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Which among the following doesn't enter human body skin? | Trichinella REF: Jawetz, Melnick, & Adelberg's Medical Microbiology, 24T" edition chapter 46 Table 46-4 Indirect repeat in December 2011, See APPENDIX-74 for "DISEASES DUE TO HELMINTHS" "Trichinella infectes by ingestion of undercooked pork which contains encysted larvae in the straited muscle" Skin penetration is seen in: Hookworms; Ancylostoma duodenale, Necator americanus Strongyloides Schistosoma (Cercariae larvae) | 3,700 | medmcqa_train |
All of the following are TRUE about the middle ear, EXCEPT: | The facial nerve passes in a canal situated in the posterior and medial walls of the middle ear. It is not associated with the anterior wall. | 3,701 | medmcqa_train |
All of the following malignancies present with osteoblastic secondaries, except | Multiple myeloma commonly presents as multiple osteolytic lesions in older patients and may simulate metastatic cacinoma. Carcinomas which present with osteoblastic secondaries are prostate carcinoma, breast carcinoma, seminoma, neurogenic tumors and carcinoid. Reference: Bone and Soft Tissue Pathology By Andrew L. Folpe, page 452. | 3,702 | medmcqa_train |
Structure passing through the greater sciatic foramen are all of the following except ` | Structure passing through lesser sciatic notch Tendon of obturator internus Pudendal nerve Nerve to obturator internus Internal pudendal aery | 3,703 | medmcqa_train |
A young 8 years old boy with multiple, small, pin point, shiny, papular lesions on dorsal aspect of hand, forearms and his penis also. Diagnosis is: | Ans. d Lichen nitidus (Ref: Mark Lebwohl 2nd/345)A young 8 years old boy with multiple, small, pin point, shiny, papular lesions on dorsal aspect of hand, forearms and his penis also. Diagnosis is Lichen nitidus.Grouped pinhead lesions on elbow. abdomen, penis and dorsum of hand in a child as shown in the picture is highly suggestive of lichen nitidus.Lie hen scrofulosorum is an uncommon asymptomatic lichenoid eruption of minute papule occurring in children and adolescents with strongly positive tuberculin reaction. It mainly involves perifollicular distribution on abdomen, chest, back and proximal limbs. A hallmark is that superficial epitheloid dermal granuloma surround hair follicles and sweat ducts and may occupy several dermal papillae. Lichen NitidusLesion and etiology are similar, but size is smaller 1.2 mm (pinhead sizeQ)Occurs as grouped lesions on elbow, abdomen, penis and dorsum of handQMucosal or nail changes are rareSelf limiting, non-itchyQHistopathology:Dense, circumscribed and distinctive infiltrate of histio-lymphocytic cells situated directly beneath thinned epidermis results in widening of papillary dermis with elongation and the appearance of embracement by neighboring rete ridges ( Ball in clutch appearanceQ).Thinned epidermis demonstrates central parakeratosisQ, variable /focal hyper keratosis without hypergranulosis, minimal hydropic degeneration and few dyskeratotic cellsTreatment:Antihistaminics particularly AstemazoleQ is effective. Lichen ScrofulosorumLichen scrofulosorum is a lichenoid eruption of minute papulesQOccurs in children and adolescents with tuberculosis.Pathogenesis:Usually associated with chronic tuberculous disease of the LNs and honesQClinical Features:Eruption is asymptomatic and is usually confined to the trunkQ.Lesions consist of symptomless, small, firm, follicular or parafollicular papules of a yellowish or pink color with flat-top or bear a minute homy spine or fine scales on their surfaceQ.It mainly involves perifollicular distribution on abdomen, chest, back and proximal limbsQ.Histopathology:A hallmark is that superficial epitheloid dermal granuloma surround hair follicles and sweat ducts and may occupy several dermal papillaeQ.Treatment:Antituberculous therapy results in complete resolution within a matter of weeksQ.FeatureLichen NitidusLichen planusSymptomsAsymptomaticItchy (marked)Cutaneous lesionMultiple, discrete (or closely grouped), minute, pinpoint to pinhead sizedQ (1- 2mm), flat/ round or dome shaped papule with a glistening (shiny surface)Q.Papules are flesh colored or pink or shiny hypopigmentedQ (in blacks)Larger, plain (flat) topped, polygonal, pruritic, pink/purple (violaceous) papuleQWickham's striaeAbsentPresentQGroupingPresentQUsually notMucous membrane involvementUncommonCommonQ (Variably present)SiteMost frequently on flexural surfaces of upper extremities i.e. arm. forearm, wrist and dorsal surface of hands, lower abdomen, breast, the glans and shaft of penis and other areas of genital regionQFlexures (wrist), extremities (shin), lower back and genitalsQ | 3,704 | medmcqa_train |
Desmoplaskin is the target antigen in: | Paraneoplastic pemphigus is a severe variant of pemphigus, associated with an underlying neoplasm - most frequently non Hodgkin's lymphoma, chronic lymphocytic leukemia, thymoma, and castleman disease. Tumor antigens are hypothesized to evoke an immune response that leads to the development of an autoimmune response to intercellular adhesins (plakins). This autoantibody response leads to blistering in mucosa and other epithelia. | 3,705 | medmcqa_train |
Highest slope of stress v/s strain curve seen in: | Elastic modulus of different materials | 3,706 | medmcqa_train |
The predominant isozyme of LDH in cardiac muscle is | In myocardial infarction, total LDH activity is increased, while H4 iso-enzyme ( monomer of LDH ) is increased 5-10 times more. The magnitude of the peak value, as well as the area under the graph, will be roughly propoional to the size of the myocardial infarct. Ref: D M Vasudevan 7th edition Page no: 304 | 3,707 | medmcqa_train |
What is the strength of shock given to below victim of cardiac arrest with shockable rhythm: | It should be between 120-200 J asynchronized shock. | 3,708 | medmcqa_train |
Unsaturated fatty acids are converted to: | A Harper, 26lh ed. p. 192 & 25th ed, p. 250 | 3,709 | medmcqa_train |
"3 by 5" initiative in AIDS control programme is ? | Ans. is 'a' i.e., Providing 3 million people treatment by end of 2005 3 by 5 target On 1st December 2003, WHO and UNAIDS announced a detailed plan to reach the "3 by 5 target" of providing antiretroviral treatment (A) to three million people living with HIV/AIDS in the developing countries by the end of 2005. Ultimate goal of this strategy is to provide universal access to A to anyone who needs it. It has five Pillars (focus areas of concerns) :? Simplified standard tools to deliver A A new service to ensure effective, reliable supply of medicines and diagnostics Dissemination and application of new knowledge and successful strategy Urgent, sustained suppo to countries Global leadership, backed by strong panership | 3,710 | medmcqa_train |
Which of the following congenital malformation is seen in a child of a mother who is on treatment with oral anticoagulants - | Ans. is 'a' i.e., Craniofacial malformations o "Administration of warfarin (Oral anticoagulants) during pregnancy causes syndrome characterized by 1. Nasal hypoplasia (Craniofacial malformation) 2. Stippled epiphyseal calcifications that resemble chondrodysplasia punctata." | 3,711 | medmcqa_train |
All of the following are advantages of LMA Except | LMA is intermediate between the face mask and endotracheal intubation in terms of reliability, invasiveness, and facilitation of gas exchange (face mask has minimum and endotracheal intubation has maximum)LMA does not prevent aspiration - should not be used in full stomach patientsLMA can be used as an alternative to endotracheal intubation for minor surgeries, where anaesthetist wants to avoid intubationLMA is introduced blindly (without laryngoscopy) | 3,712 | medmcqa_train |
Which one of the following is an absolute contraindication to the use of thrombolytic agent in the setting of an acute anterior wall myocardial infarction- | Ref: R. Alagappan Manual for Medicine 4th Edition pg no:188-189 Contraindications for Thrombolytic Therapy Absolute contraindications: Active bleeding Defective haemostasis Recent major trauma Surgical procedures < 10 days Invasive procedures < 10 days Neurosurgical procedure < 2 months GI/genito-urinary bleeding < 6 months Stroke/TIA < 12 months Prolonged CPR > 10 minutes H/O CNS tumour, aneurysm, AV malformation Active peptic ulcer Aoic dissection Acute pericarditis Active inflammatory bowel disease Active cavitary lung disease Pregnancy Relative contraindications: Systolic BP > 180 mm Hg Diastolic BP >110 mm Hg Bacterial endocarditis Haemorrhagic diabetic retinopathy H/O intraocular bleeding Chronic warfarin therapy Severe renal or liver disease Severe menstrual bleeding | 3,713 | medmcqa_train |
Calcaneum is associated most commonly with which # - | Most common mechanism of injury is fall from height, often from a ladder, onto one or both heels. The calcaneum is driven up against the talus and is split or crushed.
