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True about Hepatocellular Carcinoma ? | Ans. is 'c' i.e. HBV predisposes Most common cancers in the world are --> Lung > Breast > Colorectal. As already stated before, HCC presents quite late and thus only 15-20% cancers are resectable. Most patients with unresectable lesions die within a year after diagnosis. | 4,200 | medmcqa_train |
From A drugs which acts through inhibition of integrase activity of virus ? | Ans. is 'a' i.e., Raltegravir | 4,201 | medmcqa_train |
A 33 yr /M has history of A, now complaints of pain left hip. On examination there is Flexion, External Rotation of left lower limb is present. There is 7 cm shoening of left lower limb, there is a gluteal mass felt which moves with the movement of femoral shaft, most probable diagnosis could be? | Anterior dislocation is ruled out because it will have Flexion Abduction External Rotation with lengthening and anterior femoral head (Mass that moves with femur shaft is femur head). Central dislocation is ruled out because it will have shoening and femur head palpable on per rectal examination. Posterior dislocation will have Flexion Adduction and internal rotation with shoening and gluteal femoral head. Pipkins type IV: Shoening and gluteal mass with atypical features Type I: Femoral head fracture caudal to fovea centralis. Type II: Femoral head fracture cephalad to the fovea. Type III: Femoral head fracture associated with femoral neck fracture. Type IV: Type I, II or III with associated acetabular fracture. | 4,202 | medmcqa_train |
C-reactive proteins are - | Ans. is 'b' i.e., Beta-1 globulin C-reactive is a nonspecific inflammatory acute phase protein. It is a beta globulin which is produced in the liver. | 4,203 | medmcqa_train |
Wood's lamp is made up of - | Wood's Lamp It is a low intensity ultraviolet light(360nm) emitted by a high pressure mercury lamp fitted with a special filter made up of 9% nickel oxide and silica. | 4,204 | medmcqa_train |
In carcinoid syndrome, the ap of hea mostly affected is: | Answer is B (Inflow tract of RV) The most commonly involved valve in, carcinoid syndrome is tricuspid valve which forms the inflow tract of Right ventricle. Most commonly involved pa of hea : Inflow tract of RV (Tricuspid valve) Second most commonly involved pa of hea : Outflow tract of RV (Pulmonic valve) | 4,205 | medmcqa_train |
Premature atherosclerosis causing death is seen in: | Fabry's disease is an X-linked dominant disorder. Angiokeratoma corporis diffusum is another name for it. Neuropathy usually stas in the childhood. It is overshadowed by complications arising from the associated premature atherosclerosis that lead to death by the fifth decade of life. ALSO KNOW: Fabry's disease is caused by mutations in the Alpha -galactosidase gene. There will be accumulation of ceramide trihexoside in nerves and blood vessels. Enzyme replacement therapy with alpha galactosidase B may be useful in the early stages. Ref: Harrison, Edition-18, Page-3456 | 4,206 | medmcqa_train |
Pharmacovigilance means: | Pharmacovigilance has been defined by the WHO as the ''science and activities relating to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems'' The information generated by pharmacovigilance is useful in educating doctors about the adverse drug reaction and in the official regulation of drug use Ref; KD Tripathi Pharmacology 7th edition (page no:82) | 4,207 | medmcqa_train |
Ligament of poupart is | Ligament of poupart is another name for Inguinal ligament | 4,208 | medmcqa_train |
The chromosomal complement of a primary oocyte is- | Ans- (C) Primary oocyte | 4,209 | medmcqa_train |
Most affernt fibers from the lateral geniculate nucleus terminate in the primary visual coex is: | Most fibers from the lateral geniculate nucleus (LGN) end in layer 4 of the primary visual coex. Ref: Ganong's Review of Medical Physiology, 22nd Edition, Page 161; Berne and Levy Physiology, 5th Edition, Page 129. | 4,210 | medmcqa_train |
A 40 year old male brought to the emergency room with a stab injury to the chest.On examination pt is found to be hemodynamically stable. The neck veins are engorged and the hea sounds are muffled .The following statements are true for this pt except - | Pericardial tamponade Pericardial tamponade must be differentiated from tension pneumothorax in the shocked patient with distented neck veins It is most commonly the result of penetrating trauma. Characterized by Beck's Triad (MDH) : Muffled hea sounds, distended neck veins & Hypotension Diagnosis Chest X-Ray : Enlarged hea shadow Echocardiography : ECHO is diagnostic showing fluid in the pericardial sac. Central line : Rising central venous pressure Treatment Needle pericardiocentesis can buy enough time to move to the operating room. Treatment of choice : Surgical pericardiotomy Ref: Sabiston 20th edition Pgno :1678 | 4,211 | medmcqa_train |
Using a lens of +14D, magnification of fundus of an emmetropic eye in indirect ophthalmoscopy is: March 2013 (e) | Ans. D i.e. 5 times | 4,212 | medmcqa_train |
The characteristic feature of catatonic schizophrenia is | (D) All of the above | 4,213 | medmcqa_train |
A diabetic with orbital cellulitis and maxillary sinusitis shows hyaline, narrow, septate and ranching hyphae with invasion of the blood vessels fungus on microscopy. Which is the causative fungus ? | Ans. is 'c' i.e., Aspergillus Diagnosis of Aspergillus infection: o Histologic examination of affected tissue reveals either infarction, with invasion of blood vessels by many fungal hvphae, or acute necrosis, with limited inflammation and hyphae. o Aspergillus hyphae are hyaline, narrow, and septate, with branching at 45deg: no yeast forms are present in infected tissue. o Hyphae can be seen in cytology or microscopy preparations, which therefore provide a rapid means of presumptive diagnosis. | 4,214 | medmcqa_train |
Partogram is used to - | Ans: D | 4,215 | medmcqa_train |
Mcdonald stitch is applied in the following conditions except: | Contraindications to Circlage operation:
Intra uterine infection
Ruptured membranes
H/o vaginal bleeding
Severe uterine irritability
Cervical dilatation > 4 cm | 4,216 | medmcqa_train |
In early stages, how is acute alveolar abscess is diagnosed: | PDL widening can be the method for diagnosing the acute alveolar abscess in early stage, while chronic alveolar abscess presents as more distinct radiographic lesion. | 4,217 | medmcqa_train |
Specific reason to disallow the sample for culture - | Sample brought in formalin are not allowed for culture,as it may loose it's characteristic propeies specific to that organism. Ref ananthnarayana and panikers microbiology textbook | 4,218 | medmcqa_train |
The spirometer can estimate all the following except | The total lung capacity (TLC), about 6,000 mL, is the maximum amount of air that can fill the lungs (TLC = TV + IRV + ERV + RV Ref: guyton and hall textbook of medical physiology 12 edition page number:326,327,328 | 4,219 | medmcqa_train |
Epidural anaesthesia decrease risk of – a) Headacheb) Hypotensionc) Meningitisd) Arachnoiditis | As dura is not punctured in epidural anesthesia, chances of postdural puncture headache, meningitis and arachnoiditis are less. | 4,220 | medmcqa_train |
