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Characteristic features of a lesion in the lateral part of the medulla include all except - | Ans. is 'b' i.e., Contralateral loss of proprioception to the body and limbs | 5,500 | medmcqa_train |
Peripheral blood smear in Plasmodium falciparum infection may show all of the following except- | Examination of Giemsa-stained peripheral blood smear is the standard test for the diagnosis of malarial infection. Classic ring-shaped/headphone-shaped trophozoites,malegamates,female gamates are seen in case of Plasmodium falciparum infection. Ref Harrison20th edition pg 1078 | 5,501 | medmcqa_train |
Main vascular supply of Little's area is all, except | The anteroinferior pa or vestibule of the septum contains anastomoses between the septal ramus of the superior labial branch of the facial aery, branch of sphenopalatine aery, greater palatine and of anterior ethmoidal aery. These form a large capillary network called kiesselbachs plexus. This is a common site of bleeding from the nose or epistaxis, and is known as little's area. Ref BDC volume3,6th edition pg 241 | 5,502 | medmcqa_train |
Active agent of cannabis resemble which endogenous compound | Anandamide is a neurotransmitter produced in the brain that binds to the THC receptors. It's been called the "bliss molecule," aptly named after ananda, the Sanskrit word for "joy, bliss, or happiness." It is considered an endocannabinoid -- a substance produced in the body that binds to cannabinoid receptors Ref: guyton and hall textbook of medical physiology 12 edition page number:699,700,701 | 5,503 | medmcqa_train |
All are vector born diseases except ? | Ans. is 'c' i.e., Brucella In vector born diseases, an ahropad or any living carrier acts as a vector and transpos an infectious agent to susceptible individual. KFD, JE, and plague are transmitted by ahropods. | 5,504 | medmcqa_train |
All are true regarding CMV except - | Acyclovir is useful in prophylaxis but not in treatment. Ganciclovir and foscarnet have been found to be effective and are used in patients with AIDS. REF:ANANTHANARAYAN AND PANIKER'S TEXTBOOK OF MICROBIOLOGY 9TH EDITION PAGE NO:474 | 5,505 | medmcqa_train |
Which of the following is not seen in chronic renal failure: September 2010 | Ans. C: Hypophosphatemia CKD (Chronic kidney disease) is initially without specific symptoms and can only be detected as an increase in serum creatinine or protein in the urine. As the kidney function decreases: Blood pressure is increased due to fluid overload and production of vasoactive hormones, increasing one's risk of developing hypeension and/or suffering from congestive hea failure. Urea accumulates, leading to azotemia and ultimately uremia (symptoms ranging from lethargy to pericarditis and encephalopathy). Urea is excreted by sweating and crystallizes on skin ("uremic frost"). Potassium accumulates in the blood (hyperkalemia with a range of symptoms including malaise and potentially fatal cardiac arrhythmias) Erythropoietin synthesis is decreased (potentially leading to anemia, which causes fatigue) Fluid volume overload - symptoms may range from mild edema to life-threatening pulmonary edema Hyperphosphatemia - due to reduced phosphate excretion, associated with hypocalcemia (due to vitamin D3 deficiency). The major sign of hypocalcemia is tetany. Later this progresses to teiary hyperparathyroidism, with hypercalcaemia, renal osteodystrophy and vascular calcification that fuher impairs cardiac function. Metabolic acidosis, due to accumulation of sulfates, phosphates, uric acid etc. | 5,506 | medmcqa_train |
Carotid aery stenosis in -vivo screening choice is | Most carotid imaging is now performed with Doppler ultrasound, CTA, MRA performed without exogenous contrast injection such as 2- or 3-dimensional time-of-flight (TOF) methods or contrast-enhanced MRA (CEMRA) performed dynamically after an intravenous bolus of gadolinium-based contrast.CEMRA is the most accurate method of carotid stenosis evaluation(Grainger and Allison&;s diagnostic radiology 6th edition, page 1475) | 5,507 | medmcqa_train |
True statement about inheritence of an X linked recessive trait is - | Ans. is 'a' i.e., 50% of boys of carrier mother are affected | 5,508 | medmcqa_train |
Most common cause of subarachnoid hemorrhage is:- | MC cause of subarachnoid hemorrhage : Trauma > Spontaneous rupture of Berry Aneurysm | 5,509 | medmcqa_train |
True about 1gM: | Activates complement | 5,510 | medmcqa_train |
True regarding GERD is all except - | Gastro-oesophageal reflux disease Gastro-oesophageal reflux resulting in heaburn affects approximately 30% of the general population. Pathophysiology Occasional episodes of gastro-oesophageal reflux are common in healthy individuals. Reflux is normally followed by oesophageal peristaltic waves that efficiently clear the gullet, alkaline saliva neutralises residual acid and symptoms do not occur. Gastro- oesophageal reflux disease develops when the oesophageal mucosa is exposed to gastroduodenal contents for prolonged periods of time, resulting in symptoms and, in a propoion of cases, oesophagitis. Abnormalities of the lower oesophageal sphincter The lower oesophageal sphincter is tonically contracted under normal circumstances, relaxing only during swallowing (p. 766). Some patients with gastro-oesophageal reflux disease have reduced lower oesophageal sphincter tone, permitting reflux when intra-abdominal pressure rises. In others, basal sphincter tone is normal but reflux occurs in response to frequent episodes of inappropriate sphincter relaxation. Hiatus hernia Hiatus hernia causes reflux because the pressure gradient is lost between the abdominal and thoracic cavities, which normally pinches the hiatus. In addition, the oblique angle between the cardia and oesophagus disappears. Many patients who have large hiatus hernias develop reflux symptoms but the relationship between the presence of a hernia and symptoms is poor. Hiatus hernia is very common in individuals who have no symptoms, and some symptomatic patients have only a very small or no hernia. Neveheless, almost all patients who develop oesophagitis, Barrett's oesophagus or peptic strictures have a hiatus hernia. Delayed oesophageal clearance Defective oesophageal peristaltic activity is commonly found in patients who have oesophagitis. It is a primary abnormality, since it persists after oesophagitis has been healed by acid-suppressing drug therapy. Poor oesophageal clearance leads to increased acid exposure time. Ref Davidson edition23rd pg791 | 5,511 | medmcqa_train |
Abductor of the larynx is: | Abduction (opening) of the vocal folds: The posterior cricoarytenoid muscles pull the muscular processes posteriorly, rotating the vocal processes laterally and thus widening the rims glottides. Adduction (closing) of the vocal folds : The lateral cricoarytenoid muscles pull the muscular processes anteriorly, rotating the arytenoids so their vocal processes swing medially. When this action is combined with that of the transverse arytenoid muscles, which pull the arytenoid cailages together, the gap between the vocal folds is decreased. Air pushed through the rima glottidis causes vibration of the vocal ligaments. | 5,512 | medmcqa_train |
A patient died during surgery. The relatives allege that death was due to negligence, According to a recent Supreme Court judgment, doctor can be charged for Medical Negligence under section 304-A, only if: | Ans. c. There is gross negligence (Ref: Reddy 33/e, p40, 29/e p34)A physician can be charged with criminal negligence in Section 304 A, when a patient dies from the effects of anesthesia during, an operation or other kind of treatment, if it can be proved that the death was the result if malicious intention, or gross negligence."Section 304-A deals with criminal negligence. Criminal negligence occurs when the doctor shows gross lack of competence or inaction, gross recklessness or wanton indifference to the patient's safety, or gross negligence in the selection and application of remedies. It involves an extreme departure from the ordinary standard of care."Inadvertent Negligence (Accidental negligence):Inadvertent negligence can be called simple negligence.In this case, the harm done is neither foreseen nor willed.Corporate Negligence:It occurs when a health care corporation failed to perform those duties, it owes directly to a patient or anyone else to whom it may extend.If such a duty is breached and patient is injured due to result of the breach, the organization can be held under the theory of corporate negligence.Res Ipsa Loquitur:Latin meaning of phrase is- the things or facts speaks for itself.This rule is applied when the following conditions are satisfied:That in the absence of negligence the injury would not have occurred ordinarily.That doctor had exclusive control over injury producing instrument or treatment That the patient was not guilty of contributory negligence. | 5,513 | medmcqa_train |
