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True regarding predisposing factors for penile carcinoma are all except: March 2012, March 2013 (e) | Ans: C i.e. Circumcision Premalignant conditions for carcinoma penis Leucoplakia of the glans (similar to the condition seen n the tongue), longstanding genital was (which may rarely be the site of malignant change) & Paget's disease of the penis are definite precarcinomatous states Circumcision soon after bih confers immunity against carcinoma of penis. Later circumcision does not seem to have the same effect. | 6,700 | medmcqa_train |
A 30 year old farmer presents with the features of high fever, painful inguinal lymphadenopathy, vomiting and diarrhoea with hypotension. Which of the following stain will be helpful in making the diagnosis? | Wayson's stain is a basic fuchsin - methylene blue, ethyl alcohol - phenol microscopic staining procedure. It is a modified methylene blue stain used for diagnosing bubonic plague. Giemsa / Wayson stain revels the typical safety- pin apperance of the organism. In Bubonic plague the infected flea bite is usually on the legs and is marked by a small pustule or ulceration. More often the lymph nodes draining the area of the flea bite become affected and the resulting adenitis produces intensely painful swellings or buboes in the inguinal axillary or cervical regions depending upon the position of the bite. Ref: ALevinson W. (2012). Chapter 20. Gram-Negative Rods Related to Animal Sources (Zoonotic Organisms). In W. Levinson (Ed), Review of Medical Microbiology & Immunology, 12e. | 6,701 | medmcqa_train |
A person is said to be mentally retarded when IQ is- | Ans. is 'd' i.e., < 70 o Normal IQ- 90-109;o Borderline IQ- 70-89;o Mild mental retardation IQ- 50-69;o Moderate mental retardation IQ- 35-49;o Severe MR IQ- 20-34;o Profound MR IQ- 0-19. | 6,702 | medmcqa_train |
Differential diagnosis for pancytopenia with cellular bone marrow include the following except - | In megaloblastic anemia , RBCs WBCs & platelets decreases (pancytopenia) & the cellularity of the bone marrow increases from moderate to hypercellular.Ceain morphologic features are common to all forms of megaloblastic anemia. The bone marrow is markedly hyper- cellular and contains numerous megaloblastic erythroid pro- genitors. Megaloblasts are larger than normal erythroid progenitors (normoblasts) and have delicate, finely reticu- lated nuclear chromatin (indicative of nuclear immaturity) (Fig. 11-11). As megaloblasts differentiate and acquire hemo- globin, the nucleus retains its finely distributed chromatin and fails to undergo the chromatin clumping typical of normo- blasts. The granulocytic precursors also demonstrate nuclear- cytoplasmic asynchrony, yielding giant metamyelocytes. Megakaryocytes may also be abnormally large and have bizarre multilobed nuclei. In the peripheral blood the earliest change is the appear- ance of hypersegmented neutrophils, which appear before the onset of anemia. Normal neutrophils have three or four nuclear lobes, but in megaloblastic anemias they often have five or more. The red cells typically include large, egg- shaped macro-ovalocytes; the mean cell volume often is greater than 110 fL (normal, 82 to 92 fL). Although macro- cytes appear hyperchromic, in reality the mean cell hemoglo- bin concentration is normal. Large, misshapen platelets also may be seen. Morphologic changes in other systems, espe- cially the gastrointestinal tract, also occur, giving rise to some of the clinical manifestations. Referance : Exam preparatory manual for UGs -Ramdas Nayak page no-256 Ref Robbins 9/e pg 422 | 6,703 | medmcqa_train |
Best for systemic aspergillosus infection ? | Ans is 'b' i.e., ltraconazole o First choice drug for aspergillosis Voriconazole/Amphotericin B o Second choice drug for aspergillosis --> ltraconazole | 6,704 | medmcqa_train |
The principal vector of dengue virus- | The principal vector of dengue is the mosquito Aedes aegypti, which breeds in standing water; collections of water in containers, water based air coolers & tyre drumps are a god environment for the vector in large cities. Reference: Harrison20th edition pg 879 | 6,705 | medmcqa_train |
Which of the following is not a culture bound syndrome | Ans is 'd' i.e. Von-Gogh * Dramatic self mutilation occurring in schizophrenia has also been called Von-Gogh syndrome.Culture-bound syndrome (folk illness)* It is a combination of psychiatric and somatic symptoms that are considered to be a recognizable disease only within a specific society or culture. There is no objective biochemical or structural alterations of body organs or functions, and the disease is not recognized in other cultures.Important culture-bound syndromesNameGeographical localization* Ataque de nervios* Hispanic people as well as in the Philippines* Dhat syndrome* India, Taiwan* Khyal cap* Combodia* Ghost sickness* Native Americans* Kufungisisa* Zimbabwe* Maladi moun* Haiti* Nervios* Latin America* Shenjing shuairuo* Chinese* Susto* Central America and South America* Taijin kyofusho* Japan* Amok* Indonesia; Malaysia* Koro* South-east Asia, India, China* Latah* Indonesia; Malaysia* Windigo* Indigenous people of north-east America | 6,706 | medmcqa_train |
In Epidemic dropsy disease, toxin is:- | Epidemic dropsy It is caused by contamination of mustard oil with 'Argemone oil'. Sanguinarine is the alkaloid toxin contained in argemone oil. The symptoms of epidemic dropsy consist of sudden,non-inflammatory, bilateral swelling of legs, often associated with diarrhoea, dyspnea, cardiac failure & death may follow. Some patients may develop glaucoma. The disease may occur at all ages except breast-fed infants. Moality varies from 5-50 per cent. | 6,707 | medmcqa_train |
A female presented with long standing nasal obstruction. She also complaints about comments from her friends telling about foul smell coming from her nose which she could not recognise. On evaluation, atrophic rhinitis is diagnosed. What can be the etiology in this patient to develop secondary atrophic rhinitis? | Specific infections like syphilis, lupus, leprosy, and rhinoscleroma may cause destruction of the nasal structures leading to atrophic changes. Atrophic rhinitis can also result from long-standing purulent sinusitis, radiotherapy to nose or excessive surgical removal of turbinates. Extreme detion of nasal septum may be accompanied by atrophic rhinitis on the wider side. | 6,708 | medmcqa_train |
A 42-year old female presents with the complaint of bleeding gums for the past 20 days. Intra-oral examination shows thickened and friable gums. Also, she has hepatosplenomegaly with generalized non tender lymphadenopathy. The blood count reveals: Hemoglobin 11.4 g/dl, Platelet count 90,000/mm3, WBC count 4600/mm3. The bone marrow biopsy shows 100% cellularity, with many large blasts that are peroxidase negative and nonspecific esterase positive. Which of the following is the most likely diagnosis for this patient? | Patient has an “aleukemic” leukemia in which leukemic blasts fill the marrow, but the peripheral blood count of leukocytes is not high. The staining of the blasts suggests the presence of monoblasts (peroxidase negative and nonspecific esterase positive). So, the likely diagnosis for her is M5 leukemia, which is characterized by increased chances of tissue infiltration and organomegaly.
Other options:
Acute lymphoblastic leukemia is typically seen in children and young adults.
Acute megakaryocytic leukemia is typically accompanied by myelofibrosis and is rare. The blasts react with platelet-specific antibodies.