Gamma Carboxylation of what requires vitamin K | Biochemical functions of Vitamin K The functions of vitamin K are concerned with blood clotting process. lt brings about the post- translational (after protein biosynthesis in the cell) modification of ceain blood clotting factors. The clotting factors ll (prothrombin), Vil, lX and X are synthesized as inactive precursors (zymogens) in the liver. Vitamin K acts as a coenzyme for the carboxylation of glutamic acid residues present in the proteins and this reaction is catalysed by a carboxylase (microsomal). lt involves the conversion of glutamate (Clu) to y-carboxyglutamate (Gla) and requires vitamin K, O2 and COz. The formation of y-carboxyglutamate is inhibited by dicumarol, an anticoagulant found in spoilt sweet clover. Warfarin is a synthetic analogue that can inhibit vitamin K action Vitamin K is also required for the carboxylation of glutamic acid residues of osteocalcin, a calcium binding protein present in the bone. The mechanism of carboxylation is not fully understood. lt is known that a 2,3-epoxide derivative of vitamin K is formed as. an intermediate during the course of the reaction. Dicumarol inhibits the enzyme (reductase) that conves epoxide to active vitamin K. Ref : Biochemistry by U. Satyanarayana 3rd edition Pgno : 130 | 4,221 | medmcqa_train |
Which of the following is not an anti androgenic drug ? | Ans. is 'd' i.e., Cypionate | 4,222 | medmcqa_train |
12 years old male presented with intensely itchy grouped vesicles on buttock, trunk and scalp. On exposure to wheat they exaggerate. Diagnosis is - | Ans is 'b' i.e. Dermatitis herpetiformis o Among given options only dermatitis herpetiformis is a gluten sensitivity disorder and aggravates on on eating gluten (wheat, rye, barley).Other features in favour of diagnosis areo Intense itching (characteristic feature)o Distribution of lesion - buttock, trunk and scalpo Age group - DH is commonly seen in 2nd to 3rd decade.o Has been explained in previous sessions. | 4,223 | medmcqa_train |
Causes of a painless limp in infancy includes: | Painless Limp Painful Limp 1-3 years age group: DDH Cerebral palsy Muscular dystrophy Infantile coxa vara 4-10 years age: Limb length discrepancy Poliomyelitis Legg Calve Pehes disease Slipped capital femoral epiphysis Osteochondritis dissecans -Lateral surface of medial femoral condyle Ahritis/Synovitis/Osteomyelitis | 4,224 | medmcqa_train |
Functions of plasmin are all except- | Ans. is 'd' i.e., Stabilization of fibrin * Plasmin is a proteolytic enzyme which belongs to serine protease family.* Its function are:-i) Fibrinolysis by break down of fibrin - It is the major function.ii) Activation of Collagenaseiii) Break down of matrix proteins (fibrin, fibronectin, thrombospondin, laminin) and von Willebrand factor.* These effects are responsible for role of plasmin in embryogenesis, wound healing, angiogenesis and tumor growth & dissemination.* Plasmin released as zymogen (inactive) form, i.e. plasminogen from liver. In circulation, plasminogen is converted into active plasmin by tissue plasminogen activator (tPA), urokinase plasminogen activator (uPA), Kallikrein and Hageman factor (factor XII). | 4,225 | medmcqa_train |
What is the extent of spinal cord in an adult? | Ans. is 'a' i.e., Lower border of LI * Spinal cord begins at foramen magnum and, in adults, ends at lower border of LI.StructureExtends uptoAdult spinal cordInfant spinal cordLower border of L} or upper border of L2Upper border of L3 vertebraeFilum terminalePiamaterTip of coccyxDural sheathSubdural spaceSub arachnoid spaceS2 vertebra | 4,226 | medmcqa_train |
Which of the following are common physiological problems in neonates: | Ans. D. All of the aboveNeonates may have minor physiological peculiarities which are of no serious consequences. These include(i) Regurgitation of milk (most neonates take out small amount of curdled milk soon after feed. Child is usually active and vomitus is never yellow or green colour)(ii) Transitional stools: It is the transition from meconium to the yellow homogenous stool of a breastfed infant and is physiological(iii) Erythema toxicum: The rash usually appears on 2nd or 3rd day of life. It is scattering of erythema macules, papules and even vesicles. It occurs commonly over trunk, face and extremities and palms and soles are spared.(iv) Mongolian spots: They are pigmented lesions found at birth. The area most commonly involved is the lumbosacral region, but occasionally in the upper back, arms, buttocks and legs may be involved.(v) Neonatal Jaundice: Jaundice is common physical finding (manifesting as yellowness of the skin of the face) when serum bilirubin exceeds 5mg/dl during the first week of life. As the degree of jaundice increases, there is cephalocaudal progression. Jaundice should be considering non - physiological if it has appeared within 24 hours of age, stains palms or soles or persists beyond 10-14 days. | 4,227 | medmcqa_train |
The following is a marker of acute hepatitis B infection- | HBV-DNA can be measured by PCR in the blood. Viral loads are usually in excess of 105 copies/mL in the presence of active viral replication, as indicated by the presence of e antigen. In contrast, in individuals with low viral replication, who are HBsAg- and anti-HBe-positive, viral loads are less than 105 copies/mL. The exception is in patients who have a mutation in the pre-core protein, which means they cannot secrete e antigen into serum . Such individuals will be anti-HBe-positive but have a high viral load and often evidence of chronic hepatitis. These mutations are common in the Far East, and those patients affected are classified as having e antigen-negative chronic hepatitis. They respond differently to antiviral drugs from those with classical e antigen-positive chronic hepatitis. Measurement of viral load is impoant in monitoring antiviral therapy and identifying patients with pre-core mutants. Specific HBV genotypes (A-H) can also be identified using PCR. In some settings, these may be useful in guiding therapy, as genotype A tends to respond better to pegylated interferon-alfa compared to genotypes C and D. Ref Davidson edition23rd pg 875 | 4,228 | medmcqa_train |
Binding of gp 120 causes: | Ans. b. Facilitation of co-receptor | 4,229 | medmcqa_train |
Following is not a variety of entropion ? | Ans. is 'a' i.e., Pathological | 4,230 | medmcqa_train |
All or none law refers to: | Action potential | 4,231 | medmcqa_train |
If a biochemical test gives the same reading for a sample on repeated testing, it is inferred that the measurement is: | Criteria of screening test
Acceptability – The test should be acceptable to population to which it is going to be applied.
Repeatability (reliability, precision, reproducibility) – The test must give consistent results when repeated more than once on the same individual or material under the same condition.
Validity (accuracy) – It refers to what extent the test accurately measures which it purports to measure. (it means it expresses the ability of a test to separate or distinguish those who have the disease from those who do not). Accuracy refers to closeness with which measured values agree with “true” value.
It has two components:
i. Sensitivity – Ability of test of identify correctly all those who have disease.
ii. Specificity – Ability to test to identify correctly all those who do not have disease.
