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Neo-adjuvant chemotherapy used esophageal carcinoma | Neoadjuvant chemotherapyNeoadjuvant chemotherapy is the administration of therapeutic agents before the main treatment.Neoadjuvant therapy aims to:Reduce the size or extent of cancer.Makes procedures easier and more likely to succeed.Reduces the consequences of a more extensive treatment.Single agent chemotherapyCombination chemotherapyBleomycin5-fluorouracil (5-FU)CisplatinMitomycinCarboplatinVindesine and vinorelbinePaclitaxelDocetaxelEtoposideCisplatin and 5-FU - Most widely used.Epirubicin/Cisplatin/5-FUPaclitaxel/Cisplatin/5-FUDocetaxel/Cisplatin/5-FUIrinotecan Plus 5-FUOxaliplatin/Capecitabine | 4,600 | medmcqa_train |
A 40-year-old woman who is a known case of anxiety disorder and has prominent symptoms of frontal headache is being treated with a procedure in which the tension in the frontalis muscle is measured regularly. The readings are projected on to a computer screen, which patient can see. She is then taught to use mental techniques to decrease tension in this muscle. Which of the following treatment techniques does this example illustrate? | The treatment technique described here is biofeedback. In this treatment, the patient is being given ongoing physiological information, in this case the muscle tension in the frontalis muscle. With the help of his feedback, she learns to use mental techniques to control the tension and keep her muscles in a relaxed state. | 4,601 | medmcqa_train |
Regarding sexual differentiation of the fetus? | Goandal development begins at 5th week of intrauterine life and Male sexual differentiation occurs earlier than female."The differentiation of the gonadal ridge into the testis by 43-50 days (7-8 wks) of gestation is a rapid phenomenon that contrasts with the slower and delayed development of the ovary, which will not become apparent until 140 days (20 weeks) of gestation with the .formation of granular cells. Leydig cells are apparent by about 60 days and differentiation of the male external genitals occurs by 65-77 days of gestation. | 4,602 | medmcqa_train |
The following agent decrease gastric motility except- | Ans. is 'a' i.e., Naloxone o Opioids decrease GI motility.o Naloxone is opioid antagonist (at all receptors), thus it will counteract the GI effect of opioids.Naloxoneo It antagonizes all action of morphine (sedation is less completely reversed),o It is the drug of choice for acute morphine poisoning.o It is also used for reversing neonatal asphyxia due to opioid use during labour, alcohol intoxication and to elevate BP in endotoxic or hypovolaemic shock.o It precipitates withdrawl in dependent subjects ->> can be used for diagnosis of opioid dependence,o It partly antagonizes respiratory depression produced by certain nonopioid also, e.g. N2O, diazepam.o It is ineffective orally because of high first pass metabolism - used parenterally.o It is very short acting (t1/2 1 hour in adults and 3 hours in newborns). | 4,603 | medmcqa_train |
Water lily appearance in chest X-ray suggestive of the following condition: | Chest X-ray finding of hydatid cyst of the lung: Dense homogenous opacity Collapsed laminated membrane produces an irregular projections in a fluid level due to rupture of the cyst- 'Water-lily appearance' Crescentic cap of air, when it communicates into bronchial tree Ref: Srb's Manual of Surgery By Bhat, 2012, Page 1205. | 4,604 | medmcqa_train |
Which of the following is the most common cancer of thyroid | Papillary carcinoma is the most common malignancy of thyroid, accounts to 70-80% of all thyroid malignancies. It has the best prognosis of all thyroid cancers. Source : Sabiston 20th edition pg : 900 | 4,605 | medmcqa_train |
Osgood schlatter disease? | Ans. is 'a' i.e., Tibial tuberosity | 4,606 | medmcqa_train |
DOC in P. jeroveci | Drug of choice for Pneumocystis jirovecii pneumonia is co-trimoxazole,with adjunctive doses of steroid if the patient has hypoxia.Pneumocystis jirovecii pneumonia is common in immunocompromised individuals,like HIV positive patients.In P.jirovecii pneumonia,symptoms of cough and breathlessness can be present for several days or weeks before the onset of systemic symptoms or the appearance of X ray abnormalities.HRCT showing bilateral opacification is diagnostic. Reference:Davidson's Medicine-22nd edition,page no:400,688 | 4,607 | medmcqa_train |
Undue restlessness in a patient during the immediate post burn period is often a manifestitation of ? | Ans. is 'd' i.e., Anxiety | 4,608 | medmcqa_train |
Type D personality has been recently found to be a risk factor for: | Ans. a. Coronary artery disease Type D personality has been recently found to be a risk factor for coronary' artery disease."Type A personality (behavior pattern) includes competitiveness, time urgeny, and hostility.""Type D (distressed) personality is not oniy a risk factor for development of ischemic heart disease, it also leads to Horse prognosis following a myocardial infarction." Personality Disorder Type-A PersonalityType-B PersonalityType-D Personality* It is originally characterized by competitiveness, time urgency, hostility and anger3 (last two components are pathogenic).* Ambitiousness, aggressiveness, competitiveness, impatience, muscle tenseness, alertness, rapid and emphatic vocal style, irritation, and cynicism are other features.* Are hard working workaholics who deny emotional or physical vulnerability. Their self esteem is dependent on achievement i.e. they are impatient, achievement oriented people.* These individuals show a greater physiological reactivity (e g. BP. Heart rate) and are more likely to get engaged in unhealthy babbits e g., drinking alcohol, smoking.* And if these individuals smoke they inhale smoke for a longer time.* Associated with significantly high risk of coronary heart disease.* It includes carefree, easy going, relaxed individuals* It includes people with distressed personality who suffer from high degree of emotional distress (negative emotions /affectivity) but they consciously suppress their feelings* Type D personality is both a prognostic and risk factor for IHD.* These persons have worse prognosis after Ml with an - 4 times increased risk of sudden cardiac death, recurrent Mi and mortality.* These persons have an impaired/poor quality of life and are more likely to experience anxiety and depression (mood swings).Risk factor for cardiac disase include major depressive disorder, type D personality and ty pe A personality, (especially anger and hostality). | 4,609 | medmcqa_train |
All of the following genetic syndromes are associated with Acute Myeloid Leukemia, except: | Of all the options given Turner's syndrome is not found to be associated with increased incidence of acute myeloid leukemia (AML). Down's syndrome, Klinefelter's Syndrome, Patau Syndrome are associated with AML. Ref: Harrison's Principles of Internal Medicine16th Edition, Page 631; Excellent Care for Cancer Survivors: A Guide to Fully Meet Their Needs By Kenneth Miller - Pg 327; Childhood Leukemia: A Practical Handbook, By Gregory H. Reaman - Pg 11 | 4,610 | medmcqa_train |
RBC cast in the microscopic examination of the urine is an indicator of | (A) Acute glomerulonephritis THE GLOMERULAR SYNDROMEAcute nephritic syndromeHematuria, azotemia, variable proteinuria, oliguria, edema, and hypertensionRapidly progressive glomerulonephritisAcute nephritis, proteinuria, and acute renal failureNephrotic syndrome>3.5 gm proteinuria, hypoalbuminemia, hyperlipidemia, lipiduriaChronic renal failureAzotemia uremia progressing for yearsAzotemia uremia progressing for yearsGlomerular hematuria; subnephrotic proteinuria | 4,611 | medmcqa_train |
EKG finding of ventricular premature beats- | PVCs are characterized by premature and bizarrely shaped QRS complexes that are unusually long (typically >120 msec) and appear wide on the electrocardiogram (ECG). These complexes are not preceded by a P wave, and the T wave is usually large and oriented in a direction opposite the major deflection of the QRS. pvc is followed by a compensatory pause Ref Harrison 20th edition pg 1435 | 4,612 | medmcqa_train |
A patient presented with a hard swelling in this right testis. All are true statements except: | Ans. (a) Trans scrotal biopsy is needed* Chevassu maneuver biopsy is done inguinal.* Transcrotal biopsy will disseminate the tumor cells to Inguinal nodes | 4,613 | medmcqa_train |