Acute promyelocytic leukemia (M3-AML) has many promyelocytes filled with azurophilic granules, making them strongly peroxidase positive. | 6,709 | medmcqa_train |
Osteomeatal complex(OMC) connects: | Osteomeatal complex lies in the middle meatus. It is final common drainage pathway for the maxillary,frontal,and anterior ethmoid sinuses into the nasal cavity. Ref.Scott Brown 7/e,Vol 2 p 1345 | 6,710 | medmcqa_train |
The clinical consequences of hypokalemia in skeletal muscle include muscle weakness and cramps. What is the level of Serum Potassium at which Paralysis Is a possible complication of hypokalemia? | Paralysis occurs when potassium levels are <2.5 mEq/L. It usually stas in legs and moves to arms | 6,711 | medmcqa_train |
A subpoena is a kind of - | Summon (subpoena) is a legal document compelling attendance of a witness in a court of law. | 6,712 | medmcqa_train |
OPV bivalent vaccine contains - | <p>OPV/ Sabin vaccine Live attenuated . Contains type 1,2 and 3 viruses grown in primary monkey kidney/human diploid cell culture. Administration:- WHO programme on immunisation (EPI) and the national immunisation program in India recommend a primary course of 3 doses of vaccine with 1 month interval commencing at 6 weeks. It is recommended that a dose of OPV is required to be given to all children delivered in the hospital before discharge. Very impoant to complete vaccination before 6 months before most cases occur between 6 months- 3 years. Dose -2 drops Immunity:- prevents paralysis and intestinal reinfection. Thus limits virus transmission in community . The vaccine progeny excreted in faeces and secondary spread occurs to household contacts and susceptible contacts in community. Non immunised persons may therefore become immunised. This propey of OPV has been exploited in controlling epidemic . Advantages:- Antibodies quickly produced and therefore helps to control epidemic. Induces both humoral and intestinal immunity. Easy to administer. Complication:- Vaccine associated paralytic polio in recipients of vaccine and their contacts . Contraindications:- Immunocompromised. Malignancy . Leukemia. Storage-Requires to be stored and transpoed at sub zero temperature,unless stabilized. Problems with OPV:- 1. Instability of vaccine at high temperatures. 2. Frequent vaccine failures. 3. Small residual neurovirulence. OPV bicalent vaccine: Contains strains types 1 and 3. {Reference: park&;s textbook of preventive and social medicine, 23rd edition, pg no.207}</p> | 6,713 | medmcqa_train |
Which of the following is the classical CSF finding seen in TBM? | Harrison's textbook of internal medicine 17the edition *CSF revealed a high leucocyte count (up to 1000/microL),usually with predominance of lymphocyte s ,but sometimes with predominance of neutrophils in early stage ,protein count of 1-8g/L and low glucose concentration . | 6,714 | medmcqa_train |
Winter bottom's sign in sleeping sickness refers to- | Sleeping sickness
Fever
Loss of nocturnal sleep
Headache
Feeling of oppression
Pruritis and maculopapular rashes
Weight loss
Arthralgia
Hepatosplenomegaly
Lymphadenopathy, particularly of the posterior triangle of the neck → Winter bottom's sign | 6,715 | medmcqa_train |
Clostridium difficile causes - | Ans. is 'a' i.e., Pseudomembranous colitis & 'b' i.e., Nosocomical diarrhea * Cl difficle causes Clostridium difficle - associated diseases (CDAD).* CDAD is the most commonly diagnosed diarrheal illness acquired in the hospital.* C. difficle is acquired exogenously, most frequently in the hospital.* C. difficle is the most common bacterial cause of nosocomial diarrhea.* Diarrhea is the most common symptom of CDAD.* Pseudomembranous colitis is the advanced form of CDAD.* CDAD is almost exclusively associated with antibiotic use. It is caused most commonly by 2nd generation cephalospirinsy clindamycin, ampicillin and fluoroquinolones.* Other important risk factors (beside antibiotic use) are old age, GI surgery, use of electrical thermometer, use of antacids and PPIs, and prolonged hospital stay.* Pseudomembranous colitis is caused by two large toxins of Cl difficle1) Toxin A (enterotoxin) : Causes disruption of cystoskeleton by glycosylation of GTP-binding proteins.2) Toxin B (cytotoxin) : Has effect similar to toxin A. | 6,716 | medmcqa_train |
The muscle of hand that contains a sesamoid bone is | The tendon of inseion of adductor pollicis on the medial side of base of proximal phalanx of thumb contains a sesamoid bone.Reference: Textbook of anatomy, Upper limb, and thorax, Vishram Singh, 2nd edition, page no.144 | 6,717 | medmcqa_train |
A 70-year-old man has smoked for years despite a chronic productive cough. One day, he notices blood in his sputum and goes to see his physician. A chest x-ray reveals a mass in the left lung, which is biopsied during a fiberoptic bronchoscopy. Assuming that this patient's cancer is etiologically related to his smoking, which of the following diagnoses are most likely to be returned by the pathology laboratory? | Smoking does not increase the risk of all types of lung cancers to the same degree. Oat (small) cell carcinoma has a very strong association with smoking, with only 1% of cases occurring in nonsmokers. Squamous cell carcinoma is also strongly associated with smoking, because smoking predisposes for squamous metaplasia, a precancerous condition. The association of smoking with bronchogenic adenocarcinoma and with bronchioloalveolar carcinoma is much weaker. | 6,718 | medmcqa_train |
Which of the following exocrine glandular ducts are not obstructed in cystic fibrosis: | Answer C. Sweat glandMost CF patients have 3 distinct abnormal characteristics:The ducts of the mucus-secreting glands are obstructed due to an increase in viscosity of these secretions leading to glandular dilatation and destruction.CF patients are prone to chronic bacterial colonization and infections.The sweat glands are not obstructed in CF patients because in serous glands such as sweat glands there are abnormal concentrations of inorganic ions, rather than glandular obstruction with thick mucus.The quantitative pilocarpine iontophoresis sweat test is a uniformly accepted method for diagnosing CF. The sweat gland ducts must be patent for this test.Obstruction of airways leads to bronchiectasis and atelectasis; pancreatic duct obstruction leads to pancreatitis and malabsorption; and plugging of bile ducts leads to obstructive jaundice. | 6,719 | medmcqa_train |
Distal interphalangeal joints are involved in all except ? | Ans. is 'b' i.e., Rheumatoid ahritis | 6,720 | medmcqa_train |
Pearls index | Pearl index is defined as the number of failures per 100 woman years of exposure (HWY) Failure rate per Hundred Women Years = Total accidental pregnancies X 1200/ Total months of exposure Reference : Park&;s textbook of preventive and social medicine, 23rd edition, Page no: 510 | 6,721 | medmcqa_train |
Occult thyroid malignancy with nodal metastasis is seen in - | A small percentage of cancers present with enlarged lymph nodes in the jugular chain or pulmonary metastases with no palpable abnormality of the thyroid.
The primary tumor may be no more than a few millimetres in size and is termed occult. Such primary foci of papillary carcinoma may also be discovered in thyroid tissue resected for other reasons.
The term occult was formally applied to all papillary carcinomas less than 1.5 cm in diameter but the preferred terminology now is microcarcinoma for cancers less than 1 cm in diameter.
These have an excellent prognosis although those presenting with nodal or distant metastases justify more aggressive therapy". - Love & Bailey | 6,722 | medmcqa_train |
In stab wounds, Langer's lines determine: NEET 14 | Ans. Healing | 6,723 | medmcqa_train |
Which cranial nerve is affected the earliest in acoustic neuroma? | The pear shapped tumour from the cranial nerve VIII continue to enlarge and compress the trigeminal nerve. Cranial nerve 5 is the earliest nerve to be involved in Acoustic neuroma. The tumor is almost always arises from the Schwann cells of the vestibular, but rarely from the cochlear division of VIIIth nerve within the internal auditory canal. As it expands, it causes widening and erosion of the canal and then appears in the cerebellopontine angle. Here, it may grow anterosuperiorly to involve the IXth, Xth, and XIth cranial nerves. | 6,724 | medmcqa_train |
Which of the following decreases affinity of oxygen with hemoglobin? | Decrease affinity of oxygen with hemoglobin-Oxygen hemoglobin curve shift to right -increaseddelivery of oxygen to the tissue Increase affinity of oxygen with hemoglobin -Oxygen hemoglobin curve shift to left- Increased delivery of oxygen to the HEMOGLOBIN in lungs Factors increase hydrogen ions (acidosis ) Increase CO2 Increase in temperature Increase in 2,3 DPG Exercise Pregnancy High altitude Hemoglobin S Factors decrease hydrogen ion (alkalosis ) Decrease CO2 Decrease in temperature Fetal hemoglobin Methemoglobinemia 2,3-Bisphosphoglycerate also known as 2,3-Disphosphoglycerate (2,3 BPG or 2,3-DPG) is the most abundant organic phosphate in the erythrocyte. 2,3-BPG is produced in the erythrocytes from an intermediate (1,3-bisphosphoglycerate) of glycolysis. This sho pathway is referred to as Rapapo-Leubering cycle. | 6,725 | medmcqa_train |
Non-septate hyphae with a tendency to branch at 90 degree angle is characteristic of: | The organisms appear as large, nonseptate hyphae with branching at obtuse angles. Round or ovoid sporangia are also frequently seen in the tissue section.
Histopathologically, mucormycosis should be differentiated from aspergillosis in which the former has an acute angulating branched hyphae of smaller width and latter has septate branched hyphae.