Kala azar is spread by - | Kala azar or visceral leishmaniasis is a protozoal disease.It is transmited from person to person by bite of female Phlebotomus argentipus.Transmission also occurs by contamination of bite wound or by crushing the insect during act of feeding.it may transmit by blood transfusion also. C/f : fever,splenomegaly,hepatomegaly along with anemia and weight loss.Darkening of the skin of face,hands,feet,and abdomen. Parks textbook of preventive and social medicine.K Park. Edition 23. page no:305,306 | 5,514 | medmcqa_train |
In which of the following condition is OCP contraindicated ? | ABSOLUTE CONTRAINDICATIONS OF OCP: *Known or suspected breast cancer *Severe hyperiglyceridemia/hypercholestrolemia *Undiagnosed vaginal bleeding *Thrombophlebitis/thromboembolism , cerebral and cardiac disorders *Pregnancy *Hypeension (moderate to severe) *Impaired liver RELATIVE CONTRAINDICATIONS OF OCP: *Migraine with aura *Diabetes mellitus/gestational diabetes *Hypeension *Smoking *Uterine lieomyoma *Elective surgery *Seizure disorder *Sickle cell disease *Gall bladder disease *SLE *Mitral valve prolapse *Hyperlipidemia *Hepatic disease | 5,515 | medmcqa_train |
Polio virus is shed in stool up to - | - the polio is transmitted by faecal oral route by contaminmates food , water or hands. - in faeces, the virus is excreted as long as 3-4 months. Reference : Park's textbook of preventive and social medicine, 23rd edition, pg no:205 <\p> | 5,516 | medmcqa_train |
During normal conversation sound heard at 1meter distance is | At a distance of 1 m , intensity of Whisper - 30 dB Normal conversation - 60 dB Shout - 90 dB Discomfo of the ear - 120 dB Pain in the ear - 130 dB Ref: Dhingra 7e pg 21. | 5,517 | medmcqa_train |
Wagon wheel effect is due to: | When buccal crown torque is incorporated in the wire, the roots of anterior teeth tend to converge towards centre like spokes of wheel. It has been often called wagon wheel effect. Following final space closure required torque is attained by incorporation of active root torque in the anterior segment. Due to wagon wheel effect, incorporation of palatal root/buccal crown torque during retraction causes loss of tip.
Orthodontics: Diagnosis and Management of Malocclusion and Dentofacial Deformities
THIRD EDITION Om P. Kharbanda | 5,518 | medmcqa_train |
Macula densa in kidney is located in relation to - | B i.e. DCT | 5,519 | medmcqa_train |
Griseofulvin is not useful in one of the following: | Ans. (C) Tinea versicolor(Ref: CMDT -2010/110)Griseofulvin is used for dermatophytoses including Tinea capitis, Tinea cruris, Tinea pedis, Tinea unguum and Tinea corporis etc.Tinea versicolor is caused by a yeast Malassezia furfur. It is treated by selenium sulfide and ketoconazole shampoo. | 5,520 | medmcqa_train |
Drugs used for prophylaxis in BPD -a) Chlorpromazineb) Lithiumc) Carbamazepined) Zolpideme) Sodium valproate | Three drugs are commonly used for maintenance treatment to prevent recurrence of BPD:- Lithium (DOC), Valproate, and Carbanzezapine. Topiramate and Gabapentine can also be used. | 5,521 | medmcqa_train |
Urachus fistula is a remanant of ? | Urachus fistula is a remnant of allantoic diveiculum If patent urachus in adults, urine dribbles from umbilicus known as wheeping umbilicus Inderbir Singh's Human embryology Pg 97 | 5,522 | medmcqa_train |
The odontogenic neoplasm, which is composed of loose, primitive-appearing connective tissue that resembles dental pulp, microscopically is known as _____. | Odontogenic myxomas are connective tissue neoplasms that contain little collagen. This gives them an embryonic look microscopically | 5,523 | medmcqa_train |
Food poisoning is an example of: | 1. Point source epidemic ( single exposure ) Sudden rise sudden fall. Cluster of cases in single IP. All cases develop within one incubation period of the disease E.g. Food poisoning , Bhopal gas tragedy. 2. Common source , continuous or repeated exposure epidemics Sharp rise Fall is interrupted by secondary peaks Eg. Contaminated well in a village,Water Borne Cholera. 3. Propagated source epidemic Gradual rise & gradual fall over long time. Person to person transmission E.g:- HEP. A, POLIO. | 5,524 | medmcqa_train |
Stemmer's sign is | Skin over the dorsum of foot cannot be pinched because of subcutaneous fibrosis in filariasis = STEMMER'S SIGN. | 5,525 | medmcqa_train |
Which muscle of larynx is not supplied by recurrent laryngeal nerve - | Ans. is 'c' i.e., Cricothyroid o All intrinsic muscles are supplied by the reccurrent laryngeal nerve except cricothyroid which is supplied by the external laryngeal nerve.Nerve supply of larynxo The main cranial nerve innervating the larynx is the vagus nerve via its branches; superior laryngeal nerve (SLN) and recurrent laryngeal nerve (RLN).Sensory supply of larynxo Above the level of vocal cords, larynx is supplied by internal laryngeal nerve, a branch of superior laryngeal nerve.o Below the vocal cord, larynx is supplied by recurrent laryngeal nerve.Motor supply of larynxo All the intrinsic muscles of larynx are supplied by recurrent laryngeal nerve except for cricothyroid muscle.o Cricothyroid is supplied by external laryngeal nerve, a branch of superior laryngeal nerve. | 5,526 | medmcqa_train |
SEPS is a procedure used for : | Subfascial Endoscopic Perforator Vein Surgery (SEPS) SEPS is a new endoscopic technique for the management of chronic venous insufficiency due to incompetent perforator veins. SEPS involves inseion of a rigid endoscope through the skin and superficial fascia to a plane above the muscle, such that perforator veins are visible as they exit the muscles. These perforator veins are dissected free from surrounding tissue and closed with the help of metal clips. Ref: Sabiston 20th edition Pgno: 1809 | 5,527 | medmcqa_train |
Deficiency of which of the following vitamin is most commonly seen in sho bowel syndrome with ileal resection: | Answer is A (Vitamin B12) Cyanocobalarnine (Vitamin B12) deficiency is the most common deficiency in patients with sho bowel syndrome associated with loss of ileum (ileal resection) since vitamin B12 is absorbed only in the ileum. `Cyanocobalamine (Vitamin B12) is the most common deficiency and occurs predictably after resection of 50-60 cm of the terminal ileum'. -- 'Complications in Surgery' (Lippincott Williams) 2"" (2011)/469 `Vitamin B12 and Bile acids are absorbed only in the ileum. Loss of ileum results in malabsorption of bile acids and vitamin B12 and consequent vitamin B12 deficiency'-- 'Sleisenger and Fordtran's Gastrointestinal Diseases' 81h/2258, 2264 Vitamin Deficiencies in Sho Bowel Syndrome Sho Bowel Syndrome with Extensive Jejunal Resection This is associated primarily with deficiency of fat soluble vitamins (A, D, E. K) The most common fat-soluble vitamins that are deficienci are vitamin A and D and to a lesser extent vitamin E followed by vitamin K. Vitamin A, D > Vitamin E >> Vitamin K Deficiency of vitamin K is uncommon as vitamin K is synthesized by colonic bacteria 60% of vitamin K is synthesized by colonic bacteria 40% of vitamin K is received by dietary intake Deficiency of vitamin K is therefore uncommon in patients with sho bowel syndrome who have an intact colon. Deficiency of vitamin K is however common in those patients with sho bowel syndrome who do not have a residual colon. Sho Bowel Syndrome with Extensive ileal resection This is associated primarily with deficiency of vitamin B12 since vitamin B12 is only absorbed in the terminal ileum. Fat soluble vitamin deficiencies may also occur due to fat malabsorption from decrease in concentration of bile acids / salts. (Bile acids are absorbed only from tr..; ileum) Vitamin B12 > Fat solubleVitamin The ileum has the capacity to adapt and compensate for jejunal resection. The jejunum does not have the capacity to adapt and compensate for ileal resection (as the terminal ileum has the exclusive capacity to reabsorb bile salts &vit BO | 5,528 | medmcqa_train |
