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Pigmented "muddy brown" granular cast is characteristic of | AKI from ATN due to ischemic injury, sepsis, or ceain nephrotoxins has characteristic urine sediment findings: pigmented "muddy brown" granular casts and tubular epithelial cell casts. These findings may be absent in more than 20% of cases Ref: Harrison 19e pg: 1805 | 6,200 | medmcqa_train |
A 35-year-old hypertension patient. CXR shows? | Ans. (c) Coarctation of aorta. | 6,201 | medmcqa_train |
7Which is the most prominent spinous process? | C7 is most prominent spinous process seen at the neck region just above T 1 veebrae BD CHAURASIA HUMAN ANATOMY Vol 3 | 6,202 | medmcqa_train |
If a fracture, gives the pattern of the striking surface of the weapon it is called | Signature fracture This is a depressed comminuted fracture produced by an object with a small striking surface and will give the pattern of the striking surface of the weapon which caused it like a hammer, butt of a rifle, etc. The weapon which caused the injury can be identified. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 163 | 6,203 | medmcqa_train |
Crude birth rate is a simplest measure of fertility because it includes | Crude birth rate : Number of live births in a year per 1000 mid-year population.
CBR is simplest indicator of fertility : Total mid-year population is not exposed to child bearing thus it doesnot give true idea of fertility of a population. | 6,204 | medmcqa_train |
which layer of cornea helps in maintaining hydration OF stroma of cornea | REF : AK KHURANA 7TH ED | 6,205 | medmcqa_train |
Palpable purpura is caused by | palpable purpura is due to deposition of immune complexes at the site, seen in HSP,Ahritis, gut vasculitis,glomerulonephritis, bacterial endocarditis, gonococcaemia,meningococcaemia and rocky mountain spotted fever. Page no.309. Reference IADVL's concise textbook of dermatology | 6,206 | medmcqa_train |
Tricyclic antidepressant are contraindicated in: | Due to anticholinergic action, TCAs should be avoided in glaucoma These agents block muscarinic acetylcholine receptors, resulting in anticholinergic effects (e.g., dry mouth, blurred vision, urine retention, constipation); they are contraindicated in patients with glaucoma. | 6,207 | medmcqa_train |
With DMPA, the next injection may be taken latest by: | DMPA is effective for 13 weeks. It has grace period of 4 weeks, which means that this woman can get her next injection before completed 17 weeks. If she comes later than 17 weeks, then she will be given injection but will have to use backup for next 7 days, as injections would take time to become effective. | 6,208 | medmcqa_train |
Regarding furosemide true statement is: | Ans. (A) Acute pulmonary edema is an indication(Ref: Katzung 10/e p250)Furosemide possesses vasodilatory action which is responsible for quick relief in LVF and pulmonary edema (used i.v.). It can be used orally as well as parenterally. | 6,209 | medmcqa_train |
During surgery for aortic arch aneurysm under deep hypothermic circulatory arrest which of the following anaesthetic agent administered prior to circulatory arrest that also provides cerebral protection? | (B) Thiopental Sodium # Uses of Thiopentone Sodium:> Induction of anaesthesia;> Maintenance of anaesthesia for short procedures;> Basal narcosis by rectal administration;> Treatment of status epilepticus;> Reduction of intracranial pressure;> Fordiagnostic operative neurological procedures. | 6,210 | medmcqa_train |
Neonatal fat necrosis resembles which of the following – a) Post steroidal panniculitisb) Erythema induratumc) Lipodermatosclerosisd) Lupus panniculitis | I think there is printing mistake in this question. There should be except in this question. In that case answer will be erythema induratum.
Neonatal fat necrosis, post-steroidal panniculitis, Lipodermatosclerosis and lupus panniculitis belong to same group, i.e. Mostly lobular panniculitis without vasculitis.
Erythema induratum belongs to other class, i.e. Mostly lobular panniculitis with vasculitis. | 6,211 | medmcqa_train |
Which of the following is NOT TRUE regarding PROPOFOL ? | Ketamine is safe in porphyria. | 6,212 | medmcqa_train |
First clinical feature of cerebello-pontine angle tumor is ? | Answer- B. Loss of corneal reflexAbsent corneal reflex is the earliest sign of cerebellopontine (CP) angle tumors like acoustic neuroma. | 6,213 | medmcqa_train |
A 5-year-old boy comes with overnight petechial spots 2 weeks back he had a history of abdominal pain and no hepatosplenomegaly. Diagnosis is – | Petechial spots without hepatosplenomegaly in a 5-year-old boy suggest the diagnosis of ITP.
About other options
Acute leukaemia
Acute leukaemia will give features of involvement of all the three lineages i.e.
anaemia (erythrocyte involvement)
fever (due to neutrophil involvement)
bleeding (due to platelet involvement)
Moreover, splenomegaly and lymphadenopathy are usually present in Acute leukaemias.
Aplastic anaemia
Aplastic anaemia too will present with features, characteristic of involvement of all the three lineages i.e. severe anaemia, fever bleeding. | 6,214 | medmcqa_train |
Bevacizumab is used for treatment of carcinoma of: | The use of bevacizumab (a monoclonal antibody to VEGF) was recently approved by the U.S. Food and Drug Administration (FDA) for use in metastatic breast cancer in combination with paclitaxel chemotherapy. This approval was based on results from a phase III trial by the Eastern Cooperative Oncology Group. The group's E2100 trial showed that when bevacizumab was added to paclitaxel chemotherapy, median progression-free survival increased to 11.3 months from the 5.8 months seen in patients who received paclitaxel alone Ref: Schwaz's principle of surgery 9th edition, chapter 17. | 6,215 | medmcqa_train |
Zero order kinetics is shown by which drug - | Ans. is 'b' i.e., Theophylline 1 o Drugs showing zero/pseudo-zero order kinetics :# Phenytoin# Tolbutamide# Theophylline# Warfarin# Alcohol# Salicylates (Aspirin) | 6,216 | medmcqa_train |
Homer's syndrome consists of- | D i.e. Miosis and ptosis Homer's syndrome presents with - ENopthalmos Q, Ptosis Q, Anhidrosis, Loss of ciliospinal reflexes Q, MiosisQ (Mnemonic - "NO-PALM") Way of remembering - all things are decreased whether it be the size of pupil (miosis), or proptosis of eye (enopthalmos), or palpebral size (ptosis), or unilateral loss of sweating (anhidrosis), or reflexes (loss of ciliospinal reflexes). | 6,217 | medmcqa_train |
When is this gross motor milestone attained by a child? | The given picture shows a child creeping upstairs, that comes at around 15 months age; Another impoant milestone that appears at around 15 months age is Jargon speech | 6,218 | medmcqa_train |
Which one of the following drugs is not a uterine relaxant? | Isoxsuprine, magnesium, ritodrine, salbutamol, and terbutaline to some extent, atosiban, calcium channel blockers could act as uterine relaxants or tocolytics Ref: KD Tripathi 8th ed | 6,219 | medmcqa_train |
An example of a preventive antioxidant is: | Antioxidants fall into two classes:
Preventive antioxidants, which reduce the rate of chain initiation. ex: Catalase and other peroxidases such as glutathione peroxidase.
Chain-breaking antioxidants, which interfere with chain propagation. ex: Superoxide Dismutase, Uric Acid, Vitamin E (Most powerful).
Key Concept:
Catalase falls into preventive anti-oxidants which reduce the rate of chain initiation.
