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All of the following are true about pachydermia laryngitis except | PACHYDERMIA LARYNGIS It is a form of chronic hyperophic laryngitis affecting posterior pa of larynx in the region of interarytenoid and posterior pa of the vocal cords. Clinically, patient presents with hoarseness or husky voice and irritation in the throat. Indirect laryngoscopy reveals heaping up of red or grey granulation tissue in the interarytenoid region and posterior thirds of vocal cords; the latter sometimes showing ulceration due to constant hammering of vocal processes as in talking, forming what is called "contact ulcer." The condition is bilateral and symmetrical. It does not undergo malignant change. However, biopsy of the lesion is essential to differentiate the lesionfrom carcinoma and tuberculosis. Aetiology is unceain. It is mostly seen in men who indulge in excessive alcohol and smoking. Other factors are excessive forceful talking and gastro-oesophageal reflux disease where posterior pa of larynx is being constantly bathed with acid juices from the stomach. Treatment is removal of granulation tissue under operating microscope which may require repetition, control of acid reflux and speech therapy. Ref:- Dhingra; pg num:-292,293 | 4,900 | medmcqa_train |
The most common sequelae of tuberculous spondylitis in an adolescent is: | (b)- The usual outcome of healed tuberculosis in spine is the bony ankylosis and in peripheral joints like Hip and Knee Fibrous ankylosis is seen. | 4,901 | medmcqa_train |
Biguanides acts by following except - | Ans. is 'a' i.e., | insulin release from pancreash Biguanides acts by : o Suppress hepatic gluconeogenesis and glucose output from liver major action. o Enhance insulin mediated glucose disposal in muscle and fat (Increased peripheral utilization of glucose) by enhancing GLUT-I transpo from intracellular site to plasma membrane. o Retad intestinal absorption of glucose. o Promote peripheral glucose utilization by enhancing anaerobic glycolysis. | 4,902 | medmcqa_train |
A patient presented with renal cell carcinoma invading IVC and renal vein. False statement is: | Patients with renal vein or IVC involvement by tumour but without evidence of metastatic disease remain surgical candidates. Occasionally, nephrectomy and removal of IVC tumour thrombus need to be done. Bench surgery and autotransplantation is performed for larger tumours in a solitary kidney. Chest X-ray should be done to rule out pulmonary metastasis . | 4,903 | medmcqa_train |
Preventable cuses of mental retardation are - | Ans. is `c' i.e., Cretinism Cretinism is due to deficiency of Iodine, which can be preventable. | 4,904 | medmcqa_train |
A population of 100000 is under surveillance during an year. 100 cases were positive for malarial thick smear. What is the annual parasite index - | Ans. is 'a' i.e., 1 per 1000 * Annual Parasite Incidence = (confirmed cases during one year/population under surveillancee) x 1000* Population under surveillance = 100000* Confirmed cases =100API =100------100,000x 1000 = 1* So, API is 1 per 1000 population. | 4,905 | medmcqa_train |
Diatoms are - | Diatoms are unicellular algae. | 4,906 | medmcqa_train |
Hydramnios is complicated by all except: March 2005 | Ans. C: Post Dated Pregnancy Complications during pregnancy: Pre-eclampsia (25%) Malpresentations Premature rupture of membranes Preterm labour Accidental hemorrhage Complications during labour: Early rupture of membranes Cord prolapsed Uterine ineia Retained placenta, postpaum hemorrhage | 4,907 | medmcqa_train |
Earliest site of bone involvement in hematogenous osteomyelitis is ? | Ans. is 'a' i.e., Metaphysis Pathophysiology of acute osteomyelitis Organism reach the bone through blood stream from a septic focus elsewhere in the body. Metaphysis of long bone is the earliest and most common site involved because : - i) Metaphysis is highly vascular ii) Commonest site is metaphysis. This is because of the peculiar arrangement of the blood vessels in that area, which leads to relative vascular stasis, ouring bacterial colonization. . iii) Metaphysis has relatively few phagocytic cells than physis or diaphysis. iv) Metaphysis has thin coex. | 4,908 | medmcqa_train |
A gastric biopsy is taken from a 42 year old man. As the pathologist inspects the specimen, he observes numerous, normal cuboidal-to-columnar cells with apical membrane-bound secretion granules in the gastric glands. From which area of the stomach was the biopsy most likely taken? | The pathologist saw normal chief cells, which are abundant in the body and fundus of the stomach. Chief cells secrete pepsinogen, which is stored in apical membrane- bound granules. The body and fundus of the stomach contain high concentrations of four other types of cells in the epithelium. The parietal (oxyntic) cells are large, pyramidal, and acidophilic with central nuclei (look like a "fried egg"). They make and secrete HCl. The mucous neck cells secrete mucus and appear clear. The enteroendocrine cells have affinity for silver stains and exhibit a positive chromaffin reaction; these cells synthesize amines, polypeptides, or proteins.The cardiac region is a narrow, circular band at the transition between the esophagus and stomach, consisting of shallow gastric pits and mucous glands. It does not normally contain an abundance of chief cells.The columns of Morgagni are found in the rectum, not in the stomach. These are mucous membrane infoldings in the submucosa of the proximal anal canal. They would not contain chief cells.The greater omentum is a four-layered fold of peritoneum that hangs from the greater curvature of the stomach and attaches to the transverse colon. It would not contain chief cells. | 4,909 | medmcqa_train |
All are true about pleomorphic adenoma except:- | Risk of malignant transformation is low (3-5%) in pleomorphic adenoma. Malignant mixed tumors include cancers originating from pleomorphic adenomas, termed carcinoma ex pleomorphic adenoma, and de novo malignant mixed tumors. The risk for malignant transformation of benign pleomorphic adenomas is 1.5% within the first 5 years, but risk increases to 9.5% when the benign tumor has been present for more than 15 years. | 4,910 | medmcqa_train |
Laryngeal mask is contraindicated in all except- | Ans. is 'b' i.e., Ocular surgeries Indications of LMA1. As an alternative to intubation wrhere difficult intubation is anticipated (difficult airway).2 To facilitate endo-tracheal intubation in a patient with difficult airw ays.Situations involving a difficult mask fit.Securing airw ay (as cardiopulmonary resuscitation) in emergency where intubation and mask ventilation is not possible.For minor surgeries (short surgeries), where anaesthetist wants to avoid intubation.As a conduit for bronchoscopes, small size tubes, gum elastic bougies.For extra and intra-ocular surgeries including retinopathy surgery in premature infants LMA is particularly useful in ophthalmic surgery as problems created by other two airways are eliminated : -Face mask creates problem in surgical field access due to its size (LMA provides a better access).Endotracheal intubation may cause raised IOT (LMA has no effect).Contraindications of LMA1. Conditions with high risk of aspiration i.e., full stomach patients, hiatus hernia, pregnancy.2. Oropharyngeal abscess or mass (tumor).3. Massive thoracic injury4. Massive maxillofacial trauma | 4,911 | medmcqa_train |
A 40 year old woman has severe, disabling rheumatoid ahritis. Rheumatoid factor is positive. What would a biopsy of the synovium of her knee most likely reveal? | Severe rheumatoid ahritis causes a proliferative synovitis with extensive damage to the synovium of the joint. The synol membrane becomes markedly thickened (pannus formation), with edematous villous projections that extend into the joint space. The intense inflammatory infiltrate that is present is typically composed of plasma cells, lymphocytes, and macrophages. Ref: Bednar M.S., Light T.R. (2006). Chapter 10. Hand Surgery. In H.B. Skinner (Ed), CURRENT Diagnosis & Treatment in Ohopedics, 4e. | 4,912 | medmcqa_train |
Wernicke's aphasia is seen due to lesion in? | ANSWER: (C) Superior temporal gyrusREF: Gray's anatomy 39th edition, page 415See previous question | 4,913 | medmcqa_train |
Most common disease caused by CMV in a postrenal transplant patients: | Ans. (c) PneumoniaRef: Bailey 26th edition, Page 1416* Most common viral infection following kidney transplant is CMV- which presents with Interstitial pneumonia | 4,914 | medmcqa_train |
In myocardial infarction the infarct acquires hyperemic rim with an yellow centre at | 3 – 7 days Findings
Gross examination at border