Reference: Shafer’s Textbook of ORAL PATHOLOGY Eighth Edition page no 349 | 6,726 | medmcqa_train |
Meniscal tears usually result from which of the following circumstances? | Most meniscal tears are produced by flexion and rapid rotation. A classic example ("football knee") involves a player who is hit while running. The knee, supporting all the player's weight, usually is slightly flexed, and the foot is anchored to the ground by cleats. Impact from an opposing player usually causes rotation almost entirely restricted to the knee. The injury involves rapid rotation of the flexed femoral condyles about the tibial plateau, which most frequently tears the medial meniscus. (Less frequently, the lateral meniscus is torn.) A tear in the inner free border of the cartilage is also common whenever excessive rotation without flexion or extension occurs. Early surgical removal of the displaced menisci is usually recommended to prevent further damage to the cartilage or ligaments. | 6,727 | medmcqa_train |
Minimum reabsorption through renal tubule, among the following | Urea is a toxic waste product and it reabsorbed in minimal level.Ref: Ganong&;s Review of Medical Physiology; 24th edition; page no: 678 | 6,728 | medmcqa_train |
In formocresol, ratio of formalin to cresol: | Formocresol is a solution of 19% formaldehyde, 35% cresol in a vehicle of 15% glycerine and water. To prepare a 1:5 concentration of this formula, first thoroughly mix 3 parts of glycerin with 1 part of distilled waler, then add 4 parts of this preparation to 1 part Buckley’s formocresol, and thoroughly mix again.
Key Concept
In formocresol, we use 19% formaldehyde and 35% cresol i.e. ratio of 1:2. | 6,729 | medmcqa_train |
V. cholera is able to stay in GIT because of ? | Ans. is 'c' i.e., Motility | 6,730 | medmcqa_train |
The caudate lobe of liver corresponds to which segment of Counaud's classification | Caudate lobe is segment I Quadrate lobe is segment IVa The caudate lobe (segment I) is the dorsal poion of the liver and embraces the IVC. It lies posterior to the left poal triad inferiorly and left and middle hepatic vein superiorly. Caudate lobe is unique in sense that it receives blood supply from both the right & left poal pedicles. bile ducts drain into both right & left hepatic ducts. its venous drainage is directly into the vena cava Ref : Schwaz 9/e p1095 | 6,731 | medmcqa_train |
Which of the following can be found in ocular muscles? | Trichinella spiralis
→ It is a parasite of pig. Man is an incidental host.
→ Infective form is encysted 1st stage larva which is transmitted by eating uncooked pork.
→ Larva penetrates intestine and migrates to muscles where it undergoes encystation.
→ Most commonly involved muscles are extraocular muscles followed by biceps and muscles of jaw and neck.
→ Most infections are asymptomatic.
→ Clinical manifestations may be:
Abdominal - Diarrhea or constipation, abdominal pain, nausea, vomiting.
Hypersensitivity reaction - Fever with eosinophilia, periorbital and facial edema, hemorrhages in the subconjunctiva, retina and nail beds (splinter hemorrhages).
Rarely - Myocarditis with heart failure, encephalitis, pneumonitis.
Symptoms due to encystment of larva in muscles - Myositis with myalgia, weakness.
→ Bachman intradermal test is used for Trichinella.
Educational point
The muscles most often invaded by Trichinella are highly vascularized muscles, such as eye muscles tongue, deltoid, pectoral, intercostal, diaphragm and gastrocnemius. | 6,732 | medmcqa_train |
Continuous cell culture of bacteria | Ans. is 'c' i.e., Chemostat device Bacterial cultures can be maintained in a state of exponentional growth over long periods of time using a system of continuous culture. Continuous culture, in a device called chemostat, can be used to maintain a bacterial population at a constant density, a situation that is, in many ways, more similar to bacterial growth in natural environments. In a chemostat microbial cells are grown at a steady state where cell biomass production, substrates and products concentrations remains constant, and growth occurs at a constant rate. These features make a chemostat unique and powerful tool for biological and physiological research. | 6,733 | medmcqa_train |
Which is the most common tumor associated with superior vena cava syndrome? | The superior vena cava syndrome usually is caused by neoplasms that compress or invade the superior vena cava, such as bronchogenic carcinoma or mediastinal lymphoma. -produces a characteristic clinical complex consisting of marked dilation of the veins of the head, neck, and arms associated with cyanosis. -Pulmonary vessels also can be compressed, causing respiratory distress. | 6,734 | medmcqa_train |
All of the following enzymes are active within a cell except | Red Blood Cell Enzymopathies Hexokinase (HK), the red cell enzyme with the lowest activity in the glycolytic pathway, catalyzes the initial step in the utilization of glucose and thus is required for both glycolysis and the pentose shunt and produces glucose 6-phosphate. Ref Robbins 9/e pg 407 | 6,735 | medmcqa_train |
Pars flaccida of the tympanic membrane is also called as | Situated above the lateral process of malleus between the notch of Rivinius and the anterior and posterior malleolar fold. Reference: Dhingra 6th edition | 6,736 | medmcqa_train |
DNA analysis of chorionic villus/amniocentesis is not likely to detect: | Ans. is a, i.e. Tay-Sachs diseaseRef. JB Sharma TB of Obs pg 161; Williams Obs 25/e, p 296Ref Operative Obs and Gynae by Randhir Puri, Narendra Malhotra 1/e, p 261, 262; Obs. and Gynae Beckmann 5/e, p 45In chorionic villous biopsy, trophoblastic tissue is obtained from the chorionic villi, followed by biochemical or molecular (DNA) analysis or chromosomal analysis of this tissue to diagnose various conditions.Conditions which require molecular or DNA analysisConditions which require biochemical analysis* Hemoglobinopathies* Sickle cell disease* Alpha thalassemia* Beta thalassemia* Hemophilia A or B* Duchenne muscular dystrophy* Cystic fibrosis* Alpha-1 antitrypsin deficiency* Tay Sach's disease* Tay Sach's disease* Niemann Pick disease* Gaucher's disease* Urea cycle defects* Amino acid disorder* Congenital adrenal hyperplasia* PhenylketonuriaFor diagnosis of Tay Sach's disease biochemical analysis and DNA analysis of chorionic villous sample is done (not DNA analysis). For rest all options only DNA analyses would do that is why I am picking that option. | 6,737 | medmcqa_train |
A 37-year-old man is admitted to the hospital with a productive cough, fever, and night sweats. An X-ray film of the chest shows an ill-defined area of consolidation at the periphery of the right middle lobe and mediastinal lymphadenopathy. Sputum culture grows acid-fast bacilli. Lymph node biopsy in this patient would most likely show which of the following pathologic findings? | Tuberculosis is a chronic, communicable disease in which the lungs are the prime target. The disease is caused principally by Mycobacterium tuberculosis hominis (Koch bacillus), but infection with other species occurs, notably M. tuberculosis bovis (bovine tuberculosis). Primary tuberculosis consists of lesions in the lower lobes and subpleural space, referred to as the Ghon focus. The infection then drains to hilar lymph nodes. The combination of Ghon focus and hilar lymphadenopathy is known as "Ghon complex." The typical lesion of tuberculosis is a caseous granuloma, with a soft core surrounded by epithelioid macrophages, Langhans giant cells, lymphocytes, and peripheral fibrosis. Noncaseating granulomas (choice D) are a feature of sarcoidosis, among other causes.Diagnosis: Primary tuberculosis | 6,738 | medmcqa_train |
Most common abdominal mass in children: | c. Neuroblastoma(Ref: Nelson's 20/e p 2464-2466, Ghai 8/e 617-618)Neuroblastoma is the most common extracranial solid tumor in childrenLocalized Neuroblastoma can manifest as an asymptomatic mass or can cause symptoms because of the mass itself, including spinal cord compression, bowel obstruction & superior vena cava syndrome.Note: Both Neuroblastoma & Wilms' tumor can present as abdominal mass in children but Neuroblastoma is more common than Wilms' tumor, so it is the better answer to this question | 6,739 | medmcqa_train |
Healthworker-hand washing | (A) Cleaning hands with spirit before and after examiation of each patient > Introduction of easily accessible dispensers with an alcohol-based waterless handwashing antiseptic led to significantly higher handwashing rates among health care workers. | 6,740 | medmcqa_train |
All of the following statement about Renal Calculi are true, Except: | Answer is D (Uric acid stones are resistant to ESWL): Uric acid stones are not resistant to ESWL. Uric acid stones are infact most responsive to Lithotripsy along with calcium oxalate dehydrate stones. | 6,741 | medmcqa_train |
Shenton line is seen in X-ray of | Shenton line is an imaginary curved line drawn along the inferior border of the superior pubic ramus (superior border of the obturator foramen) and along the inferomedial border of the neck of femur. Ref essentials of ohopaedic maheshwari and mhaskar 6/e p150 | 6,742 | medmcqa_train |
Normal size but non functioning uterus is usually associated with : | A hysterosalpingogram or preferably a diagnostic hysteroscopy helps to establish the diagnosis of Asherman syndrome, first described in 1948. Operative hysteroscopy to lyse the synechiae, followed by cyclic hormonal therapy with high doses of conjugated oestrogens of 2.5-5.0 mg/day for 3-6 months, results in the restoration of menstruation in about 50% cases. Some surgeons prefer to inse an intrauterine device in the uterine cavity after lysis of adhesions to ensure keeping the cavity patent and prevent recurrence of adhesions. Asherman syndrome is caused by dilatation and curettage (D&C), medical termination of pregnancy (MTP), uterine packing in postpaum haemorrhage, uterine infection and tubercular endometritis. It causes amenorrhoea, oligomenorrhoea, dysmenorrhoea, habitual aboion and infeility depending upon the extent of uterine cavity obliteration. Hormonal levels are under control SHAW'S TEXTBOOK OF GYNAECOLOGY, Pg no:330,16th edition | 6,743 | medmcqa_train |
All are used in treating spasmodic dysmenorrhea except: | Spasmodic dysmenorrhoea is another name for primary dysnenorrhoea. (i.e. no pelvic pathology is responsible for pain)
Characteristics of spasmodic dysmenorrhoea
• Seen in adolescent girls
• Pain appears within 2 years of menarche
• Family history may be present
• Pain is spasmodic nature. It is located in lower abdomen and may radiate to back and medial aspect of thigh.
