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All are seen in blunt injury of the eye except: | Ans. Double perforation | 4,500 | medmcqa_train |
Features of neurogenic shock are - | NEUROGENIC SHOCK -,* Interruption of sympathetic vasomotor input after a high cervical spinal cord injury, *inadveent cephalad migration of spinal anesthesia, or * devastating head injury may result in neurogenic shock. In addition to aeriolar dilation, venodilation causes pooling in the venous system, which DECREASES VENOUS RETURN AND CARDIAC OUTPUT.. The extremities are often warm, in contrast to the usual sympathetic vasoconstriction-induced coolness in hypovolemic or cardiogenic shock. Treatment involves a simultaneous approach to the relative hypovolemia and to the loss of vasomotor tone. Excessive volumes of fluid may be required to restore normal hemodynamics if given alone. Once hemorrhage has been ruled out, norepinephrine or a pure a-adrenergic agent (phenylephrine) may be necessary to AUGMENT VASCULAR RESISTANCE. and maintain an adequate mean aerial pressure. ref:harrison&;s principles of internal medicine,ed 18,pg no 2639 | 4,501 | medmcqa_train |
Which of the following is an example of precipitation reaction? | Precipitation is a method for detecting an antigen-antibody reaction. When antigen and antibody combine in the proper propoions, a visible precipitate is formed. Optimum antigen-antibody ratios can be produced by allowing one to diffuse into the other, most commonly through an agar matrix (immunodiffusion). Counterimmunoelectrophoresis (CIE) is a type of precipitation reaction where immunodiffusion carried out in an electrophoretic field. Both the speed and the sensitivity of immunodiffusion are improved by CIE. Ref: Ray C.G., Ryan K.J. (2010). Chapter 4. Principles of Laboratory Diagnosis of Infectious Diseases. In C.G. Ray, K.J. Ryan (Eds), Sherris Medical Microbiology, 5e. | 4,502 | medmcqa_train |
Most common anomaly of upper urogenital tract is - | Ans. is 'a' i.e., Uretero pelvic junction stenosis o UPJ stenosis is most common abnormality in childhood and is more frequent in male children, characterised by narrowing usually on left side.o Overall, position & shape of kidney being most common one.o Horse shoe kidney is the most common and most frequently found renal abnormality among men. | 4,503 | medmcqa_train |
Which of the following is not seen in papilledema: March 2009 | Ans. D: Prominent optic disc margin Signs of papilledema: Early and mild Papilledema - Subtle gray peripapillary halo - Normal radial optic nerve head disrupted and nerve fibers accentuated by grayish opacity - Concentric folds of the retinochoroid Moderate Papilledema - Borders of optic disc become obscure - Disc margins are progressively elevated - Nerve head diameter increases - Major blood vessels leaving the disc are obscured Severe Papilledema - Optic Nerve head protrudes - Peripapillary halo demarcated Optic cup is obliterated Associated findings Loss of spontaneous retinal vein pulsations - Pulsations disappear at CSF Pressure > 250 mm water, Many normal patients lack venous pulsations (Unreliable sign) - Hyperemia - Retinal vessel touosity - Retinal hemorrhages - Retinal exudates - The radiating, oedematous folds around the macula take on the appearance of a macular star, usually incomplete and fan-shaped on the side towards the disc, while pluffy patches (cotton wool spots due to Nerve fiber infarctions) appear scattered throughout the posterior half of the fundus. - Optic Nerve pallor Papilledema shows a distended Optic Nerve sheath. | 4,504 | medmcqa_train |
Name of mumps vaccine is - | Ans. is 'a' i.e., Jeryl lynn VaccineStrainso RubellaRA27/3o MeaslesEdomonston Zagreb strain (most common) Schwarts strain Mortaten straino MumpsJeryll Lynn straino Chicken poxOKA strainoBCGDanish 1331o JENakavam strain (MC), Beizing P3 strain, SA 14-14-2o Yellow fever17 Do MalariaSPf.66,Pf25o HIVmvA (modified vaccinia ankara) rAAV (recombinant adeno associated viral) AIDSVAX Subunit vaccine strain | 4,505 | medmcqa_train |
Which of the following biochemical reaction is associated with substrate level phosphorylation? | Conversion of succinyl CoA to succinate is an example of substrate level phosphorylation in which a high energy phosphate is generated from the energy trapped in the thioester bond of succinyl CoA. Enzyme succinic thiokinase catalyses this step. In this reaction a molecule of GDP is phosphorylated into GTP and succinate is formed. GTP so formed is conveed into ATP by reacting with an ADP molecule. Ref: Lippincott's Biochemistry, 2nd Edition, Page 109; Textbook of Biochemistry By D M Vasudevan, 3rd Edition, Pages 75-77, 194, 204 | 4,506 | medmcqa_train |
The sputum examination under DTP is done when the patient present with - | <p> Hemoptysis Sputum examination under TB programme is done when patient presents with -cough more than 2 weeks. -fever with an evening rise. -hemoptysis. -unexplained weight loss. -reduced appetite. Park&;s textbook of preventive and social medicine,K.Park,21st edition,page no:392, 22nd edition,page no:396. <\p> | 4,507 | medmcqa_train |
Largest branch of veebral aery is | Anterior inferior cerebellar aery is a branch of Basilar aery | 4,508 | medmcqa_train |
An orthopedician adducts the flexed hip and gently pushes the thigh posteriorly in an effort to dislocate the femoral head of a neonate. What is this maneuver called? | D i.e. Barlow testRef: Nelson, Textbook of Pediatrics, 20th edition, page 3274Developmental Dysplasia of the Hip (DDH)Ranges from simple acetabular dysplasia, acetabular dysplasia plus subluxation to dislocation of the hip joint.Two major groups:Typical (otherwise normal individuals without defined syndromes or genetic conditions); andTeratologic (with identifiable causes) - small, shallow acetabulum and a stiff hip joint at birth.1-1.5 of 1000 live births, multifactorial etiology, involving both genetic and intrauterine environmental factors.Marked geographic and racial variation (Positive family history 12-33% of affected patients).Common - female patients, left hip (maternal hormones such as relaxin, which increases ligamentous laxity) and delivered by cesarean section.High rate of association in tighter intrauterine space (oligohydramnios, large birth weight, and first pregnancy) which supports the "crowding phenomenon" theory.Untreated typical DDH have changes may include (hypertrophy of the lateral cartilage of the acetabulum (neolimbus formation), hypertrophy of the ligamentum teres, capsular laxity, hourglass constriction of the hip capsule and hypertrophy of the transverse acetabular ligament, and excess femoral anteversion).Clinical Findings:CharactersBarlow testOrtolani testIntroductionProvocative maneuver / assesses the potential for dislocation of a nondisplaced hipNonforced maneuver / reverse of Barlow test- attempt to reduce a dislocated hipMethodAdducts the flexed hip and gently pushes the thigh posteriorly in an effort to dislocate the femoral headGrasps the child's thigh between the thumb and index finger and, with the 4th and 5th fingers, lifts the greater trochanter while simultaneously abducting the hipPositive testThe hip will be felt to slide out of the acetabulum and while relaxing the proximal push, the hip can be felt to slip back into the acetabulumThe femoral head will slip into the socket with a delicate "clunk" that is palpable but usually not audible Hip click - high-pitched sensation (or sound) felt at the very end of abduction during testing for DDH with Barlow and Ortolani maneuvers (originate in the ligamentum teres or occasionally in the fascia lata or psoas tendon and do not indicate a significant hip abnormality).Hip clunk - which is felt as the hip goes in and out of joint (signifies hip abnormality).Infant (1 to 3 months of age ) - hip is no longer reducible, limited hip abduction (most reliable sign of a dislocated hip), apparent shortening of the thigh, proximal location of the greater trochanter, asymmetry of the gluteal or thigh folds and pistoning of the hip.Galeazzi sign (Shortening of the thigh): Placing both hips in 90 degrees of flexion and comparing the height of the knees, looking for asymmetry.Klisic testPlaces the 3rd finger over the greater trochanter and the index finger of the same hand on the anterior superior iliac spine.* Normal hip - an imaginary line drawn between the two fingers points to the umbilicus.