Softening yellow-tan center Histopathology
(light microscopy)
Beginning of disintegration of dead muscle fibers
Necrosis of neutrophils
Beginning of macrophageremoval of dead cells at border | 4,915 | medmcqa_train |
Middle lobe of prostrate is present in between: | A i.e. Prostratic urethra & Ejaculation duct Board Review series AnatomyMedian lobe which lies between urethra and the ejaculatory duct is prone to benign hyperophy. QPosterior lobe, which lies behind the urethra and below the ejaculatory duct contains glandular tissue and is prone to carcinomatous transformation.Q | 4,916 | medmcqa_train |
Iritis roseata is seen in: | Ans. Syphilis | 4,917 | medmcqa_train |
Which of the following is NOT a component of Saint's triad? | Saint's triad is a medical condition of the concurrence of hiatus hernia,gallstones& diveiculosis of colon. Reference:SRB's manual of surgery,5th edition,page no:641. | 4,918 | medmcqa_train |
After overnight fasting, levels of glucose transporters reduced in: | Ans. C. Adipocytes(Ref: Harper 29/e page 158, Harper 30/e page 192)GLUT-4 and InsulinGlucose uptake into muscle and adipose tissue is controlled by insulin, which is secreted by the islet cells of the pancreas in response to an increased concentration of glucose in the portal blood.In the fasting state, the glucose transporter of muscle and adipose tissue (GLUT-4) is in intracellular vesicles.An early response to insulin is the migration of these vesicles to the cell surface, where they fuse with the plasma membrane, exposing active glucose transporters.These insulin sensitive tissues only take up glucose from the bloodstream to any significant extent in the presence of the hormone.As insulin secretion falls in the fasting state, so the receptors are internalized again, reducing glucose uptake. | 4,919 | medmcqa_train |
Which of the following is the most severe form of Diptheria | Ref: Harrisons, 19th ed. pg. 978* Diptheria is a nasopharyngeal and skin infection caused by Corynebacterium diphtheriae. Toxigenic strains of C. diphtheria produce a protein toxin that causes systemic toxicity, myocarditis, and polyneuropathy.* The toxigenic strains cause pharyngeal diphtheria, while the non-toxigenic strains commonly cause cutaneous disease.* Harrisons states: "Respiratory/pharyngeal form of diphtheria is from notiable diseases, while cutaneous diphtheria is NOT"* Most severe form of diphtheria: Laryngeal | 4,920 | medmcqa_train |
A 5-year-old child presents with a history of fever off–and–on for past 2 weeks and petechial spots all over the body and increasing pallor for past 1 month. Examination reveals splenomegaly of 2 ems below the costal margin. The most likely diagnosis is – | Pallor (anemia), petechial spot (thrombocytopenia), fever (infection due to neutropenia) with splenomegaly suggest the diagnosis of acute leukemia.
Further, the presence of splenomegaly eliminates aplastic anaemia and ITP as the possibilities
"Splenomegaly and lymphadenopathy are extremely uncommon in ITP and their presence should lead one to consider other possible diagnosis". - Robbin's
"Splenomegaly is characteristically absent in aplastic anemia and if present the diagnosis of a plastic anemia should be seriously questioned".
Hypersplenism is a condition characterised by splenomegaly and cytopenias with a normal hyperplastic marrow and response to splenectomy.
Although cytopenias resulting from hypersplenism may give rise to most manifestations mentioned in the question these are more likely with massively enlarged spleens and not with minimally enlarged spleen as in the question above (2cm below costal margin in a 2 year old child). | 4,921 | medmcqa_train |
A 23-year-old male patient presented with a history of back pain, which is more in the morning and relieved by bathing in warm water. What is the likely additional finding present in this patient? | Ans. d. Decreased chest wall expansion (Ref: Harrison 19/e p2170, 18/e p2775)History of back pain, which is more in the morning and relieved by bathing in warm water is characteristic of spondylo arthropathy, like ankylosing spondylitis. Ankylosing spondylitis leads to extra-parenchymal restrictive lung disease, associated with decreased chest wall expansion."Ankylosing Spondylitis: The initial symptom is usually dull pain, insidious in onset, felt deep in the lower lumbar or gluteal region, accompanied by low-back morning stiffness of up to a few hours 'duration that improves with activity and returns following inactivity. "- Harrison 19/e p2170"Ankylosing Spondylitis: Initially; physical findings mirror the inflammatory process. The most specific findings involve loss of spinal mobility, with limitation of anterior and lateral flexion and extension of the lumbar spine and of chest expansion. Limitation of motion is usually out of proportion to the degree of bony ankylosis, reflecting muscle spasm secondary to pain and inflammation. Pain in the sacroiliac joints may be elicited either with direct pressure or with stress on the joints. In addition, there is commonly tenderness upon palpation at the sites of symptomatic bony tenderness and paraspinous muscle spasm. ''-- Harrison 19/e p2170A. Obstructive lung diseaseB. Restrictive lung disease* Asthma* Bronchiectasis* Bronchiolitis* Cystic fibrosis* COPD (Chronic bronchitis, Emphysema)Mnemonic- "ABCDE"ParenchymalExtra Parenchymal* Sarcoidosis* Pneumoconiosis* Idiopathic pulmonary fibrosis* Drug/Radiation induced interstitial lung disease* Neuromuscular diseases:- Diaphragmatic palsy- Guillain-Barre syndrome- Muscular dystrophy- Cervical spine injury* Chest wall diseases:- Kyphoscoliosis- Obesity- Ankylosing spondylitisAnkylosing Spondylitis/Marie-Strumpell or Bchtrew's diseaseEtiology & Pathogenesis:More than 90% patients of AS are HLA B27 positiveQ.The enthesis. the site of ligament attachment to bone is primary site of pathology in ASQ.Sacroilitis is the earliest manifestation with features of both enthesitis & synovitisQ.Clinical Presentation:Males are affected more frequently than females.Age of onset is 15-25 years (late adolescence & early adulthood )Q.The initial symptom is usually dull pain, insidious in onset, accompanied by low back morning stiffness of up to few hours duration that improves with activity and returns following period of inactivityQ.Arthritis in hips & shoulders (root joints) occur in 25-35%Q.Peripheral joints (usually shoulder, hips & knees) are involved in one third of patientsQ.Most serious complication of spinal disease is spinal fracture with even minor trauma.MC extra-articular manifestation is acute anterior uveitis (iridocyclitis)Q.Diagnosis:Radiological Examination(The following changes may be seen on an X-ray of the pelvis)* Haziness of sacro-iliac jointsQ* Irregular subchondral erosions in SI jointsQ* Sclerosis of the articulating surfaces of SI jointsQ* Widening of sacro-iliac joint spaceQ* Bony ankylosis of the sacro-iliac jointsQ* Calcification of the sacro-iliac ligaments and sacro- tuberous ligaments* Evidence of enthesopathy: Calcification at the attachment of the muscles, tendons and ligaments, particularly around the pelvis & heelQ.X-ray of Lumbar spine in Ankylosing Spondylitis* Squaring of vertebraQ: The normal anterior concavity of the vertebral body is lost because of calcification of the anterior tongitudinai ligament* Loss of lumbar lordosisQ* Bridging osteophytes (syndesmophytes)Q* Bamboo spine appearanceQ due to syndesmophytes & paravertebral ossificationTreatment:Phenylbutazone is the most effective drugQ (causes aplastic anemia).Indomethacin is most commonly used NSAIDQ. | 4,922 | medmcqa_train |
Drug given for antibiotic associated pseudomembranous enterocolitis and is part of anti H. Pylori treatment: | Ans. C. MetronidazoleTriple drug regimen given for H. Pylori include- clarithromycin, amoxicillin, tetracycline, metronidazole. Out of all these drugs metronidazole is drug of choice for pseudomembranous colitis. | 4,923 | medmcqa_train |
True about pseudocyst of pancreas - | Answer is 'd' i.e. can present from mediastinum of pubis | 4,924 | medmcqa_train |
Postponing paying attention of conscious impulse or conflict is mature defence mechanism known as | Sublimation: Gratification of an impulse whose goal is retained but whose aim or object is changed from a socially objectionable one to a socially valued one. Suppression: Conscious or semiconscious decision to postpone attention to a conscious impulse or conflict. Humour:ove expression of feelings without personal discomfo and without unpleasant effo on others. Anticipation: Realistic anticipation of or planning for future inner discomfo. Ref: Synopsis of Psychiatry, 11e, pg 161. | 4,925 | medmcqa_train |