About one fifth of these patients suffer associated injuries of the spine, pelvis or hip. | 3,714 | medmcqa_train |
A farmer presented with a black mole on the check. It increased in size, more than 6mm with sharply defined borders with central black lesion, what could be the diagnosis? | Superficial spreading melanoma It is the M/C type of melanoma It is the M/C type which occurs in a patient with pre existing mole. R/F for superficial spreading melanoma- Increasing age Melanoma in situ Many melanocytic nevi Multiple >5 atypical nevi Strong family H/O melanoma | 3,715 | medmcqa_train |
Which of the following types of pancreatitis has the best prognosis | .Ranson's prognostic criteria On admission:--* Old age >55 years * Blood sugar >200 mg% * TC >16,000/mm3 * Serum LDH > 350 IU/L * Serum SGOT > 250 IU/L In 48 hrs: * Base deficit > 4 mEq/L * Serum calcium < 8 mEq/L * Haematocrit : altered by 10% * Aerial O2 (PO2) < 60 mm Hg * Extravascular space fluid loss: > 6 * Blood urea (BUN) altered > 5 mg% of the normal Total score is 11 Scores up to 5 -- better prognosis 5-7 -- equivocal--but dangerous >7 -- is highly dangerous Glasgow criteria-* Age > 55 years * PO2 < 8 KPa * Total count >15000 cells/mm3 * Serum calcium < 2 mmoles/L * Blood urea > 16 mmol/L * Blood glucose > 10 mmols/L (200 mg%, no H/O diabetes) * SGPT > 200 IU/L * LDH > 600 U/L * Serum albumin < 3.2 gm/dl Note: * Decrease serum calcium level is worst prognostic indicator of pancreatitis. * These scoring systems differ for non gall stone pancreatitis and gall stone pancreatitis. * Other scoring systems which are often used are APACHE II (Acute Physiology And Chronic Health Evaluation II) and SAP (simplified acute physiology) scoring systems. Twelve variables are used to assess in APACHE II scoring. ref:SRB&;S manual of surgery,ed 3,pg no 620 | 3,716 | medmcqa_train |
Which method is used to locate a known gene locus? | Ans. A. FISH(Ref: Robbins 9/e page 177)Robbins 9th edition gives the following descriptionFISH uses DNA probes that recognize sequences specific to particular chromosomal regions.MethodRequires growing cellsDetects deletion and duplicationDetects balanced structural rearrangementsDetects uniparental disomyLower limits of detectionG bandingYesYesYesNo5-10mbMetaphase FISHYesYesYesNo40-250 thousand mbInterphase FISHNoYesSomeNo40-250 thousand mbCGH arrayNoYesNoNoSingle Exon or Single geneSNP arrayNoYesNoSomeSingle Exon or Single gene | 3,717 | medmcqa_train |
A child is posted for operative repair of exostrophy of bladder with renal failure. Which anesthetic should be preferred? | C i.e. Ataracurium In pediatric patients the choice of non depolarizing muscle relaxant depends on side effects and duration of action. The method of excretion of atracurium and cisatracurium (Hofman elimination and ester hydrolysis) makes these relaxants paicularly useful in newborns and children with liver or renal diseaseQ. If tachycardia is desired (eg with fentanyl anesthesia), pancuronium would be an appropriate choice. Vecuronium, atracurium, rocuronium & cisatracurium are useful for shoer procedures. Rocuronium offers an advantage that it can be administered intramuscularly (like Sch) preferably in deltoid however, the duration of action is - 1 hour, which could be a distinct disadvantage for a brief procedure. Vecuronium is valuable because no histamine is released; however, its duration of action is prolonged in newborns, which makes it similar to pancuronium The potential for rhabdomyolysis & hyperkalemia (paicularly in boys < 8 yrs who may have unrecognized muscular dystrophy), as well as for masseter spasm (jaws of steel), malignant hypehermia, cardiac arrhythmias, and myoglobinemia after administration of succinyl choline suggests that Sch should not be used routinely in children. Unlike adult patients profound bradycardia & sinus node arrest can develop in pediatric patients following 1st dose of Sch without atropine pretreatment. If a child unexpectedly experiences cardiac arrest following Sch administration, immediate treatment for hyperkalemia should be instituted. Howeve, it is the only available ultrasho acting muscle relaxant that provides a dependable, rapid onset of action. IV use of Sch should be limited to children who have full stomach or to treat laryngospasm. Intramuscular, intralingual (Submental) use is indicated for children with difficult intravenous access when control of airway is deemed essential. Mivacurium is an alternative to Sch when profound neuromuscular block of sho duration is required but rapid onset of action is unnecessary. Antagonism of neuromuscular blockade in all neonates & small infants, is recommended, even if they have recovered clinically, because any increase in work of breathing may cause fatigue and respiratory failure. Sugammadex, a cyclodextrin whose endoskeleton forms a water soluble complex with exoskeleton of rocuronium, is designed to antagonize the effects of rocuronium. As it is made of sugars and antagonize by covalent bonding the side effects are minimal. Antagonism is more rapid than neostigmine/atropine. It also reverse the other steroidal relaxants vecuronium & pancuronium to a lesser extent. The mechanism of reversal is lowering of plasma conentation & thus reversing the concentration gradient and pulling the rocuronium off the myoneural junction. | 3,718 | medmcqa_train |
Which of the following is the best predictor for future risk of cardiovascular events? | CRP is made in the liver in response to excess triglyceride storage. Elevated CRP levels>3mg/l using a high sensitive assay is associated with an increased risk of CHD. Another useful marker is lipoprotein associated phospholipase A2(LpPLA2). It is made by macrophages in response to excess cholesterol storage. Its level when >270ng/ml is associated with CHD. Ideal value for CRP is <2mg/l and for LpPLA2 is < 200ng/ml. Ref: Glycemic Control in Hospitalized Patients By Lillian Lien, Page 38; High Density Lipoproteins, Dyslipidemia and Coronary Hea Disease By Ernst J. Schaefer, Pages 186-7 | 3,719 | medmcqa_train |
Enzyme use in ELISA - | (A) (Alkaline Phosphate) (64- Harper 29th) (730 U. Satyanarayana 4th)ELlSAs use antibodies covalently linked to a "reporter enzyme" such as alkaline phosphatase or horseradish peroxidase whose products are readily detected, generally by the absorbance of light or by flourescence (64- Harper 24th)* ELISA is based on the immunochemical principles of antigen-antibody reaction***Applications:1. Determination of small quantities of proteins (hormones antigen, antibodies) and other biological substances.2. Most commonly used pregnancy test for the defection of hCG in urine is based on ELISA, by this test pregnancy can be detected within few days after conception.3. Diagnosis of AIDS. | 3,720 | medmcqa_train |
Which of the following structures is not at immediate risk of erosion by cholesteatoma? | Cholesteatoma has the propey to destroy the bone by viue of the enzymes released by it.Structures immediately at the risk of erosion are:-The long process of the incusFallopian canal containing facial nerveHorizontal/lateral semicircular canalRef: PL Dhingra, Diseases of Ear, Nose & Throat, 7th edition, pg no. 73 - 74 | 3,721 | medmcqa_train |
High-risk breast cancer female investigation of choice is? | – To differentiate scar from recurrence.
– To image breasts of women with implants.
– To evaluate the management of axilla and recurrent disease.
It is useful in screening females with the high-risk group.
T1 and T2 weighted images are taken.
Irregular mass with speculations, changes in skin and nipple, lymphoedema are the findings in carcinoma breast.
MRI breast is not accurate if done within 9 months of the radiotherapy in carcinoma of the breast.