* Dislocated hip - the trochanter is elevated, and the line projects halfway between the umbilicus and the pubis.Walking child-Limp (toe-walk on the affected side), a waddling gait, leg-length discrepancy, positive trendelenburg sign and excessive lordosis.Ultrasonographic Findings:In < 6 mo of age - acetabulum and proximal femur are cartilaginous and not visible on plain radiographs and are best visualized with ultrasonography,Dynamic assessment about the stability of the hip joint.Monitor acetabular development, particularly of infants in Pavlik harness treatment.Radiographic Findings:> 6 mo of age. Anteroposterior view of the pelvis - use of several classic lines drawn on itLineTypeLandmarksInterpretationHilgenreiner lineHorizontallineDrawn through the top of both triradiate cartilages (the clear area in the depth of the acetabulum).* Perpendicular to the Hilgenreiner line* Ossific nucleus of the femoral head should be located in the medial lower quadrant of the intersection of these two linesPerkins lineVerticallineThrough the most lateral ossified margin of the roof of the acetabulumShenton lineCurvedlineDrawn from the medial aspect of the femoral neck to the lower border of the superior pubic ramus* Line is a continuous contour - normal* Two separate arcs / "broken" - in DDHAcetabular indexAngleFormed between the Hilgenreiner line and a line drawn from the depth of the acetabular socket to the most lateral ossified margin of the roof of the acetabulum (angle measures the development of the osseous roof of the acetabulum)* Newborn, the acetabular index can be up to 40 degrees* By 4 months in the normal infant, it should be no more than 30 degreesIn older childCenter-edge angleAngleFormed at the juncture of the Perkins line and a line connecting the lateral margin of the acetabulum to the center of the femoral head* 6-13 years old, an angle >19 degrees - normal* >14 years and older, an angle >25 degrees - normal Treatment Goals: Obtain and maintain a concentric reduction of the femoral head within the acetabulum.AgeTreatment< 6 months of age* Triple diapers or abduction diapers no role.* Pavlik harness - In normal newborns with all degrees of hip dysplasia.* Other braces - von Rosen splint, Frejka pillow.* 1 and 6 mo of age - Pavlik harness (full-time basis for 6 weeks), hip instability resolves in 95% of cases.* 6 months of age, the failure rate for the Pavlik harness is >50% (increasingly active and crawling child).6 months to 2 years* Closed reductions under general anesthesia. And casting in human position of moderate flexion and abduction for 12 weeks.* The replaced by an abduction orthotic device for 2 months (until acetabular development is normal).* Failure to obtain a stable hip needs open reduction.Older than 2 years of age* Open reduction is usually necessary.Sequlae: Avascular necrosis of the Capital Femoral epiphysis (< 6 months of age), redislocation, residual subluxation, and acetabular dysplasia. | 4,509 | medmcqa_train |
True statement regarding ectopic pregnancy: | If the serum beta hcg value is 1500 IU/L and an intrauterine pregnancy is not visualized in a TVS it is likely to be an ectopic .This is the level at which intrauterine gestational sac is seen and is called discriminatory zone (refer pgno:159 sheila 2 nd edition) | 4,510 | medmcqa_train |
The Vitamin A activity of beta-carotene compared to that of retinol is? | Beta-Carotene (provitamin A):
This is found in plant foods. lt is cleaved in the intestine to produce two moles of retinal.
ln humans, this conversion is inefficient, hence beta-carotene possesses about one-sixth vitamin A activity compared to that of retinol.
Reference: Satyanarayana- Biochemistry, 3rd edition, pg-119 | 4,511 | medmcqa_train |
Insulin causes all of the following except | Refer Katzung 11/e p 731 Insulin inhibits the formation of ketone bodies, therefore it's deficiency can result in diabetic ketoacidosis | 4,512 | medmcqa_train |
True statement about fatty acid: | C, B, > A i.e. (Hydrogenated vegetable oils contains Trans fatty acid; Biologically arachidonic acid is essential to life >Polyunsaturated FA is essential for membrane structure) | 4,513 | medmcqa_train |
Which of the following can cause toxic megacolon in 36 year old lady? | The hallmarks of toxic megacolon (toxic colitis), a potentially lethal condition, are nonobstructive colonic dilatation larger than 6cm and signs of systemic toxicity. The impoant etiologies of toxic megacolon include the following inflammatory causes: Ulcerative colitis Crohn colitis Pseudomembranous colitis The complication of toxic megacolon is perforation, even in the absence of colonic dilatation. | 4,514 | medmcqa_train |
Percentage of cold nodules that becomes malignant are? | ANSWER: (C) 20 %REF: Bailey and love 25th ed page 779See details of thyroid nodules in Surgery June 2011About 80% of discrete swellings are cold. The risk of malignancy is higher in "cold" lesions (20%) compared to "hot" or "warm" lesions (<5%). | 4,515 | medmcqa_train |
Long acting beta agonist used once a day: | Ans. C. IndacaterolRef: Katzung's Basic and Clinical Pharmacology 13th/ed, p340ExplanationAns. c. Indacaterol Ref: Katzung's Basic and Clinical Pharmacology 13th/ed, p340Explanationb agonistFeatures* Albuterol (salbutamol)* Terbutaline* Metaproterenol* Pirbuterol* Metered-dose inhalers* Bronchodilation is maximal within 15-30 minutes and persists for 3-4 hours.Frequent administrations required based on clinical status.* Can be given by nebulizer if using metered dose is not possible.* Albuterol and terbutaline are also available in tablet form (2 to 3 times daily) (option d), no added advantage therefore prescribed rarely. * Only terbutaline is available for subcutaneous injection; useful in severe asthma requiring emergency treatment when aerosolized therapy is not available or has been ineffective; CAUTION: Due to its longer duration of action cumulative effects may be seen after repeated injections.Bambuterol* It is prodrug of terbutaline.* Slowly hydorlyzed by pseudocholinesterase to release the active drug over a period of 24 hours.* Available in tablet form and given once daily.Long acting: Salme-Terol* Formoterol* Arformoterol* Carmoterol* Salmeterol a partial agonist and formoterol a full agonist.* Duration of action: 12 hours or more; used 2 times daily (options a,b,e).* In asthma should not be used as monotherapy; interact with inhaled corticosteroids to improve asthma control.Indacaterol* Ultra long acting p2 agonist; used once daily (Answer)* Approved for once daily long-term treatment of COPD and not for asthma and not for acute exacerbations of COPD. | 4,516 | medmcqa_train |
Essential for tumor metastasis is- | Angiogenesis is the mechanism of formation of new blood vessels. It is very critical in establishing the metastasis at the new area. Basic Pathology, Robbins. Page no.: 194 | 4,517 | medmcqa_train |
Large dose of EDTA are used in carbonic anhydrase enzyme inactivation. The mechanism by which EDTA act is - | Ans. is 'a' i.e., It chelates with metal ions of the enzyme o EDTA is a chelating agent and it has already been explained that chelating agent has legands (reactive groups) for metal binding. o These ligands of chelating agent bind to metal ions and cause chelation. o EDTA binds to zinc ion of carbonic anhydrase and this results in formation of ternary complex involving the enzyme, chelating agent and metal ions. The formation of ternary complex results in inactivation of enzyme. | 4,518 | medmcqa_train |
Drug contraindicated in hyperiglyceridemia | Bile acid binding resins like cholestyramine causes increase in triglycerides and are thus contraindicated in patients with hyperiglyceridemia due to risk of development of pancreatitis. Statins - decrease LDL and increase HDL Niacin - decrease LDL and triglyceride, maximum increase in HDL Fibrates - decrease triglyceride, decrease LDL. | 4,519 | medmcqa_train |
Culture media for transport of stools in suspected case of shigellosis - | Ans. is 'd' i.e., Buffered glycorol salineOrganismTransport mediaStreptococcus pyogenesPike's mediumNeisseriaStuart's medium, Amies mediumFor stool specimenBuffered glycerol saline, Carly-Blair, Stuart mediumSalmonella, ShigellaSach's buffered glycerol salineV choleraeVR medium, Cary-Blair medium, Autoclaved sea waterBordetellaModified Stuart's, Mischulow's charcol agar | 4,520 | medmcqa_train |