Which of the following is common with Streptococcus infection? | Ref: Microbiology by Ananthanarayan and Paniker, 8th ed. pg. 205SKIN AND SOFT TISSUE INFECTION BY STREPTOCOCCUS1. Erysipelas-diffuse infection involving the superficial lymphatics2. Impetigo-superficial infection of skin (pyoderma)3. Cellulitis-cellulitis is caused mainly by hemolytic streptococci. It specifically affects the dermis and subcutaneous fat.4. Lymphangitis* Gangrene-type of ischemic necrosis# Dry gangrene: Arterial obstruction# Wet gangrene: Venous obstruction* Pyoderma is most commonly caused by Staph Aureus | 4,614 | medmcqa_train |
A 40-year-old man without a significant medical history comes to the emergency room with a 3-day history of fever and shaking chills, and a 15-minute episode of rigor. He also reports a cough productive of yellow-green sputum, anorexia, and the development of right-sided pleuritic chest pain. Shortness of breath has been present for the past 12 hours. Chest x-ray reveals a consolidated right middle lobe infiltrate, and CBC shows an elevated neutrophil count with many band forms present. Which feature would most strongly support inpatient admission and IV antibiotic treatment for this patient? | Because of the development of effective oral antibiotics (respiratory fluoroquinolones, extended spectrum macrolides), many patients with community-acquired pneumonia (CAP) can be managed as an outpatient as long as compliance and close follow-up are assured. The CURB-65 score is a validated instrument for determining if inpatient admission (either observation or full admission) is indicated. Factors predicting increased severity of infection include confusion, urea above 19 mg/dL, respiratory rate above 30, BP below 90 systolic (or 60 diastolic), and age 65 or above. If more than one of these factors is present, hospitalization should be considered.This patient's presentation (lobar pneumonia, pleuritic pain, purulent sputum) suggests pneumococcal pneumonia. The pneumococcus is the commonest organism isolated from patients with CAP. Fortunately, Spneumoniae is almost always sensitive to oral antibiotics such as clarithromycin/azithromycin and the respiratory fluoroquinolones. A Gram stain suggestive of pneumococci would therefore only confirm the clinical diagnosis. Exposure to influenza is an important historical finding. Patients with influenza often have a prodrome (upper respiratory symptoms, myalgias, prostrating weakness), but influenza would not cause a lobar infiltrate. Staphylococcus aureus pneumonia can sometimes follow influenza. Acute lobar pneumonia, even in an HIV-positive patient, is usually due to the pneumococcus and can often be treated as an outpatient. Pneumocystis jiroveci pneumonia is usually insidious in onset, causes diffuse parenchymal infiltrates, and does not cause pleurisy or pleural effusion. Physical examination signs of consolidation confirm the CXR finding of a lobar pneumonia (as opposed to a patchy bronchopneumonia) and would simply affirm the importance of coverage for classic bacterial pathogens (i.e., pneumococci, H influenzae). Atypical pneumonias (due to Mycoplasma, Chlamydia, or Legionella) are usually patchy and do not usually cause pleural effusion. Currently recommended treatment regimens for CAP cover both typical and atypical pathogens. | 4,615 | medmcqa_train |
Pramlintide is ? | Ans. is 'a' i.e., Synthetic amylin analogue NEWER ANTIDIABETIC DRUGS Exenatide Exenatide is a synthetic glucagon-like peptide - 1 (GLP-1) analogue. GLP-1 is an impoant incretin that is released from gut in response to oral glucose. But GLP-1 can not be used clinically as it is degraded rapidly by enzyme dipeptidly peptidase - (DPP-4). Exenatide is resistant to DPP-4. It acts similar to GLP-1 - Enhancement of postprandial insulin release, suppression of glucagon release and appetite as well as slowing of gastric emptying. It is given by subcutaneous route & used in type 2 DM Nausea is most impoant side effect. Sitagliptin This is orally active inhibitor of DPP-4. It prevents degradation of endogenous GLP-1 and other incretins, potentiating their action, resulting in limitation of postprandial hyperglycemia. It is used in type 2 DM. Other DPP-4 inhibitor is vildagliptin Pramlintide This is a synthetic amylin analogue (Amylin is a polypeptide produced by pancreatic (3-cells which reduces glucagon secretion from a-cells and delays gastric emptying). Pramlintide attenuates postprandial hyperglycemia and exes a centrally mediate anorectic action. o It is given by subcutaneous route and is used in both Type 1 and Type 2 DM. Glucomannan This is powdered extract from tuber of konjar. It is promoted as a dietary adjunct for diabetes. It swells in stomach by absorbing water and is claimed to reduce appetite, blood sugar, serum lipids and relieve constipation. Bromocriptine Recently bromocriptine has been approved by FDA, as an adjunct to diet and exercise to improve glycemic control in type 2 DM. It has been found that dopamine alter insulin resistance by acting on hypothalmus and bromocriptine blocks O2 receptors. | 4,616 | medmcqa_train |
The operation of plication of inferior lid retractors is indicated in - | Plication of inferior lid retractors is done to strengthen them. This operation is performed in severe cases of senile entropion or when recurrence occurs after other procedures. It is known as the Jones, Reeh and Wobig operation. | 4,617 | medmcqa_train |
A 74-year-old woman has symptoms of shortness of breath on exertion and waking up at night. Her physical examination reveals a JVP at 8 cm, extra third heart sound, lung crackles, and pedal edema. She is started on furosemide 80 mg/day for heart failure, while further investigations are performed.For the above patient with new symptoms, select the most likely acid base disorder. | Diuretics are a common cause of metabolic alkalosis. The disorder can occur in volume expanded patients in whom the alkalosis is unresponsive to sodium chloride loading, as in primary hyperaldosteronism or volume contraction with secondary hyperaldosteronism, as in this case. | 4,618 | medmcqa_train |
who is the sceintist who got noble prize for his contribution for psychosurgery | * Jacobson=================lobotomy in chimpanzees * Almedia lima+ egaz moniz===PF leukotomy * Subcaudate tractotmy======OCD * Limbic leukotomy=========OCD and depression * Anterior capsulotomy Anterior cingulotomy Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no. 1065 | 4,619 | medmcqa_train |
In a patient presenting with diarrhoea due to vibrio cholera, which of the following will be present ? | Ans. is 'd' i.e., Neutrophilia On laboratory evaluation there will be : Mild neutrophilic leukocytosis (neutrophilia) Elevated hematocrit Elevated BUN and creatinine Normal sodium, potassium and chloride levels. Markedly reduced bicorbonate level Elevated anion gap Acidosis (Low pH) | 4,620 | medmcqa_train |
Neuroleptic malignant syndrome is characterized by | Features of Neuroleptic malignant syndrome Increased body temperature >38degC (>100.4degF), orConfused or altered consciousnessDiaphoresis "sweat shock"Rigid musclesAutonomic imbalanceLabile hypeension Metabolic acidosis (Refer: Kaplan and Saddock's Synopsis of Psychiatry, 10th edition, pg no: 995) | 4,621 | medmcqa_train |
Coicosteroids suppress: September 2009 | Ans. B: ACTHFree glucocoicoids inhibit ACTH secretion, and the degree of pituitary inhibition is propoionate to the circulating glucocoicoid level. The inhibitory effect is exeed at both the pituitary and the hypothalamic levels. The inhibition is due primarily to an action on DNA, and maximal inhibition takes several hours to develop, although more rapid "fast feedback" also occurs. The ACTH-inhibiting activity of the various steroids parallels their glucocoicoid potency. A drop in resting coicoid levels stimulates ACTH secretion, and in chronic adrenal insufficiency the rate of ACTH synthesis and secretion is markedly increased.Thus, the rate of ACTH secretion is determined by two opposing forces: the sum of the neural and possibly other stimuli converging through the hypothalamus to increase ACTH secretion, and the magnitude of the braking action of glucocoicoids on ACTH secretion, which is propoionate to their level in the circulating blood | 4,622 | medmcqa_train |
Eicosanoids are derived from | EICOSANOIDSThey are 20 C compounds (Greek, eikosi = twenty), derived from arachidonic acid. Their names are:1. Prostanoids, containing1-a. Prostaglandins (PGs);1-b. Prostacyclins (PGIs);1-c. Thromboxanes (TXs)2. Leukotrienes (LTs)Ref: DM Vasudevan - Textbook of Biochemistry, 6th edition, page no: 163 | 4,623 | medmcqa_train |
