query
stringlengths 1
1.57k
| pos
stringlengths 1
22.5k
| idx
int64 0
161k
| task_name
stringclasses 1
value |
---|---|---|---|
A 27 year old man develops bilateral parotid gland swelling and orchitis, and is generally ill with fever of 102deg F. Which of the following substances is most likely to be significantly elevated in the patient's serum? | The disease is mumps, caused by a paramyxovirus. In children, mumps causes a transient inflammation of the parotid glands, and less commonly, the testes, pancreas, or central nervous system. Mumps tends to be a more severe disease in adults than in children. Mumps in adults involves the testes (causing orchitis) and pancreas with some frequency. Pancreatic involvement can cause elevation of serum amylase.. ALT and AST are markers for hepatocellular damage. Ceruloplasmin is a copper-carrying protein that is decreased in Wilson's disease. Ref: Ray C.G., Ryan K.J. (2010). Chapter 10. Mumps Virus, Measles, Rubella, and Other Childhood Exanthems. In C.G. Ray, K.J. Ryan (Eds), Sherris Medical Microbiology, 5e. | 4,400 | medmcqa_train |
The MR imaging in multiple sclerosis will show lesions in: | A i.e. White matter | 4,401 | medmcqa_train |
Duroziez's sign is seen in | Ref Harrison 19 th ed pg 1536 booming "pistol-shot" sound can be heard over the femoral aeries (Traube's sign), and a to-and-fro murmur (Duroziez's sign) is audible if the femoral aery is lightly compressed with a stethoscope. | 4,402 | medmcqa_train |
Not a sign of blunt trauma? | Rings of Trauma: Hidden signs of Blunt trauma 1.Central Iris: Sphincter Tear 2.Peripheral Iris: Iridodialysis 3.Anterior Ciliary body: Angle recession 4.Separation of ciliary body from scleral spur: Cyclodialysis 5.Trabecular Meshwork: Trabecular Meshwork tear 6.Zonule/ lens: Zonular tear with possible lens subluxation 7.Retinal Dialysis: Separation of Retina with Ora Serrata | 4,403 | medmcqa_train |
Following constitute dietary fibres except : | D i.e. Riboflavin | 4,404 | medmcqa_train |
A patch test is what type of hypersensitivity? | HYPERSENSITIVITY REACTIONS | 4,405 | medmcqa_train |
Ganglion of tendons is an example of - | Ganglion
A ganglion is a small cyst located near a joint capsule or tendon sheath. A common location is around the joints of the wrist where it appears as a firm, fluctuant, pea-sized, translucent nodule. It arises as a result of cystic or myxoid degeneration of connective tissue; hence the cyst wall lacks a true cell lining. The fluid in the cyst is similar to the synovial fluid; However, there is no communication with the joint space. | 4,406 | medmcqa_train |
Epidemiological Web of Causation theory was given by | The 'web of causation' considers all the predisposing factors of any type and their complex interrelationship with each other. Ref: 25th edition, Park's Textbook of Preventive and Social Medicine, Page no. 41 | 4,407 | medmcqa_train |
A 57 year old male suffering from acute pancreatitis develops sudden onset breathlessness with a CVP< 18mmHg. The chest xray shows bilateral infiltrates. The possible diagnosis is - | Ans. is 'a' i.e., ARDS ARDS Criteria 1. Acute, meaning onset over 1 week or less. 2. Bilateral opacities consistent with pulmonary edema must be present and may be detected on CT or chest radiograph. 3. PF ratio < 300 mmHg with a minimum of 5 cmH20 PEEP (or CPAP). 4. C VP < 18 mmHg. X-Ray showing bilateral infiltrates: | 4,408 | medmcqa_train |
Action potential is produce by | (A) Sodium Influx # Action potential is due to opening of Na+ channels causing "Na+ influx"> As the membrane potential is increased, sodium ion channels open, allowing the entry of sodium ions into the cell. This is followed by the opening of potassium ion channels that permit the exit of potassium ions from the cell.> Inward flow of sodium ions increases the concentration of positively-charged cations in the cell and causes depolarization, where the potential of the cell is higher than the cell's resting potential.> Sodium channels close at the peak of the action potential, while potassium continues to leave the cell.> Efflux of potassium ions decreases the membrane potential or hyperpolarizes the cell.> For small voltage increases from rest, the potassium current exceeds the sodium current and the voltage returns to its normal resting value, typically -70 mV.> However, if the voltage increases past a critical threshold, typically 15 mV higher than the resting value, the sodium current dominates.> This results in a runaway condition whereby the positive feedback from the sodium current activates even more sodium channels. Thus, the cell "fires," producing an action potential | 4,409 | medmcqa_train |
Therapeutic drug monitoring is required for: March 2010 | Ans. D: Gentamycin | 4,410 | medmcqa_train |
Binswanger&;s disease is a form of | Binswanger's disease, also known as subcoical leukoencephalopathy and subcoical aeriosclerotic encephalopathy (SAE), is a form of small vessel vascular dementia caused by damage to the white brain matter. White matter atrophy can be caused by many circumstances including chronic hypeension as well as old age. | 4,411 | medmcqa_train |
Crippling fluorosis occurs at what level ? | Ans. is 'd' i.e., 10 mg/liter Crippling fluorosis This occurs at fluoride level > 10 mg/litre (PPM). Patient is crippled and bed ridden. | 4,412 | medmcqa_train |
Lineage specific T Cell marker is | CD 3 is considered as lineage specific for Tcells. | 4,413 | medmcqa_train |
Oesophageal manometry is used in: | Ans. (d) Achalasia CardiaRef Bailey and Love 26th edition Page 1015* Manometry is the investigation to study the physiology of the functions of esophagus.* It is the investigation of choice to detect the motility disorders like achalasia cardia, DES, nut cracker esophagus.* Barrett IOC: Endoscopic biopsy* Cancer Esophagus IOC: Endoscopic biopsy* Zenker IOC: Barium swallow | 4,414 | medmcqa_train |
Syndrome associated with anosmia is: | The most well-known type of congenital anosmia is Kallmann syndrome, an X-linked disorder. Caused by mutation in the KAL gene, Kallmann syndrome is characterized by hypogonadotropic hypogonadism, which results when olfactory receptor neurons and neurons synthesizing gonadotropin-releasing hormone fail to migrate from the olfactory placode. | 4,415 | medmcqa_train |
Anesthetic agent contraindicated in acute intermittent porphyria is? | Ans. is 'd' i.e., Thiopentone Anesthetics in porphyriaSafeUnsafe (should not be used)* Propofol* Benzodiazepines* Opioids (other than pentazocine)- morphine, codeine, pethidine, fentanyl, alfentanyl, naloxone* Lidocaine, Bupivacaine* Muscle relaxants* Neostagmine, atropine, glycopyrrolate* Aspirin, indomethacin, naproxen* Halothane, N2O, isoflurane* Barbiturate (thiopentone)* Etomidate* Pentazocine* Ropivacaine | 4,416 | medmcqa_train |
Anterior scalloping of veabrae seen in - | Ans is option 2... Aoic aneurysm Anterior scalloping is seen in following conditions Aoic aneurysm, tuberculous spondylosis, lymphadenopathy, delayed motor development (in downs syndrome) Posterior scalloping is seen in Tumors in spinal canal (ependymoma, lipoma,, neurofibroma), neurofibromatosis, acromegally, achondroplasia, congenital syndromes like Ehler-Danlos, Marfans, Hurlers etc Ref Chapman 3/e p 88,89 | 4,417 | medmcqa_train |
Reversible dementia is seen in all EXCEPT: | Ans. (b) Alzheimer'sRef: Harrison's 18th ed. 3300-07* Alzheimer's disease is most common cause of irreversible dementia.Reversible vs Irreversible dementiaReversibleIrreversibleVitamin deficiency# B1-Wernicke's# B12-SCID# Nicotinic acid- PellagraAlzheimer'sEndocrine (hypothyroidism, adrenal insufficiency, cushing's)Vascular dementia (multi- infarct)Head trauma and diffuse brain damageHaemorrh age- subdural, epidural,Normal pressure hydrocephalusLeucoencephalopathyPrimary metastatic brain tumorMetabolic disorder (wilson's disease, Leigh disease, Leucodystrophy)Toxic dementia (MCC of reversible dementia)Degenerative disorder (parkinsonism, Pick's disease, Prion's disease, multiple sclerosis, hunting ton's disease, diffuse lewy body dementia) | 4,418 | medmcqa_train |
Which sign is seen due to thrombosis of mastoid emissary veins? | Ans. is'b'i.e., Gresinger sign (Ref Dhingra 5th/e p. 95) Griesinger's sign: - Edema over the posterior pa of mastoid due to thrombosis of mastoid emissary veins. | 4,419 | medmcqa_train |