All are true about SLE in pregnancy except? | Increased anti Ro and La implies high risk of congenital hea block. Anti Ro antibody can be transmitted transplacentally and can lead to complete hea block leading to neonatal lupus. Steroids can be given in pregnancy as they fall in category A with no evidence of teratogenicity. But a placental enzyme 11 dehydrogenase deactivates glucocoicoids. Presence of anti-cardiolipin antibody and anti beta 2 glycoprotein antibody can lead to uterine aery or venous thrombosis leading to recurrent aboions. Most women can tolerate pregnancy without flare but it can worsen in some requiring aggressive treatment. All autoimmune diseases can worsen in pregnancy except rheumatoid ahritis. | 4,521 | medmcqa_train |
An orbital tumor has the following characteristics: Retrobulbar location within the muscle cone, well defined capsule, presents with slowly progressive proptosis, easily resectable, occurs most commonly in the 2" to 4th decade. The diagnosis is: | Cavernous hemangioma Cavernous hemangioma is the most common benign, intraconal tumor in adults. Hemangiopericytoma is also retro bulbar intraconal lesion. found in adults but is a rare tumor. Moreover owing to its tendency to invade the adjacent tissues, its margins are less distinct than cavernous hemangioma. Rest 2 options i.e. Dermoid and Capillary hemangiomas are primarily extraconal lesions. Cavernous hemangioma Cavernous hemangioma is the most common orbital vascular tumor in adults. Patients are typically middle aged (2nd to 4th decade) Present with slowly progressive painless proptosis Mostly its intraconal (>80%) but may also be extraconal. Cavernous hetnangiomas possess a distinct fibrous pseudo capsule and therefore on CT and MR appear well defined masses. Cavernous hemangioma is easily resectable as it is: - well encapsulated - does not have a prominent aerial supply (in contrast to capillary hemangioma) Capillary hemangioma Capillary hemangiomas occur primarily in infants. The tumor often increases in size for 6 to 10 months and then gradually involutes. Mostly extraconal, commonly occur in superior nasal quadrant. Capillary hemangiomas in and around the orbit may have an aerial supply from either the external carotid or internal carotid aeries. These tumors are capable of profuse bleeding. On CT and MR these lesions appear fairly well marginated to poorly marginated. Hemangiopericytomas Hemangiopericytomas are rare, slow growing vascular neoplasms that arise from the pericytes of Zimmermann, which normally envelop capillaries. About 50% cases are malignant. On CT and MR the orbital hemangiopericytoma, in contrast to cavernous hemangioma, appear less distint owing to its tendency to invade the surrounding tissues. Angiography may differentiate the tumors from cavernous hemangioma, meningioma, and schwannoma. - Hemangiopericytomas usually have an early florid blush - Cavernous hemangiomas show late minor pooling of contrast, or often appear as avascular masses - Meningiomas may show multiple tumor vessels and a late blush - Schwannomas may show no tumor blush. Dermoid Dermoid and epidermoids are the most frequent development cysts of the orbit. They result from the inclusion of ectodermal elements during closure of the neural tube. The dermoid contains one or more dermal adnexal structures such as sebaceous glands and hair folliclels. Dermoids are extraconal lesions. mostly located at the superior temporal quadrant of the orbit. On CT or MR demonstration offat within the lesion is almost diagnostic of dermoid. | 4,522 | medmcqa_train |
Cillia can transport radiolabelled particle in antrum with: | Cilia can transport radiolabeled particles an average of 6mm/min, with a range of 1-20mm/min. Thus this transport can clear inhaled particles from nasal cavity in 10-20 min. | 4,523 | medmcqa_train |
Following can lead to osteomalacia EXCEPT- | Calcium is the most abundant cation in the body and powerful homeostatic mechanisms control circulating ionised calcium levels . The WHO's dietary guidelines for calcium differ between countries, with higher intakes usually recommended in places with higher fracture prevalence. Between 20% and 30% of calcium in the diet is absorbed, depending on vitamin D status and food source. Calcium requirements depend on phosphorus intakes, with an optimum molar ratio (Ca:P) of 1 : 1. Excessive phosphorus intakes (e.g. 1-1.5 g/day) with a Ca:P of 1 : 3 have been shown to cause hypocalcaemia and secondary hyperparathyroidism Calcium absorption may be impaired in vitamin D deficiency and in malabsorption secondary to small intestinal disease. Calcium deficiency causes impaired bone mineralisation and can lead to osteomalacia in adults. Too much calcium can lead to constipation, and toxicity has been observed in 'milk-alkali syndrome' Ref Harrison 20th edition pg 78 | 4,524 | medmcqa_train |
All the following inflammatory mediators are derived from the cells except | . Kinins | 4,525 | medmcqa_train |
Investigation of choice for subdural hemorrhage is? | Ans. (b) NCCTRef Appendix-81 for "Traumatic intracranial hemotomas | 4,526 | medmcqa_train |
Hydatid disease of liver is caused by - | The larval stage is present in the animals including man,giving rise to hydatid cyst.Sheep ,pigs,cattle ,horse ,goat and man may act as intermediate host. Hydatid cyst involve liver , lung,brain,hea,kidney,spleen,bone,musclesetc. Liver is the commonest site and right lobe is frequently involved.The disease remains symptomless for many years.Chronic abdominal discomfo may be present in case of liver cyst.Cyst in the lungs are asympotomatic but may cause cough , breathlessness or chest pain (refer pgno:107 baveja 3 rd edition,panikers textbook of Medical parasitology 8th edition page 131) | 4,527 | medmcqa_train |
A 30-year-old man has had cramping abdominal pain and bloody diarrhea for the past 4 days. On physical examination, there is diffuse tenderness on palpation of the abdomen. Bowel sounds are present. There are no masses and no organomegaly. A stool culture is positive for Shigella flexneri. The episode resolves spontaneously within 1 week after onset. Six weeks later, he has increasingly severe lower back pain. Physical examination now shows stiffness of the lumbar spine and tenderness of the sacroiliac joints. He is treated with nonsteroidal anti-inflammatory agents. Two months later, the back pain recurs, and he complains of redness of the right eye and blurred vision. Serologic testing for which of the following is most likely to be positive in this patient? | This patient developed enteritis-associated arthritis affecting the lumbar and sacroiliac joints several weeks after Shigella dysentery. He subsequently developed conjunctivitis and, most likely, uveitis. This symptom complex is a classic representation of a cluster of related disorders called seronegative spondyloarthropathies. This cluster includes ankylosing spondylitis, reactive arthritis, psoriatic arthritis, and enteropathic arthritis (as in this case). A common feature is a very strong association with the HLA-B27 genotype. Despite some similarities with rheumatoid arthritis, these patients invariably have a negative test result for rheumatoid factor. Urethritis caused by Chlamydia trachomatis can trigger reactive arthritis, another form of seronegative spondyloarthropathy. Such infection precedes the onset of arthritis, however. There is no relationship between infection with Borrelia burgdorferi, the causative agent of Lyme disease, and reactive arthritis in individuals testing positive for HLA-B27. Similarly, Epstein-Barr virus infection is not a trigger for these disorders. | 4,528 | medmcqa_train |
Radiolucent periapical lesions have the following except | The features of periapical inflammatory lesions vary depending on the time course of the lesion. More chronic lesions may show lytic (radiolucent) or sclerotic (radiopaque) changes, or both. The lamina dura around the apex of the tooth usually is lost.
In most instances, the periphery of periapical inflammatory lesions is ill defined, showing a gradual transition from the surrounding normal trabecular pattern into the abnormal bone pattern of the lesion. In chronic cases, the new bone formation may result in a very dense sclerotic region of bone, obscuring individual trabeculae.