Both precontrast and postcontrast MRI are done. | 3,722 | medmcqa_train |
Radiosensitisers are all Except | Radiosensitisers are agents that increase the lethal effects of radiation when given during (or sholy prior) to its delivery. There are three clinically used radiosensitisers - hypoxic cell sensitisers, hypoxic cell cytotoxics and the halogenated pyrimidines - that increase the sensitivity of tumour cells with minimal effect on normal tissues. chemotherapy drugs like cisplatin, 5FU are radiosensitisers.Reference: Eric J Hall Textbook of Radiobiology for Radiologist; 5th edition | 3,723 | medmcqa_train |
Open reduction is indicated in | Ans. is 'c' i.e. lateral condyle humerus lateral condyle humerusis commonly displaced and is treated by OR & IF with K wires*Treatment of clavicle -Conservative figure of 8 bandage *Treatment of both bones fore arm in children -In children these fractures are often undisplaced or minimally displaced therefore managed conservatively - CR & immobilization in an above elbow plaster cast. forearm in adultsis often displaced so treatment by OR & IF.Treatment of supracondylar humerusMostly conservative - CR immobilization in an above elbow plaster slab with the elbow in hyperflexionon failure of conservative methods sometimes OR & IF with K wires is done. | 3,724 | medmcqa_train |
A neonate delivered at 38 weeks of gestation with a bih weight of 2.2 kg develops intolerance to feed /abdominal distension on second day. Physical examination is unremarkable. Sepsis screen is negative. PCV is observed to be 72%. Which of the following represents the best management option? | Neonate mentioned in the case is suffering from neonatal polycythemia. Long term complications of neonatal polycythemia can be prevented by treating symptomatic children with paial exchange transfusion of blood. Ref: Neurology in Clinical Practice: The neurological disorders - Page 1108; Blueprints pediatrics By Bradley S. Marino, Katie Snead Fine, Julia A. McMillan, Page 183. | 3,725 | medmcqa_train |
22-year-old lady, with a history of epilepsy is undergoing the pre-anaesthetic review. The use of which inhalational agent is contraindicated in this patient? | Enflurane can precipitate generalized tonic clonic seizure in epileptics. It is however safer than halothane, causes less myocardiac depression and less hypotension. | 3,726 | medmcqa_train |
Commonest side effect of cryotherapy for carcinoma cervix in situ : | Persistent watery discharge | 3,727 | medmcqa_train |
Most commonly associated Fungus with orbital cellulitis in patients with Diabetic Ketoacidosis is | (B) MucorRhino - Orbital mucormycosis:Mucormycosis is a very rare opportunistic infection caused by fungi of the family Mucoraceae, which typically affects patients with diabetic ketoacidosis or immunosuppression. This aggressive and often fatal infection.Specific infections - rhinocerebral mucormycosis:Fungal infection caused by order of mucorales (mucor, rhizopus, absidia).Usually seen in diabetic ketoacidosis.Fungus inhaled into paranasal sinuses, germinates and invades palate, sphenoid, cavernous sinus, orbit, brain.Neurological deficits occur when fungus involves vessels.Proptosis, visual loss ophthalmoplegia, cranial nerve palsies occur. #SIS CLASSIFICATION OF MUCORMYCOSIS & ASPERGILLOSIS AspergillosisMucormycosis (rhino-orbital cerebral mucormycosis)OrderOrder EurotialesOrder MucoralesGenus Aspergillus SpeciesAspergillus fumigatusRhizopus orzae (most common - 90%)Aspergillus flavusAbsidiaAspergillus nigerMucor Rhizomucor pusillus Apophysomyces elegansHyphaeSeptate with dichomatous branches at 45degNon septate filamentous fungi branched at 45degThis is a purulent inflammation of the cellular tissue of the orbit.It is due most frequently to extension of inflammation from the neighbouring parts, especially the nasal sinuses; other less common causes are deep injuries, especially those with a retained foreign body, septic operations, posterior extension of suppurative infections of the eyelids or the eyeball such as panophthalmitis, facial erysipelas, or metastases in pyaemia.In diabetics a particularly fulminant infection with Mucor or Aspergillus is possible.Biopsy to find out non-septate broad branching hiphae.Treatment:Correction of underlying metabolic defect.Intra venous antifungal, antibiotics, E.g., Amphotericin-BWide excision of devitalized necrotic tissues exenteration may be required.Hyperbaric oxygen.Phacomycosis:Mucormycosis is rare a aggressive & often fatal infection caused by the fungus of family Mucoraceae, infection acquired by inhalational of spores.Other Options[?]Candida Ophthalmic Infections:The eye infections that may be caused by Candida species range from extraocular (keratitis, orbital cellulitis) to intraocular (endophthalmitis, panophthalmitis).[?]Aspergillus:Aspergillosis is caused by fungus in the order Eurotiales and genus Aspergillus.[?]Histoplasma:Presumed ocular histoplasmosis syndrome (POHS) occurs secondary to infection with the yeast form of Histoplasma capsulatum. The disease is characterized by atrophic chorioretinal scars, peripapillary atrophy (PPA) & the absence of vitritis. | 3,728 | medmcqa_train |
All of the following are ocular symptom seen in Herpes ophthalmicus, EXCEPT: | Herpes Zoster ophthalmicus involves ophthalmic branch of the trigeminal nerve. Herpes Zoster affecting the second and third division of the trigeminal nerve, and other cranial nerves is likely uncommon. When it occurs it may produce lesions in the mouth, ear, pharynx or larynx. Signs of Herpes Ophthalmicus are: Acute vesicular dermatomal skin rash along 1st division of trigeminal nerve Hutchinson sign Corneal pseudodendrites Stromal keratitis Nummular, Disciform keratitis Uveitis Sectoral iris atrophy Scleritis Retinitis Choroiditis Optic neuritis Elevated intraocular pressure Ref: Herpes Zoster: Recent Aspects of Diagnosis and Control ; 18 Tables edited by Gerd Gross, Hans Wilhelm Doerr vol 26, page 25. The Chicago Eye and Emergency Manual By Thomas John page 228. | 3,729 | medmcqa_train |
True about pilocytic astrocytoma all except aEUR' | Median age at presentation is more than 80 years Astrocytomas Histologically astrocytomas are classified into ? a) Protoplasmic or fibrillary b) Gemistocytic (enlarged cells distended with hyaline and eosinophilic material) c) Pilocytic (consists of enlarged bipolar cells) d) Mixed astrocytoma or oligodendroglioma Astrocytomas have been graded into 4 grades based on their biological behaviour (WHO grading schemes). Grading schemes for astrocytomas have clinical utility in predicting prognosis and treatment options. The tumour grade is expressed in the format X/IV. Pilocytic astrocytomas They are also called low grade astrocytomas. These are the predominant group of astrocytomas in childhood. Juvenile pilocytic astrocytoma is the most common astrocytoma in children accounting for 20% of all brain Although JPA can occur anywhere in the C.N.S. the classic site of presentation is cerebellum (posterior fossa). tumours. Microscopically it is characterized by Rosenthal fibres - compact area of condensed mass of glial filaments. Classic neuroradiological findings is the presence of contrast medium enhancing nodule within the wall of a cystic mass. JPA has low metastatic potential and is rarely invasive. JPA very rarely undergoes malignant transformation. Treatment With complete surgical resection the overall survival approaches 80-100%. | 3,730 | medmcqa_train |
Radiofemoral delay is characteristic of ____________ | In coarctation of aoa there will be radiofemoral delay. Ref : Ghai essential of pediatrics, eighth edition, p.no:432 | 3,731 | medmcqa_train |
Dried semen stains on clothes identified by - | Ref: the synopsis of forensic medicine &toxicology-Dr.K.S. Narayana reddy 28th edition pg no:236 proof of semen: the only absolute prrof of semen is the finding of atl;east one unbroken spermatozoon,or electrophoretic LDH isoenzyme detection of sperms. in the absence of spermatozoa, a stain which gives characteristic fluorescence in ultraviolet light , a high level of acid phosphatase , a high creatine phosphokinase and P30 can be considerd due to semen | 3,732 | medmcqa_train |
Superior quadrantanopia is seen in lesion of: | Ans: b (Temporal lobe) Ref: Khurana, 4th ed,p. 290Superior quadrantanopia is seen in temporal lobe lesions and inferior quadrantanopia is seen in parietal lobe lesions.Lesions of the visual pathway* Optic nerve- u/1 complete loss of vision* Optic chiasma(Central lesion)-bitemporal hemianopia* Lateral chiasma-binasal hemianopia* Optic tract- homonymous hemianopia* Lateral geniculate body- homonymous hemianopia* Optic radiation Total- complete homonymous hemianopiaParietal- inferior quadrantic hemianopia (pie on the floor)Temporal- superior quadrantic hemianopia (pie in the sky)* Visual cortex- congruous homonymous hemianopia +/- macular sparingWhen first order neurons are affected - first colour affected is blue If second order neurons are affected- first colour affected is red SiteLesionClinical featuresOptic nerveoptic atrophy, traumatic avulsion, acute optic neuritisloss of vision on the affected side + I/L loss of light reflexOptic chiasmasuprasellar aneurysms, pituitary tumours, craniopharyngioma, suprasellar meningioma, third ventricular dilatation due to obstructive hydrocephalusBitemporal hemianopia +Bitemporal hemianopic paralysis of papillary reflexesLateral chiasmal lesionsDistended third ventricle, atheroma carotids and PCABinasal hemianopia with binasal hemianopic paralysis of papillary reflexesOptic tract lesionsSyphilitic meningitis or gumma TB, tumours of optic thalamus, PCA aneurysmsHomonymous hemianopia with C/L hemianopic pupillary reactionLateral geniculate body Homonymous hemianopia sparing pupillary reflexesVisual cortexPCA occlusionHomonymous hemianopia sparing maculaPupillary light reflex- normal Optic radiation * TotalVascular occlusionsComplete homonymous hemianopia* Parietal lobeTraumaInferior quadrantic hemianopia (pie in the floor)* Temporal lobeTumoursSuperior quadrantic hemianopia (pie in the sky) | 3,733 | medmcqa_train |