Kary otyping is done in which phase of cell cycle- | Ans. is 'b' i.e., Metaphase o To produce a karyotype, one must obtain cells capable of growth and division as karyotyping is done by arresting mitosis in dividing cells in metaphase.o Karyotyping is the study of chromosomes and is used in cytogenetics to study the chromosomal abnormalities,o After arresting the cells in metaphase the chromosomes are examined to see for:i) Numbers - to detect abnormalities in chromosome numbers such as aneuploidy (trisomy, tetrasomy), polyploidy,ii) Structure - to detect structural chromosomal anomalies such as translocations, deletions, inversions.Karyotypingo It is the study of chromosomes,o It is used in cytogenetics to study the chromosomal abnormalities.o A karyotype is a standard arrangement of a photographed or imaged stained metaphase spread in which chromosome pairs are arranged in order of decreasing length.o To produce a karyotype, one must obtain cells capable of growth and division as karyotyping is done by arresting mitosis in dividing cells in metaphase,o Samples used are : -Amniotic fluids (cells from amnion, skin, urogenital system, respiratory system and GI system).# Chorionic vill.# Bone marrow# Skin fibroblasts# Peripheral blood lymphocytes# Fetal umblical blood.# Lymph node tissue# Solid tumor sample | 4,624 | medmcqa_train |
Which one of the following lysosomal storage disorder is associated with mental retardation? | (D) All of the above# Metachromatic leukodystrophy (MLD, or Arylsulfatase A deficiency) is a lysosomal storage disease which is commonly listed in the family of leukodystrophies. Leukodystrophies affect the growth and/or development of myelin, the fatty covering which acts as an insulator around nerve fibers throughout the central and peripheral nervous systems. It involves sulfatide accumulation.> Like many other genetic disorders that affect lipid metabolism, there are several forms of MLD, which are late infantile, juvenile, arid adult.> Children with the juvenile form of MLD (onset between 3-10 years of age) usually begin with impaired school performance, mental deterioration, and dementia and then develop symptoms similar to the late infantile form but with slower progression.> Age of death is variable, but normally within 10 to 15 years of symptom onset although some juveniles can live for several decades or longer after onset.> Tay-Sachs disease (abbreviated TSD, also known as GM2 gangliosidosis or Hexosaminidase A deficiency) is an autosomal recessive genetic disorder.> In its most common variant, known as infantile Tay-Sachs disease, it causes a relentless deterioration of mental and physical abilities that commences around six months of age and usually results in death by the age of four.> Fabry disease (also known as Fabry's disease, Anderson.> Fabry disease, angiokeratoma corporis diffusum and alpha-galactosidase A deficiency) is a rare X-linked recessive (inherited) lysosomal storage disease, which can cause a wide range of systemic symptoms.Full body or localized pain to the extremities (known as acroparesthesia) or Gl tract is common in patients with Fabry disease.Kidney complications are a common and serious effect of the disease; renal insufficiency and renal failure may worsen throughout life.> Cardiac complications occur when glycolipids build up in different heart cells; heart related effects worsen with age and may lead to increased risk of heart disease.> Hypertension (high blood pressure) and cardiomyopathy are commonly observed.mental retardation is rare presentation | 4,625 | medmcqa_train |
Diagnosis of beta Thalassemia is established by | Diagnostic test for thalassemia is Hb electrophoresis. NESTROFT Test - Naked Eye Single Tube Red Cell Osmotic Fragility Test - used for screening for Thalassemia HbA1c - Used to assess long term glycemic control in diabetics (blood sugar control over past 3 months) Target cells - A feature of thalassemia, but not diagnostic Reference : Ghai essential of pediatrics, eighth edition, p.no:342 | 4,626 | medmcqa_train |
The best marker to diagnose thyroid related disorder is | Answer is C (TSH) : The enhanced sensitivity and specificity of TSH assays have greatly improved laboratory assessment of thyroid function - Harrison With rare exceptions a normal TSH level excludes a primary abnormality of thyroid function.- Harrison Approach to thyroid testing: Because TSH change dramatically in response to alteration of free T4 and T3, a logical approach to thyroid testing is to determine first whether TSH is suppressed, normal or elevated - Harrison | 4,627 | medmcqa_train |
Which of the following medications is contraindicated in the treatment of an acute attack of gout? | Gout is a metabolic disease process with abnormal amounts of urates in the body characterized by recurring acute ahritis. The diagnosis is verified by the presence of urate crystals in the fluid of affected joints. Treatment of an acute attack may include non-steroidal anti-inflammatory drugs, colchicines or coicosteroids for symptomatic relief. The xanthine oxidase inhibitor allopurinol promptly lowers plasma urate concentration and is helpful in preventing recurrences. The most frequent adverse effect, however, is the precipitation of an acute gouty attack. Ref: Burns C., Womann R.L. (2013). Chapter 44. Gout. In J.B. Imboden, D.B. Hellmann, J.H. Stone (Eds), CURRENT Diagnosis & Treatment: Rheumatology, 3e. | 4,628 | medmcqa_train |
Which is the most common joint involved in thalassemia? | Ans. B. Knee* Most common joint involved in thalassemia is Knee joint.* Most common orthopedic symptom in thalassemia is leg pain. | 4,629 | medmcqa_train |
The drug of choice to treat Chlamydia infection in pregnancy is: | From the options listed in the question erythromycin is the drug used in the treatment of chlamydial infections in pregnancy. Erythromycin should be given for 7-10days. According to the latest recommendation Azithromycin 1gm as a single dose is the drug of choice in Chlamydia infection during pregnancy. As a prophylaxis to ophthalmia neonatorum 1% erythromycin ointment is applied to the infant's eye soon following bih. Neonatal infection is treated with erythromycin for 14-21days. Ref: Williams Obstetrics, 23rd Edition, Page 1241 ; Practical Gynecology, 2nd Edition, Page 200 ; Textbook of Obstetrics By DC Dutta, 6th Edition, Page 294-5 | 4,630 | medmcqa_train |
Malignant hypehermia is caused by | Ans. is 'a' i.e., Succinylcholine + halothane | 4,631 | medmcqa_train |
In indentation tonometry: | Ans. Lower scale readings are obtained in high intraocular pressure | 4,632 | medmcqa_train |
Umbilical aery is a branch of | Anterior division of internal iliac aeryA pa of Umbilical aery persists as superior vesical aery and remaining aery becomes obliterated forming medial umbilical ligament. | 4,633 | medmcqa_train |
Which one of the following ultrasound marker is associated with greatest increased risk for Trisomy 21 in fetus | (D) Nuchal edemaINCIDENCE OF MAJOR & MINOR DEFECTS/MA Trisomy 21NormalLikelihood ratio for isolated marker* Nuchal Fold33.5%0.6%9.8* Short humerus33.4%1.5%4.1* Short femur41.4%5.2%1.6* Hydronephrosis17.6%2.6%1.0* Echogenic focus in heart28.2%4.4%1.1* Echogenic bowel13.3%0.6%3.0* Major defect21.4%0.65%5.2 | 4,634 | medmcqa_train |
Proper technique of endotracheal intubation involves: March 2012 | Ans: B i.e. Flexion of the neck and extension of the atlanto-occipital joint Optimal head and neck positioning while intubation is obtained by flexion of the neck and extension of the atlanto-occipital joint | 4,635 | medmcqa_train |
Which animal is used to test pathogenicity in Cryptococcus neoformans? | CD1-cryptococcus D strain-infected mice were examined for survival and fungal loads in either brain or lung during the course of infection. Ref: Baveja 5th ed pg: 565 | 4,636 | medmcqa_train |
A 10 year old boy complains of discoloration of upper front teeth. He was on tetracycline therapy few years ago and also gives a history of chronic productive cough. General physical examination shows increased chest diameter and clubbing of fingers. USG findings are suggestive of cystic degeneration of pancreas. Which of the following statements is FALSE with regard to the given clinical situation? | Cystic Fibrosis
The genetically altered protein affects exocrine gland function. The defective exocrine gland function leads to microobstruction of the pancreas, which results in cystic degeneration of the pancreas and, ultimately, a digestive enzyme deficiency producing malabsorption of nutrients.The defective gene products cause abnormal water and electrolyte transport across epithelial cells, which results in a chronic disease of the respiratory and gastrointestinal system, elevated levels of electrolytes in sweat, and impaired reproductive function.In the lungs, retention of mucus occurs.