Oral radiology ; White and Pharaoh 7th edition page no 316-317 | 4,529 | medmcqa_train |
All are risk factors for preterm delivery except : | Absence of fetal fibronectin at < 37 weeks | 4,530 | medmcqa_train |
Antitumor activity is shown by all except - | Ananthanarayanan and Paniker's textbook of microbiology 9th edition. cytotoxic T cells can kill and lyse target cells carrying new or foreign antigens including tumor,allograft and virus infected cells. Natural killer cells are natural defence against virus infected and malignant mutant cells. activated macrophages secrete a number of biologically active substances including hydrolytic enzymes , TNF , Colony stimulating factor and IL 1. This they have tumor cytotoxicity.. | 4,531 | medmcqa_train |
Immunoglobulins are produced by - | Immunoglobulin (Ig),is a large, Y-shaped protein produced mainly by plasma cells that is used by the immune systema Ref: Ananthanarayan & Panikers textbook of microbiology 9th edition pg:94 | 4,532 | medmcqa_train |
Single most important feature to diagnose fetal aneuploidy: | Ans: (a) Increased nuchal translucencyRef: Current Progress in Obstetrics and Gynecology, John Stud, Volume Page 17Ultrasound markers of fetal aneuploidy:Nuchal translucency is the single most powerful tool. More than 3 mm needs evaluationAbsence of nasal boneAbsence or reversal of flow in the ductus venosus on DopplerTricuspid regurgitationIncrease in frontomaxillary angle more than 85 deg | 4,533 | medmcqa_train |
Ponderal's index for "small for gestational age" child: March 2013 | Ans. B i.e. Less than 2 Ponderal Index (for neonates) Calculated as Weight in gm X 100/ (length in cm)3 A child with ponderal index 3.0 or more can be considered overweight but in some conditions such as in maternal smoking, reduced length may also be implicated. An index between 2.5 and 3.0 is considered normal, Between 2.0 and 2.5 marginal, and A child with this index less than 2.0 is classified as small for gestational age (SGA). | 4,534 | medmcqa_train |
According to European laryngeal Society, Subligamental cordectomy is classified as | Subligamental cordectomy is classified as Type II Excision of vocal cord after splitting the larynx (cordectomy laryngofissure) Ref: PL Dhingra; Textbook of EAR, NOSE and THROAT; edition 6; page no 310 | 4,535 | medmcqa_train |
Infeility can be defined as: UP 11; KCET 13 | Ans. Not conceiving after 1 year of unprotected intercourse | 4,536 | medmcqa_train |
The commonest cause of primary amenorrhea with ambiguous genitalia in a female with 46XX chromosome : | A i.e. 21- hydroxylase deficiencyClassic 21 - hydroxylase deficiency is most common cause of ambiguous genitalia in new born (virilization) and primary amenorrheaQ. i.e. Pseudohermaphroditism of female childPrimary amenorrhea with VirilizationQ in females is in:- 21 - hydroxylase deficiency- 11 - Hydroxylase deficiencyTypesMain function ofenzymeMineralococoid(M)Glucocoicoid(G)AndrogenFeatures21- OH-deficiencyGlucocoicoid &Mineralocoicoidproduction U"l'* HypotensionQ(salt losing virilization)* VirilizationQ in females* Precocious pubey in femalesQ.11 hydroxylase-deficiencyGlucocoicoidproductionT.1.1,T* HypeensionQ* VirilizationQ in females* Precocious pubey in femalesQ.17- hydroxylasedeficiencyGlucocoicoid &Androgen production'1'.1,14* Male hermaphroditeQ* Primary atnenorrhea infemalesQ.* HypeensionQ3 - p-hydroxylasedeficiencyMineralcoicoid &glucocoicoidproduction..1,.1,T* Male hermaphrodite. | 4,537 | medmcqa_train |
While going for oxidation in the mitochondria, free fatty acid are transpoed by: | Free fatty acids (FFA)-also called unesterified (UFA) or nonesterified (NEFA) fatty acids--are fatty acids that are in the unesterified state. In plasma, longer chain FFA are combined with albumin, and in the cell they are attached to a fatty acid binding protein. Shoer chain fatty acids are more water-soluble and exist as the unionized acid or as a fatty acid anion. Ref: Botham K.M., Mayes P.A. (2011). Chapter 22. Oxidation of Fatty Acids: Ketogenesis. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K. Murray, V.W. Rodwell (Eds), Harper's Illustrated Biochemistry, 29e. | 4,538 | medmcqa_train |
Sepsis of index finger will spread to? | Ans. a (Thenar).Deep thenar space infection occurs in the potential space between the palmar aponeurosis and the fascia overlying adductor policis, which contains not only the flexor pollicis longus tendon plus the neurovascular (NV) bundles to the thumb, but also the NV bundle on the radial side of the index plus the flexor tendons of the index. Therefore, a deep thenar space infection can involve both the thumb and the index finger.The pollical sheath extends distally almost to its insertion, and that part of the common sheath for the little finger usually does likewise. The ring, middle, and index fingers are provided with digital sheaths that usually extend proximally no further than the necks of their metacarpal bones, leaving a gap of 1 to 3 cm below the common sheath. Hence infection of the synovial sheaths of the thumb or little finger may spread along tendon sheaths readily into the palm and even into the forearm.Also remember:Hypothenar musclesMuscle Origin Insertion InnervationActionAbductor digiti minimi Pisiform}Medial side of}} Abducts little fingerFlexor digiti minimi brevis}Hooks of hamate}proximal phalanxDeep branch of ulnarFlexes little fingerOpponens digiti minimi Front of 5th metacarpal Draws 5th metacarpal forwardPalmaris brevis Medial border of palmar aponeurosis Skin on medial side of hand Superficialbranch of ulnarDeepens hollow of palm & protects ulnar nerve & arteryThenar MusclesMuscles Origin Insertion InnervationActionAbductor pollicis brevis}Flexor ratinaculum}Lateral sesamoid &} Abducts thumb Flexes thumbFlexor pollicis brevis}& tubercle of trapezium}base of proximal phalanx}Recurrent branch of medianRotates 1st metacarpalOpponens pollicis Lateral side of 1st metacarpal- mediallyAdductor pollicis Capitate, trapezoid, base of 2nd metacarpal {oblique head) & front of 3rd metacarpal (transverse head) Medial sesamoid & base of proximal phalanx Deep branch of ulnarAdducts thumb | 4,539 | medmcqa_train |
Defective chromosome associated with De-George syndrome is - | Ans. is 'd' i.e., 22 This syndrome encompasses a spectrum of disorders that result from a small deletion of band q 11.2 on long arm of chromosome 22. Clinical features are considered to represent two different disorders :-1) Di George syndromeThese patients have thymic hypoplasia with resultant T-cell immunodeficiency.Other features include parathyroid hypoplasia (causing hypocalcemia), cardiac malformations & facial anomalies.TBX-1 gene (a T-box transcription factor) is most closely associated with this syndrome.The target of TBX-1 include PAX 9, a gene that controls the development of the palate, parathyroid and thymus.2) Veto cardio facial sndromeThis syndrome is characterized by facial dysmorphism (prominant nose, retrognathia), cleft palate, cardiovascular anomalies, and learning disabilities. | 4,540 | medmcqa_train |
all are true about s1 except | CHARACTERISTICS OF S1 Normally heard as fused single hea sound Medium to High Frequency Low Pitched Best heard with diaphragm M1 louder than T1 M1 best heard at apex T1 best heard at Left LSB Splitting can be heard in Expiration and L-LSB ref : harrisons 21st ed | 4,541 | medmcqa_train |
Central dot sign is seen in | "central dot" sign: enhancing dots within the dilated intrahepatic bile ducts, representing poal radicles (seen in CT). | 4,542 | medmcqa_train |
Which of the following is/are an example(s) of non-Mendelian inheritance? | Single-Gene Disorders with Non classic Inheritance. -This group of disorders can be classified into four categories: Diseases caused by trinucleotide-repeat mutations Disorders caused by mutations in mitochondrial genes Disorders associated with genomic imprinting Disorders associated with gonadal mosaicism | 4,543 | medmcqa_train |
The period of training for a village health guide is - | After selection village health guide undergoes a sho training in primary health care.The training is arranged in nearby health center,subcenter or any other suitable place for the duration of 200 hours ,spread over a period of 3 months.During training period they receive a stipend of Rs 200 per month (refer pgno:902 park 23rd edition) | 4,544 | medmcqa_train |
