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All are true about Glomus body tumor except: (PGI May 2010) | Ans: D (Brain..) Chemodectomas (Glomus Body Tumors) Dewta 7th/720-22# These are uncommon group of neoplasms that may originate anywhere glomus bodies are found.# The lesions are rare before the age of 20, there is a female predominance in some series, and the lesions may occur in multiple sites in about 10% to 20% of cases, especially in families with a history of this tumor.# These tumors usually occur later in life, around age 60 or 70, but can appear at any age. www.livestrong.com/glomus- jugulare-tumor# Carotid body tumors are associated with conditions producing chronic hypoxia, such as high-altitude habitation.# The normal glomus bodies in the head and neck vary from 0.1 to 0.5 mm in diameter. Tumors arising in glomus bodies {i.e., chemodectomas or nonchromaffin paragangliomas) arise most often from the carotid and temporal bone glomus bodies, with rare reports of tumors arising in the orbit, nasopharynx, larynx, nasal cavity, paranasal sinuses, tongue, and jaw.# The temporal bone glomus bodies are not found consistently in any location. At least one half of the glomus bodies are found in the general region of the jugular fossa and are located in the adventitia of the superior bulb of the internal jugular vein. The remainings are distributed along the course of the nerve of Jacobson (a branch of cranial nerve X).# The carotid bodies are located in relation to the bifurcation of the common carotid.Orbit bodies are in relation to the ciliary nerve, and vagal bodies are adjacent to the ganglion nodosum of the vagus nerve.Pathology# Chemodectomas are histologically benign tumors resembling the parent tissue and consist of nests of epithelioid cells within stroma-containing, thin-walled blood vessels and nonmyelinated nerve fibers. The tumor mass is well circumscribed, but a true capsule is not seen.# The criterion of malignancy is based on the clinical progress of the disease rather than the histologic picture. Chemodectomas without cellular atypia may metastasize to regional nodes or to distant organ sites.Patterns of SpreadThese lesions usually grow slowly; it is usual to have a history of symptoms fora few years and occasionally for 20 years or longer.LymphaticLymphatic metastases occur in about 5% of carotid body tumors but are very rare for temporal bone tumors. An upper neck mass may be an inferior extension of a jugular fossa or vagal tumor rather than a lymph node metastasis.Distant MetastasesDistant metastases have been rarely reported for temporal bone tumors; carotid body tumors have a low risk for distan t metastases, probably in the range of 5% or less. | 4,300 | medmcqa_train |
The most common site of implantation in ectopic pregnancy is - | Ans-A Ampulla .The most common site of ectopic pregnancy is a fallopian tube (as if and in fallopian tube the most common site is Ampulla (55%).Sites of ectopic pregnancy in fallopian tube in decreasing order of frequency :AmpullaIsthmusInfundibulumInterstitial | 4,301 | medmcqa_train |
An epidemiologic study observes increased numbers of respiratory tract infections among children living in a community in which most families are at the poverty level. The infectious agents include Streptococcus pneumoniae, Haemophilus influenzae, and Klebsiella pneumoniae. Most of the children have had pneumonitis and rubeola infection. The study documents increased rates of keratomalacia, urinary tract calculi, and generalized papular dermatosis in these children as they reach adulthood. These children are most likely to have a deficiency of which of the following vitamins? | Vitamin A is important in maintaining epithelial surfaces. Deficiency of this vitamin can lead to squamous metaplasia of respiratory epithelium, predisposing to infection. Increased keratin buildup leads to follicular plugging and papular dermatosis. Desquamated keratinaceous debris in the urinary tract forms the nidus for stones. Ocular complications of vitamin A deficiency include xerophthalmia and corneal scarring, which can lead to blindness. Vitamin B1 (thiamine) deficiency causes problems such as Wernicke disease, neuropathy, and cardiomyopathy. Vitamin D deficiency in children causes rickets, characterized by bone deformities. Vitamin E deficiency occurs rarely; it causes neurologic symptoms related to degeneration of the axons in the posterior columns of the spinal cord. Vitamin K deficiency can result in a bleeding diathesis. | 4,302 | medmcqa_train |
Bullous impetigo is caused by ? | Ans. is 'b' i.e., Staphylococcus Impetigo Impetigo is a highly contagious, Gram-positive bacterial infection of superficial layer of epidermis. Impetigo occurs in Two forms : ? 1. Non - bullous impetigo (Impetigo contagiosa) It is the most common bacterial infection of children (occurs mainly in children in contrast to Bullous impetigo which occurs in infants). It is caused by both staphylococcus aureus and hemolytic group A streptococcus (Str. pyogens), though it is mostly caused by staph aureus. Most commonly occurs on face, i.e., around nose & mouth; and exposed pas, i.e., arms, legs. Presents erythematous macule/papule which changes into vesicle which soon ruptures with formation of crusting. Crust has characteristic features : - Honey-yellow colour in streptococcal impetigo. Waxy in staphylococcal impetigo. Lesion heal without scarring. Mucous membrane involvement is rare. Lymphadenopathy is common 2. Bullous impetigo It is caused by staphylococcus aureus most often phage type 71. It usually occurs in infants and manifests as vesicle that develop into bulla and later a pustule without any surrounding erythema. It mainly occurs on face. Mucous membrane may be involved (in contrast to impetigo contigiosa). Lymphadenopathy is rare. | 4,303 | medmcqa_train |
Which of the following are the objective tests of refraction ? | Ans. is 'd' i.e., All the above | 4,304 | medmcqa_train |
In substantia nigra, the major neurotransmitter is: | Ans. A. Dopaminergica. There is a system of dopaminergic neurons in nigrostriatal dopaminergic system with cell bodies in substantia nigra and axon endings in caudate nucleus.b. In Parkinson's disease there is loss of dopaminergic cells in the substantia nigrawhich leads to striatal dopamine depletion.c. As DOPAMINE activates excitatory D1 receptors in the direct pathway and represses inhibitory D2 receptors in the indirect pathway, this depletion leads to decreased activity of the direct pathway and increased activity of the indirect pathway | 4,305 | medmcqa_train |
Rh negative mother, ICT negative was given Anti D at 28 week of pregnancy. Which of the following is the follow up schedule? | Anti D in Rh negative women: Anti-D immune globulin is given prophylactically to all D negative, unsensitized women at approximately 28 weeks' gestation, and a second dose is given after delivery if the newborn is D-positive. There are various recommendations regarding a second dose after 6 weeks of the first injection (i.e. at 34 weeks) but it is not being practiced. Following delivery, anti-D immune globulin should be given within 72 hours. 40 percent of neonates born to D-negative women are also D negative,so Anti-D given only if newborn is confirmed to be D positive Post-natally, within 72 hours all women who deliver an Rh (D) positive baby should have quantification of feto-maternal haemorrhage to guide the appropriate dose of anti D prophylaxis If immune globulin is missed following delivery, it should be given as soon as the omission is recognized, because there may be some protection up to 28 days postpaum | 4,306 | medmcqa_train |