So, if test gives the same reading for a sample on repeated testing means test is precise (i.e., reliable, reproducible, repeatable). | 4,232 | medmcqa_train |
Example of asymmetric mixed-onium chlorofumarate is: | Gantacurium represents a new class of nondepolarizing neuromuscular blockers called asymmetric mixed-onium chlorofumarates. Ref: Miller's anesthesia-7th ed , Chapter 29. | 4,233 | medmcqa_train |
The optic cup is an evagination of which of the following? | The optic cup and its derivatives--the retina and optic nerve--develop from the diencephalon. | 4,234 | medmcqa_train |
Best treatment for gas gangrene | "High-dose penicillin G and clindamycin, along with third-generation cephalosporins, should be given intravenously until the patient's toxicity abates. The mainstay of management is early surgical excision of the necrotic tissue " Bailey and love 26th edition Pg 430 | 4,235 | medmcqa_train |
Radium emits which of the following? | Ans. is 'b' i.e., a, b, g o Radium emits a, b and g rays. Radium also produces neutrons when mixed with beryllium. | 4,236 | medmcqa_train |
A 45 year old male presents with 4 X 4 cm, mobile right solitary thyroid nodule of 5 months duration. The patient is euthyroid. The following statements about his management are true except | Malignancy is present in 15% to 20% of cold nodules and in less than 5% of hot nodules. Although suggestive, malignancy of a nodule can be neither confirmed nor excluded based on radionuclide uptake. Note :Option "Patient should undergo hemithyroidectomy if FNAC repo is inconclusive " is controversial. Close surveillance with ultrasound, genetic and molecular testing or other alternatives to diagnostic thyroidectomy. Even after diagnostic thyroidectomy, patient still requires survelliance for other lobe or may require total thyroidectomy if biopsy proves malignancy. | 4,237 | medmcqa_train |
Duration of action of flumazenil is: | Flumazenil is absorbed orally ;oral bioavailability is ~16% but its not used orally .On I.v .injection ,action of flumazenil stas in seconds &last for 1-2 hours ;elimination t1/2 is 1 hour due to rapid metabolism. REF: KD Tripathi 8th ed. | 4,238 | medmcqa_train |
Cryptococcal meningitis is common in: | Ans. is 'a' i.e., Renal transplant recipientPredisposing factors of cryptococcal meningitis are AIDS, hematologic malignancies, transplant recipients and patients on immunosuppressive or steroid therapy. | 4,239 | medmcqa_train |
All of the following structures can be viewed through a bronchoscope, EXCEPT: | Subcarinal lymph nodes are mediastinal lymph nodes located around the carina on the other side of the tracheal wall and hence not visualized on bronchoscopy. Involvement of subcarinal nodes may be suspected on bronchoscopy by widening and fixity of the carina and/or paralysis of the vocal cords but these nodes cannot be 'directly visualized'. | 4,240 | medmcqa_train |
Hyperesthesia over the region of 12th is called | Boa's sign is present in acute cholecystitis | 4,241 | medmcqa_train |
With regard to the malignant behavior of leiomyosarcoma, the most impoant criterion is | Option 4 is correct=the number of mitosis per high power field Leiomyosarcomas typically take the form of soft, hemorrhagic, necrotic masses. The diagnostic features of ove leiomyosarcoma include tumor necrosis, cytologic atypia, and mitotic activity. Robbins basic pathology 9th edition page no 694,heading=leiomyosarcomas..box=Morphology ref img | 4,242 | medmcqa_train |
In which case Immunoguided surgery is done | Ans is 'a' ie Ca Colon Radioimmunoguided surgery (RIGS) is a new technology capable of detecting minimal neoplastic lesions using radiocolloids, intraoperatively. It has numerous uses in oncology, it uses colloid radiotracers, monoclonal antibodies or non-immunological tracers. Its uses are Radioguided Occult Lesion Localization (ROLL) and Sentinel Lymph-Node Biopsy (SLNB).The malignancies mentioned in the above given web addresses of Pubmed, in which RIGS is being used are:Breast cancerColorectal cancerNon-small cell lung cancer | 4,243 | medmcqa_train |
The maxillary sinus open intlo middle meatus at the level of: | Ref: Dhingra 7e pg 151,209. | 4,244 | medmcqa_train |
Dutcher bodies are seen in? | Ans. is 'd' i.e., Bone marrow * In multiple myeloma plasma cells can infiltrate the bone marrow diffusely or may be present in sheet like masses that completely replace normal elements.* Plasma cells may be normal plasma cells but mostly they are atypical plasma cells (variants of plasma cell) produced by intracellular accumulation of intact or partially degraded immunoglobulins. These atypical plasma cells are :i) Flame cellsii) MOTT cells* Intracellular inclusions are Russel bodies (cytoplasmic), Dutcher bodies (nuclear), crystalline rods and fibrils.* Dutcher bodies, which are attributed to immunoglobulin filled cytoplasm invaginating into the nucleus creating the appearance of an intranuclear inclusion. | 4,245 | medmcqa_train |
Treatment of choice for placental site trophoblastic disease is - | Ans. is 'b' i.e., SurgeryPlacental Site Trophoblastic TumorArises from the placental bed trophoblasts and invades the myometrium.Most of these tumors run a benign course, malignancy is rare.Tumor is resistant to chemotherapy.Hysterectomy is the recommended treatment. | 4,246 | medmcqa_train |
Most common site of GIST is | Gastrointestinal Stromal Tumors Gastrointestinal stromal tumors (GISTs) are the most common sarcomatous tumors of the GI tract. Originally thought to be a type of smooth muscle sarcoma, they are now known to be a distinct tumor derived from the interstitial cells of Cajal, an intestinal pacemaker cell. They can appear anywhere within the GI tract, although they are usually found in the stomach (40% to 60%), small intestine (30%), and colon (15%). GISTs vary con- siderably in their presentation and clinical course, ranging from small benign tumors to massive lesions with necrosis, hemorrhage, and wide metastases | 4,247 | medmcqa_train |
PSA is measured in which units | Ans. is 'd' i.e., ng/ml Prostate specific antigen* It is a glycoprotein produced only in the prostatic cells (both benign & malignant). It facilitates liquefaction of semen.* It is neither sensitive nor specific for early prostate carcinoma (it is prostate specific and not prostate cancer specific)y nevertheless it gives some help in making a diagnosis.# Normal serum level - less than 4 ng/ml# 4-10 ng/ml - this range is common for both BHP and Ca.# More than 10 ng/ml - approx 75% will have cancer.* Since PSA is not specific for Ca, PSA Velocity & PSA density are used to detect Prostate cancer.* PSA velocity is the rate of change in PSA levels over time and is expressed most commonly as the PSA doubling time. For men with a PSA above 4, PSA velocity of more than .75 ng/ml year is suggestive of Ca. While for those with lower PSA levels, rates above 0.5 ng/mL per year should be used to advise biopsy.* PSA density is calculated by dividing the serum PSA by the estimated prostate weight (measured by TRUS). It was developed to correct for the contribution of BPH to the total PSA level.# Values <0.10 are consistent with BPH.# >0.15 suggest cancer | 4,248 | medmcqa_train |
In Angle's classification for malocclusion, key tooth is: | Angle’s postulate was that the upper first molars were the key to occlusion and that the upper and lower molars should be related so that the mesiobuccal cusp of the upper molar occludes in the buccal groove of the lower molar. If the teeth were arranged on a smoothly curving line of occlusion and this molar relationship existed , then normal occlusion would result.
Angle then described three classes of malocclusion, based on the occlusal relationships of the first molars:
Class I: Normal relationship of the molars, but line of occlusion incorrect because of malposed teeth, rotations, or other causes.
Class II: Lower molar distally positioned relative to upper molar, line of occlusion not specified.
Class III: Lower molar mesially positioned relative to upper molar, line of occlusion not specified.