A 50 year old man presents with paresthesia. Hb = 6.8 gms/dl. Peripheral smear shows macrocytes and neutrophis with hypersegmented nuclei. Endoscopy reveals atroghic gastritis. Which of the following deficiency is more likely? | above clinical features point towards Vit B12 deficiency due to Pernicious anemia. Pernicious anemia -Type II Hypersensitivityin which ABs are formedagainst intrinsic factorthus inhibits the binding of IF+B12. Intrinsic factor deficiency-Malabsorption of vitamin B12 - Megaloblastic anemia /Pernicious anemia | 4,545 | medmcqa_train |
Which of the following is a stage of intuitive thought appearance in jean-Piaget scheme : | C i.e. Preoperational stage | 4,546 | medmcqa_train |
An expectant mother feels quickening at : | In second trimester the pregnant women feels much better ,the nausea vomiting and bladder frequency is almost gone She slowly stas feeling growing uterus per abdomen Of interest and excitement to her is the very first perception of foetal movement called quickening felt at around 18 weeks in a primigravida and 16 -18 wks in a multigravida (refer pgno:90 Sheila 2 nd edition) | 4,547 | medmcqa_train |
Renal transplantation, in which mother acts as a donor of one kidney to her son is an example of | Ans. is 'c' i.e., Allograft Transplantation terminologyAutograft:Tissue transplanted from one part of the body to another in the same individual.Also called an autotransplant.Isograft:Is a graft of tissue between two individuals who are genetically identical (i.e. monozygotic twins). Transplant rejection between two such individuals virtually never occurs.Allograft:An organ or tissue transplanted from one individual to another. | 4,548 | medmcqa_train |
All of the following statements about Zenker's diveiculum are true Except: | Ans is D i.e. Out pouching of the anterior pharyngeal wall, just above the cricopharyngeus muscle Zenker's diveiculum is out pouching of the posterior pharyngeal wall, where pharyngeal mucosa herniates through the Killian's dehiscence (the weak area between the upper oblique fibres and the lower horizontal fibres of the inferior constrictor muscle). Zenker's diveiculum is an acquired diveiculum and not a congenital diveiculum. It's a false diveiculum as it does not contain all the anatomic layers of the oesophageal wall. Barium swallows are diagnostic. Lateral views are essential as these are posterior outpouchings. | 4,549 | medmcqa_train |
The blood pressure measured by a sphygmomanometer | At the point at which systolic pressure in the aery just exceeds the cuff pressure, a spu of blood passes through with each heabeat and, synchronously with each beat, a tapping sound is heard below the cuff.Ref: Ganong&;s Review of Medical Physiology 25th Edition. Page: 577 | 4,550 | medmcqa_train |
A decrease in basal metabolic rate (BMR) is seen in which of the conditions? | Obesity by definition is an increase in the amount of adipose tissue mass or fat mass. Adipose tissue is relatively ine from a metabolic rate. Basal metabolic rate depends on the amount of metabolically active tissue or the lean body mass. An obese individual has higher propoion of fat relative to lean body mass than a non- obese individual with the same weight, and hence a lower basal metabolic rate. Ref: Understanding Nutrition By Ellie Whitney, Eleanor Noss Whitney, Sharon Rady Rolfes, Page 246; Biochemistry By Debajyoti Das, Page 570. | 4,551 | medmcqa_train |
Patient with fixed dilated pupil, with iris atrophy and secondary glaucoma after penetrating keratoplasty is suggestive of. | Ans. d. Urrets Zavalia syndrome A fixed dilated pupil following penetrating keratoplasty is a well recognized if rare postoperative complication. The mydriasis following penetrating keratoplasty was first described by Castroviejo but it was Urrets-Zavalia who first published his observations on a series of six cases and suggested an association of fixed dilated pupil, iris atrophy. and secondary glaucoma. The pupil can become abnormally dilated following penetrating keratoplasty for keratoconus, paicularly if dilating drops are used. In addition to the pupil and iris abnormalities, Urrets-Zavalia also described other features__ iris ectropion, pigment dispersion, anterior subcapsular cataract and posterior synechiae. Urrets Zavalia Syndrome Urrets Zavalia Syndrome is characterized by triad of: Secondary glaucoma + Iris atrophy + Fixed dilated pupil') Urrets-Zavalia syndrome (UZS) consists of a fixed dilated pupil associated with iris atrophy. It is a poorly understood complication following penetrating keratoplasty for keratoconus. Posner Shlossman syndrome It is also called as glaucomatocyclitic crisis. Episodic unilateral mild anterior uveitis, photophobia, reduced vision and colored rings around lights (from secondary corneal edema Benedict's Syndrome If red nucleus is involved, tremors and jerky movements occur in contralateral side of the body. This condition combined with ipsilateral 3rd nerve paralysis is called as Benedict's syndrome. McKusick-Kaufmann Syndrome McKusick-Kaufman syndrome: A rare genetic disorder characterized by hydrometrocolpos (fluid buildup in vagina and uterus), extra fingers and congenital hea defects | 4,552 | medmcqa_train |
Which of the following is not used for emergency contraception? | Emergency contraception should be given within 72 hours of unprotected sex. They interfere with postovulatory events which normally results in pregnancy and therefore known as incentives - As the most common method and drug is - levonorgestrel with success rate of 95 %.the tablets can be offered up to 120 hours. however, sooner the tablets taken after intercourse is more effective and most effective method is IUCD as it is given by the doctor itself to inject the IUCD and the failure rate is 0.1% Mifepristone is a steroid for progesterone receptor. It does not prevent feilization but by blocking the action of progesterone on the endometrium, it causes sloughing and shedding of decidua and prevents implanatation. Danazol is contraceptive drug it is anti - estrogenic in nature but it is not the best drug because of the failure rate chance of this drug and if mother is having female fetus it can cause virilization of unborn female child. | 4,553 | medmcqa_train |
About first order kinetics,true statement is | Clearance is variable in zero-order kinetics because a constant amount of the drug is eliminated per unit time, but it is constant in first-order kinetics, because the amount of drug eliminated per unit time changes with the concentration of drug in the blood Ref-KDT 6/e p32 | 4,554 | medmcqa_train |
True statement about streptococcus faecalis ? | Ans. is 'a' i.e., Growns in 6.5% Nacl solution | 4,555 | medmcqa_train |
In national vector borne disease control program which disease is not included? | Ans. (b) Yellow feverRef. K. Park 21sted./380* The National Vector Borne Disease Control Programme (NVBDCP) is implemented for the prevention and control of vector borne diseases such as: Malaria, Filariasis, kala-azar, Japanese encephalitis, Dengue and Chikunguniya.* Yellow fever is NOT a part of NVBDCP. | 4,556 | medmcqa_train |
Last pa of the hea to be repolarised is: | Depolarization occurs from apex to base & endocardium to epicardium; Repolarization occurs from base to apex & epicardium to endocardium Last to depolarize are: Base of LV (epicardium) Pulmonary conus. Upper most pa of interventricular septum. Last to repolarise: Apex endocardium | 4,557 | medmcqa_train |
Hassal's corpuscles are seen in: | Hasal's corpuscles/thymic corpuscles are structures found in the medulla of the human thymus, formed from type VI epithelial reticular cells.They are named for Ahur Hill Hassall, who discovered them in 1849. | 4,558 | medmcqa_train |
At the altitude of 6500 meters, the atmospheric pressure is 347 mmHg. What is the inspired PO2. | According to law of paial pressures : Pressure exeed by a gas in a mixture is directly propoional to its concentration in the mixture. In inspired gases; 20 % = O2 78% = N2 PH2O = 47 mmHg (air humidified with inspiration) =347 - 47 = 300 mmHg = gaseous component | 4,559 | medmcqa_train |
Management of medulloblastoma in 1.5 year old. What is not done in curative therapy? | . Treatment consist of relief of raised intracranial pressure,establishment of pathological diagnosis,removal of beningn tumors,decompressive surgeries for malignant tumor,shunt surgeries to drain CSF_ventriculo peritonial shunt or ventriculo atrial shunt,radiotherapy ,chemotherapy-temozolamide (Ref;SRB's Manual of Surgery,5th edition,pg no. 1105) | 4,560 | medmcqa_train |