Which of the following pigments accumulates in liver in Dubin-Johnson syndrome? | Ans. b (Epinephrine metabolite) (Ref. Robbins Pathologic basis of disease 7th/ 887-888; Table 18-4)Dubin-Johnson syndrome# Hereditary defect in hepatocellular excretion of bilirubin glucuronides across the canalicular membrane due to absence of the canalicular protein, the multidrug resistance protein 2 (MRP2; located on chromosome 10q24), that isresponsible for transport of bilirubin glucuronides and related organic anions into bile.# The liver is darkly pigmented owing to coarse pigmented granules within the cytoplasm of hepatocytes.# Electron microscopy reveals that the pigment is located in lysosomes, and it appears to be composed of polymers of epinephrine metabolites., not bilirubin pigment.# The liver is otherwise normal.# Apart from chronic /recurrent jaundice (fluctuating intensity), patients are asymptomatic and have normal life span.OTHER HEREDITARY HYPERBILIRUBINEMIASCrigler-Najjar syndrome type I# The enzyme UGT1A1 is completely absent.6# The liver is incapable of synthesizing a functional enzyme, and the colorless bile contains only trace amounts of unconjugated bilirubin.# The liver is morphologically normal by light and electron microscopy.# However, serum unconjugated bilirubin reaches very high levels, producing severe jaundice and icterus.# Without liver transplantation, this condition is invariably fatal.Crigler-Najjar syndrome type II# It is a less severe, nonfatal disorder in which UGT1A1 enzyme activity is greatly reduced, and the enzyme is capable of forming only monoglucuronidated bilirubin.# Almost all patients develop normally and the only major consequence is extraordinarily yellow skin from high levels of circulating unconjugated bilirubin; but there is a risk of neurologic damage from kemicterus.# Phenobarbital improves bilirubin glucuronidation by inducing hypertrophy of hepatic endoplasmic reticulum.Gilbert syndrome# It is a relatively common, benign, somewhat heterogeneous inherited condition presenting with mild, fluctuating hyperbilirubinemia.# Main cause is reduction in hepatic bilirubin glucuronidating activity (UGT1A1) to about 30% of normal.# Gilbert syndrome has no clinical consequence except for the anxiety.Rotor syndrome# It is a rare form of asymptomatic conjugated hyperbilirubinemia with multiple defects in hepatocellular uptake and excretion of bilirubin pigments.# The liver is not pigmented.# As with Dubin-Johnson syndrome, patients with Rotor syndrome exhibit jaundice but otherwise live normal lives. | 4,307 | medmcqa_train |
Floor of 4th ventricle has ? | Floor of 4th ventricle (Rhomboid fossa) It is diamond or rhomboidal shaped and is formed by posterior surface of pons (upper triangular pa or pontine pa) and dorsal surface of medulla (lower triangular pa or medullary pa) junction of pons and medulla forms intermediate pa. Features of 4th ventricle are :? Median sulcus (a midline groove) divides the floor into two symmetrical halves. Medial eminence is present an each side of median sulcus. It presents facial colliculus formed by genu (recurving fibers) of facial nerve looping around abducent nucleus. Facial colliculus lies in pons (i.e. in pontine pa of floor). Hypoglossal triangle overlying hypoglossal nucleus and vagal triangle overlying dorsal nucleus of vagus. Both of these triangle lie in the medulla (medullary pa of floor). Vestibular area overlies vestibular nuclei, paly in pons and paly in medulla. Sulcus coeruleus, a bluish area due to presence of pigmented neurons containing substantia ferruginea. Superior and inferior ea. | 4,308 | medmcqa_train |
Visual acuity is a measure of: | Ans. Form sense | 4,309 | medmcqa_train |
Precancerous lesion of gall bladder is | Ans is 'a' ie Porcelain gall bladder "The calcified porcelain' gallbladder is associated with more than a 20% incidence of gallbladder carcinoma. These gallbladders should be removed, even if the patients are asymptomatic" - Schwartz SurgeryMirizzi SyndromeBiliary obstruction may occur in cases of acute cholecystitis, as a result of external compression of the CBD by a large stone impacted in the Hartman pouch and the associated intense pericholecystic inflammatory process; this is termed Mirizzi Syndrome. (Washington Manual of Surgery, 4/e, p 310) | 4,310 | medmcqa_train |
A 35 yr old male female singer presents with complains of hoarseness, vocal fatigue & pain in neck on prolonged phonation. Direct laryngoscopy shows bilateral pin head size swelling on Ant.1/3 & post 2/3 junction of vocal cord. What could be the probable diagnosis ? | Vocal nodule (singer's or screamer's node) Seen symmetrically on the free edge of vocal cord, at the junction of anterior one third, with the posterior two thirds (i.e. area of maximum vibration of cord). Vocal nodules are bilateral. Mostly seen in teachers, vendors, actors or pop singers as they speak in unnatural low tones or at high intensities for prolonged periods. symptoms include: hoarseness breathlessness a "rough" voice a "scratchy" voice a harsh-sounding voice shooting pain from ear to ear feeling like you have a "lump in your throat" neck pain less ability to change your pitch voice and body tiredness Vocal polyp is typically unilateral but arising from the same position as vocal nodule. Treatment Voice rest and speech therapy (Speech therapy re-education in voice production are essential in preventing recurrence) Microlaryngoscopic excision of nodules--Using microsurgical instruments or laser differential diagnosis is VOCAL CORD POLYP- Usually unilateral at the junction of anterior and middle third of vocal cord. caused by Voice abuse, chronic irritation like smoking Sudden shouting results in hemorrhage and submucosal edema. Treatment is Microlaryngeal excision. Acute laryngitis is a temporary condition caused by overusing the vocal cords. It can also be caused by an infection. Acute laryngitis may be caused by viral infections. Acute pharyngitis is inflammatin of the pharynx causing Pain or irritation in the throat that can occur with or without swallowing, often accompanies infections, such as a cold or flu. | 4,311 | medmcqa_train |
Lowest risk of malformations is seen with which of the following antiepileptic drug? | A metanalysis of 31 studies found lamotrigine and levetiracetam to carry the lowest risk of malformations(Ref: William's Obstetrics; 25th edition) | 4,312 | medmcqa_train |
Column concept of spine stability was given by - | REF : textbook of ohopedics, John ebnezer, 4th edition ,pg.no.311 Three column concept of spine stability was given by Denis *The anterior column consists of anterior half of the veebral body , anterior pa of the disk & anterior longitudinal ligament. * The middle column consists of posterior half of the body & the disk , posterior longitudinal ligament. *The posterior column consists of the posterior veebral arch consisting of transverse process , spinous process & the accompanying ligaments. One column injury is stable , 2 column injury is unstable - it is a dangerous spine for it may injure the spinal cord. | 4,313 | medmcqa_train |
Kernig's sign is seen in: September 2009 | Ans. B: Pyogenic Meningitis The main clinical signs that indicate meningism are nuchal rigidity, Kernig's sign and Brudzinski's signs. None of the signs are paicularly sensitive; in adults with meningitis, nuchal rigidity was present in 30% and Kernig's or Brudzinski's sign only in 5%. Nuchal rigidity is the inability to flex the head forward due to rigidity of the neck muscles; if flexion of the neck is painful but full range of motion is present, nuchal rigidity is absent. Kernig's sign is positive when the leg is fully bent in the hip and knee, and subsequent extension in the knee is painful (leading to resistance).This may indicate subarachnoid haemorrhage or meningitis.Patients may also show opisthotonus --spasm of the whole body that leads to legs and head being bent back and body bowed backwards. The most commonly used sign (Brudzinski's neck sign) is the appearance of involuntary lifting of the legs in meningeal irritation when lifting a patient's head off the examining couch, with the patient lying supine. | 4,314 | medmcqa_train |
In osteogenesis imperfecta the defect is in the: | Ans; a (Synthesis of type I collagen) Ref: Robbins, ed, p. 1279Osteogenesis imperfecta is due to deficiency in the synthesis of Type I collagen structures affected are - bone, joints,eyes, ear, skin and teethCytogenetic abnormality:Mutation in the genes that codes for a1, and a2 chains of collagen autosomal dominant inheritanceClinical features:All types are characterized by extreme skeletal fragilityOther features are blue sclera, hearing impairment,Dentiogenesis imperfecta, growth retardation etcREMEMBER:Type of osteogenesis imperfecta incompatable with life = type IIType of osteogenesis imperfecta with normal sclera = type IVBRIDGE:Van der hoeve's syndrome - AD osteogenesis imperfecta, blue sclera, hearing loss | 4,315 | medmcqa_train |
A 30 year old male patient was on Isoniazid therapy for Tuberculosis.He developed rashes on exposed pas of body.He has disoriented memory. Family members gives history of diarrhea also.What is the diagnosis? | Isoniazid inhibits the endogenous syntheisis of Niacin so,the patient developed dermatitis,diarrhea,dementia. Prolonged treatment with Isoniazid leads to Pyridoxine deficiency,which is required for endogenous synthesis of niacin Reference: Harpers illustrated biochemistry 30th edition | 4,316 | medmcqa_train |