A 30 year old G1P1001 patient comes to see you In office at 37 weeks gestational age for her routine OB visit. Her 1st pregnancy resulted in a vaginal delivery of a 9-lb, 8-02 baby boy after 30 minutes of pushing. On doing Leopold maneuvers during this office visit codetermine ttwt the fetus is breech. Vaginal exam demonstrate that the cervix is 50% effaced and 1-2 cm dilated. The presenting breech is high out of pelvis. The estimated fetal weight, is about 7 lb. yn the patient- for a USG, which confirms a fetus frank breech prestation. There is a normal am &; amniotic fluid present, and the head is well-felt the patient&;s obstetrician, you offer all the following possible mgmt plans except | definite indications for elective Caesarean section all complicated breech pregnancy Contracted or borderline pelvis Large babies Severe IUGR Hyper extension of fetal head Footling or knee presentation Previous Caesarean section Lack of an obstetrician experienced in assisted breech delivery can also be considered an indication for for elective Caesarean section (refer pgno:378 sheila textbook of obstetrics 2 nd edition) | 5,529 | medmcqa_train |
Which of the following is true regarding lattice formation? | Marrack proposed the lattice hypothesis to explain the mechanism of precipitation. Precipitation results when a large lattice is formed consisting of alternating antigen and antibody molecules. This is possible only in the zone of equivalence. The lattice hypothesis holds good for agglutination also.Ref: Ananthanarayan 9th edition, p105 | 5,530 | medmcqa_train |
Calcium channel blockers are used in all except | Calcium channel blockers prevent calciumfrom entering cells of the hea and blood vessel walls, resulting in lower blood pressure. Calcium channel blockers, also called calcium antagonists, relax and widen blood vessels by affecting the muscle cells in the aerial walls Refer kDT 6/e p 502,551 | 5,531 | medmcqa_train |
A patient presented with abdominal pain, jaundice and melena. The diagnosis is | Clinical features of Hemobilia Characterised by Quinck's triad (Sandblom's triad) : GI hemorrhage +biliary colic +jaundice Presentation: Melena (90 %), hemetemesis (60%), biliary colic (70%), and jaundice (60%). Tendency for delayed presentation (upto weeks) and recurrent brisk but limited bleeding over months and even years Ref : Sabiston 20th edition Pgno :1472-1474 | 5,532 | medmcqa_train |
Diabetes mellitus is associated with all except - | Ref -researchgate.net | 5,533 | medmcqa_train |
AFP is raised in all except: | As we have discussed earlier – AFP levels are raised in :
Under estimated gestational age
Decreased liqour
Decreased birth weight of infant and decreased maternal weight
IUD
Multifetal pregnancy (The amount of AFP entering the maternal circulation is proportional to the number of fetuses).
Defects which permit more release of AFP into maternal serum
– Neural tube defects
– Abdominal wall defects :
omphalocele
gastroschisis
– Pilonidal cysts
– Congenital skin defects
Maternal causes:
– Preeclampsia
– Maternal hepatoma, teratoma, endodermal sinus tumor
Shaw 14/e, p 380
Placental causes:
– Chorioangioma of placenta
– Placenta accreta
– Abruptio placentae | 5,534 | medmcqa_train |
Treatment objective for serial extraction: | Benefits of Serial Extraction
Serial extraction guides or encourages eruption of permanent teeth in a favorable position.
Reduces malposition of individual teeth.
Avoids loss of labial alveolar bone.
Reduces treatment time when active orthodontic treatment is required.
Textbook of ORTHODONTICS Sridhar Premkumar | 5,535 | medmcqa_train |
Kwashiorkor is similar to marasmus in that both diseases have | Both marasmus and kwashiorkor are associated with anemia.
Marasmus is characterized by a low calorie intake. Dietary deficiencies are compensated for by the breakdown of protein and fats. Key findings include:
Growth failure, Alertness, Hunger, Monkey-like appearance , Broomstick extremities , Muscle wasting, Mild anemia
Kwashiorkor is characterized by a normal total caloric intake but a decreased intake of protein (minimum protein intake is 8% of the total calories). Key findings are as follows:
Growth failure
Apathy and irritability with difficulty in feeding
Hepatomegaly (fatty liver)à apoprotein deficiency
Pitting edema
Flaky paint dermatitis (looks like paint coming off a building)
Areas of depigmentation
Diarrhea due to the loss of brush border enzymes
("use it or lose it") and parasitic diseases
Flag sign in hair (alternating dark and light areas)
Protuberant abdomen (fatty liver from decreased apoproteins, ascites, bowel distention with air) | 5,536 | medmcqa_train |
In varicocele surgery, venous drainage is done by: | Treatment* High inguinal ligation (near deep ring) of pampiniform plexus of veins* Microvascular sub inguinal ligation (best results)* Palomo's operation: ligation of Left Gonadal Vein in retroperitoneum * Alternative venous drainage cremasteric veins | 5,537 | medmcqa_train |
Ventouse is contraindicated in all except : | Anemia | 5,538 | medmcqa_train |
Cholangiocarcinoma ? | Ans. is 'b' i.e., Opistorchissinensis infectionCholangiocarcinomaCholangiocarcinoma is malignancy of the biliary tree, arising from bile ducts within or outside the liver.Risk factors : -Primary sclerosing cholangitisCongenital fibropolycystic disease of the biliary system (caroli disease, choledochal cyst).Exposure to thorotrast.Opisthorchis sinensis infection.PathologyCholangiocarcinoma are adenocarcinoma arising from bile ducts epithelium.Most are well to moderately differentiated.Markdly desmoplastic, with dens collegenous stroma separating the glandular elements.Cells are not bile stained, because bile is synthesized by hepatocytes and not by bile duct epithelium. | 5,539 | medmcqa_train |
Hormone responsible for decidual reaction and arias Stella reaction in ectopic pregnancy is - | Hormone responsible for decidual reaction and arias Stella reaction in Ectopic as well as Intrauterine pregnancy is Progesterone Arias stella reaction is the localized hypersecretory endometrium seen in ectopic pregnancy. | 5,540 | medmcqa_train |
Treatment of erythematous skin rash with multiple pus lakes in a pregnant woman is: | A i.e. Coicosteroids | 5,541 | medmcqa_train |
|A 65-year-old male complains of severe back pain and inability to move his left lower limb. Radiographic studies demonstrate the compression of nerve elements at the intervertebral foramen between vertebrae L5 and S1. Which structure is most likely responsible for this space-occupying lesion? | Compression of nerves at the intervertebral foramen indicates a disk herniation. A disk herniation is characterized by protrusion of the nucleus pulposus from the anulus fibrosus posterolaterally into the spinal canal or intervertebral foramen. The ligaments may be affected by the herniation but are not responsible for the compression of the spinal nerve roots. | 5,542 | medmcqa_train |
A patient presents with a unilateral ca breast of 4 cm size with skin ulceration involving the nipple. On palpation axillary lymph nodes are positive. Management would involve: | Here this patient is having Stage III disease (T4, N1 or N2, M0) according to the TNM table given above. Hence the management would be - Neoadjuvant chemotherapy + MRM + adjuvant radiation therapy + chemotherapy + antiestrogen therapy | 5,543 | medmcqa_train |