Drug of choice for reversal of is neuromuscular blockade by vacuronium- | Ans: C. Sugamadex(Ref: KDT 7h/e p. 355; Basic of Anasthesia e book - 157)Sugamadex provides faster reversal of vacuronium - induced neuromuscular blockade compared with neostigmine.A modified gamma-cyclodextrin with high affinity towards vacuronium & recuronium. | 3,734 | medmcqa_train |
A 23-year-old woman has noticed that she develops a skin rash if she spends prolonged periods outdoors. She has a malar skin rash on physical examination. Laboratory studies include a positive ANA test result with a titer of 1 :1024 and a "rim" pattern. An anti-double-stranded DNA test result also is positive. The hemoglobin concentration is 12.1 g/dL, hematocrit is 35.5%, MCV is 89 mm3, platelet count is 109,000/mm3, and WBC count is 4500/mm3. Which of the following findings is most likely to be shown by a WBC differential count? | An autoimmune disease, most likely systemic lupus erythematosus (SLE) in this patient, can be accompanied by monocytosis. Cytopenias also can occur in SLE because of autoantibodies against blood elements, a form of type II hypersensitivity. Basophilia occurs infrequently, but also can be seen in chronic myelogenous leukemia (CML). Eosinophilia is a feature more often seen in allergic conditions, tissue parasitic infestations, and CML. Neutrophilia is seen in acute infectious and inflammatory conditions. Thrombocytosis usually occurs in neoplastic disorders of myeloid stem cells, such as the myeloproliferative disorders that include CML and essential thrombocytosis. | 3,735 | medmcqa_train |
Basal Metabolic Rate depends most closely on: | A i.e. Lean body mass | 3,736 | medmcqa_train |
Teratozoospermia refers to? | Ans. (d) Morphologically defective spermsRef: Harrison 18thed ch-346, Smith Urology 17thed p.691, style="font-size: 1.04761904761905em; font-family: Times New Roman, Times, serif"> publications/2010Z9789241547789_eng.pdf | 3,737 | medmcqa_train |
Tamoxifene - | Ans. is 'b' i.e., SERM o Tamoxifen is a selective estrogen receptor modulator (SERM).SELECTIVE ESTROGEN RECEPTOR MODULATION (SERMs)1. Tamoxifen citrate# It is a nonsteroidal compound# It has both estrogen antagonist as well as partial agonist activity -Tamoxifen (selective estrogen receptor modulator)o Sites on which it acts as estrogen antagonisti) Breast carcinomaii) Blood vesselsiii) Some peripheral sitesSite at which it acts as partial agonisti) Uterus - Causes proliferation of endometriumii)Bone - Improves bone mass d/t its antiresorptive effectiii) Lipid profile - Decrease LDL without any change in HDL (| risk of coronary artery disease)# Incresed risk of deep vein thrombosis.Tamoxifen is the standard hormonal treatment of breast cancer in both pre and postmenopausal women, though aromatase inhibitors are now becoming choice.Improvement in bone mass (due to antiresorptive effect) and in lipid profile are the benefits of tamoxifen.It has biphasic t1/2 - (10 hours and 7 days).2. Toremifene (Has been added to 6th/e of KDT)Newer tamoxifen congener with similar action and uses.3. RaloxifeneThis SERM is different from tamoxifen in that it has antagonistic action on endometrium (Tamoxifen has partial agonistic action) - No risk of endometrial proliferation amd carcinoma.All other actions are same.It is mainly used as first line drug for prevention and treatment of osteoprorosis.4. QrmeloxifeneIt also has antagonistic action on endometrium - has been approved for dysfunctional uterine bleeding.o Fulvestrant - It is a selective estrogen receptor down regulators (SERDs) or pure estrogen antagonist. In contrast to tomoxifen, it inhibits estrogen receptor (ER) dimerization so that ER interaction with DNA is prevented and receptor degradation is enhanced. The ER is thus down regulated resulting in more complete suppresion of ER responsive gene function. It is used for ER positive metastatic breast cancer. | 3,738 | medmcqa_train |
A myocardial infarct specimen is showing early granulation tissue. According to this change when has the infarct occurred? | Following a myocardial infarction, early formation of fibrovascular granulation tissue at margins occur in 7-10 days.Ref: Robbins Pathologic Basis of Disease, 6th Edition, Page 558; Essentials of Rubin's Pathology By Emanuel Rubin, 5th Edition, Pages 277-8 | 3,739 | medmcqa_train |
A man came to the casualty with some skin lesions after exposure to the sun. He is allergic to sunlight. Solar uicaria is characterized by: | Uncommon sunlight-induced whealing confined to exposed body sites. Eruption occurs within minutes of exposure and resolves in a few hours. Very disabling and sometimes life threatening. Action spectrum is UVB, UVA, and visible light or any combination thereof. Most commonly UVA. Is an immediate type I hypersensitivity response to cutaneous and/or circulating photo allergens. Therapy: multiple phototherapy sessions in low but increasing doses on the same day ("rush hardening"); oral immunosuppressive agents or plasmapheresis. Prevention: sun avoidance, sunscreens with high protection factors against action spectrum. Ref: Suurmond D. (2009). Section 10. Photosensitivity, Photo-Induced Disorders, and Disorders by Ionizing Radiation. In D. Suurmond (Ed),Fitzpatrick's Color Atlas & Synopsis of Clinical Dermatology,6e. | 3,740 | medmcqa_train |
A double aoic arch is due to persistent ? | Double aoic arch is most common vascular ring, caused by abnormal persistence of the distal segment of the RIGHT of 4th aoic arch. On lateral, arches are posterior to esophagus and anterior to trachea. Symptoms (of tracheal compression or difficulty swallowing) may begin at bih. Aoic arches: Aoic arches are sho vessels connecting ventral and dorsal aoae on each side they run within branchial (pharyngeal) arches are based gradually the 4th and 5th week, in 6 pairs in total the first, second and fifth pairs are developmental in perspective and they soon disappear.1. 1st aoic arch: disappears, a small poion persists and forms a piece of the maxillary aery.2. 2nd aoic arch: disappears, small poions of this arch contributes to the hyoid and stapedial aeries. 3. 3rd aoic arch: common carotid and initial segments of internal carotid aery.4. 4th aoic arch: has ultimate fate different on the right and left side on the left.RIGHT, the proximal segment of the right dorsal aoa persists and is incorporated into the R subclan aery whereas the distal segment regresses.LEFT, both the proximal and distal segments are retained and incorporated into the descending arch of the aoa.5. 5th aoic arch - is transient and soon obliterates.6. 6th aoic arch - pulmonary arch - RIGHT arch: the proximal segment is incorporated into the R pulmonary aery; the distal segment regresses. LEFT arch: the proximal segment is incorporated into the L pulmonary aery; the distal segment persists as the ductus aeriosus.Ref: Embryology for Medical Students, By Sudhir Sant, 2nd Edition, Page 133 | 3,741 | medmcqa_train |
"Intranuclear inclusions" in oligodendrocytes are seen in | progressive multifocal leukoencephalopathy, JC virus-infected oligodendroglia display 2 distinct patterns of intranuclear viral inclusions: full inclusions in which progeny virions are present throughout enlarged nuclei and dot-shaped inclusions in which virions are clustered in subnuclear domains termed "promyelocytic leukemia nuclear bodies" (PML-NBs) Surrounding the demyelinated areas, the oligodendrocytes are enlarged and contain intranuclear inclusionbodies filled with papovavirus paicles, often forming pseudocrystalline arrays Ref ganong's review of medical physiology 25e | 3,742 | medmcqa_train |
PSGN (post-streptococcal GN) associated with - | Electron microscopy shows deposited immune complexes arrayed as subendothelial, intramembranous, or, most often, subepithelial "humps" nestled against the GBM robbins book of pathology. 9th edition. Page 529 | 3,743 | medmcqa_train |
Essential atrophy of the choroid is due to inborn error of metabolism of which amino acid? | Ans.D.) Ornithine. Ornithine aminotransferase deficiency (also known as gyrate atrophy of the choroid and retina) is an inborn error of ornithine metabolism, caused by decreased activity of the enzyme ornithine aminotransferase. Biochemically, it can be detected by elevated levels of ornithine in the blood. Clinically, it presents initially with poor night vision, which slowly progresses to total blindness. It is believed to be inherited in an autosomal recessive manner. | 3,744 | medmcqa_train |
A 9-year-old girl is diagnosed with acute rheumatic fever. Instead of recovering as expected, her condition worsens and she dies. Which of the following is the most likely cause of death? | The most common cause of death that occurs during acute rheumatic fever is cardiac failure secondary to myocarditis. | 3,745 | medmcqa_train |