Ref : Harper’s illustrated biochemistry, 31st edition. | 6,220 | medmcqa_train |
Characteristic of exudative fluid is - | Ans. is 'd' i.e., Cellular debris Types of edema fluidIn edema, the fluid accumulated in interstitial fluid may be either a transudate or an exudate. Exudate is an inflammatory fluid that contains high protein content, cellular debris, and specific gravity >1.020. It occurs due to increased vascular permeability.Transudate contains low protein (mostly albumin) with specific gravity < 1.012.It is an ultrafiltrate of plasma that results from hydrostatic or osmotic imbalance between intravascular and extravascular compaments despite normal vascular permeability | 6,221 | medmcqa_train |
Largest turbinate is | Conchae or turbinates are the curved bony projections directed downwards and medially.Below and lateral to each concha is the corresponding meatus.From above downwards the conchae are superior, middle, and inferior nasal conchae. Sometimes a 4th concha, the concha suprema is also present. Superior and middle nasal conchae are projections from the medial surface of the ethmoidal labyrinth.Inferior concha is an independent bone. The superior concha is the smallest and the inferior is the largest in size. Reference: Textbook of anatomy, Head neck and brainVishram Singh, 2nd edition, page no255. | 6,222 | medmcqa_train |
The following statments are true for negri bodies except - | Ans. is 'd' i.e., They do not contain rabies virus antigen | 6,223 | medmcqa_train |
HIV transmission to the newborn is most commonly and effectively by | Ans. b (Vaginal delivery). (Ref. Harrison's Principles of Internal Medicine, 16th/pg.38, 1082)MATERN AL-FETAL/INFANT TRANSMISSION# The predominant cause of HIV infection in children is transmission of the virus from the mother to the newborn during the perinatal period.# The majority of cases of mother-to-child (vertical) transmission of HIV-1 occur during the intrapartum period.# Exposures, which increase the risk of mother-to-child transmission, include -- Vaginal delivery,- Preterm delivery,- Maternal bleeding, and# Trauma to the fetal skin.# Perinatal HIV transmission can be most accurately correlated with measurement of maternal plasma HIV RNA burden.# In the absence of prophylactic antiretroviral therapy to the mother during pregnancy, labor, and delivery, and to the fetus following birth (see below), the probability of transmission of HIV from mother to infant/fetus ranges from 15- 25% in industrialized countries and from 25-35% in developing countries.# In developed countries, current recommendations to reduce perinatal transmission of HIV include- universal voluntary HIV testing and counseling of pregnant women,- antiretroviral prophylaxis with one or more drugs in cases in which the mother does not require therapy for her HIV infection,- combination therapy for women who do require therapy,- obstetric management that attempts to minimize exposure of the infant to maternal blood and genital secretions, and- avoidance of breast-feeding.# Certain studies have demonstrated that truncated regimens of zidovudine alone or in combination with lamivudine given to the mother during the last few weeks of pregnancy or even only during labor and delivery, and to the infant for a week or less, significantly reduced transmission to the infant compared to placebo.# Short-course prophylactic antiretroviral (ARV) regimens, such as a single dose of nevirapine given to the mother at the onset of labor and a single dose to the infant within 72 h of birth, are of particular relevance to low- to mid-income nations because of the low cost and the fact that in these regions perinatal care is often not available and pregnant women are often seen by a health care provider for the first time at or near the time of delivery.# Indeed, short-course ARV regimens have now been used for several years in developing nations for the prevention of mother-to-child transmission. | 6,224 | medmcqa_train |
A patient presents with headache for one hour on awakening, associated with nasal stuffiness and reddening of eye. Suggestive of | (A) Cluster headache # Cluster headache (CH) is an idiopathic syndrome consisting of recurrent brief attacks of sudden, severe, unilateral periorbita pain> Attacks of CH are typically short in duration (5-180 min) and occur with a frequency from once every other day to 8 times a day, particularly during sleep. As opposed to migraine, CH is not preceded by aura, affording patients little or no warning.> Pain generally is described as excruciating, penetrating, and not throbbing.> It may radiate to other areas of the face and neck but is typically periorbital.> It may be triggered by stress, relaxation, extreme temperatures, glare, allergic rhinitis, and sexual activity.> CH rarely is triggered by ingestion of specific foods, although tobacco or alcohol products may precipitate an attack.> An attack of CH is a dramatic event during which the patient may be extremely restless. In desperation, CH patients may rock, sit, pace, or bang themselves against a hard surface.> The association of prominent autonomic phenomena is a hallmark of CH. Such signs include ipsilateral nasal congestion and rhinorrhea, lacrimation, conjunctival hyperemia, facial diaphoresis, palpebral edema, and complete or partial Horner syndrome (which may persist between attacks). Tachycardia is a frequent finding.> A distinctive CH face is described as follows: leonine facial appearance, multifurrowed and thickened skin with prominent folds, a broad chin, vertical forehead creases, and nasal telangiectasias.> Persons affected by CHs often are tall and rugged-looking. | 6,225 | medmcqa_train |
Hematuria during labour in previous is sign of - | Ans. is a i.e. Impending rupture of scar Now friends - here in the question it is asked specifically that hematuria is seen in a patient with previous LSCS during labour - which indicates impending rupture of scar? "There are no reliable signs of impending uterine rupture that occurs before labor, although the sudden appearance of gross hematuria is suggestive. Here in this questions obstructed labor is not given in the options, but even if it was given, I would have still opted for impending scar rupture as the question is specifically asking, in a case of previous LSCS. | 6,226 | medmcqa_train |
All the following statements are true for influenza viruses except: | Influenza viruses show following features: 1. Influenza viruses are spherical or filamentous,posses helical symmetry, enveloped paicles 80-120 nm in diameter. 2. Influenza virus is composed of a characteristic segmented single-stranded RNA genome, a nucleocapsid, and an envelope. 3. The viral genome is a single-stranded antisense RNA. The genome consists of an RNA-dependent RNA polymerase, which transcribes the negative-polarity genome into mRNA. 4. The genome consists of eight segments. These segments code for different proteins which are NS1, NS2, NP, M1, M2, M3, HA, and NA. 5. Two types of spikes or peplomers project from the envelope: (a) the triangular hemagglutinin (HA) peplomers and (b) the mushroom-shaped neuraminidase (NA) peplomers. | 6,227 | medmcqa_train |
Macrocytic anaemia in children is produced by all except - | Ans. is 'c' i.e., Copper deficiency Morphology of RBC o Normal human red blood cells are biconcave discs (diskocytes) with a.mean diameter of about 7.5 m. o The hemoglobin of red cells is located peripherally, leaving an area of central pallor equal to approximately 30-35% of diameter of the cells. o Cells of normal size and normal hemoglobin content (color) are termed normocytic and nonmochromic. o When red cells diameter is greater than 9 mm, they are referred as macrocytes. o When red cells diameter is less than 6 mm, they are referred as microcytes. o Variation in size of RBCs is known as anisocytosis. o Variation in shape of RBCs is known as poikilocytosis. Causes of macrocytosis o Causes of megaloblastic anaemia : Vitamin B deficiency : Decrease intake - Inadequate diet, vegetarianism. Impaired absorption : Intrinsic factor deficiency Pernicious anaemia Gastrectomy Malabsorption states Diffuse intestinal disease eg Lymphoma, systemic sclerosis. Heal resection, ilitis Competitive parasitic uptake eg. fish tape worm infestation. Bacterial over growth in blind loops and diveicula of bowel. Increased requirement: pregnancy, hypehyroidism, disseminated cancer. Folic acid deficiency : Decreased intake : inadequate diet, alcoholism & infancy Impaired absorption e.g. malabsorption state Intestinal diseases Anticonvulsants, OCP. Increased loss: haemodialysis Increased requirement : Pregnancy, infancy, disseminated cancer & markedly increased haemoptysis. Impaired use : folic acid antagonist. Other causes of megaloblastic anemia Thiamine deficiency Hereditary orotic aciduria Congenital dyserythropetic anemia Pyridoxine deficiency Di-Gueglielrno syndrome Hypothyroidism | 6,228 | medmcqa_train |
