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If the prevalence is very low as compared to the incidence for a disease, it implies | Prevalence = Incidence * Duration of illnessIf incidence is high and prevalence is low compared to the incidence, it means the duration of illness is low.Duration can be low if the disease is fatal or disease is easily curable.Park 23e pg: 62 | 6,800 | medmcqa_train |
The distance of aoic constriction of the oesophagus from the upper incisor teeth | First constriction, at the pharyngo-esophageal junction, 9 cm (6 inches) from the incisor teeth. Second constriction, where it's crossed by the arch of aoa, 22.5 cm (9 inches) from the incisor teeth. Third constriction, where it's crossed by the left principal bronchus, 27.5 cm (11 inches) from the incisor teeth. Fouh constriction, where it pierces the diaphragm, 40 cm (15 inches) from the incisor teeth. Ref - sciencedirect.com | 6,801 | medmcqa_train |
At autopsy, a patient who had died with acute anuria and uremia is found to have ischemic necrosis of the coex of both kidneys with relative sparing of the medulla. These pathological findings are MOST likely related to which of the following underlying conditions? | Diffuse coical necrosis, as described in this patient, is usually seen in the setting of disseminated intravascular coagulation, typically in the context of overwhelming sepsis. It can also be seen following hypotension combined with vasoconstriction. Multiple myeloma is associated with renal deposition of amyloid protein and damage to both glomeruli and tubules. Adult polycystic kidney disease would produce enlarged kidneys filled with cystic masses. Pyelonephritis would produce inflammation, often most severe in the renal pelvis. Ref: Levi M., Seligsohn U. (2010). Chapter 130. Disseminated Intravascular Coagulation. In J.T. Prchal, K. Kaushansky, M.A. Lichtman, T.J. Kipps, U. Seligsohn (Eds), Williams Hematology, 8e. | 6,802 | medmcqa_train |
Down Syndrome, All are seen except? | Ans. is 'c' i.e., t (11:14) In 95% of cases of Down Syndrome - trisomy of 21 Extra chromosome is of maternal in origin 1% have mosaic with 46 chromosomes o 4% have robesonian translocation. t (13 : 21) t(14:21) t (15 : 21) o Very rarely long arm of chromosome 21 is triplicate (Paial trisomy) | 6,803 | medmcqa_train |
In an 8 yr old girl with symptoms of rickets, lab investigations show Serum Calcium 7.2 mg/dl, Serum Phosphates 2.3 mg/dl Alkaline Phosphatase 2420 IU/L. The most probable diagnosis is? | ANSWER: (C) Nutritional RicketsREF: Nelson 17th edition page 2342 Table 691-2Table 691-2 Clinical variants of Rickets and Related ConditionsTypeSerum calcium LevelSerumPhosphorusLevelAlkaline Phosphatase ActivityUrine Concentration of Amino AcidsGeneticsI. Calcium deficiency with secondary hyperparathyroidism (deficiency of vitamin D; low 25(OH) D and no stimulation of higher 1,25 (OH)2 D values)1. Lack of vitamin D a. Lack of exposure to sunlighN orLLE E b. Dietary deficiency of vitamin in DN orLLEE c. CongentialN or LLEE 2. Malabsorption of Vitamin DN or LLEE 3. Hepatic diseaseNorLLEE 4. Anticonvulsive drugsN or LLEE 5. Renal osteodystrophyN or LEEV 6. Vitamin D-dependent type ILN or LE EARII. Primary phosphate deficiency (no secondary hyperparathyroidism)1. Genetic primary hypophosphatemiaNLENXD2. Fanconi syndrome a. CystinosisNLEEARb. TyrosinosisNLEEARc. Lowe syndromeNLEEXRd. AcquiredNLEE 3. Renal tubular acidosis, type II proximalNLEN 4. Oneogenic hypophosphatemiaNLEN 5. Phosphate deficiency or malabsorption a. Parenteral hyperalimentationNLEN b. Low phosphate intakeNLEN III. End-organ resistance to 1.25(OH)2 D31. Vitamin D-dependent type II (Several variants)LL or NEEARIV. Related conditions resembling rickets1. HypophosphatasisNNLPhosphoet- hanolamine AR elevated 2. Metaphyseal dysostosis a. Jansen typeENENADb. Schmid typeNNNNADN = normal; L = low; E = elevated; V = variable; X = X-linked; A = Autosomal; D = dominant; R = recessive; Yes = Y.Rickets may be classified as calcium-deficient or phosphate-deficient rickets. The two types of rickets are distinguishable by their clinical manifestations (Table 691-2)In this case Serum Ca levels are low; Phosphate levels are low, while ALP levels are high. | 6,804 | medmcqa_train |