• Associated systemic discomfort seen
• Pain begins few hours before a rest of menstruation and losts for 12–24 hours, but never 48 hours more than
• Pain is often cured after child birth
• Management: NSAID’s or OCP’s | 6,744 | medmcqa_train |
Which of the following is not a characteristic of right sided failure - | Ans. is 'a' i.e., Pulmonary edema Pulmonary edema is due to Lt sided hea failure that results in increased back pressure in pulmonary circulation. Signs of CHF in infants Left sided failure Tachypnea Tachycardia Cough Wheezing Rales in chest Hoarse Cry Failure of either side Cardiac enlargement Gallop rhythm (S3) Peripheral cyanosis Small volume pulse Absence of weight gain Oliguria Pulmonary edema Edema of feet Right sided failure Hepatomegaly Facial edema Jugar venous engrogment Ascites may occur in older children. | 6,745 | medmcqa_train |
An 8 years old boy from Bihar presents with a 6 months history of an ill defined, hypopigmented slightly atrophic macule on the face. The most likely diagnosis is: | Indeterminate leprosy is characterized by: a. Solitary, hypo pigmentary patch over face in a child b. Scaling absent c. Atrophy present d. Patient from endemic area eg Bihar, Jharkhand, Chhattisgarh Differential diagnosis Pityriasis alba Intermediate leprosy Solitary, hypo pigmentary patch over face in a child + + Scaling + - H/O of Atopy + - H/o Atrophy - + Sensation Intact Impaired Histology Spongiosis Perifollicular paraneural lymphocytic infilterate Treatment Self limiting Paucibacillary- multi drug therapy | 6,746 | medmcqa_train |
A 25yr old male with thyroid swelling Biopsy shows intense lymphocytic infiltration along with huhle cell change TSH increased | Hashimoto&;s Thyroiditis Biopsy features of lymphocytic infiltrate along with huhle cell change in thyroid swelling is diagnostic of hashimoto&;s thyroiditis ref : robbins 10th ed | 6,747 | medmcqa_train |
The lineage specific marker for B cells is | Lineage specific B cell marker is CD 19. However on IHC the best marker is CD 20. CD 21 is the receptor for EBV | 6,748 | medmcqa_train |
Reversible loss of polarity with abnormality in size and shape of cells is known as - | Metaplasia Metaplasia is an adaptive change in which one adult (mature) cell type is replaced by another adult (mature) cell. In this differentiation is not lost, rather it changes from one lineage to another, i.e. stems cell differentiates along a new pathway. But, the resulting cells are fully mature and differentiated. It is reversible. There is no pleomorphism, and cell polarity as well as cell & nuclear size are not altered. Dysplasia Dysplasia means disordered (abnormal) growth ---> there is disordered differentiation and maturation. This generally consists of an expansion of immature cells, with a corresponding decrease in the number and location of mature cells there is loss of uniformity of individual cells. Dysplastic cells show following feature Loss of polarity Hyperchromatosis Increased nuclear cytoplasmic size ratio (normal 1:4 to 1:6). Pleomorphism Increased number of mitosis with normal pattern. Dysplasia is parially reversible, i.e. It is reversible in early stage and later on it is irreversible. Term Dysplasia is usually used, when these changes occur in epithelium. When dysplastic changes involve the entire thickness of epithelium, it is concidered as preinvasive lesion and is referred to as carcinoma in situ. Anaplasia Anaplasia means lack of differentiation. That means anaplastic cells resemble primitive appearing, unspecialized (undifferentiated) cells. o Anaplasia is seen only in malignancy. Anaplastic cell shows - Loss of polarity Hyperchromatasia Increased nuclear cytoplasmic cell ratio Pleomorphism Increased number of mitosis which is atypical Anaplasia is irreversible. | 6,749 | medmcqa_train |
All of the following statements are true regarding sumatriptan except | TRIPTANS Sumatriptan is the drug of choice for aboing acute attack of migraine. It acts as a selective agonist at 5 HT1B/1D receptors. This result in constriction of cranial vessels. It also suppresses the vomiting of migraine. It is a sho acting drug and has low oral bioavailability. Frovatriptan is the longest acting and rizatriptan is the fastest acting congener. All of these drugs can cause coronary vasospasm and are contraindicated in ischemic hea disease. Triptans are also contra-indicated in patients with hypeension, epilepsy, pregnancy, liver and renal impairment. Triptans and ergotamine should not be administered within 24 hours of each other. | 6,750 | medmcqa_train |
The most common form of dissociative hysteria is: | Dissociative amnesia is the most common type of dissociative disorder. | 6,751 | medmcqa_train |
Which is a large granular lymphocyte? | Ans. (a) NK cell(Ref: Wintrobe's clinical hematology - 12th ed, pg 300; Robbins 9th/pg 192; 8th/pg 188)Most lymphocytes in blood are small (<=10mm), while some are large, known as large granular lymphocytes (LGL), as they contain azurophilic granules in their cytoplasm.These cells are LGL type of natural killer (NK) cells. | 6,752 | medmcqa_train |
Schaumann bodies are seen in - | question repeated In pathology, Schaumann bodies are calcium and protein inclusions inside of Langhans giant cells as pa of a granuloma. Many conditions can cause Schaumann bodies, including: Sarcoidosis, Hypersensitivity pneumonitis, and Berylliosis. uncommonly, Crohn's disease and tuberculosis. | 6,753 | medmcqa_train |
Which of the following drugs is associated with untoward side effect of renal tubular damage- | Some nephrotoxic agents which cause tubular necrosis. o Aminoglycosides o Colistin o Methoxyfluranes o Sulfonamides o Amphotericin B o Cyclosporine o Polymyxin o Tetracyclines o Cephaloridine o Intravenous immune globulin o Radioiodinated contrast o Acetaminophenmedium o Cisplatin REF : katzung pharmacology : 14th ed | 6,754 | medmcqa_train |
Which of the following nucleus in brain is common to IX, X & XI cranial nerves? | Nucleus ambiguus consists of large motor neurons and is situated deep within the reticular formation. The emerging nerve fibers join the glossopharyngeal, vagus and cranial pa of the accessory nerve and are distributed to voluntary skeletal muscle. The neurons in the nucleus ambiguus innervate the ipsilateral laryngeal, pharyngeal, and tongue muscles involved in breathing and in maintaining the patency of the upper airway. Ref: Clinical Neuroanatomy By Richard S. Snell, 2010, Page 204. | 6,755 | medmcqa_train |
Digoxin toxicity it can be increased by all except | Hyperkalemia is the usual electrolyte abnormality precipitated by digoxin toxicity, primarily in the acute setting. Hyperkalemia may be associated with acute renal failure that subsequently precipitatesdigoxin toxicity. Chronic digoxin toxicity does not usually causehyperkalemia. Refer katzung 11e p216 | 6,756 | medmcqa_train |
A double apical impulse is seen in | (D) HOCM# Physical findings of HCM are associated with the dynamic outflow obstruction that is often present with this disease.> Upon auscultation, the heart murmur will sound similar to the murmur of aortic stenosis.> However, a murmur due to HCM will increase in intensity with any maneuver that decreases the volume of blood in the left ventricle (such as standing abruptly or the strain phase of a Valsalva maneuver). Administration of amyl nitrite will also accentuate the murmur by decreasing venous return to the heart.> Classically, the murmur is also loudest at the left parasternal edge, 4th intercostal space, rather than in the aortic area.> If dynamic outflow obstruction exists, physical examination findings that can be elicited include the pulsus bisferiens and the double apical impulse with each ventricular contraction.> A double apical impulse may be recognized, particularly with the patient in the left lateral recumbent position. | 6,757 | medmcqa_train |
Which of the following agent is used in day care surgery? | Ans. a. Propofol (Ref: Miller's Anesthesia 8/e p726; Lee 13/e p158-160; Morgan 3/e 173, 884)Propofol is used in day care surgery.'Any induction agents used in day-case anesthesia should ensure a smooth induction, good immediate recovery and a rapid return to street fitness. Propofol is now used widely as the primary induction agent, which has advantage of rapid recovery and low incidence of post-operative nausea and vomiting.'Preferable agents in Day Care AnaesthesiaMivacuriumQ (muscle relaxant of choice, shortest duration of action)SuccinylchoIineQ (for Ultra short period of profound muscle relaxation: Disadvantage: Post-operative myalgia)lsofluraneQ (volatile inhalational agent)AlfentanylQPropofolQ (inducing agent of choice)MidazolamQ (for initial anaxiolysis and sedation)Mnemonic: Manmohan Singh Is A Prime Minister | 6,758 | medmcqa_train |