Following changes are seen during capacitation of a sperms except ? | Ans. is 'b' i.e., Decreased permeability to calcium Capacitation of sperm (spermatozoa) Spermatozoa leaving the testis (seminiferous ubules) are not fully mobile. They continue their maturation and acquire their mobility during their passage through epididymis. From epididymis they come to vas deference, distal end of which also receives the secretions of seminal vesicle, and continues as the ejeculatory duct. The ejeculatory duct joins the prostatic urethra. Once ejeculated into the the female, vaginal secretions improve the motility and feilizing ability of sperms. Fuher exposure to secretions of female genital tract (in uterus and/or fallopian tube) fuher improves the mobility and feilizing ability of the sperms. The beneficial effects of stay in the female genital tract are collectively called capacitation, from the isthmus, capacitated sperms move rapidly to the ampullas, where feilization takes place. Following changes occur during capacitation :- i) Uterine and fallopian tube fluids wash away the various inhibitory factors that suppress sperm activity in male genital tract. ii) Removal of cholesterol vesicle from acrosome so that acrosomal membrane becomes weak and can release enzyme at the time of feilization. iii) Increase membrane permeability to calcium ion. | 5,544 | medmcqa_train |
Which among the following statement regarding skeletal and cardiac muscle is false | Ans: c (Both have graded contraction) Ref: Ganong 22nd ed/p.79Cardiac action potentialAction potential can be defined as the sequence of changes in the membrane potential in an excitable cell due to opening and closure of differention channels after application of a threshold stimulus.Phases of action potentialPhase 0 - Opening of voltage gated Na channel.Phase 1 - closure of sodium chan-nel- leads to initial rapid depolarization.Phase 2 - plateau phase- due to opening of L type Ca2+channels.Phase 3 - final repolarization due to closure of Ca2+ channels & K+ efflux.Phase 4 - resting membrane potential. | 5,545 | medmcqa_train |
A high tracheostomy may be indicated in- | “It is important (in tracheostomy) to refrain from causing any damage in the region of cricoid cartilage.
An exception to this rule is when a patient has laryngeal malignancy and under these circumstances tracheostomy should be placed high so as to allow resection of tracheostomy site at the time of laryngectomy”.
“ The high tracheostomy is generally avoided because of the postoperative risk of peri-chondritis of the cricoid cartilage and subglottic stenosis. In cases of carcinoma larynx with stridor when total laryn-gectomy would be done, high tracheostomy is indicated.” | 5,546 | medmcqa_train |
A 67 year male smoker presents with haemoptysis and cough. Brochoscopic biopsy revealed undifferented tumour. The immunohistochemical marker that can be most helpful is: | Cytokeratin | 5,547 | medmcqa_train |
A 74-year-old man has a 5-hour elective operation for repair of an abdominal aoic aneurysm. He had a small myocardial infarction 3 years earlier. In the ICU on the first postoperative day, he is hypotensive and is receiving dobutamine by continuous infusion.select the best method of physiologic monitoring necessary for the patient. | This patient requires pulmonary aery catheter readings to allow his physicians to assess his volume status and need for ongoing inotropic suppo. Fuhermore, the patient continues to be hypotensive and requires fuher investigation as to the etiology that would subsequently dictate treatment (volume, afterload reduction, etc). Central venous monitoring alone does not allow the physician to assess cardiac function. Miller&;s anaesthesia 9th edition p578 | 5,548 | medmcqa_train |
Deficiency of the ' Intrinsic factor of Castle ' causes- | Pernicious anemia is a chronic disease resulting from deficiency of Intrinsic factor leading to impaired absorption of Vitamin B12. Megaloblastic anemia is due to deficiency of Cobalamin/folate. Reference: Atlas and text of Hematology, 3rd edition, pg:102. Exam preparatory manual for UGs by Ramdas Nayak page no: 259 | 5,549 | medmcqa_train |
Which is true about central retinal aery? | The central aery of the retina -It is an end aery. It does not have effective anastomoses with other aeries. Occlusion of the aery results in blindness. The intraocular pa of the aery can be seen, in the living, through an ophthalmoscope. Ref : B D Chaurasia's Human Anatomy , seventh edition , volume 3 , pg. no.,216. | 5,550 | medmcqa_train |
In Citric acid cycle, which enzyme is inhibited by arsenite? | Ans. is 'b' i.e., a ketoglutarate DehydrogenaseArsenite binds to the sulfhydryl group and hence inhibits the activity of enzymes which have lipoamide in the active site, Hence Arsenite inhibits Pyruvate Dehydrogenase and a ketoglutarate dehydrogenase of citric acid cycle, It is an example for non competitive inhibition, Succinate dehydrogenase is inhibited by malonate. | 5,551 | medmcqa_train |
Which steroid is formed from cholesterol without hydroxylation - | Cholesterol is first changed to form pregnenolone (common pathway). For this free cholesterol is released in the cytosol from cholesteryl esters of cytoplasmic lipid droplets and transferred into mitochondria. An enzyme called "cytochrome-P- 450-sidechain cleavage" enzyme (P450 sce) present in inner mitochondrial membrane hydroxylates cholesterol at C22 and C20 (also called "20, 22-desmolase") and then cleaves the side chain to form pregnenolone and isocaproic aldehyde. The enzyme requires molecular O2 and NADPH like all mono-oxygenases and also require FAD-containing Fp, a Fe2S2 protein (called adreno- doxin). Pregnenolone to 17-OH pregnenolone: Pregnenolone is transferred to smooth endoplasmic reticulum (ER), where it is conveed to 17-OH-pregneno- lone catalysed by the enzyme 17-aaa-hydroxylase. * Conversion of 17-OH pregnenolone to 17-OH progesterone: This is achieved by two enzymes, one is NAD+ dependent 3 bbb-OH-steroid dehydrogenase and the other is DDD4,5-isomerase. Alternatively, the same pregnenolone may be first conveed to 'progesterone' by the action of the two enzymes dehydrogenase and isomerase and it is acted upon by the enzyme 17-a-hydroxylase to form 17-OH progesterone. PROGESTERONE * Progesterone is the hormone of the corpus luteum, the structure which develops in the ovary from the ruptured Graafian follicle. It is also formed by the placenta, which secretes progesterone, during the later pa of pregnancy. Progesterone is also formed in the adrenal coex, as a precursor of both C19 and C21 coicosteroids. It is also formed in the testes. Chemistry: Progesterone may be regarded as a derivative of "pregnane" and is designated chemically as "4- pregnane-3, 20-dione". It is a C21 steroid and has a - CH3 group at C10 and C13. Biosynthesis: Progesterone has a role as an intermediate in the biogenesis of adrenocoical hormones and of androgens. Indirectly androstenedione and testosterone, it also serves as precursors for estrogens also. Progesterone is formed from acetate cholesterol, 'Pregnenolone' is the immediate precursor. Mechanism of action: It is similar to estrogen.Ref: Textbook of Medical Biochemistry, Eighth Edition, Dr (Brig) MN Chatterjea, page no: 590-591,603-604 | 5,552 | medmcqa_train |
Ohngren's line extends from- | Ans. is 'b' i.e., Medial canthus of eye to angle of mandible Qhngren's lineo In head and neck cancer, Ohngren's line is a line that connects the medial canthus of the eye to the angle of the mandibleo The line defines a plane orthogonal to a sagittal plane that divides the maxillary sinus into (1) an anterior-inferior part, and (2) a superior-posterior part.o Tumours that arise in the anterior-inferior part, i.e. below Ohngren's line, generally have a better prognosis than those in the other groupo Addition to above a vertical line through pupil is also considered, which divides the above mentioned structures into 4 different regions. The structures at posterosuperior medial have worst prognosis and that at anteroinferior medial are least dangerous. | 5,553 | medmcqa_train |
Severity of mitral stenosis is determined by : | Since there is mitral stenosis, more time for blood to enter LV. Therefore, increased transient time, so increase duration of murmur of S1 sound can be loud or soft. If sound is soft it tells us about calcified mitral valves but not of severity | 5,554 | medmcqa_train |
Probiotics are useful for - | Probiotics are substances secreted by one organism which stimulates the growth of another.