A middle aged female repoed with dull diffuse progressive headache of 2 months duration associated with episodes of vomiting and blurred vision at times. Cough increases the headache.Likely patient has | A space-occupying lesion of the brain is usually due to malignancy but it can be caused by other pathology such as an abscess or a haematoma. Almost half of intracerebral tumours are primary but the rest have originated outside the CNS and are metastases Features of a headache indicating a high risk of a space-occupying lesion of the brain or idiopathic intracranial hypeension include: A new headache with features suggestive of raised intracranial pressure, including papilloedema, vomiting, posture-related headache, or headache waking the patient from sleep Ref Harrison20th edition pg 2456 | 4,561 | medmcqa_train |
Which is not secreted by stomach? | Gastric lipase is an acidic lipase secreted by the gastric chief cells in the fundic mucosa in the stomach. It is a weak fat-splitting enzyme. Pepsinogen is secreted by the chief cells of main gastric glands which are found in the body & fundus of stomach. It is a proteolytic enzyme. HCl is secreted by the parietal cells of main gastric glands found in body & fundus of stomach. It paicipates in the breakdown of protein, provides an optimal pH for action of pepsin & hinders the growth of pathogenic bacteria. Ref: Medical Physiology, Indu Khurana | 4,562 | medmcqa_train |
Which of the following is an alternative to methadone for maintenance treatment of opiate dependence | The withdrawal symptoms can be managed by one of the following methods: 1. Use of substitution drugs such as methadone 2. Clonidine is a a2 agonist that acts by inhibiting norepinephrine release at presynaptic a2 receptors. 3. Naltrexone with Clonidine: Naltrexone is an orally available narcotic antagonist which, when given to an opioid-dependent individual, causes withdrawal symptoms. These symptoms are managed with the addition of clonidine for 10-14 days after which clonidine is withdrawn and the patient has continued on naltrexone alone. 4. Other Drugs: The other detoxification agents include LAAM ( Levo-alpha-acetyl-Metha dol), propoxyphene, diphenoxylate, buprenorphine (long-acting synthetic paial m-agonist which can be administered sublingually), and lofexidine (a2 agonist, similar to clonidine). In paicular, Buprenorphine has recently been used widely for detoxification as well as for maintenance treatment in many pas of the World. Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no. 44 | 4,563 | medmcqa_train |
The MOST likely site of lesion in a patient with Wernicke's hemianopic pupil is: | Wernicke's hemianopic pupil indicates lesion in the optic tract. In this condition light reflex is absent when light is thrown on temporal half of the retina of the affected side and nasal half of retina of the opposite side. In this condition light reflex is present when light is thrown on nasal half of affected side and temporal half of affected side. This patient also has homonymous hemianopia. Ref: Textbook of Ophthalmology edited by Sunita Agarwal, page 304. | 4,564 | medmcqa_train |
Use of oral contraceptives increases the risk of which cancer - | Ans. is 'c' i.e., breast * Important adverse effects of OCPs are: (1) Nausea, vomiting, headache (worsening of migraine), (2) breakthrough bleeding, (3) mastalgia, (4) weight gain, (5) acne and hirsutism, (6) cholasma and pruritis, (7) carbohydrate intolerance, (8) leg vein and pulmonary thrombosis, (9) coronary and cerebral thrombosis (MI & stroke), (10) hypertension, (11) increased risk of breast and cervical carcinoma, (12) benign hepatoma, (13) gall stones, (14) precipitation of acute intermittent porphyria. | 4,565 | medmcqa_train |
Most common location of accessory spleen | Accessory spleen, in other words supernumerary spleens, splenunculi, or splenules, results from the failure of fusion of the primordial splenic buds in the dorsal mesogastrium during the fifth week of fetal life. Incidence of accessory spleen in the population is 10%-30% of patients in autopsy series and 16% of patients undergoing contrast enhanced abdominal CT. Although the most common location for an accessory spleen is splenic hilum (75%) and pancreatic tail (25%) , it can occur anywhere in the abdomen including gastrosplenic or splenorenal ligaments, wall of stomach or bowel , greater omentum or the mesentery, and even in the pelvis and scrotum. Accessory spleen usually measures 1 cm in diameter, but its size varies from a few milimeters to centimeters. Also the number of accessory spleens can vary from one to six . Accessory spleens are usually incidentally detected and asymptomatic, but in case of unexpected locations, accessory spleen can be of clinical impoance. Ref - radiologyassistant.com | 4,566 | medmcqa_train |
Leaving (or forgetting) an instrument or sponge in the abdomen of the patient during a surgery and closing operation is: | Ans. d (Criminal negligence). (Ref. Textbook of FMT by Parikh 6th ed. 1.46)Contributory negligencea common law defence to a claim or action. It applies to a situation where a plaintiff claimant has, through their own negligence, caused or contributed to the injury they suffered. For example where a pedestrian crosses a road carelessly and is hit by a driver who is also driving carelessly.Comparative negligencea system of apportioning recovery for a tort based on a comparison of the plaintiff's negligence with the defendant's. It contrasts with the doctrine of contributory negligence, which disallows recovery by a plaintiff whose actions in some way, however small, contributed to the tort.Criminal negligencedefined as careless, inattentive, neglectful, willfully blind, or in the case of gross negligence what would have been reckless in any other defendant. For example, leaving (or forgetting) an instrument or sponge in the abdomen of the patient during a surgery and closing the operation contributes to criminal negligence.Corporate manslaughtera term for an act of homicide committed by a company. In general, a legal person is in the same position as a natural person, and may be convicted for committing virtually all offences, under English criminal law. The Court of Appeal confirmed in one of the cases following the disaster that a company can in principle omit manslaughter, although all defendants in that case were acquitted | 4,567 | medmcqa_train |
In a pregnant female, there is decreased requirement of the spinal anaesthetic agent because of all of the following except – | A smaller dose of local anaesthetic is nedded to produce the same level of neuraxial block in pregnant women compared with nonpregnant women.
The causes may be :-
Compression of the inferior vena cava by the pregnant uterus causes "distension or engorgment" of the epidural venous plexus. This decreases the volume of the epidural space and also the volume of the CSF per spinal segment. Therefore a given dose of epidural or intrathecal local anaesthetic will produce a greater degree of demiatomal involvement.
Pregnant women exhibit increase susceptibility to local anaesthetics.
Apex of lumbar lordosis cauded to thoracic kyphosis is reduced in supine position. This may enhance the cephalad spread of CSF. | 4,568 | medmcqa_train |
True statement regarding upper GI bleeds: | UPPER GI BLEED: Bleeding up to Lig. of Treitz M/c cause- Non-variceal peptic ulcer bleeding Causes of upper gastrointestinal bleeding Condition % Ulcers 60 Oesophageal 6 Gastric 21 Duodenal 33 Erosions 26 Oesophageal 13 Gastric 9 Duodenal 4 Mallory-Weiss tear 4 Oesophageal varices 4 Tumour 0.5 Vascular lesions, e.g. Dieulafoy's disease 0.5 Others 5 Risk stratification system for UPPER GI BLEEDS: - Help to identify the patients at higher risk of major bleeding or death (facilitate patient triage) Commonly used scoring systems: - Rockall score -takes account of endoscopic findings, most useful - Blatchford score -during initial assessment, does not require endoscopic data. Commonly Used Risk Stratification Systems for Upper GI Bleeds Blatchford Score (PUSH + Melena/Syncope + Cardiac/Hepatic Dysfunction) Rockall & Baylor Score (CASDE) PulseQ Blood Urea nitrogenQ Systolic BPQ HemoglobinQ Presence of MelenaQ, SyncopeQ, HepaticQ or Cardiac dysfunctionQ Comorbid diseaseQ (cardia, hepatic, renal, or disseminated) * AgeQ (<60 years, 60-79 years >80 years) ShockQ (systolic BP <100 mm Hg. HR >100 beats/min) Diagnosis at the time of endoscopy (Mallory-Weiss non-malignant lesions, or malignant lesions) Endoscopic Stigmata of recent bleedQ | 4,569 | medmcqa_train |
All of the following are seen in Lichen planus except? | Granular cell layer is absent in psoriasis where as Lichen planus is characterized by Hypergranulosis.