Children with cystic fibrosis have a high incidence of tooth discoloration when systemic tetracyclines are taken during tooth formation. With the advent of alternative antibiotics, the incidence of tooth discoloration is decreasing. The incidence of dental caries in children with cystic fibrosis is low secondary to long-term antibiotic therapy, buffering capacity of excess calcium in the saliva, and pancreatic enzyme replacement therapy. There is a high incidence of mouth breathing and open-bite malocclusion associated with chronic nasal and sinus obstruction. Patients with cystic fibrosis may prefer to be treated in a more upright position to allow them to clear secretions more easily. The use of sedative agents that interfere with pulmonary function should be avoided, and the patient’s physician should be contacted before nitrous oxide–oxygen sedation is used in a patient exhibiting evidence of severe emphysema. | 4,637 | medmcqa_train |
Mifepristone is not used in: | In case of threatened aboion ,patient presents with amenorrhoea followed by painless vaginal bleeding,but may sonetimes accompained by mild abdominal cramps and backache. Treatment modalities include hormobe therapy with natural progesterone is sometimes given on an empirical basis,anti D is given ,if patient is Rh negative,follow up with ultrasound is essential to detect progression to missed aboion. mefipristone is used in the other given options. Refet page 145 of Text book of obstetrics,sheila balakrishnan 2 nd edition. | 4,638 | medmcqa_train |
Accumulation of homogentisic acid causes which of the tissue changes? | Ochronosis is the bluish black discoloration of ceain tissues, such as the ear cailage and the ocular tissue, seen with alkaptonuria. Alkaptonuria is a rare autosomal recessive metabolic disorder caused by deficiency of homogentisic acid oxidase. This deficiency results in accumulation and deposition of homogentisic acid (HGA) in cailage, causing the characteristic diffuse bluish black pigmentation. These affected connective tissue become weak and brittle with time, leading to chronic inflammation, degeneration, and osteoahritis. Ref: Textbook of Ohopaedics and Trauma By GS Kulkarni, 2009, Page 197; Clinical Paediatric Dermatology By Thappa, 2009, Page 156; Differential Diagnosis in Internal Medicine: From Symptom to Diagnosis, 2007, Page 347 | 4,639 | medmcqa_train |
Vidian nerve is- | Ans. is 'c' i.e., Nerve of pterygoid canal * Greater petrosal nerve joins the deep petrosal nerve to form vidian nerve (nerve to pterygoid canal) and carries secretomotor fibres to the lacrimal gland, nasal gland, Palate gland and pharyngeal gland after relaying in pterygopalatine ganglion. | 4,640 | medmcqa_train |
Longest diameter of fetal skull is? | Ans. (d) Mento verticalRef : D.C. Dutta 8th ed. / 94-97DIAMETERS OF SKULL* The antero-posterior diameters of the head which may engage are:DiametersMeasurment (In Cm)PresentationSuboccipito-bregmatic9.5 cmVertexSuboccipito-frontal10 cmVertexOccipito - frontal11.5 cmVertexMento-vertical: extend from mid-point of chin to the highest point on the saggital suture14 cmBrowSubmento-vertical11.5 cmFaceSubmento-bregmatic9.5 cmFace * The transverse diameters which are concerned in the mechanism of labor are# Biparietal diameter - 9.5 cm: extends between two parietal eminences.# Super-subparietal - 8.5 cm# Bitemporal diameter: 8 cm# Bimastoid diameter - 7.5 cm | 4,641 | medmcqa_train |
Ethambutol causes | Refer Katzung 10/e p774 KDT 6/e p 742 Ethambutol causes retobulbar neuritis It can result in red green colour blindness | 4,642 | medmcqa_train |
Mechanism of action of dipyridamole - | Ans. is 'a' i.e., Adenosine reuptake inhibition o Dipyridamole is a powerful coronary dilator; increases total coronary flow by preventing uptake and degradation of adenosine. Remember o Dipyridamol potentiates the action of PG12. | 4,643 | medmcqa_train |
Antisera are prepared from | AntiseraIs a material prepared in animalsPassive immunization was achieved by the administration of antisera or antitoxins prepared from horsesAdministration of antisera give rise to serum sickness and anaphylactic shock(Refer: K. Park's Textbook of Preventive and Social Medicine, 24th edition, pg no:112) | 4,644 | medmcqa_train |
Which of the following is secondary level of prevention: March 2005 | Ans. D: Cervical pap smear checking The levels of prevention: Primordial prevention is prevention of the emergence/development of the risk factors in countries/population in which they have not yet appeared. e.g. obesity and hypeension prevention Primary prevention methods are used before the person gets the disease. Primary prevention aims to prevent the disease from occurring. So primary prevention reduces both the incidence and prevalence of a disease. Encouraging people to protect themselves from the sun's ultraviolet rays is an example of primary prevention of skin cancer. Secondary prevention is used after the disease has occurred, but before the person notices that anything is wrong. A doctor checking for suspicious skin growths is an example of secondary prevention of skin cancer. The goal of secondary prevention is to find and treat disease early. In many cases, the disease can be cured. Secondary prevention can be defined as action which halts the progress of a disease at its incipient stage and prevents complications. The specific interventions are early diagnosis (e.g. screening tests, case finding programmes) and adequate treatment. Teiary prevention targets the person who already has symptoms of the disease The goals of teiary prevention are: Prevent damage and pain from the disease - Slow down the disease - Prevent the disease from causing other problems (These are called "complications.") - Give better care to people with the disease - Make people with the disease healthy again and able to do what they used to do Developing better treatments for melanoma is an example of teiary prevention. Examples include better surgeries, new medicines, etc. | 4,645 | medmcqa_train |
Perfusion pressure is | Perfusion pressure is arterial pressure minus venous pressure. | 4,646 | medmcqa_train |
A study comparing the behavioral and developmental changes in a normal brain with a damaged brain is: | Ans. a. Neuropsychology (Ref: www.wikipedia.org/Neuropsychology)A study comparing the behavioral and developmental changes in a normal brain with a damaged brain is Neuropsychology.'Clinical neuropsychology is the application of neuropsychological knowledge to the assessment, management, rehabilitation of the people who have suffered illness or injury (particularly to the brain), which has caused neurocognitive problems.'NeuropsychologyNeuropsychology studies the structure and function of the brain as they relate to specific psychological processes and behaviours.The term neuropsychology has been applied to lesion studies of brain in humans.Clinical neuropsychology is the application of neuropsychological knowledge to the assessment, management, rehabilitation of the people who have suffered illness or injury (particularly to the brain), which has caused neurocognitive problems. | 4,647 | medmcqa_train |
Bleeding from peptic ulcer most commonly involve | Bleeding peptic ulcer MC indication for operation and principal cause of death in PUD patients The most significant hemorrhage occurs when duodenal or gastric ulcers penetrate into branches of the gastroduodenal aery or left gastric aery, respectively Incidence of peptic ulcer bleeding decreased over past decade, but Moality was stable for both gastric and duodenal ulcer bleeding, higher in patients of advanced age Cause of death: Multiple system organ failure (not the exanguinating hemorrhage) Treatment Irrigation with room temperature saline to lyse red cells in an effo to return clear fluid and to allow for the performance of endoscopy Figure of eight suture to Ligate the gastroduodenal aery. A 'U' stich is placed in the base to occlude pancreatic branches of the gastroduodenal aery Truncal vagotomy and pyroplasty is the most frequently used operation for bleeding duodenal ulcer Ref: Sabiston 20th edition Pgno : 1202-1203 | 4,648 | medmcqa_train |
A female developed brown macule on the cheek, forehead and nose after exposure to light following delivery of a baby, the diagnosis is | Answer is B (Chloasma): Patient has a characteristic 'brown' macule on cheek, with no history suggestive of any systemic involvement, with positive history of delivery of a baby suggesting pregnancy. | 4,649 | medmcqa_train |
