with combination radiation and chemotherapy, with approximately 20% cure rate. Extensive tumors are treated with palliative chemotherapy alone; durable remissions are rare. Surgery is not curative in SCLC.Bronchial carcinoids are usually benign. Although they can produce ACTH, mediastinal involvement and hyponatremia would not be expected. Adenocarcinoma of the lung, although common, rarely causes a paraneoplastic syndrome. Localized benign lung infections (especially lung abscess) can cause syndrome of inappropriate antidiuretic hormone (SIADH) but would not account for this patient's mediastinal adenopathy. Lung abscess usually causes fever and fetid sputum. Pulmonary aspergilloma (a fungus ball growing in an old cavitary lesion) can cause hemoptysis but not this patient's hyponatremia or mediastinal lymphadenopathy. | 3,530 | medmcqa_train |
Private Doctor refusing to treating a case of sexual offence and referring to govt hospital is | Treatment of rape victim and information to police: All hospitals, public or private, should immediately provide first-aid or medical treatment, free of cost, to the survivor/victim of rape or acid attack, and should immediately inform the police . Denial of treatment of such victims is punishable under Sec. 166-B IPC with imprisonment upto 1 year and with/without fine. | 3,531 | medmcqa_train |
Which of the following is true about female health worker? | ANSWER: (B) Covers a population of 5000 populationREF: Park 18th ed p. 809-810Under the multipurpose health worker scheme one health worker male and one health worker female are posted at each sub-centre, and are expected to cover a population of 5000.Female health worker makes at least 2 post natal visits.Chlorinating the wells is function of the male health worker. | 3,532 | medmcqa_train |
One unit of fresh blood raises Hb% ( Hemoglobin concentration ) by | Single unit of whole blood raises Hb by 1 gm% and Hematocrit by 3% More than 70% of transfused cells will be ble after 24 hours Ref: Harrison's 19th edition Pgno :138 | 3,533 | medmcqa_train |
Coagulative necrosis is seen in: | Coagulative necrosis is a form of necrosis in which the underlying tissue architecture is preserved for at least several days after the death of cells in the tissue. The affected tissues take on a firm texture. Presumably, the injury denatures not only structural proteins but also enzymes, thereby blocking the proteolysis of the dead cells; as a result, eosinophilic, anucleate cells may persist for days or weeks. Leukocytes are recruited to the site of necrosis, and the dead cells are ultimately digested by the action of lysosomal enzymes of the leukocytes. The cellular debris is then removed by phagocytosis, mediated primarily by infiltrating neutrophils and macrophages. Coagulative necrosis is characteristic of infarcts (areas of necrosis caused by ischemia) in all solid organs except the brain.
Robins 10 th ed P:36 | 3,534 | medmcqa_train |
Incubation period of scabies is: | Scabies - Causative agent: Sarcoptes Scabies Var Hominis Incubation Period: 3-4 weeks after the infection is acquired. If pt. reinfested- ICP is 2 days | 3,535 | medmcqa_train |
Which of the following phospholipid serves as a marker of apoptosis | Phosphatidyl serine is normally present on inner mitochondrial membrane, flipping of it to the outer mitochondrial membrane is seen in apoptosis. | 3,536 | medmcqa_train |
The triple P procedure for placenta percreta involves all except: | Ans. is c, i.e. Peripartum hysterectomyRef Fernando Arias 4/e, p 396Triple P procedure has been developed for placenta percreta as a conservative surgical alternative to peripartum hysterectomy. It consists of following 3 steps:1. Perioperative placental localization and delivery of fetus via transverse uterine incision above the upper border of placenta.2. Pelvic devascularization3. Placental nonseparation is dealt with myometrial excision and reconstruction of uterine wall. | 3,537 | medmcqa_train |
Routine second look endoscopy in the setting of non variceal upper GI bleeding is recommended in patients with: | Routine second look endoscopy in the setting of non variceal upper GI bleeding is recommended in patients with Patients who had an incomplete initial endoscopic examination Patients with clinically significant rebleeding Patients who are treated with epinephrine injection alone Ref: Sleisenger and Fordtran's, E-9, P-297. | 3,538 | medmcqa_train |