Which of the following can prevent neural tube defects in pregnancy? | Ans: c (Folic acid) Ref: Dutta, 6th ed, p. 104, 409Folic acid is supplemented in the first trimester to prevent neural tube defects.Folic acid supplementation:1. Normal pregnancy -0.5 mg in first trimester2. Pregnancy with history of NTD - folic acid 4mg daily, 1 month before conception continued for 12 weeks of pregnancy.Folic acid requirements - ICMR recommendations:1. Healthy adults -100 pg / day2. Pregnancy - 400 pg / day3. Lactation -150 pg /day4. Children -100 pg / dayBRIDGE:unmanifested deficiency of folic acid has been implicated as a cause of abruption placenta. | 6,759 | medmcqa_train |
Which one of the following hepatic lesions can be diagnosed with high accuracy by using nuclear imaging ? | Ans. is 'c' i.e., Focal nodular hyperplasia Liver parenchyma is primarily made up of two types of cells. i) Hepatocytes -> Perform excretory and synthetic function ii) Kupffer cells -> They have reticuloendothelial function Both these cells can be investigated with 99mTc labelled cells. Two types of radionucleide imaging procedure are used in liver Hepatocyte based imaging (IDA Imaging) - IDA compound are taken up by functioning hepatocytes, excreted unchanged in the bile and are not reabsorbed from the gut This propey of IDA compounds is used in imaging of liver and biliary tract. It will allow the imaging of functioning liver parenchyma and trace the flow of the bile, in the ducts, gall bladder and bowel - Its clinicals use are i) Assessment of regional liver function ii) Demonstration of bile leaks in liver trauma iii) Investigation of biliary obstruction iv) Choledochal cyst v) Demonstration of gall bladder function including cystic duct obstruction as a marker of acute cholecystitis. - Remember the question asked about the use of HIDA scan in acute cholecystitis. If the gall bladder is not demonstrated by 4 hrs it is a good indicator of acute cholecystitis due to mechanical or functional obstruction of cystic duct. vi) Differentiation of hepatocellular tumours. | 6,760 | medmcqa_train |
Flexion, adduction and medial rotation of arm is done by which muscle | Muscle Action Pectoralis major Adducts and medial rotation of arm Pectoralis minor Stabilizes the scapula Subclavius anchors and depresses the scapula Serratus Anterior protracts the scapula laterally rotates the scapula overhead abduction | 6,761 | medmcqa_train |
In a patient with poor glycemic control, hypertriglyceridemia, low HDL, which of the following drug Rx would be best without the risk of myositis as its side effect? | Ans.B Nicotinic acidLIPID-LOWERING AGENTSDrugEffect on LDLEffect on HDLEffect on triglyceridesSide effects/problemsHMG-CoA reductase Inhibitors(Lovastatin, Simvastatin) pravastatin, Atorvastatin)|||||Expensive, reversible LFT's MyositisNiacin|||||Red, flushed fate, which is by aspirin or long-term useBile acid resins(cholestyramine)||?Slightly |Patients hate it-tastes bad and causes GI discomfortCholesterol absorption blocker (ezetimibe)|| -Rare | LFTs"Fibrates" (gemfibrozil, clofibrate, bezafibrate, fenofibrate)|||||Myosistis, | LFTsFenofibrate: Another 2nd generation prodrug fibric acid derivative which has greater HDL-CH raising and greater LDL- CH lowering action than other fibrates: may be more appropriate as an adjunctive drug in subjects with raised LDL-CH levels in addition to raised TG levels. No rise in LDL-CH has been observed in patients with high TG levels. Its t 1/2 is 20 hr. Adverse effects are myalgia, hepatitis, rashes. Cholelithiasis and rhabdomyolysis are rare. Fenofibrate appears to be the most suitable fibrate for combining with statins, because statin metabolism is minimally affected and enhancement of statin myopathy risk is lower. Indications of fenofibrate are similar to that of gemfibrozil. Gemfibrozil is the drug of choice for patients with markedly raised TG levels, whether or not CH levels are also raised. Episodes of acute pancreatitis are prevented in patients with chylomicro naemia and severe hypertriglyceridaemia. It is mo*t effective in type III hyperlipoproteinaemia; also a first line drug in type IV and type V disease. | 6,762 | medmcqa_train |
Most common cause of primary hyperparathyroidism- | Most common cause of primary hyperparathyroidism is autonomous secretion of parathyroid hormone (PTH) by a parathyroid adenoma. Single adenoma (90%), multiple adenomas(4%), nodular hyperplasia(5%), carcinoma(1%). Reference : page 769 Davidson's Principles and practice of Medicine 22nd edition | 6,763 | medmcqa_train |
O2 delivery to tissues depends on all of the following factors, EXCEPT: | The fundamental purpose of the cardiorespiratory system is to deliver O2 and nutrients to cells and to remove CO2 and other metabolic products from them. Proper maintenance of this function depends not only on intact cardiovascular (cardiac output) and respiratory systems but also on an adequate number of red blood cells and hemoglobin and a supply of inspired gas containing adequate O2. Affinity of hemoglobin for 02 also determine the oxygen delivery. Ref: Loscalzo J. (2012). Chapter 35. Hypoxia and Cyanosis. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e. | 6,764 | medmcqa_train |
Which of the following is commonest primary intraocular tumour in childhood is | (Retinoblastoma): Ref: 280-KH, 358-K, 397-PRETINOBLASTOMA - is the most common primary intraocular malignancy of childhood.* The retinoblastoma may be heritable (40%) or non heritable (60%)* The predisposing gene (RPE1) is at 13q14* Leukocoria (white papillary reflex) is the commonest (60%) presentation* Delation involving the long arm of chromosomes 22 (22ql 1) are most common microdeletions identified to date, VCF (Velo Cardio Facial) syndrome is the most common associated syndromeTreatments1. Small tumour - no more than 4 mm diameter and 2 mm thickness without vitreous or subretinal seeds - Trans papillary thermotherapy laser or cryotherapy2. Median size tumour(I) Brachytherapy - is indicated for tumours of no more than 12 mm diameter and 6 mm thickness (60Co or I125)(II) Chemotherapy - (Carboplatin, vincristine, etoposide) may be combined with cyclosporin(III) External beam radiotherapy - should be avoided, because high risk of complications, cataract formation, radiation retinopathy and cosmetic deformity and secondary malignancy.3. Large tumours (a) Chemotherapy (b) Enucleation4. Extra ocular extension - beyond the lamina cribosa is treated with chemotherapy after enucleation* Extension to the cut end of the optic nerve or extension through the sclera - chemotherapy and irradiation of the affected orbit5. Metastatic disease: - High dose chemotherapy Enucleation is the treatment of choice when the child is brought in clinical stage II or late stage I (when tumour is more than 100 mm in size or when optic nerve is involved) (270-KH) | 6,765 | medmcqa_train |
Sho stature, secondary to growth hormone deficeincy is associated with - | Ans. is 'a' i.e., Normal body propoion | 6,766 | medmcqa_train |