Laminin is present in:(1998) | Ans: b (Basement membrane)Ref: Robbin's, 7th ed, p. 105 & 6thed, p. 100 | 4,926 | medmcqa_train |
Which radiological procedure is used for studying vesico-ureteric reflux? | The diagnosis of vesico ureteric reflux is made using micturition cystourethrogram. Other techniques used in diagnosing vesico ureteric reflux are simple or delayed cystography or voiding cinefluoroscopy. In a case of vesico ureteral reflux, cystogram may show one of the following findings: Persistently dilated lower ureter, areas of dilatation in the ureter, ureter visualized throughout its entire length shows, presence of hydroureteronephrosis with a narrow juxtavesical ureteral segment or changes of healed pyelonephritis. Ref: Smith's General Urology, 17e, Chapter 12 | 4,927 | medmcqa_train |
A 43-year-old man with chronic hepatitis and liver cirrhosis is admitted with upper GI bleeding. He has marked ascites and shows multiple telangiectasias, liver palmar erythema, and clubbing. A diagnosis of bleeding esophageal varices secondary to portal hypertension is made. Portal pressure is considered elevated when it is above which of the following? | Portal hypertension is suspected clinically if esophageal varices are detected, hypersplenism occurs, or ascites develop. Normal portal venous pressure is 5-10 mm Hg. Pressure may be measured indirectly by using hepatic venous wedge pressure (occlusive hepatic wedge pressure). About two-thirds of patients with portal hypertension will develop varices of which one-third will bleed. | 4,928 | medmcqa_train |
In a patient with AIDS, chorioretinitis is typically caused by – | The most common cause of chorioretinitis in AIDS is CMV. | 4,929 | medmcqa_train |
All are true about persistent caliber aery except? | Persistent caliber aery is called Dieulafoy's lesion. It is a large calibre aeriole that runs beneath the gut mucosa and bleeds pinpoint mucosal erosion. For management of bleeding in Dieulafoy's lesion, endoscopic therapy like thermal coagulation or band ligation is effective. In case of failure to control bleeding with above methods, angiographic embolization is used. Deep enteroscopy is used in patients with diffuse small bowel pathology like vascular ectasia. | 4,930 | medmcqa_train |
Dark ground microscopy is used to see? | Darkfield / Dark ground microscope in which reflected light is used instead of transmitted light used in the ordinary microscope. Flagella are less than 0.02 um in thickness and hence beyond the limit of resolution of the light microscopes. They may in some instances be seen under dark field / Dark ground illumination. They can be visualized by special staining techniques in which their thickness is increased by mordanting or by electron microscopy. Ref: Textbook of Microbiology; Ananthanarayan and Paniker; 9th edition; Pg no: 11 | 4,931 | medmcqa_train |
Infant with hepatomegaly, hypoglycemia. hyperlipidemia and acidosis , diagnosis? | In type 1 Glycogen storage disorder the usual clinical features are : hepatomegaly failure to thrive hypoglycemia, becomes worse after overnight fasting, an inability of the liver to release glucose into the blood. ketosis acidosis hyperlipidemia, since free fatty acids are mobilised excessively to provide for energy needs of the body Ref : ESSENTIAL PEDIATRICS,O.P.GHAI,PG NO:636,7 th edition | 4,932 | medmcqa_train |
Hairy cell leukemia&; is a Neoplastic proliferation of : | Hairy cell leukemia review : Presentation is with a triad of : Splenomegaly :often massive. However hepatomegaly is less common while lymphadenopathy is rare. Pancytopenia and thereby, resulting infections. Vasculitis like syndrome :Erythema nodosum and cutaneous nodules due to perivasculitis and PAN. Course : Hairy cell leukemia follows an indolent course. REF: ROBBINS pathology 10th edition | 4,933 | medmcqa_train |
Beaded margin of eyelid is seen in? | Lipoid proteinosis REF: org/121/ case pre sentations/lipoid2/robati.html, http: //en .wikipedia. org/wiki/Urba chdeg70E2%80%93Wiethe_diseas e "Urbach--Wiethe disease (also known as lipoid proteinosis and hyalinosis cutis et mucosae) is a rare autosomal-recessive disorderwith fewer than 300 repoed cases since its discovery, that presents in early childhood with hoarseness, skin infiltration, and thickening, with beaded papules on eyelid margins, and facial acneiform or pock-like scars" | 4,934 | medmcqa_train |
A 40-year-old man presents with 5 days of productive cough and fever. Pseudomonas aeruginosa is isolated from a pulmonary abscess. The CBC shows an acute effect characterized by marked leukocytosis (50,000 WBC/mL), and the differential count reveals numerous immature cells (band forms). Which of the following terms best describes these hematologic findings? | Leukemoid reaction. Circulating levels of leukocytes and their precursors may occasionally reach very high levels (>50,000WBC/mL). Such a situation, referred to as a leukemoid reaction, is sometimes difficult to differentiate from leukemia. In contrast to bacterial infections, viral infections (including infectious mononucleosis) are characterized by lymphocytosis, an absolute increase in the number of circulating lymphocytes. Parasitic infestations and certain allergic reactions cause eosinophilia, an increase in the number of circulating eosinophils. Leukopenia is defined as an absolute decrease in the circulating WBC count. Myloid metaplasia (choice C) and myeloproliferative disease (choice D) are chronic disorders of the hematopoietic system. Although technically correct, neutrophilia (choice E) by itself does not demonstrate immature cells (band forms) and usually refers to lower levels of increased neutrophils.Diagnosis: Pulmonary abscess | 4,935 | medmcqa_train |
Hydrogen peroxide is conveed to water and oxygen by enzyme? | Catalase, present in peroxisomes, catalyzes the decomposition of hydrogen peroxide (2H2O2 - O2 + 2H2O). Glutathione (GSH) peroxidases are a family of enzymes whose major function is to protect cells from oxidative damage 2 GSH (glutathione) + H2O2 - GS-SG + 2 H2O. myeloperoxidase conves H2O2 to a highly reactive compound hypochlorite Superoxide dismutase conves superoxide into H2O2 ref robbins basic pathology 9th ed page 15 | 4,936 | medmcqa_train |
Hypercalciuria is seen in: | Answer is D (All of the above): Hypercakiuria may be associated with Vitamin D intoxication (hypervitaminosis D), Sarcoidosis and hyperparathyroidism. Causes of Hypercalciuria-associated Nephrolithiasis in Children and Adults Idiopathic hypercalciuria Increased intestinal calcium absorption - Granulomatous disease e.g. sarcoidosis - Hypervitaminosis D - Milk alkali syndrome Increased bone resorption Immobilization e.g. paraplegia and quadriplegia High animal protein diet Systemic acidosis e.g. distal renal tubular acidosis - Adrenocoicotrophic hormone or coisol excess - Primary hyperparathyroidism Decreased renal calcium reabsorption - Barret's syndrome - Chronic loop diuretic administration - X-linked hypercalciuria nephrolithiasis - Familial hypocalcemic hypercalciuria Systemic disease associated with chronic hypercalcemia - Williams syndrome - Primary hyperparathyroidism | 4,937 | medmcqa_train |
Schneider's Ist rank symptoms seen in: | D i.e. Schizophrenia | 4,938 | medmcqa_train |
Killian's dehiscence is seen in - | Between these two parts of inferior constrictor exists a potential gap called Killian's dehiscence.
It is also called the gateway to tear as perforation can occur at this site during esophagoscopy.
It is also the site for herniation of pharyngeal mucosa in case of the pharyngeal pouch. | 4,939 | medmcqa_train |
Hypsarrythmia in a child is due to- | Ans. is 'c' i.e., Myoclonic epilepsy Myoclonic epilepsy may be ? i) Infantile spasm or Infantile myoclonus or west syndrome ii) Juvenile myoclonic epilepsy Infantile spasm (Infantile myoclonus or west syndrome) o The onset is usually between 3-8 months of life o It is characterized by triad of ? i) Salaam spells (sudden droping of the head & flexion of arms) ii) Mental retardation iii) Hypsarrhythmic pattern of EEG (diffuse high voltage slow spike and chaotic activity) o The spasm occur in clusters usually on waking. o Prognosis for normal mental development is poor. Treatment of infantile myoclonus o ACTH and coicosteroids are given for 2-12 weeks, depending upon resonse. o Vagabatrin is the DOC Now. | 4,940 | medmcqa_train |
All of the following are adverse effects of thalidomide except : | Thalidomide was banned because of teratogenic effects (phocomelia). Now it has come again in the market for use as an anticancer drug in multiple myeloma and melanoma.
Lenalidomide is its more potent and non-teratogenic derivative.