Lateral Medullary Syndrome involves all of the following cranial nerves, Except: | Answer is D (XII CN): Cranial Nerve XII is involved in the Medial medullary syndrome and not in Lateral medullary syndrome. Lateral Medullary Syndrome involves the spinal nucleus of the trigeminal nerve and its tract (CN V); Vestibular nuclei (CN VIII); Nucleus Ambiguous (IX, X, XI) and fibers of the cranial nerves IX and X. Cranial Nerves involved in Lateral Mediallary syndrome: V, VIII, IX, X, XI | 6,229 | medmcqa_train |
Bivalent meningococcal vaccine is ? | Ans. is 'b' i.e., A C Two type of meningococcal vaccine develop Unconjugated polysaccharide vaccine. Conjugated group C vaccine. Polysaccharide vaccines Internationally marketed meningococcal polysaccharide vaccines are o Bivalent (A and C), Trivalent (A, C and W-135) Tetravalent (A, C, Y and W-135). The vaccines are purified, heat-stable, lyophilized capsular polysaccharides from meningococci of the respective serogroups. A protective antibody response occurs within 10 days of vaccination. In schoolchildren and adults, one dose of these polysaccharide vaccines appears to provide protection for at least 3 years, but in children under 4 years of age the levels of specific antibodies decline rapidly after 2-3 years. | 6,230 | medmcqa_train |
A patient has extremely enlarged palatine tonsils. You suggest surgical removal of the tonsils, but you do explain that there is a small risk of the surgery, which may result in which of the following? | The palatine tonsil sits in the lateral wall of the oropharynx in the palatine arch posterior to the palatoglossus muscle and anterior to the palatopharyngeus muscle. In the bed of the palatine tonsil runs the glossopharyngeal CN (IX) that carries afferent information back to the brain regarding both general sensation and the special sense of taste from the posterior one-third of the tongue. The glossopharyngeal nerve is at risk for being cut during tonsillectomy. The ability to taste in the anterior two-thirds of the tongue is not at risk because that information is carried by the lingual nerve, below the tongue. The ability to protrude your tongue is provided by innervation from the hypoglossal nerve, which innervates all the intrinsic tongue muscles and lies below the tongue and is not a risk. Neither the ability to open your jaw wide nor to move your jaw from side to side is controlled by the mandibular division of the trigeminal CN (V), which does not course near the palatine arch and would not be at risk. | 6,231 | medmcqa_train |
A per NFHS III data, the wealthiest state is: | Delhi has the highest percentage of population (70%) in the highest quintile of wealth index, followed by Goa (55%). States with low wealth index include Chhattisgarh and Orissa. Ref: Park 21st edition page: 639. | 6,232 | medmcqa_train |
Calcification is best detected by - | Calcification is best detected by CT scan. | 6,233 | medmcqa_train |
A 3-day-old male has a noticeably small mandible. A CT scan and physical examinations reveal hypoplasia of the mandible, cleft palate, and defects of the eye and ear. Abnormal development of which of the following pharyngeal arches will most likely produce such symptoms? | The listed symptoms are typical of first arch syndrome because the first arch normally gives rise to muscles of mastication, mylohyoid, anterior belly of the digastric, tensor tympani, tensor veli palatini, malleus, and incus. Abnormal development of the second arch would affect the muscles of facial expression, the stapes, and parts of the hyoid bone. Abnormal development of the third pharyngeal arch would affect only the stylopharyngeus and parts of the hyoid bone. Abnormal development of the fourth and sixth arch would affect various muscles and cartilages of the larynx and pharynx and would not produce the hypoplastic mandible characteristic of first arch syndrome. | 6,234 | medmcqa_train |
A 70-year male utters same answers to all questions. He is suffering from | Same answers to all questions' can be seen in schizophrenia, mania and organic brain disease also but the age factor in this question is pointing more towards organic brain disease like dementia. Hence option C is more appropriate answer among the given options. Reference: The peak ages of onset of schizophrenia are 10 to 25 years for men and 25 to 35 years for women.About 90 percent of patients in treatment for schizophrenia are between 15 and 55 years old. Onset of schizophrenia before age 10 years or after age 60 years is extremely rare. The age of onset for bipolar I disorder ranges from childhood (as early as age 5 or 6 years) to 50 years or even older in rare cases, with a mean age of 30 years. The mean age of onset for major depressive | 6,235 | medmcqa_train |
Onset of post spinal headache is usually at hours after spinal anesthesia | Ans. is 'c' i.e., 12 - 72 | 6,236 | medmcqa_train |
A 6-year old child who presented with perianal pruritus, excoriation of skin and nocturnal enuresis was found to be infected with a parasite causing autoinfection. The infective form of parasite for humans is the - | Enterobius vermicularus mainly affects children. The gravid female worm lays ova around the anus ,causing itching especially at night .The ova are often carried to the mouth on the fingers & so re-infection or human to human infection takes place. Reference: Harrison20th edition pg 1120 | 6,237 | medmcqa_train |
Child admitted with meningitis. Examination reveals gram negative diplococci. History of previous similar infection is present with same organism. Which of the following should be suspected? | Ans: A (Complement deficiency) Ref: Harrison's Principles of Internal Medicine, 17th edition, 2008, Chapter 136, pg: 911 and Nelson Textbook of Pediatrics, 19th editionExplanation:Defects in Complement SystemHost DefectDisease or Therapy Associated With DefectCommon Etioiogic Agent of InfectionC3* Congenital liver disease* SLE* Nephrotic syndrome* S. aureus* S. pneumoniae* Pseudomonas spp* Proteus spc.C5* Congenital* Neisseria spp.* Gram-negative rodsC6,C7,C8* Congenital,* SLE* Neisseria meningitidis* N. qonorrhoeaeAlternativepathway* Sickie cell disease* S. pneumonia* Salmonella spp. | 6,238 | medmcqa_train |
Non coding RNAs are: | A, B, C, i.e. siRNA, miRNA, tRNANoncoding (nc) RNAs are all RNAs that do not encode protein. They are also called non protein coding (npc) RNA, non-messenger (nm) RNA, small (s) RNA, and functional (fl RNA. The gene (DNA sequence) from which a nc-RNA is transcribed as end product is called non coding RNA gene or RNA gene.Non coding (nc) RNAs include ribosomal (r) RNA, transfer (t) RNA, small nuclear (sn) RNA, small nucleolar (sno) RNA, sca RNA, small temporal (st) RNA, micro (mi) RNA, small interfering (si)RNAQ, pi RNA, rasi RNA, line RNA, antisense RNA, and long nc RNAs like Xist & HOTAIR,Messenger (m) RNA is a coding RNA. | 6,239 | medmcqa_train |
All of the following is true about achalasia cardia except- | Ans. is 'b' i.e., Males are affected more than the females * Achalasia cardia is a motor disorder of the esophageal smooth muscle in which the LES does not relax normally with swallowing, & the esophageal body undergoes nonperistaltic contractions. (Primary peristalsis is absent or reduced).* The pathogenesis of Achlasia is poorly understood.* It involves:# Neurogenic degeneration either idiopathic or due to infection. The degenerative changes are either intrinsic (degeneration of ganglion cells of Aurebach'smyentric plexus) or extrinsic (extraesophagealvagus nerve or the dorsal motor nucleus of vagus)# Pharmacologic studies suggest dysfunction of inhibitory neurons containing nitric oxideand vasoactive intestinal polypeptide in the distal esophagus (LES). The cholinergic innervation of the LES is intact or affected only in advanced disease.* Asa result of the abnormality, the LES fails to relax, primary peristalsis is absent in esophagus which dilates. As the disease progresses the esophagus becomes massively dilated and tortuous.Clinical findings# Both sexes are equally affected # May develop at any age but peak years are from 30 to 60.# Classical clinical symptom is progressive dysphagia for both solids and liquids. Dysphagia is worsened by emotional stress and hurried eating.# Regurgitation and Pulmonary aspiration occur because of retention of large volumes of saliva and ingested food in the esophagus.# Esophagitis with ulceration may occur with chronic retention of food.