Which of the following drugs have maximum capacity to lower serum triglyceride levels? | Fibrates: maximum capacity to lower serum triglyceride levels. Statins: Max. LDL lowering capacity ANTI-DYSLIPIDEMIC AGENTS Group Mechanism Drugs Special points Statins HMG CoA reductase inhibition Atorvastatin, Rosuvastatin Max LDL lowering capacity Fibrates Stimulation of PPAR-alpha Clofibrate Fenofibrate Gemfibrozil Max TG lowering capacity Bile acid sequestrants Binds bile acids in GIT Cholestyramine Colestipol Cholesevalam Safe in pregnancy and children Ezetimibe Inhibit intestinal cholesterol absorption Ezetimibe Given with statins Nicotinic acid Inhibit lipase Niacin Max HDL increasing capacity | 4,650 | medmcqa_train |
Which of the following is not a Sarcolemmal P proteins? | Perlecan is a large multidomine proteolycan that binds to and cross links many ECM components and cell surface molecules Ref:Guyton and Hall textbook of medical physiology 12th edition,page number:8,9,10 | 4,651 | medmcqa_train |
An alcoholic was found to be dead by cardiac arrest due to hydrocution. Hydrocution is: | Hydrocution or Immersion syndrome or Submersion inhibition: Death results from cardiac arrest due to vagal inhibition as a result of, Cold water stimulating the nerve endings of the surface of the body Water striking the epigastrium Cold water entering eardrums, nasal passages, and the pharynx and larynx which cause stimulation of nerve endings of the mucosa Ref: The Essentials of Forensic Medicine and Toxicology, 27th edition, Page 324. | 4,652 | medmcqa_train |
In lag screw technique, what is the function of counter-sink? | To flush the obliquely place screw head with the rest of the proximal cortex, countersink is made that acts as a receptacle for engaging the end of screw head. | 4,653 | medmcqa_train |
Coffee bean sign is a radiologic finding in which of the following abdominal condition? | Volvulus refers to torsion of the bowel. It most commonly occurs in the sigmoid colon or caecum of constipated elderly adults who have redundant loops of colon on a long mesentery and are therefore at risk of the colon twisting around its mesenteric axis. Coffee bean sign is a radiologic feature of sigmoid volvulus which occur when two grossly distended loops of bowel are closely apposed their compressed medial walls forms a central cleft resembling o coffee bean. Other abdominal X ray features of volvulus are: Grossly distended inveed U shaped loop of sigmoid colon extending from the pelvis to the diaphragm with a curved inner colonic wall. RUQ pointing loop suggests sigmoid volvulus and LUQ pointing loop suggests cecal volvulus. Loss of haustral folds due to distention. Ref: Radiology at a Glance By Rajat Chowdhury, page 43. | 4,654 | medmcqa_train |
WRONG about ileum as compared with jejunum is | Jejunum has long and sparse vasa recta as compared to ileum. Jejunum are thick walled and peritoneal windows are transparent as compared to ileum. Peyer patches are present in ileum which are absent in jejunum. Jejunum have 1 or 2 rows of aerial arcades whereas ileum have 4 to 5 aerial arcades Ileum have sho club shaped villi. Ileum have more fat in mesentry. | 4,655 | medmcqa_train |
Mammalian Mitochondria are involved in all of the following except – | Protein synthesis is a cytoplasmic process.
Fatty acid synthesis starts with the production of Acetyl Co A within the mitochondria .
β-oxidation of fatty acid oxidation also occurs in mitochondria .
Mitochondrial DNA synthesis occurs within the mitochondria . Protein synthesis Process whereby DNA encodes for the production of amino acids and proteins. This process can be divided into two parts:
1. Transcription
Before the synthesis of a protein begins, the corresponding RNA molecule is produced by RNA transcription. One strand of the DNA double helix is used as a template by the RNA polymerase to synthesize a messenger RNA (mRNA). This mRNA migrates from the nucleus to the cytoplasm. During this step, mRNA goes through different types of maturation including one called splicing when the non-coding sequences are eliminated. The coding mRNA sequence can be described as a unit of three nucleotides called a codon.
2. Translation
The ribosome binds to the mRNA at the start codon (AUG) that is recognized only by the initiator tRNA. The ribosome proceeds to the elongation phase of protein synthesis. During this stage, complexes, composed of an amino acid linked to tRNA, sequentially bind to the appropriate codon in mRNA by forming complementary base pairs with the tRNA anticodon. The ribosome moves from codon to codon along the mRNA. Amino acids are added one by one, translated into polypeptidic sequences dictated by DNA and represented by mRNA. At the end, a release factor binds to the stop codon, terminating translation and releasing the complete polypeptide from the ribosome. One specific amino acid can correspond to more than one codon. The genetic code is said to be degenerate. | 4,656 | medmcqa_train |
Cluster headache is characterized by all, except: | Answer is A (Affects predominantly females) : Cluster headache affects predominantly males. Men are affected 3 times more often than women. | 4,657 | medmcqa_train |
Which of the following is an approach in health education: | Approaches in Health Education:
Regulatory approach
Service approach
Educational approach
Primary Health Care approach | 4,658 | medmcqa_train |
Blood supply of breast: | A i.e. Internal thoracic aery; B i.e. Lateral thoracici aery; C i.e. Inter costal aery | 4,659 | medmcqa_train |
Which of the following is involved in transpo of large molecules from cytoplasm to the cell nucleus?(2018) | Clathrin mediated endocytosis is responsible for the internalization of many receptors and the ligands bound to them--including, for example, nerve growth factor(NGF). Rafts and caveolae,are involved in cholesterol regulation and transcytosis. Ref:- Ganong, pg num:-46, 47 | 4,660 | medmcqa_train |
The cause of hyperuricemia and gout in glucose-6- phosphatase deficiency is | Purine overproduction and hyperuricemia in von Gierke disease (glucose-6-phosphatase deficiency) occurs secondary to enhanced generation of PRPP precursor, i.e. ribose-5-phosphate (a pentose).
In glucose-6-phosphatase deficiency, glucose-6-phosphate cannot be converted to glucose. Accumulated glucose-6-phosphate is then metabolized via HMP shunt, which in turn generates large amounts of ribose-5-phosphate, a precursor of PRPP. The increased synthesis of PRPP then enhances de novo synthesis of purine nucleotides. | 4,661 | medmcqa_train |
Heimlich valve is used for drainage of | The Heimlich valve(flutter valve)is a small one-way valve used for chest drainage that empties into a flexible collection device & prevents return of gases or fluids into the pleural space.The heimlich valve is less than 13 cm long and facilitates patient ambulation. Reference:SRB's manual of surgery,5th edition,page no:1116. | 4,662 | medmcqa_train |
A 47 year old alcoholic presents with acute upper left abdominal pain with pain on palpation. The pain is referred to his back. Lab results reveal a low serum calcium level. His hypocalcemia probably reflects which of the following? | The patient most likely has acute pancreatitis, which is commonly caused by either alcoholism or impaction of a small gallstone in the common bile duct. Acute pancreatitis causes the release of many digestive enzyme precursors, which are then conveed to the active form in the damaged tissues. These enzymes degrade the adipose tissue around the pancreatic lobules, producing enzymatic fat necrosis. As pa of this process, many free fatty acids are produced that can bind as soaps with extracellular calcium in chemical equilibrium with serum calcium. This will often cause a significant decrease in serum calcium levels. Caseous necrosis is seen in granulomata produced by infection with M. tuberculosis. Coagulative necrosis preserves the outlines of cells in affected tissue. This common type of necrosis is seen in the hea following an infarct. Gangrenous necrosis is massive necrosis associated with loss of vascular supply, and is generally accompanied by bacterial infection. Ref: Wyatt C., Butterwoh IV J.F., Moos P.J., Mackey D.C., Brown T.G. (2008). Chapter 1. Cellular Pathology. In C. Wyatt, J.F. Butterwoh IV, P.J. Moos, D.C. Mackey, T.G. Brown (Eds), Pathology: The Big Picture. | 4,663 | medmcqa_train |