Rokitansky Kuster Hauser syndrome is associated with: | Ans. is b, i.e. Absent fallopian tubeTo understand why distal part of fallopian tube is present:Mullerian ducts grow downward, therefore there will be cases where there will be well formed abdominal ostia associated with hypoplasia or absence of the remainder of the tubes, uterus and vagina or the tubes and uterus may be present and the vagina absent.As discussed, vaginal atresia means urogenital sinus fails to develop. Hence both vaginal atresia and mullerian agenesis are different."Typically, a portion of the distal fallopian tube are present". | 4,317 | medmcqa_train |
What is the most common cause of failure of radiotherapy for stage II cervical carcinoma? | In stage II cervical cancer, the incidence of nodal involvement is 25%-40%. Most tumors are not radioresistant, and distant metastasis (i.e., a more advanced stage) are a late complication of more advanced stages of the disease. | 4,318 | medmcqa_train |
A young male presented with dyspnea, bleeding and petechial hemorrhage in the chest after 2 days following fracture shaft of the femur right side. Most likely cause is: | Ans. (b) Fat embolism* Fat embolism usually manifests following Long bone fractures* MC after Closed fractures > Open fractures* MC in Young (more bone marrow) > Old* MC in Long bones (Femur) > Pelvis> Smaller bones* 90% will develop fat emboli after traumatic fracture but only 1-5% develop fat embolism syndrome* Also seen in other causes like- Pancreatitis, Fatty liver, Steroid therapy, Liposuction etc.* Fat embolism is a clinical diagnosis and not a Chemical diagnosis.* It manifests in 24-72 hours. Rare in < 24 hours and > 72 hours* Classic Triad- Hypoxemia + Petechial Rash + neurological abnormalities* Hypoxemia early finding, Petechial rash is late finding* Platelet count - Normal* Purtschers Retinopathy +* Lipiduria+* Treatment: Immobilization of fracture, Mechanical Ventilation, Steroids. | 4,319 | medmcqa_train |
A female with H/o oligohydramnios during her pregnancy, brings her newborn baby to OPD, on noticing asymmetric thigh folds in her child. The examiner performs flexion, IR and abduction, which produces a click sound. Which is the test done by the examiner? | Clinical Diagnosis - DDH based on the following 1. Abduction is limited (especially in flexion) 2. Asymmetric thigh folds Oolani's Test--the first two alphabets O and R (Oolani for Reduction) and for Reduction we do abduction of hip. It is similar to 2nd pa of Barlow's test McMurray circumduction test is used to evaluate individuals for tears in the meniscus of the knee | 4,320 | medmcqa_train |
Most desirable structure to anastomose with esophagus is: | Ans. (a) StomachRef Schackelford Page 256 7th edition* Best conduit for esophageal replacement-- Stomach* Best conduit for short segment replacement of esophagus-- Jejunum* Best conduit in cases of corrosive injury to stomach and esophagus-- Colon | 4,321 | medmcqa_train |
WHO recommended dose of misoprostol in the treatment of post partum hemorrhage is | Ans. (C) 800 mcg sublingual(Ref: WHO recommendations for prevention and treatment of PPH 2012)According to WHO 2012 recommendationsOxytocin is drug of choice for treatment and well as prevention of post partum hemorrhage.Alternatives are ergometrine, fixed dose combination of oxytocin and ergometrine and misoprostolMisoprostol is recommended as 600 microgram orally for prevention of PPH and 800 microgram sublingually for treatment of PPH.The use of tranexamic acid is recommended for the treatment of PPH if oxytocin and other uterotonics fail to stop bleeding or if it is thought that the bleeding may be partly due to trauma. | 4,322 | medmcqa_train |
Which of the following virus is from Herpes virus family? | A VIRINAE B VIRINAE VIRINAE Includes HSV 1 HSV 2 HHV 3 Affects Ganglionic cells Includes HHV 5 HHV 6 HHV 7 Affects salivary glands Includes HHV 4 HHV 8 Affects B cells HHV - 3 - varicella zoster HHV - 4 - EBV HHV - 5 - Cytomegalo virus HHV - 8 - Kaposi saroma causing virus HSV - 1 - Herpes simplex virus 1 HSV - 2 - Herpes simplex virus 2 | 4,323 | medmcqa_train |
False about PCOS | In PCOS, LH:FSH ratio is increased Shaw's Textbook of gynaecology,16th edition page no 432 | 4,324 | medmcqa_train |
A 30-year-old male on methotrexate 7.5 mg once daily for arthritis attends clinic for starting family. Wife takes no other medication apart from OCP. What should be the advice before conceiving? | Ans: A (Husband should stop methotrexate and wife should continue contraception for 3 months) Ref: Internet Source (e Therapeutic Guidelines Complete --Use of Anti-Rheumatic Drugs in Pregnancy) and Textbook of Management of Psoriasis by Nikhil YawalkarExplanation:Methotrexate interferes with the biosynthesis of purines via the enzyme dihydrofolate reductase.A teratogenic syndrome called Ami nopterin syndrome has been described in women being treated for malignancies on higher doses of methotrexate than used in rheumatoid arthritis i.e., higher than 10 to 25 mg per week.Am inopterin Syndromeo Skeletal abnormalities of skull and limbs,o Microcephaly; ando Facial dysmorphism.Animal studies show a widely varying species susceptibility to this drug.Several small studies of human use of methotrexate suggest increased risk of abnormality after exposure during a critical period from 8 to 10 weeks gestation. A safe contraception and ceasing methotrexate before conception are recommended.Contraception is essential in fertile women during treatment with methotrexate and for 3 months following its discontinuation due to its teratogenic properties and prolonged presence in tissues.The same duration of contraception (3 months} is also advisable in men as methotrexate reduces spermatogenesis. | 4,325 | medmcqa_train |
Which of the following is considered the MOST impoant risk factor for necrotizing enterocolitis? | Prematurity is the most impoant risk factor for necrotizing enterocolitis, although term infants also sometimes develop the condition. Clinical series have repoed that between 60 and 95% of affected babies are premature, and the incidence is markedly increased in babies born at lower gestational ages. Many other purpoed risk factors have also been cited but seem to have a lesser effect, including perinatal asphyxia, respiratory distress syndrome, umbilical catheterization, hypothermia, shock, patent ductus aeriosus, cyanotic congenital hea disease, polycythemia, thrombocytosis, anemia, exchange transfusion, congenital GI anomalies, chronic diarrhea, non-breast milk formula, nasojejunal feedings, hypeonic formula, and colonization with necrogenic bacteria. It may simply be that any already fragile baby, paicularly if premature, who has other significant underlying disease, is at increased risk for developing necrotizing enterocolitis. Ref: Thilo E.H., Rosenberg A.A. (2012). Chapter 2. The Newborn Infant. In W.W. Hay, Jr., M.J. Levin, R.R. Deterding, J.J. Ross, J.M. Sondheimer (Eds), CURRENT Diagnosis & Treatment: Pediatrics, 21e. | 4,326 | medmcqa_train |
After how many days of ovulation embryo implantation occurs ? | 7 - 9 days "From the time a feilized ovum enters the uterine cavity from the fallopian tube (which occurs 3-4 days after ovulation) until the time ovum implants (7-9 days after ovulation) the uterine secretions called uterinemilk provide nutrition for the early dividing ovum" "At the time of implantation, on days 21-22 of menstrual cycle the predominant morphologic feature is edema of the endometrial stroma." Impoant facts : Oogenesis begins in ovary at 6-8 weeks of gestation.deg Maximum number of oocytes (6-7 million) are attained at 20 weeks of gestation.deg All the primary oocytes in the ovary of a newborn are arrested In the late prophase (of meiosis) till pubey.deg At pubey as a result of mid cycle preovulatory surge, meiosis is resumed and compTetedjust prior to ovulation.deg Therefore first polar body is released just prior fo ovulation The second division stas immediately after_ it and is arrested in metaphase.deg At the time of feilization second division is completed which results in the release of oocyte and second polar body. Therefore second polar body release occurs only at the time of feilisation.deg LH surge preceedes ovulation by 34-36 hours.o LH peak preceedes ovulation by 10-16 hours.o Prior to ovulation :- Follicle reaches a size of 18-20mm. - Endometrium is 9-10 min trick.o - Endometrium show triple line on USG.o Ovulation occurs 14 days before the next menstruation.deg Maximum action of corpus luteum is at 22 day of menstruationdeg (following which it stas regressing ~ 8 years after ovulation).deg In absence of feilisation and implanation the corpus leteum persists for 12-14 days.o Maximum growth of corpus lutem of pregnancy is at 8th week of gestation and degenerates at 6 months of gestation.o Feilisation occurs in the ampullary pa of fallopian tube.deg Feilised egg enters the uterus on day 18 - 19 of the cycle.deg | 4,327 | medmcqa_train |