Reference: Contemporary orthodontics, Proffit 6th ed page no 2 | 4,249 | medmcqa_train |
Which is the most common type of persistent delusional disorder ? | Ans. A. Delusion of persecution Delusion of persecution is the most common type of persistent delusional disorder. | 4,250 | medmcqa_train |
All age groups are included in numerator of dependency ratio except - | Numerator in dependency ratio includes:-
i) 0-14 years (option a & b)
ii) > 65 years (option d) | 4,251 | medmcqa_train |
True about Type 1 diabetes mellitus | * Patients may become hyperglycemic in poorly controlled type 1 diabetes mellitus . The reason being - due to lack of insulin to stimulate uptake and utilization of glucose and also because in the absence of insulin which antagonize the actions of glucagon, there is increase in gluconeogenesis from amino acids in liver. * Lack of insulin (which antagonize the actions of glucagon) results in increased lipolysis in adipose tissue , and the resultant NEFAs become substrates for ketogenesis in the liver. There is defect in the utilization of ketone bodies in muscle because of lack of oxaloacetate . * In uncontrolled diabetes, ketosis is severe enough to cause pronounced acidosis (ketoacidosis). * Coma results from both the acidosis and also the considerably increased osmolality of extracellular fluid (mainly as a result of the hyperglycemia, and diuresis resulting from the excretion of glucose and ketone bodies in the urine). Ref:- Harper 30/e; pg num:- 149 | 4,252 | medmcqa_train |
Vitamin k associated clotting factors are | Ref Robbins 8/e 118-119 ; 9/e p 119 Physiologic Effects of Vitamin K Vitamin K serves as an essential cofactor for a carboxylase that catalyzes carboxylation of glutamic acid residues on vitamin K-dependent proteins. The key vitamin K-dependent proteins include: Coagulationproteins: factors II (prothrombin), VII, IX and X. | 4,253 | medmcqa_train |
Anti-parkinsonism drug that is selective COMT inhibitor? | Ans. a (Entacapone) (Ref. KDT 6th/pg. 415)ADRENERGIC DRUGSSr NoStep/siteActionDrugResponse1.Synthesis of NAInhibition Utilization of same synthetic pathwaya-methyl-p-tyrosine a-methyl dopaDepletion of NAReplacement of NA by a-methyl NA(false transmitter)2.Axonal uptakeBlockadeCocaine, desipra- mine, guanethidine, antihistaminics, ephedrinePotentiation of NA (endo- and exogenous), inhibition of tyramine3.Granular uptakeBlockadeReserpineDepletion of NA (degraded by MAO)4.Nerve impulse coupled release of NAInhibitionGuanethidine, bretyliumLoss of transmission5.Granular NADisplacementGuanethidineInitially sympathomimetic, depletion later.6.Membrane NA poolExchange diffusionTyramine, ephedrineIndirect sympathomimetic7.MetabolismMAO inhibition COMT inhibitionNialamid tranylcy- promine Tolcapone, entacaponePotentiation of NA (slight),| Of tyramine (marked) Potentiation of NA (slight)8.ReceptorsMimickingPhenylephrine Clonidinea1 sympathomimetica2-inhibition of NA release, |sympathetic outflow IsoprenaiineSalbutamolb1+ b2 - sympathomimeticb2-sympathomimetic BlockadePhenoxybenzaminePrazosinYohimbinePropranololMetoprolola1 + a2 - blockadea1- blockadea2 - blockadeb1 + b2 - blockadeb1 - blockadePergolidePergolide, another ergot derivative, directly stimulates both D1 and D2 receptors.It too has been widely used for parkinsonism, and comparative studies suggest that it is more effective than bromocriptine in relieving the symptoms and signs of parkinsonism, increasing "on-time" among response fluctuators, and permitting the levodopa dose to be reduced.PramipexolePramipexole, which is not an ergot derivative, has preferential affinity for the D3 family of receptors. It is effective when used as monotherapy for mild parkinsonism.RopiniroleRopinirole, another nonergoline derivative, is a relatively pure D2 receptor agonist that is effective as monotherapy in patients with mild disease and as a means of smoothing the response to levodopa in patients with more advanced disease and response fluctuations.RasagilineRasagiline, another monoamine oxidase B inhibitor, is more potent than selegiline in preventing MPTP- induced parkinsonism and is currently under study as a neuroprotective agent.TolcaponeSelective COMT inhibitors such as tolcapone and entacapone also prolong the action of levodopa by diminishing its peripheral metabolism. | 4,254 | medmcqa_train |
Loop of Henle handles the following ions except: | D i.e. UreaIn the thick ascending limb, a carrier co-transpos one Na+, one K.' and 2C1-Q from the tubular lumen into the tubular cells. | 4,255 | medmcqa_train |
A 25 year old man undergoes orchiectomy for a testicular tumor. Microscopically, the tumor shows a variety of patterns, including lobules containing large cells with watery cytoplasm, structures resembling primitive glomeruli, syncytiotrophoblast, and shafts of undifferentiated cells with focal glandular differentiation. Which of the following terms most accurately describes this tumor? | This is a mixed testicular tumor. Mixed patterns occur in 60% of testicular tumors, with the most common pattern being teratoma (not present in this patient), embryonal carcinoma, yolk sack tumor, and hCG-containing syncytiotrophoblast. This patient's tumor also contains elements of seminoma. The prognosis of these tumors is determined by the presence or absence of more aggressive elements, notably choriocarcinoma. Choriocarcinoma contains both syncytiotrophoblast and cytotrophoblast. Embryonal carcinoma is characterized by sheets of undifferentiated cells with focal glandular differentiation. Seminoma shows lobules containing large cells with watery cytoplasm. Ref: Wyatt C., Butterwoh IV J.F., Moos P.J., Mackey D.C., Brown T.G. (2008). Chapter 17. Pathology of the Male and Female Reproductive Tract and Breast. In C. Wyatt, J.F. Butterwoh IV, P.J. Moos, D.C. Mackey, T.G. Brown (Eds),Pathology: The Big Picture. | 4,256 | medmcqa_train |
Hormone synthesized as peptide precursor is/are | Insulin- A polypeptide hormone secreted by the islets of Langerhans and functioning in the regulation of the metabolism of carbohydrates and fats, especially the conversion of glucose to glycogen, which lowers the blood glucose level.Ref: Ganong&;s review of medical physiology; 24th edition; page no: 431 | 4,257 | medmcqa_train |
The derivative of midgut among the following is | HUMAN EMBRYOLOGY-INDERBIR SINGH TENTH EDITION-PAGE NO:188Caecum and appendixThe caecal bud is a diveiculum that arises from the post aerial segment of the midgut Loop. The caecum and appendix are formed by the enlargement of this bud. The proximal pa of the bud grows rapidly to form the caecum. Its distal pa remains narrow and forms the appendix | 4,258 | medmcqa_train |
Kidney cortex contains: | Ans. C Collecting tubule and ductRef: BDC, 6th ed. vol. II pg. 315-16* The kidney consists of an outer renal cortex and an inner renal medulla that contains the renal pyramids which drain into - Calyx - Pelvis.* Cortex forms a continuous smooth outer zone with a number of projections (cortical columns) that extend down between the pyramids.* It contains the renal corpuscles and the renal tubules except for parts of the loop of Henle which descend into the renal medulla. It also contains blood vessels and cortical collecting ducts.* The renal cortex is the part of the kidney where ultrafiltration occurs. | 4,259 | medmcqa_train |
X-linked muscular dystrophy is? | Ans. is 'd' i.e., Duchenne's muscular atrophy X-linked Recessive disordersMusculoskeletalHematologicalImmuneMetabolicNervous* Duchene muscular dystrophy* Chronic granulomatous disease* Hemophilia A & B* G-6-PD deficiency* Agamma - globulinemia* Wiskott - Aldrich synd.* Diabetes insipidus* Lesch Nyhan syndrome* Fragile - X- syndrome* Colour blindnessX-linked dominant disorders* Vitamim D resistant (X-linked hypophosphatemic) Rickets.* Familial hypophosphatemia.* Incontinentia pigmenti. | 4,260 | medmcqa_train |