Not true about Vi polysaccharide vaccine of typhoid- | Ans. is 'c' i.e., Given at birth Antityphoid vaccineso Two safe and effective vaccines are licensed and available1) The Vi polysaccharide vaccine (TYPHIM Vi Vaccine)# It contains purified Vi capsular polysaccaride from Ty2 strain.# It is given as single dose by subcutaneous or intramuscular route.# It confers protection 7 days after the injection.# To maintain protection, re-vaccination is recommended every 3 years.# It is given in individuals PS2 years of age (not given < 2 years of age).# The vaccine can be co-administered with other vaccines relevant for international travellers, e.g. yellow fever and hepatitis A.# The vaccine has no serious systemic or local side effects. There is no major contraindication, except for hypersensitivity.2) The Ty 21 a Oral vaccine (TYPHORAL Vaccine)# It is an orally administered live attenuated vaccine.# It contains > 109 viable organisms of live attenuated Ty 21a strain which lacks enzyme UDP-galactose-4- epimerase (Gal E mutant).# Vaccine is administered on 1, 3 and 5th day, Le. a 3-dose regimen.# Vaccine conferes the protection 7 days after the last dose.# The recommendation is to repeat the series (3 doses) every 3 years for people living in endemic areas and every year for individuals travelling from non-endemic to endemic countries.o The 'old' heat killed phenol extracted whole cell vaccines are not used now because of strong side effects. These vaccines were monovalent (contains S. typhi), bivalent (contains S. typhi and S. paratyphi A), and TAB vaccine (contains S. typhi, S. parathyphi A and S. paratyphi B). | 4,664 | medmcqa_train |
True about Rheumatic carditis - | Ans. is `d' i.e., Pancarditis Rheumatic carditis Seen in 40-60% of patients. o Usually seen within 3 weeks. o It is a pancarditis involving all the three layers --> Myocardium, endocardium & Pericardium. o Rheumatic carditis is the only manifestation of acute RF that has the potential to cause long term disability and death. o The diagnosis of rheumatic carditis requires presence of one of the following. Organic cardiac murmurs not present previously. Cardiomegaly Congestive hea failure Pericarditis | 4,665 | medmcqa_train |
Infective dose of salmonella typhi ? | Ans. is 'c' i.e., 103-106 bacilli In human volunteer experiments, the infective dose was found to be 103-106 bacilli. | 4,666 | medmcqa_train |
Following are tests to confirm blood stains except | To find out whether the stain is blood or Not: 1. Catalytic color test Phenolphthalein test Oho-toluidine test Benzedine test 2. Crystal test Hemin crystal test(Teichmann's test) Hemochromogen crystal test(Takayamma test) Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 317 | 4,667 | medmcqa_train |
Following are true of transferable drug resistance except : | Drug Resistance 1. Transferable drug resistance cannot be prevented by use of drug combinations. Drug combinations are used to get synergistic effect of antibiotics on pathogens in serious diseases. 2. Antimicrobial resistance can be of two types:-* Intrinsic Resistance: It is the innate ability of a bacterium to resist a class of antibiotics* Acquired Resistance: It is the emergence of resistance in bacteria, by acquiring the drug resistant genes either by - (i) Mutational or by (ii) Transferable drug resistance 3. Transferable drug resistance: * Multiple drug resistance at the same time* High degree resistance* Cannot be overcome by drug combinations* Virulence not decreased* Resistance is transferable to other organisms- Spread by: horizontal spread (conjugation, or rarely by transduction/transformation) 4. Transfer of plasmids during conjugation is responsible for the spread of multiple drug resistance among bacteria. -The plasmid responsible for drug resistance consists of two components, namely, F and a resistance determinant (r) for each of the several drugs. -Transferable drug resistance occurs widely among pathogenic as well as commensal bacteria of humans and animals. Plasmid is also responsible for production of colicins, the antibiotic-like substances lethal to other Gram-negative bacteria. -The plasmid that encodes for production of colicins is known as col factor and is also transferred by conjugation. | 4,668 | medmcqa_train |
A 40-year-old patient is suffering from carotid body tumor. Which of the following is the best choice of treatment for him? | Ans. (a) Excision of tumorRef: Schwartz 10th Edition Page 678* It is a non-chromaffin paraganglioma* 10% have family history* FNAC and Biopsy are contraindicated* Carotid Angiogram shows - LYRE sign* Excision of the tumor is the treatment of choice.* It rarely metastasize and growth is very slow hence in old age no need of surgery.* Complications of Excision:# Most common nerve injured: Superior Laryngeal Nerve# First bite syndrome: Pain with mastication# Baroreceptor failure if both side carotid body tumor is excised (Wide fluctuations in BP happens) | 4,669 | medmcqa_train |
CD4 is a marker for? | Ans. is 'd' i.e., T - cells o See above explanation. | 4,670 | medmcqa_train |
Neonatal complications of the fetus in a diabetic include all the following except : | Omphalitis | 4,671 | medmcqa_train |
Pneumactocele is commnly found in case of- | Pneumocystis jirovecii pneumonia can present with progressive dyspnoea,dry cough & fever.Chest X ray shows bilateral interstitial infiltrate spreading out from hilar region.High resolution CT is more sensitive,showing typical 'ground-glass 'interstitial infiltrates.Pneumatocoeles can occur and may rupture,resulting in a pneumothorax.Treatment is with high dose co-trimoxazole,together with adjunctive steroids. Reference:Davidson's Medicine-22nd edition,page no:400. | 4,672 | medmcqa_train |
The prognosis of rhabdomyosarcoma is likely to be poor if the site of the tumour is: | The prognosis of rhabdomyosarcoma is likely to be poor if it involves the extremity. Extremity rhabdomyosarcomas in adolescents and young adults usually have alveolar histologic characteristics and carry a worse prognosis. Other poor prognostic factors associated with it includes age less than 1 and more than 10 years, alveolar histology, unorable primary size, size greater than 5cm and higher clinical group. Ref: CURRENT Diagnosis and Treatment: Surgery, 13th Edition, Chapter 43; Radiation Oncology: Management Decisions By K. S. Clifford Chao, 3rd Edition, Page 755; Kelley's Essentials of Internal Medicine By H. David Humes, 2nd Edition, Page 445. | 4,673 | medmcqa_train |
The rate-limiting step in the synthesis of coisol is catalyzed by | The first and rate-limiting step in all steroid biosynthesis is catalyzed by cholesterol sidechain cleavage enzyme, resulting in pregnenolone and isocaproic acid. | 4,674 | medmcqa_train |
Peripoal fibrosis is caused by? | Methotrexate. This drug is a well-established cause of hepatic fibrosis and cirrhosis. These complications are best recognized following long-term use of the agent in inflammatory disorders such as psoriasis and rheumatoid ahritis, although cases have also followed administration for neoplastic diseases. The risk of liver damage depends largely on the dose, duration, and timing of therapy. In prospective studies, up to 25% of patients receiving a cumulative dose of 1.5 to 2 grams over five years have developed fibrosis or cirrhosis. The risk appears to be lessened by weekly, as opposed to daily, administration of the drug, and exacerbated by concomitant obesity or alcohol abuse. Methotrexate-induced hepatotoxicity is often clinically silent and, even in advanced disease, can exhibit an indolent clinical course. Evidence of poal hypeension or liver failure can nonetheless develop in some cirrhotic cases and may lead to death or the necessity for liver transplantation. | 4,675 | medmcqa_train |
Stylohyoid ligament is derived from: | Ans. B 2nd branchial archRef: Gray's Anatomy, 41st ed. pg. 449* The stylohyoid ligament is a fibrous cord extending from the tip of the styloid process to the lesser cornu of the hyoid bone. It gives attachment to the highest fibres of the middle pharyngeal constrictor and is intimately related to the lateral wall of the oropharynx. Below, it is overlapped by hyoglossus.* The ligament is derived from the cartilage of the second branchial arch and may be partially calcified. | 4,676 | medmcqa_train |
Mucoepidermoid carcinoma arises form - | Mucoepidermoid carcinomas are composed of variable mixtures of squamous cells, mucus-secreting cells, and intermediate cells.
"The low-grade mucoepidermoid carcinoma is composed of largely mucin-secreting cells, whereas in high-grade tumors, the epidermoid cells predominate."- Schwartz
They are the most common malignant tumors of the salivary glands.
Treatment
The primary t/t of all salivary malignancy is surgical excision:
for parotid malignancies-
Superficial parotidectomy with preservation of CN VII.