All of the following are clinical features of MEN-II EXCEPT: March 2004 | Ans. A i.e. Pituitary tumour Pituitary tumours are a pa of MEN-I/ Wermer syndrome | 4,328 | medmcqa_train |
Type of collagen present in cornea ? | Ans. is 'a' i.e., Type I | 4,329 | medmcqa_train |
Caplan's syndrome is | Rheumatoid Arthritis + Pneumoconiosis nodules = Caplan's syndrome.
Neutropenia + Splenomegaly + Nodular RA = Felty's syndrome. | 4,330 | medmcqa_train |
Profunda femoris aery at its origin lies on which side of the femoral aery ? | Ans. is 'b' i.e., LateralProfunda femoris aery arises from lateral side of femoral aery about 4 cm below the inguinal ligament. | 4,331 | medmcqa_train |
A patient treated for infeility with clomiphene citrate presents with sudden onset of abdominal pain and distension with ascites the probable cause is | Ovarian Hyperstimulation syndrome It is an iatrogenic complication of ovulation induction with exogenous gonadotropins and clomiphene-induced cycles Charecteristic feature of OHSS is an increase in capillary permeability resulting in fluid shift from intravascular to extravascular spaces Mechanism of Action Probably mediated by increased ovarian secretion of vasoactive substances including Vascular endothelial growth factor , elements of Renin-Angiotensin system and other cytokines Risk factors Young age, low body weight, PCOS, higher doses of gonadotropins and previous episodes of hyperstimulation Mild illness Charecterised by Ovarian enlargement, lower abdominal discomfo, mild nausea and vomiting, diarrhea and abdominal discomfo. Managed by outpatient basis with analgesics and bedrest; monitored by daily weight checkup, urinary frequency, clinical examination to detect ascites, lab tests of hematocrit, electrolytes and serum creatinine Serious illness Characterised by severe pain, rapid weight gain, tense ascites, hemodynamic instability, respiratory diffiulty, progressive oliguria leadng to renal failure, ovarian rupture and thromboembolic phenomenon Hospitalization and treated according to symptoms Ref: Clinical Gynecologic Endocrinology and Infeility; Eigth Edition; Chapter 31 | 4,332 | medmcqa_train |
A 42-year-old man presents with long-standing abdominal pain after meals, which is relieved by over-the-counter antacids. The patient has lost 9 kg (20 lb) in the past year. Physical examination reveals peripheral edema and ascites. Laboratory studies show decreased serum albumin but normal serum levels of transaminases and gastrin. Gross and microscopic examination of this patient's stomach would most likely show which of the following pathologic changes? | Menetrier disease /Hyperplastic hypersecretory gastropathy Mean age 30-60 years Rare disorder associated with excessive secretion of transforming growth factor (TGF)-a, which is an EGF receptor (EGFR) ligand, and hyperactivation of the epidermal growth factor receptor on gastric epithelial cells. Excessive EGFR activation causes diffuse hyperplasia of foveolar epithelium within the body and fundus Hypoproteinemia occurs to albumin loss across the gastric mucosa Secondary symptoms such as weight loss, diarrhea, and peripheral edema are commonly present Enlarged rugae are present in the body and fundus but the antrum is generally spared Risk of gastric adenocarcinoma is increased -Histology shows characteristic feature that is: Hyperplasia of surface and glandular mucous cells Marked intraepithelial lymphocytosis. Diffuse or patchy glandular atrophy The glands are elongated with a corkscrew-like appearance and cystic dilation present | 4,333 | medmcqa_train |
A middle-aged male comes to the outpatient depament (OPD) with the only complaint of hoarseness of voice for the past 2 years. He has been a chronic smoker for 30 years. On examination, a reddish area of mucosal irregularity overlying a poion of both cords was seen. Management would include all except: | The mentioned symptoms indicate that either it is pachydermia laryngitis or it can be early carcinoma: Both the conditions can be distinguished by biopsy only In either conditions: smoking is a causative factor and should be stopped. Regular follow up is a must in either of the conditions. Bilateral cordectomy is not required even if it is glottic cancer because early stages of glottic cancer are treated by radiotherapy. Management of pachydermia is microsurgical excision of hyperplastic epithelium (cordectomy has no role). | 4,334 | medmcqa_train |
Antibody found in patients of myaesthenia gravis is directed against | *myasthenia gravis is an autoimmune disease,most commonly caused by antibodies to acetylcholine receptors in the post junctional membrane of the neuromuscular junction ,which are found in around 80%of affected patients. Ref Harrison20th edition pg 2378 | 4,335 | medmcqa_train |
All are true foe annular pancreas except | upper GI series is not the investigation of choice.They are plain X-ray abdomen,ERCP and Radioscopic study , Barium meal. SRB,5th,712 | 4,336 | medmcqa_train |
Which of the following liver enzymes is predominantly mitochondrial? | In old literature, it was called as serum glutamate oxaloacetate transaminase (SGOT). AST needs pyridoxal phosphate (vitamin B6) as co-enzyme. Normal serum level of AST ranges from 8 to 20 U/L. It is a marker of liver injury and shows moderate to the drastic increase in parenchymal liver diseases like hepatitis and malignancies of the liver.Ref: DM Vasudevan, Page no: 269 | 4,337 | medmcqa_train |
The normal P wave is biphasic in lead | The normal P wave in lead V1 may be biphasic with a positive component reflecting right atrial depolarization, followed by a small (<1 mm2 ) negative component reflecting left atrial depolarization. Ref Harrison 20th edition pg 1455 | 4,338 | medmcqa_train |
Mycosis cells are altered : | A. i.e. T lymphacytis | 4,339 | medmcqa_train |
All of the following are indices to define obesity, EXCEPT: | Various indices used to detect obesity include: Corpulence index Quetlet's index/ Body mass index Ponderal index Broca index Lorentz's formula Ref: Park 21st edition, page 369. | 4,340 | medmcqa_train |
Surfactant appears in amniotic fluid at the gesta?tional age of : | Ans. is b i.e. 32 weeks Friends, I had to search a lot for this answer but all in vain. Only Nelson Paediatric throws some light on this issue : "Pulmonary surfactant is a heterogenous mixture of phospholipids and proteins secreted into the saccular or alveolar sub-phase by the type ll pneumocytes. Its presence is first recognised in characteristic secretory organelles known as lamellar bodies as early as the 24th week of gestation. However, surfactant lipids of which the most abundant is phosphatidyicholine, are not detectable in the amniotic fluid until the 30th week of gestation, suggesting that there is a chronologic gap between surfactant synthesis and secretion. Labour probably shoens this gap because phospholipids are consistently found in the air spaces of infants born before the 30th week of gestation." From the above lines it is clear : Surfactant synthesis occurs in 24th week of gestation, it appear in amniotic fluid in 30th week of gestation. Since 30 weeks is not given in options, I would personally go with 32 weeks, when surfactant will absolutely be detected in amniotic fluid, whereas at 28 weeks it can detected only if preterm labour occurs. | 4,341 | medmcqa_train |
For termination of pregnancy, consent is needed from | Pregnancy can only be terminated on the written consent of the woman. Husband's consent is not requiredPregnancy in a minor girl (below the age of 18 years) or lunatic cannot be terminated without written consent of the parents or legal guardianReference: Textbook of Obstetrics; Sheila Balakrishnan | 4,342 | medmcqa_train |
The usefulness of a 'screening test' in a community depends on its - | Screening refer to 'the search for unrecognized disease or defect by means of rapidly applied tests, examinations or other procedures in apparently healthy individuals'
For screening a disease the most important parameter is sensitivity
Sensitivity is defined as the ability of a test to identify correctly all those who have the disease i.e., true positives as it reflects the ability to detect those who have the disease amongst the hidden cases in the community.