What is incidence of emergence delirium after ketamine anaesthesia- | The observed incidence of emergence delirium after ketamine ranges from 5% to 30 %. | 4,420 | medmcqa_train |
This drug has activity against many strains of P. aeruginosa. However, when it is used alone, resistance has emerged during the course of treatment. The drug should not be used in penicillin-allergic patients. Its activity against gram-negative rods is enhanced if it is given in combination with tazobactam. Which of the following drugs is being described? | Antipseudomonal penicillins: Piperacillin and Ticarcillin are called antipseudomonal penicillins because of their activity against Pseudomonas aeruginosa. Piperacillin and Ticarcillin are effective against many gram-negative bacilli But not against Klebsiella because of its constitutive penicillinase. Formulation of ticarcillin or piperacillin with clavulanic acid or tazobactam, respectively, extends the antimicrobial spectrum of these antibiotics to include penicillinase-producing organisms. | 4,421 | medmcqa_train |
TESPAL done in - | Ans. is'a' i.e., Severe epistaxisManagement of intractable spontaneous epistaxis.TESPAL - transnasal endoscopic sphenopalatine aery ligationIndication:Epistaxis not responding to conventional conservative management.Posterior epistaxis | 4,422 | medmcqa_train |
The mean of the 25 patients' plasma volumes is 12.5 litres. Standard detion is 0.25. Calculate standard error | S.E = S/[?]n S = Standard detion = 0.25 n = sample size = 25 S.E. = 0.25/[?] 25 = 0.25/5 = 0.05 | 4,423 | medmcqa_train |
Best gas used for creating pneumoperitonium at laparoscopy is : | CO2 CO, is the gas used to create pneumoperitoneum during laparoscopy. Other option is - N20 : But it is expensive, less soluble in blood and suppos combustion. Also know : Instrument used for creating pneumoperitoneum is veress needle. Flow Rate of CO, for creating pneumoperitoneum 200 - 2000 ml/min & pressure between 15 - 25 mm of Hg. | 4,424 | medmcqa_train |
Which of the following drug is contraindicated in a patient of myasthenia gravis: September 2008 | Ans. B: Tubocurare Drugs contra-indicated in myasthenia gravis Absolute contraindication: - Curare - D-penicillamine Botulinum toxin - Interferon alpha Contraindicated -- Antibiotics -- aminoglycosides (gentamycin, kanamycin, neomycin, streptomycin, tobramycine); macrolides (erythromycin, azithromycin, telithromycin,) Fluoroquinolones (ciprofloxacin, norfloxacin, levofloxacin); -- Quinine, quinidine, procainamide, -- Magnesium salts, iv magnesium replacement. Caution- may exacerbate weakness in some myasthenics - Calcium channel blockers - Beta blockers - Lithium - Statins Iodinated contrast agents | 4,425 | medmcqa_train |
Which of the following can be blocked by atropine, a muscarinic receptor blocker? | Atropine is a muscarinic antagonist. Muscarinic antagonists competitively inhibit the effect of acetylcholine at muscarinic receptors. Bradycardia caused by infusion of acetylcholine- can be blocked by atropine | 4,426 | medmcqa_train |
Specific cell surface proteins, such as alkaline phosphatase, and lipoprotein lipase, are anchored to the cell membrane. This anchoring is accomplished by covalent binding through an oligosaccharide bridge to component of the cell membrane. This component is | Phosphatidylinositol derivatives play several distinct roles in the cell membrane, one of which is that they anchor several cell surface proteins. Cell surface proteins bound to phosphatidylinositol are also found in several parasitic protozoa. By altering these proteins, these protozoa can change their antigenic properties and avoid immunosurveillance. Being attached via a telatively long chain to the membrane via phosphatidylinositol, rather than being a part of the membrane itself, allows these proteins lateral movement on the cell surface. The proteins can be cleaved from the membrane by the action of phospholipase C. The other compounds listed are also phospholipids, but they do not anchor proteins in the membrane. | 4,427 | medmcqa_train |
The most common cause of Left Ventricular Hyperophy is: | Answer is A (Hypeension) The most common cause of Left Ventricular Hyperophy is Systemic Hypeension Left Ventricular Hyperophy may be produced as a result of all of the above conditions but systemic hypeension remains the single most common cause. Left Ventricular Hyperophy (LVH) Pressure overload states: Hypeension (most common cause of LVH). Aoic stenosis Coarctation of Aoa Volume overload states: Aoic or mitral regurgitation Hyperophic cardiomvopathy (HCM): A group of genetic diseases of the cardiac sarcomere characterized by hyperophy of the left ventricle. The most common cause of Left Axis Detion of ECG is Left Anterior Hemiblock | 4,428 | medmcqa_train |
Lung to lung metastasis is seen in- | Ref:Textbook of pathology (Harsh mohan) 6th edition,page no.500 Adenocarcinoma, also called peripheral carcinoma due to its location and scar carcinoma due to its association with areas of chronic scarring, is the most common bronchogenic carcinoma in women and isslow-growing.Recent estimates on adenocarcinoma place this as the most frequent histologic subtype of lung cancer. Adenocarcinoma is fuher subclassified into 4 types: i) Acinar adenocarcinoma which has predominance of glandular structure and often occurs in the larger bronchi. ii) Papillary adenocarcinoma which has a pronounced papillary configuration and is frequently peripherally located in the lungs and is found in relation to pulmonary scars (scar carcinoma). iii) Bronchiolo-alveolar carcinoma is characterised by cuboidal to tall columnar and mucus-secreting epithelial cells growing along the existing alveoli and forming numerous papillary structures. Ultrastructurally, these tumour cells resemble Clara cells or less often type II pneumocytes. iv) Solid carcinoma is a poorly-differentiated adenocarcinoma lacking acini, tubules or papillae but having mucuscontaining vacuoles in many tumour cells. The tumour extends directly by invading through the wall of the bronchus and destroys and replaces the peribronchial lung tissue. As it grows fuher, it spreads to the opposite bronchus and lung, into the pleural cavity, the pericardium and the myocardium and along the great vessels of the hea causing their constriction. | 4,429 | medmcqa_train |
Regarding the lipid or liposomal formulation of amphotericin B which of the following statements is accurate | Ref-KDT 6/e p758 Newer liposomal preparations of amphotericin B have the following features: Less chances of nephrotoxicity and infusion related reactions Lesser uptake in the tissues like kidney More expensive Similar in efficacy and antifungal spectrum as conventional preparations | 4,430 | medmcqa_train |
Which of the following is IL-2 receptor inhibitor : | Both Basiliximab & Daclizumab are monoclonal antibodies against IL-2 receptor. | 4,431 | medmcqa_train |
Which vaccine is recommended in disasters - | Ans. is 'd' i.e., DiphtheriaVaccines recommended in disasters -* Following vaccines are recommended1) Children < 10years:- DPT, inactivated polio (IPV), H.influenzae type b (Hib), hepatitis B, pneumococcal conjugate vaccine (PCV), measles-mumps-rubella (MMR), varicella vaccine, influenza, hepatitis A and rotavirus.2) Children and adolescents (11-18 years):- Tetanus, diphtheria, pertussis, meningococcal conjugate vaccine (MCV), Influenza.3) Adults (>18 years):- Tetanus, diphtheria, pertussis, pneumococcal polysaccharide vaccine (PPSV23), and influenza.* Vaccination against typhoid and cholera is not recommended. | 4,432 | medmcqa_train |
Glomus cells are found in | The glomus cells (type I) are specialized glandular-like cells, mainly located in the carotid bodies and aoic bodies, that control the respiratory activity.The glomus cells have a high metabolic rate and good blood perfusion and synapses directly or indirectly with nerve endings. Thus are sensitive to changes in aerial blood gas (specially to low pO2)(Ref: Guyton & hall, pg- 367) | 4,433 | medmcqa_train |