# Pain is infrequent in classical achlasia but a variant called vigrous achlasia is characterized by chest pain and esophageal spasms that generate non-propuloine high-pressure waves in the body of the esophagus.Diagnosis# Chest x-ray - shows absence of gastric air bubble, an air-fluid level in the mediastinum in the upright position representing retained food in oesophagus.# Barium swallow - shows dilated esophagus with tapering narrowing in the terminal end of esophagus described as 'birds' beak' appearance. Fluoroscopy shows loss of normal peristalsis in the lower two thirds of esophagus.# Endoscopy may be done to rule out any secondary cause of achlasiaeg. carcinoma, stricture at LES.Manometry# It's the most confrmatory investigation# it is able to distinguish between various forms of motor disorders of esophagus# Manometric characteristics of Achlasia* Incomplete lower esophageal sphincter relaxation (< 75% relaxation)* Elevated LES pressure* Loss of primary peristaltic waves in the esophageal body, but disorganized muscular activity may be present.* Increased intraesophageal baseline pressure relative to gastric baseline.* Cholecystokinin (CCK) which normally causes a fall in the sphincter pressure, paradoxically causes contraction of the LES (the CCK test). This paradoxical response occurs because, in achlasia the neurally transmitted inhibitory effect of CCK is absent owing to the loss of inhibitory neurons. | 6,240 | medmcqa_train |
Fenestration operation is which type of tympanoplasty? | Types of Tympanoplasty Wullstein classified tympanoplasty into five types . Type I Defect is perforation of tympanic membrane which is repaired with a graft. It is also called myringoplasty. Type II Defect is perforation of tympanic membrane with erosion of malleus. Graft is placed on the incus or remnant of malleus. Type III Malleus and incus are absent. Graft is placed directly on the stapes head. It is also called myringostapediopexy or columella tympanoplasty. Type IV Only the footplate of stapes is present. It is exposed to the external ear, and graft is placed between the oval and round windows. A narrow middle ear (cavum minor) is thus created to have an air pocket around the round window. A mucosa-lined space extends from the eustachian tube to the round window. Sound waves in this case act directly on the footplate while the round window has been shielded. Type V Stapes footplate is fixed but round window is functioning. In such cases, another window is created on horizontal semicircular canal and covered with a graft. Also called Fenestration operation. Re: Textbook of Ear, Nose and Throat, Dhingra, 6th Edition, page 30. | 6,241 | medmcqa_train |
External Cephalic Version (ECV) is contraindicated in all of the following , EXCEPT? | ECV -Absolute contraindications : Placenta pre Multifetal gestation Severe contracted pelvis - Relative contraindications Early labor oligohydramnios or rupture of membranes structural uterine abnormalities fetal growth restriction prior abruption | 6,242 | medmcqa_train |
The external urethral sphincter is located in which of the following regions? | The external urethral sphincter is the voluntary sphincter composed of skeletal muscle, the sphincter urethrae muscle. This muscle, along with the deep transverse perineal muscle, are in the deep perineal space and form the muscular layer of the urogenital diaphragm. The internal urethral sphincter is composed of smooth muscle in the neck of the bladder. The internal and external sphincters are both open during micturition. During ejaculation, the external sphincter is open and the internal sphincter is closed. | 6,243 | medmcqa_train |
Neurotransmitter released in response to raised blood pressure: | Ans. A. AcetylcholineWhenever blood pressure rises, there is reflex stimulation of baroreceptors. These release Ach and depress the heart. | 6,244 | medmcqa_train |
A 43-year-old man is hit in the face with a baseball bat and presents to the emergency department with massive facial swelling, ecchymosis, and an elongated face. There is mobility of the middle third of the face on digital manipulation of the maxilla. What is the likely diagnosis? | The physical findings are characteristics of a Le Fort III fracture (Figure below). In this injury, the fracture passes through maxilla and nasal bones and above the zygomatic bone.Classic Le Fort fracture patterns | 6,245 | medmcqa_train |
Ovary develop from: | Ans. is b, i.e. Genital ridgeRef: Dutta Gynae 8th/ed, p38Male and female derivatives of embryonic urogenital structures.Part of female genital systemOriginates fromOvaryGenital ridgeFallopiantubesUterus CervixUpperpartofvagina [?][?][?][?][?][?][?][?][?] Mullerian/paramesonephric ductLower part of vaginaSinovaginal bulb/urogenital Sinus | 6,246 | medmcqa_train |
Characteristic toxicity of daxorubicin - | Ans. is 'b' i.e., Cardiotoxicity Anthracvclineso Anthracyclines are anticancer antibiotics and they include Doxorubicin (Adriamycin) and Daunorubicin.o The major toxicity of anthracyclines is potentially irreversible cumulative dose related toxicityo They may causes arrhythmias and cardiomyopathy. Because of their carditoxicity these drugs should be avoided in the patient with MI and CHF.o The antracyclines exert their anticancer activity through four major mechanisms -1. Inhibition of topoisomerase II2. Blockade of synthesis of DNA & RNA, and DNA strand scission.3. Alter fluidity and ion transport.4. Generation of semiquinone free radicals and oxygen free radicals - this free radical mechanism is the cause of cardiotoxicity.o This cardiootoxicity can be prevented by using dexrazoxane (a free radical scavenger) and a-tocopherol.o Liposomal forms of these drugs also reduce cardiac toxicity.o Adverse effects - Dose related myelosuppression with neutropenia, dose limiting mucositis, cardiotoxicity (AI 96, 94, AIIMS 93)o Uses of Doxorubicin# Ca Breast# Ca Endometrium# Ca ovary# Ca testicle# Ca thyroid# Ca lung# Hodgkin s disease# Non Hodgkin disease# Sarcomaso Uses of Daunorubicin# It has far narrower spectrum of activity than Doxorubicin# It is mainly used in acute leukemia. | 6,247 | medmcqa_train |
Which of the following event occurs during the ovulation phase ? | The activins and inhibins are glycoproteins that belong to the transforming growth factor -b superfamily. They are secreted from granulose cells. FSH induces steroidogenesis (estradiol production) in granulosa cells in the preovulatory phase (follicular phase). Stimulation of the arrested meiotic division of the ovum occurs at ovulation, till then the oocyte is resting in the prophase of the first meiotic division. This is the reason why the 1st polar body is released along with ovulation. (The second polar body is released after feilisation). Inhibin B has shown increased levels in mid-follicular phase, has a periovular peak, and then declines in luteal phase. Inhibin A is low in follicular phase, reaches a small peak in mid-follicular phase, and increases to reach a peak in luteal phase. Just like inhibin, which is a inhibitory co-molecule of FSH, Activin is also a co-molecule of FSH and is increased when action of FSH is required. i.e. action of FSH is activin mediated. Hence, activin will be highest when the FSH action is maximum in the early follicular phase | 6,248 | medmcqa_train |
The Ames test is a method for detecting | Mutagenesis in bacteria The Ames test is carried out in Salmonella and detects mutations in the bacterial DNA. Because mutagenic potential is associated with carcinogenic risk for many chemicals, the Ames test is often used to claim that a paicular agent may be a carcinogen. However, the test itself only detects mutations. | 6,249 | medmcqa_train |
Ureteric constriction is seen at all the following positions, except | Ureter has three constrictions, which are the most common sites of renal calculus obstruction: at the pelvi-ureteric junction (PUJ) of the renal pelvis and the ureter as the ureter enters the pelvis and crosses over the common iliac aery bifurcation at the vesicoureteric junction (VUJ) as the ureter obliquely enters the bladder wall Ref - BDC vol2 6e , researchgate.net | 6,250 | medmcqa_train |
Most important muscle which opens mouth is - | Lateral pterygoid depresses the mandible to open the mouth, with suprahyoid muscles. | 6,251 | medmcqa_train |
Temp of water used to cool the burn wound? | 15ºC is the best temp for cooling burn wound. | 6,252 | medmcqa_train |
A male 45 years old presents to the dental clinic with pain in lower back tooth region. Intraoral examination reveals carious 36. Root canal treatment done and metal ceramic crown has to be placed. Dentist makes an impression. All of the following are the properties of the material except: | To produce accurate replicas of intra- and extraoral tissues, the impression materials should be:
Sufficiently fluid to adapt to the oral tissues.