For confirming a patient as diseased most important parameter is specificity
Specificity is defined as the ability of a test to identify correctly all these who do not have the disease i.e., true negative.
Memo: ELISA is a sensitive test for HIV: ELISA is used as screening test for HIV
Western blot is a specific test for HIV : Western blot is used as a confirmatory test for HIV.
Usefulness of a screening test is given by sensitivity
Statistical index of diagnostic accuracy → specificity | 4,343 | medmcqa_train |
The laryngeal mask airway used for securing the airway of a patient in all of the following conditions except: | D i.e. In a patient with large tumor of the oral cavity | 4,344 | medmcqa_train |
Ratio of lung weight to body weight is calculated in | Plocquet's test is one of the tests for live birth.
Before respiration: Ratio of lung weight to body weight is I/70.
After respiration: Ratio is 1/35. | 4,345 | medmcqa_train |
Which of the following is a false physical parameter during pregnancy? | On an average the non pregnant levels of blood fibrinogen is 260mg%. But in pregnancy it can reach an average value of 388 mg% (288 - 576 mg%) even then the clotting and bleeding times remains unchanged. Ref: Mudaliar and Menon's Clinical Obstetrics, 9th Edition, Page 41. | 4,346 | medmcqa_train |
Chocolate agar is ? | Ans. is 'c' i.e., Enriched medium | 4,347 | medmcqa_train |
Which of these is the characteristic feature of membranoproliferative glomerulonephritis- | Ans. is 'c' > 'd' ie splitting of glomerular basement membrane > sub endothelial deposits Both the features mentioned in the options d & c are present in membranoproliferative glomerulonephritis.Membranoproliferative glomerulonephritis is of 2 typesTYPE I characterized byDeposition of subendothelial* immune on complexes in the glomerular capillarySplit basement membrane (Double contour or tram track appearance)Type II Characterized by:Dense intramembranous* deposits electron microscopyRemember the only other condition where subendothelial deposits are seen is - SLE.Glomerular depositsSub epithelialDiffuse proliferative glomerulonephritis*Membranous glomerulopathy*.IntramembranousMembranoproliferative glomerulonephritis type II *Mesangial Focal segmental glomerulonephritis*Henoch Schonlein purpura * | 4,348 | medmcqa_train |
Main hormone acting upon uterus to initiate labor- | Ans-A i.e., Oxytocin Oxytocino Oxytocin is a nonapeptide,o It is secreted by the posterior pituitary along with vasopressin (ADH).o Both oxytocin and ADH are synthesized within the nerve cell bodies in the supraoptic and paraventricular nuclei of the hypothalamus; are transported down the axon and stored in the nerve endings within the neurohypophysis.o They are stored in separate neurons as complexes with their specific binding proteins (Neurophysin).o ActionsUterusIt increases the force and frequency of uterine contraction.Estrogens sensitize the uterus to oxytocin, while progestins decrease the sensitivity.The increased contractility is restricted to the fundus and body,, lower segment is not contracted, may even be relaxed at term.BreastOxytocin contracts myoepithelium of mammary alveoli and forces milk into bigger sinusoids - Milk ejection or milk letdown reflex.CVSHigher doses cause vasodilation - Brief fall in BP, reflex tachycardia, and flushing.The umbilical vessels are constricted oxytocin may help their closure at birth.KidneyOxytocin in high doses exerts ADH like action -->> water retention can occur. | 4,349 | medmcqa_train |
Non -sterile hypopyon is seen in - | In fungal ulcer, usually a big hypopyon is present even if the ulcer is small.Unlike the bacterial ulcer,the hypopyon may not be sterile as the fungi can penetrate into the anterior chamber without perforation. Reference:Comprehensive ophthalmology,AK Khurana,6th edition,page no.106 | 4,350 | medmcqa_train |
A highly specific inhibitor that targets the phosphorylation activity of TFIIH is added to an in vitro transcription reaction. Which one of the following steps is most likely to be affected? | Most likely to be affected by inhibitor that targets the phosphorylation activity of TFIIH is promoter clearance Transcription factor II H has two activities : Helicase Kinase -Unwinds the DNA -Phosphorylates the TFIIH- Promoter clearance. | 4,351 | medmcqa_train |
All of the following histopathological changes are seen in psoriasis except? | Dyskeratosis is premature &abnormal keratinization below the level of stratum corneum,seen in Bowen's disease,SCC,Dyskeratosis congenita. | 4,352 | medmcqa_train |
X-ray of a patient shows the following changes: Bulbous ends of long bones, normal appositional bone growth and there is failure of physiologic root resorption. Lab finding shows myelophthisic anemia. What can be the probable diagnosis? | OSTEOPETROSIS:
Roentgenographic features:
Medullary cavities are replaced by bone and the cortex is thickened.
Density of bone may be such that, the roots of the teeth are nearly invisible on dental roentgenogram.
Ends of long bones are bulbous called Erlenmeyer's flask deformity.
In osteopetrosis, there is normal appositional bone growth, but failure of physiologic root resorption.
On X-ray, bones might appear club-like or show an appearance of a bone within bone (Endobone). Vertebrae are extremely radiodense and may show alternating bands, known as the "rugger-jersey" sign.
Lab findings of Osteopetrosis:
Myelophthisic anemia (as bone marrow is replaced by bone).
Hypocalcemia (Shafer reports normal serum calcium, phosphorus and alkaline phosphatase levels).