Most common paranasal sinus involved by Fibrous dysplasia is? | ANSWER: (A) Maxillary sinusREF: Ballenger's Otorhinolaryngology: Head and Neck Surge by James Byron Snow, PhillipA. Wackym, John Jacob Ballenge centennial ed p. 506Indirect repeat ENT 2012 Session 1 (see details of Fibrous dysplasia)See APPENDIX-49 "PARANASAL SINUSES" APPENDIX - 49Paranasal Sinuses:Paranasalsinus(PNS)Status at birth1stRadiologicalEvidenceBestradiologicalviewAdult sizeDrains intoCommentsMaxillaryPresent4-5 monthsWaters'view/Ocdpitomental/nose-chinposition15 yearsMiddle meatusLargest PNS, capacity of 15 ml in an adult, Antrum of HighmoreEthmoidPresent1 yearCaldwellviewSizeincreases until teensAnterior & middle Etbmoid= middle meatus, Posterior Ethmoid= Superior meatusNumber varies from 3 to 18FrontalAbsent6 yearsCaldwellview7 years,Middle meatus6-7 ml capacitySphenoidAbsent4 yearsWater's view with open mouthBetween 15 years to adult ageSphenoethmoidalrecess2.2 cm x 2 cm x 2.2 cm.Also know:Streptococcus pneumoniae is the most common organism implicated to acute sinusitis in both adults and childrenIn children with cystic fibrosis, most common organism implicated to sinusitis is staphylococcus aureus.Chronic sinusitis is most commonly associated with s. aureus and <2 hemolytic streptococciAspergillus mucormycosis is the most common organism implicated to fungal sinusitis with maxillary sinus most frequently involvedWagner's granulomatosis is the most common granulomatous sinusitis with maxillary sinus most commonly involved.Acute sinusitis almost always involves single sinus, with ethmoid sinus being most common in children and maxillary in adults.Maxillary sinus is the most common location of chromic sinusitis in both children and adults closely followed by ethmoid sinus.(Note: To he more particular "Anterior ethmoid cells'' are most common site of chronic sinusitis in children but comparing sinuses as a whole maxillary becomes more common than ethmoid)Mucous retention cyst (different from mucocele) is most commonly found at maxillary sinus.Most common site of mucocele is frontal sinus (60%), least common at sphenoid sinus.Squamous cell carcinoma is the most common malignant tumor of sinuses with maxillary sinus most commonly involved (80%)Most common site of adenocarcinoma of sinus is ethmoid sinus.Brain abscess is the most common intracranial complication of sinusitis (as a whole)Meningitis is the most common intracranial complication of acute sinusitis.Orbital complication is the most common extracranial an overall complication of sinusitis | 3,539 | medmcqa_train |
A child is spinned around by holding his hand by his father. While doing this the child started crying and does not allow his father to touch his elbow. The diagnosis is - | This is case of pulled elbow and a dramatic cure is achieved by forcefully supinating and then flexing the elbow. | 3,540 | medmcqa_train |
A 40 yr old male has a rash over groin with demarcated peripheral scaling and central clearing. It could be due to: September 2005 | Ans. C: Trichophyton Tinea cruris, a pruritic superficial fungal infection of the groin and adjacent skin, is the second most common clinical presentation for dermatophytosis The most common etiologic agents for tinea cruris include Trichophyton rubrum and Epidermophyton floccosum; less commonly Trichophyton mentagrophytes and Trichophyton verrucosum are involved. Tinea cruris is a contagious infection transmitted by fomites, such as contaminated towels or hotel bedroom sheets, or by autoinoculation from a reservoir on the hands or feet (tinea manuum, tinea pedis, tinea unguium). The etiologic agents in tinea cruris produce keratinases, which allow invasion of the cornified cell layer of the epidermis. Findings includes: Large patches of erythema with central clearing are centered on the inguinal creases and extend distally down the medial aspects of the thighs and proximally to the lower abdomen and pubic area. Scale is demarcated sharply at the periphery. In acute tinea cruris infections, the rash may be moist and exudative. Chronic infections typically are dry with a papular annular or arciform border and barely perceptible scale at the margin. Central areas typically are hyperpigmented and contain a scattering of erythematous papules and a little scale. Malassezia furfur is implicated in pityriasis versicolor and malassezia folliculitis. | 3,541 | medmcqa_train |
Drug used for penile erection - | Ans. is'd'i.e., All of the above[Ref KDT fl/e p. 303-304 6 &/e p. 296; Katzung LLth/e p. 197)Drugs used in erectile dysfunctionPhosphodiesterase-S inhibitors (Sildenafil, Todafil, Vardenafil)Alprostadil (Prostaglandin El) | 3,542 | medmcqa_train |