Which of the following is not produced by hepatocytes:September 2006, September 2012 | Ans. A: Gamma globulinThe hepatocyte manufactures serum albumin, fibrinogen, and the prothrombin group of clotting factors (except for Factor 3,4)It is the main site for the synthesis of lipoproteins, ceruloplasmin, transferrin, complement, and glycoproteinsThe liver forms fatty acids from carbohydrates and synthesizes triglycerides from fatty acids and glycerol. Hepatocytes also synthesize apoproteinsIt also synthesizes cholesterol from acetate and fuher synthesizes bile salts. The liver is the sole site of bile salts formationRemember the only major class of plasma proteins not synthesized by the liver are the immunoglobulins | 4,434 | medmcqa_train |
The commonest presentation of meckel's diveiculum is - | Ans. is 'a' i.e., Bleeding | 4,435 | medmcqa_train |
Which of the following immunoglobulin is absent in Ataxia telangiectasia: | Ataxia telangiectasia (AT) Present in the first decade of life with progressive telangiectatic lesions associated with deficits in cerebellar function and nystagmus. There is a high incidence of recurrent pulmonary infections (bronchiectasisQ) and neoplasms of the lymphatic and reticuloendothelial system. It is caused due to defect in DNA repair genes Thymic hypoplasia with cellular and humoral (IgAQ and IgG2) immunodeficiencies, premature aging and endocrine disorders such as insulin resistance or type-I DM The most striking neuropathologic changes include loss of Purkinje, granule and basket cells in the cerebellar coex as well as of neurons in the deep cerebellar nuclei. A poorly developed or absent thymus gland is the most consistent defect of the lymphoid system. | 4,436 | medmcqa_train |
An adult with newly diagnosed tuberculosis is most likely to have which of the following types of lesions? | This is something of a trick question, but it stresses an impoant fact many medical students do not realize. Primary tuberculosis infection characteristically involves the lung subjacent to the pleura in either the lower pa of the upper lobe or the upper pa of a lower lobe of one lung. The mediastinal nodes are also usually involved , rather than having a single lesion subjacent to the pleura without lymph node involvement. However, the "trick" pa of this question rests on the fact that roughly 80% of newly diagnosed pulmonary tuberculosis cases in adults are actually due to reactivation of an often clinically unsuspected infection acquired years-to-decades previously. The reinfection site usually is in the apex of the lung. You should also be aware that the lungs are not the only site where tuberculosis can occur (it can occur throughout the body), and isolated gastrointestinal involvement is (uncommonly) also seen. Ref: Raviglione M.C., O'Brien R.J. (2012). Chapter 165. Tuberculosis. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e. | 4,437 | medmcqa_train |
Essential for tumour metastasis is ? | Angiogenesis Tumour angiogenesis plays a very significant role in the metastasis since the new vessel formed as a pa of growing tumour are more vulnerable to invasion because these evolving cells are in direct contact with cancer cells. According to Harrison "Cancer research studying the conditions necessary for cancer metastasis have discovered that one of the critical events required is the, growth of a new network of blood vessels called tumour angiogenesis". Angiogenesis in tumours :? Tumour stimulates the growth of host blood vessels. Which is essential for supplying nutrients to the tumour. Tumours cannot enlarge beyond 1-2 mm in diameter or thickness unless they are vascularized because the 12 mm zone represents the maximal distance across which oxygen and nutrients can diffuse from blood vessels. Angiogenesis of tumour impas two benefits A) Growth of tumour By supplying oxygen and nutrient to tumour cells. Endothelial cells of new blood vessels secrete growth factors which stimulate the growth of adjacent tumour cells. B) Distant metastasis Without access to the vasculature, the tumour cells cannot rapidly spread to distant sites. Tumour associated angiogenic factors :? Tumours secrete ceain factors which induce neovascularization Two most impoant are ? i) Vascular endothelial derived growth factor (VEGF) ii) Basic fibroblast growth factor (BFGF) Steps in the spread of cancer ? Aggressive clonal proliferation and angiogenesis The first step in the spread of cancer cells is the development of rapidly proliferating clone of cancer cells. Detachment of tumour cells Normal cells remain glued to each other due to presence of cell adhesion molecules (CAM) i.e. E cadherin. Normal function of E cadherin is dependent on catenins that helps in linkage of cytoskeleton to E cadherin. Down regulation of expression of either E cadherins or catenins results in loosening of cells that helps in metastasis. Tumour cell and extracellular matrix interaction Loosened cancer cells attach to ECM proteins mainly Laminin and fibronectin through a special protein integrin. Degradation of ECM Tumour cells overexpress proteases and matrix degrading enzymes i.e., metalloproteinases that includes collagenase and gelatinase. Another protease cathepsin D is also increased in ceain cancers. These enzymes bring about dissolution of extracellular matrix - Firstly basement membrane of tumour itself; is dissolved then it make way for the tumour cells through the interstitial matrix and.finally the basement membrane of the vessel wall is dissolved. Entry of tumour cells into capillary lumen :? Tumour cells after degrading the basement membrane are ready to migrate into lumen of capillaries or venules for which the following mechanisms play a role. i) Autocrine motility factor (AMF) is a cytokine derived from tumour cells and stimulate receptor mediated motility of tumour cells. ii) Cleavage product of matrix components. Which are formed following degradation of ECM have propeies of tumour cell chemotcuis, growth promotion and angiogenesis in cancer. After the malignant cells have migrated through the breached basement membrane, these cells enter the lumen of lymphatic and capillary channels. Thrombus formation The tumour cells protruding in the lumen of the capillary are now covered with constituents of the circulating blood and form the thrombus. Thrombus provides nourishment to the tumour cells and also prevent them from immune attack. Extravasation of tumour cells Tumour cells in the circulation may mechanically block these vascular channels and attach to vascular end. In this way, the sequence similar to local invasion is repeated and the basement membrane is exposed. | 4,438 | medmcqa_train |
Todd's palsy can occur after episode of | Todd's paralysis, or Todd's palsy. Specialty. Neurology. Todd's paresis (or postictal paresis/paralysis, "after seizure") is focal weakness in a pa or all of the body after a seizure. This weakness typically affects appendages and is localized to either the left or right side of the body. Ref Harrison20th edition pg 2456 | 4,439 | medmcqa_train |
Pheochromocytoma may be associated with: | Ans. A. Medullary carcinoma of the thyroidMEN 2a: Sipple syndromeMEN 2ba. Thyroid; Medullary thyroid carcinomaa. Thyroid: Medullary thyroid carcinomab. Pheochromocytomab. Pheochromocytomac. Parathyroid hyperplasiac. Mucosal neuromas and Marfanoid appearance | 4,440 | medmcqa_train |
A patient with alkaline urine which is cloudy with plenty of pus cells is suffering from: | Ans: b (Proteus)Ref: Bailey & Love, 24th ed, p. 1324 & 23rd ed, p. 1191Proteus and Staphylococcus split urea, forming ammonia which makes the urine alkaline and promotes formation of calculi. | 4,441 | medmcqa_train |
In a population of 10,000, literate people are 4000. In same population 2000 are 0-6 years old. What is the literacy rate of that population - | Ans. is 'c' i.e., 50% * The term literacy rate is used for the population relating to seven years age & above.* In the given question, population 7 years 8c above is 8000. Out of which 4000 are literate thus literacy rate is 50%. | 4,442 | medmcqa_train |