Necrotic / apoptotic keratinocytes are called as "colloid / civatte bodies" and spaces left at the dermo - epidermal junction are termed as "Max - joseph spaces".Both are seen due to autoimmune destruction of basal keratinocytes,classical of lichen planus. | 4,570 | medmcqa_train |
Noonan syndrome is characterized by all except | Coarctation of aorta is not the cardiovascular manifestation in Noonan syndrome. | 4,571 | medmcqa_train |
Pain Assessment Tool is best done by | (B) TachycardiaPAT - Pain Assessment ToolParameters012Posture/tone ExtendedDigits widespreadShoulders raised off bedFlexed and/or tenseFists clenchedTrunk guardingLimbs drawn to midlineHead and shoulder resist posturingCryNo YesWhen disturbedDoesn't settle after handlingLoudWhimperingWhiningSleep patternRelaxed Agirated or withdrawnWakes with startleEasily wokenRestlessSquirmingNo clear sleep/wake patternEye aversion "shut out"Expression FrownShallow furrowsEyes lightly closedGrimaceDeep furrowsEyes tightly closedPupils dilatedColorPink, well perfused Pale/dusky/flushed, Palmar swearingRespirations TachypneaArt restApneaAt rest or with handlingHeart rate TachycardiaAt restFluctuatingSpontaneous or at restOxygen saturationNormal Desaturation with or without handlingBlood pressureNormal Hypo-/hypertension at restNurse's perceptionNo pain perceived by me I think the baby is in painNote: Infants are assessed and scores obtained every 2 to 4 hours. An infant with a score > 5 requires comfort measures; >10 requires analgesia dose adjustment# Pain causes stress. The endocrine system reacts by releasing an excessive amount of hormones, ultimately resulting in carbohydrate, protein, and fat catabolism (destruction); poor glucose use; and other harmful effects. This reaction combined with inflammatory processes can produce weight loss, tachycardia, increased respiratory rate, fever, shock, and death. Unrelieved pain prolongs the stress response, adversely affecting the patient's recovery.> Cardiovascular system responds to stress of pain by activating the sympathetic nervous system, which produces a variety of unwanted effects.> In the postoperative period, these include hypercoagulation and increased heart rate, blood pressure, cardiac work load, and oxygen demand.> Aggressive pain control is required to reduce these effects and prevent thromboembolic complications.> Cardiac morbidity is the primary cause of death after anesthesia and surgery | 4,572 | medmcqa_train |
Most fatal amoebic encephalitis is caused by ? | Ans. is 'b' i.e., Naeglaria . Amongst the given options Naeglaria and Acanthamoeba cause amoebic encephalitis. " The prognosis of Naeglaria encephalitis is uniformaly poor, most patients die within a week."---Harrison "Acanthamoeba encephalitis follows a more indolent course."----- Harrison . So, amongst the given options Naeglaria causes most fatal amoebic encephalitis . | 4,573 | medmcqa_train |
In an adult, the hyoid bone is seen at which of the following level of the cervical veebrae? | The hyoid bone is found at the level of third cervical veebrae in adults. It is situated above the thyroid cailage in the anterior wall of the hypopharynx in relation to the base of the tongue. It is made up of a body, bilateral greater cornua and bilateral lesser cornua. It is a sesamoid bone and is suspended in between the supra hyoid and infra hyoid musculature and is therefore responsible for the concavity between the chin and the anterior neck. The body is convex from side to side. At either end of the body on its upper surface is a small tubercle called lesser cornu. It is the point of attachment of medial end of middle constrictor muscle and stylohyoid ligament. | 4,574 | medmcqa_train |
Which of the following statements about Von-Hippel Lindau syndrome is true | Harrison's principles of internal medicine 17th edition. *In VHL somatic mutation of normal allele leads to retinal angiomas, CNS hemangioblastoma,pheochromocytomas and multicentric clear cysts,hemangiomas and adenomas of kidney | 4,575 | medmcqa_train |
Which of the following statement regarding measurement of BP with sphygmomanometer versus intra aerial pressure measurements is true? | The measurement of aerial pressure using a sphygmomanometer bag with a standard arm cuff is subject to inaccuracy leading to falsely high aerial pressure readings. Using sphygmomanometer blood flow is detected. The accuracy of blood pressure measurement is affected by the cuff size. Inadequate cuff size result in falsely elevated blood pressure reading. A large cuff size result in falsely low reading. Ref: Medicine for Anaesthetists By Michael Douglas Vickers, Ian Power, Ppage 285; Critical Care Study Guide: Text and Review By Gerard J. Criner, Page 157. | 4,576 | medmcqa_train |
The earliest sign of iron deficiency anaemia - | <p>Plasma ferritin is a measure of iron stores in tissues & is the single test to confirm iron deficiency .It is a very specific test. In the course of development of anaemia, firstly storage iron(ferritin) depletion occurs during which iron reserves are lost without compromise of the iron supply for erythropoiesis.</p><p>Plasma iron & total iron binding capacity(TIBC) are measures of iron availability ;hence they are affected by many factors besides iron stores.Plasma iron has a diurnal & day -to-day variation & becomes very low in acute phase response .</p> | 4,577 | medmcqa_train |
Most potent bronchodilator among inhalational anesthetic agents is | Effect of inhalational agents on respiratory systemAll inhalational agents are bronchodilators -Halothane cause maximum bronchodilatation. The inhalational agent of choice in asthmatics (intravenous anaesthtic of choice is ketamine).All inhalational agents cause respiratory depression to some extent - Maximum depression of respiration is seen with enflurane, on the other hand, maximum inhibition of ventilator response to increased CO2 and hypoxia is caused by halothaneAll inhalational agents vasodilate pulmonary vascular bed by blunting the hypoxic pulmonary vasoconstriction (HPV) response. Halothane has maximum effect: Isoflurane, Enflurane, desflurane, sevoflurane have similar effect.(Refer: Morgan and Mikhail's Clinical Anaesthesiology, 5th edition, pg no. 167 - 169) | 4,578 | medmcqa_train |
Compared to the other antidepressant drugs miazapin has the distinct ability to act as an antagonist of: | Ref: KDT 8th ed Miazapine blocks presynaptic [?]2 receptors on NA and 5-HT neurons. This increases the release of both NA and 5-HT. It also inhibits 5-HT2 and 5-HT3 receptors. | 4,579 | medmcqa_train |
All is true about von Hippel Lindau syndrome except: | C i.e. Tumors of Schwann cells are common Von Hippel-Lindau (VHL) syndrome is associated with multiple hemangioblastomasQ of infratentorial craniospinal axis, retina and pancreas. Supratentorial HB are uncommonQ. | 4,580 | medmcqa_train |
Nucleus ambiguus is composed of: | Ans. C. 9,10,11 cranial nerve nucleusCells in nucleus ambiguus contain motor neurons associated with three cranial nerves (rostral pole = C.N. IX = glossopharyngeal; middle part = C.N. X = vagus; caudal pole = C.N. XI = spino accessory). Axons arising from nucleus ambiguus pass laterally and slightly ventrally to exit the medulla just dorsal to the inferior olive. These axons then course with the three cranial nerves IX (glossopharyngeal), X (vagus) and XI (spino accessory) to innervate the striated muscles of the soft palate, pharynx, larynx, and upper part of the esophagus. | 4,581 | medmcqa_train |
At what age a child's height is expected to be 100 cm? | ANSWER: (C) 4 yearsREF: Essence of Paediatrics Prof. MR Khan 4th ed page 59, Clinical Pediatrics by D. N. Chatterjee page 18 A simple rough formula for calculation height from 2-14 years is:Height in inches = (2.5 x age in years) + 30* Thus the expected height at 4 year of age = (2.5 x 4) + 30 = 40 inches* As 1 inch = 2.5 cm, 40 inches = 100 cm | 4,582 | medmcqa_train |
True about mesenteric vein thrombosis ? | Answer is 'd' i.e. Surgery can lead to sho-bowel syndrome Peritoneal signs are present in less than half the cases. Any length of bowel may be involved depending on the level and extent of thrombosis. Resection of the nonble bowel along with its mesentry is the treatment of choice. Heparin is given in all cases and along with bowel rest and fluid resuscitation is sufficient in patients without bowel infarction, but I am not sure whether it should be termed tit of choice. | 4,583 | medmcqa_train |