pH of vagina in pregnancy is - | Ans-A i.e., 4.5 Physiological chanses in vaeina durine pres nancy:o The vaginal walls become hypertrophied, edematous and more vascular.o Increased blood supply to venous plexus surrounding the was Us gives bluish colouration of the mucosa jacquemier's sign).o The length of the anterior vaginal wall is increased.o The secretion of vagina becomes copious, thin and curdy white, due to marked exfoliated cells and bacteria,o The pH becomes acidic (3.5 - 6) due to more conversion of glycogen into lactic acid by lactobacillus acidophilus consequent on high estrogen level The acidic pH prevents multiplication of pathogenic organisms,o There is predominance of navicular cells in cluster and plenty' of lactobacilli. Navicular cells are small intermediate cells with elongated nuclei. | 3,543 | medmcqa_train |
Drug of choice of trachoma is- | 1. Topical therapy regimes. It is best for individual cases. It consists of 1 percent tetracycline or 1 percent erythromycin eye ointment 4 times a day for 6 weeks or 20 percent sulfacetamide eye drops three times a day along with 1 percent tetracycline eye ointment at bed time for 6 weeks. 2.Systemic therapy regimes. Tetracycline or erythromycin 250 mg orally, four times a day for 3-4 weeks or doxycycline 100 mg orally twice daily for 3-4 weeks ref: A K KHURANA OPTHALMOLOGY,E4, Page-67 | 3,544 | medmcqa_train |
In maple syrup disease, the amino acids excreted in urine are, EXCEPT: | Maple syrup urine disease (MSUD), or branched-chain ketoaciduria, is caused by a deficiency in activity of the branched-chain -keto acid dehydrogenase Inborn error of metabolism of valine leucine and isoleucine associated with gross mental deficiency. Branched chain alpha-keto acid dehydrogenase is located in the inner mitochondrial membrane and requires thiamin pyrophosphate, lipoic acid, CoA, and Nicotinamide adenine dinucleotide (NAD) Disease associated with Branched chain aminoacids: Disease Deficiency Maple syrup urine disease Alpha keto acid deydrogenase deficiency Isovaleic acidaemia IsovalerylCoA dehydrogenase deficiency Methylmanlonic acidaemia Coenzyme A mutase deficiency Methyl malonyl CoA mutase deficieny Propionic acidaemia Propionyl CoA carboxylase deficiency Leucinosis Isoleucine and lecine transaminase deficiency Valinaemia Valine dehydrogenase (NADP+)deficiency Ref: Harper's illustrated biochemistry, 26 th Edition, Page 259 | 3,545 | medmcqa_train |
The difference between leukemia and leukemoid reaction is done by - | Leukemoid reaction is defined as a reactive excessive leukocytosis in peripheral blood resembling that of leukemia in a subject who doesnot have leukemia. Leucocyte alkaline phosphatase (LAP) score in the cytoplasm of mature neutrophils is high in leukaemoid reaction whereas reduced in CML .It is very useful to distinguish between the two. Reference; Harsh Mohan textbook of pathology, 7th edition.Pg no.332 | 3,546 | medmcqa_train |
A 32 year old woman presents with complaints of several months of burning substernal chest pain exacerbated by large meals, cigarettes, and caffeine. Her symptoms are worse when she lies on her back, especially when sleeping at night. Antacids often improve her symptoms. This patient is at risk for which of the following conditions? | This woman likely suffers from reflux esophagitis, a condition in which the lower esophageal sphincter (LES) does not adequately prevent acidic gastric contents from refluxing back into the distal esophagus. Most commonly, there is a defect in the LES mechanism itself, in addition to secondary causes such as pregnancy (due to increased abdominal pressure) and some medications (anticholinergics, beta-2 agonists, theophylline, nitrates, calcium-channel blockers). Symptoms can mimic cardiac chest pain and must be carefully evaluated. Complications of reflux esophagitis include esophageal strictures, ulcerations, laryngitis, pulmonary aspiration, and Barrett's esophagus (columnar metaplasia of the distal esophagus). Barrett's esophagus is considered a premalignant state, with roughly a 30-fold increase in the incidence of esophageal adenocarcinoma. The normal squamous epithelium of the esophagus transforms into columnar epithelium similar to gastric epithelium as a result of recurrent reflux of acidic gastric contents. Anginal pain, signaling cardiac ischemia, is generally not burning in nature, and is not relieved by antacids. Mallory-Weiss lesions are actual tears of the epithelia of the proximal stomach or distal esophagus as a result of retching (seen in anorexics and alcoholics). The incidence of pure squamous cell carcinoma is not increased by acid reflux disease. Ref: Wyatt C., Butterwoh IV J.F., Moos P.J., Mackey D.C., Brown T.G. (2008). Chapter 14. Gastrointestinal Pathology. In C. Wyatt, J.F. Butterwoh IV, P.J. Moos, D.C. Mackey, T.G. Brown (Eds), Pathology: The Big Picture. | 3,547 | medmcqa_train |
Which of the following anticholinergic is used for peptic ulcer disease | Pirenzepine is a M1 receptor antagonist.