Malignant hyperthermia is caused due to which of the following mechanism? | Ans. is 'c' i.e., Increased intracellular Ca o The mechanism involves a sudden rise in intracellular calcium due to release of stored calcium in sarcoplasmic reticulum, stimulating contraction, rhabdomyolysis and a hypermetabolic state.o Tachycardia and not bradycardia, is a feature of malignant hyperthermia.MALIGN ANT HYPERTHERMIAo Malignant hyperthermia is a life-threatening medical emergency which is genetically determined. The condition occurs during or immediately after anaesthesia and may be precipitated by potent inhalational agents,o The mechanism involves a sudden rise in intracellular calcium due to release of stored calcium in sarcoplasmic reticulum stimulating contraction, rhabdomyolysis and a hypermetabolic state.Drugs causing malignant hyperthermia# Succinylcholine# Desflurane# Tricyclic antidepressants# Halothane# Cyclopropane# Phenothiazines# Isoflurane# Ether# Lignocaine# Enflurane# Methoxyflurane # Sevoflurane# MAO inhibitors o Succinylcholine is the most common cause of MHoAmongst inhalational agents halothane is the most common cause.o Combination of Sch and Halothane has a much higher incidence.Clinical featureso Masseter spasm - if a patient develops severe masseter spasm after suxamethonium, there is a significant possibility of malignant hyperthermia.o Tachycardia, arrhythmias and hypertension.o Hyperthermiao Rise in end-tidal CO2 - May rise to more than 100 mm Hg (normal is 32-42 mm Hg). It is the earliest and most sensitive indicator.o Hyperkalemia, metabolic acidosis, elevated creatininephosphokinase, muscle rigidity,o Increased myoglobin, renal failure.o Muscle biopsy contracture test (definitive diagnostic procedure) :- The muscle biopsy contracture test is the most sensitive and specific test. The Caffeine Halothane Contracture test (CHCT), a test performed on freshly biopsied muscle; is the "gold standard" for diagnosis of malignant hyperthermia. However, the test is available only at few centers in the world (only about 30 centers world wide) and it is very costly. The CHCT test should be considered for all those judged to be at significant risk for malignant hyperthermia, either through family history, or by elicitation of signs of an episode of malignant hyperthermia, or if there had been any previous uncharacterized adverse reaction to a general anesthetic.Managemento Stop all anaesthetics immediately,o Hyperventilation with 100% oxygeno Cooling of body by ice coolingo Correct acidosis and hyperkalemia,o Maintain urine output,o IV dantrolene is the drug of choiceo Procaine is the local anaesthetic of choice for malignant hyperthermia patients,o Propofol is the intravenous anaesthetic of choice for malignant hyperthermia patient | 6,767 | medmcqa_train |
Posterior cardinal vein develops into: | -Right Posterior cardinal veins contribute to inferior vena cava and common iliac veins. Left anterior and Left posterior cardinal veins regress - Superior vena cava and jugular veins develop from anterior cardinal veins. | 6,768 | medmcqa_train |
All of the following are seen in polycythemia rubra vera except : | Answer is B (Decreased LAP Score): Leucocyte alkaline phosphatase is increased in polycythemia vera Characteristic features associated of polycythemia vera Elevated Red Cell Mass/ haematocrit (polycythemia)Q Normal aerial oxygen saturation (a low oxygen saturation would be a physiological stimulus) Plasma erythropoetin levels < 4 mu/ml (normal range : 4-26 mu/ml) (not increased) Q Increased Leucocyte alkaline phosphatase Increased uric acid Q? Increased serum vitamin B12 or vitamin B12 binding capacityQ Massive splenomegaly or in the absence of splenomegaly leucocytosis & thrombocytosisQ No increase in ESRQ Memo : LAP score is decreased in CML PNH | 6,769 | medmcqa_train |
A 52 year old woman has long standing rheumatoid ahritis (RA) and is being treated with coicosteroids and nonsteroidal anti-inflammatory drugs (NSAIDs). Which of the following cardiac complications may arise in this clinical setting? | Long-standing inflammatory conditions such as rheumatoid ahritis (RA) are associated with deposition of a form of amyloid known as AA (amyloid-associated protein), which may involve kidneys, hea, liver, skeletal muscle, and skin, for example. Amyloid deposition in the myocardium results in decreased compliance and impaired diastolic filling, i.e., restrictive cardiomyopathy. The myocardium has a rigid and waxy texture. This form of amyloid, as well as any other biochemical form, can be visualized on tissue section by staining with Congo red, which acquires a characteristic apple-green birefringence under polarized light. Constrictive pericarditis is due to any pathologic process that results in fibrous thickening of the pericardium, with resultant impaired compliance. Clinically, therefore, this condition manifests with a picture similar to restrictive cardiomyopathy because of impaired diastolic filling. Constrictive pericarditis is usually caused by previous episodes of acute pericarditis, especially hemorrhagic, suppurative, and caseous pericarditis. Dilated cardiomyopathy is characterized by massive ventricular dilatation and may be caused by genetic alterations, myocarditis, toxic insults (alcohol), metabolic disorders (hemochromatosis), etc. Most cases are idiopathic. The main pathophysiologic alteration is impaired contractility. You may be tempted to think that this patient is prone to developing hypersensitivity myocarditis, but this form of myocardial disease has been repoed after treatment with some antihypeensive agents,antibiotics, diuretics and not with coicosteroids or NSAIDs. Fuhermore, myocarditis manifests acutely with arrhythmias and hea failure, and chronically with dilated cardiomyopathy and congestive hea failure. Ref: Hoit B.D. (2011). Chapter 34. Restrictive, Obliterative, and Infiltrative Cardiomyopathies. In V. Fuster, R.A. Walsh, R.A. Harrington (Eds), Hurst's The Hea, 13e. | 6,770 | medmcqa_train |
Bleeding time is not prolonged in- | Bleeding time is prolonged in all the platelet disorders like ITP ,TTP and heparin and also prolonged in all types of coagulation disorders and DIC Where is it is normal in vascular diseases like vascular purpuras Reference: textbook of Pathology, 7th edition author Harsha Mohan, page number 317 | 6,771 | medmcqa_train |
The "gp 120" in HIV helps in: | Virus attachment | 6,772 | medmcqa_train |
LASIK (Laser assisted in situ keratomileusis) is useful in treatment of | Ans. d (All of the above) (Ref. Khurana's ophthalmology, 2nd ed., p 77; Parson's 20th/pg. 76)EXCIMER LASER IN SITU KERATOMILEUSIS (LASER)# Principle:- Myopia is corrected with preservation of Bowman's layer.- A superficial corneal flap (approx. 160 pm) is created with a microkeratome.- The keratome is withdrawn, the flap is reflected, and the exposed underlying corneal stroma is ablated with an excimer laser to correct the myopia.- Then the flap is repositioned on the corneal bed and fixed in place by force of its own adhesion.# Indication:- Severe myopia (up to 10-12 diopters).- Photoablation:* Excimer laser produces photoablation.* It produces UV light of very short wavelength, which breaks chemical bonds of biologic materials, converting them into small molecules that diffuse away.- Photorefractive keratectomy:* LASIK for correcting refractive errors and* LASIK for phototherapeutic keratectomy for corneal disease like "band-shaped" keratopathy.# LASIK is superior to photorefractive keratectomy in that it:- Less painful procedure* As LASIK does not expose raw corneal surface at the end of surgery it is less painful.- Can be repeated by lifting the flap created if further refinement is necessary- Gives a faster visual rehabilitation- Has less myopic regression- Causes less scarring than photorefractive keratectomy- Can Rx higher myopia* It can also treat a higher myopia, causes less scarring and has less myopic regression. However, because a flap needed to be created, it has a higher potential risk.* Involves the use of microtome* Is contraindicated in patients with thin cornea# Side effects of LASIK:- Reduced corneal sensation- Inaccurate biometry if the patient requires cataract surgery in later life- Tear film abnormality- Erroneously high intraocular pressure with applanation tonometer. | 6,773 | medmcqa_train |
The tissues most sensitive to atropine are | Atropine is highly selective for muscarinic receptors. Its potency at nicotinic receptors is much lower, and actions at nonmuscarinic receptors are generally undetectable clinically.The effectiveness of antimuscarinic drugs varies with the tissue and with the source of agonist. In most tissues, antimuscarinic agents block exogenously administered cholinoceptor agonists more effectively than endogenously released acetylcholine.Tissues most sensitive to atropine are the salivary, bronchial, and sweat glands.Secretion of acid by the gastric parietal cells is the least sensitive. Katzung 13e pg: 122 | 6,774 | medmcqa_train |
Most common cause of scleritis - | Ans. is 'a' i.e., Rheumato.id arthritis Scleritiso Scleritis is an uncommon disorder which is characterized by cellular infiltration, destruction of collagen and vascular remodelling. Scleritis is usually a bilateral disease and occurs most frequently in women. It is associated with connective tissue diseases in 50% of cases. Rheumatoid arthritis is the most common association . Other important causes are PAN, SLE, Ankylosing spondylitis, Wegener's granulomatosis, dermatomyositis, Reiter's syndrome, Non- specific arteritis, Polychondritis and Gout.Clinical features of Scleritiso Patients complain of moderate to severe pain which is deep and boring in character and often wakes thepatient early in the morning. Ocular pain radiates to the jaw and temple. It is associated with localised or diffuse redness, mild to severe photophobia and lacrimation. Occasionally there occurs diminution of vision.Complicationso Complications are common in necrotizing scleritis and include sclerosing keratitis, Keratolysis, Complicated cataract, Uveitis and secondary glaucoma. Rarely, scleritis may also cause retinal detachment and macular edema. These are due to spread of inflammation from sclera into the uveal tract. | 6,775 | medmcqa_train |