Which of the following is not true about apoptosis? | Ans. is 'a' i.e., Presence of inflammation o The two most striking features of apoptosis are:i) In contrast to necrosis it does not elicit inflammationii) Considerable apoptosis may occur in tissues before it becomes apparent in histological section (because it occurs very rapidly).Morophological changes in apoptosisi) Cell shrinkage : It is the earliest changes.ii) Chromatin condensation (pyknosis)Znuclear compaction : It is the most characteristic feature.iii) Formation of cytoplasmic blebs : It is the end stage of apoptosis.iv) Cytoplasmic eosinophilia.v) Chromosomal DNA fragmentation : It is due to activity of endonuclease and caspases.vi) Formation of apoptotic bodies : These are membrane bound round masses of eosinophilic cytoplasm with tightly packed orgaelles which may contain nuclear debries).vii) Phagocytosis of apoptotic cells and bodies by adjacent macrophages or healthy parenchymal cells. | 4,443 | medmcqa_train |
All of the following are causes of acalculous cholecystitis except | Causes of Acalculous cholecystitis Common causes Elderly and critically ill patients after trauma Burns Longterm TPN Major operations(Abdominal aneurysm repair and cardiopulmonary bypass) Diabetes mellitus Uncommon causes Vasculitis Obstructing GB adenocarcinoma GB torsion Parasitic infestation Unusual bacterial infection - Leptospira, streptococcus, salmonella , Vibrio cholera Ref: Harrison's 19th edition Pgno : 2081 | 4,444 | medmcqa_train |
Biotin deficiency is due to | (Avidine) (146 - U.S 3rd) (178- R.S. 7th)Biotin deficiency (anti egg, white injury factor, vitamin B7 or vitamin - H) is a sulfur containing B complex. It is directly participates as coenzyme in the carboxylation reactions* High consumption of raw egg. The raw egg white contains a glycoprotein - avidin. Which is highly binds with biotin and blocks its absorption from the intestine. | 4,445 | medmcqa_train |
Which one of the following virus is double stranded RNA virus? | All RNA viruses are single stranded except Reo virus. | 4,446 | medmcqa_train |
Urine sample examinations is a useful investigation in infestation of | Ans. a (S. hematobium) (Ref. H - 18th/ ch. 219)SCHISTOSOMIASIS (BILHARZIA)Distribution and important species of Schistosoma are:# S. japonica is found in Central and Eastern China, and the Philippines and nearby islands; and primarily affects the liver and intestines.# 5. mansoni is found in Africa, the Eastern Mediterranean, the Caribbean, and South America and primarily affects the liver and intestines.# S. haematobium is found in Africa, the Middle East, and Eastern Mediterranean and primarily affects the urinary tract.# S. mekongi is found in Southeast Asia and primarily affects the liver and intestines.Incubation:# Symptoms of acute schistosomiasis begin about a month after infection.Signs and Symptoms# Acute schistosomiasis ->>Katayama fever.Q# The last (chronic) stage varies according to species, i.e., S. japonica, 5. mansoni, and S. mekongi primarily affect liver and intestines; while S. haematobium primarily affects the urinary tract.# In general, patients with chronic schistosomiasis tend to present in developed countries with lethargy, colicky abdominal pain, mucoid/bloody diarrhea, or dysuria and hematuria.# Chronic hepatosplenic schistosomiasis is a consequence of eggs retained in tissue and prolonged infection - usually of > 10 years duration.# Fibrosis may cause portal hypertension, splenomegaly, or esophageal or gastric varices.Q# Chronic genitourinary schistosomiasis is associated with chronic 5. haematobium infection.# Hematuria and dysuria are common from the acute through chronic stages. Bladder cancer rates are increased in endemic areas. Salmonella infection concurrent with schistosomiasis is common and is resistant to treatment unless the schistosomiasis is also treated.Diagnosis# Diagnosis of S. japonicum and S. mansoni is by the presence of ova in feces or tissue. Diagnosis of S. haematobium is by the presence of ova in urine or tissue. However, ova loads are not always sufficient for diagnosis, especially in long-standing chronic illness. Immunofluorescent antibody tests and antigen detection assays are increasingly used.# "Fetal head" bladder calcification may be shown in X-rays in chronic S. haematobium infection. QTreatment# For S. haematobium and S. mansoni, praziquantel 20/kg po bid for one day; for S. japonica and S. mekongi, praziquantel 20/kg po tid for one day are the treatments of choice.# S. mansoni may also be treated with oxamniquine in a single po dose (with food) of 15 mg/kg. S. haematobium in North and East Africa may be treated with metrifonate 7.5-10 mg/kg every other week for a total of 3 doses.Also Know:# The second most common urologic cancer and the most frequent malignant tumor of the urinary tract is bladder cancer. Usually a transitional cell carcinoma. Most prevalent in men during the sixth and seventh decades. Risk factors include smoking, diets rich in meat and fat, schistosomiasis, chronic treatment with cyclophosphamide, and exposure to aniline dye (a benzene derivative).# Causes of portal hypertesnion are as follows: 1. Presinusoidal: Splenic or portal vein thrombosis, schistosomiasis. granulomatous disease. 2. Sinusoidal: Cirrhosis, granulomatous disease. 3. Postsinusoidal: Right heart failure, constrictive pericarditis, hepatic vein thrombosis. | 4,447 | medmcqa_train |
Genus neisseria is - | Ans. is 'b' i.e., Gram negative diplococci o The genus Neisseria consists of Gram negative aerobic nonsporulating, non motile oxidase positive cocci typically arranged in pairs (diplococci).o Two important pathogens are -N. meningitidisN. gonorrhoeae | 4,448 | medmcqa_train |
L-Dopa is combined with carbidopa in the treatment of parkinsonism to - | Ans. is 'b' i.e., Inhibit peripheral decarboxylation of levodopa Carbidopa is combined with levodopa to inhibit peripheral decarboxylation of levodopa and make more levodopa available to cross the blood brain barrier to reach its site of action. | 4,449 | medmcqa_train |
Acrodermatitis entropathica is | Acrodermatitis enteropathica is an autosomal recessive disorder postulated to occur as a result of mutations in the SLC39A4 gene located on band 8q24.3. The SLC39A4 gene encodes a transmembrane protein that is pa of the zinc/iron-regulated transpoer-like protein (ZIP) family required for zinc uptake. This protein is highly expressed in the enterocytes in the duodenum and jejunum; therefore, affected individuals have a decreased ability to absorb zinc from dietary sources. Absence of a binding ligand needed to transpo zinc may fuher contribute to zinc malabsorption. Ref: Medscape | 4,450 | medmcqa_train |
Commonest cause of hea failure in infancy is ________ | Most common cause of congestive cardiac failure in infants is congenital hea disease. Ref : Ghai essential of pediatrics, eighth edition ,p.no:397 | 4,451 | medmcqa_train |
Which of the following tests are used in the evaluation of a suspected CSF leak? | Detection of beta-2 transferrin is considered pa of standard evaluation when CSF leak is suspected. Nasal and ear fluids are tested for detection of the beta-2 transferrin band by immunofixation electrophoresis (IFE) or Western blot analysis as a diagnostic tool for the presence of CSF or perilymph. This test is helpful in the differential diagnosis for CSF otorrhoea or CSF rhinorrhoea. The beta-2 transferrin band has not been detected in multiple fluids including serum, ear fluid, nasal secretions, saliva, tears or endolymph, indicating the specificity of the slower beta-2 transferrin isoform for CSF. | 4,452 | medmcqa_train |
Which of the following decreases in length during the contraction of a skeletal muscle fiber? | The physical lengths of the actin and myosin filaments do not change during contraction. Therefore, the A band, which is composed of myosin filaments, does not change either. The distance between Z disks decreases, but the Z disks themselves do not change. Only the I band decreases in length as the muscle contracts. | 4,453 | medmcqa_train |