Secondary hyperparathyroidism. | 4,353 | medmcqa_train |
A 70-year-old male has a pathologic fracture of femur. The lesion appears a lytic on X-rays film with a circumscribed punched out appearance. The curetting from fracture site is most likely to show which of the following? | Old patient along with lytic circumscribed punched out X-ray appearance suggests multiple myeloma Multiple myeloma most often presents as multifocal destructive bone tumors composed of plasma cells throughout the skeletal system. It shows sheets of atypical plasma cells. | 4,354 | medmcqa_train |
Not a common complication of hemithyroidectomy | As parathyroids on the opposite side are preserved and not dealt with during surgery hypoparathyroidism is not seen after hemithyroidectomy. | 4,355 | medmcqa_train |
Diet given to pregnant lady under ICDS is | In ICDS supplementary nutrition is given to children below 6 years, nursing and expectant mothers from low-income group.Each child 6-72 months of age get 500 Cal and 12-15Gm of proteinSeverely malnourished child 6-72 months of age get 800 Cal and 20-25Gm of proteinEach pregnant and nursing women to get 600 Cal and 18-20Gm of proteinPark 23e pg: 591 | 4,356 | medmcqa_train |
Pulpotomy is not indicated in- | If the patient is seen within an hour or two after the injury, if the vital exposure is small, and if sufficient crown remains to retain a temporary restoration to support the capping material and prevent the ingress of oral fluids, the treatment of choice is direct pulp capping.
If the pulp exposure in a traumatized, immature permanent (open apex) tooth is large, if even a small pulp exposure exists and the patient did not seek treatment until several hours or days after the injury, or if there is insufficient crown remaining to hold a temporary restoration, the immediate treatment of choice is a shallow pulpotomy or a conventional pulpotomy.
A shallow or partial pulpotomy is preferable if coronal pulp inflammation is not widespread and if a deeper access opening is not needed to help retain the coronal restoration.
Pulpotomy is also indicated for immature permanent teeth if necrotic pulp tissue is evident at the exposure site with inflammation of the underlying coronal tissue, but a conventional or cervical pulpotomy would be required.
Yet another indication is trauma to a more mature permanent (closed apex) tooth that has caused both a pulp exposure and a root fracture. In addition, a shallow pulpotomy may be the treatment of choice for a complicated fracture of a tooth with a closed apex when definitive treatment can be provided soon after the injury. | 4,357 | medmcqa_train |
The site at which 1,25-hydroxylation of Vitamin-D takes place in the kidneys is: | Proximal convoluted tubules | 4,358 | medmcqa_train |
Pharyngoconjunctival fever is caused by - | Pharyngoconjunctival fever is caused most commonly by serotypes 3 and 7, but serotypes 2, 4 and 14
also, have been documented as etiologic agents.
Ocular infections caused by Adenovirus -
i. Epidemic keratoconjunctivitis → Serotypes 8, 19, 37
ii. Follicular conjunctivitis → Serotypes 3,7
iii. Pharyngoconjunctival fever - Serotypes 3, 7
Adeno Virus
Non-enveloped, DNA (ds DNA) Virus
Has characteristic morphology consisting of an icosahedral shell composed of 20 equilateral triangular faces and 12 vertices → space vehicle appearance.
Human adenovirus grows only in tissue culture of human origins, such as human embryonic kidney, HeLa or HEP-2.
The cytopathic effect in tissue culture → cell rounding and aggregation into grape-like clusters.
Adenovirus has been used as a vector for gene therapy.
Adenovirus cause infections of the respiratory tract and eyes and less often of the intestine and urinary tract.
Most frequently affect infants and children
Clinical manifestations
□ Most common manifestation in children is an acute upper respiratory tract infection with prominent rhinitis.
□ Most common manifestation in an adult is ARDS | 4,359 | medmcqa_train |
Emergency contraceptive drugs are: | Postcoital (emergency) contraception : 1. Levonorgestrel 0.5 mg + ethinylestradiol 0.1mg taken as early as possible but within 72 hours of unprotected intercourse and repeated after 1 2 hours. Progesterone and estrogen combination can also be used in emergency contraception. 2. levonorgestrel 3. ulipristal 4. mifepristone (REF.Essentials of Pharmacology TD TRIPATHI 6th EDITION page no 310) | 4,360 | medmcqa_train |
The following are features of primary hyperladosteronism EXCEPT: March 2013 | Ans. D i.e. Hyperkalemia Conn's syndrome 3asic pathology: Hyperaldosteronism Features: - Hypeension, - Decreased K., - I-olyuria, - Poiydypsia and - Proximal myopathy | 4,361 | medmcqa_train |
Ring sequestrum causes: | Sequestrum is the dead bone separated out from the living bone by the granulation tissue. The factors responsible for bone death in chronic osteomyelitis are: raised intravascular pressure Vascular stasis and small vessel thrombosis periosteal stripping bacterial toxins Sequestrum is the hall mark of chronic osteomyelitis Ring sequestrum causes : Ring sequestrum * Amputation stump * Pin tract infection Cylindrical/pencil like Infants Green Pseudomonas osteomyelitis Black Amputation stump due to exposure of bone with air. | 4,362 | medmcqa_train |
Following represents fetal hypoxia except: | Normal fetal scalp pH ranges from 7.25 to 7.35.
Fetal hypoxia is indicated by ‘acidosis’ or fall in fetal scalp pH to values below normal (Not by increase).
It is used to corroborate the significance of fetal CTG (Cardiotocography).
Interpretation of Fetal Scalp blood sampling | 4,363 | medmcqa_train |
Which of the following is physiological uncoupler- | Ans. is 'a' i.e.* Thermogenin o Amongst the given options, a, b and c are uncouplers.o However, only thermogenin, among these three is a natural (physiological) uncouplex.Uncoupleso As the name suggests, these componds block the coupeling of oxidation with phosphorylation. These compounds allow the transfer of reducing equivalents in respiratory' chain but prevent the phosphorylation of ADP to ATPQ by uncoupling the linkage between ETC and phosphorylation. Thus the energy instead of being trapped by phosphorylation is dissipated as heat. Uncouplers may beNatural:- Thermogenin, thyroxineSynthetic :- 2, 4-dinitrophenol (2, 4-DNP), 2, 4-dinitrocresol (2, 4-DNC), and CCCP (chlorocarbonylcyanidephenvl hvdrazone).o Thermogenin is an uncoupler protein present in brown adipose tissue (brown fat0). It uncouples oxidation and phosphorylation by acting as a channel for IT ions so that hydrogen ion gradient cannot build up. Oxidation occuring in brown adipose tissue without generation of ATP results in production of heatQ . | 4,364 | medmcqa_train |
Most common mode of treatment for laryngomalacia is: | In most patients laryngomalacia is a self-limiting condition. Treatment of laryngomalacia is reassurance to the parents and early antibiotic therapy for upper respiratory tract infections. Tracheostomy is required only in severe respiratory obstruction. Surgical intervention (supraglottoplasty i.e. reduction of redundant laryngeal mucosa) is indicated for 10% of patients. Main indications for surgery are: Severe stridor Apnea Failure to thrive Pulmonary hypeension Cor pulmonale | 4,365 | medmcqa_train |
Sensory fiber with least conduction velocity:September. 2005 | Ans. A: C- fiberAlpha fibers are the thickest (fiber diameter of 12-20 micrometer) and fastest conduction velocity (of 70-120 mis) whereas C-fibers are the thinnest (fiber diameter of 0.3-1.2 micrometer) and slowest conduction velocity (of 0.5-2 m/s) | 4,366 | medmcqa_train |
Which of these structures appears radiopaque? | Radiopaque refers to that portion of the radiograph that appears light or white. Radiopaque structures are dense and absorb or resist the passage of the X-ray beam, E.g., Enamel, dentin and bone.
Nasal septum
On the panoramic radiograph, it appears as a vertical radiopaque partition that divides the nasal cavity.