Viscous enough to be contained in a tray.
Able to transform (set) into a rubbery or rigid solid in the mouth in a reasonable time (less than 7 min).
Resistant to distortion or tearing when removed from the mouth.
Dimensionally stable long enough to allow one or more casts to be poured.
Biocompatible.
Cost-effective in terms of time as well as the expense of the associated processing equipment.
Key Concept:
The impression material should be resistant to distortion or tearing when removed from the mouth.
Reference: Phillips’ science of dental materials / Kenneth J. Anusavice, Chiayi Shen, H. Ralph Rawls.—12th ed.Page no 152 | 6,253 | medmcqa_train |
Desert rheumatism is caused by: | Ans. C. CoccidioidesSporothrix (Sporotrochosis), Histoplasma (Histoplasmosis), Coccidioides (Desert rheumatism or Valley fever), Paracoccidioides (South American Blastomycosis), Blastomyces (North American Blastomycosis), Talaromycesmarneffei. | 6,254 | medmcqa_train |
A 40 year old female presented with numerous, nonitchy, erythematous scaly papules (lesions) on trunk, with few oral white mucosal plaques. She also had erosive lesions in perianal area. The probable diagnosis is | B i.e. Secondary syphilis Secondary syphilis presents with generalized, symmetrical, nonitchy, coppery red maculoppular lesions (+- scales) on trunk, extremities and even palm and solesQ. Oral and genital superficial mucosal erosion (patches) are painless silver-grayQ surrounded by red periphery. And warm, moist, interiginous areas (such as perianal area, vulva and scrotum) show large, hyperophic, coalesced gray-white, highly infections papules (Condylomata lata)Q. | 6,255 | medmcqa_train |
Based on the type of life cycle, zoonoses are classified into all of the following except - | Ans. is 'c' i.e., Anthropozoonoses Classification of zoonoses 1) Based on direction of transmission : (i) Anthropozoonoses, (ii) Zoonthroponoses, and (iii) Amphixenoses 2) Based on type of life cycle : (i) Direct zoonoses, (ii) Cyclo-zoonoses, (iii) Meta-zoonoses, and (iv) Sporozoonoses. | 6,256 | medmcqa_train |
A 58 year old male alcoholic with chronic pancreatitis develops a palpable abdominal mass. Ultrasound reveals a 9 cm cystic lesion adjacent to the pancreas. An impoant complication that might occur if this cyst ruptured would be? | The patient most likely has a pancreatic pseudocyst, which is a complication of pancreatitis. Pancreatic pseudocyst is not a true cyst; it is lined by granulation tissue and collagen. It contains pancreatic juices and lysed blood, so rupture would spill the active digestive enzymes onto the adjacent viscera, paicularly the stomach, small intestine, and transverse colon. Digestive action produces potentially severe gastrointestinal hemorrhage. Anaphylactic shock results from massive activation of the IgE-mediated branch of the immune system. Pancreatic secretions do not elicit an IgE response. The classic abdominal cyst that ruptures, producing anaphylactic shock, is a hydatid cyst. Carcinomatosis is widespread serosal spread of a carcinoma, typically due to tumor spillage into a body cavity. Although this may occur with pancreatic mucinous cystadenocarcinoma, this disease is far less likely to occur than is pancreatic pseudocyst in a patient with chronic pancreatitis. Pancreatic pseudocyst is not an infective disease. Although septic abscesses do occur in the abdomen, and may even complicate a pancreatic pseudocyst, the danger of rupture is more associated with tissue destruction by pancreatic enzymes than with infection. Ref: Fisher W.E., Anderson D.K., Bell R.H., Saluja A.K., Brunicardi F.C. (2010). Chapter 33. Pancreas. In F.C. Brunicardi, D.K. Andersen, T.R. Billiar, D.L. Dunn, J.G. Hunter, J.B. Matthews, R.E. Pollock (Eds), Schwaz's Principles of Surgery, 9e. | 6,257 | medmcqa_train |
What is the wavelength of light used in light cure system: | The range is 400-500nm.
But if question has been asked for specific wavelength then 474nm is more appropriate. | 6,258 | medmcqa_train |
Signs and symptoms usually develop within 15-30 minutes of strychnine ingestion. What is the fatal dose of strychnine? | Strychnine poisoning: It is an alkaloid derived from the seeds of the tree Strychnos nux-vomica. The potentially fatal dose of strychnine is approximately 50-100 mg (1 mg/kg) and fatal period is 1-2 hours. Strychnine competitively antagonizes glycine, an inhibitory neurotransmitter released by postsynaptic inhibitory neurons in the spinal cord. Muscular stiffness and painful cramps precede generalized muscle contractions, extensor muscle spasms, and opisthotonus. Death usually is caused by respiratory arrest that results from intense contraction of the respiratory muscles. Ref: Nordt S.P. (2012). Chapter 145. Strychnine. In K.R. Olson (Ed), Poisoning & Drug Overdose, 6e. | 6,259 | medmcqa_train |
Which of the following drugs decreases the effect of levodopa- | Ans. is 'c' i.e., Vit. B complex Interactions of levodopa Pyridoxine abolishes the therapeutic effect by enhancing peripheral decarboxylation of levodpa. Less levodpoa is thus available to cross BBB, to be conveed into dopamine in dopaminergic neurones in CNS Phenothiazines, butyrophenones, and metoclopramide reverse therapeutic effect by blocking DA receptors. The antidopaminergic domperidone blocks levodopa induced nausea and vomiting without abolishing its antiparkinsonian effect, because domperidone does not cross the blood brain barrier. Reserpine abolishes levodopa action by preventing entry of DA into synaptic vesicles. Nonselective MAO inhibitors: prevent degradation of peripherally synthesized DA and NA hypeensive crisis may occur. Atropine and other anticholinergic drugs have additive antiparkinsonion action, but retard its absorption more time is available for peripheral degradation Efficacy of levodopa may be reduced. Note : Pyridoxine is a component of vit B complex. | 6,260 | medmcqa_train |
Which of the following contraceptives can prevent a pregnancy when used alone after an act of unprotected intercourse? | Emergency contraceptives IUCD: Can prevent implantation up till 5th day of unprotected inter-course Progesterone only pill: LNG 1.5 mg :can reduce tubal motility , make endometrium 'Out of Phase" for implantation of embryo Combined Pill: the Yuzpe regimen can prevent embryo implantation since the estrogen component makes the endometrium unreceptive. Mifepristone, Antiprogestin, RU 486, prevents implantation Ulipristal acetate: SPRM: Selective progesterone receptor modulator | 6,261 | medmcqa_train |
All except one are true about spinothalamic tract | Anterior spinothalamic tract joins medial lemniscus. | 6,262 | medmcqa_train |
Hypercalciuria is seen in - | <p>Primary hyperparathyroidism is a generalized disorder of calcium, phosphate, and bone metabolism due to an increased secretion of PTH. The elevation of circulating hormone usually leads to hypercalcemia and hypophosphatemia. There is great variation in the manifestations. Patients may present with multiple signs and symptoms, including recurrent nephrolithiasis, peptic ulcers, mental changes, and, less frequently, extensive bone resorptionHypercalcemia in vitamin D intoxication is due to an excessive biologic action of the vitamin, perhaps the consequence of increased levels of 25(OH)D rather than merely increased levels of the active metabolite 1,25(OH) 2 D (the latter may not be elevated in vitamin D intoxication). 25(OH)D has definite, if low, biologic activity in the intestine and bone. The production of 25(OH)D is less tightly regulated than is the production of 1,25(OH) 2 D. Hence concentrations of 25(OH)D are elevated severalfold in patients with excess vitamin D intakeIn patients with sarcoidosis and other granulomatous diseases, such as tuberculosis and fungal infections, excess 1,25(OH) 2 D is synthesized in macrophages or other cells in the granulomas.Indeed, increased 1,25(OH) 2 D levels have been repoed in anephric patients with sarcoidosis and hypercalcemia. Macrophages obtained from granulomatous tissue conve 25(OH)D to 1,25(OH) 2 D at an increased rate. There is a positive correlation in patients with sarcoidosis between 25(OH)D levels (reflecting vitamin D intake) and the circulating concentrations of 1,25(OH) 2 D, whereas normally there is no increase in 1,25(OH) 2 D with increasing 25(OH) D levels due to multiple feedback controls on renal 1a-hydroxylase(harrison 18 pg 3108)</p> | 6,263 | medmcqa_train |