Criteria for diagnosing SIRS all seen except: | D i.e. >50% immature neutrophilsRef: Nelson, Textbook of Pediatrics, 20th edition, page 522Explanation:Systemic Inflammatory Response Syndrome (SIRS)It's an inflammatory cascade that is initiated by the host in response to infection, occurs when the host defense system does not adequately recognize or clear the infection.InfectionSuspected or proven infection or a clinical syndrome associated with high probability of infectionSystemic Inflamma-tory Response Syndrome (SIRS)2 out of 4 criteria, 1 of which must be abnormal temperature or abnormal leukocyte count1. Core temperature >38.5degC or <36degC (rectal, bladder, oral, or central catheter)2. Tachycardia: Mean heart rate >2 SD above normal for age in absence of external stimuli, chronic drugs or painful stimuli; OR unexplained persistent elevation over 0.5-4 hr; OR in children <1 year old persistent bradycardia over 0.5 hr (mean heart rate <10th percentile for age in absence of vagal stimuli, (3 blocker drugs, or congenital heart disease)3. Respiratory rate >2 SD above normal for age or acute need for mechanical ventilation not related to neuromuscular disease or general anesthesia4. Leukocyte count elevated or depressed for age (not secondary to chemotherapy) or >10% immature neutrophilsSepsisSIRS plus a suspected or proven infectionSevere SepsisSepsis plus 1 of the following:1 Cardiovascular organ dysfunction defined as:Despite >40 mL/kg of isotonic intravenous fluid in 1 hrHypotension <5th percentile for age, systolic blood pressure <2 SD below normal for age OR Need for vasoactive drug to maintain blood pressure OR2 of the following:Unexplained metabolic acidosis: Base deficit >5 mEq/LIncreased arterial lactate >2 times upper limit of normalOliguria: Urine output <0.5 mL/kg/hrProlonged capillary refill 5 secCore to peripheral temperature gap >3degC2.Acute respiratory distress syndrome (ARDS) as defined by the presence of a Pa02/Fi02 ratio <300 mm Hg, bilateral infiltrates on chest radiograph and no evidence of left heart failureORSepsis plus 2 or more organ dysfunctions (respiratory, renal, neurologic, hematologic or hepatic)Septic ShockSepsis plus cardiovascular organ dysfunction as defined aboveMultiple Organ Dysfunction Syndrome (MODS)Presence of altered organ function such that homeostasis cannot be maintained without medical intervention | 4,454 | medmcqa_train |
According to myogenic theory of renal autoregulation, the afferent aerioles contract in response to stretch induced by | Myogenic autoregulation - through opening of Calcium channels Tubuloglomerular feedback - through release of adenosine Ref: Ganong 25th ed/page 678 | 4,455 | medmcqa_train |
Maxillary aery is | Branches of external carotid aery Anterior Superior thyroid Lingual Facial Posterior Occipital Posterior auricular Medial Ascending pharyngeal Terminal Maxillary Superficial temporal Ref BDC volume 3 ;sixth edition pg 101 | 4,456 | medmcqa_train |
Amsler sign? | Ans. is `a' i.e., Fuch heterochromatic iridocyclitis During paracentesis in Fuch's heterochromic iridocyclitis, there is bleeding from neo-vasculorization.This is known as "Amsler's sign". Fuch's heterochromic iridocyclitis (Fush's uveitis syndrome) It is a form of anterior and intermediate uveitis. The condition is usually unilateral and chronic in nature and is characterized by a chronic non-granulomatous uveitis and eventually results in iris heterochromia (a change in the colour of iris) The disease has following characteristic features : Heterochromia of iris Diffuse stromal iris atrophy Fine KPs at back of cornea Faint aqueous flare Absence of posterior synechiae A fairly common rubeosis iridis, sometimes associated with neovascularisation of the angle of anterior chamber. Comparatively early development of complicated cataract and secondary glaucoma (usually open angle type). Glaucoma has been repoed in 10-59% of cases. Treatment Fuch's heterchromic uveitis responds variable to steroids and cycloplegics. The complications of long term use of these drugs may at times outweigh their potential benefits. Therefore, treatment with topical steroids is given to iritis which is sufficiently active to require the treatment, otherwise the patient is routinely followed without giving any treatment. Cataract responds well to mostforms of intraocular surgeries, including the standard IOL implantation. Hyphernia may occur because of rubeosis iridis (neovascularization of iris). Glaucoma control may be somewhat more problematic, with surgical options indicated for later forms of disease. | 4,457 | medmcqa_train |
Cruel behavior towards wife by husband, family members or his relatives comes under which IPC section: | Ans. (a) 498 ARef.: The Essentials ofFSM by K.S. Narayan Reddy 31st ed. / 272-73* Cruel behavior towards wife by husband or his relatives punished by IPC 498 A.* IPC section 498 A states that whosoever being husband or relative subject women to cruelty shall be punished with imprisonment of upto 3 years with or without fine. | 4,458 | medmcqa_train |
All are true about scrub typhus, except : | “Mite feeds on serum of warm blood animals only during there larval stage (chiggers) and adult mites feed only on plants”
Scrub typhus :
Caused by O. tsutsugamushi
Transmitted by trombiculid mite which also shows transovarian spread
Clinical features :
Fever, headache, myalgia, cough and GI symptoms.
Classic case includes an eschar, regional lymphadenopathy and a maculopapular rash. | 4,459 | medmcqa_train |
Which of the following amino acid is active at neutral pH? | Ans. aRef.: Harper's Illustrated Biochemistry, 30th edn.Option aTrueYes, due to its pyrolidone ring is stable at neutral pH (pH 7)Option bFalseNo, glycine is simplest amino acid and not affected by pHOption cFalseNo, it is steric hinderance is there due to branched chain amino acidOption dFalseNo, false, it is not affected by pH due to guanidino groupOption eFalseNo, not affected due to aromaticityAt physiological pH (around 7.4) the carboxyl group of the amino acid is unprotonated and the amino group is protonated. Thus an amino acid with no ionizable R-group would be electrically neutral at this pH. This species is termed a zwitterion.Histidine is a unique amino acid as pKa of its imidazole group permits it at pH 7 to function either as a base or as an acid. A minor change in pH changes the ionization charge on histidine to buffer pH change. Therefore it can serve as a buffer and is most stable at physiological pH.However, when histidine is incorporated into a protein, its side chain can be either positively charged or neutral, depending on the ionic environment provided by the polypeptide chains of the protein.This is an important property of histidine that contributes to the role it plays in the functioning of proteins such as hemoglobin.Extra edge: A tetrahydral carbon atom with four distinct parts is known as chiral. Only GLYCINE does not show chirality.Amino Acid ClassificationNon-polar Amino Acids.Aliphatic: glycine, alanine, valine, isoleucine, leucine.Aromatic: phenylalanine, tryptophan.Cyclic: Proline..Polar Amino Acids.Sulfur-containing: cysteine, methionine..Hydroxyl-containing: serine, threonine.Aromatic: tyrosine.Acidic Amide: asparagine, glutamine.Charged Amino Acids (at physiological pH).Acidic: aspartic acid, glutamic acid.Basic: histidine, lysine, arginine. | 4,460 | medmcqa_train |
Which of the following is a content of bicipital groove? | Bicipital groove of inteubercular sulcus of humerus: The groove lies between greater and lesser tuberosities of humerus. Bilaminar tendon of the pectoralis major is inseed into the lateral lip of the groove. Teres major is inseed into the medial lip of the groove. Tendon of the latissimus dorsi is inseed into the floor of the groove.Contents of groove:Tendon of the long head of triceps and its synol sheathAscending branch of the anterior circumflex humeral aery | 4,461 | medmcqa_train |
Which of the following statements is true regarding the pituitary gland -a) It is separated from the optic chiasma by the sella turcicab) It is situated deep in the sellac) The sphenoidal air cells lie inferior to itd) It develops from the base of the 3rd ventricle form the pars anteriore) It is supplied by a branch of the internal carotid artery | Pituitary is situated into sella turcica.
Optic chiasma is superior to pituitary.
Sphenoidal air sinuses are inferior to pituitary.
Pituitary is supplied by a single inferior hypophyseal artery and several superior hypophyseal arteries. These hypophyseal arteries are branches of internal carotid artery.