Acetyl choline acts on M1 receptors present on gastric glands to increase acid secretion and Pirenzepine is used to treat peptic ulcer disease by blocking these receptors. | 3,548 | medmcqa_train |
A pt. presents with hematuria of several days and dysmorphic RBC casts in urine. The site of origin is : | Ans. is 'a' ie kidney " Isolated microscopic hematuria can be a manifestation of glomerular disease. The RBCs of glomerular origin are often dysmorphic."" Hematuria with dysmorphic RBCs, RBC casts and protein excretion > 500 mg/day is virtually diagnostic of glomerulonephritis."SoDysmorphic RBCs - origin is kidney*RBCs cast - origin is kidney *Broad cast - Seen in chronic renal diseases.Granular cast - ARF*Waxy casts - seen in chronic renal disease.WBC casts - pyelonephritis*.Also rememberHematuria is defined as two to five RBCs per high power fieldNormal RBCs excretion is upto 2 million RBCs/day | 3,549 | medmcqa_train |
All cause brain lesions except | (A) Giardiasis # G. lamblia is seen typically within the crypts in duodenum> It does not invade tissues, but remains tightly attached by means of the sucking disc to the epithelial surface in the duodenum and jejunum.> The diarrhoea in some cases may be steatorrhoeic with excess mucus and fat, but no blood.> Children may develop chronic diarrhoea, malabsorption, weight loss and a sprue-like syndrome.> Occasionally giardia may colonise the gallbladder, causing biliary colic and jaundice. | 3,550 | medmcqa_train |
Commonest cause of raised serum calcium is - | Ans. is 'c' i.e., Parathyroid adenoma o Primary hyperparathyroidism is the most common cause of hypercalcemia overall. o The frequency of the various parathyroid lesions underlying the hyperfunction is as follows : ? Parathyroid adenoma - 75% to 80% Primary hyperplasia - 10% to 15% Parathyroid carcinoma- < 5% o After hyperparathyroidism, malignancy is the 2nd most common cause of hypercalcemia by one of the following mechanisms. i) Osteolysis ii) Secretion of parathormone related peptide. | 3,551 | medmcqa_train |
MAC stands for | Minimum alveolar concentration is defined as the alveolar concentration of an inhaled anesthetic agent that prevents movement in 50% of patients in response to a standardized surgical stimulus. Low MAC - High potency MAC values of adult Halothane: 0.75 Sevoflurane: 2.0 Isoflurane: 1.2 Desflurane: 6.0 Enflurane: 1.7 Xenon: 70 N2O: 104 Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e | 3,552 | medmcqa_train |
Hecht's pneumonia is a complication of | Hecht's pneumonia is a giant cell pneumonia in immunodeficient people,rare complication of measles. | 3,553 | medmcqa_train |
Suicide is most common in - | Ans. is 'a' i.e., Depression Causes/Risk factors for suicidePsychiatric disorders : - Depression (most common), alcoholism (2nd me), Drug/Substance dependence, Schizophrenia, Dementia.Physical illness : - Cancer, AIDS, Multiple sclerosis, Head trauma.Psychosocial factors : - Failure in love, marital difficulties, family dispute, illegitimate pregnancy.Biological factors : - Decrease in serotoninOther - Male sex, Age > 40 years, Single (Unmarried, divorced or widowed), previous suicide attempt, social isolation. | 3,554 | medmcqa_train |
Most of the drug resistance occurs due to:(1996) | Ans: d | 3,555 | medmcqa_train |
In leprosy which of the following is not seen – a) Abnormal EMGb) Voluntary muscle wastingc) Decreased proprioceptiond) Decreased response to tactile sensatione) Increased response to tactile sensation | Muscle deficit (voluntary muscle wasting) results in abnormal EMG.
There is decreased response to tactile stimulation (not increased).
Proprioception and vibration is not affected as leprosy spares posterior column | 3,556 | medmcqa_train |
Which of the following antitussive can lead to hallucinations | Dextromethorphan is a NMDA antagonist used for Mild cough, which can lead to hallucination & addiction. | 3,557 | medmcqa_train |
A 19-year-old fell from a cliff when he was hiking in the mountains. He broke his fall by grasping a tree branch, but he suffered injury to the C8-T1 spinal nerve roots. Sensory tests would thereafter confirm the nature of his neurologic injury by the sensory loss in the part of the limb supplied by which of the following? | In a lesion of the lower trunk, or the C8 and T1 nerve roots, there is sensory loss on the medial forearm and the medial side of hand (dorsal and ventral). The medial cord is the extension of the lower trunk. The medial cord gives origin to the medial antebrachial cutaneous nerve, which supplies the T1 dermatome of the medial side of the antebrachium. The lower lateral brachial cutaneous nerve arises from the radial nerve, C5 and C6. The musculocutaneous nerve arises from the lateral cord, ending in the lateral antebrachial cutaneous nerve, with C5 and C6 dermatome fibers. The intercostobrachial nerve is the lateral cutaneous branch of the T2 ventral primary ramus and supplies skin on the medial side of the arm. The median nerve distributes C6 and C7 sensory fibers to the lateral part of the palm, thumb, index, long finger, and half of the ring finger. | 3,558 | medmcqa_train |