Minimal change glomerulopathy may be seen ' association with all of the following except, | Secondary MCD wherein the extraglomerular disease process evokes, directly or indirectly, the characteristic changes in permselectivity and morphology. In this circumstance the morphology is similar, if not identical, to primary or 'idiopathic' MCD. Moreover, it is possible, even likely, that similar or identical pathogenetic mechanisms are operative. In this scenario, a distinct etiologic link is presumed to exist between the extraglomerular disease process and the occurrence of MCD. Such a linkage would be strongly suppoed if cure of the extraglomerular disease lead to the eradication of MCD and if recurrence of the extraglomerular disorder was associated with relapse. While an attempt has been made to be comprehensive, it is possible that individual repos describing an association between the specific extra-glomerular disease and MCD may have been overlooked. The majority of the instances in which MCD has been associated with an extraglomerular disease involve neoplastic processes and idiosyncratic, hyper-sensitivity or toxic reactions to drugs. Neoplasia A variety of neoplastic processes have been repoed in association with MCD (Table 2) . In some, the association is rare enough to suspect that chance alone may have been the operational mechanism underlying the association. In others, the association is clearly contemporaneous and likely causal. Among patients with glomerular disease associated with neoplasia, 40% have MCD on renal biopsy. As mentioned previously it is possible that some of the described associations between neoplasia and MCD may be the consequence of treatment of MCD (especially cytotoxic drug therapy) predisposing to the emergence of a malignancy. Hodgkin's disease and non-Hodgkin's lymphoma are among the most frequently repoed neoplastic processes associated with MCD . Interestingly, repos describing the concurrence of MCD and Hodgkin's disease have decreased in recent years, perhaps due to the more effective diagnostic and therapeutic strategies available for this and related diseases. MCD is a rare complication of Hodgkin's ppdisease occurring in from 1:2000 to 1:10 000 cases. MCD has been associated with both limited (Stage 1) and disseminated (Stage 4) forms of Hodgkin's disease.Therapy of Hodgkin's disease, either by local radio- therapy to regional lymph nodes or by systemic chemotherapy, has often resulted in remission of MCD and recurrences of Hodgkin's disease have been associated with recurrence of MCD. These observations strongly imply a causal relationship between the tumour (or a product of the abnormal neoplastic cells) and the pathophysiological abnormalities involved in MCD. Indeed, it is quite possible that the same clone of cells which are involved in the development of Hodgkin's disease are also involved in the pathogenesis of MCD in both the primary and secondary forms. Such an explanation is more difficult to conjecture for the association of MCD with theother tumours listed in Table 2, except for mycosis fungoides, angiofollicular lymph node hyperplasia, non-Hodgkin's lymphoma and chronic lymphatic leukaemia . Perhaps, in these instances, the peurbations for MCD have also triggered the oncogenic potential of cells predisposed to neoplastic transformation (e.g. lack of a wild type tumour suppressor gene). Alternatively, lymphocytes infiltrating neoplastic growths could be induced to elaborate factors responsible for abnormal permeability. Whatever the case may be, it is wohwhile to consider potential underlying neoplasia in patients with MCD when atypical features are present such as weight loss, anorexia, lymphadenopathy, haematuria, fever, pleural effusions or skin lesions. Overall, the occurrence of MCD as a complication of neoplastic disorders is quite uncommon. MCD may precede the diagnosis of neoplasia by months or years or may follow the diagnosis of neoplasia by months or years. Some repos have suggested that NK-cell deficiency is associated with the development of MCD in patients with Hodgkin's disease Ref Harrison20th edition pg 299 | 3,746 | medmcqa_train |
Reactive ahritis is usually caused by: | Organisms that have been associated with Reiter Ahritis include the following: C trachomatis (L2b serotype) Ureaplasma urealyticum Neisseria gonorrhoeae Shigella flexneri Salmonella enterica serovars Typhimurium Mycoplasma pneumoniae Mycobacterium tuberculosis Yersinia enterocolitica and pseudotuberculosis Campylobacter jejuni Clostridium difficile Beta-hemolytic (example, group A) and viridans streptococci | 3,747 | medmcqa_train |
Puerperal sepsis is due to spread of Infection along which route : | Direct extension | 3,748 | medmcqa_train |
Which of the following characterizes mallampati class 3 | Both hard and soft palate should be seen in grade 3. | 3,749 | medmcqa_train |
Functions of limbic system : | A i.e. Emotion B i.e., Memory C i.e., Higher function Limbic System It is the entire neuronal circuit that controls emotional behaviour & motivational drives and a term that originally was used to describe bordering structures around basal region of cerebrum. Functions of hypothalamus Posterior Hypothalmus Pa of hypothalmus Vegetative & endocrinal function Behavioural function Lateral area * Thirst & hunger Stimulation centre increases general - Stimulation 1/t level of activity extreme hunger, voracious appetite l/t fighting & ove rage (1`. BP) & intense desire to search food deg - Damage causes lost desire for food and lethal starvation. Ventro medial * Satiety center Stimulation 1/t - Stimulation l/t satiety, decreased eating tranquility - Destruction 1/t voracibus appetite * Neuroendocrinal control Mamillary * Feeding reflexes body such as licking of lips & swallowing Functions of other pas Hippocampus - Almost any sensory experience activates some pa which intum distribute signals to other pa of limbic system. So it acts as a channel through which incoming sensory signals can initiate behavioural reactions for different purposes. - Becomes hyper excitable and gives off prolonged output signals. So in hippocampal seizures psychomotor (olfactory, visual, auditory, tactile) hallucinations cannot be suppressed as long as seizure persists. - Provides the drive that causes consolidation of long term memory (i.e. translates sho term memory into long term memory)Q. It determines the impoance of incoming sensory signal and has a critical decision making role that the information is likely to be committed to memory, making the mind rehearse over & over the new information until permanent storage takes place. - B/L damage I/t anterograde amnesia, with lost ability to establish memory lasting longer then few minutes. Amygdala - Coicomedial nuclei concerned with olfaction - Basolateral nuclei is more developed in humans which is concerned with behavioural activities - It is the window through which limbic system sees the place of person in the worldQ Stimulation can cause all the effects of hypothalmus puls tonic / clonic / rhythmical / circling movements, rage, escape, punishment, severe pain, fear, reward, pleasure, and even sexual activities such as erection, copulatory movements, ejaculation, ovulation, uterine activity & premature labor. Kluver Bucy syndrome d/t bilateral ablation of arnygadalaQ presents with (1) loss of fear, (2) extreme curosity (3) tendency to place everything in mouth (4) forgets rapidly and (5) strong sex drive so much so that it attempts to copulate even with wrong (immature, wrong sex, different species) anmials & inanimate objects. Limbic coex Anterior temporal coex : Gustatory & olfactory behavioural association - Posterior orbital frontal coex damage: Insomnia with intense motor restlessness (unable to sit still & moving about continuously) Parahippocampal gyri : complex auditory & thought associations derived fro Wernike's area | 3,750 | medmcqa_train |
Variconazole is not effective against- | Ans. is 'b' i.e., Mucormycosis o Amongst azole, only posaconazole is active against mucormycosis. o Voriconazole is used for i) Invasive aspergillosis (voriconazole is the DOC) Candida infection iii) Pseudollescheria boydii (Scedosporium apiospermum) infection iv) Fusarium infection | 3,751 | medmcqa_train |
The third heart sound is due to: | “A soft, low-pitched third sound is heard about one third of the way through diastole in many normal young individuals.” | 3,752 | medmcqa_train |
All of the following are branches of cerebral pa of the internal carotid aery, EXCEPT: | Meningeal aery is a branch of cavernous pa of Internal carotid aery.Must know:The internal carotid aery begins at the superior border of the thyroid cailage as one of the terminal branches of common carotid aery.Its course is divided into four pas: Pas of ICABranches(A) Cervical pasNo branches(B) Petrous paCaroticotympanic aeryPterygoid aery(C) Cavernous paCavernous branches (to trigeminal ganglion, walls of cavernous and inferior petrosal sinuses and contained nerves)Superior hypophysial aeryInferior hypophysial aeryMeningeal aery(D) Cerebral paOphthalmic aeryAnterior cerebral aeryMiddle cerebral aeryPosterior communicating aeryAnterior choroidal aeryRef: BDC 4/e Vol 3 page, 103, 178-179; Grays anatomy 38/e, Cardiovascular system | 3,753 | medmcqa_train |
Fundoscopic features of papilledema include all the following except - | Physiological cup is filled and obliterated (not becomes deep).