Probiotics are useful in following conditions:
Rota virus diarrhea
Antibiotic associated diarrhea
Radiation induced diarrhea
Traveller’s diarrhea
Inflammatory bowel disease
Cancers | 5,555 | medmcqa_train |
A 28-year-old woman with type 1 diabetes presents to the clinic for evaluation of skin lesions on her leg. They are not painful or itchy and have developed gradually over time. There is no history of previous trauma to the site either.On physical examination the skin changes have a central depression and raised irregular margin. The surrounding area is not red, tender, or indurated. They are shown in Figure below. Which of the following is the most likely diagnosis? | Necrobiosis lipoidica diabeticorum is more frequent in females and may antedate other clinical signs and symptoms of diabetes. The plaques are round, firm, and reddish-brown to yellow in color. They most commonly involve the legs but can also involve the hands, arms, abdomen, and head. This in not a staphylococcal skin infection since it is not tender, indurated or warm to touch, and erythema nodosum is characterized by round, tender elevated lesions usually on the anterior shin. | 5,556 | medmcqa_train |
The main function of Vitamin C in the body is - | Ans. is 'c' i.e., Involvement as antioxidant Vitamin C ( Ascorbic acid)o Ascorbic acid (Vitamin C) is also called antiscorbutic factor. It is very heat labile, especially in basic medium. Ascorbic acid itself is an active form. Maximum amount of vitamin C is found in adrenal cortex,o Ascorbic acid functions as a reducing agent and scavanger of free radicals (antioxidant). Its major functions are:- In collagen synthesis: - Vitamin C is required for post-translational modification by hydroxylation of proline and lysine residues converting them into hydroxyproiine and hydroxy lysine. Thus vitamin C is essential for the conversion of procollagen to collagen, which is rich in hydroxyproiine and hydroxylysine. Through collagen synthesis, it plays a role in formation of matrix of bone, cartilage, dentine and connective tissue.Synthesis of norepineph rine from dopamine by dopamine-b-monoxygenase (dopamineb-hydroxylase) requires Vitamin C.Carnitine synthesisBile acid synthesis :- 7-a-hydroxylase requires vitamin C.Absorption of iron is stimulated by ascorbic acid by conversion of ferric to ferrous ions.During adrenal steroid synthesis, ascorbic acid is required during hydroxylation reactions.Tyrosine metabolism : - Oxidation of P-hydroxy-phenylpyruvate to homogentisate.Folate metabolism : - Folic acid is converted to its active form tetrahydrofolate by help of Vitamin C. | 5,557 | medmcqa_train |
Action of superior oblique is following except - | Superior oblique causes intorsion (not extorsion). | 5,558 | medmcqa_train |
Which of the following areas of brain is most resistant to Neurofibrillary tangles in Aizeimer's disease - | The lateral geniculate nucleus (LGN; also called the lateral geniculate body or lateral geniculate complex) is a relay center in the thalamus for the visual pathway. It receives a major sensory input from the retina. The LGN is the main central connection for the optic nerve to the occipital lobe, paicularly the primary visual coex. In humans, each LGN has six layers of neurons (grey matter) alternating with optic fibers (white matter And is resistant to neurofibrillary tangles Ref Harrison20th edition pg 2345 | 5,559 | medmcqa_train |
Amino acid required for formation of thyroxine- | Ans. is 'b' i.e.. Tyrosine o The term thyroid hormone denotes both thyroxine (T4) and triodothyronine (T3).o Both T4 and T are iodine derivatives of thyronine.o Thyronine is a condensation product of two molecules of amino acid tyrosine.o Thyroxine is 3, 5, 3', 5' - tetraiodothvronineandT, is 3,5,3'-triiodothyronine.o Thyroid hormones are synthesized and stored in the thyroid follicles as apart of thyroglobulin molecule. | 5,560 | medmcqa_train |
Minimal reabsorption from kidney is of - | Ans. is 'd' i.e., Urea Renal handling of various plasma constrituents in a normal adult human on an average diet. Per 24 Hours SubstanceFitteredReabsorbedSecretedExcretedPercentage ReabsorbedNa+ (mEq)26,00025,850 15099.4K+(mEq)600560a5029093.3C1- (mEq)18,00017,850 15099.2HCO3-mEq)4,9004,900 0100Urea (mmol)870460 b 41053Creatinine (mmol)121clc12 Uric acid (mmol)50494598Glucose (mmol)800800 0100Total solute (mOsm)54,00053,40010070098.9Water (mL)180,000179,000 100099.4 SubstancePercentage ReabsorbedNa+(mEq)99.4K+(mEq)93.3CT (mEq)992HC03-(mEq)100Urea (mmol)53Uric acid (mmol)98Glucose ( mmol)100Total solute (mOsm)98.9Water (mL)99.4 | 5,561 | medmcqa_train |
Nagayama spots are seen in: | Nagayama spots: Roseola infantum Koplik spots- Measles Forchheimer spots- Rubella | 5,562 | medmcqa_train |
Cells affected in glaucomatous optic neuropathy are:(AIIMS May 2014, Nov 2013) | Ans. c. Ganglion cells (Ref: Parsons 21st/280-281; www.nebi nlm.nih.gov.57(4) Jul-Aug 2009)Cells most commonly affected in glaucomatous optic atrophy are ganglion cells."Absence of the ganglion cell and nerve fiber layers is a hallmark of glaucoma". Robbins 8/e p1328"Glaucoma, the second leading cause of blindness, is characterized by changes in the optic disc and visual field defects. The elevated intraocular pressure was considered the prime factor responsible for the glaucomatous optic neuropathy involving death of retinal ganglion cells and their axons."- www.ncbi.nlm.nih.govGlaucomaGlaucoma, the second leading cause of blindness, is characterized by changes in the optic disc and visual field defects.The elevated intraocular pressure was considered the prime factor responsible for the glaucomatous optic neuropathy involving death of retinal ganglion cellsQ and their axons.Glaucoma, a leading cause of irreversible visual loss, is characterized by loss of retinal ganglion cells (RGC)Q and their axons over a period of many years.Mainly the ganglions cellsQ are affected in glaucoma patients, which may lead to glaucomatus optic atrophy.Glaucomatous optic neuropathy is characterized by changes in the optic disc and visual field defects.The morphologic changes in the optic disc are in the form of thinning of neuroretinal rim, pallor and progressive cupping of the optic discQ.The hemorrhage-associated retinal nerve fiber layer defects precede measurable changes of the optic disc configurationQ.The visual field defects in glaucoma are often detected only after 40% of the axons are lostQ. | 5,563 | medmcqa_train |
Miriam, a college student with acute rhinitis sees the campus nurse because of excessive nasal drainage. The nurse asks the patient about the colour of the drainage. In acute rhinitis, nasal drainage normally is: | Normally, nasal drainage in acute rhinitis is clear.