Following anatomical changes predisposes to angle closure glaucoma except: March 2007 | Ans. B: Flat cornea Angle closure glaucoma is caused by contact between the iris and trabecular meshwork, which in turn obstructs outflow of the aqueous humor from the eye. Predisposing factors include sho eye, small corneal diameter, a shallow anterior chamber, and a relative anterior positioning of the lens-iris diaphragm. These all lead to a very narrow space at the angle of the anterior chamber. In over half of all cases, prolonged contact between iris and TM causes the formation of synechiae (effectively "scars"). These cause permanent obstruction of aqueous outflow. Diagnosis is made from physical signs and symptoms: very highly raised intraocular pressure,pupils are veically oval and mid-dilated and unresponsive to light, cornea edematous (cloudy), reduced vision, redness, pain. Once any symptoms have been controlled, the first line (and often definitive) treatment is laser iridotomy. This may be performed using either Nd:YAG or argon lasers, or in some cases by conventional incisional surgery. In early to moderately advanced cases, iridotomy is successful in opening the angle in around 75% of cases. In the other 25% laser iridoplasty, medication (pilocarpine) or incisional surgery may be required. | 6,264 | medmcqa_train |
Which of the following ovarian tumor is most prone to undergo torsion during pregnancy : | "A benign cystic teratoma is the most common neoplasm to undergo torsion, and it to the M/C benign tumor diagnosed during pregnancy." A benign cystic teratoma is synonymous to dermoid cyst. REF : gynecology book of shaw 17th | 6,265 | medmcqa_train |
Per TCA with 3 NADH and 1 FADH2, generates how many ATP- | Ans. is 'b' i.e., 9 o One N ADH produces 2.5 ATP and one FADH2 produces 1.5 ATP. Thus 3 NADH and 1 FADH2 will produce 9 ATP.o There is production of ATP at substrate level also. Thus total 10 ATP molecules are produced per cycle.Energetics of TCA cycles iKreb's cycle)o One turn of the TCA cycle, starting with acetyl CoA produces 10 ATPs. When the starting molecule is pyruvate, the oxidative decarboxylation of pyruvate, the oxidative decarboxylation of pyruvate yields 2[?]5 ATPs and therefore, 12[?]5 ATPs are produced when starting compound is pyruvate. Since, two molecules of pyruvate enter the TCA cycle when glucose is metabolized (glycolysis produces 2 molecules of pyruvate), the number of ATPs is doubled. Therefore, 25 ATP molecules, per glucose molecule, are produced when pyruvate enters the TCA cycle,o Note : Previously calculations were made assuming that NADH produces 3 ATPs and FADH generates 2 ATPs. This will amount a net generation of 30 ATP molecules in TCA per molecule glucose and total 38 molecules from starting. Recent experiments shoiv that these values are overestimates and NADH produces 2[?]5 ATPs and FADH produces T5 ATPs. Therefore, net generation during TCA is 25 ATPs and complete oxidation of glucose through glycolysis plus citric acid cycle yield a net 32 ATPs.o Energy yield (number of ATP generated) per moleeule of glucose wrhen it is completely oxidized through glycolysis plus citric acid cycle, under aerobic conditions, is as follows :- Method ofATP formationNo of ATPs gained perglucose (new calculation)No of ATPs As per old calculationPathwayStepEnzymeSource Glycolysis1 Hexokinase.Minus 1Minus 1Do3Pbosphofructoki nase-Minus 1Minus 1Do5Glyceraldehyde-3-p DHNADHRespiratory chain2-5x2 = 53x2=6Do61,3-BPG kinaseATPSubstrate level1x2= 21x2=2Do9Pyruvate kinaseATPSubstrate level1x2= 21x2=2Pyruvate to-PyruvateNADHRespiratory chain2-5x2= 53x2=6Acetyl CoA Dehydrogenase TCA cycle3Isocitrate DHNADHRespiratory chain2-5x2= 53x2=6Do4Alpha keto giutarate DHNADHRespiratory chain2-5x2= 53x2=6Do5Succinate thiokinaseGTPSubstrate level1x2= 21x2=2Do6Succictnate DHFADH2Respiratory chain1-5x2= 32x2=4Do8Malate DHNADHRespiratory chain2-5x2= 53 x 2= 6Net generation in glycolytic pathway 9 minus 2=710 minus 2=8Generation in pyruvate dehydrogenase reaction=5 =6Generation in citric acid cycle=20 =24Net generation of ATP from one glucose mole=32 =38 | 6,266 | medmcqa_train |
"Microabscess of munro" is seen in: | Ans: b (Psoriasis) Ref: Pavithran's textbook of dermatology, p. 14,15Micro abscess of Munro is seen in psoriasis.PsoriasisType IType IIHeriditaryStrong HLA association (HLA CW6)Severe course and early onsetArthropathy more common.SporadicHLA unrelatedMild course and late onsetThe most important locus for psoriasis susceptibility is Psors 1 (psoriasis susceptibility locus on chromosome 6p 21.3.T cells(helper) are fundamental in activating the disease process. The trigger to their activation may be conventional antigens or bacterial superantigens.Histopathology of psoriasis# Parakeratosis# Micro munro abscess-collection of neutrophils in stratum comeum# Spongiform pustules of Kogoj-aggregates of neutrophil in stratum spinosum.# Acanthosis with regular elongation of rete ridges-camel foot appearance.# Edema of dermal papillae with dilated & tortuous capillaries.Treatment of choice for generalized pustular psoriasis & psoriatic erythroderma is-Acetretin | 6,267 | medmcqa_train |
Lipopolysaccharide structure is characteristic of - | Endotoxins heat stable lipopolysaccharides which form an integral pa of the cell wall of gram-negative bacteria . Their toxicity depends on the lipid component. They are released only by the disintegration of the cell wall. They cannot be toxoided. They are poor antigens and their toxicity is not completely neutralized by the homologous antibodies. they are active only in relatively large doses. Ref Ananthanarayan & paniker's Textbook of Microbiology 9th edition pg no 74. | 6,268 | medmcqa_train |
A 60-year-old nursing home resident presents with a 3-day history of progressive shortness of breath and cough. The lung examination reveals right basilar crackles. The chest x-ray shows right lower lobe consolidation. Sputum culture grows methicillin-resistant Staphylococcus aureus (MRSA) Select the most appropriate isolation precaution. | There are four types of isolation precautions that can be implemented in health care settings. Any given patient might require more than one type of precaution. Standard precautions apply when interacting with any patient, regardless of the diagnosis. They include hand washing before and after contact with every patient and the use of gloves, gowns, masks, and eye protection when contact with open sores, blood, or body secretions is anticipated. Contact precautions reduce the risk of spreading microorganisms that are transmitted by direct or indirect contact. They include private room placement of the patient and the use of gloves and gowns when in contact with the patient or the immediate environment. Contact precautions are indicated in patients colonized or infected with MRSA, vancomycin-resistant enterococci (VRE), and C difficile.Droplet precautions limit the transmission of infections that are carried in respiratory droplets (>5 mm in size) such as influenza and meningococcal meningitis. Droplet precautions include placing the patient in a private room and asking health care professionals to use surgical masks within 3 ft from the patient. Airborne precautions reduce the risk of airborne particulate (particles less than 5 mm in size) transmission of infectious agents such as tuberculosis. The patient is placed in a private negative-pressure room with high-efficiency masks, such as the N95 mask, worn by all health care professionals upon entering those rooms. The patient has health care-associated MRSA pneumonia and requires contact precautions. | 6,269 | medmcqa_train |
Transcripton is inhibited by: | A i.e. Actinomycin | 6,270 | medmcqa_train |
Triage is – | Triage
When the quantity and severity of injuries overwhelm the operative capacity of health facilities, a different approach to medical treatment must be adopted.