Ophthalmoscopic signs of papilloedema
Blurring of disc margin (first sign)
Venous :- Engorgment, congestion, loss of pulsation
Hyperemia of the disc with capillary dilatation.
Filling of physiological cup with gradual obliteration of physiological cup.
Gradual elvetion of disc (mushroom or dome shaped) with sharp bending of vessels over its margins.
Cotton- wool spots (soft exudates) and both flame shaped (superficial) and punctate (deep) hemorrhages
Macular fan or macular star due to hard exudates.
Late findings in long standing (vintage) papilloedema: - Markedly elevated disc with champagne cork appearance, post neuritic optic atrophy, corpora amylacea deposits on disc margin, generalized retinal pigmentation. | 3,754 | medmcqa_train |
All of the following statements are true regarding poliovirus, except: | Ans. is 'c' i.e., There is a single serotype causing infection There are 3 types of poliovirus which are associated with infection. | 3,755 | medmcqa_train |
Consider the following disorder- Sydenham's chorea Migraine Mania Obsessive compulsive disorder Valproic acid is used in ehich of the above disorders? | Treatment. There is no specific treatment for Sydenham's chorea and symptoms usually resolve themselves in approximately 3 to 6 months. Bed rest, sedatives and medication to control movements may be prescribed. Penicillin prophylaxis may also be prescribed to avoid fuher streptococcal infection. valproic acid can also be used Valproic acid is used to treat bipolar disorder. It's occasionally used to prevent migraine headaches and can also be used to treat epilepsy. This medicine is only available on prescription. It comes as capsules or tablets. Valproic acid is used to treat various types of seizure disorders. Valproic acid is also used to treat manic episodes related to bipolar disorder (manic depression), and to prevent migraine headaches. Valproic acid may also be used for purposes not listed in this medication guide. Ref Davidson 23rd edition pg 1067 | 3,756 | medmcqa_train |
The fibers from the contralateral nasal hemiretina project to the following layers of the lateral geniculate nucleus | Look at figure 12-17 trace the nasal field of one eye it goes to layers 1,4,6 on contralateral side. Ref: Ganong&;s review of medical physiology;23rd edition; pg:194 | 3,757 | medmcqa_train |
Delta waves are seen in: | REM sleep is characterized by b waves, the waves actually of ale wakefulness. Hence, REM sleep is also called "paradoxical sleep". Awake state with eyes closed - a waves; with eyes open - b waves. NREM sleep: stage 1 shows periodic sho bursts of a waves. | 3,758 | medmcqa_train |
Eyelid drooping in/are seen in: | Ans. Damage to sympathetic nerve supply | 3,759 | medmcqa_train |
Van Nuys prognostic indicator for DCIS does not include which of the following parameter? | Ans. (c) Type of DCIS(Ref: Sterenberg diagnostic surgical pathology 5th ed p 312)The Van Nuys Prognostic Index (VNPI) classifies patients with DCIS to guide decisions on the best treatment option. The index uses patient age, tumour size, tumour growth patterns (histological grade) and the amount of healthy tissue surrounding the tumour after removal (resection margin width) to predict the risk of cancer returning. | 3,760 | medmcqa_train |
Wernicke's encephalopathy, during refeeding syndrome, can be precipitated in deficiency of which of the following vitamin: September 2011 | Ans. C: Thiamin In patients who are thiamin deficient, Wernicke's encephalopathy can be precipitated by refeeding with carbohydrates This is prevented by administering thiamin before staing nutritional suppo | 3,761 | medmcqa_train |
Condition that can be diagnosed on laparoscopy? | Ans. a (Endometriosis). (Ref. Williams, Obstertrics, 21st ed., 930)ENDOMETRIOSISDefinition# Occurrence of ectopic endometrial tissues outside the true cavity of uterus.Etiology# Samson's implantation theory attributed to reflux of menstrual endometrium through tubes.# Coelomic metaplasia theory.# Metastatic theory.# Histogenesis by induction.# Hormonal influence: mainly estrogen.# Common among woman in child bearing age, especially belonging to affluent class.The commonest sites# Are the ovary 55%, posterior broad ligament 35%, anterior and posterior pouch of Douglas 34% and uterosacral ligaments 28%.Clinical features# Pain is usually associated with menstruation or may occur immediately premenstrually.# Dyspareunia is common. It does not cause postmenopausal bleeding.# There may rarely be rupture or torsion of an endometrioma, irregular menses or cyclical problems with rectal bleeding, tenesmus, diarrhea, constipation, haemoptysis, dysuria, ureteric colic or scar pains.# The chance of conception may be as low as half that of the normal population (infertility).Investigations# Laproscopy is the best diagnostic measure.# Laparoscopically, endometriosis may appear white or red (active lesions), black/brown 'Powder9 burns or burn matchstick like lesions or white plaques of old collagen.# There may also be circular defects in the peritoneum (peritoneal windows/Allemmaster syndrome) or endometriomas with 'chocolate' fluid containing debris from cyclical menstruation.# Chocolate cysts of ovaries represents the most important manifestation of endometriosis.Medical treatment# Drugs are not indicated for the RX of asymptomatic, minimal endometriosis in patients wishing to conceive.# Recurrence after treatment is common.# All therapies suppress ovulation, thus conception is unlikely with good compliance.# For symptomatic endometriosis, continuous progestogen therapy, e.g., medroxyprogesterone acetate 10 mg TID for 90 days is most cost effective, has fewer side-effects and is more suitable for long-term use compared with more expensive alternatives. It acts by producing a state of pseudo-pregnancy, which ultimately leads to regression of the disease .# Another very cost effective alternative suitable for long term use is the continuous low-dose OCpills.# Second line drugs (alternative therapy) are the GnRH analogues, which can be administrated by nasal spray or implants (e.g., nafarelin, buseralin, goseralin, leuproelin), and the danazol 200 mg OD-TID.# Danazol is mildly anabolic, androgenic, anti-estrogenic and anti-progestational drug which acts by inhibiting pituitary gonadotropins (AIIMS-93). It causes pseudomenopause.# Its side effects are atrophy of the breasts, weight gain, hirsutism, excessive sweating, depression, & vaginitis# Conservative treatment: This may be carried out at laproscopy or laprotomy and includes diathermy destruction or laser vaporization of endometriosis deposits. Adhesions may be divided. It is also possible to enucleate or excise endometriomas.# Advantages of laser therapy in treatment of endometriosis are:- Precise tissue destruction- Minimum damage to surrounding tissues.- Relatively bloodless field- Promotes tissue healing without adhesion formation.Surgical treatment# Radical surgery (BSO +/- TAH) This may be indicated for those in whom fertility is no longer required. HRT may lead to a recurrence of endometriosis. | 3,762 | medmcqa_train |
The Point of distinction between paial mole to complete mole is | Ref: Shaw&;s Textbook of Gynecology; 16th edition; Chapter 22; Gestational Trophoblastic Diseases | 3,763 | medmcqa_train |
The late features of kernicterus include all except | Hypotonia is not a feature of kernicterus . Initial findings associated with kernicterus may vary from case to case, but often include lack of energy (lethargy) or drowsiness, poor feeding habits, fever, a shrill high-pitched cry, and/or absence of ceain reflexes (e.g., Moro reflex, etc.). Affected infants may eventually experience respiratory distress, mild to severe muscle spasms including those in which the head and heels are bent backward and the body bows forward (opisthotonus), and/or diminished muscle tone (hypotonia). As an affected infants ages, other symptoms and physical findings may develop including delayed and/or abnormal motions or motor development; convulsions or seizures; impaired ability to coordinate voluntary movements (ataxia); abnormal muscle rigidity resulting in muscle spasms (dystonia); slow, continuous, involuntary, writhing movements (athetosis) of the arms and legs (limbs) and/or entire body; problems with sensory perception; lack of upward gaze; and/or hearing loss. In some cases, affected infants may exhibit mental retardation and difficulty speaking (dysahria). In most cases, the syndrome characteristic of kernicterus develops by three to four years of age. Reference: GHAI Essential pediatrics, 8th edition | 3,764 | medmcqa_train |
Drug of choice for gonococcal as well as non gonococcal urethritis is | Gonococcal Infections For gonococcal urethritis: DOC is ceftriaxone For non gonococcal urethritis: DOC is AZITHROMYCIN It is used in combination with ceftriaxone in both gonococcal & non gonococcal urethritis AZITHROMYCIN (Single dose is enough) | 3,765 | medmcqa_train |
Hardy Weinberg law indicates all except: | Ans. (d) Natural selection is a process where harmful genes are not eliminated from the gene pool and genes favorable to individual are not passed onto offspring.Acc to Hardy Weinberg law genes are passed on to the offsprings in a gene pool. | 3,766 | medmcqa_train |
River blindness is caused by : | Ans. is 'b' i.e. Onchocerca volvulus Onchocerca volvulus is transmitted by Simulium damnosum, a black fly* that breeds in areas of rapidly flowing streams thus the term 'river blindness9T/t by Ivermectin* | 3,767 | medmcqa_train |
All are indications for stopping effending ATT drug permanently except | Ans. is 'd' i.e., Hepatitis For patients with symptomatic hepatitis and those with marked (five to six fold) elevations in serum levels of aspaate aminotransferase, treatment should be immediately stopped and drugs reintroduced one at a time after liver function has returned to normal. Indications for stopping the A.T.T. permanently Hyperuricemia and ahralgia Optic neuritis Autoimmune thrombocytopenia | 3,768 | medmcqa_train |
True regarding 10-0 sutures is/are? | Answer- B. Synthetic suturesThe larger the size ascribed to the suture, the smaller the diameter be.10-0 sutures- 0.2 (0.020-0.029) | 3,769 | medmcqa_train |
For Ca Anal canal t/t of choice is - | Nigro regimen refers to combined chemotherapy and radiotherapy for primary treatment of malignant tumors of the anal canal.