Yellow or green drainage indicates the spread of the infection to the sinuses.
Gray drainage may indicate a secondary infection. | 5,564 | medmcqa_train |
Which of the following is not seen in coronal CT paranasal sinuses? | ANSWER: (D) Frontoethmoid recessREF: Sutton 7th ed vol 2 page 1519-1522, Grainger 5th ed chapter 62See previous question | 5,565 | medmcqa_train |
After a 26-year-old man's car was roadsided by a large truck, he is brought to the emergency depament with multiple fractures of the transverse processes of the cervical and upper thoracic veebrae. Which of the following muscles might be affected? | The Levator Scapulae arise from the transverse processes of the Upper Cervical Veebrae and inses on the medial border of the Scapula. The other muscles are attached to the Spinous Processes of the Veebrae. | 5,566 | medmcqa_train |
At what size of mean gestational sac diameter measured on TVS with no embryonic pole is labelled as 'Anembryonic Gestation' - | An intrauterine gestational sac is reliably visualized with transvaginalsonography by 5 weeks, and an embryo with cardiac activity by 6 weeks The embryo should be visible transvaginally once the mean sac diameter hasreached 25 mm--otherwise the gestation is anembryonic. Cardiac motion isusually visible with transvaginal imaging when the embryo length reaches 5 mm. | 5,567 | medmcqa_train |
The typical appearance of "spider leg" on excretory urography is seen in: | Diagnosis USG: Enlarged kidney with uniformly medullary echogenicity. IVP in ADPKD Stretching of the calyces by the cysts (spider leg or ball like deformity. Bubble appearance (calyceal distoion) Swiss cheese appearance. CT scan is IOC in ADPKD | 5,568 | medmcqa_train |
All take place in mitochondria except | Ans. is 'b' i.e. EMP pathway Embedem Meyerhof Parnas (EMP) pathway or glycolysis occurs in cytosolFor rest see above question | 5,569 | medmcqa_train |
The aerial supply of duodenum is / are derived from ? | The duodenum develops paly from the foregut and paly from the midgut. The opening of the bile duct into the second pa of the duodenum represents the junction of the foregut and the midgut. Upto the level of the opening, the duodenum is supplied by the superior pancreaticoduodenal aery, and below it by the inferior pancreaticoduodenal aery. Ref : B D Chaurasia's Human Anatomy , seventh edition , volume 2 , pg. no., 288. ( fig . 20. 13 - 289 page ). | 5,570 | medmcqa_train |
Keoppe nodules are present on - | The pathological reaction in granulomatous uveitis is characterised by infiltration with lymphocytes, plasma cells, with mobilization and proliferation of large mononuclear cells which eventually become epithelioid and giant cells and aggregate into nodules. Iris nodules are usually formed near pupillary border (Koeppe's nodules). and sometimes near collarette (Busacca nodule). | 5,571 | medmcqa_train |
Commonest operation done for gastric outlet obstruction with peptic ulcer is: March 2007 | Ans. A: Truncal vagotomy with gastrojejunostomyGastric outlet obstruction is manifested by obstruction at the level of the pylorus, which is the outlet of the stomach. Patients may develop vomiting, which may be projectile but non-bilious in nature, nausea or abdominal pain. An unusual finding that may lead to the diagnosis is the succussion splash, a splash-like sound heard over the stomach in the left upper quadrant of the abdomen on shaking the patient, with or without the stethoscope.The diagnosis is typically made by X-ray, which will show an absent air bubble in the stomach, or by CT scan.Causes of gastric outlet obstruction include peptic ulcer disease; tumours of the stomach, including adenocarcinoma (and its linitis plastica variant), lymphoma, and gastrointestinal stromal tumours; infections, such as tuberculosis; and infiltrative diseases, such as amyloidosis.Metabolic alkalosis may develop as a result of loss of acid.Traditionally severe cases of Gastric outlet obstruction are treated usually by a gastroenterostomy rather than a pyloroplasty. Truncal vagotomy leads to reduction of the maximal acid output by 50% as vagus nerves are sectioned which critically controls the secretion of gastric acid. | 5,572 | medmcqa_train |
A 30 year old presents with nausea, weakness, headache and impaired vision and high anion gap metabolic acidosis. Most likely cause is: | Methanol | 5,573 | medmcqa_train |
Amongst the following, which carries the least chance of transmitting HIV infection: September 2010 | Ans. A: Heterosexual Intercourse. Heterosexual Intercourse is the most common route but the chance of infection is less (0.30%) ,looking to the other options. Average per act risk of getting HIVby exposure route to an infected source Exposure routeChance of infection Blood transfusion 90% Childbih (to child) 25% Needle-sharing injection drug use 0.67% Percutaneous needle stick 0.30% Receptive anal intercourse* 0.04-3.0% Inseive anal intercourse* 0.03% Receptive penile-vaginal intercourse* 0.05-0.30% Inseive penile-vaginal intercourse* 0.01-0.38% Receptive oral intercourse*SS 0-0.04% Inseive oral intercourse*SS 0-0.005% * assuming no condom useSS source refers to oral intercourseperformed on a man Most commonly, people get or transmit HIV through sexual behaviors and needle or syringe use. MC mode of transmission: Hetero-sexual In hetero-sexual transmission: Male to female is commoner (as compared to female to male) Chances of transmission with accidental needle prick: 0.3%. Less commonly, HIV may be spread From mother to child during pregnancy, bih, or breastfeeding. Although the risk can be high if a mother is living with HIV and not taking medicine, recommendations to test all pregnant women for HIV and sta HIV treatment immediately have lowered the number of babies who are born with HIV. In extremely rare cases, HIV has been transmitted by Oral sex--putting the mouth on the penis (fellatio), vagina (cunnilingus), or anus (rimming). In general, there's little to no risk of getting HIV from oral sex. Receiving blood transfusions, blood products, or organ/tissue transplants that are contaminated with HIV. This was more common in the early years of HIV, but now the risk is extremely small because of rigorous testing of the blood supply and donated organs and tissues. Eating food that has been pre-chewed by an HIV-infected person. The contamination occurs when infected blood from a caregiver's mouth mixes with food while chewing. The only known cases are among infants. Being bitten by a person with HIV. Each of the very small number of documented cases has involved severe trauma with extensive tissue damage and the presence of blood. There is no risk of transmission if the skin is not broken. Contact between broken skin, wounds, or mucous membranes and HIV-infected blood or blood-contaminated body fluids. Deep, open-mouth kissing if both paners have sores or bleeding gums and blood from the HIV-positive paner gets into the bloodstream of the HIV-negative paner. HIV is not spread through saliva. | 5,574 | medmcqa_train |