Reilly bodies are seen in? | Mucopolysaccharidoses (MPSs) are characterized by defective degradation and excessive storage of mucopolysaccharides in various tissues. Hepatosplenomegaly, skeletal deformities, lesions of hea valves, subendothelial aerial deposits, paicularly in the coronary aeries, and lesions in the brain, are features that are seen in all of the MPSs. Of the seven recognized variants, only two well-characterized syndromes are discussed briefly here. MPS type I, also known as Hurler syndrome, is caused by a deficiency of a-L-iduronidase. Accumulation of dermatan sulfate and heparan sulfate is seen in cells of the mononuclear phagocyte system, in fibroblasts, and within endothelium and smooth muscle cells of the vascular wall. The affected cells are swollen and have clear cytoplasm, resulting from the accumulation of material positive for periodic acid-Schiff staining within engorged, vacuolated lysosomes. Lysosomal inclusions also are found in neurons, accounting for the mental retardation. MPS type II or Hunter syndrome differs from Hurler syndrome in its mode of inheritance (X-linked), the absence of corneal clouding, and often its milder clinical course. Despite the difference in enzyme deficiency, an accumulation of identical substrates occurs because breakdown of heparan sulfate and dermatan sulfate requires both a-L-iduronidase and the sulfatase; if either one is missing, fuher degradation is blocked. Diagnosis is made by measuring the level of enzyme in leukocytes. Ref: ROBBINS BASIC PATHOLOGY 10th Ed. pg no: 260 | 6,805 | medmcqa_train |
Dehydrogenase in HMP shunt act in oxidative phase to generate which of the following? | . | 6,806 | medmcqa_train |
A 47-year-old man with type II diabetes repos for his 6-month checkup. His doctor prescribes a daily 30-minute routine of walking at a brisk pace. During aerobic exercise, blood flow remains relatively constant to which of the following organs? | Cerebral blood flow at rest is about 750 mL/min and remains unchanged during any grade of muscular exercise. During exercise, coronary blood flow is increased by four to five times with 100% O2 utilization. Renal blood flow is also decreased by 50-80% in severe exercise. During strenuous exercise muscle blood flow can increase up to 20 times, i.e. about 50-80 mL/ 100 g/min muscle tissue. | 6,807 | medmcqa_train |
The conversion of a fatty acid to an active fatty acid is catalysed by which of the following enzymes? | Fatty acids must first be converted to an active intermediate before they can be catabolized. This is the only step in the complete degradation of a fatty acid that requires energy from ATP. In the presence of ATP and coenzyme A, the enzyme acyl-CoA synthetase (thiokinase) catalyzes the conversion of a fatty acid (or FFA) to an “active fatty acid” or acyl-CoA, using one high-energy phosphate and forming AMP and PPi . The PPi is hydrolyzed by inorganic pyrophosphatase with the loss of a further high-energy phosphate, ensuring that the overall reaction goes to completion. Acyl-CoA synthetases are found in the endoplasmic reticulum, peroxisomes, and inside and on the outer membrane of mitochondria.