Reference: Freny R Karjodkar Oral Radiology Principles and Interpretation 2nd edition page no 251 | 4,367 | medmcqa_train |
Coliform test is for - | Ans. is 'b' i.e., Water Contomination Bacteriological indicators of w ater contaminationo Presence of following organism indicate fecal contamination of water.Coliform : by all practical point of view it is assumed that all coliform are fecal in origin unless a non-fecal origin can be proved.Fecal streptococci or enterococci :They regularly occur in feces. Finding of fecal streptococci in water is regarded as important confirmatory evidence of recent fecal contamination water.Clostridium perfringens: They also regularly occur in feces. Presence of spore of Cl. perfringens and absence of coliform group indicate remote contamination of water. | 4,368 | medmcqa_train |
Seoli cell secrets | Androgen binding protein is a protein secreted by testicular Seoli cells along with inhibin and mullerian inhibiting substance. Androgen binding protein probably maintains a high concentration of androgen in the seminiferous tubules.Ref: Ganong&;s review of medical physiology; 24th edition; page no: 421 | 4,369 | medmcqa_train |
High plasma protein binding of a drug results in:- | * High plasma protein binding (PPB) of a drug decreases its distribution into tissue and thus lower the volume of distribution. * As only free drug can be metabolized or excreted, high PPB usually increases the duration of action. * With higher PPB, there is more chance of getting displaced by other drugs leading to more drug interactions. * Drugs with high plasma protein binding have lesser glomerular filteration as proteins cannot be filtered across the glomerulus. | 4,370 | medmcqa_train |
Earliest fetal anomaly to be detected by USG: March 2013 | Ans. C i.e. Anencephaly | 4,371 | medmcqa_train |
Treatment of depression with suicidal tendencies is? | ANSWER: (C) ECTREF: Kaplan synopsis 10th ed p. 557ECT is therapy of choice depression with:Suicidal tendencyPsychomotor retardationPsychotic and delusional features with somatic syndromeIntolerance , contraindication, refractory to drugs | 4,372 | medmcqa_train |
A 32 year old male presents with a laceration he sustained after stepping on broken glass at the beach. The examination reveals an 8cm cut on the medial plantar aspect of the left foot. Which peripheral nerve block is appropriate? | Posterior tibial nerve * The posterior tibial nerve innervates the sole of the foot. To perform a peroneal nerve block, 1 percent lidocaine is injected into the subcutaneous tissue lateral to the posterior tibial aery at the upper border of the medial malleolus. * None of the other nerves listed supply the plantar surface of the foot. The saphenous nerve provides sensation to the skin over the medial malleolus. The sural nerve supplies the lateral foot and fifth toe. * The superficial peroneal nerve innervates the dorsum of the foot and the other toes, except the adjacent sides of the first and second toes, which derive sensation from the deep peroneal nerve. | 4,373 | medmcqa_train |
Complication of positive pressure ventilation – | PEEP & CPAP can cause barotrauma which may result in pneumothorax, pneumoperitoneum, penumopericardium/ cardiac tamponade. | 4,374 | medmcqa_train |
The most common cause of conductive deafness in children is | SEROUS OTITIS MEDIA, SECRETORY OTITIS MEDIA, MUCOID OTITIS MEDIA, "GLUE EAR" This is an insidious condition characterized by accumulation of nonpurulent effusion in the middle ear cleft. The fluid is nearly sterile. The disease affects children of 5-8 years of age. Hearing loss. This is the presenting and sometimes the only symptom. It is insidious in onset and rarely exceeds 40 dB. Deafness may pass unnoticed by the parents and may be accidentally discovered during audiometric screening tests. Ref : Diseases of ENT by Dhingra 6th edition Pgno : 64 | 4,375 | medmcqa_train |
Drug of choice in absence seizure- | Ans. is 'd' i.e., Ethosuximide | 4,376 | medmcqa_train |
A young girl has had repeated infections with Candida albicans and respiratory viruses since the time she was 3 months old. As pa of the clinical evaluation of her immune status, her responses to routine immunization procedures should be tested. In this evaluation, the use of which of the following vaccines is contraindicated? | Recurrent severe infection is an indication for clinical evaluation of immune status. Live vaccines, including BCG attenuated from Mycobacterium tuberculosis, should not be used in the evaluation of a patient's immune competence because patients with severe immunodeficiencies may develop an overwhelming infection from the vaccine. For the same reason, oral (Sabin) polio vaccine is not advisable for use in such persons. Reference: Ananthanarayan and Paniker&;s Textbook of Microbiology Tenth edition | 4,377 | medmcqa_train |
Choanal atresia is due to the persistence of | Choanal atresia
Choana, also called posterior nares, is an opening in the posterior part of each nasal cavity, through which the nasal cavity communicates with nasopharynx.
Choanal atresia is a congenital anomaly characterized by closure of one or both posterior nasal cavies (i.e., choana). It is due to the persistence of bucconasal membrane.
Approximately 60- 70% of cases are unilateral and are more common on the right side.
Bilateral cases occur in 20-30% of patients and 50% of these patients are associated with other congenital anomaly, i.e.,
CHARGE syndrome
→ Coloboma, Heart defects, Choanal atresia, Retarded growth, Genitourinary abnormalies and Ear defects.
Diagnosis - Unilateral lesions go unnoticed until the child presents with persistent unilateral nasal discharge.
There is the absence of air bubbles in nasal discharge.
A simple test for unilateral choanal atresia is to have the child attempt nose blowing with opposite nostril occluded by external pressure.
Failure to detect any air movement is suspicious for complete obstruction.
Bilateral choanal atresia presents as respiratory distress in newborn and requires support immediately after birth. | 4,378 | medmcqa_train |
Cells seen at the function between two layers ofplacenta are? | Ans. is'a'i.e., Hofbauer cellHofbauer cells (HBCs) are placental macrophages that are present in the core of villus.Major cell type in placenta include syncytiotrophoblasts which line intervillous space and are in direct contact of maternal blood.Underlying stromal cells adjacent to fetal capillaries largely consisting off bro blasts and Hofbauer cells (fetal tissue macrophages) | 4,379 | medmcqa_train |
Mode of excretion of cyclophosphamide is - | Ans. is 'c' i.e., Kidney [Ref: style="font-size: 1.04761904761905em; font-family: Times New Roman, Times, serif; margin: 0 0 8pt 8px; text-indent: 0; text-align: left">o Cyclophosphomide is primarily metabolized (80%) and metabolites are excerted in urine.o 10 to 20% is excreted unchanged in urine and 4% is excreted in bile. | 4,380 | medmcqa_train |
HPV with low risk sexually transmitted types include | (A) 6 & 11# GENITAL INFECTIONS: Since cervical and female genital infection by specific HPV types is highly associated with cervical cancer, those types of HPV infection have received most of the attention from scientific studies.> HPV infections in that area are transmitted primarily via sexual activity.> Of the 120 known human papillomaviruses, 51 species and three subtypes infect the genital mucosa. 15 are classified as high-risk types (16, 18, 31,33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73, and 82) 3 as probable high-risk (26, 53, and 66) 12 as low-risk (6, 11,40, 42, 43, 44, 54, 61, 70, 72, 81, and CP6108).> If a college woman has at least one different partner per year for four years, the probability that she will leave college with an HPV infection is greater than 85%.> Condoms do not completely protect from the virus because the areas around the genitals including the inner thigh area are not covered, thus exposing these areas to the infected person's skin. | 4,381 | medmcqa_train |
Infection by which virus gives rise to the following skin lesions? | c Varicella zoster virusSimultaneous presence of various types of skin lesions including macules, papules & vesicles are suggestive of Chicken Pox', caused by Varicella zoster virus | 4,382 | medmcqa_train |
Action of Antidote of heparin (Protamine) is based on: | Chemical antagonism | 4,383 | medmcqa_train |
Breast milk storage in a refrigerator is upto ? | Ans. is 'd' i.e., 24 hrs Breast milk o Can be stored at room temperature --> For 8-10 hours o In a refrigerator --> For 24 hours o In a freezer --> -20degc for 3 months | 4,384 | medmcqa_train |
Currarino triad includes: | Currarino triadorASP triad: - Anorectal malformation or congenital anorectal stenosis - Sacrococcygeal osseous defect (always present) - Classically, hemisacrum with intact first sacral veebra ("sickle-shaped sacrum") - Mild (hypoplasia) to severe (agenesis) of sacrum and coccyx - Presacral mass (various types) - Anterior sacral meningocele - Tumor, e.g. mature teratoma - Dermoid/epidermoid cyst | 4,385 | medmcqa_train |
The International Neuroblastoma Staging System (INSS) stage 4S includes metastasis to all the following except | INSS stage 4S refers to neuroblastoma in children younger than 1 yr of age with dissemination to liver, skin, and/or bone marrow without bone involvement and with a primary tumor that would otherwise be staged as INSS stage 1 or 2. Reference: Nelson; Neuroblastoma; Page no: 2463 | 4,386 | medmcqa_train |
Anuria is defined passing Less than _____ ml urine/day | Anuria <100ml.