Integrity of the optic nerve is tested by except : | Electroretinography (ERG) measures the electrical response of the retina to flashes of light, the flash electroretinogram, or to a reversing checkerboard stimulus, the pattern ERG (PERG).All other test in the option tests the integrity of optic nerve. Perimetry or Tangent Screen examination is used to examine the central and peripheral visual fields. Usually performed separately for each eye, it assesses the combined function of the retina, the optic nerve, and the intracranial visual pathway. The visual evoked response (VER) measures the electrical potential resulting from a visual stimulus. However, because it is measured by scalp electrodes placed over the occipital coex, the entire visual pathway from retina to coex must be intact in order to produce a normal electrical waveform reading. Ref : Chang D.F. (2011). Chapter 2. Ophthalmologic Examination. In P. Riordan-Eva, E.T. Cunningham, Jr. (Eds), Vaughan & Asbury's General Ophthalmology, 18e. | 3,559 | medmcqa_train |
Which of the following cardiac complications may develop in a 33 year old woman with systemic lupus erythematosus (SLE) because of her underlying condition? | Libman-Sacks endocarditis affects patients with systemic lupus erythematosus (SLE). Small granular vegetations consisting of fibrin develop on the undersurface of the leaflets of mitral and aoic valves. Fragments of vegetations may detach, resulting in embolism. Eventually, vegetations heal by organization of fibrin and subsequent fibrosis, leading to distoion of valve leaflets and resultant insufficiency or stenosis. The pathogenesis is unclear but is probably related to thrombotic diathesis. Hemorrhagic pericarditis is usually a consequence of tuberculosis or metastatic spread of cancer to the pericardium. An exudate containing blood accumulates in the pericardial sac, producing pain and a characteristic auscultatory phenomenon known as a pericardial rub. SLE is associated instead with fibrinous pericarditis, which also manifests with chest pain and pericardial rub. Infective endocarditis is prevalent in patients with damaged or prosthetic valves and in intravenous drug abusers. It is associated with formation of bulky, friable vegetations that consist of masses of fibrin, neutrophils, and bacteria. Such vegetations cause extensive destruction of valve leaflets and may release fragments into the bloodstream, with resultant septic embolism. There is no association between SLE and mitral valve prolapse, which is a frequent, usually asymptomatic, valvular abnormality that occurs in 2% to 3% of the general population. Mitral valve prolapse is also associated with Marfan syndrome. Complications include sudden death, thromboembolism, and mitral regurgitation. Ref: Kaul M.S., Tapson V.F., St. Clair E. (2011). Chapter 89. Rheumatologic Diseases and the Cardiovascular System. In V. Fuster, R.A. Walsh, R.A. Harrington (Eds), Hurst's The Hea, 13e. | 3,560 | medmcqa_train |
Which is the first country in south east Asia to have eliminated trachoma? | 21 May 2018 - The World Health Organization (WHO) has validated Nepal for having eliminated trachoma as a public health problem - a milestone, as the country becomes the first in WHO's South-East Asia Region to defeat the world's leading infectious cause of blindness. Several criteria are used to assess a country's claim for having eliminated trachoma as a public health problem. These include: Less than 5% of children aged 1-9 years have signs of active trachoma (trachomatous inflammation-follicular), which can be treated with antibiotics, in each previously-endemic district; Less than 0.2% of people aged 15 years and older have trachomatous trichiasis, which requires eyelid surgery, in each previously-endemic district; and A health system which can identify and manage new cases of trachomatous trichiasis. | 3,561 | medmcqa_train |
One of the following is a sure sign of rape : | C i.e. Semen in fornix in a girl < 14 years | 3,562 | medmcqa_train |
All of the following bases are present in DNA, EXCEPT: | DNA contains only four different bases: adenine (A), guanine (G), thymine (T), and cytosine (C). DNA exists as a double helix in which A is always paired with T, and G is always paired with C. RNA contains the ribonucleotides of adenine, guanine, and cytosine, it does not possess thymine. Instead of thymine, RNA contains the ribonucleotide of uracil. Ref: Weil P. (2011). Chapter 34. Nucleic Acid Structure & Function. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K. Murray, V.W. Rodwell (Eds), Harper's Illustrated Biochemistry, 29e. | 3,563 | medmcqa_train |
An auto rickshaw ran over a child's thigh, there is a mark of the tyre tracks, it is an example of: AIIMS 10 | Ans. Patterned abrasion | 3,564 | medmcqa_train |
Dilantain (Phenytoin) is known to cause: | Folic acid deficiency | 3,565 | medmcqa_train |