HARPERS ILLUSTRATED BIOCHEMISTRY30th ed page no. 224 | 6,808 | medmcqa_train |
In which of the following structure of central nervous system the major autonomic reflex centers are found? | The medulla oblongata, commonly called the medulla, is located at the level of the foramen magnum. It serves as the major autonomic reflex center that relays visceral motor control to the hea, blood vessels, respiratory system, and gastrointestinal tract. It possesses the nuclei for the glossopharyngeal, vagal, accessory, and hypoglossal nerves (CNN IX, X, XI, and XII, respectively). Ref: Moon D.A., Foreman K.B., Albeine K.H. (2011). Chapter 16. Brain. In D.A. Moon, K.B. Foreman, K.H. Albeine (Eds), The Big Picture: Gross Anatomy. | 6,809 | medmcqa_train |
Similar features between cerebral abscess and cerebral infarct - | Causes of acquired cerebral palsy may include1,2: Brain damage in the first few months or years of life. Infections, such asmeningitis or encephalitis. Problems with blood flow to the brain due to stroke, blood clotting problems, abnormal blood vessels, a hea defect that was present at bih, orsickle cell disease. A cerebral infarction is an area of necrotic tissue in the brain resulting from a blockage or narrowing in the aeries supplying blood and oxygen to the brain Refer robbins 1258 and 1263 | 6,810 | medmcqa_train |
Metastasis from follicular carcinoma should be treated by: September 2007 | Ans. A: Radioiodine Follicular thyroid carcinoma (FTC) is a well-differentiated tumor. In fact, FTC resembles the normal microscopic pattern of the thyroid. FTC originates in follicular cells and is the second most common cancer of the thyroid, after papillary carcinoma. Follicular and papillary thyroid cancers are considered to be differentiated thyroid cancers; together they make up 95% of thyroid cancer cases. Papillary/follicular carcinoma must be considered a variant of papillary thyroid carcinoma (mixed form), and Huhle cell carcinoma should be considered a variant of FTC. Despite its well-differentiated characteristics, follicular carcinoma may be ovely or minimally invasive. In fact, FTC tumors may spread easily to other organs. The prognosis is better for younger patients than for patients who are older than 45 years. Patients with FTC are more likely to develop lung and bone metastases than are patients with papillary thyroid cancer. The bone metastases in FTC are osteolytic. Older patients have an increased risk of developing bone and lung metastases. The initial treatment for cancer of the thyroid is surgical. The exact nature of the surgical procedure to be performed depends for the most pa on the extent of the local disease. A total thyroidectomy is performed if the primary tumor is larger than 1 cm in diameter or if there is extrathyroidal involvement or distant metastases. Clinically evident lymphadenopathy should be removed with a neck dissection. If the primary tumor is less than 1 cm in diameter, a unilateral lobectomy might be considered. About 4-6 weeks after surgical thyroid removal, patients must have radioiodine to detect and destroy any metastasis and any residual tissue in the thyroid. | 6,811 | medmcqa_train |
Contraindications of ergometrine is - | Ans: C | 6,812 | medmcqa_train |
Hypercalcemia in ECG is diagnosed by- | The main ECG abnormality seen with hypercalcaemia is shoening of QT interval In severe hypercalcaemia, Osborn wave (J waves) may be seen Ventricular irritability and VF arrest has been repoed with extreme hypercalcaemia Increased PR interval and tall T waves are not seen in hypercalcemia Ref Harrison 20th edition pg 1523 | 6,813 | medmcqa_train |
A 8-year-old male had non-blanching rashes over the shin and swelling of the knee joint with haematuria +++ and protein +. Microscopic analysis of his renal biopsy specimen is most likely to show – | This child has →
i) Rash
ii) Arthritis (swelling of knee joint)
iii) Haematuria
All these suggest the diagnosis of Henoch Schonlein purpura
HSP is characterized by deposition of IgA in the mesangium. | 6,814 | medmcqa_train |
FIGLU excretion test is used for assessment of deficiency of - | Ans. is 'c' i.e., Folic acid Assessment of folate deficiencyo Following tests are used for assessment of folate deficiency.Blood levelNormal level in scrum is about 2-20 nanogram/mJ and about 200 micorgram.'ml of packed cells.Histidine load test or FIGLU excretion test :- Histidine is normally metabolized to formimino glutamic acid (FIGLU) from wrhich formimino group is removed by THF. Therefore in folate deficiency, FIGLU excretion is increased in urine.AICAR excretion In purine nucleotide synthesis the 2nd last step is the addition of C2 with the help of N10-formyl THF. This step is blocked in folate deficiency and the precursor, i.e., amino imidazole carboxamide ribosyl-5-phosphate (AICAR) accumulates and is excreted in urine.Peripheral blood picture Macrocytosis, tear drop cells, hvpersegmented neutrophils, anisopoikilocvtosis. | 6,815 | medmcqa_train |