Thalidomide most commonly causes sedation and constipation in cancer patients. It can also cause peripheral sensory neuropathy.
Two enantiomers of thalidomide (R and S) are present but these are interconvertible in the body, therefore racemic mixture is used. | 4,941 | medmcqa_train |
Neurotoxin is which snake - | Ans. is 'b' i.e., Krait Type of poisoningSnakeVasculotoxicVipersMyotoxicSea snakesNeurotoxicElapids- cobra, Krait, coral | 4,942 | medmcqa_train |
Single gene defect causing multiple unrelated problems is called? | Pleotropism refers to single gene defect causing multiple traits. Penetrance- extent to which a paicular gene or set of genes is expressed in the phenotypes of individuals carrying it Pseudodominance- sudden appearance of a recessive phenotype in a pedigree, due to deletion of a masking dominant gene Anticipation- disease manifestation worsen from 1 generation to next | 4,943 | medmcqa_train |
Urinary bacterial count of 105 is insignificant, in the absence of symptoms, in all of the following conditions except - | Significant growth of a Uropathogen in the absence of symptoms is termed Asymptomatic bacteriuria. Urinary bacterial count of 105 is significant in Pregnancy. Pathogens associated with UTI most commonly in pregnancy are most commonly E coli, along with Klebsiella, proteus, enterobacter, staphylococcus saprophyticus. Since Asymptomatic bacteriuria is associated with Preterm delivery and low bih weight, then treatment is prudent choice with drugs like Nitrofurantoin, Trimethoprim (after 12 weeks), Cephalosporins like Cephalexin or penicillin like ampicillin. | 4,944 | medmcqa_train |
Elastomers are | According to Chemistry
Chemically, there are four kinds of elastomers:
Polysulfide
Condensation polymerizing silicones
Addition polymerizing silicones
Polyether | 4,945 | medmcqa_train |
Cotton fever is due to the abuse of: | COTTON FEVER : Fever developing due to injection of a water extract of the cotton remaining after the heroin supply is used in a "bag" | 4,946 | medmcqa_train |
What causes both destruction of bone and reduction of joint space? | (a)TB in spine involves- 2 Vertebra (Bone) + Disk (Cartilage)- Paradiscal- Anterior (to spinal cord)Note: Involvement of posterior elements and single vertebra is relatively rare in TB. | 4,947 | medmcqa_train |
The commonest malignant tumour of the lids is | MALIGNANT TUMOURS Basal-cell carcinoma It is the commonest malignant tumour of the lids (90%) usually seen in elderly people. It is locally malignant and involves most commonly lower lid (50%) followed by medial canthus (25%), upper lid (10-15%) and outer canthus (5-10%). Clinical features: It may present in four forms: Noduloulcerative basal cell carcinoma is the most common presentation. It stas as a small nodule which undergoes central ulceration with pearly rolled margins. The tumour grows by burrowing and destroying the tissues locally like a rodent and hence the name rodent ulcer. Ref:- A K KHURANA; pg num:-360 | 4,948 | medmcqa_train |
Point B in the treatment of carcinoma cervix receives the following dose of: | Two important points in the radiotherapy of cancer cervix are | 4,949 | medmcqa_train |
A 40-year old alcoholic develops cough and fever. Chest X-ray show an air-fluid level in the superior segment of the right lower lobe. The most likely etiologic agent is: | Ans. D. AnaerobesOf the organisms listed, only anaerobic infection is likely to cause a necrotizing process Type III pneumococci have been reported to cause cavitary disease, but this is unusual. The location of the infiltrate suggests aspiration, also making anaerobic infection most likely. The superior segment of the right lower lobe is the one most likely to develop an aspiration pneumonia. | 4,950 | medmcqa_train |
The antidote of poisoning due to Arninanita muscaria is | D i.e. Atropine Amanita muscaria & Amanita phalloides are poisonous mushrooms with parasympathetic (Cholinergic) symptoms. So AtropineQ is used as antidote in severe cases; but avoided in mild case as it excerhates delirium. | 4,951 | medmcqa_train |
Baonella quintana causes: | Ans. is. 'a' i. e., Trench fever | 4,952 | medmcqa_train |
The main poion of the ovarian aery, vein, and nerves are carried to and from the ovary by way of the: | The suspensory ligament attaches the ovary to the pelvic wall and carries within its folds the main poion of the ovarian vessels and nerves. The ovarian ligament attaches the inferior pole of the ovary to the uterus. The broad ligament is a double-fold of parietal peritoneum, which hangs over the uterus (mesentery of the uterus) and connects lateral margins of the uterus with the side wall of the pelvis. The mesovarium, the posterior extension of the broad ligament, suppos the ovary and becomes continuous with the serosa (or germinal epithelium) of the ovary. The mesosalpinx, which is the superior limit of the broad ligament, suppos the uterine tube. Some branches of the ovarian vessels lie within the mesosalpinx. Ref: Cunningham F.G., Leveno K.J., Bloom S.L., Hauth J.C., Rouse D.J., Spong C.Y. (2010). Chapter 2. Maternal Anatomy. In F.G. Cunningham, K.J. Leveno, S.L. Bloom, J.C. Hauth, D.J. Rouse, C.Y. Spong (Eds), Williams Obstetrics, 23e. | 4,953 | medmcqa_train |
Barr body is absent in - | Ans. is 'b' i. e., Turner Barr body (Sex- chromatin)o It is a densely staining inactivated condensed 'X' chromosome that is present in each somatic cells of female,o It is found in the nucleus.o It is used as a test of genetic femaleness - it is possible to determine the genetic sex of an individual according as to whether there is a chromatin mass present on the inner surface of the nuclear membrane of cells with resting or internment nuclei. Remember following fact and the question will seem very easy.o Chromatid body (Barr body or sex chromatin) is derived from one of the two X-chromosomes which becomes inactivated.o The numer of Barr bodies is thus one less than the number of X-chromosomes.Now see each option one by oneo Kleinefelter's syndrome (XXY) - Two 'X' chromosomes - 1 Barr body (2-1).o Turner syndrome (XO) - one 'X' chromosome -No Barr body (1-1 =0).o Superfemale (XXX) - Three 'X' chromosome -2 Barr bodies (2-1).Note-o Barr body is found in female but :-Kleinefelter syndrome is male with Barr body.Turner syndrome is female without Barr body. | 4,954 | medmcqa_train |
Which of the following is most likely to produce a junctional scotoma | Junctional scotoma is due to lesion at junction of Optic nerve and chiasma. Which is m/c due to meningioma. | 4,955 | medmcqa_train |
Perversion with pain to self: TN 09; Maharashtra 11 | Ans. Masochism | 4,956 | medmcqa_train |
In acute inflammation endothelial retraction leads to | ref Robbins 8/e p45,9/ep74 Several mechanisms may contribute to increased vascu- lar permeability in acute inflammatory reactions: * Endothelial cell contraction leading to intercellular gaps in postcapillary venules is the most common cause of increased vascular permeability. Endothelial cell con- traction occurs rapidly after binding of histamine, bra- dykinin, leukotrienes, and many other mediators to specific receptors, and is usually sho-lived (15 to 30 minutes). A slower and more prolonged retraction of endothelial cells, resulting from changes in the cytoskel- eton, may be induced by cytokines such as tumor necro- sis factor (TNF) and interleukin-1 (IL-1). This reaction may take 4 to 6 hours to develop after the initial trigger and persist for 24 hours or more. * Endothelial injury results in vascular leakage by causing endothelial cell necrosis and detachment. Endothelial cells are damaged after severe injury such as with burns and some infections. In most cases, leakage begins immediately after the injury and persists for several hours (or days) until the damaged vessels are throm- bosed or repaired. Venules, capillaries, and aerioles can all be affected, depending on the site of the injury. Direct injury to endothelial cells may also induce a delayed prolonged leakage that begins after a delay of 2 to 12 hours, lasts for several hours or even days, and involves venules and capillaries. Examples are mild to moderate thermal injury, ceain bacterial toxins, and x- or ultraviolet irradiation (i.e., the sunburn that has spoiled many an evening after a day in the sun). Endo- thelial cells may also be damaged as a consequence of leukocyte accumulation along the vessel wall. Activated leukocytes release many toxic mediators, discussed later, that may cause endothelial injury or detachment. | 4,957 | medmcqa_train |
Aery of anatomical snuffbox? | Ans. is 'a' i.e., RadialAnatomical Snuffbox Triangular depression on the dorsal and radial aspect of the hand become visible when thumb is fully extended. BoundariesMedial/Posterior--Tendon of the extensor pollicis longus.Lateral/Anterior--Tendon of the extensor pollicis brevis and abductor pollicis longus.Roof--Skin and fascia with beginning of cephalic vein and crossed by superficial branch of the radial nerve. Floor--Styloid process of radius, trapezium, scaphoid and base of 1st metacarpal.Contents--The radial aery. | 4,958 | medmcqa_train |