Evagination of floor of 3rd ventricle (diancephalon) in region of infundibulum forms posterior pituitary (pars posterior) and not pars anterior. | 4,462 | medmcqa_train |
All of the following are Glycoproteinoses, EXCEPT | Ans: b) Sanfilippo A syndrome Sanfilippo A syndrome is a mucopolysaccharidosis, not Glycoproteinoses. Lysosomal hydrolases like a-neuraminidase, b-galactosidase, b-hexosaminidase are involved in the degradation of oligosaccharide chains during glycoprotein turnover. Enzyme defects lead to abnormal degradation of glycoproteins and accumulation of paially degraded glycoproteins in tissues, known as Glycoproteinoses. Glycoproteinoses are classified into lysosomal storage disorders. All Glycoproteinoses are associated with mental retardation. autosomal recessive mode. Glycoproteinoses Defective enzyme Fucosidosis a-Fucosidase a-Mannosidosis a-Mannosidase b-Mannosidosis b-Mannosidase Aspaylglucosaminuria Aspaylglucosaminidase Sialidosis Neuraminidase | 4,463 | medmcqa_train |
What is the total osmolarity of low osmolarity ORS? | Composition of reduced osmolarity ORS: Components Amount in mmol/ litre Sodium 75 Chloride 65 Glucose, anhydrous 75 Potassium 20 Citrate 10 Total osmolarity 245 Ref: Park 21st edition, page 202. | 4,464 | medmcqa_train |
Chronic hemodialysis in ESRD patient is done | Ans. (c) Thrice per weekRef : Harrison 19th ed. /1823For the majority of patients with ESRD, between 9 and 12 h of dialysis are required each week, usually divided into three equal sessions.Current Targets of Hemodialysis* Urea reduction ratio (the fractional reduction in blood urea nitrogen per hemodialysis session) of >65-70%.* Body water-indexed clearance x time product (KT/V) above 1.2 or 1.05.REMEMBERHypotension is the most common acute complication of hemodialysis. Since the introduction of bicarbonate- containing dialysate, dialysis-associated hypotension has become less common. The management of hypotension during dialysis consists of discontinuing ultrafiltration, the administration of 100-250 mL of isotonic saline or 10 mL of 23% saturated hypertonic saline, or administration of salt-poor albumin. | 4,465 | medmcqa_train |
Sideroblastic anemia is caused by all except - | This is a refractory anaemia defined by the presence of many pathological ring sideroblasts in the bone marrow.These are abnormal erythroblasts containing numerous iron granules arranged in a ring or collar around the nucleus.Sideroblastic anaemia is diagnosed when 15% or more of marrow erythroblasts are ring sideroblasts.sideroblatic anemia iron containing inclusions are seen in RBCs . Here serum iron concention is seen to be markedly increased. Reference : Hoffbrand Hematology, 6th edition, pg 47. Exam preparatory manual for UGs by Ramdas Nayak Page no: 283 | 4,466 | medmcqa_train |
Which one of the following form Blood Brain Barrier? | (A) Astrocytes and endothelial cells # "Blood Brain Barrier" (BBB) results from the selectivity of the tight junctions between endothelial cells in CNS vessels that restricts the passage of solutes.> At the interface between blood and the brain, endothelial cells are stitched together by these tight junctions, which are composed of smaller subunits, frequently biochemical dimers, that are transmembrane proteins such as occludin, claudins, junctional adhesion molecule (JAM), or ESAM, for example.> Each of these transmembrane proteins is anchored into the endothelial cells by another protein complex that includes zo-1 and associated proteins.> Blood-brain barrier is composed of high-density cells restricting passage of substances from the bloodstream much more than endothelial cells in capillaries elsewhere in the body.> Astrocyte cell projections called astrocytic feet ("glia limitans") surround the endothelial cells of the BBB, providing biochemical support to those cells.> BBB is distinct from the quite similar blood-cerebrospinal-fluid barrier, which is a function of the choroidal cells of the choroid plexus, and from the blood-retinal barrier, which can be considered a part of the whole realm of such barriers. | 4,467 | medmcqa_train |
Primary prevention includes all, except: | Pap smear and self breast examination are screening methods Ref: Park, 20th Edition, Page 39 | 4,468 | medmcqa_train |
Subdural empyema is a complication of all the following conditions except? | d. Boil over face(Ref: Nelson's 20/e p 2936-2948, Ghai 8/e p 563-565)Infections of the sinuses, ear and skull bones can lead to Subdural empyema. | 4,469 | medmcqa_train |
The complication of diabetes which cannot be prevented by strict control of blood sugar is - | Ans. is 'c' i.e., Macular edema o The DCCT demonstrated that improvement of glvcemia controly Reduced nonproliferative and proliferative retinopathy (47% reduction).y Microalbuminuria (39% reduction).y Clinical nephropathy (54% reduction).y Neuropathy (60% reduction).y Improved glycemic control also slowed the progression of early diabetic complication.y There vras a nonsignificant trend in reduction of macrovascular events during the trial.o The UKPDS demonstrated that each percentage point reduction in AIC was associated with a 35% reduction in microvascular complications. | 4,470 | medmcqa_train |
In cancer colon investigation of choice is: | Ans. (c) ColonoscopyRef: Bailey and Love 27th edition, Page 1262* Investigation of choice for cancer colon is colonoscopy as we can take biopsy and confirm the lesion.* Risk of perforation is 1:1000.* Helps to detect synchronous lesions also. | 4,471 | medmcqa_train |
Which is the only amino acid with good buffering capacity at physiological pH? | Histidine plays a key role in making hemoglobin an excellent buffer in red blood cells. | 4,472 | medmcqa_train |
Normal expiratory reserve volume of adult? | Ans. is 'c' i.e., 1200 ml(Ref: Ganong 24n/e p.629)Inspiratory reserve volume - 3000 mlExpiratory reserve voulume -1200 ml | 4,473 | medmcqa_train |
Fixation at which psychosexual stage results in development of OCD- | Phase Age Organ of Gratification Psychiatric disorders linked to fixation 1 Oral Phase Bih to 1 1/2 years Oral region 2 Phases: Oral erotic phase (sucking) Oral sadistic phase (biting) Schizophrenia Dependent personality disorder Alcohol dependence syndrome 2 Anal Phase 1 1/2 to 3 years Anal and perianal area 2 Phases: Anal erotic phase (excretion) Anal sadistic phase ('holding' and 'letting go' at will) Obsessive compulsive personality traits and disorder OCD (Anal sadistic phase) 3 Phallic (Oedipal) Phase 3 to 5 years Genital areas Males: Sexual gratification towards mother Castration anxiety Oedipus complex Females: Penis envy Electra complex Sexual detions Sexual dysfunctions Neurotic disorders 4 Latency Phase 5 to 12 years - Special point: Super-ego is formed at this stage Neurotic disorders 5 Genital Phase > 12 years Genitals Neurotic disorders | 4,474 | medmcqa_train |
Recurrent laryngeal nerve is in close association with: | Ans. is 'b' i.e. Inferior thyroid arteryRef: B.D. C 2nd/e Vol III page 137 & 138, Repeat Inferior thyroid artery is a branch of the thyrocervical trunk. During its course it passes behind the carotid sheath and the middle cervical sympathetic ganglion and its terminal part is related to the recurrent laryngeal nerve.More Questions about arterial supply of the thyroid glandThe thyroid gland in supplied by the following arteriesSuperior thyroid artery a branch of the external carotid arterylies in close association with the external laryngeal nerve.Inferior thyroid artery a branch of the thyrocervical trunk (which arises from the subclavian artery)- its terminal part is intimately related to the recurrent laryngeal nerve. Accessory thyroid arteriesarise from tracheal and esophageal arteriesThyroidea ima artery (or the lowest thyroid artery)found in only about 3% of individualsarises from the brachicephalic trunk or directly from the arch of aorta.During thyroidectomy the superior thyroid artery is ligated near to gland (to save the external laryngeal nerve); and the inferior or thyroid artery is ligated away from the gland (to save the recurrent laryngeal nerve)Questions on venous drainage of thyroid glandThe thyroid gland is drained by the following veinsSuperior thyroid vein.Drains in the internal jugular vein orthe common facial veinMiddle thyroid veinAlso drains in the internal jugular veinInferior thyroid veinDrains into the left brachiocephalic veinA fourth thyroid vein (of Kocher), may emerge between middle and inferior veins and drains into the internal jugular vein | 4,475 | medmcqa_train |
All the following are characteristic feature of Cluster headache except: | Ans: C (Bilateral photophobia) Ref: Hcirrisotis principles of Internal Medicine. 18th edition. 2012. Chapter 14. Pg.112Explanation:CLUSTER HEADACHEThe pain is deep, usually retroorbital, excruciating in intensity, nonfluctuating, and explosive in quality.A core feature of cluster headache is Periodicity. At least one of the daily attacks of pain recurs at about the same hour each day for the duration of a cluster bout.The typical cluster headache patient has daily- bouts of one to two attacks of relatively short- duration unilateral pain for 8 to 10 weeks a year; this is usually followed by a pain-free interval that averages a little less than 1 year.Patients are generally perfectly well between episodes.Onset is nocturnal in about 50% of patients, and men are affected three times more often than women.Patients with cluster headache tend to move about during attacks, pacing, rocking, or rubbing their head for relief. This is in sharp contrast to patients with migraine, who prefer to remain motionless during attacks.Cluster headache is associated with ipsilateral symptoms of cranial parasympathetic autonomic activation: conjunctival injection or lacrimation, rhinorrhea or nasal congestion, or cranial sympathetic dysfunction such as ptosis.The sympathetic deficit is peripheral and likely to be due to parasympathetic activation with injury to ascending sympathetic fibers surrounding a dilated carotid artery as it passes into the cranial cavity.When present, photophobia and phonophobia are far more likely to he unilateral and on the same side of the pain, rather than bilateral, as is seen in migraine.Cluster headache is likely to be a disorder involving central pacemaker neurons in the region of the posterior hypothalamusTreatment:Acute Attack TreatmentOxygen inhalation.Sumatriptan 6 mg SC is rapid in onset and will usually shorten an attack to 10-15 minSumatriptan (20 mg) and zolmitriptan (5 mg) nasal spraysOral sumatriptan is not effective for prevention or for acute treatment of cluster headache.Preventive Treatments (See the following table)Neurostimulation TherapyIndicated when medical therapies failDeep-brain stimulation of the region of the posterior hypothalamic gray matter has proven successful in a substantial proportion of patients. | 4,476 | medmcqa_train |