100. A Patient presents with pain in Meta-Tarso-Phalangeal joints and is a known case of chronic renal failure. This is due to accumulation of: | Ans. b. Uric acid The underlying basis of gouty ahritis is increased serum uric acid level. Most common joint involved in gout: Meta-Tarso-Phalangeal jointsQ Precipitation of monosodium urate crystalsdeg into the joints is the underlying basis for these urate crystals is increased total body urate levels | 6,816 | medmcqa_train |
Amount of water lost in stools | Normal" Output: 1400-2300 mL/d Urine: 800-1500 mL Stool: 200 mL-250mL Insensible loss: 600-900 mL (lungs and skin). (With fever, each degree above 98.6degF adds 2.5 mL/kg/d to insensible losses; insensible losses are decreased if a patient is undergoing mechanical ventilation; free water gain can occur from humidified ventilation.)Ref: <a href=" | 6,817 | medmcqa_train |
Cerebral angiography was performed by | Ans. is 'd' i.e., Egas Moniz | 6,818 | medmcqa_train |
Which of the following is used for acute variceal bleeding? | Ans. A. Octreotide.The medical management of acute variceal hemorrhage includes the use of vasoconstricting agents, usually somatostatin or Octreotide. Vasopressin was used in the past but is no longer commonly used. Balloon tamponade (Sengstaken- Blakemore tube or Minnesota tube) can be used in patients who cannot get endoscopic therapy immediately or who need stabilization prior to endoscopic therapy. Control of bleeding can be achieved in the vast majority of cases; however, bleeding recurs in the majority of patients if definitive endoscopic therapy has not been instituted. Octreotide, a direct splanchnic vasoconstrictor, is given at dosages of 50-100mg/h by continuous infusion. | 6,819 | medmcqa_train |
Lateral wall of mastoid antrum is related to ? | MacEwen's triangle or suprameatal triangle overlies the lateral wall of mastoid antrum. It is bounded above by supramastoid crest, anteroinferiorly by posterosuperior margin of external auditory canal and posteriorly by a tangent drawn from zygomatic arch. | 6,820 | medmcqa_train |
Hagemann factor is involved in: March 2009 | Ans. B: Intrinsic pathway Hageman factor is factor XII, also known as glass factor. The initial reaction in the intrinsic system is conversion of inactive factor XII to active factor XII (XIIa). This activation, which is catalyzed by high-molecular-weight kininogen and kallikrein, can be brought about in vitro by exposing the blood to electronegatively charged wettable surfaces such as glass and collagen fibers. Activation in vivo occurs when blood is exposed to the collagen fibers underlying the endothelium in the blood vessels. Active factor XII then activates factor XI, and active factor XI activates factor IX. Activated factor IX forms a complex with active factor VIII, which is activated when it is separated from von Willebrand factor. The complex of IXa and VIIIa activate factor X. Phospholipids from aggregated platelets (PL) and Ca2+ are necessary for full activation of factor X. | 6,821 | medmcqa_train |
Respiratory centre depression is caused by all exceptaEUR' | Strychnine Strychnine is a respiratory stimulant, itfant, it stimulates all pas of CN.S. -In strychnine poisoning the person is not able to breathe but it does not occur due to respiratory centre depression instead it is caused by spasm of the diapharm and thoracic muscles. Respiratory depression with opioids is well known. Barbiturates Wray also cause respiratory depression at high doses (depresses the medullary respiratory centre). Gelesmium The young root of gelesmium is used to prepare homeopathic remedy. The roots have analgesic, antispasmodic, diaphoretic hypnotic, mydriatis, nervine, sedative and vasodilator propeies. It is a powerful depressant of the central nervous system, deadening pain. It is said to suspend and hold in check muscular irritability and nervous excitement with more force and power than any know treatment. Excessive dose of gelesmium causes: ? - Respiratory depression (due to depression of medullary centre) - Giddiness - Double vision - Paralyze the spinal cord - Almost complete loss of muscular power and death should not be recommended .for patients with hea disease, hypotension. | 6,822 | medmcqa_train |