Dysphagia caused by in Plummer Vinson Syndrome is due to | (Web) (1024-25-LB) (737, 1043-B &L 25th)Plummer-Vinson Syndrome (Brown-Kelly Paterson syndrome or sideropenic dysphagia)* Young women with iron deficiency anaemia and dysphagia referred high in the neck.* The dysphagia was said to be caused by spasm or a web in the post-cricoid area. The patients were said to have an increased tendency to post-cricoid cancer.* Web certainly occurs in the upper oesophagus. More recently it has been noted that there is often a patch of heterotopic gastric mucosa in the upper oesophagus (probably congenital)* Complications - ulceration, stricture and adenocarcinoma | 4,584 | medmcqa_train |
Most common cause of ectopic ACTH production- | Ans. is 'c' i.e.. Small cell carcinoma lungo Ectopic ACTHproduction accounts for 10-20% cases of cushings syndromeo Small cell lung carcinoma (SCLC) is by far the most common causes of ectopic ACTH.# If accounts for more than 50%cases of cushings syndrome due to ectopic ACTH production.Other carcinomas associatedThymic carcinoid (15%)Islet cell tumour (10%)Bronchial carcinoid (10%)Other carcinoids (5%)Pheochromocytoma (2%) | 4,585 | medmcqa_train |
Which of the following describes the reflex increase in hea rate with on atrial distension? | Bainbridge reflex: When the hea rate is slow, intravenous infusions of blood or electrolyte solutions usually accelerate the hea. Both atria have receptors that are affected by changes in blood volume and that influence the hea rate. These receptors are located principally in the venoatrial junctions: in the right atrium at its junctions with the venae cavae and in the left atrium at its junctions with the pulmonary veins. Distention of these atrial receptors sends afferent impulses to the brainstem in the vagus nerves. The efferent impulses are carried from the brainstem to the SA node by fibers from both autonomic divisions. Bezold-Jarisch reflex or the coronary chemoreflex: Activation of chemosensitive vagal C fibers in the cardiopulmonary region (eg, juxtacapillary region of alveoli, ventricles, atria, great veins, and pulmonary aery) causes profound bradycardia, hypotension, and a brief period of apnea followed by rapid shallow breathing. It can be elicited by a variety of substances including capsaicin, histamine, serotonin, phenylbiguanide, and veratridine. In human this reflex may be activated: During myocardial ischemia or, reperfusion (thrombolytic therapy) as a result of increased production of oxygen radicals. By agents used as radiocontrast for coronary angiography. It is cardioprotective by producing bradycardia, thus reduce the amount substances get absorbed into the blood Vasovagal syncope has been attributed to activation of the Bezold-Jarisch reflex J reflex or pulmonary chemoreflex: Because the C fiber endings are close to pulmonary vessels, they have been called J (juxtacapillary) receptors. They are stimulated by hyperinflation of the lung, but they respond as well to intravenous or intracardiac administration of chemicals such as capsaicin. The reflex response that is produced is apnea followed by rapid breathing, bradycardia, and hypotension Oculocardiac reflex: Traction on the extraocular muscles (especially the medial rectus), conjunctiva, or orbital structures causes hypotension and a reflex slowing of the HR, as well as arrhythmias Cushing's reflex: Increased CSF pressure (intracranial pressure) - cerebral aery compressed - CNS ischemia that causes hypoxia and hypercapnia in medulla, which directly stimulates the vasomotor centre - increased BP - baroreceptor mechanisms causes reflex Bradycardia. Cushing reflex causes the symptoms of Cushing triad: Bradycardia Hypeension (with widened pulse pressure) Irregular respiration (bradypnea) | 4,586 | medmcqa_train |
FLT3-TKD gene is located at? | FLT3-TKD- present in approx. 30% of cases of AML. It is located on long arm of Chromosome 13. AML: Good prognosis t (15;17) t (8;21) inv 16 Poor prognosis t (6;9) inv 3 7 deletion | 4,587 | medmcqa_train |
Recovery in cataract surgery is fastest with which of the following - | smaller incision nd post operative astigmatism. REF:khurana,pg 199 | 4,588 | medmcqa_train |
Haemophilia is a genetic disorder of coagulation seen only in males. It is transmitted as | Mendelian diseases and their inheritance: | 4,589 | medmcqa_train |
Which of the following amino acid contains free sulphydryl group | Ans. is 'a' i.e.,Cysteine There are two sulfur containing amino acids :?CysteineMethionineThe side chain of cysteine contains sulfhydryl group that has a pKa of approximately 8.4 for dissociation of its hydrogen sulfhydryl groups of two cystein molecules can form covalent disulfide bond to form cystine.Methionine although it contains sulfur group, does not containt sulfhydryl group and cannot form disulfide bond. | 4,590 | medmcqa_train |
Drug not contraindicated in a pregnant lady for Hypeension: March 2009 | Ans. B: Hydralazine Intravenous form of hydralazine is useful when treating severe hypeension due to preeclampsia/eclampsia. It has got a long record of safe use during pregnancy, but troublesome adverse effects occur. It decreases systemic resistance through direct vasodilation of aerioles. | 4,591 | medmcqa_train |
Glucose is transpoed in the presence Na+ ions in intestine. This is a type of | The active transpo of Na+ into the ECF by Na+-K+ pump is coupled to the transpo of other substances across the cell membrane against their concentration gradient. The energy for the transpo is not directly derived from ATP hydrolysis. Na+ Cotranspo of glucose is an example(Ref: Diseases. Textbook of medical physiology-Geetha) | 4,592 | medmcqa_train |
On routine examination, it is discovered that a 35-year-old woman had been exposed in-utero to Diethylstilbestrol (DES) administered to her mother, who had had a history of recurrent spontaneous aboion. This history suggests that the patient might be at increased risk of which of the following? | Diethylstilbestrol (DES) is the risk factor for clear cell adenocarcinoma of the vagina and cervix in young women with a history of in utero exposure to DES while their mothers were pregnant. | 4,593 | medmcqa_train |
Childhood osteopetrosis is characterized by – a) B/L frontal bossingb) Multiple # (fracture)c) Hepatosplenomegalyd) Cataracte) Mental retardation | Osteopetrosis
Osteopetrosis is an autosomal recessive heredofamilial disorder in which partly calcified cartilaginous intercellular ground substance is not regularly reabsorbed & replaced by regular osteoid tissue & bone.
Manifested by :
Increased bone density masking the distinction between cortex & medulla, bone within bone appearance (Marble's bone).
Brittle bone & easily fracturability
Fracture healing satisfactory resulting in skeletal deformities.
Myelophthisic anemia
Hepatosplenomegaly & presence of immature leukocytes & normoblasts in the peripheral blood.
Growth retardation,Macrocephaly.
Thickening of cranial foramina & thus causing pressure on optic nerve & optic atrophy.
Deafness & blindness
Dental problems & osteomyelitis of the mandible.
Learning disorder but may have normal intelligence despite hearing & visual loss. | 4,594 | medmcqa_train |
Refractive index of cornea is | Corneal refractive index is 1.376 | 4,595 | medmcqa_train |
First change in a dead body is: | Greenish discolouration of RIF | 4,596 | medmcqa_train |
Supports of uterus are all except | Ans. C. Broad ligamentCLASSIFICATIONPrimary supportsa. Muscular or activei. Pelvic diaphragmii. Perineal bodyiii. Urogenital diaphragmb. Fibromuscular or mechanicali. Uterine axisii. Pub cervical ligamentiii. Transverse cervical ligamentiv. Uterosacral ligamentv. Round ligament of uterusSecondary supportsi. Broad ligamentsii. Uterovesical fold of peritoneumiii. Rectovaginal fold of peritoneum Broad Ligaments:These are folds of peritoneum which attach the uterus to the lateral pelvic wall, it has anterior and posterior surfaces and upper, lower, medial and lateral borders. It contains the following structures:Uterine tubei. Round lig. of uterusii. Lig. of ovaryiii. Uterine and ovarian plexus and nerve plexusiv. Epoophoron and paroophoronv. Lymphaticsvi. Connective tissue. | 4,597 | medmcqa_train |
Most common site of primary spinal tumor | - MC spinal tumor - Metastasis - MC primary spinal tumor - Nerve sheath tumor - MC intra - Medullary tumor - Astrocytoma - MC site of primary spinal tumor - Intra-dural; Extra medullary | 4,598 | medmcqa_train |
Warfarin induced skin necrosis is seen in ? | Ans. is 'a' i.e., Protein C deficiency o Warfarin - induced skin necrosis occurs in patients with undiagnosed protein C deficiency. | 4,599 | medmcqa_train |
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