Drugs which cause hirsutism are all except | Penicillamine causes Hypertrichosis, not Hirsutism. | 4,477 | medmcqa_train |
Delayed tuberculin test response is due to: September 2004 | Ans. B i.e. T lymphocytes | 4,478 | medmcqa_train |
A 70-year-old man with a history of diabetes presents with severe pain in his right ear. The patient was diagnosed with external otitis. Further tests suggested that the patient suffered bone and nerve damage. Clinical laboratory analysis showed that the isolated microorganism produced a distinct blue pigment as well as an ADP-ribosylation toxin. What is the most likely causative agent? | External otitis or swimmer's ear is an inflammation of the outer ear and the ear canal. In the virulent form of the disease-malignant external otitis, which occurs in people with diabetes, damage to the cranial nerves and bone may occur. External otitis is caused by either bacterial or fungal pathogens. Bacterial pathogens include Pseudomonas aeruginosa, Staphylococcus aureus, Staphylococcus epidermidis, and Enterococcus faecalis. Fungal pathogens include Candida albicans and Aspergillus spp. The majority of bacterial external otitis is caused by P. aeruginosa. P. aeruginosa produces pyocyanin, which is a blue pigment that catalyzes the production of superoxide and hydrogen peroxide. Pyocyanin also stimulates the release of IL-8 (CXCL8 in humans). P. aeruginosa also produces exotoxin A, which ADP-ribosylates EF-2 in the eukaryotic cell leading to the cessation of protein synthesis and cell death. Neither pyocyanin nor exotoxin A is produced by the other pathogens listed (S. aureus, S. epidermidis, E. faecalis, and C. albicans). | 4,479 | medmcqa_train |
Mallory weiss syndrome common in | (Chronic alcoholic patients) (236, 1746-H) (242, 1854-H17th)Mallorv-Weiss Syndrome - classic history is vomiting, retching or coughing preceding hematemesis, especially in an alcoholic patients.* Bleeding usually on the gastric side of the gastroesophageal junction, Stops spontaneously in 80-90% of the patients and recors in only 0 to 5%* Endoscopic therapy is indicated for actively bleeding.* Angiographic therapy with intraarterial infusion of vasopressin or embolization and operative therapy with oversewing of the tear are rarely required. | 4,480 | medmcqa_train |
Propaganda is defined as - | - propaganda is one in which knowledge is instilled in the minds of people. - prevents or discourage thinking by ready made slogans. - knowledge is spoon fed and passively received. Reference : Park's textbook of preventive and social medicine, 23rd edition, pg no:859 <\p> | 4,481 | medmcqa_train |
Which of the following ganglion is associated with lacrimation? | Secretomotor fibres for lacrimal gland arise from the facial nerve at geniculate ganglion, travel in greater petrosal nerve and join the sphenopalatine ganglion as vidian nerve. After relay in the ganglion, they are distributed to lacrimal gland. | 4,482 | medmcqa_train |
Best way to evaluate discrepancy in articular disc of TMJ is: | Soft tissues of the joint (articular disk) can be imagined with MRI or Arthrography. MRI produces superb images of the soft tissues in internal derangement of the disk. Arthrography is invasive and has the risk of infection and allergic reaction due to the contrast agent. | 4,483 | medmcqa_train |
A 40-year-old male comes with complaint of indigestion and decreased appetite. He has a history of being treated for duodenal ulcer 4 years back. Investigation reveals elevation of gastrin levels. Which of the following statement is true regarding gastrin? | Ans: D (It gets stimulated by endolumina I peptides in stomach) Ref: Ganong's Review of Medical Physiology. 21st ed and Khurana Textbook of Medical Physiology By Khurana, pg: 605Explanation:GASTRINGastrin is secreted into the blood circulation and NOT into gastric juice.It reaches stomach through the arterial circulation.Stimulates secretory activity of parietal and chief cells.SourcesG cells - Antral mucosa (Most important source) -- Also called APUD cells.TG cells - found throughout the stomach and small intestine.Pancreatic islets in fetal life.Anterior and intermediate lobes of pituitary gland, hypothalamus, medullar oblongata, vagus and sciatic nerves.TypesG17, 14 and G34.FunctionsStimulates Gastric acid / HCI secretion from parietal cells.Stimulates HCI secretion by stimulating secretion of histamine from the enterochromaffin like cells (ECL) present in body of stomach.Stimulation of pepsin secretion.Stimulates growth of stomach and intestinal mucosa (Trophic action).Increases gastric and intestinal motility.Increases pancreatic secretion of Insulin and Glucagon but only after a protein meal.The functions of gastrin in the pituitary gland, brain and peripheral nerves are unknown.Control of Gastrin SectionFactors Stimulating Gastrin StimulationVagaf StimulationIncreases gastrin release through gastrin releasing peptide (GRP) and not through neurotransmitter ACHBecause of this reason, anti- muscarinic blocker atropine does not affect release of gastrin from G cellsDistension of Pyloric antrumThrough intrinsic innervation Proved by Heidenhain pouchProducts of protein digestionPeptides, amnioacidsCalcium Epinephrine Alcohol Coffee Factors Inhibiting Gastrin StimulationLow pH of gastric juice ( <3) -- Negative feedback mechanism.Somatostatin - Released by D cell.Secretin.Gastric Inhibitory Peptide (GIP)Vasactive intestinal peptide (VIP).Glucagon.Calcitonin. Control of gastrinsection | | | Stimuli increasinggastrin section Stimuli decreasinggastrin section || | | | |Luminal* Peptides and aminoacids* Distension Neural* Increased vagal discharge viaGRP* Calcium* Epinephrine Luminal* Acid* Somatostatin Blood Borne* Secretin* GP* VIP*Glucagon*Calcitonin | 4,484 | medmcqa_train |
Newer Influenza vaccine- | <p> Newer vaccines for influenza are Split virus vaccine Neuraminidase specific vaccine Recombinant vaccine. Park&;s textbook of preventive and social medicine,K.Park,23rd edition,page no:155. <\p> | 4,485 | medmcqa_train |
Treatment of choice for chloroquine resistant malaria is : | Ans. is 'b'. Sulfadoxine + Pyrimethamine * Under the recent 'National anti-Malaria Programme.' the drug policy for malaria treatment is as follows-Any fever in endemic areas during transmission season without any other obvious cause may be considered as malaria and investigated/treated accordingly.Drug resistance foci are prevalent in the country but chloroquine is still the safe, effective and cheap antimalarial drug and is simple to be administered.The best approach in malaria treatment is diagnosis and treatment on the same day.b(Plasmodium falciparum predominant and drug resistance areas)Presumptive treatment of all suspected/clinical malaria cases :Day 1 Tab. Chloroquine - 10 mg/kg body weight (600 mg adult dose)+Tab. Primaquine - 0.75 mg/kg body weight (45 mg adult dose)Day 2 Tab. Chloroquine - 10 mg/kg body weight (600 mg adult dose)Day 3 Tab. Chloroquine - 5 mg/kg body weight (300 mg adult dose)Radical treatment after microscopic confirmation of species :P vivax - Tab. Primaquine 0.25 mg/kg body wt. (15 mg adult does) daily for 5 days.P. falciparum - No further treatment required.In chloroquine resistant p. falciparum cases/areaSingle dose of 25 mg / kg bw tab. Sulfalene / Sulfadoxine and 1.25 gg/ kg body wt. Pyrimethamine combination (3 tabs, adult does) thereafter tab. Primaquine 0.75 mg/kg body wt. These drugs should be given cautiously and not on the same day as both are known to precipitate haemolytic crisis in sensitive cases with G6PD deficiency.In low risk areasPresumptive treatmentDay 1 - Tab. Chloroquine 10mg / kg body weight (600 mg adult does)Radical Treatment after confirmation of speciesP. Vivax - Tab. Chloroquine 10 mg/ kg body wt. single dose and tab. Primaquine 0.25 mg/kg body wt. daily for 5 days.R falciparum - Tab. Chloroquine 10 mg/ kg body wt. plus tab. Primaquine 0.75 mg / kg body wt. single dose.Severe and Complicated malaria - cases are to be hospitalized for treatment.Choice of antimalarial is quinine injection preferably, 10 mg/ kg body wt. I/V drip in5% dextrose saline to be run over 4 hours, 8 hourly. Switch over to oral dose as early as possible and total duration of treatment should be 7 days including both parenteral and oral doses.Injectable form of Artemisinin derivative may be used for severe and complicated malaria only. The recommended injectable dosages are as follows :Artemisinin - 10mg./kg body wt. once a day for 5 days with a double divided does on first day.Artesunate - 1 mg/kg body wt. IM or IV two doses at an internal of 4-6 hours on the first day followed by once a day for 5 daysArtemether - 1.6 mg/kg body wt. IM, two doses at an interval of 4-6 hours on the first day followed by once daily for 5 days.Artether - 150 mg daily IM for 3 days for adults onlyTab. Mefloquine is to be used only in Pf. cases having proven resistance to chloroquine.Primaquine is not to be given to pregnant women*, infants* and glucose 6 phosphatase deficient persons*. | 4,486 | medmcqa_train |
Which of the following hypnotic drugs facilitates the inhibitory actions of GABA but lacks anticonvulsant or muscle relaxing properties and has minimal effect on sleep architecture | Zolpidem, zaleplon and zopiclone are agonists at BZD receptors.