An 18-year-old boy presented with repeated epistaxis and there was a mass arising from the lateral wall of his nose extending into the nasopharynx. It was decided to operate him. All of the following are true regarding his management except | TREATMENT OF NASOPHARYNGEAL ANGIOFIBROMA Surgery:- Surgical excision is the treatment of choice though radiotherapy and chemotherapy singly or in combination have also been used. Ref:- Dhingra; pg num:-248,249 | 6,823 | medmcqa_train |
Bacteria causing acute hemorrhagic conjunctivitis is | Pneumococcus is the only bacteria causing acute hemorrhagic conjunctivitis. | 6,824 | medmcqa_train |
In the cou of law, professional secrecy can be divulged under: MAHE 11 | Ans. Privileged communications | 6,825 | medmcqa_train |
"Cruising" is a developmental milestone attained at the age of: | Cruising is attained by 10-11 months "Cruising" is an action in which a child pulls to the standing position and then scuffles around holding onto a piece of furniture. Ref: Ghai Essentials Pediatrics 9th edition Pgno: 43 | 6,826 | medmcqa_train |
Which of the following muscle relaxant has the maximum duration of action – | On this, there is controversy in different books :-
According to Goodman & Gilman, Pancuronium is the longest acting.
According to Lee Pipecuronium is the longest acting.
Some books have given Doxacurium as longest acting (KDT, Ajay Yadav)
You are lucky as you have got only one amongst these three. For this question doxacurium is the answer for sure. | 6,827 | medmcqa_train |
Superior rib notching is not associated with which of the enlisted conditions? | . | 6,828 | medmcqa_train |
Amniocentesis conducted during genetic counseling of a pregnant woman reveals a fetal adenosine deaminase deficiency. This autosomal recessive immunodeficiency is usually associated with which of the following? | Immunodeficiency disorders can be categorized according to whether the defect primarily involves humoral immunity (bone marrow derived, or B lymphocytes) or cellular immunity (thymus derived, or T lymphocytes) or both. Swiss-type hypogammaglobulinemia, ataxia-telangiectasia, the Wiskott-Aldrich syndrome, and severe combined immunodeficiency disorders all involve defective B-cell and T-cell function. Infantile X-linked agammaglobulinemia is caused chiefly by deficient B-cell activity, whereas thymic hypoplasia is mainly a T-cell immunodeficiency disorder.The fetus represented has severe combined immunodeficiency disease (SCID) characterized by defects in early stem cell differentiation. As a result, B cells and T cells are both defective, immunoglobulins are very low, and tonsils and lymph nodes are absent. | 6,829 | medmcqa_train |
Breast feeding is not contraindicated if: | Breast feeding is not contraindicated if the mother has hepatitis B infection. Infants routinely receive hepatitis B immunoglobulin and hepatitis B vaccine if mother is HBsAg positive. No delay in initiation of breastfeeding is required. Contraindications of Breastfeeding: Donot Breastfeed Infant factors Classic galactosemia maternal factors Human T-cell lymphocyte virus (HTLV) infection Ebola virus infection PCP/Cocaine abuse Donot breastfeed (Temporarily) Donot give expressed breastmilk (Temporarily) Maternal factors: Brucellosis Undergoing Diagnostic imaging with radiopharmaceuticals Active herpes simplex virus (HSV) infection with lesions on the breasts Donot Breastfeed (Temporarily) Can give expressed breastmilk Maternal factors Untreated, active tuberculosis active varicella infection Alcohol consumption and smoking are not contraindications of breastfeeding. However, smoking and alcohol consumption should be discouraged Ref: Nelson textbook of pediatrics 21st edition Pgno: 322 | 6,830 | medmcqa_train |
In the absence of any clear history of trauma, this radiograph done in a patient of shoulder pain most likely suggests: | Ans. B Calcific tendinitisCalcific density is seen adjacent to the greater tuberosity of humerus - mostly this is within the supraspinatus tendon and seen in chronic calcific tendinitis. | 6,831 | medmcqa_train |
Most common causative organism for bacterial meningitis beyond 3 years of age is - | Most common causative organism for bacterial meningitis beyond 3 years of age is - Pneumococcus | 6,832 | medmcqa_train |
Rhinoscleroma occurs due to | Rhinoscleroma
The causative organism is Klebsiella rhinoscleromatis Frisch bacillus, which can be cultured from the biopsy material.