Which of the following can be given orally? | MESNA ,is a drug used to reduce the undesired side effects of ceain chemotherapy drugs. It is referred to as a "chemoprotectant." and prophylactic agent used to reduce the incidence of ifosfamide-induced hemorrhagic cystitis. How this drug is given: As an injection or infusion through the vein (intravenous, IV). This is given with or after the chemotherapy drug has been given. As a pill by mouth. Comes in 400mg tablet size. Recommended that it is taken with strong tasting liquid to mask the taste. If not taken as tablet, solution is made using carbonated beverage, juice or milk. REFERENCE: www.mayoclinic.org, www.chemocare.com | 4,959 | medmcqa_train |
This cream is appropriate for all of the following procedures Except | EMLA (eutectic mixture of local anesthetics) is a eutectic mixture of 5 percent lidocaine and prilocaine that is used to produce anesthesia over intact skin. Its primary use is to produce anesthesia before venipuncture and lumbar puncture. In other settings, this cream has been used for anesthesia of split-thickness graft donor sites, curettage of molluscum contagiosum, cautery of genital was, and myringotomy. EMLA is not recommended for topical anesthesia of lacerations because it induces an exaggerated inflammatory response, thereby damaging host defenses and inviting the development of infection. | 4,960 | medmcqa_train |
Not a fungal infection is: | Ans: A (Mycoses fungoides) Ref: Rook's Dermatology, 8th ed.Explanation:Mycosis Fungoides/Sezary SyndromeMycosis fungoides and Sezary syndrome are different manifestations of a tumor of CD4+ helper T cellsClinically, the cutaneous lesions of mycosis fungoides typically progress through three somewhat distinct stages, an inflammatory premycotic phase, a plaque phase, and a tumor phaseHistologically, the epidermis and upper dermis are infiltrated by neoplastic T cells, which often have a cerebriform appearance due to marked infolding of the nuclear membrane.Sezary syndrome is a variant in which skin involvement is manifested as a generalized exfoliative erythroderma.In contrast to mycosis fungoides, the skin lesions rarely proceed to tumefaction, and there is an associated leukemia of "Sezary" cells with characteristic cerebriform nuclei.The tumor cells express the adhesion molecule CLA and the chemokine receptors CCR4 and CCR10Transformation to aggressive T-cell lymphoma occurs occasionally as a terminal event.FUNGAL INFECTIONSNatural defence against fungiFatty acid content of the skinpH of the skin, mucosal surfaces and body fluidsEpidermal turnoverNormal floraPredisposing factorsTropical climate, Manual labour populationLow socioeconomic status. Profuse sweatingFriction with clothes, synthetic innerwearMalnourishment, Immunosuppressed patientsHIV, Congenital Immunodeficiencies, patients on corticosteroids, immunosuppressive drugs. DiabetesFungal Infections: ClassificationSuperficial cutaneous:Surface infections eg. P.versicolor, Dermato- phytosis. Candidiasis, T.nigra, PiedraSubcutaneous:Mycetoma, Chromoblastomycosis, SporotrichosisSystemic (opportunistic infection)Histoplasmosis, CandidiasisOf these categories, Demiatophvtosis, P.versicolor, Candidiasis are common in daily practicePityriasis versicolorEtiologic agent: Malassezia furfurClinical Features:Multiple, discrete, discoloured, macules.Fawn, brown, grey or hypopigmentedPinhead sized to large sheets of discolourationSeborrheic areas, upper half of body: trunk, arms, neck, abdomen.Scratch sign positiveWood's Lamp examination: Yellow fluoro-scenceKOH preparation: Spaghetti and meatball appearanceCoarse mycelium, fragmented to short filaments 2-5 micron wide and up to 2-5 micron long, together with spherical, thick-walled yeasts 2-8 micron in diameter, arranged in grape like fashion.TreatmentTopical:Ketoconazole. Clotrimazole. Miconazole, Bifonazole, Oxiconazole, Butenafine.Terbinafine. Selenium sulfide. Sodium thiosulphateOral:Fluconamg 4(X)mg single doseKetoconazole 2(X)mg OD x I4daysGriseofulvin is NOT effective.Hypopigmentation will take weeks to fadeScaling will disappear soonPityrosporum folliculitisEtiology: Malassezia furfurAge group: Teenagers or young adult malesClinical features: Itchy papules and pustules, scattered on the shoulders and back.Treatment: Oral Itraconazole, Ketaconazole, Fluconazole or topical Ketoconazole shampoo.Tinea nigra palmarisEtiology: Exophiala werneckiiClinical features: Asymptomatic superficial infection of palms; deeply pigmented, brown or black macular, non-scaly patches, resembling a silver nitrate stain.Treatment: Topical Econazole. Ketoconazole. Benzoic acid compound, Thiabendazole 2% in 90% DMSO or 10% Thiabendazole suspension.Black piedraEtiology: Piedraia hortaeClinical features: Hard, dark, multiple superficial nodules: firmly adherent black, gritty, hard nodules on hairs of scalp, beard, moustache or pubic area, hair may fracture easily.Treatment:Shaving or cutting the hair.Terbinafine, Benzoic acid compound ointment, 1:2000 solution of mercury perchlorideWhite piedraEtiology: Trichosporon beigeliiClinical features:Soft, white, grey or brown superficial nodules on hairs of the beard, moustache, pubic areas. Hair shaft weakened and breaks.Treatment: Shaving or cutting the hair. Responses to topical antifungals, azoles and allvamines have been reported but are unpredictable.DermatophytosisMycology:Three genera:Microsporum, Trichophyton, EpidermophytonThrive on dead, keratinized tissue - within the stratum comeum of the epidermis, within and around the fully keratinized hair shaft, and in the nail plate and keratinized nail bed.Tinea capitisEndothrix and EctothrixMost common - trichophyton violaceumVarieties:Non inflammatoryGray patchBlack dotSeborrheic dermatitisInflammatoryFavusKerion. agminate folliculitisNon inflammatory Tinea capitis:Black dot/Grey patchBreakage of hair gives rise to 'black dots*Patchy alopecia, often circular, numerous broken-off hairs, dull greyWood's lamp examination: green fluorescence (occasional non-flu ore scent cases)Tinea capitis: Kerion, agminate folliculitisInflammatory varietyMicrosporum,Trichophyton verrucosum. Trichophyton mentagrophytesPainful, inflammatory boggy swelling with purulent discharge.Hairs may be matted, easily pluckableLymphadenopathyCo-infection with bacteria is commonMay heal with scarring alopeciaTinea capitis: FavusInflammatory varietyKashmirTrichophyton schonleiniiYellowish, cup-shaped crusts develop around a hair with the hair projecting centrally.Extensive patchy hair loss with cicatricial alopeciaTinea facieiErythematous scaly patches on the faceAnnular or circinate lesions and indurationItching, burning and exacerbation after sun exposureSeen often in immunocompromised adultsTinea barbaeRingworm of the beard and moustache areasInvasion of coarse hairsDisease of the adult maleHighly inflammatory, pustular folliculitisHairs of the beard or moustache are surrounded by inflammatory' papulopustules, usually with oozing or crusting, easily pluckablePersist several monthsTinea corporisLesions of the trunk and limbs, excluding ringworm of the specialized sites such as the scalp, feet and groins etc.The fungus enters the stratum corneum and spreads centrifugally. Central clearing results once the fungi are eliminated.A second wave of centrifugal spread from the original site may occur with the formation of concentric erythematous inflammatory rings.Classical lesion:Annular patch or plaque with erythematous papulovesicles and scaling at the periphery with central clearing resembling the effects of ring worm.Polycyclic appearance in advanced infection due to incomplete fusion of multiple lesionsSites: waist, under breasts, abdomen, thighs etc.Tinea crurisItchingErythematous plaques, curved with well demarcated margins extending from the groin down the thighs.Scaling is variable, and occasionally may mask the inflammatory changes.Vesiculation is rareTinea mannumTwo varieties:Non inflammatory: Dry, scaly, mildly itchyInflammatory: Vesicular, itchy Tinea pedisWearing of shoes and the resultant macerationAdult males commonest, children rarelyPeeling, maceration and fissuring affecting the lateral toe clefts, and sometimes spreading to involve the undersurface of the toes.Varieties:Interdigital typePapulosquammous ('moccasin foot')Vesiculo-bullousTinea UnguiumDirty, dull, dry, pitted, ridged, split, discoloured, thick, uneven, nails with subungual hyperkeratosis Different types described depending on the site of nail involvement and its depth.Distal and lateral onychomycosesProximal subungual onychomycosesWhite superficial onychomycosesTotal dystrophic onychomycosesTreatment: RingwormTopical: Bifonazole. Ketoconazole Oxiconazole, Clotrimazole, Miconazole, Butenafine, Terbinafine.Vehicle: Lotions, creams, powders, gels are available.CANDIDIASISCausative organism:Candida albicans, Candida tropicalis, Candida pseudotropicalisSites of affection:Mucous membraneSkinNailsCandidiasis : MucosalOral thrush:Creamy, curd-like, white pseudomembrane, on ery thematous baseSites:Immunocompetent patient: cheeks, gums or the palate.Immunocompromised patients: affection of tongue with extension to pharynx or oesophagus; ulcerative lesions may occur.Angular cheilitis (angular stomatitis / perleche): Soreness at the angles of the mouthVulvovaginitis (vulvovaginal thrush): Itching and soreness with a thick, creamy white dischargeBalanoposthitis:Tiny papules on the glans penis after intercourse, evolve as white pustules or vesicles and rupture.Radial fissures on glans penis in diabetics. Vulvovaginitis in conjugal partnerCandidiasis - FlexuralIntertrigo: (Flexural candidiasis)Erythema and maceration in the folds; axilla, groins and webspaces.Napkin rash:Pustules, with an irregular border and satellite lesionsCandidiasis: FlailChronic Paronychia:Swelling of the nail fold with pain and discharge of pus.Chronic, recurrent.Superadded bacteria! infectionOnychomycosis:Destruction of nail plate.Treatment of candidiasisTreat predisposing factors like poor hygiene, diabetes, AIDS, conjugal infectionTopical:Clotrimazole, Miconazole, Ketoconazole. Ciclopirox olamineOral:Ketoconazole 200mg, Itraconazole 100-200mg and Fluconazole 150mg | 4,961 | medmcqa_train |