The diagnostic test for rickettsial infection is: | Weil-felix reaction | 4,261 | medmcqa_train |
Synchysis refers to | VITREOUS LIQUEFACTION (SYNCHYSIS) Vitreous liquefaction (synchysis) is the most common degenerative change in the vitreous. Causes of liquefaction: 1. Degenerations such as senile, myopic, and that associated with retinitis pigmentosa. 2. Post-inflammatory, paicularly following uveitis. 3. Trauma to the vitreous which may be mechanical (blunt as well as perforating). 4. Thermal effects on vitreous following diathermy, photocoagulation and cryocoagulation. 5. Radiation effects may also cause liquefaction. Ref:- A K KHURANA; pg num:-244 | 4,262 | medmcqa_train |
A 52 year old female presents with groin pain. Physical examination reveals a bulge in the groin area immediately inferior to the inguinal canal. The physician suspects that the patient has a femoral hernia containing a loop of small intestine. Which of the following structures is located immediately medial to the hernia sac? | A femoral hernia exits the abdominal cavity through the femoral ring to enter the femoral canal. The femoral ring is bounded medially by the lacunar ligament. Compression of the herniated intestine against the sharp edge of the lacunar ligament may cause strangulation of the intestine. The other borders of the femoral ring are the inguinal ligament anteriorly, the pubis posteriorly, and the femoral vein laterally.The femoral aery is within the femoral sheath along with the femoral hernia, but is lateral to the femoral vein, which separates the aery from the hernia. The femoral nerve is not inside of the femoral sheath, but is lateral to the sheath. The femoral vein is lateral to the femoral canal within the femoral sheath. Ref: Deveney K.E. (2010). Chapter 32. Hernias & Other Lesions of the Abdominal Wall. In G.M. Dohey (Ed), CURRENT Diagnosis & Treatment: Surgery, 13e. | 4,263 | medmcqa_train |
Vitamin D from the skin or diet is metabolized primarily in the liver to 25-hydroxyvitamine D3. What is the rate limiting enzyme in Vitamin D synthesis? | Vitamin D from the skin or diet is metabolized primarily in the liver to 25-hydroxyvitamine D3. 25D is the 'storage' form of vitamin D and is used to determine the vitamin D status of individuals. The last and rate limiting step in the synthesis of 'active' 1,25D is catalyzed by the mitochondrial enzyme 1 hydroxylase and is conventionally known to take place in kidneys. | 4,264 | medmcqa_train |
Features of Von Willebrand disease are - | Ans. is 'a' i.e., | BT and | PTT Von willebrand diseaseo Von willebrand disease is characterized by the deficiency of vWF, while the synthesis of factor VIIIc is normal,o vWF has two major function: -i) Helps in platelet adhesionii) Stabilizes factor VIIIc.o So, deficiency of vWF results in manifestation of both.Platelet adhesion defecto Bleeding from small venules and capillaries of skin and mucous membrane e.g., epistaxis.o Menorrhagia and GI bleeding,o Proioged bleeding time (TBT)Coagulation defect (due to factor VIII dysfunction)o Bleeding into weight bearing joints.o Large post traumatic ecchymoses or hematoma,o Prolonged bleeding after any form of surgical procedure or a laceration,o Prolonged PTT.o vWF can be assayed by restocetin agglutination test which measures the ability of restocetin to promote the interaction between vWF and platelet membrane glycoprotein Ib-IX.o Von willebrand disease is of follow ing types: -Type I (most common 70%) - Autosomal dominant, with reduced quantity of vWF.Type II (25%) - Autosomal dominant, with qualitative defect of vWF.Type III - Autosomal recessive, with reduced quantify of vWF.Hemophilia A & Hemophilia B|PTT Normal BT Normal PTVon-Willebrand disease| PTT |BT Normal PTPlatelet dysfunction| BTo Bemard-soulier syndrome o Glanzmann's thrombastheniaNormal PT & PTTo ITP Henoch Schonlein purpuraNormal BT, PT & PTT | 4,265 | medmcqa_train |
The design of choice for endodontic microsurgery is the: | The design of choice for endodontic microsurgery is the sulcular full-thickness flap
The mucogingival flap or Luebke-Ochsenbein flap is preffered for crowned anterior teeth for esthetic reasons. This flap which includes scalloped horizontal incision provides a guide for meticulous repositioning of the flap.
The first known record for endodontic flaps was by Partsch. He is credited with the Partsch incision or semilunar incision. It is a submarginal curved flap. There is limited surgical access, proor wound healing, and laximum disruption of the blood supply to the adjacent tissues. | 4,266 | medmcqa_train |
All of the following can cause DIC during pregnancy except: | Ans. is a, i.e. Diabetes mellitusDIC is a pathological condition associated with inappropriate activation of coagulation and fibrinolytic system. It is a secondary phenomenon resulting from an underlying disease state.Obstetric conditions associated with DIC:More commonLess common* Intrauterine fetal death* Chorioamnionitis* Amniotic fluid embolism* Pyelonephritis in pregnancy* Pre eclampsia- Eclampsia* H. mole* HELLP syndrome* Instillation of intraamniotic hypertonic saline* Placenta Abruption* Feto maternal bleed* Septic Abortion* Incompatible blood transfusion* Viremia -HIV, varicella, CMV hepatitis. COGDT p 997Pathogenesis: | 4,267 | medmcqa_train |
The mother of a newborn boy is alarmed that her baby regurgitates at every feeding. An endoscopic examination reveals that the child's esophagus is almost completely occluded. This finding represents an example of which of the following errors of morphogenesis? | Atresia refers to defects caused by the incomplete formation of a lumen. Many hollow organs originate as strands and cords of cells whose centers are programmed to die, thus forming a central cavity or lumen. Atresia of the esophagus is characterized by partial occlusion of the lumen, which was not fully established in embryogenesis. Dysplasia (choice C) is caused by abnormal organization of cells into tissues, which is a situation that results in abnormal histogenesis. Tuberous sclerosis is a striking example of dysplasia, in which the brain contains aggregates of normally developed cells arranged into grossly visible "tubers." Ectopia (choice E) is an anomaly in which an organ is outside its normal anatomic site.Diagnosis: Esophageal atresia | 4,268 | medmcqa_train |
Investigation of choice for pericardial effusion is | Transthoracic echocardiography (TTE) is usually the initial investigation of suspected pericardial disease. It is cheap and widely available and has high accuracy for detecting pericardial effusions and signs of tamponade. TTE is also helpful for guiding diagnostic or therapeutic pericardiocentesis. Restricted acoustic windows limit its evaluation of the entire pericardium; loculated collections, intrapericardial blood clot, and pericardial thickening may be difficult to assess.CT and MR are indicated when TTE is inconclusive or when loculated or hemorrhagic effusion or pericardial thickening is suspectedIOC for aoic dissection-- MRI IOC for pericardial effusion= M- mode ECHOIOC for valvular disease = 2 D - ECHO IOC FOR RADIOTHERAPY CAUSED FIBROSIS= BIOPSY(Grainger and Allison&;s diagnostic radiology 6th edition, page 240) | 4,269 | medmcqa_train |