The disease is endemic in several parts of the world.
In India, it is seen more open in northern than in the southern parts.
Biopsy shows infiltration of submucosa with plasma cells, lymphocytes, eosinophils, Mikulicz cells & Russell bodies.
There two are diagnostic features of the disease.
The disease starts in the nose & extends to nasopharynx, oropharynx, larynx, trachea & bronchi.
Mode of infection is unknown.
Both sexes of any age may be affected. | 6,833 | medmcqa_train |
Nerve which loops around submandibular duct? | Submandibular duct It is 5 cm long duct and runs forwards on hyoglossus, between lingual and hypoglossal nerves. At the anterior border of the hyoglossus muscle it is crossed by lingual nerve which loops around it. It opens into the floor of mouth, on the summit of the sublingual papilla at the side offrenulum of tongue. | 6,834 | medmcqa_train |
How soon after feilization occurs within the uterine tube does the blastocyst begin implantation?, | The blastocyst begins implantation by day 5 after feilization. | 6,835 | medmcqa_train |
In a pregnant women of 28 weeks gestation IUD is earliest demonstrated on X-ray by : | Gas in vessels | 6,836 | medmcqa_train |
Average duration of function of primary dentition | Average duration of function of primary dentition is 6 yrs while maximum duration is 10 years. | 6,837 | medmcqa_train |
A patient comes with 6 weeks amenorrhoea and features of shock- | Ans. is 'a' i.e., Ectopic pregnancy Clinical features of ectopic pregnancyo Classical triad is abdominal pain (100%), amenorrhea (75%) & vaginal bleeding (70%).o Amenorrhea usually of short period (6-8 weeks)o Abdominal pain it is acute, agonising & colicky. Located in lower abdomen: unilateral, bilateral or may be generalised.Sometimes the pain may also be referred to shoulder,o Vaginal bleeding may be slight & continuous,o Vomiting & fainting attack.Signso General look (diagnostic)- Patient is quite & conscious, perspires & looks blanched,o Pallor - Severe & proportionate to the amount of internal haemorrhageo Features of shock - Rapid & feeble pulse, hypotension cold & clammy extremities.o Abdominal examination (lower abdomen) - tense, tumid, tender. No mass felt. Shifting dullness present. Muscle guard is usually absento Pelvic examination - Less informative. Vaginal mucosa is blanched white uterus may b normal in size or bulky. Extreme tenderness on fornix palpation or on cervical movements. The uterus floats as if in the water. | 6,838 | medmcqa_train |
The carrying capacity of any given population is determined by its | Limiting resource Carrying capacity : The suppoable population of an organism, given the food, habitat, water and other necessities available within an ecosystem is known as the ecosystem is known as the ecosystem's carrying capacity for that organism RRefers to the number of individuals who can be suppoed in a given area within natural resource limits, and without degrading the natural social, cultural and economic environment for present and future generations For human population more complex variables (Sanitation, medical care) are sometimes considered as pa of necessary infrastructure Below carrying capacity, population typically increase ; While above, they typically decrease May depend on a variety of factors including food availability ; water supply, environmental condition and living space Ref: internet (Wikipedia) | 6,839 | medmcqa_train |
FNAC is the IOC is given below thyroid conditions except | FNAC is the IOC for most of thyroid disorder except Anaplastic carcinoma. Thyroid lymphoma & Reidel's thyroiditis where "tru - cur biopsy" is the investigation of choice. | 6,840 | medmcqa_train |
The treatment of choice for hydatiform mole with a uterine size of 28 weeks is: | Management of vesicular mole/complete mole Suction evacuation (also do a gentle curettage with a sharp curette) Do USG after a week to rule out retained bits Do CXR to rule out metastasis HCG follow up | 6,841 | medmcqa_train |