Patellar plexus is formed by which nerve | Patellar Plexus - It is a plexus of fine nerves situated in front of the patella, the ligamentum patellae and the upper end of the tibia. It is formed by contributions from: (a)The anterior division of the lateral cutaneous nerve, (b) the intermediate cutaneous nerve, (c) the anterior division of the medial cutaneous nerve, and (d) the infrapatellar branch of the saphenous nerve. Ref : B D Chaurasia's Human Anatomy, seventh edition , volume 2, pg. np., 46. | 6,776 | medmcqa_train |
NADPH used in which pathway- | Ans. is 'a' i.e., Fatty acid synthesisUses of NADPH:* Reductive biosynthesis of lipids# Fatty acid synthesis# Cholesterol synthesis# Steroid hormone synthesis# Fatty acid elongation# Bileacid synthesis | 6,777 | medmcqa_train |
Ankylosing spondylitis may be associated with | Ref Davidson 23e p1030 | 6,778 | medmcqa_train |
Sec. 377 IPC deals with: AIIMS 09 | Ans. Sodomy | 6,779 | medmcqa_train |
All are used to produce controlled hypotension except | Isoflurane > sevoflurane > desflurane are the inhalational agents of choice for controlled hypotension. | 6,780 | medmcqa_train |
Relative Risk can be obtained from - | Ans. is 'b' i.e., Coho study | 6,781 | medmcqa_train |
A 60-year old male has a long 5tanding history of breathlessness lie has been a heavy smoker since the age of 20 years. Physical examination reveals an anxious male who is emaciated, puffing for breath but is not cyanosed. The chest is barrels shaped. An additional clinical finding would be - | From the history and clinical findings,the patient is having chronic obstructive pulmonary disease-emphysematous type.it is characterised by hyperinflation of lungs with low set diaphragm.Breath sounds are typically quiet.Right hea failure and cor pulmonale can occur in severe cases,evident as bilateral pitting pedal edema. Ref:Harrison's medicine-18th edition,page no:2156;Davidson's medicine-22nd edition,page no:674. | 6,782 | medmcqa_train |
All of the following are true about nosocomial infections except | Nosocomial infection occurs in a patient already suffering from a disease and a new infection is set up from another host or another external source. It occurs 48hours after admission or discharge from the hospital. Ref: Ananthanarayan& Paniker&;s textbook of microbiology, 9th edition. Pg no.71 | 6,783 | medmcqa_train |
Tumor marker for Ca colon for follow up | Up to a half of all patients with colorectal cancer will develop liver metastases at some point and regular imaging of the liver (by ultrasound and CT scan) and measurement of carcinoembryonic antigen (CEA) is designed to diagnose this early, in order to allow curative metastectomy. Trials of the optimum follow-up pathway have suggested that CEA measurement alone can be as effective as regular imaging.Ref: Bailey and Love, 27e, page: 1266 | 6,784 | medmcqa_train |
If parents or guardian is not available consent can be taken from teacher or principal under | Loco parentis In an emergency involving children, when their parents or guardian are not available, consent can be taken from the person who is in charge of the child, eg. teacher or the principal of the residential school. They can give consent in the place of the parent. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 385 | 6,785 | medmcqa_train |
True statements about Pneumococcus are all except | The virulence of Streptococcus pneumoniae depends on; Capsular polysaccharide, because of its acidic and hydrophilic propeies, protects the cocci from phagocytosis. Capsulated streptococcus pneumoniae are not phagocytosed efficiently in fluid media or exudates, however, they are susceptible to surface phagocytosis, being engulfed against a firm surface, such as a fibrin clot or epithelium. The enhanced virulence of type 3 Streptococcus pneumoniae is due to the abundance of its capsular material. Non-capsulated strains are avirulent. Pneumolysin: a membrane damaging toxin. Cytotoxic, complement activating propeies and is immunogenic. Autolysin: by releasing bacterial components in infected tissues, it may also contribute to virulence. Reference: Textbook of Microbiology; Anathanarayan and panicker's; 10th edition; Page no: 226 | 6,786 | medmcqa_train |
Keshan disease is caused by deficiency of: | Ans. C. Selenium* Selenium is a constituent of glutathione peroxidase, an antioxidant in red blood cells and other tissues.* Glutathione peroxidase scavenges free Hydro peroxidases generated during fatty acid oxidation, thus protecting the cell from damage due to free radical formation.* Severe deficiency is the major cause of Keshan disease, which presents as cardiomyopathy in young children. Skeletal myopathies have also been reported.* Mild deficiency is associated with macrocytosis and loss of hair pigment. | 6,787 | medmcqa_train |
Postganglionic sympathetic fibres are | The axons of postganglionic neurons are mostly unmyelinated C fibres and terminate on visceral effectors. Ref: Ganong&;s review of medical physiology; 23rd edition; pg:263. | 6,788 | medmcqa_train |
Which of the following drugs is recommended for the treatment of Heparin Induced thrombocytopenia? | Lepirudinis a recombinant preparation of hirudin which acts by inhibiting thrombin directly. It is the recommended drug for treatment of heparin induced thrombocytopenia. Ref: Goodman And Gillman's Manual of Pharmacology, 2007, Page 955; Clinical Hematology & Oncology By Bruce Furie, 2003, Page 488. | 6,789 | medmcqa_train |
The Sphenopalatine foramen is formed by all of the following structures, EXCEPT: | Sphenopalatine foramen is formed by the junction of the sphenopalatine incisure of the palatine bone with the sphenoid bone, located immediately posterior to the middle turbinate. This is the principal foramen through which branches of the sphenopalatine aery and maxillary nerve pass from the pterygopalatine fossa into the nasal cavity. Ref: Imaging of the Head and Neck, By Mahmood Mafee, Minerva Becker, 2nd Edition, Page 434 | 6,790 | medmcqa_train |
MRI is contraindicated in patients with: | Ans. A. Metallic foreign body in eyeApplications of MRI are many, but amongst the commonly imaged parts are brain, spine and musculoskeletal tissues.Contraindications to MRI:a. Cardiac pacemakersb. Intraocular metallic foreign bodyc. Cochlear implantsd. Prosthetic heart valvese. Aneurysmal clipsf. Claustrophobia | 6,791 | medmcqa_train |
True about cross section study- | Ans. is 'd' i.e., All of the above Cross - sectional studieso Cross sectional study is the simplest form of an observational study.o It is also known as prevalence study.o It is based on a single examination of a cross - section of population at one point of timeo Results of this examination can be projected on the whole populationo Cross-sectional study tells about the distribution of a disease rather than its etiology.o Cross-sectional studies can be thought of as providing a snapshot of the frequency and characteristic of a disease in a population at a particular point in timeo Cross-sectional study is more useful for chronic diseaseo As population is studied at once, no follow-up is required. | 6,792 | medmcqa_train |
Angiotensin II receptor antagonist is | (Losartan) (453-54-KDT) (469-70-BB) (488-KDT6th)I. ACE-Inhibitors - Captropril, Enalapril, Lisinopril, benazepril, ramipril, perindopril (Available in India)* Quinapril, cilazapril, Zolfenopril, fosinopril (Marketed in other countries)II. Angiotensin Antagonists* Losartan, Candesartan and Irbesartan (Available in India)* Valsartan, telmisartan and eprosartan (Marketed elsewhere) | 6,793 | medmcqa_train |
Arsenic causes : | A i.e. Rain drop pigmentation | 6,794 | medmcqa_train |
Part of eukaryotic DNA contributing to polypetide synthesisa) Exonb) Enhancerc) Leader sequenced) tRNAe) ncRNA | Exon (coding protein) : Sequence of a gene that is represented as m-RNA.