The usual principle of first come, first treated", is not followed in mass emergencies.
Triage consists of rapidly classifying the injured and the likelihood of their survival with prompt medical intervention.
Higher priority is granted to victims whose immediate or long-term prognosis can be dramatically affected by simple intensive care.
Moribund patients who require a great deal of attention, with questionable benefit have the lowest priority. | 6,271 | medmcqa_train |
All of the following are true in respect of hereditary angioneurotic edema (HAE), except: | Hereditary angioneurotic edema (HAE) It is caused by an inherited deficiency of C1 esterase inhibitor that results in excessive activation of the early components of the complement system and production of vasoactive mediators. Angioneurotic edema is classically non-pitting in nature. Uicaria(hives) may develop simultaneously, pruritus is not present. In severe cases, stridor of the airway occurs, with gasping or wheezy inspiratory breath sounds. It is an autosomal dominant disorder. | 6,272 | medmcqa_train |
A 63-year-old bartender presents at his physician's office complaining of a painful sore on his tongue. On examination, it is found that he has an ulcerated lesion on his tongue and a mass in the submandibular gland triangle. What is the most likely diagnosis? SELECT ONE. | The tip of the tongue drains into the submental lymph nodes, whereas, the side of the tongue drains into the submandibular lymph nodes. | 6,273 | medmcqa_train |
Urogenital Diaphragm is made up of the following, except: | Colle's fascia does not contribute to the Urogenital Diaphragm. It is attached posteriorly to the posterior border of the urogenital diaphragm but does not form pa of this diaphragm. Ref: BDC, Volume 2, 4th Edition, Page 332; Grants Method of Anatomy, 11th Edition, Page 244; Gray's Anatomy, 36th Edition, Page 563 | 6,274 | medmcqa_train |
Child with Type I Diabetes. What is the advised time for fundus examinations from the time of diagnosis? | Screening for diabetic retinopathy To prevent visual loss occurring from diabetic retinopathy a periodic follow-up is very impoant for a timely intervention. The recommendations for periodic fundus examination are as follows : First examination, 5 years after diagnosis of type 1 DM and at the time of diagnosis in type 2 DM. Every year, till there is no diabetic retinopathy or there is mild NPDR. Every 6 months, in moderate NPDR. Every 3 months, in severe NPDR Every 2 months, in PDR with no high-risk characteristics. Ref;A.K.Khurana; 6th edition; Page no: 280 | 6,275 | medmcqa_train |
Most sensitive test for H pylori is- | <P>Davidson&;s principles and practice of medicine 22nd edition. *biopsbiopsy unease test is cheap,quick ,specific(95%) and sensitivity (85%)</p> | 6,276 | medmcqa_train |
Cushing syndrome is characterized by all except * | Cushing&;s syndrome characterised by centripetal obesity , hypeension, fatigability, weakness, edema , glucosuria( Harrison 17 pg 2254) | 6,277 | medmcqa_train |
Ligation of the common hepatic aery will compromise blood flow in | Rt. Gastric aeryarises from common hepatic aery andRt. Gastroepiploic aeryarises fromgastroduodenal aerywhich is a branch of common hepatic aery. Therefore,ligation of common hepatic aerywill lead to impaired blood supply inRt. Gastric aeryandRt. Gastroepiploic aery. Left gastric aery arises from CT. Sho gastric aeries arise from splenic aery. | 6,278 | medmcqa_train |
Typhoid investigation of choice in 1st week | (A) Blood culture # Typhoid investigation of choice code 'BASU'> 'B' i.e. Blood culture in the first week (Better is Bone Marrow culture)> 'A' i.e. Antibodies (Widal) in the second week> 'S' i.e. Stool culture in the third week> 'U' i.e. Urine culture in the 4th week> Widal test shows diagnostic titre for S. typhii usually after 7 to 10 days of the illness - 2nd week> Positivity with Widal test is maximum in third week.> Widal - The agglutinins tested by the Widal test appear by the end of the first week. The titre increases steadily till the third or the fourth week, after which it declines gradually.> Maximum titre is found in third week.> Blood culture- They are positive in approximately 90% of cases in the first week of fever, 75% of cases in the second week, 60% in the third week and 25% thereafter till the subsidence of pyrexia. Test of choice in first week.> Stool culture - Salmonellae are shed in the faeces throughout the course of the disease and even in convalescence, with varying frequency. So a positive fecal culture may occur in carriers as well as in patients. Thus the test is not very useful for a recent infection.> Urine culture - Salmonellae are shed in the urine irregularly and infrequently. Cultures are generally positive only in the second and third weeks and then only in about 25% of cases. | 6,279 | medmcqa_train |
A series of posters which are continuous and gives an idea about a subject is called: | Ans: d (Flip chart) Ref: Park, 19h ed, p. 717Flip chart- They consist of a series of charts, each with an illustration pertaining to the talk to be given. They are meant to be shown one after another. The message on the chart must be brief and to the point.Flannel graph- A piece of rough flannel or khadi fixed over a wooden board provides a background for displaying cut out postures, graphs and other illustrations.Exhibits- Objects, models, specimen, etc convey a specific message to the viewer. | 6,280 | medmcqa_train |
Perforation of stomach is more common due to ingestion of - | Stomach perforation is more common with H2SO4. | 6,281 | medmcqa_train |
Which of the following inflammatory mediator doesn't cause fever: | Pyrogens A pyrogen is a substance that induces fever. These can be either internal (endogenous) or external (exogenous) to the body. The bacterial substance lipopolysaccharide (LPS), present in the cell wall of some bacteria, is an example of an exogenous pyrogen. Endogenous Pyrogens IL 1 TNF PGs Depyrogenation may be achieved through filtration, distillation, chromatography, or inactivation. | 6,282 | medmcqa_train |
Brown tumour is seen in | Brown's tumour: This is an expansile bone lesion, a collection of osteoclasts. It commonly affects the maxilla or mandible, though any bone may be affected. Commonly seen in Hyperpathyroidism Ref: Maheshwari 6e pg 313. | 6,283 | medmcqa_train |
The technique for accurate quantification of gene expression is | PCR Real-time PCR Traditional PCR For accurate quantification of the amount of initial DNA in the reaction Detects the DNA by electrophoresis at the end-point of the reaction | 6,284 | medmcqa_train |
A patient presents to the doctor with diplopia when looking towards the right. On examination, he is unable to move his right eye laterally past the midline. Damage to which of these nerves would produce this clinical presentation? | Clinical Presentation is of impaired abduction of one eye (right eye) d/t damage of VI nerve. Lateral rectus is paralysed | 6,285 | medmcqa_train |
Who was the first to determine the sequence of a polypeptide? | Sanger was the first to determine the sequence of a polypeptide. Mature insulin consists of the 21-residue A chain and the 30-residue B chain linked by disulfide bonds. Frederick Sanger reduced the disulfide bonds, separated the A and B chains, and cleaved each chain into smaller peptides using trypsin, chymotrypsin, and pepsin.