Antisocial personality is seen with : | A i.e. Drug abuse | 4,962 | medmcqa_train |
All are viral causes of PUO except: | Ans: d (Leptospirosis) Ref: Harrison, 16 ed, p. 116, 17th ed, p. 132A quite straight forward question. The answer is leptospirosis because it is not a viral cause of PUOPUO: (Pyrexia of unknown origin)Definition:Temperature >38.3(IC on several occasionsOrA duration of fever of >3 weeksOrFailure to reach a diagnosis despite I week of inpatient investigationClassic PUOFever with 3 outpatient visitsOr3 days in the hospital without elucidation of a causeOr1 week of intelligent and invasive work upNosocomial PUOA temperature of more than or equal to 38.3degC develops on several occasions in a hospitalized patient who is receiving acute care and in whom infection was not manifest or incubating on admission.Neutropenic PUOTemperature more than or equal to 38.3degC on several occasions in a patient whose neutrophil count is <500/ml or is expected to fall to that level in 1 or 2 days.HIV associated PUOTemperature more than or equal to 38.3ftC on several occasions over a period of >4 weeks for outpatients or > 3 days for hospitalized patients with HIV infection. | 4,963 | medmcqa_train |
In disaster management following are practiced except | Disaster Management includes three aspects: 1. Disaster impact and response: Search, rescue, and first-aid * Field care * Triage * Tagging * Identification of the dead 2. Rehabilitation or recovery: * Water supply * Basic sanitation and personal hygiene * Food safety * Vector control 3. Mitigation: Measures designed either to prevent hazards from causing disaster or to reduce the effects of the disaster. This also includes preparedness for any impending disasters or in disaster-prone areas. Ref: Park 24th edition | 4,964 | medmcqa_train |
A patient having cystic medial necrosis with necrotising aeritis is suffering from? | Cystic medial degeneration . Smooth muscle loss . Fibrosis . Inadequate ECM synthesis . Accumulation of increasing amounts of amorphous proteoglycans Robbins 9 th edition page no. 345 | 4,965 | medmcqa_train |
A 27 year old female having a family history of autoimmune disease presents with the complaints of a skin rash and recurrent joint pains 3 months after delivering a baby. She is most likely to have which of the following disorders? | Acquired factor VIII deficiency Muscle and soft tissue bleeds are common. Bleeding into a joint results in severe pain and swelling, as well as loss of function, but is rarely associated with discoloration from bruising around the joint. Life-threatening sites of bleeding include bleeding into the oropharynx, where bleeding can obstruct the airway, into the central nervous system, and into the retroperitoneum. Mixing studies -used to evaluate a prolonged aPTT or PT. -to distinguish between a factor deficiency and an inhibitor. In this assay, normal plasma and patient plasma are mixed in a 1:1 ratio, and the aPTT or PT is determined immediately and after incubation at 37degC for varying times, typically 30, 60, and/or 120 min. -With isolated factor deficiencies, the aPTT will correct with mixing and stay corrected with incubation. With aPTT prolongation due to a lupus anticoagulant, the mixing and incubation will show no correction. -In acquired neutralizing factor antibodies, the initial assay may or may not correct immediately after mixing but will prolong with incubation at 37degC. | 4,966 | medmcqa_train |
Commonest cause of cataract | D i.e. Age related Radiation cataract is caused by exposure to almost all types of radiation energy such as infrared or heat (in glass-blowers or glass-workers, and iron-workers), irradiation caused by X-rays, gamma-rays or neutrons (in workers in atomic energy plant, survivors of atomic bomb and in patients inadequately protected during treatment for malignant conditions near eye) and sunlight (especially the ultraviolet A and UV-B components). Microwave radiation has shown to cause cataract in animals. But MRI has no radiation exposure. - Cataract may be caused by chloroquine, coicosteroids, copper metabolism error (Wilson's disease), Calcium decrease (hypocalcemia or hypoparathyroidism or parathyroid tetany), galactosemia, hypo glycemia and diabetes mellitusQ. (Mn- CG=Cataract G) Cataract is the most common cause of blindness in India Q. Senile cataract or age related cataract is the commonest type of acquired cataract Q affecting equally persons of either sex usually above the age of 50 years. Overall incidence of acquired cataract is more than congenital. | 4,967 | medmcqa_train |
All are metabolic causes of liver disease except | Ans. is 'a' i.e., HistiocytosisMetabolic liver diseases can be classified into 3 categories:Manifestations due to hepatocellular necrosis: Galactosemia, hereditary fructose intolerance, tyrosinemia type I, Wilson disease, Hemochromatosis and al -antitrypsin deficiency.Cholestatic jaundice :Al -antitrypsin deficiency, Byler's disease, cystic fibrosis, Niemann-Pick disease and some disorders of peroxisome biogenesis.Hepatomegaly (disorders with liver damage & storage diseases ): Glycogen storage diseases, cholesteryl ester storage disease and, when associated with splenomegaly, lysosomal storage diseases (eg:- Gaucher disease). | 4,968 | medmcqa_train |
The most common type of intussusception? | Ans. a (Ileocolic) (Ref. Bailey and Love 26th/pg. 114).ACUTE INTUSSUSCEPTION# Telescoping/invagination of one portion of the gut within an immediately adjacent segment; invariably it is the proximal into distal bowel. An intussusception is composed of three parts: the entering or inner tube; the returning or middle tube; and the sheath or outer tube (intussuscipiens).# most common in children, where it occurs in an idiopathic form with a peak incidence at 3-9 months.# Seventy to 95% of cases are classed as idiopathic. It is believed that hyperplasia of Peyer's patches in the terminal ileum may be the initiating event. This is due to weaning/viral infection.# Ileocolic type is otherwise most common and the colocolic variety is common in adults.# C/F: Intermittent sudden spasmodic abdominal pain, the 'red currant' jelly stool, palpable lump, feeling of emptiness in the right iliac fossa (the sign of Dance) and Empty RIF sign.# Ultrasonography is preferred over Barium enema today.# Ultrasound shows the mass with pseudokidney apperance or a target lesion or a bowel mass-like'doughnut sign.# A barium enema may diagnose by demonstrating signs like the claw sign and the coiled spring appearance.# Hydrostatic reduction is contraindicated in the presence of obstruction, peritonism or a prolonged history (greater than 48 hours) and is unlikely to succeed where a lead point is likely. It is successful in 50% of cases with a recurrence rate 5%.# Surgery is required where hydrostatic reduction has failed or is contraindicated. Reduction is achieved by squeezing the most distal part of the mass in a cephalad direction. Do not pull. In difficult cases the little finger may he gently inserted into the neck of the intussusception to try and separate adhesions (Cope's method).# In the presence of an irreducible or gangrenous intussusception the mass should be excised in situ and an anastomosis or temporary end stoma created. | 4,969 | medmcqa_train |
Holdswoh classification of thoracolumbar spine fracture is based on how many columns of spine? | Answer- A. TwoHoldswoh,s proposed two column concept of thoracolumbar spine fractureAntetior column : Consists veebral body, annulus fibrous, Anterior and posterior longitudinal ligamentsposterior column: Consists of veebral arch (pedicle, facets, laminae) and posterior ligaments (ligamentum flavum,interspinous and supraspinus ligament) | 4,970 | medmcqa_train |
Chvostek’s sign is elicited by | The Clinical manifestations of hypocalcemia are mostly due to neuromuscular irritability.