All the following muscles have dual nerve supply except | 1) Flexor digitorum profundus is supplied by - (i) Medial half by ulnar nerve and Lateral half by anterior interosseous nerve(C8 , T1) ( branch of median nerve ). 2)Subscapularis is supplied by - Upper and lower subscapular nerves ( C5 , C6 ). 3) pectoralis major is supplied by - Medial and lateral pectoral nerves. 4)pronator teres is supplied by - median nerve only. Ref : B D Chaurasia's Human Anatomy , seventh edition , volume 1 , pg. no., 44, 70, 110, 108. | 3,566 | medmcqa_train |
Essential atrophy of choroid is due to inborn error of metabolism of amino acid: | Ans. Ornithine E Lysine | 3,567 | medmcqa_train |
The interior of right atrium is partially divided into two parts by - | Right atrium is divided into rough anterior and smooth posterior parts by crista terminalis. | 3,568 | medmcqa_train |
Anterolateral avulsion fracture of the distal tibial physis is known as - | Two unusual injuries of the growing ankle are the Tillaux fracture and the notorious triplane fracture. The TILLAUX fracture is an avulsion of a fragment of tibia by the anterior tibiofibular ligament; in the child or adolescent this fragment is the lateral pa of the epiphysis and the injury is therefore a Salter-Harris type 3 fracture. REF:Apley&;s system of ohopaedics- 9th edn - pg no 918 . | 3,569 | medmcqa_train |
Swimmer after coming out frm swimming pool presents with redness and mucopurulent discharge. There is no history of contact lens wear. On examination, no corneal involvement seen. Probable diagnosis is - | This is case of Swimming pool conjunctivits/granuloma-Which is adult inclusion conjunctivitis caused by chlamydia trachomatis. Ref: Khurana 7th/e p.73 & 4th/e p.63,68 | 3,570 | medmcqa_train |
Normal paogram include all of the following EXCEPT: March 2013 | Ans. A i.e. Cervical dilatation in X-axis Chas Paogram is: - Graphical representation of stages of labour; - Assessment of labour Cervicograph is: Graph showing relationship between cervical dilatation & labour | 3,571 | medmcqa_train |
Growth of C diphtheriae in Tellurite agar occurs in - | Ans. is 'd' i.e., 1-2 days * The usual media employed for cultivation of diphtheria bacillus are:-1) Loeffler's serum slope# It is used for rapid diagnosis as growth is shown within 4-8 hours.2) Tellurite blood agar (Tinsdale medium)# It acts as selective media, as tellurite inhibits growth of most other bacteria.# Growth may take two days to appear. | 3,572 | medmcqa_train |
Aspergillus causes all except | Dermatophytosis is caused by dermatophytes, which includes Microsporum, Trichophyton and Epidermophyton. Ref: Textbook of Microbiology, Ananthanarayan and Paniker; 9th edition | 3,573 | medmcqa_train |
The most commonly employed method for superficial, minimally invasive nodular Basal cell carcinoma (BCC)? | All given options are used for Rx of BCC, but Electro-desiccation and curettage (ED&C) is most commonly employed method for superficial, minimally invasive nodular BCCs and low-risk tumors. Wide local excision is selected for invasive, ill-defined, and more aggressive sub types of tumors, or for cosmetic reasons. Mohs micrographic surgery (MMS), a specialized type of surgical excision, best method for tumor removal while preserving uninvolved tissue. | 3,574 | medmcqa_train |
Regarding antibiotics true are | In clean contaminated surgeries (ex : gastric) , Prophylactic antibiotics are used In contaminated surgeries , lke colorectal surgeries prophylactic antibiotics are used | 3,575 | medmcqa_train |
Used for averting smoking habit is - | Antismoking drugs are :- Vareniciline, Bupropion, Amfebutamone, Clonidine, Rimonabant, Topiramate, Nortryptyline, Glucose, Mecamylamine. | 3,576 | medmcqa_train |
Tick transmits all except - | Chaga's disease: It is transmitted by reduviid bugs.They are also called conenose bugs, they are of large size. Adults have wings. These bugs live exclusively on the blood of animals including man and transmit Trypanosoma cruzi, the causative agent of Chaga's disease. Ticks are ectoparasites of veebrate animals. They transmit tick typhus, viral encephalitis, viral fevers, tularemia, tick paralysis, Q fever, relapsing fever, KFD. Description: Vector Diseases transmitted Soft tick Relapsing fever, Q fever, KFD (outside India) Hard tick Tularemia, Babesiosis, KFD (India), Tick paralysis, Tick encephalitis, Indian tick typhus, Tick hemorrhagic fever, Rocky Mountain spotted fever. REF: PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE, 25TH EDITION, PG NO. 841 | 3,577 | medmcqa_train |
The dorsal pa of the ventral mesogastrium forms(2018) | The lesser omentum is formed by two layers of peritoneum separated by a variable amount of connective tissue and fat. It is derived from the ventral mesogastrium. Ref:- Gray's anatomy, pg num:- 1101 | 3,578 | medmcqa_train |
Antigaucomatous drug causing spasm of accommodation | Ans. is 'b' i.e., Pilocarpine Ocular side effects of topical agents for POAG 13-blocker: Allergic blepheroconjunctivitis, corneal hyposthesia, blurred vision, dry eye, superficial punctate keratitis. Cholinomietics (pilocarpine): Blurred vision, miosis, accommodative spasm, browache. Sympathomimetics Non-selective (Dipivefrine): Follicular conjunctivities, rebound congestion, macular edema in aphakic Apraclonidine: Allergies, lid retraction, follicular conjunctivitis, fluctuation in visual acuity Brimonidine: Ocular allergy, conjuntival blanching. Carbonic anhydrase inhibitors (Dorzolamide, brinaolamide): Punctate keratitis, ocular allergies. Prostaglandin analogues (Latanoprost): Punctate keratitis, iris pigmentation. | 3,579 | medmcqa_train |