Oliguria < 400ml. | 4,387 | medmcqa_train |
At the superficial inguinal canal increased abdominal pressure leads to closure by approximation of crura in the opening. This defect is seen in an aponeurosis formed by which of the following muscles? | Ans. is'b'i.e., External oblique(Ref: BDC &/e Vol. II p. 212, 213; Ramesh Babu p. 219)Examinar is asking about superficial inguinal ring which is triangular defect in external oblique aponeurosis.Superficial inguinal ring is an anatomical structure in the anterior abdominal wall. It is a triangular shaped defect in the aponeurosis of external oblique muscle | 4,388 | medmcqa_train |
Heller's myotomy is done for: September 2007, 2009, 2010 | Ans. C: Achalasia cardia Achalasia is associated with loss of ganglion cells in the esophageal myenteric plexus. These impoant inhibitory neurons induce LES relaxation and coordinate proximal-to-distal peristaltic contraction of the esophagus Achalasia is an esophageal motor disorder characterized by increased lower esophageal sphincter (LES) pressure, diminished-to-absent peristalsis in the distal poion of the esophagus composed of smooth muscle, and lack of a coordinated LES relaxation in response to swallowing. Barium radiology may show 'bird's beak' appearance. Esophageal (Heller) myotomy is a surgical procedure that is performed with minimally invasive techniques. The laparoscopic approach appears to be most appropriate. | 4,389 | medmcqa_train |
Which of following anatomical information may assist you during post-partum tubal sterilization. | Round ligament originates below and anterior to origin of fallopian tube. | 4,390 | medmcqa_train |
Features of alcoholic liver disease - | Ans. is AllPathology of alcoholic liver diseaseSteatosis (fatty liver)o Microvesicular fatty change o Later changes to macrovesicular fatty changeAlcoholic hepatitiso Hepatocellular necrosis o Ballooning degeneration o Mallory bodieso Neutrophilic infiltration Perivenular and perisinusoidol fibrosis --*central hyaline sclerosisAlcoholic cirrhosiso Nodularity o Fibrosis | 4,391 | medmcqa_train |
Which of the following is the commonest tumour of thyroid - | Ans. is 'c' i.e., Papillary 'Papillary carcinoma accounts for 80% of all thyroid malignancies in iodine-sufficient areas and is the predominant thyroid cancer in children and individuals exposed to external radiation." - SchwartzIncidence of primary malignant tumors of thyroid gland (Harrison 17/e)Type of thyroid carcinomaApproximate PrevalencePapillary Carcinoma80-90%Follicular Carcinoma5-10%Medullary Carcinoma10%Anaplastic CarcinomaRareLymphomas1-2%* Also rememberThyroid carcinoma is the most common malignancy of the endocrine system (Ref: Harrison, 17/e, p 2243) | 4,392 | medmcqa_train |
SVC syndrome is most commonly associated with: | If the superior or inferior vena cava is obstructed, the venous blood causes distention of the veins running from the anterior chest wall to the thigh.The lateral thoracic vein anastomoses with the superficial epigastric vein, a tributary of the great saphenous vein of the leg. In these circumstances, a touous varicose vein may extend from the axilla to the lower abdomenThe most common cause of superior vena cava syndrome is cancer.Primary or metastatic cancer in the upper lobe of the right lung can compress the superior vena cava.Lymphoma or other tumors located in the mediastinum can also cause compression of the superior vena cava.Less often, the superior vena cava can become blocked with a blood clot from within.Invasive medical procedures (Blood clot (thrombus) formation that causes superior vena cava syndrome is a complication of pacemaker wires, dialysis, and other intravenous catheters that are threaded into the superior vena cava)Infection (syphilis and tuberculosis) is another cause of superior vena cava syndrome. Sarcoidosis (a disease that results in masses of inflamed tissue) may also cause this syndrome. | 4,393 | medmcqa_train |
There is a pressure sore extending into the subcutaneous tissue but underlying structures are not involved. Stage of the pressure sore is | Stage 1Non-blanchable erythema without a breach in theepidermisStage 2Paial-thickness skin loss involving the epidermis and dermisStage 3Full-thickness skin loss extending into the subcutaneous tissue but not through underlying fasciaStage 4Full-thickness skin loss through fascia with extensive tissue destruction, maybe involving muscle, bone, tendon or joint Bailey and Love 27e pg: 29 | 4,394 | medmcqa_train |
The fluidity of the plasma membrane is increased by | Cholesterol maintains the fluidity of the membrane. Cholesterol acts as a buffer to modify the fluidity of membranes. A lipid bilayer made up of only one type of phospholipid changes from a liquid state to a rigid crystalline state (gel state) at a characteristic freezing point. This change in state is known as a phase transition, and the temperature at which it occurs is called the phase transition temperature (Tm). The Tm is higher (fluidity is low) when the constituent fatty acid chains are long and mostly saturated (without double bonds). Long chains have greater interactions among themselves, making the membrane stiffer. Saturated fatty acids have straight tails, whereas unsaturated fatty acids have kinked tails. As more kinks are inseed in the tails, the membrane becomes less tightly packed, and therefore its fluidity increases. . | 4,395 | medmcqa_train |
In transverse lie, the presentation is: | Transverse lie The long axes of the fetal and maternal ovoid are approximately at right angles to each other and the shoulder is presenting at pelvic inlet.The baby may be directly across the mother&;s abdomen,when it is a transverse lie,or obliquely across with the head or breech in one iliac fossa ,when it is an oblique lie (refer pgno:383 sheila textbook of obstetrics 2 nd edition) | 4,396 | medmcqa_train |
Infection of CNS spreads to inner ear through | The scala tympani is closed by a secondary tympanic membrane. It is also connected with subarachnoid space through aqueduct of cochlea Reference: Dhingra 6th edition. | 4,397 | medmcqa_train |
Resting membrane potential of a neuron is | In neurons, the resting membrane potential is usually about - 70mV, which is close to the equilibrium potential for K+. Because there are more open K+channels than Na+ channels at rest Ref: Ganong&;s Review of medical physiology;25th edition; pg: 90 | 4,398 | medmcqa_train |
All of the following are true about Cholesterol Ester Transfer Protein(CETP) , EXCEPT: | Cholesterol ester transfer protein (CETP): Facilitates the transfer of cholesterol ester from HDL to VLDL, IDL and LDL in exchange for triacylglycerol. Relieves the product inhibition of the LCAT enzyme. | 4,399 | medmcqa_train |
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