The patients complains of paresthesias which are typically perioral or of the hands and feets
Tetany is the classic manifestation of hypocalcemia, the manifestations are :
Corpopedal Spasm o Laryngospasm o Seizures Latent tetany occurs which can be manifested by
Chvostek sign and Trousseau sign Electrocardiographic manifestations The classic E.C.G.
change with hypocalcemia is prolonged corrected QT interval Other possible E. C. G.
findings are o Prolonged ST interval o Peaked T waves o Arryhtmmias Heart block (hypocalcemia may impair cardiac contractility and decrease blood pressure) GI.
T manifestations o Intestinal cramps and malabsorption NOTE: Corpopedal spasm: o Contraction the muscels of the hand and feet.
The wrists are flexed and fingers extended, with the thumbs adducted over the palms. Chvostek sign:
Tapping the facial nerve anterior to the external auditory meatus elicits a twitch of the upper lip or entire mouth.
This is not a very specific sign because it is positive in about 10% of patients without hypocalcemia. Trousseau sign:
A blood pressure cuff is inflated slightly above the systotic blood pressure for more than 3 minutes.
Corpopedal spasm occurs if hypocalcemia is present as a result of the ischemia of motor nerves. | 4,971 | medmcqa_train |
All of the following may be used to differentiate Central Retinal Venous Occlusion (CRVO) from ocular Ischemic syndrome due to carotid artery stenosis, Except – | Dilated retinal vein is seen both in CRVO and ocular ischemic syndrome; therefore, this feature cannot differentiate these two. However, in CRVO vein is tortuous while in ocular ischemic syndrome it is non-tortuous.
Retinal artery perfusion pressure is decreased in ocular ischemic syndrome and is normal in CRVO.
Ophthalmodynamometry shows low ophthalmic artery pressure in ocular ischemic syndrome and normal to high pressure in CRVO. | 4,972 | medmcqa_train |
The commonest clinical pattern of basal cell carcinoma is - | • Locally invasive carcinoma, arises from the basal layer of the epidermis
• MC type of skin cancer
• 90% of BCC are seen in the face, above a line from the corner of mouth to lobule of ear.
• MC site: Nose >Inner canthus of the eye, also known as Tear cancer.
Types of BCC
• Nodular: MC type of BCC, characterized by small slow growing pearly nodules, often with telengiectatic vessels on its surface.
Central depression with umbilication is a classic sign.
• Pigmented: Mimic malignant melanoma
• Cystic
• Superficial | 4,973 | medmcqa_train |
Rose-waaler test is | It is rapid slide haemagglutination test for detection of rheumatoid factor. | 4,974 | medmcqa_train |
Medical treatment of ectopic pregnancy is : | Methotrexate | 4,975 | medmcqa_train |
A class C diabetic patient delivers at term, it is impoant to check her blood sugar levels immediately postpaum, since there may be a decrease in the insulin requirements of diabetic patients. This can be paly explained by : | Decrease in plasma chorionic somatomammotropin | 4,976 | medmcqa_train |
True about third hea sound is- | The third hea sound (S 3 ) occurs during the rapid filling phaseof ventricular diastole. It can be a normal finding in children,adolescents, and young adults; however, in older patients it signifieshea failure. A left-sided S 3 is a low-pitched sound best heard overthe left ventricular (LV) apex. A right-sided S 3 is usually betterheard over the lower left sternal border and becomes louder withinspiration. A left-sided S 3 in patients with chronic hea failure ispredictive of cardiovascular morbidity and moality. Interestingly,an S 3 is equally prevalent among hea failure patients with andwithout LV systolic dysfunction.Harrison's principle of internal medicine,20edition,pg no.1554 | 4,977 | medmcqa_train |
Large way vegetation are characteristic of? | Ans. is 'b' i.e., SABE | 4,978 | medmcqa_train |
Drug of choice for treatment of intermediate uveitis is | Treatment for Intermediate uveitis : Intravitreal or Posterior Subtenon's Steroid injections : Triamcinolone acetonide Steroids may also be given by subconjuntival route or by Subtenon's route | 4,979 | medmcqa_train |
Primary bile acid is? | Ans. is 'c' i.e., Chenodeoxycholic acid Primary bile acids are cholic acid and chenodeoxycholic acid, which are synthesized from cholesterol in liver. In the intestine some of the primary bile acids are conveed into secondary bile acids, i.e., deoxycholic acid (formed from cholic acid) and lithocholic acid (derived from chenodexoxycholic acid). Glycine and taurine conjugates of these bile acids are called as bile salts. For example, cholic acid is a bile acid, and its glycine conjugate (glycocholic acid) is a bile salt. | 4,980 | medmcqa_train |
What diagnosis is suggested by these spirography findings? | Answer A. Intrathoracic localized obstructionAn intrathoracic localized obstruction is demonstrated on spirography. The patient underwent flexible fiberoptic bronchoscopy, which revealed nearly complete (greater than 90%) occlusion of the distal trachea by a vascular mass. The patient recovered after endoscopic laser ablation of the mass. | 4,981 | medmcqa_train |
Which is a yeast like fungi: September 2007 | Ans. B: Candida Yeast like fungi grow paly as yeast and paly as elongated cells resembling hyphae.The latter form a pseudomycelium. Candida albicans is a pathogenic yeast-like fungus. | 4,982 | medmcqa_train |
Observation of yeast cells with multiple budding in tissue in the form of a “the shape shown in below pictomyograph ” is highly suggestive of | Paracoccidioides brasiliensis causes paracoccidioidomycosis. It is a dimorphic fungus that exists as a mold in soil and as a yeast in tissue. The yeast is thickwalled with multiple buds ("ship's wheel" appearance), in contrast to Blastomyces dermatitides, which has a yeast with a single bud that has a broad base. Histoplasma capsulatum occurs as an oval budding yeast inside macrophages, whereas Coccidioides is a spherule in tissue, with many endospores within the spherule. Sporothrix, a dimorphic fungus from vegetation, is introduced into the skin and forms a local pustule or ulcer with nodules; round or cigar-shaped budding yeasts are seen in tissue specimens. | 4,983 | medmcqa_train |
Which of the following is the most significant component of a behavioral program developed to help a mother deal with a child having oppositional defiant disorder? | Positive reinforcement of promoting desirable behaviours through rewards is the most significant component of the program used to deal with ODD. | 4,984 | medmcqa_train |
Most common cause of leukocoria in newborn is | . | 4,985 | medmcqa_train |
Which of the following is the site of bladder injury in abdominal hysterectomy is : | Posterior wall | 4,986 | medmcqa_train |
A 10 year old child with aggressive, self mutilating behavior and poor concentration is brought with presenting complaints of joint pain and reduced urinary output. Child's presentation is most likely due to the deficiency of which enzyme? | The child in the question stem is showing features of Lesch nyhan syndrome caused by deficiency of HGPase. Hypoxanthine guanine phosphoribosyl transferase is an enzyme responsible for the formation of hypoxanthine to inosoic acid and guanine to guanylic acid. This enzyme deficiency can present in a complete form only in boys and is transmitted through sex linked mode of inheritance. Leschnyhan syndrome is a severe form of this enzyme deficiency resulting in mental retardation, compulsive mutilating behavior and choreoathetosis. In addition to the above, patients exhibit hyperuricemia and hyperuricosuria as well as signs of gouty ahritis and uric acid stone disease. Treatment consist of dietary reduction of purines, increased fluid uptake, alkalinization of urine to pH 6.6 with potassium citrate. Ref: Clinical Pediatric Urology By A. Barry Belman, Page 1231;Inherited Metabolic Diseases: A Guide to 100 Conditions By Steve Hannigan, Page 85; Harrison's Principle of Internal Medicine, 18th Edition, Chapters 359, 361 | 4,987 | medmcqa_train |