True about hepatocelluar ca is - | Answer is 'a' i.e. Associated with HBV & HCV; 'b' i.e. Cirrhosis is a predisposing factor; 'c' i.e. Fibrolamellar variety is not associated with cirrhoris "All patterns of hepatocellular carcinomas have a strong propensity for invasion of vascular channels." - Robbins | 4,270 | medmcqa_train |
A patient is having thick, gray coating on the throat and tonsils, followed with fever, chills and swollen glands in the neck. Microscopic examination of nasopharyngeal or pharyngeal swab showed gram positive organism with a special stain. The constitutes of the stain are:- | Gram positive organism causing gray colored coating (pseudomembrane) is Corynebacterium diphtheriae . So the specific stain is Albe stain. Contents of Albe stain:-Stain A- glacial acetic acid, malachite green ,toluidine blueStain B- KI + I2 | 4,271 | medmcqa_train |
Which of the following is known as abdominal policeman? | In the early twentieth century, the British surgeon Rutherford Morison noted that the omentum tended to wall off areas of infection and limit the spread of intraperitoneal contamination. He termed the omentum the abdominal policeman. Ref: Schwaz's principle of surgery 9th edition, chapter 35. | 4,272 | medmcqa_train |
Hernia with highest rate of strangulation is? | Femoral hernia REF: Sabiston 18th ed chapter 44 The likelihood of strangulation and need for hospitalization also increase with aging. Strangulation, the most common serious complication of a hernia, occurs in only 1% to 3% of groin hernias and is more common at the extremes of life. Most strangulated hernias are indirect inguinal hernias; however, femoral hernias have the highest rate of strangulation (15%-20%) of all hernias, and for this reason, it is recommended that all femoral hernias be repaired at the time of discovery. | 4,273 | medmcqa_train |
A 63-year-old man with hearing loss in his left ear complains of a loss of taste and drooling from the left side of his mouth. A CT scan shows a tumor compressing the nerve entering the skull through which of the following openings? | The tumor is compressing the facial nerve, which runs through the internal acoustic meatus along with the vestibulocochlear nerve, which provides sense of taste to the anterior two thirds of the tongue via the chorda tympani and also mediates all of the facial muscles, except the muscles of mastication. The mandibular branch of the trigeminal nerve courses through the foramen ovale and mediates motor to the muscles of mastication and sensory to the lower third of the face. The maxillary branch of the trigeminal passes through the foramen rotundum and is sensory to the middle third of the face. The jugular foramen has the glossopharyngeal, vagus, and accessory nerves coursing through it. Finally, the superior orbital fissure has the ophthalmic branch of the trigeminal nerve coursing through it, along with the oculomotor, trochlear, and abducens nerves. | 4,274 | medmcqa_train |
Which of the following statements regarding ANB angle is false? | The ANB angle indicates the magnitude of the skeletal jaw discrepancy. The magnitude of the ANB angle, however, is influenced by two factors other than the anteroposterior difference in jaw position. One is the vertical height of the face. As the vertical distance between nasion and points A and B increases, the ANB angle will decrease. The second is that, if the anteroposterior position of nasion is abnormal, the size of the angle will be affected.
Ref: Contemporary orthodontics, William Proffit, 4th edition page 209 | 4,275 | medmcqa_train |
Cholinomimetic drugs can be used for the treatment of all the following conditions except. | Ans. (B) Bradycardia(Ref KDT 8th/e p114)Cholinomimetic drug will cause bradycardia as an adverse effect and thus cannot be used for its treatment. | 4,276 | medmcqa_train |
A 19 year old young girl with previous history of repeated pain over medial canthus and chronic use of nasal decongestants, presented with abrupt onset of fever with chills & rigor, diplopia on lateral gaze, moderate proptosis & chemosis. On examination optic disc is congested. Most likely diagnosis is: | Patient is suffering from cavernous venous thrombosis, as a complication of chronic ethmoidal sinusitis. The facial veins make clinically impoant connections with the cavernous sinus through the superior ophthalmic veins. Cavernous sinus thrombosis usually results from infections in the orbit, nasal sinuses, and superior pa of the face. Think Detail: Cavernous sinus: is located on the side of the body of sphenoid. The cavernous sinuses consist of extradural venous plexuses surrounded by a dural fold. Structures Within its cavity Internal carotid aery Abducent nerve Carotid sympathetic plexus Lateral wall Oculomotor nerve Trochlear nerve Opthalmic division of trigeminal nerve Maxillary division of trigeminal nerve Tributaries: Anteriorly Opthalmic veins (connects with the facial vein) Posteriorly Superior petrosal sinus (connects with transverse sinus) Inferior petrosal sinus (conncets with internal juglar vein) Medially Anterior and posterior intercavernos sinuses (connects the two cavernous sinuses) Superiorly Superficial middle cerebral vein (from latwral surface of the brain) Cerebrsl veins from inferior surface of brain Cavernous sinus thrombosis (CST) is a late complication of facial or paranasal sinus infection, resulting in thrombosis of the cavernous sinus and inflammation of its surrounding anatomic structures, including cranial nerves. Clinical features: Infection of the cavernous sinus is characterized by sepsis, orbital pain, chemosis, proptosis, and ophthalmoplegia. Cavernous sinus thrombosis results in paresis of cranial nerves III, IV, and VI and the opthalmic and maxillary divisions of the cranial nerve V. The diagnosis is based primarily on clinical data. CT and MR imaging can provide diagnostic information.Treatment is with broad spectrum antibiotics and should be staed early .This has high moality. Cavernous sinus syndrome: is characterized by multiple cranial neuropathies. The clinical presentation includes impairment of ocular motor nerves, Horner's syndrome, and sensory loss of the first or second divisions of the trigeminal nerve in various combinations. The pupil may be involved or spared or may appear spared with concomitant oculosympathetic and parasympathetic involvement. Ref: 1) Comprehensive opthalmology,by AK Khurana,4th Edition, Page 384-389; 2) Parsons ' Diseases of the Eye, 20th Edition, Page 456-459; | 4,277 | medmcqa_train |
Following sign is seen in which condition: | Ans. A. Medial medullary syndromeImage shows one sided deviation of tongue, i.e. paralysis of XIIth nervea. This occurs in Medial Medullary syndrome or Dejerine syndromeb. It occurs due to occlusion of anterior spinal arteryc. It is characterized by Ipsilateral XIIth nerve paralysis with contralateral hemiplegia. | 4,278 | medmcqa_train |
ESR in increased in - | Ans. is 'b' i.e., Multiple myelomaFactors affecting ESR 1. Plasmao RBCs carry a negative electric charge, whereas plasma carries a postive charge.o Any condition in plasma that increases its positive charge, increases rouleaux formation and increases ESR by lengthening stage I.o Following factors increase positive charge and ESR : -i) Fibrinogen ----> Any condition which increases fibrinogen level will increase ESR - e.g.,a) Infectionb) Inflammationc) TBii) Globulin --> Conditions which increases globulin level will increase ESR.a) Kala azarb) Multiple myelomac) Some lymphoproliferative disordersd) Rheumatic feveriii) Cholesterol --> Hypercholesterolemia increases ESR.o Any condition in plasma that decreases its positive charge, decreases rouleaux formation and decreases ESR.i) Albumin --> Hyperalbuminemia decreases ESR.ii) Decreased fibrinogen ---> In afibrinogenemia, ESR is zero.2. RBCso Increase in blood count as in polycythemia decreases ESR due to the jostling (or pushing one another) effect on the cells.o Anemia increases the ESR by opposite effect, there are two exceptions.i) Sickle cell anemiaii)Microcytic hypochromic anemia (iron deficiency, Thalassemia)o In last two types of anemia, ESR decreases because altered red cell shape prevents rouleux formation.3. Physiological variationso ESR is low in infancyo ESR is high at pubeyo ESR is greater in women than man.4. Ohterso ESR is decreased in congestive hea failureo ESR is increased in acute myocardial infarction. | 4,279 | medmcqa_train |