Increasing number of services in rural areas is a pa of - | Ref: 25th Ed K.Park's Textbook Of Preventive and Social Medicine | 3,580 | medmcqa_train |
Placenta accreta is associated with all except : | Risk factors for placenta accreta : Present placenta pre Previous H/o cesarean section Previous curettage Previous manual removal of placenta Previously treated Asherman syndrome Myomectomy Multiparity Advanced age Ref: Datta Obs 9e pg 394. | 3,581 | medmcqa_train |
Recurrent dislocations are least commonly seen in: | Complete dislocation of Ankle is rare because the talus cannot be completely dislocated from the joint unless all ligaments are torn. Recurrent ankle instability following ligamentous injury may be seen, but such instability is not associated with frank dislocations (although subluxation of joint may be seen). Ref: Campbell's Operative Ohopaedics, 10th Edition, Pages 2655, 2670, 2677, 2717; Oxford Handbook of Ohopaedic and Trauma Nursing By Rebecca Jester, Julie Santy, Jean Rogers, Page 342 | 3,582 | medmcqa_train |
Ectopic ACTH is commonly secreted by: September 2007 | Ans. A: Small cell carcinoma of the lungs Endogenous Cushing's syndrome results from some derangement of the body's own system of secreting coisol. Normally, ACTH is released from the pituitary gland when necessary to stimulate the release of coisol from the adrenal glands. In pituitary Cushing's, a benign pituitary adenoma secretes ACTH. This is also known as Cushing's disease and is responsible for 65% of endogenous Cushing's syndrome. In adrenal Cushing's, excess coisol is produced by adrenal gland tumors, hyperplastic adrenal glands, or adrenal glands with nodular adrenal hyperplasia. Finally, tumors outside the normal pituitary-adrenal system can produce ACTH that affects the adrenal glands. This final etiology is called ectopic or paraneoplastic Cushing's syndrome and is seen in diseases like small cell lung cancer. | 3,583 | medmcqa_train |
Pearl's index indicates: | Ans. is c, i.e. Contraceptive failureRef: Dutta Obs 6th/ed, p532-532Pearl index indicates the effectiveness of a contraceptive or is an index of contraception failure.* It is expressed in terms of "failure rate per hundred women - years of exposure (HWY)".* Failure rate per HWY=No.ofpatientsobservedxmonthsofuseTotalaccidentalpregnanciesx1200(12x100) * In applying the above formula the following points must be kept in mind:a. The total accidental pregnancies shown in the numerator must include every known conception, whatever its outcome.b. The factor 1200 is the number of months in 100 years.c. The total months of exposure in the denominator is obtained by deducing from the period under review of 10 months for a full term pregnancy and 4 months for an abortion. | 3,584 | medmcqa_train |
drug transpo mechanisms include | Ref-KDT 7/e p11-13 drugs are transpoed across the membrane by passive diffusion and filtration specialized transpo | 3,585 | medmcqa_train |
Which can be used in pregnancy? | Propylthiouracil is used for hyperthyroidism during pregnancy.
ACE inhibitors and Losartan should be avoided during pregnancy.
ACE inhibitors can cause fetal renal tubular dysplasia when used in second and third trimester leading to oligohydramnios,
fetal limb contractures, craniofacial deformities and hypoplastic lung development. | 3,586 | medmcqa_train |
Frequency of renal involvement in HSP ? | Ans. is 'c' i.e., 40-60%The repoed incidence of renal involvement in HSP varies considerably between different studies.o This may be because of the different criteria used to describe the involvement & the variability of the length used to follow up.o In different studies incidence of pediatric renal involvement in HSP was between 20-56% and in adults 50-78% | 3,587 | medmcqa_train |
A 23-year-old woman consults an obstetrician because of the onset of vaginal bleeding in what she considers to be the fifth month of pregnancy; however, examination reveals the uterus to be enlarged to the size of a 7-month pregnancy. Intravaginal ultrasound fails to detect a fetal heabeat and instead shows a "snowstorm pattern." HCG is markedly elevated. These findings are strongly suggestive of | Hydatidiform mole should be suspected when the uterus is enlarged beyond the expected size for the time of the pregnancy. HCG is markedly elevated in this gestational trophoblastic disease. H. mole on ultrasound shows a "snowstorm pattern ". Preeclampsia and eclampsia are forms of toxemia of pregnancy marked by severe hypeension, albuminuria and edema, with the addition of convulsions and DIC in the latter. Ectopic pregnancy is usually discovered early in a suspected pregnancy when ultrasound examination reveals the uterus to be empty. | 3,588 | medmcqa_train |