In the 1970s, Nigro pioneered preoperative combination chemoradiation therapy to convert unrespectable cases to respective cases. There was no surgical pathological evidence of tumor found in three out of three patients treated with this approach in an early report.
This led to the concept of definitive radiation therapy combined with chemotherapy. Prior to this, the standard definitive treatment for carcinoma of the anal canal was abdominal-perineal resection, which necessitated a permanent colostomy.
The organ preservation concept following the discovery of a high complete response rate from combined chemoradiation saves a large number of patients from undergoing abdominal-perineal resection and colostomy. | 3,770 | medmcqa_train |
All are involved in iron metabolism except: | Ans. C. TransthyretinHepcidin is the regulator of iron homeostasis. Ferroprotin is their on exporter protein into circulation from intestinal cells. Ceruloplasmin has ferroxidase which convert Fe2+ to Fe3+ so it can serve the purpose of hephaestin in iron metabolism. Transthyretin is a transport protein for Thyroxine and Retinol. | 3,771 | medmcqa_train |
All are a type of audio-visual aids except | Flannel graph: Audiovisual aids: No health education can be effective without audiovisual aids. Auditory aids: radio, cassette tape-recorder, microphone, amplifier, earphone, public address system, disks Visual aids: Not requiring projection: Chalk-bored, leaflets, posters , chas, flannel graphs, exhibits, models, specimens, diagrams, photographs Requiring projection: Slides, filmstrips, overhead projector, epidiascope Combined A-V aids : Televsion, sound films (cinema, synchronized slide-tape combination, multimedia, videotape, drama, skits Ref: Park 25th edition Pgno: 926 | 3,772 | medmcqa_train |
All are true regarding satellite DNA EXCEPT? | Ans. is 'd' i.e., Transcriptionally active Repetitive sequences in DNAis also called (satellite DNA)These consist of 5-500 base pair lengths repeated many times.These are often clustered in centromeres (central protein of chromosomes where sister chromatids join each other) and telomeres (repeated sequence at the end of chromosomes).The majority of these sequences are transcriptionally inactiveand play a structural rolemicrosatellite sequences most commonly are found as dinucleotide repeats of AC on one strand and TG on the opposite strand.Microsatellite repeat sequences consist of 2-6 bp repeated upto 50 times. The AC repeat sequences occur at 50000-100000 locations in human genome. | 3,773 | medmcqa_train |
What happens to corneal endothelium after injury? | (Refer: AK Khurana Comprehensive Ophthalmology, 6th edition, pg no. 95 - 96)The cell density of endothelium is around 3000 cells/mm2 in young adults, which decreases with the advancing ageCorneal endothelium does not regenerate but adjacent cells slide to fill in a damaged area.Endothelium studied by specular microscope. | 3,774 | medmcqa_train |
Drug not causing exanthematous skin eruption | Drugs causing exanthematous eruptions are penicillin, sulfonamides, anticonvulsants, anti tubercular , allopurinol, nevirapine, phenylbutazone. Hydrocoisone is a coicosteroid is used for the treatment of severe drug reactions but will not induce exanthem | 3,775 | medmcqa_train |
Cochlear function in fetus develops between | Cochlear function develops between 22 and 25 weeks, and its maturation continues for six months after delivery.Reference: William&;s Obstetrics; 24th edition; Chapter 7; Embryogenesis and Fetal Morphological Development | 3,776 | medmcqa_train |
Which of the following is not one of the phases of Implantation of Embryo? | Implantation of Embryo can be divided into three phases: Apposition--initial contact of the blastocyst to the uterine wall Adhesion--increased physical contact between the blastocyst and decidua; and Invasion--penetration and invasion of syncytiotrophoblast and cytotrophoblast into decidua , inner third of the myometrium, and uterine vasculature. | 3,777 | medmcqa_train |
Which is false about pulmonary embolism? | Dysponea is the commonest symptom and tachyponea is the commonest sign. The most common presenting symptom of pulmonary embolism is dyspnea. Dyspnea, pleuritic chest pain, and tachypnea were present in 97% of patients with pulmonary embolism. PE most commonly results from deep vein thrombosis. Clinical signs include low blood oxygen saturation and cyanosis, rapid breathing, and a rapid hea rate, left parasternal heave, a loud pulmonary component of the second hea sound, and raised jugular venous pressure. | 3,778 | medmcqa_train |
Dysmorphic RBC with ARF is seen in? | Ans. (a) Glomerular disease(Ref: Henry's 22nd/ 457- 458)Dysmorphic RBCs with ARF is seen in Glomerular disease, while isomorphic RBCs are seen in non-glomerular bleeds; | 3,779 | medmcqa_train |
Cadaveric spasm develops | (Instantaneous with death): (150 31st/edition; 3.18- Parikh's 6th/e)CADAVERIC SPASM or instantaneous rigor or Cataleptic rigidityCharacterized by stiffening of the muscles immediately after death without being preceded by the stage of primary relaxationThe conditions necessary for its development are1. Somatic death must occur with extreme rapidity2. The person must be in a state of great emotional tension3. The muscle must be in physical activity at that timeTraitRigor mortisCadaveric spasm1. ProductionFreezing and exposure to temperature above 65degC will produce rigorCan not be produced by any method after death2. MechanismKnownNot clearly krown3. Predisposing factorsNilSudden death, excitement, fear, exhaustion nervous tension etc4. Time of onset1 to 2 hours after deathInstantaneres5. Muscles involvedAll the muscles of the body both voluntary and involuntaryUsually restricted to a single group of voluntary muscles6. Muscle stiffeningNot marked, moderate force can overcome itMarked very force is require to over come it7. Molecular deathOccursDoes not occurs8. Body heatColdWarm9. Electrical stimuliMuscles do not respondMuscles response10. Muscular reactionAcidicAlkaline11. Medicolegal importanceIndicate time of death*** Indicate mode of death*** Sudden death associated with great emotional tension* Indicates the muscles in the physical activity at the time of death | 3,780 | medmcqa_train |
LEAST common presentation of fibroid uterus is? | Symptoms of fibroid uterus Menorrhagia, polymenorrhoea, metrorrhagia, continuous or postmenopausal bleeding Infeility, recurrent aboions Pain Pressure symptoms Abdominal lump Vaginal discharge | 3,781 | medmcqa_train |
All of the following is given for the treatment for Pityriasis versicoler Except: | B i.e. Griseofulvin | 3,782 | medmcqa_train |
All of the following drugs are indicated in the treatment of bipolar disorder except? | BIPOLAR DISORDER Drug of choice for bipolar disorder is lithium. Alternatives to lithium are some antiepileptics (carbamazepine, valproate, lamotrigine, topiramate), antipsychotics (olanzapine, aripiprazole, haloperidol) and benzodiazepines. Carbamazepine and valproate are useful in manic depressive psychosis (bipolar disorder). These can also be used for acute mania. Valproic acid is the drug of choice for treatment of rapid cyclers (> 4 cycles/year). Lamotrigine is specifically useful for depressive phase of bipolar disorder. It is the first agent to be approved by FDA for bipolar disorder without an indication for acute mania. Benzodiazepines like lorazepam are the drugs of choice for acute mania when combined with lithium. Olanzapine and other atypical antipsychotics show efficacy in bipolar disorder as well as acute mania. | 3,783 | medmcqa_train |
Cultivable (in vitro) hepatitis virus is? | Ans. is 'a' i.e., Hepatitis A "HAV can be cultivated reproducibly in vitro" - Harrison Remember . HAV is the only cultivable hepatitis virus | 3,784 | medmcqa_train |
In all of the following diseases chronic carriers are found except: | Ans. is 'a' i.e. Measles In measles the only source of infection is a case of measles. Carriers are not known to occur.For more see Q no. 31 of Dec 1998. | 3,785 | medmcqa_train |
Most common cause of hydronephrosis is children | In children Most common cause of hydrophosis is Pelvi Ureteric junction obstruction. | 3,786 | medmcqa_train |