Signature fracture of skull is seen in - | Ans. is 'b' i.e., Depressed fracture | 4,280 | medmcqa_train |
Light entering the eye passes through which retinal layer first? | The most anterior layer of the retina, through which light passes first, is the retinal ganglion layer. Light then passes through the other cell layers of the retina until it reaches the photoreceptors in the posterior region of the retina. Visual processing/Phototransduction occurs in the opposite direction(Photoreceptors- ganglion cell layer) | 4,281 | medmcqa_train |
Paltauf's hemorrhages are seen in: AP 11; NEET 13 | Ans. Lungs | 4,282 | medmcqa_train |
Least common quadrant for breast carcinoma is | Most common quadrant for breast carcinoma upper outer quadrant. | 4,283 | medmcqa_train |
All of the following are features of mumps except _______ | *Mumps is an acute viral infection characterised by painful enlargement of the salivary glands,most commonly the parotid glands.It is caused by an RNA virus of the genus paramyxovirus in the family paramyxoviridae. *It follows an incubation period of 2-4 weeks. Complications include epididymoorchitis in adolescent boys or postpubeal men.Aseptic meningitis is seen in 1-10% patients with parotitis.The risk of encephalitis is between 0.02-0.3% cases.Other neurological manifestations include deafness,cerebellar ataxia,facial neuritis,transverse myelitis and guillain barre syndrome. Reference: Essential pediatrics,op ghai, 9 edition,pg no: 213 | 4,284 | medmcqa_train |
Which of the following does not changes in the old age: | C i.e. Hematocrit | 4,285 | medmcqa_train |
A 16-year-old male complains of nasal obstruction, nasal blockage, a mass is seen in the nasopharynx with minimal extension into sphenoid sinus. What is the stage of nasopharyngeal fibroma? | Ans. B. IB* Angiofibroma is the most common benign tumor of the nasopharynx.* It is typically seen in young adolescent males, i.e. occurs near puberty, hence called juvenile nasopharyngeal angiofibroma.Clinical features:* Recurrent episodes of profuse epistasis* Unilateral nasal obstruction* Nasal bones leading to broadening of nasal bridge* Red fleshy mass can be seen in the nasal cavityInvestigations* CECT: It is the golden test* Antral sign/Holman Miller sign seenStaging of angiofibromaRadkowski ClassificationsIALimited to nose and/or nasopharyngeal vault BExtension into 1 paranasal sinusIIAMinimal extension through sphenopalatine foramen into sphenopalatine/pterygomaxillary fossa BFills sphenopalatine fossa bowing the posterior wall of the maxillary antrum anteriorly or extending into the orbit via the inferior orbital fissure CExtends beyond sphenopalatine fossa into infratemporal fossaIIIAErosion of skull base--minimal intracranial extension BErosion of skull base--extensive intracranial extension with or without cavernous sinus invasionTreatment:* Surgical excision* Radiotherapy is indicated in stage III, when tumor has intracranial extension. | 4,286 | medmcqa_train |
Which antimalarial drug is known to cause neuropsy-chiatric adverse reaction? | Adverse effects :Mefloquine is bitter in taste; common reaction is dizziness, nausea, vomiting, diarrhoea, abdominal pain and sinus bradycardia. These are usually mild and largely dose related, but may be severe in some. Major concern has been a variety of neuropsychiatric reactions (disturbed sense of balance, ataxia, errors in operating machinery, strange dreams, anxiety, hallucinations, rarely convulsions) occurring in some recipients. These are dose related and subside in 1-3 weeks. Rare events are haematological, hepatic and cutaneous toxicity. Mefloquine appears to be safe during pregnancy, but should be avoided in 1st trimester unless absolutely essential. ESSENTIALS OF PHARMACOLOGY page no.824 | 4,287 | medmcqa_train |
The most sensitive indicator of environmental iodine deficiency is | Ans. d. Neonatal hypothyroidism | 4,288 | medmcqa_train |
Dementia is produced by deficiency of vitamin | (C) Thiamine # DEMENTIA is the progressive decline in cognitive function due to damage or disease in the brain beyond what might be expected from normal aging.> Although dementia is far more common in the geriatric population, it may occur in any stage of adulthood.> This age cutoff is by definition, as similar sets of symptoms due to organic brain dysfunction are given different names, such as developmental disorders, in populations younger than adulthood.> In dementia, affected areas in cognition may be memory, attention, language, and problem solving.> Especially in the later stages of the condition, affected persons may be disoriented in time (not knowing what day of the week, day of the month, or even what year it is), in place (not knowing where they are), and in person (not knowing who they are).> Symptoms of dementia can be classified as either reversible or irreversible depending upon the etiology of the disease. Less than 10 percent of cases of dementia are due to causes which may presently be reversed with treatment. | 4,289 | medmcqa_train |
Local anaesthetic injected directly into the tissue - | Ans. is 'a' i.e., Infiltration anaesthesia Infiltration anaesthesiao It is the injection of local anaesthetic directly into tissue without taking into consideration the course of cutaneous nerve.o It can be so superficial as to include only the skin, it also can include deeper structureso It is used for minor surgeries, e.g. incision & drainage, suturing etc.o Adrenaline can be used along with LA to prolong its duration of action and to prevent its systemic absorptiono However adrenaline containing solution should not be used into tissues supplied by endarteries, e.g. in fingers and toes, ear, nose, and penis because vasoconstriction may lead to gangrene.Conduction blockA. Field blocko Is produced by subcutaneous injection of a solution of local anaesthetic in order to anaesthetize the region distal to the injection.o For example, subcutaneous infiltration of the proximal portion of the volar surface of the forearm results in extensive area of cutaneous anaesthesia that starts 2 to 3 cm distal to the site of injection.B. Nerve blocko LA is injected around a peripheral nerve or a plexus. Examples are -Upper limb - brachial plexus and wrist blockHead & Neck - Stellate ganglion block, trigeminal nerve block.Thorax & abdomen - Interc4ostal nerve & celiac plexuso Note - Most common complication of brachial plexus block is pneumothorax. | 4,290 | medmcqa_train |
A 40 year old female patient complains of excessive bleeding. Patient gives a history of road traffic accident 5 hours ago and had a lacerated wound on lower back region. Blood grouping test reveals presence of antigen A and antigen B. This system for blood grouping consists of 3 major allelic genes which are located on: | → This system consists of 3 major allelic genes; those are A, B and O.
→ They are located on long arm of chromosome 9.
→ These genes control the synthesis of blood group antigens A and B.