Ref: Harper’s illustrated biochemistry. 30th edition page no: 29 | 6,286 | medmcqa_train |
Indications of circumcision are all except: | Indications of Circumcision Phimosis Religion (Jews and Muslims) Paraphimosis Balanitis or balanoposthitis Recurrent UTI BXO (balanitis xerotica obliterans) | 6,287 | medmcqa_train |
The arrow marked structure is which part of corpus callosum: | Ans. D. SpleniumThe arrow marked structure is splenium of corpus callosum. | 6,288 | medmcqa_train |
Cytosolic cytochrome C plays an impoant function in - | Ans. is 'a' i.e. ApoptosisMechanism ofApoptosiso Apoptosis is induced by a cascade of molecular events that may be initiated in distinct ways but culminate in the activation of caspases.o Caspases are central to the pathogenesis of apoptosiso The process of apoptosis is divided into two phasesi) Initiation phase --> During this phase caspases become catalytically activeii) Execution phase --> During this phase caspases act to cause cell death. | 6,289 | medmcqa_train |
Trigeminal nerve has how many nucleus? | Ans. C.4Trigeminal nerve has four nuclei - 3 sensory and 1 motor nucleus.The sensory nucleus is divided into three parts, from rostral to caudal (top to bottom):a. The mesencephalic nucleusb. The chief sensory nucleus (or "main sensory nucleus" or "principal nucleus")c. The spinal nucleus | 6,290 | medmcqa_train |
The deformity of tibia in triple deformity of the knee is? | Flexion, posterior subluxation & external rotation REF: Apley's 8th ed p. 42 Triple deformity of knee consists of flexion, posterior subluxation of tibia and external rotation of tibia Treatment: ATT, Ahrodesis Causes: TB, Rheumatoid ahritis | 6,291 | medmcqa_train |
Dates are rich source of - | In dates calcium present is 120mg,vitamin C is 3,carotene is 44mg per 100mg of datesREF. PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICAL 21ST EDITION. PAGE NO - 581 | 6,292 | medmcqa_train |
Punishment for issuing false ceificate - | Sec 197 IPC: Issuing or signing the false ceificate Imprisonment up to 7 years. Ref: Dr. K.S. Narayan Reddy's Synopsis Of Forensic Medicine & Toxicology, 29th edition, Chap 3, Page-31. | 6,293 | medmcqa_train |
What is the most common site of origin of thrombotic pulmonary emboli? | An embolus is a detached intravascular mass that has been carried by the blood to a site other than where it was formed. Emboli basically can be thrombotic or embolic, but most originate from thrombi. These thromboemboli, most of which originate in the deep veins of the lower extremities, may embolize to the lungs. | 6,294 | medmcqa_train |
FDA approved antifungal treatment of mucormycosis? | Amphotericin B Deoxycholate is the only FDA approved drug for mucormycosis.Ref: Harrison 18th/pg 1663 | 6,295 | medmcqa_train |
Which of the following nipple discharge is most probably; physiological: | Ans. (b) B/L milky discharge with squeezing from multiple ductsRef: Bailey and Love 27th edition page 864* Bilateral milky discharge is from physiological lactation All other secretions may be pathological. | 6,296 | medmcqa_train |
Hallmark of breast malignancy on mammography? | Ans. c (Clusters of microcalcification) (Ref Graingerys Diagnostic Radiology, 4th ed., 2239)Diagnostic mammography verses screening mammography# Diagnostic mammography should not be confused with screening mammography, which is performed after a palpable abnormality has been detected. Diagnostic mammography is aimed at evaluating the rest of the breast before biopsy is performed or occasionally is part of the triple-test strategy to exclude immediate biopsy.# Subtle abnormalities (like clustered microcalcifications, densities , and new or enlarging architectural distortion) that are first detected by screening mammography should be evaluated carefully by compression or magnified views.Mammographic features of breast cancer- "Irregular" "Spiculated" margins (of the mass) is most common feature- Architectural distortion- High density lesion 0- clusters of pleomorphic "Microcalcifications" is pathognomonic sign (may be seen in 30% cases of invasive carcinoma and 95% of cases of DCIS ).- Others:# "sunburst" appearance.# True radiolucent halo is almost always benign.# Fat-containing lesions are never malignant. 0# Granular calcification (amorphous, dot-like/elongated, fragmented, grouped very close to each other) and casting calcification (fragmented cast of calcification within ducts) favour malignancy.# Ultrasound features of breast cancer- Spiculations- Taller than wide- Angular margins- Acoustic shadowing- Branch pattern- Markedly hypoechoic- Calcifications- Duct extension- MicrolobulationEducational Points about Mammography# Screening tool of choice for Ca breast.0# Cannot substitute biopsy.# Every female after the age of 40 yrs should undergo annual mammography screening.# If during screening a lesion with "low index" of suspicion for Ca is encountered, follow-up every 6 months should be done.# If while screening a lesion with "high index" of suspicion for Ca is found, stereotactic core biopsy should be done.# Radiation (X-ray) energy used is less than even a chest radiograph.# 'Target material" or anode in mammography X-ray tubes should be made up of molybdenum or rhodium (not tungsten as it produces higher energy x-rays than that of Mb).# K-edege X-ray filters are used.# "Mean/average glandular dose per mammography should be < 0.2 mGy or 0.02 cGy (optimum dose per mammo should be 0.1 mGy or 0.01 cGy).# In young females mammography is not a good screening tool because young breast are more dense, i.e., glandular tissue is more than fatty tissue in young females.# MRI is screening tool of choice for Ca breast in young females, especially in those with positive family history or for who are BRCA1 &/or 2 gene carriers.# Triple assessment consists:- Clinical examination (palpation)- Mammography# The BIRADS (Breast Imaging Reporting and Dictation System) lexicon was developed by the American College of Radiology to provide a clear and concise way to report mammographic result.# MRI is more sensitive than mammography for DCIS.Sr. noType of calcificationBreast disease1.Coarse irregular 'popcorn'Benign lesions like fibroadenoma calcification2.Egg shell calcificationTraumatic fat necrosis3.Tentacles, spiculesScirrhous Ca4.Fine, irregular, polymorphic (clusters of) microcalcificationsCa breast (Scirrhous Ca, intraductal Ca)5.Needle shapedPlasma cell mastitis6.Crescentic or 'tea cup' likeMicrocysts7.Amorphous lumpsFat necrosis and scars8.Fine, smooth, punctate, spherePapilloma, sclerosing adenosis, epithelial hyperplasiaDIFFERENTIAL DIAGNOSIS OF FAT-CONTAINING BREAST LESIONSQ# Lipoma# Oil cyst# Galactocele = fluid with high lipid content (last phase)# Hamartoma# Traumatic fat necrosis (cyst)# Focal collection of normal breast fat | 6,297 | medmcqa_train |
Not intravenous Anasthetic agent | D i.e. Cyclopropane | 6,298 | medmcqa_train |
Computed Tomography (CT scan) is least accurate for diagnosts of: | D i.e. 1 cm size Gall stones CT scan has a very limited role in diagnosis of gall stone (Cholelithiasis) as only a minority (20-60%) of gall bladder stones are visibleQ which show calcification. Most (70%) stones are cholesterol stones and 93% of them are radiolucent). CT scan, however, can evaluate complications such as pancreatitis, pericholecystic fluid, abscess or perforation. Ultrasound is the most accurate modality for the diagnosis of gall bladder stonesQ, which appear as echogenic foci producing acoustic shadows. Stone mobility is also identified (although not essential for making diagnosis). Small stones are differentiated from small polyps by the demonstration of mobility or the presence of an acoustic shadow. Non visualization of gall bladder on US may be d/t previous Acoustic Shadow cholecystectomy, nonfasting, abnormal gall bladder position, emphysematous cholecystitis or because the gall bladder' is filled with stones. The latter can be identified by double-arc shadow sign = hypoechoic line between two echogenic lines in gall bladder fossa (i.e. 2 parallel curved echogenic lines seperated by a thin anechoic space with dense acoustic shadowing distal to the deeper echogenic line). - CT scan is one of the most accurate procedure in detection of lesions in pancreas (including tail), retroperitoneum (eg paraaoic lymph nodes) and liver (focal lesions like aneurysm, hemangioma etc). | 6,299 | medmcqa_train |
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