The most common histologic type of thyroid cancer is | Papillary carcinoma accounts for 80% of all thyroid malignancies in iodine-sufficient areas and is the predominant thyroid cancer in children and individuals exposed to external radiation." The incidence of primary malignant tumours of the thyroid gland Also, remember - Thyroid carcinoma is the most common malignancy of the endocrine system Ref : Schwaz 9/e p1361 | 3,589 | medmcqa_train |
Not true about right kidney is: | Ans. (a) Right kidney is preferred over the left for transplantationLeft Kidney is preferred over the right kidney - Reasons:* Left kidney is chosen for its long renal vein which makes surgery easier.* Right kidney is related with duodenum.* Right kidney is lower than left kidney. | 3,590 | medmcqa_train |
All of the following are true regarding Down's Syndrome EXCEPT; | Down's syndrome (Trisomy 21): Mental retardation Epicanthic folds and flat facial profile Simian's crease Umblical hernia Hypotonia Gap between first and second toe Congenital hea defects | 3,591 | medmcqa_train |
A 49 yr old male with a 35-pack-year history of smoking presents with a painless left scrotal mass. Examination revealed microscopic hematuria, absence of AFP and LDH. The most probable cause of the scrotal mass is: | Ans is 'b' i.e. Renal cell ca History of smoking suggests either Ca lung or Renal cell ca. Microscopic hematuria ors RCC. The painless left scrotal mass can be metastasis from RCC to the scrotum (which is rare but several cases have been repoed) or the mass could be varicocele. A secondary varicocele can be caused by compression of the testicular vein by the renal mass (infact RCC is the most common cause of secondary varicocele). Ca lung has no relationship with microscopic hematuria or a scrotal mass (though in extremely rare circumstances may (t) metastasize to scrotum). Seminoma and epididymitis have no relationship to smoking or microscopic hematuria. . | 3,592 | medmcqa_train |
Which personality disorder/s can be a pa of autistic sPectrum of disorders? | Ans. D. All the aboveFollowing personality disorders can be diagnosed later in life in patients with childhood autistic spectrum of disorders: Borderline, Obsessive compulsive, narcissitic, paranoid, schizotypical and, avoidant, personality. | 3,593 | medmcqa_train |
Principal cell in granuloma is | Ans. is 'b' i.e., Histiocyte Granuloma is characteristic ofgranulomatous inflammation. o The major cell of granuloma is epitheloid cell which is a modified tissue macrophage (histiocyte) that has been transformed into epithelium like cell. | 3,594 | medmcqa_train |
Which of the following is not seen in ARDS? | Ref: Harrison's 18/e p2206, 17/e p1680,1681 | 3,595 | medmcqa_train |
Calcitonin is used in all of the following conditions, EXCEPT: | The ability of calcitonin to block bone resorption and lower serum calcium makes it a useful drug for the treatment of Paget's disease, hypercalcemia, and osteoporosis. Fanconi syndrome is a disease of the proximal renal tubules of the kidney in which glucose, amino acids, uric acid, phosphate and bicarbonate are passed into the urine, instead of being reabsorbed. Treatment of children with Fanconi syndrome mainly consists of replacement of substances lost in the urine (mainly fluid and bicarbonate). Calcitonin is not indicated in this disease. In paget's disease bisphosphonates and calcitonin decrease the elevated biochemical markers of bone turnover, such as plasma alkaline phosphatase activity and urinary excretion of hydroxyproline. Ref: Bikle D.D. (2012). Chapter 42. Agents that Affect Bone Mineral Homeostasis. In B.G. Katzung, S.B. Masters, A.J. Trevor (Eds), Basic & Clinical Pharmacology, 12e. | 3,596 | medmcqa_train |
"Microsomia" is defined as | A neonate whose weight falls between the 10th and <90th percentile for gestational age is considered as Appropriate for gestational age (AGA). If the weight falls below the 10th percentile, the neonate is classified as Small for gestational age (SGA) or microsomic. If the weight falls at or above the 90th percentile, then the neonate is classified as Large for gestational age (LGA) or macrosomic. Reference : page 137 Ghai Essential Pediatrics 8th edition | 3,597 | medmcqa_train |
1. Which does not pass through the aoic opening(2018) | The aoic hiatus trans- mits the aoa, thoracic duct, lymphatic trunks from the lower posterior thoracic wall and, sometimes, the azygos and hemiazygos veins | 3,598 | medmcqa_train |
Which of the following drug is given unsupervised as per National Health Programmes ? | Dapsone is not required to be given under supervision . Under NLEP, Rifampicin and Clofazimine are given under supervision for both Multibacillary and Paucibacillary Leprosy. Rifampicin is given 600 mg once a month under supervision. Clofazimine is given 300 mg once a month under supervision and 50 mg daily unsupervised for 28 days. Dapsone is given 100 mg once daily unsupervised for 28 days. Multibacillary Leprosy is treated for 12 months and Paucibacillary Leprosy for 6 months. Under RNTCP, DOTS: Rifampicin, Isoniazid, Pyrazinamide and Ethambutol are administered under supervision. | 3,599 | medmcqa_train |
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