→ Based on the presence or absence of antigen A and antigen B, blood is divided into 4 groups i.e A, B, AB and O. | 4,291 | medmcqa_train |
Fibrous pericardium in supplied by | Fibrous pericardium in supplied by phrenic Nerve. Visceral pericardium does not have somatic sensation. | 4,292 | medmcqa_train |
A 70-years-old retired military person with good previous medical record complains of bi-temporal headache which is decreased in lying down position. He states that he gets relief by giving pressure over bilateral temples. The patient also complains of loss of appetite with feeling feverish. Diagnosis is: | Ans. a. Chronic tension headache (Ref: Harrison 19/e p107t, p2587t, 2593-2594, 18/e p122, 2849)Tension-type Headache:Tension-type headache (TTH) is commonly used to describe a chronic head-pain syndrome characterized by bilateral tight, bandlike discomfortQ.Pain typically builds slowly, fluctuates in severity, and may persist more or less continuously for many daysQ.Headache maybe episodic or chronic (present >15 days per month)Q.A useful clinical approach is to diagnose TTH in patients whose headaches are completely without accompanying features such as nausea, vomiting, photophobia, phonophobia, osmophobia, throbbing, and aggravation with movementQ.Such an approach neatly separates migraineTemporal arteritis:Women account for 65% of casesMigraine:Pain often preceded by auraQFibromyalgia:Fibromyalgia (FM) is characterized by chronic widespread musculoskeletal pain and tenderness.Patients with FM have an increased prevalence of other syndromes associated with pain and fatigueQ.More common in womenQCommon Causes of HeadachePrimary HeadacheSecondary Headache* Tension-type (69%)* Migraine (16%)* Idiopathic stabbing (2%)* Exertional (1%)* Cluster (0.1%)* Systemic infection (63%)* Head injury (4%)* Vascular disorders (1%)* SAH (<1%)* Brain tumor (0.1%)Tension-Type Headache (TTH)Tension-type headache (TTH) is commonly used to describe a chronic head-pain syndrome characterized by bilateral tight, handlike discomfortQ.Pathophysiology:Pathophysiology is incompletely understoodQ.It seems likely that TTH is due to a primary disorder of CNS pain modulation alone, unlike migraine, which involves a more generalized disturbance of sensory modulation.Clinical Features:TTH: Chronic head-pain syndrome characterized by bilateral tight, bandlike discomfortQ.Pain typically builds slowly, fluctuates in severity, and may persist more or less continuously for many daysQ.Headache maybe episodic or chronic (present > 15 days per month)Q.A useful clinical approach is to diagnose TTH in patients whose headaches are completely without accompanying features such as nausea, vomiting, photophobia, phonophobia, osmophobia. throbbing, and aggravation with movementQ.Such an approach neatly separates migraine.Treatment: Tension-Type HeadacheAnalgesics (acetaminophen, aspirin, or NSAIDs).Behavioral approaches including relaxation can also be effective.Chronic TTH: Amitriptyline is the only proven treatmentQThere is no evidence for the efficacy of acupuncture.MigraineCluster Headache* LateralizedQ usually frontotemporal, can be generalized* All age groupsQ are affected* FemalesQ are affected more than males* Family history presentQPresentation:* Pain often preceded by auraQ* Builds up graduallyQ* May lasts for several hoursQ or longer* Usually throbbingQ but maybe dull* Onset is after awakeningQ and quietened by sleepQ* Lateralized, periorbitalQ or less commonly temporal* All ages >10 yearsQ with peak at 30-50 yrsQ* Male preponderanceQ (90%): Men affected 7-8 times more than females.* Hereditary factors usually absentQPresentation:* Pain (periodic attacks 1-2/day)* Begins without warningQ* Reaches crescendo within 5 minutesQ* Lasts for 45 minutesQAssociated symptoms:* Nausea, vomiting, diarrheaQ* Photophobia and visual disturbance in the form of photopsia and fortification spectraQ* Paraesthesia with tingling and numbnessQ* Other focal neurological symptoms such as clumsiness and weaknessQ.* Excruciating, deep, explosive pain but only rarely pulsatileQ* Commonly awakens patients from sleepQAssociated symptoms:* Homolateral lacrimationQ* Reddening of eyeQ* Nasal stuffinessQ* PtosisQ* NauseaQTemporal ArteritisAverage age of onset is 70 yearsQWomen account for 65% of cases.Typical presenting symptoms: Headache, polymyalgia rheumatica, jaw claudication, fever, and weight lossQ.Headache is the dominant symptom, often appears in association with malaise and muscle achesQ.Head pain maybe unilateral or bilateralQ and is located temporally in 50% of patients but may involve any and all aspects of the cranium.Pain usually appears gradually over a few hours before peak intensity is reached; occasionally, it is explosive in onset.The quality of pain is only seldom throbbing; it is almost invariably described as dull and boring, with superimposed episodic stabbing pains similar to the sharp pains that appear in migraine.Most patients can recognize that the origin of their head pain is superficial, external to the skull, rather than originating deep within the cranium (the pain site for migraineurs).Scalp tenderness is present, often to a marked degree; brushing the hair or resting the head on a pillow maybe impossible because of painQ.Headache is usually worse at night and often aggravated by exposure to coldQ.Additional findings may include reddened, tender nodules or red streaking of the skin overlying the temporal arteriesQ, and tenderness of the temporal or, less commonly, the occipital arteries.ESR is often, though not always, elevatedQ; a normal ESR does not exclude giant cell arteritis.A temporal artery biopsy followed by immediate treatment with prednisone 80 mg dailyQ for the first 4-6 weeks should be initiated when clinical suspicion is high.FibromyalgiaFibromyalgia (FM) is characterized by chronic widespread musculoskeletal pain and tenderness.Patients with FM have an increased prevalence of other syndromes associated with pain and fatigueQ.More common in womenQClinical Features:MC presenting complaint: "Pain all over."QPain is typically above and below the waist on both sides of the body and involves the axial skeletonQ (neck, back, or chest).Pain is poorly localized, difficult to ignore, severe in its intensity, and associated with a reduced functional capacity.QFibromyalgia classification criteriaHistory of chronic widespread pain > 3 monthsQ>11 of 18 tender pointsQNeuropsychological Symptoms: Fatigue, stiffness, sleep disturbance, cognitive dysfunction, anxiety, and depressionQ. | 4,293 | medmcqa_train |
In basal body temperature method, after the rise of temperature, the unsafe period lasts for :- | - In BBT, the rise of temperature signifies ovulation. - Since maximum survival of ovum post ovulation is 3 days, the unsafe period is 3 days post rise of body temperature. Other natural methods of contraception are: Calender method / feile period method/ safe period method/ rhythm method Cervical mucus method Symptothermic method Coitus interruptus Abstinence - most effective method | 4,294 | medmcqa_train |
Hypercalcemia is associated with all Except: | Answer is D (Celiac disease): Celiac disease is not a cause for hypercalcemia. Hyperparatlzyroidism, Sarcoidosis and Milk alkali syndrome, may all lead to hypercalcemia. | 4,295 | medmcqa_train |
Which is the best screening test to evaluate hearing in a neonate? | Otoacoustic emissions (OAEs) are objective, noninvasive, and rapid measures (typically less than 2 minutes) used to determine cochlear outer hair cell function. OAE testing is commonly used in newborn hearing screening because of its speed and noninvasive nature. It is also used in confirming pure-tone test results obtained from young children, in patients for whom a functional hearing loss is suspected, for audiometric configuration confirmation, for ototoxic drug monitoring, and in hearing aid candidacy. More recently, OAEs, in conjunction with ABR, can be used in identifying individuals with auditory neuropathy, also termed auditory dyssynchrony. Ref: Sweetow R.W., Sabes J.H. (2012). Chapter 45. Audiologic Testing. In A.K. Lalwani (Ed), CURRENT Diagnosis & Treatment in Otolaryngology--Head & Neck Surgery, 3e. | 4,296 | medmcqa_train |
A Toxic doses, zero order kinetics is seen in | Phenytoin follows nonlinear (or zero-order) kinetics at therapeutic concentrations, because the rate of metabolism is close to the maximum capacity of the enzymes involved Ref-KDT 6/e p31 | 4,297 | medmcqa_train |
The use of combined oral contraceptive pill is associated with an increased incidence of: | There is an overall reduction in the incidence of PID with OCPs but Chlamydial PID may increase. This is classically an indolent PID where the patient has no pain, no discharge. | 4,298 | medmcqa_train |
Post-moem staining' is distinguished from bruise by all except | Extravasation of blood into surroundings tissues is not possible in postpaum staining. Ref synopsis of forensic medicine laxminarayana 4e | 4,299 | medmcqa_train |
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