Total parotidectomy with nerve preservation if deep lobe is involved.
for other salivary gland -
Enbloc removal of the involved gland
Neck dissection for lymph nodes is done
clinically palpable nodes
for high grade malignancies
Radiation therapy is used postoperatively for specific indications
high grade histology
presence of extraglandular disease
perineural invasion
direct invasion of regional structure
regional metastasis | 4,677 | medmcqa_train |
Positive Fouchet's test gives which color? | Fouchet's test : This test is also employed for the detection of bile pigments. Bile pigments are adsorbed on barium sulfate. Fouchet's reagents (containing ferric chloride in trichloroacetic acid) oxidizes bilirubin to biliverdin (green) and bilicyanin (blue).
Satyanarayana, Ed 3, Pg No 767 | 4,678 | medmcqa_train |
A CKD patient had to undergo dialysis. His Hb was 5.2gm% so two blood transfusions were to be given. First bag was completed in 2 hours. Second was staed and midway he developed shoness of breath, hypeension. Vitals: BP 180/120 mm Hg and pulse rate 110/min. What is the cause? | This C.K.D patient has developed severe anemia which is a compensated hea failure state. The patient was given first unit of blood in two hours instead of standard four hours and he is already in compensated hea failure. The acute decompensation due to volume overloading that has subsequently occurred will result in pulmonary edema and shoness of breath. This presentation is called as transfusion associated circulatory overload. Ideally patients of CKD should be given erythropoietin injections to reduce the incidence of having severe anemia. | 4,679 | medmcqa_train |
The factories Act (1976) prohibits employment of a person below - | Ans. is `b' i.e., 14 years | 4,680 | medmcqa_train |
Most stable amino acid at the physiological pH is | As histidine titrates in the physiological pH range it remains stable. | 4,681 | medmcqa_train |
Trolly tract sign is seen in - | Trolly track sign : The Central radiodense line on frontal radiographs is related to ossification of supraspinous and interspinous ligaments. In addition, there are two more lateral veical linear lines, which represent ossification of the apophyseal joint capsules. The three veical ossified lines together make up the trolley-track sign. Radiological features of Ankylosis spondylitis are : Sacroiliitis Enthesopathy Romanus lesions Bamboo spine Rugger Jersy spine Interveebral disc calcification Dagger sign Trolley track sign Squarring of veebrae. | 4,682 | medmcqa_train |
Pulsatile liver and ascites is found in: | . Ans. a. TR Hepatomegaly with systolic pulsations (of the liver} and ascites are typically seen in tricuspid regurgitation.Tricuspid Regurgitation (TR)* The clinical features of TR result primarily from systemic venous congestion and reduction in cardiac output.Typical Physical Examination Findings in Tricuspid Regurgitation* Gross fluid retention:* Significant peripheral edema* Ascites* Pieural effusion* Hepatomegaly with a pulsatile liver (enlarged tender liver with systolic pulsations)* Positive hepatojugular reflux* Dilated jugular veins with prominent 'v' waves and rapid 'y' decent* Blowing holosystolic murmur along lower left sternal margin that increases with inspiration* Prominent RV pulsations (Parasternal heaves) over left parasternal region. | 4,683 | medmcqa_train |
Which of the following is a treatment option for Volkmann's ischemia? | Ans. A. FasciotomyVolkmann's ischemia is synonymous with Compartment syndrome. If the same is missed, there occurs necrosis followed by fibrosis of forearm flexors leading to a flexion contracture in hand also called as Volkmann's ischemic contracture. | 4,684 | medmcqa_train |
Migratory thrombophlebitis is associated with the following malignancies except - | Ans. is None or 'b' i.e., Prostate cancer "Multifocal migratory thrombophlebitis has been associated with numerous malignancies especially in patients younger than 50 years of age. It is most commonly found with GI cancer, but also lung, prostate, ovary, as well as leukemias and lymphomas. It may be related to hypercoagulable state associated with advanced cancer. Specific syndrome of a cordlike thrombophlebitis of anterior chest (Mondor's disease) may be associated with breast cancer."- Devita's Oncology Migratory thromobophlebitis In ceain cancers hypercoagulability occurs as a paraneoplastic syndrome. The resultant venous thrombosis have a tendency to appear in one site, only to disappear and to be followed by thrombosis in other veins. This is called migratory thrombophlebitis (Trousseau sign). | 4,685 | medmcqa_train |
Child has lesion on buttocks since 2 year spreading peripherally with central scarring non symptomatic diagnosis- | Ans. is 'a' i.e., Erythema annuiase cetrifugam o Erythema annulare centrifugum : an asymptomatic or pruritic eruption of variable duration. The eruption may be associated with an underlying disease (eg, infection, malignancy, sarcoidosis, other systemic illness)o The eruption begins as erythematous papules that spread peripherally while clearing centrally. These lesions enlarge at a rate of approximately 2-5 mm/d to produce annular, arcuate, figurate, circinate, or polycyclic plaqueso Lesions demonstrate a predilection for the thighs and the legs, but they may occur on the upper extremities, the trunk, or the face. The palms and the soles are spared.o Erythema migrans: These lesions are typically less numerous, less circinate in configuration, and often accompanied by a history# of a tick bite.o Erythema gyratum repens: EAC can be distinguished from this condition by its slower rate of spread and by its less bizarre configuration. Also, erythema gyratum repens is almost always associated with an underlying malignancy.o Erythema marginatum rheumaticum: This is a nonscaling gymate erythema that by definition is found in association with rheumatic fever (10-18% of patients with rheumatic fever). | 4,686 | medmcqa_train |
Thornwaldt's abscess treatment does not include | Treatment includes- Antibiotics to treat infection Marsupialization of cystic swelling Adequate removal of its lining membrane Ref: Textbook of ENT, Dhingra; 6th edition; Pg no: 245 ref img | 4,687 | medmcqa_train |
A 2 month old child has a respiratory rate of 45/ minute. He is not accepting feeds from last 4 days and shows sign of dehydration. Which type of pneumonia is this: March 2013 (c) | Ans. C i.e. Severe pneumonia In children below 2 months of age, presence of any of the following indicates severe disease: Fever (38 degree C or more) Convulsions Abnormally sleepy or difficult to wake Not feeding Tachypnea Altered sensorium etc. | 4,688 | medmcqa_train |
Most common inherited childhood tumor is: | Retinoblastoma is a neuroectodermal malignancy arising from embryonic retinal cells. It is the most common intraocular tumor in pediatric patients and causes 5% of cases of childhood blindness. Retinoblastoma is the prototype of hereditary cancers due to a mutation in the retinoblastoma gene (RB1), which is located on the long arm of chromosome 13 (13q14). Approximately 40% of retinoblastoma are inherited. Ref: Graham D.K., Quinones R.R., Keating A.K., Maloney K., Foreman N.K., Giller R.H., Greffe B.S. (2012). Chapter 31. Neoplastic Disease. In W.W. Hay, Jr., M.J. Levin, R.R. Deterding, J.J. Ross, J.M. Sondheimer (Eds), CURRENT Diagnosis & Treatment: Pediatrics, 21e. | 4,689 | medmcqa_train |
In Burkitts lymphoma, translocation seen is chromosome | Answer is B (8 - 14 translocation) Presence oft (8; 14) or one of its variants t (2; 8) or t (8; 22) can be confirmatory - Harrison 16th/ 652. Impoant translocation to be remembered | 4,690 | medmcqa_train |
False statement about cleft palate repair is: March 2011 | Ans. C: Repaired immediately after bih Timing of primary cleft palate procedures: Soft palate alone: One operation at 6 months Soft and hard palate: 2 operations; Soft palate at 6 months and hard palate at 15-18 months | 4,691 | medmcqa_train |