The following are direct signs of Lung collapse seen on the Chest X-ray except: | Ans. A. Mediastinal shift. (Ref. Sutton radiology 7th ed. 161)Direct signs of lung collapse includeIndirect signs are:i) opacity of the affected lobe(s)ii) crowding of the vessels and bronchi within the collapsed area:iii) displacement or bowing of the fissures.i) compensatory hyperinflation of the normal lung or lobes resulting in an increase in transradiancy with separation of the vascular marking;ii) displacement of the mediastinal structures toward the affected side.iii) displacement of the ipsilateral hilum which changes shape.Special signs of Lung Collapse:1.Rounded atelectasis"Comet tail" sign (vascular shadows seen radiating from opacity). Known in Asbestosis.2.Golden's 'S' signRight hilar/central mass with upper lobe collapse seen as convexity at the medial aspect of pulled up major fissure.3.Broncholobar signLower lobe bronchus is displayed within the opacity of the collapsed left lower lobe.4.Luftsiche! signGerman words luft = air, sichel = sickle, literally describes an 'air crescent' which may be seen between the aortic arch and the medial border of the collapse .The hyperextended superior segment of the ipsilateral lower lobe accounts for the paramediastinal lucency outlining the medial surface of the collapsed right or left upper lobe. | 3,787 | medmcqa_train |
A patient presents with melaena normal renal function, hypeension and mononeuritis multiplex. The most probable diagnosis is: | Answer is A (Classic PAN) : Amongst the options provided, mononeuritis multiplex is a feature of classical PAN and microscopic polyangitis. Presence of hypeension (infrequent in microscopic polyangitis) and normal renal function (infrequent in microscopic polyangitis) leads us to a diagnosis of classical polyaeritis nodosa. Renal involvement in classic PAN Pathology in kidney is that of aeritis without glomeruionephritis (involves small & medium sized muscular aeries) Renal impairment is uncommon-- Hypeension is frequent Renal involvement is mainly in the form of Renovascular hypeension . Renal involvement in microscopic polyangitis Pathology in kidney is that of glomerulonephritis Rapid renal impairment is characteristic-- API 7th/1183 Hypeension is infrequent-API 7th/1183 Causes of mononeuritis multiplex : Common causes Uncommon causes Classic polaeritis nodosa Mixed cryoglobulinemia Microscopic polyangitis Sjogren syndrome RA Wegner's granulomatosis SLE Progressive systemic sclerosis Mixed connective tissue disease Churg-strauss allergic granulomatosis Hypersensitivity angitis Leprosy Amyloidosis Diabetes | 3,788 | medmcqa_train |
A wave in JVP is due to - | Ans. is 'a' i.e., Atrial systole JUGULAR VENOUS PULSE.a waveIt is the positive presystolic wave produced by right atrial contraction.x descenta wave is followed by the negative systolic wave the x' descent.The x descent is produced due to atrial relaxation.The atrial relaxation is produced as a result of ventricular contraction.c waveThe x descent is interrupted by second positive wave the 'c' wave.It is produced by bulging of the tricuspid valve into the right atriumQ during RVisolvolumetric contraction.v waveIt is the positive systolic wave.It result from increase in the blood volume in the venacava during systole, when the tricuspid valve is closed.y descentFollowing the "v wave" this is a negative descending limb referred to as the y descent or diastolic collapse.It is due to tricuspid valve opening and rapid inflow of blood into the right ventricle.So there areThree visible major positive waves (a,c and v) andTwo negative waves (x and y). | 3,789 | medmcqa_train |
Area falling under 2 S.D. curve would be around - | Ref: Parks 23rd edition pg 848 The several measures of variation or dispersion of which the following are widely known : RangeThe mean or Average detion The standard detion . Ref:Parks 23rd edition pg 849. 1SD : confidence limit = 68% 2SD : confidence limit = 95% 3SD : confidence limit = 99.7% | 3,790 | medmcqa_train |
Hypoxic pulmonary vasoconstriction due to | Hypoxic pulmonary vasoconstriction (HPV), also known as the Euler-Liljestrand mechanism, is a physiological phenomenon in which small pulmonary aeries constrict in the presence of alveolar hypoxia (low oxygen levels). Ref Harrison20th edition pg 2334 | 3,791 | medmcqa_train |
Drug of choice for Zollinger Ellison syndrome: | Proton pump inhibitor | 3,792 | medmcqa_train |
A 24 year old construction worker presents to his physician after an injury on the job. Physical examination is remarkable for marked flexion of the ring and little fingers of the left hand. Which of the following additional findings would most likely be found on physical examination? | Clawing of the ring, forefinger and little fingers is characteristic of an ulnar nerve lesion. Ulnar nerve lesions can also produce wasting of the hypothenar eminence and dorsal interosseous muscles. The latter causes "guttering" between the extensor tendons on the back of the hand. Ulnar lesions also cause loss of sensation to the back of the little finger and half of the ring finger.Sensation on the back of the thumb is provided by the radial nerve.Sensation on the palmar side of the forefinger is provided by the median nerve. Wasting of the thenar eminence is associated with lesions of the median nerve. | 3,793 | medmcqa_train |
Which of the following fat soluble vitamin has been identified to function as a coenzyme? | Most of the water soluble vitamins exert the functions through their respective coenzymes while only one fat soluble vitamin (K) has been identified to function as a coenzyme.
Reference: Satyanarayana- Biochemistry, 3rd edition, pg-117 | 3,794 | medmcqa_train |
Chassar Moir surgery is done is case of: | Ans. is b, i.e. VVF repairRef: Shaw 14th/ed, p168SurgeryDone in1. Kelly stitch/Boney's Test/Marshall Marchetti Krantz SurgeryStress Urinary Incontinence2. Chassar Moir Technique/ Latzko technique/ layer techniqueVVF Repair3. Boari Flap TechniqueUretrovaginal Fistula repair4. Purandare Sling/ Fothergill's Repair/ Manchester Repair/Ward Mayo Hysterectomy/ Lefort's ColpocleisisProlapse Uterus5. Strassman Unification SurgeryBicornuate/Didelphic uterus (Indication for operation, if bicornuate or didelphic uterus lead to >3 Abortion)6. Hysteroscopic Septal Resection (M/c done), Jones/Thompkins/ Williams metroplastySeptate Uterus7. McIndoe VaginoplastyMRKH Syndrome/Vaginal agenesis (Best time to perform this surgery is just before/just after marriage)8. Me Donald/Shirodkar CerclageIncompetent Internal os9. Baldy Webster operation, Modified Gilliams operation, Laparoscopic ventrosuspensionRetroversion of the uterus10. Haultains Operation(via abdominal route Spinellis operation (via vaginal route)Inversion of uterus | 3,795 | medmcqa_train |
Not associated with coal tar | (D) Leukaemia# Occupational exposure to coal tar or coal-tar pitch is associated with an increased risk of skin cancer.> Other types of cancer, including lung, bladder, kidney, and digestive tract cancer, have also been linked to occupational exposure to coal tar and coal-tar pitch. | 3,796 | medmcqa_train |
What is the most probable cause of large head in this child? | c. HydrocephalusLarge head in an infant with venous prominences over scalp and presence of 'setting-sun sign', suggest hydrocephalus. | 3,797 | medmcqa_train |
A 20 year old man presented with abdominal pain, vomiting and bloody diarrhea, his stool sample grew Escherichia coli in pure culture. Which of the following serotype of E.coli is the causative agent of hemorrhagic colitis? | Enterohemorrhagic E.coli O157:H7 is the serotype of E.coli causing hemorrhagic colitis. It is associated with the ingestion of undercooked hamburger, sprouts, unpasteurized milk or juice. EHEC produces a shiga toxin and can cause colitis after an incubation period of 3 -5 days. It typically produces watery diarrhea that progress to bloody diarrhea after a few hours to few days. Fatigue, abdominal pain, nausea and vomiting are associated complaints. Mechanism of enterohemorrhagic colitis appears to be vascular endothelial damage that leads to platelet aggregation and initiation of the coagulation cascade. This in turn, leads to ischemia of the colon and results in hemorrhagic colitis. Ref: Mayo Clinic Gastroenterology and Hepatology Board Review By Stephen Hauser, 4th Edition, Page 197 | 3,798 | medmcqa_train |
Which year MTP act was passed - | park's textbook of preventive and social medicine 23rd edition. *implementing rules and regulations for legalisation of aboion was initially written in 1971 were revised again in 1992 came to be known as the MTP act 1971. | 3,799 | medmcqa_train |
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