These are hypnotic drugs that lack muscle relaxant and anticonvulsant actions.
These have negligible effect on REM sleep and do not affect sleep architecture. | 4,487 | medmcqa_train |
All of the following statement regarding ewings sarcoma are true except? | In ewings sarcoma, Homer-Wright pseudo rosettes are seen.
Flexner-Wintersteiner rosettes are seen in retinoblastoma. | 4,488 | medmcqa_train |
Which of the following condition is not true about Hemochromatosis? | Phlebotomy is the treatment of choice of hemochromatosis. Chelating agent desferrioxamine is indicated when anemia or hypoproteinemia is severe enough to preclude phlebotomy. Hemochromatosis is a common inherited disorder of iron metabolism in which dysregulation of intestinal iron absorption results in deposition of excessive amounts of iron in parenchymal cells resulting in tissue damage and organ dysfunction. Liver is the first organ to be affected and hepatomegaly is seen in more than 95% of patients. Diabetes mellitus occur in 65% of patients with advanced disease. Ahropathy is seen in 20-25% of symptomatic patients. Second and third metacarpophalangeal joints are the first joints to be involved. Manifestations of hypogonadism includes loss of libido, impotence, amenorrhea, testicular atrophy and gynecomastia. Most common cardiac manifestation is congestive hea failure. | 4,489 | medmcqa_train |
Blood component products are all except? | Ans. is None | 4,490 | medmcqa_train |
Which of the following drugs require therapeutic drug monitoring? | * Therapeutic drug monitoring is adjustment of dose of the drug according to its plasma concentration. It is required for A Aminoglycosides (e.g. gentamicin) Drug Digitalis Possessing Phenytoin (anti-epileptics) Low Lithium Therapeutic Tricyclic antidepressants Index Immunomodulators (e.g. cyclosporine) | 4,491 | medmcqa_train |
Black line in the gingiva that follows the contour of the margin is due to: | Black line in the gingiva that follow the contour of the margin is due to Bismuth, Arsenic and Mercury. | 4,492 | medmcqa_train |
Which of the following Immunoglobulin acts as a receptor for antigens | Major Functions of ImmunoglobulinsImmunoglobulinMajor FunctionsIgGMain antibody in the secondary response. Opsonizes bacteria, making them easier to phagocytose. Fixes complement, whichenhances bacterial killing. Neutralizes bacterial toxins and viruses. Crosses the placenta.IgASecretory IgA prevents attachment of bacteria and viruses to mucous membranes. Does not fix complement.IgMProduced in the primary response to an antigen. Fixes complement. Does not cross the placenta. Antigen receptor on the surfaceof B cells.IgDFound on the surfaces of B cells where it acts as a receptor for antigenIgEMediates immediate hypersensitivity by causing the release of mediators from mast cells and basophils upon exposure to antigen(allergen). Defends against worm infections by causing the release of enzymes from eosinophils. Does not fix complement. Mainhost defense against helminthic infections.Ref: Harper&;s Biochemistry; Chapter 52; Plasma Proteins & Immunoglobulins; Table: 52-9 | 4,493 | medmcqa_train |
By which nerve is the hip joint supplied ? | Nerve supply of hip joint
- Femoral nerve- by nerve to rectus femoris
- Obturator nerve- by anterior division
- Nerve to quadratus femoris
- Superior gluteal nerve | 4,494 | medmcqa_train |
Which of the following statements is FALSE regarding vincristine? | Ans. (C) It does not cause alopecia(Ref: KDT 8th/e p924)Vincristine is a vinca alkaloid.It is used for the induction of remission in ALL.It is a marrow sparing drug but causes peripheral neuropathy, alopecia and SIADH as adverse effects. | 4,495 | medmcqa_train |
Maturation failure in poor absorption of the vitamin B12 causes: | (Occurs in 3-4 months after absorption): Ref: 682-R (438- Basic pathology 8th)Vitamin B12 deficiency* Macrocytic megalablastic anaemia is the cardinal features* Usually pernicious (Addisonian) anaemiaDiagnostic features include:1. A moderate to severe megaloblastic anaemia2. Leukopenia with hypersegmented granulocytes3. Mild to moderate thrombocytopenia4. Mild jaundice due to ineffective erythropoisis and peripheral hemolysis of red cells5. Neurologic changes related to involvement of the posterolateral spinal tracts6. Achlorhydria even after histamine stimulation7. Inability to absorb an oral dose of cobalamin (assessed by urinary excretion of radio labeled cyanocobalamin given orally, called the shilling test)8. Low serum levels of vitamin Bj2 (less than 100 pg/ml)9. Elevated levels of homocysteine and methylmalonic acid in the serum (This is more sensitive than serum levels of vitamin B!2)10. A striking reticulocytic response and improvements in hematocrit levels beginning about 5 days after IV administration of vitamin B12. Serum antibodies to intrinsic factor are highly specific for pernicious anemia. Their presence attests to the cause of vitamin B12 deficiency, rather than the presence or absence of cobalamine deficiency.Polvcvthaemia - Vitamin B12 levels are strikingly elevated because of increased levels of transcobalamin III (501- CMDT-06)* Deficiency of vitamin B12 takes at least 2 years to develop when the body stores are totally depleted. (380-HM) | 4,496 | medmcqa_train |
Rivastigmine is given in: | (Ref: Katzung, 10th ed. Ch 7)* Rivastigmine is a parasympathomimetic drug used for the treatment of mild to moderate dementia of the Alzheimer's type and dementia due to Parkinson's disease* DOC for Alzheimer's disorder-Donepezil* DOC for OCD: Fluoxetine* DOC for parkinsonism: Levodpa + Carbidopa* DOC for drug induced parkinsonism: Benzhexol (centrally acting anticholinergic) | 4,497 | medmcqa_train |
IOC for neonatal hypertrophic pyloric stenosis: | Ans. (d) UltrasoundRef: SRB Manual of Surgery 4th ed. 1877* Ultrasound abdomen is the investigation of choice for diagnosing hypertrophic pyloric stenosis.* It is reliable, highly sensitive, highly specific, and easily performed.* The mandatory measurements include pyloric muscle thickness and pyloric channel length.* Muscle wall thickness 3 mm or greater and pyloric channel length 14 mm or greater are considered abnormal in infants younger than 30 days. | 4,498 | medmcqa_train |
A 42 yearold female has palpable purpura with rash over buttocks, pain in abdomen, and ahropathy diagnosis is - | HSP a small vessel vasculitis is commonly seen in young males characterized by palpable purpura of dependent areas. It is associated with ahritis, gut vasculitis and glomerulonephritis. Page 309. Reference IADVL's concise textbook of dermatology | 4,499 | medmcqa_train |
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.