Enhancer: Are special cis-acting DNA sequences that increase the rate of initiation of transcription of eukaryotic genes by RNA polymerase II.
Leader sequence: Sequence at the 5' end of a mRNA that is not translated into protein.
Non-coding RNA (nc RNA): Functional RNA that is not translated into a protein. Non-coding RNAs include tRNA, rRNA, Sno RNA, mi-RNA, si-RNA, pi-RNA and long nc RNA like Xist & HOT AIR. | 6,795 | medmcqa_train |
Following are the features of persistent post operative pain except? | Ans. is 'b' i.e., Pain present for atleast 3 months Precision does not currently exist in defining persistent post operative pain, however following features are taken into consideration :- Pain that develops after surgical procedure Pain present for atleast 2 months Pain where other causes are excluded Pain from pre surgical problem is exclu | 6,796 | medmcqa_train |
Jone's fracture is? | ANSWER: (A) Avulsion fracture of base of fifth metatarsalREF: APPENDIX-68 below for "ALPHABETICAL LIST OF EPONYMOUS FRACTURES"Jones fracture is avulsion fracture of base of fifth metatarsal APPENDIX - 68Alphabetical List of Eponymous FracturesFractureDescriptionMechanism of injuryAviators fractureFracture neck of talusDorsiflexionBumper fracturecompression fracture of lateral condyle of tibial (always intra articular)Forced valgus of knee when struck from side by car bumperBoxer's fractureFracture of distal 5th metacarpalPunching solid objectBos worth fractureFracture of distal fibula with posterior dislocation of the proximal fibula behind the tibiaSevere external rotation of the footBennett's fractureIntra-articular fracture of base of first metacarpalAxial load along metacarpal in a partially flexed thumb (Abductor pollids longus pull)Barton's fractureIntra articular distal radius fracture invoking the articular surface with dislocation of the radio carpal jointFall on outstretched handBankart's fractureFracture of anterior glenoid associated with anterior shoulder dislocationExternal rotation and abduction of shoulderColies' fractureDistal radius fracture with dorsal angulation, impaction and radial driftFall on outstretched handCotton's fractureTrimalleolar fracture of ankle Clay shoveller's fractureStress avulsion fracture of Spinous process of C6, C7 or T1Forced hyper flexion of neckCh opart's fracture- dislocationFoot dislocation through talonavicular and calcaneocuboid joints with associated fractures, usually after ankle twisting. Treated in a non-weight bearing cast for 6-8 weeks Chauffeur's fractureIntra-articular fracture of radial styloidForced ulnar deviation of the wrist causing avulsion of the radial styloidChance fractureHorizontal fracture of vertebral bodyHyper flexion of spine, seen in car accidents when lap belts xvere usedDuverney fractureIsolated fracture of the iliac wingDirect traumaEssex-LoprestifractureComminuted radial head fracture xvith interosseous membrane disruption and distal radioulnar joint subluxationFall from heightGosselin fractureV-shaped distal tibia fracture extending into the tibial plafond Galeazzi fractureRadius shaft fracture with dislocation of distal radioulnar jointBlow to forearmHolds worth fractureUnstable spinal fracture-dislocation at the thoracolumbar junction Hume fractureOlecranon fracture with anterior dislocation of radial head Hill-Sachs fractureImpacted posterior humeral head fracture occurring during anterior shoulder dislocation Hangman s fractureFracture of both pedicles of C2Distraction and extension of neck (judicial hanging)Jones fractureFracture of base of 5th metatarsal extending into intermetatarsal jointInversion of ankle (pronator brevis pull)Jefferson fractureBurst fracture of 1st cervical vertebraCompression of neckLisfranc fractureFracture dislocation of midfootForced plantar flexion of foot or dropping heavy weight on footLe Forts fracture of the ankleVertical fracture of distal fibula with avulsion of medial malleolus Le Fort fracturesSeries of facial fracturesDirect trauma to faceMoores fractureDistal radius fracture with ulnar dislocation and entrapment of styloid process under annular ligament Monteggia fractureProximal ulna fracture with dislocation of radial headBlow to forearmMarch fractureStress fracture of 2n<1 /3rd metatarsal shaftHeavy or unaccustomed exerciseMalgaignesfractureVertical pelvic fracture through both pubic rami and the ilium or sacroiliac joint with vertical displacementHigh energy impact to pelvis (front to back)MaisonneuvefractureSpiral fracture of proximal fibulaExternal rotation of anklePipkin fracture- dislocationPosterior dislocation of hip with avulsion fracture of fragment of femoral head by the ligamentum teresImpact to the knee with the hip flexed (dashboard injury)Pilon fractureComminuted fracture of distal articular fracture with fibular fracture Pott's fractureBimalleolar fracture of the ankleEversion of ankleRolando fractureIntra articular T or Y shaped Comminuted fracture of base of V metacarpalAxial load along the metacarpal causing splitting of the proximal articular surfaceRunner's fractureStress fracture of distal fibula 3-8 cm above the lateral malleolusRepeated axial stress on fibulaStieda fractureAvulsion fracture of the medial femoral condyle at the origin of the medial collateral ligament Smith's fractureDistal radius fracture with volar displacementFall on outstretched hand with wrist in flexed positionShepherd s fractureFracture of the lateral tubercle of the posterior process of the talus Segond fractureLateral tibial plateau avulsion fracture with anterior cruciate ligament tear| Internal rotation of the kneeSalter-HarrisfracturesFractures involving a growth platevariousTitlaux fractureSalter-Harris III fracture of the tibiaForced lateral rotation of footToddlers fractureUndisplaced spiral fracture of distal tibia in children under 8 years oldLow-energy trauma t often rotational | 6,797 | medmcqa_train |
Most common cause for subdural hematoma | Injury to MMA or MMV - Epidural.
Rupture of berry aneurysm - SAH. | 6,798 | medmcqa_train |
All of the following statement are true about wiskott Aldrich syndrome except | Ref Robbins 9/e p242;218 Wiskott-Aldrich Syndrome Wiskott-Aldrich syndrome is an X-linked recessive disease characterized by thrombocytopenia, eczema, and a marked vul- nerability to recurrent infection, ending in early death; the only treatment is bone marrow transplantation. This is a curious syndrome in that the clinical presentation and immunologic deficits are difficult to explain on the basis of the known underlying genetic defect. The thymus is ini- tially normal, but there is progressive age-related depletion of T lymphocytes in the peripheral blood and lymph nodes, with concurrent loss of cellular immunity. Additionally, patients do not make effective antibody responses to poly- saccharide antigens, and are therefore paicularly suscep- tible to infections with encapsulated, pyogenic bacteria. Affected patients also are prone to the development of malignant lymphomas. The responsible gene encodes a protein (Wiskott-Aldrich syndrome protein) that links several membrane receptors to the cytoskeleton. Although the mechanism is not known, a defect in this protein could result in abnormal cellular morphology (including platelet shape changes) or defective cytoskeleton-dependent acti- vation signals in lymphocytes and other leukocytes, with abnormal cell-cell adhesions and leukocyte migration. | 6,799 | medmcqa_train |
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