All of the following are true regarding Legionella except. | Ans. is 'c' i.e., Legionella are communicable from infected patients to othersRef: Harrison, 19th/e, p. 1014; Ananthanarayan, 9th/e, p. 401* No man to man transmission occurs.* Aspiration is predominant mode of transmission. Other modes include aerosolization, direct instillation into lungs.* Aerosolization by AC, nebulizer, humidifier, overhead showers and direct installation into lungs are other modes.* Aerosol spread leading to epidemics. | 5,575 | medmcqa_train |
Which is not true about Fragile X syndrome ? | Ans. is 'b' i.e., Pigmented nevi Fragile - X syndrome Fragile - X syndrome is the prototype of diseases in which the mutation is characterized by a long repeating sequence of three nucleotides. o In fragile X syndrome,trinucleotide repeat mutation involve CGG on non coding region. o Clinical features of fragile - X syndrome Mental retardation Long face with large mandible Hyperexntesible joint Mitral valve prolapse Large eveed ears Large testis (macro-orchidism) High arched palate o Fragile X syndrome is the second most common cause of mental retardation, after Downs syndrome. | 5,576 | medmcqa_train |
Autoimmune thyroiditis is associated with all except - | Ans. is 'd' i.e., Psoriasis o Autoimmune thyroiditis (Hashimoto thyroiditis) patients are at increased risk for developing other autoimmune disease :- i) Endocrine : Type 1 DM, autoimmune adrenalitis. ii) Non-endocrine : SLE, mysthenia gravis, sjogren syndrome. o These patients are also at increased risk for development of B-cell non-Hodgkin lymphoma, especially marginal cell lymphoma of MALT lymphoma. | 5,577 | medmcqa_train |
In Aspirin mechanism of action | (B) Cyclooxygenase decreased # Aspirin acts by inhibiting cyclooxygenase enzyme, thereby inhibiting prostaglandin synthesis.> Leukotriens acts by inhibiting Lipooxygenase> Steroids acts by inhibiting phospholipase | 5,578 | medmcqa_train |
A farmer visiting a orchard gets unconscious, excessive salivation , constricted pupils and fasciculation of muscles, treatment staed with | A i.e. Atropine | 5,579 | medmcqa_train |
In follicular carcinoma chromosomal translocation is? | Ans. is 'a' i.e., PAX8- PPARrl Various genes involved in thyroid carcinomas arePapillaryo Tyrosine kinase receptors RET or NTRK1o RAS mutationo BRAF oncogeneFollicularo RAS oncogene (NRAS, HRAS and KRAS)o PAX8- PPARrl translocationMedullaryo RETprotooncogne. | 5,580 | medmcqa_train |
An absolute contraindication of MRI is: | Ans. is 'a' i.e. Automatic Cardioverter-defibrillators MR is considered among the safest imaging modalities for patients, even at very high field strengths, more than 3-4 tesla. But Ferromagnetic objects under magnetic field can be vulnerable to 4 adverse effects: Movement (causing structural injury), Current conduction (potentially causing electrical shock), Heating (possibly causing bum injury), and Artifact generation Serious injuries can be caused by attraction of ferromagnetic objects into the magnet, which would act as missiles if brought too close to the magnet. Ferromagnetic implants, such as aneurysm clips, may torque (turn or twist) due to the magnetic field, causing damage to vessels and even death. Metallic foreign bodies in the eye have moved and caused intraocular hemorrhage. Pacemakers and pacemaker leads are a contraindication, as the pacemaker can malfunction and cause arrhythmia or even death. However with growing expansion of MR, increasing number of implant medical devices are being MR safe. So newer pacemaker and aneurysm clips are being made which are MR safe. Absolute Contraindications for the MRI scan: Electronically, magnetically, and mechanically activated implants Ferromagnetic or electronically operated active devices like automatic cardioverter defibrillators Cardiac pacemakers- but there are pacemakers available from Medtronic which are safe in MRI environment but not so widely used. Metallic splinters in the eye Ferromagnetic hemostatic clips in the central nervous system (CNS) Patients with an implanted cardiac pacemaker have been scanned on rare occasions, but pacemakers are generally considered an absolute contraindication. Relative Contraindications for the MRI scan: Cochlear implants Other pacemakers, e.g. for the carotid sinus Insulin pumps and nerve stimulators Lead wires or similar wires (MRI Safety risk) Prosthetic heart valves (in high fields, if dehiscence is suspected) Hemostatic clips (body) Non-ferromagnetic stapedial implants Women with a first-trimester pregnancy Tattoos (only a problem in higher-strength magnetic field i.e. more than 3 tesla) | 5,581 | medmcqa_train |
Mandibular nerve does not supply: | Buccinator is supplied by facial nerve (7th nerve).
Mandibular nerve is nerve of 1st branchial arch & supplies all muscles derived from it, i.e. | 5,582 | medmcqa_train |
Which of the following is used to differentiate between hypercalcemia of malignancy from primary hyperparathyroidism? | Answer- A. Hydrocoisone suppression testlf doubt exists, hyilrocokone suppression test is of value.If the test is performed as originally described, (120 mg hydrocoisone per day for 10 days, correcting the serum calcium for haemodilution), it provides an excellent discrimination, since significant suppression ofserum calcium does not occur in primary hyperparathyroidism, where as malignant hypercalcemia is usually completely alleted. | 5,583 | medmcqa_train |
"Hair on End" appearance is seen in: | Thalassemia | 5,584 | medmcqa_train |
Acute diffuse proliferative glomerulonephritis will have all of the following features, except ? | Ans. is 'd' i.e., Hypo albuminaemiao Diffuse proliferative glomerulonephritis is characterized by nephritic syndrome whereas hypoalbuminemia is a feature of Nephrotic syndrome.o Clinical features of Diffuse proliferative glomerulonephritis | 5,585 | medmcqa_train |
A child with three days history of upper respiratory tract infection presents with stridor, which decreases on lying down position. What is the most probable diagnosis – | This child has : -
3 days history of upper respiratory tract infection.
Followed by stridor
These features suggest the diagnosis of croup.
Clinical manifestations of Croup
Most patients have an upper respiratory tract infection with some combination of -
Rhinorrhea
A mild cough
Pharyngitis
Low-grade fever
After 1-3 days signs and symptoms of upper respiratory tract obstruction become apparent -
Barking cough
Hoarseness
Inspiratory stridor
Symptoms are characteristically worse at night.
Symptoms often recur with decreasing intensity for several days and resolve completely in one week.
Agitation and crying aggravate the symptoms.
The child may prefer to sit up in bed or be held upright.