A 56 year old man has been having bloody bowel movements on and off for the past several weeks. He repos that the blood is bright red, it coats the outside of the stools, and he can see it in the toilet bowl even before he wipes himself. When he does so, there is also blood on the toilet paper. After fuher questioning, it is asceained that he has been constipated for the past 2 months and that the caliber of the stools has changed. They are now pencil thin, rather the usual diameter of an inch or so that was customary for him. He has no pain. Which of the following is the most likely diagnosis? | The combination of red blood coating the stools and a change in bowel habit and stool caliber spells out cancer of the rectum in someone in this age group. Anal fissure is typically seen in young women who have very painful bowel movements with streaks of blood. Pain is the dominant symptom in this condition. Cancer of the cecum leads to anemia and occult blood in the stools, but the blood is rarely seen. If it is, the entire stool is bloody. Fuhermore, there is no change in bowel habit or stool caliber when the tumor is so proximal in the colon. External hemorrhoids hu and itch, but they rarely bleed. Ref: Chang G.J., Shelton A.A., Welton M.L. (2010). Chapter 30. Large Intestine. In G.M. Dohey (Ed), CURRENT Diagnosis & Treatment: Surgery, 13e. | 4,988 | medmcqa_train |
What is the best procedure to control external hemorrhage in an event of accidental injury? | Direct firm pressure applied over the bleeding area or the involved aery at a site that is proximal to the wound is the best way to control external hemorrhage. A firm pressure dressing is applied and the injured pa is elevated to stop venous and capillary bleeding if possible. If the injured area is an extremity it should be immobilized first. A tourniquet is applied to an extremity only as a last reso when the external hemorrhage cannot be controlled in any other way and immediate surgery is not feasible. The tourniquet should be applied proximal to the wound and tied tightly enough to control aerial blood flow. Ref: Brunner and Suddah's Textbook of Medical-Surgical, Volume I, Page 2162 | 4,989 | medmcqa_train |
5day baby full term breast fed with bilirubin 14mg Idl weight is 2700g what should be done next ? | Age Min TSB to sta phototherapy 24hrs > 10mg 1dL 48hrs >13mg 1dL 72hrs >15mg1dL 96hrs and beyond >18mg1dL Reference: GHAI Essential pediatrics, 8th edition | 4,990 | medmcqa_train |
The paradoxical response of GH release to TRH is seen in - | TRH stimulates the secretion of prolactin as well as TSH,
Normally it does not affect growth hormone secretion but in acromegaly TRH induced growth hormonal stimulation Occurs.
Note:
"In prolactinomas paradoxical response of TRH to prolactin occurs".
In normal individuals,
TRH stimulates prolactin release
Where as in prolactinomas
There is little or no rise in prolactin in response to TRH. | 4,991 | medmcqa_train |
How many mm from the limbus is the safest site of intravitreal injection? | (Refer: AK Khurana Comprehensive Ophthalmology, 6th edition, pg no. 171)Intravitreal injection (distance from Limbus)For aphakics-3mmFor pseudophakes-3.5mmFor phakics-4mm | 4,992 | medmcqa_train |
Which one of the following cofactors must be utilized during the conversion of acetyl-CoA to malonyel-CoA? | FAD The key enzymatic step of fatty acid syn thesis is the carboxylation of acetyl-CoA to form malonyl-CoA. The carboxyl of biotin is covalently attached to an E-amino acid group of a lysine residue of acetyl-CoA carboxylase. The reaction occurs in two stages. In the first step, a carboxybiotin is formed: HCO3- + biotin-enzyme + ATP CO2 - biotin-enzyme+ ADP + Pi In the second step, the CO2 is transferred to acetyl CoA to produce malonyl CoA: CO2-biotin-enzyme + acetyl CoA malonyl CoA+ biotin-enzyme None of the other cofactors listed are involved in this reaction. | 4,993 | medmcqa_train |
Which of the following is not consider to be a slow viruse diseases - | kuru,scrapie,&CJD Are caused by slow virus REF:ANATHANARAYANAN MICROBIOLOGY NINTH EDITION PAGE.557 | 4,994 | medmcqa_train |
Sleepwalking occur in which stage of sleep - | Sleep walking (somnambulism) is seen in stage 3 & 4 of NREM sleep. | 4,995 | medmcqa_train |
Which one of the following device provides fixed performance oxygen therapy: | B i.e. Ventimask Ventimask or venturimasks are high flow or fixed performance (performance not affected by changes in patient's tidal volume and respiratory rate) oxygen delivery devicesQ delivering accurate oxygen concentration | 4,996 | medmcqa_train |
Nerve supply of tip of nose | Nerve supply General sensory nerves derived from the branches of trigeminal nerve are distributed to whole of the lateral wall: Anterosuperior quadrant is supplied by the anterior ethmoidal nerve branch of ophthalmic nerve. Anteroinferior quadrant is suplied by the anterior superior alveolar nerve branch of infraorbital continuation of maxillary nerve. Posterosuperior quadrant is supplied by the lateral posterior superior nasal branches from the pterygopalatine ganglion. Posteroinferior quadrant is supplied by the anterior palatine branch from the pterygopalatine ganglion REF.BDC VOL.3,FIFTH EDITION | 4,997 | medmcqa_train |
Features of carcinoma penis include all except: March 2007 | Ans. C: Hypospadias is a premalignant lesion Following as risk factors for penile cancer: Human papillomavirus (HPV) infection, smoking, smegma, phimosis, treatment of psoriasis, age, and AIDS. The other etiologic factor most commonly associated with penile carcinoma is poor hygiene. Lichen sclerosus (also known as balanitis xerotica obliterans) may also be a risk factor. Symptoms Redness, irritation and a sore or a lump on the penis. Pathology Precancerous Dermatologic Lesions Carcinoma in Situ (Bowen Disease, Erythroplasia of Queyrat) Invasive Carcinoma of the Penis A Squamous cell carcinoma usually originating in the glans or foreskin is by far the most common type, occurring in 9 out of 10 cases. Staging The stages are assessed as follows: Stage I - Cancer has only affected the glans and/or foreskin. Stage II - Cancer has spread to the shaft of the penis. Stage III - Cancer has affected the penis and surrounding lymph nodes. Stage IV - Cancer has moved beyond the groin area to other pas of the body. Recurrent - Cancer that has returned after treatment. The most common treatment is one of five types of surgery: Wide local excision - The tumor and some surrounding healthy tissue are removed Microsurgery - Surgery performed with a microscope is used to remove the tumor and as little healthy tissue as possible Laser surgery - laser light is used to burn or cut away cancerous cells Circumcision - cancerous foreskin is removed Amputation (penectomy) - a paial or total removal of the penis, and possibly the associated lymph nodes. This is the most common and effective treatment. Radiation therapy is usually used adjuvantly with surgery to reduce the risk of recurrence. With earlier stages of penile cancer, a combination of topical chemotherapy and less invasive surgery may be used. More advanced stages of penile cancer usually require a combination of surgery, radiation and chemotherapy. | 4,998 | medmcqa_train |
A 60-year-old male, chronic smoker, presented with fatigue and chest pain. On examination, there was inset left eyeball with drooping upper left eyelid and reduced left pupil size. Which of the following is the most likely diagnosis in this condition? | Most tumors of the apex of the lung are adenocarcinomas Pancoast tumors - apical lung tumors in the superior pulmonary sulcus tend to invade the neural structures around the trachea, including the cervical sympathetic plexus. Involvement of sympathetic fibers gives rise to severe pain in the distribution of the ulnar nerve and Horner syndrome. Features of Horner syndrome are: S Sympathetic Injury A Anhidrosis M Miosis P Ptosis L Loss of ciliospinal reflex E Enophthalmos | 4,999 | medmcqa_train |
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