The legal responsibilities of an intoxicated person is given under Section______ of IPC: | Ans. d. 85 (Ref: Reddy 33/e p290-297, 400-401, 411-414 28/e p423-426; Textbook on the Indian Penal Code by Krishna Deo Gaur 4/e p594; the-indian-penal-code-pdf-d74214920)The legal responsibilities of an intoxicated person are given under section 85 of IPC.Section 193 in the Indian Penal Code deals with punishment for giving false evidence.Section 193 Indian Penal CodeWhoever intentionally gives false evidence in any stage of a judicial proceeding, or fabricates false evidence for the purpose of being used in any stage of a judicial proceeding, shall be punished with imprisonment of either description for a term which may extend to seven years, and shall also be liable to fine, and whoever intentionally gives or fabricates false evidence in any other case, shall be punished with imprisonment of either description for a term which may extend to three years, and shall also be liable to fine.Important Criminal Procedure Codes (CrPC)CrPCDescription39Doctor is duty bound to provide information about enlisted offences to the policeQ53Examination of accused by medical practitioner at request of policeQ53AExamination of accused of rapeQ54Examination of arrested person by medical officer at request of arrested personQ61Format of summonsQ62Summons how servedQ70Form of warrant of arrest and durationQ174Police inquestQ176Magistrates inquestQ238-265Magistrates trialQ293Exception to oral evidenceQ327Open trial-closed room. In camera trial-rape casesQ416Postponement of capital sentence pregnant womanQImportant Indian Evidence Acts (IEA)IEADescription114ADoctrine of adverse inferenceQ (presume absence of consent)137Recording of evidenceQ139Cross-examination of a person called to produce a documentQ141Leading questionsQ152Question intending to insult or annoyQ159Refreshing memoryQ162Production of documentsQ SectionDeals with44 IPCDefinition of injury (any harm caused to a person in body, mind, reputation or property)53 IPCAn accused can be examined by a medical practitioner at the request of police, even without his consent and by use of forceQ84 IPCInsanity & criminal responsibilityQ85 IPCCriminal responsibility of a person incapable of judgment by reasons intoxication caused against his will191 IPCDefines perjury or hostile witnessQ193 IPCPunishment for perjuryQ197 IPCPunishment for doctors for submitting false medical certificates202 IPCIntentional omission to give information of offence by person bound to inform228A IPCDisclosure of identity of victim of certain offences under section 376 (rape) Q269 IPCNegligent act likely to spread infection or disease dangerous to lifeSectionDeals with270 IPCMalignant act likely to spread infection or disease dangerous to life299 IPCCulpable homicideQ300 IPCDefinition of murderQ302 IPCPunishment for murderQ304A IPCCausing death by negligence, punishment up to 2 years (medical negligence)304B IPCDowry deathQ, punishment 7 years to life imprisonment306 IPCAbetment of suicideQ307 IPCAttempt to murderQ306 IPCAbetment to commit culpable homicideQ312 IPCCausing illegal miscarriage with woman's consentQ313 IPCCausing illegal miscarriage without woman's consentQ314 IPCDeath of mother caused by act done with intent to cause miscarriageQ315 IPCAct done with intent to prevent child being born alive or to cause it to die after birthQ316 IPCCausing death of quick unborn child by act amounting to culpable homicideQ317 IPCExposure & abandonment of child under 12 years318 IPCConcealment of birth by secret disposal of dead body319 IPCDefinition of Hurt (whoever causes bodily pain, disease, or infirmity to any person is said to cause hurt)320 IPCGrevious hurtQ definition321 IPCVoluntarily causing hurtQ322 IPCVoluntarily causing Grevious hurtQ323 IPCPunishment for voluntarily causing hurt324 IPCVoluntarily causing hurt by dangerous weapons or means325 IPCPunishment for voluntarily causing grievous hurt326 IPCVoluntarily causing grievous hurt by dangerous weapons or means330 IPCVoluntarily causing hurt to extort confession or to compel restoration of property331 IPCVoluntarily causing grievous hurt to extort confession or to compel restoration of property351 IPCDeals with assaultQ354 IPCAssault or criminal force to woman with intent to outrage her modesty375 IPCDefines rapeQ376 IPCPunishment of rapeQ377 IPCUnnatural sexual offencesQ497 IPCAdultery | 4,692 | medmcqa_train |
All are true regarding menstrual regulation except: | Ans. is c i.e. Done upto 12 weeks Menstrual regulation - consists of aspiration of contents of uterine cavity by means of plastic cannula (Karman's cannula) and a plastic 50 cc syringe. It is carried out effectively within 14 days of beginning of LMP. A paracervical block or pre-operative sedative alone suffices but sometimes in apprehensive patient GA is required. Blood loss is less. It is included in methods of performing MTP. Friends-- there are 2 different methods -- menstrual regulation and manual vaccum aspiration. Both of them are based on same principle i.e. creating a vaccum which helps in extracting out the products of conception. But menstrual regulation is done within 2 weeks whereas, manual vaccum aspiration is a safe method uptil 12 wks. | 4,693 | medmcqa_train |
Which of the following is true about Constitutional Delay in growth? | Constitutional growth delay is a physiological variant of sho stature. Here children grow normally upto 6-12 months of life. Thereafter, there is deceleration such that the height and weight fall below the 3rd centile. By 3 yrs of age,normal height velocity is resumed and continues to grow below and parallel to the 3rd centile. Here pubey is delayed; And the bone age is consistent with the child&;s height age, but lower than the chronological age by 2-3 yrs , unlike in the familial sho stature. Hence IGF-1 produced is low for the chronological age but consistent with the bone age that corresponds to the height age. Ref. OP.Ghai ,9th edition, chapter 2 | 4,694 | medmcqa_train |
A 32-year-old male with a painless lymph node in the cervical region. Lymph node biopsy showed normal thyroid gland features. The thyroid is normal on palpation clinically. The diagnosis is | Thyroid tissue present in cervical lymph nodes in the face of a clinically normal thyroid gland is a metastasis from an occult primary thyroid carcinoma
Occasionally, a metastatic papillary thyroid cancer manifests as a painless lateral neck mass that is clinically detected before detecting the primary thyroid lesion.
Comment: Normal thyroid tissue is a trap by the examiner, remember in young people papillary thyroid cancer mostly is well differentiated.
Well, differentiated cells look like normal cells and tend to grow .and spread more slowly than poorly differentiated cells (anaplastic carcinoma). | 4,695 | medmcqa_train |
The 27-year-old male triathlon competitor complained that he frequently experienced deep pains in one calf that almost caused him to drop out of a regional track-and-field event. Doppler ultrasound studies indicated, and surgical exposure confirmed, the existence of an accessory portion of the medial head of the gastrocnemius that was constricting the popliteal artery. Above the medial head of the gastrocnemius, the superior medial border of the popliteal fossa could be seen. Which of the following structures forms this border? | The tendons of the semitendinosus and semimembranosus provide the superior medial border of the popliteal fossa. The semitendinosus inserts with the pes anserinus on the proximal, medial tibia. The semimembranosus inserts on the tibia posteriorly. The biceps femoris forms the superior lateral border of the fossa, as the tendon passes to insertion on the fibula. The plantaris arises from the femur just above the lateral head of the gastrocnemius, passing distally to insert on the calcaneus via the tendo Achilles. The popliteus arises from the tibia and passes superiorly and laterally to insert on the lateral condyle of the femur, with a connection to the lateral meniscus. | 4,696 | medmcqa_train |
All of the following are layers of the scalp except - | Ans. is 'd' i.e., Dura o A mnemonic for the layers of the scalp is:# SCALPo This is particularly helpful when considering the location of a scalp haematoma.# S: skin# C: connective tissue# A: (galea) aponeurosis# L: loose connective tissue# P: periosteumo A retractor is applied between the galea aponeurotica and the loose connective tissue during surgery as the first three layers are tightly bound to each other. | 4,697 | medmcqa_train |
The number of major hormones produced by the anterior pituitary gland is | Six major hormones produced by anterior pituitary gland are Prolactin (PRL), Growth hormone (GH), Adrenocoicotropin hormone (ACTH), Luteinizing hormone (LH), Follicle-stimulating hormone (FSH) & Thyroid-stimulating hormone (TSH).Reference: Harrison 19th edition 401e-1 | 4,698 | medmcqa_train |
Glaucomflecken are seen in: | Angle-closure glaucoma can have the appearance of glaucomflecken. Glaucomflecken are small anterior subcapsular opacities secondary to lens epithelial necrosis resulting from acute angle-closure glaucoma. - Signs of Angle closure glaucoma :Stony hard eye, steamy cornea, Veically oval mid-dilated non reacting pupil - Symptoms: Severe pain, coloured halos, sudden drop in vision. Symptoms occurs in late night - Nd-Yag Laser iridotomy is done for management of Angle closure glaucoma | 4,699 | medmcqa_train |
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