Chest X-ray
Characteristic narrowing of the subglottic region known as the steeple sign. | 5,586 | medmcqa_train |
cGMP is second messenger for which of the following harmone | Atrial natriuretic factor (ANF) and Nitric acid (NO) user cGMP as second messenger. | 5,587 | medmcqa_train |
Investigation of choice in an unstable patient with suspected intraabdominal injury is | The investigation of choice in an unstable patient with suspected intraabdominal injury is ultrasound. Focused abdominal sonar for trauma(FAST) is a technique whereby ultrasound(sonar) imaging is used to assess the torso for the presence of free fluid, either in the abdominal cavity, and is extended into the thoracic cavities and pericardium(eFAST). eFAST is accurate at detecting <100ml of free blood. CT is the gold standard for the intr-abdominal diagnosis of injury in the stable patient. Reference: Bailey & love, 27th Edition, page no = 372. | 5,588 | medmcqa_train |
In lepromatous leprosy the single drug dapsone is continue for - | In lepromatous leprosy the single drug is continued to one year. REF. PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE 21ST EDITION. PAGE NO - 297 | 5,589 | medmcqa_train |
A knownHIV positive patient is admitted in anisolation ward after an abdominal surgery followingan accident. The resident docter who changed hisdressing the next day found it to be soaked in blood hich of the following would be the right method ofchoice of descarding the dressing - | Ans. is 'c' i.e., Put the dressing material directly in an appropriate bag and send for incineration o This waste category lies in category No. 6 o No.6 category of solid wastes consists of : Items contaminated with blood and fluid containing u Cotton dressings Soiled plaster casts o Linen o Beddings Other materials contaminated with blood o Treatment and disposal of this category of wastes o Incineration (There will be no chemical pretreatment prior to incineration) Autoclaving/microwaving | 5,590 | medmcqa_train |
Most common organ involved in congenital Tb is? | Ans. is 'a' i.e., Liver Congenital tuberculosis Although it is rare as mother having tuberculosis primarily present with infeility. Tuberculous bacilli sometimes pass throgh umblical vein and may develop focus in liver (hepatic complex). When neonate aspirate amniotic fluid containing bacilli then develop GI tuberculosis or lung infection. Neonate usually present as respiratory distress, hepatosplenomegaly lymphadenopathy. Overall liver is most commonly involved in congenital tuberculosis | 5,591 | medmcqa_train |
Organism identified by interferons: | Ans. is. 'd' i. e., M. tuberculosis | 5,592 | medmcqa_train |
Trantas spots are seen in | VERNAL KERATOCONJUNCTIVITIS (VKC) OR SPRING CATARRHIt is a recurrent, bilateral, interstitial, self-limiting, allergic inflammation of the conjunctiva having a periodic seasonal incidence.Signs of vernal keratoconjunctivitis can be described in following three clinical forms:1. Palpebral form: Usually upper tarsal conjunctiva of both eyes is involved. The typical lesion is characterized by the presence of hard, flat-topped, papillae arranged in a &;cobble-stone&; or &;pavement stone&;, fashion. In severe cases, papillae may hyperophy to produce cauliflower like excrescences of &;giant papillae&;. Conjunctival changes are associated with white ropy discharge.2. Bulbar form: It is characterized by (i) dusky red triangular congestion of bulbar conjunctiva in the palpebral area; (ii) gelatinous thickened accumulation of tissue around the limbus; and (iii) presence of discrete whitish raised dots along the limbus (Tranta&;s spots).3. Mixed form. It shows combined features of both palpebral and bulbar forms.Ref. Khurana; 4th edition; Pg no. 74 | 5,593 | medmcqa_train |
Screening is done because of all except: | Screening is testing for infection or disease in populations or in individuals who are not seeking health care. It is defined presumptive identification of unrecognized disease. E.g. serological testing for AIDS virus in blood donors, neonatal screening, pre-marital screening for syphilis . Search for unrecognized disease or defect by means of rapidly applied test, examinations or other procedures in apparently healthy individuals. Case finding is use of clinical and/or laboratory tests to detect disease in individuals seeking health care for other reason ; for example, the use of VDRL test to detect syphilis in pregnant women. | 5,594 | medmcqa_train |
Hepatitis can be a complication of ...... | Metabolic byproduct of halothane can cause autoimmune hepatitis. Halothane hepatitisis rare with an incidence of 1 per 35,000 cases but very fatal, with amoality of 50-75%. It is an immune mediated due to antibodies against highly reactive trifluoroacetyl chloride which is a metabolite of halothane. Risk factors for halothane hepatitis: Multiple exposures to halothane at sho intervals middle-aged obese women - because halothane undergo extensive metabolism in obese patients familial predisposition to halothane Another theory for halothane hepatitis is that it is caused by a hypersensitivity reaction associated with oxidative metabolism of halothane. The liver in halothane hepatitis shows centrilobular necrosis. In a patient with prior history of halothane hepatitis, inhalational induction agent of choice is Sevoflurane. Other points related to effect of halothane on hepatic system : Disrupts dual blood supply of liver ( Among all volatile anesthetic agent , it cause max decrease in hepatic flow) Contraindicated in Pre-existing liver days function C/I in hepatic surgery | 5,595 | medmcqa_train |
Tinea versicolor is seen with | Tinea versicolor is caused by Pityrosporum orbiculare (also called Malassezia furfur). | 5,596 | medmcqa_train |
Doppelganger is- | Ans. is `b' i.e., Feeling of double of oneself Doppelgangers (subjective double) is the delusion that there is double of oneself. A person feels that double of himself exists elswhere. | 5,597 | medmcqa_train |
All of following are true about neonatal sepsis except- | Ans. is 'c' i.e., Most common transmission of infection is through nursery personal o Early onset sepsis is caused by organisms prevalent in the maternal genital tract. o Late onset sepsis is caused by organisms of the external environment of home or hospital and the infection is transmitted most frequently by the hands of the care-provider. Predisposing factors for neonatal sepsis 1) For early onset sepsis o Low bih weight or prematurity o Maternal fever o Prolonged rupture of membrane o Difficult or prolonged labor Foul smelling liquor o Meconium aspiration Multiple per vaginum examination 2) For late onset sepsis Low bih weight o Lack of breast feeding Superficial infections (pyoderma, umblical sepsis) o Aspiration of feeds o Disruption of skin integrity with needle pricks and use of iv fluids. Note? Option 'C' is also paially correct --> most common mode of infection transmission for late onset neonatal sepsis is through the hands of nursery personel, but it is not the most common mode of transmission for overall sepsis, i.e. early plus late neonatal sepsis. | 5,598 | medmcqa_train |
Deltoid ligament is attached to all, Except: | Medial cuneiform The ankle or the talocrural joint has 2 ligaments: the medial collateral (or deltoid ligament) and the lateral collateralligamentMedial collateral ligament (or deltoid ligament)It consists of two sets of fibres, superficial and deep. Both pas have a common attachment above to the apex and margins of the medial malleolus. The lower attachment is indicated by the name of the fibres.Superficial fibresOf the superficial fibres,- The most anterior (tibionavicular) fibres pass forward to be inseed into the tuberosity of the navicular bone, and immediately behind this they blend with the medial margin of the plantar calcaneonavicular ligament (spring ligament);- The middle (tibiocalcaneal) fibres descend almost perpendicularly to be inseed into the whole length of the sustentaculum tali of the calcaneum;- The posterior fibres (posterior tibiotalar) pass backward and laterally to be attached to the medial side of the talus, and its medial tubercleDeep fibres- The deep fibres (anterior tibiotalar) are attached to the anterior pa of medial surface of the talus. The deltoid ligament is crossed by the tendons of the Tibialis posterior and Flexor digitorum longus.Lateral collateral ligamentThe lateral ligament has 3 discrete bands or pas:The anterior talofibular ligament- extends anteromedially from the anterior margin of the fibular malleolus to the neck of the talus.The posterior talofibular ligament- extends almost horizontally from the lateral malleolar fossa to the lateral tubercle of the talusThe calcaneofibular ligament - is a long cord which passes from a depression anterior to the apex of the fibular malleolus to a tubercle on the lateral calcaneal surface. It is crossed by the tendons of the peroneus longus and brevis.The above attachments of the two ligaments of the ankle joint could be simplified as:The medial collateral or deltoid ligament passes from the medial malleolus (tibia) to the talus, calcaneum, navicular and the spring ligament.The lateral collateral ligament passes from the lateral malleolus (fibula) to the talus and calcaneum. | 5,599 | medmcqa_train |
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