Which of the following is true regarding olazapine except- | Ans. is 'd' i.e., Less epileptogenic action than phenothiazine o Clozapine and olanzapine are most epileptogenic antipsychotics. o Olanzapine blocks multiple monoaminergic (D2, 5-HT2, al, a2) as well as muscarinic and H1receptors. o It causes weight gain o It causes little rise in prolactin level. | 6,842 | medmcqa_train |
Juxtaglomerular apparatus lies in relation to : | Glomerulus As the name implies ju.aglomerulus apparatus (JGA) lies at hilum of glomerulus Juxtaglornerulus apparatusThe juxtaglomerular apparatus is a microscopic structure in the kidney, which regulates the function of Lech nephron. The juxtaglomerular apparatus is named for its proximity to the glomerulus: it is found between the vascular pole of the renal corpuscle and the returning distal convoluted tubule of the same nephron. This location is critical to its function in regulating renal blood flow and glomerular.filtration rate.The three microscopic components of the apparatus are the macula densa, extraglomerular mesangial cells (lacis cells), and juxtaglomerular cells.Juxtaglomerular cellJuxtaglomerular cells (JG cells, also known as granular cells) are the site of renin secretion.The JG cells are found in the media of afferent aerioles of the glomerulus and act as an intro-renal pressure sensor Lowered pressure leads to decreased pressure on the JG cells stimulating renin secretion. Renin then acts to increase systemic blood pressure (while maintaining GFR) the resi angiotensin systemMacula densaAt the point where the afferent aeriole enters the glomerulus and the efferent leaves it, the tubule of the nephron touches the aeriole of the glomerulus from which it arose.At this location, which marks the sta of the distal convulation, there is the modified region of tubular epithelium called the macula densaThe macula densa senses sodium chloride concentration in the distal tubule of the kidney and secretes a locally active (paracrine) vasopressor which acts on the adjacent afferent aeriole to decrease glomerular filtration rate (GFR), as pa of the tubuloglomerular feedback loop. Specifically, excessive filtration at the glomerulus or inadequate sodium uptake in the proximal tubule / thick ascending loop of Henle brings fluid to the distal convoluted tubule that has an abnormally high concentration of sodium. Na/K/2C1 cotranspoers move sodium into the cells of the macula densa. The increased Na+ conc. triggers a signal that causes constriction of the afferent aeriole thus reducing the GFRLacis cells or extraglomerular mesangial cellsThe function of the extraglomerular mesangial cells remains somewhat mysterious. They contain actin and myosin, allowing them to contract when stimulated by renal sympathetic nerves, which may provide a way for the sympathetic nervous system to modulate the actions of the juxtaglomerular apparatus. In addition, extraglomerular mesangial cells are strategically positioned between the macula densa and the afferent aeriole, and may mediate signalling between these two structures | 6,843 | medmcqa_train |
Founder effect describes the distribution of diseases on the basis of | In population genetics, the founder effect is the loss of genetic variation, and/or occurrence of genetic disorders when a new population is established by a very small number of individuals from a larger population. Ref: 25th edition, Park's Textbook of Preventive and Social Medicine, Page no. 888 | 6,844 | medmcqa_train |
In Maroteaux- Lamy syndrome, the enzyme deficient is? | Ans. A (Arylsulfatase B). (Ref. Harrison, Medicine, 18th/ Chapter 361. Lysosomal Storage Diseases) Maroteaux-Lamy syndrome (MPS type VI) is due to deficiency of N-acetyl galactosamine (arylsulphatase B enzyme). Mucopolysaccharidoses (MPS) Disorder Enzyme Deficiency Stored Material Inheri- tance Neuro- logic Liver Spleen Enlarge- ment Skeletal Dysplasia Ophthal- mologic Hemato- logic Unique Features MPS I, Hurler -L-lduroni- dase Dermatan sulfate Heparan sulfate AR Mental retardation Mental retardation None + + + ++++ Corneal clouding Vacuola- ted lympho- cytes Coarse facies; cardiovas- cular involve- ment; joint stiffness MPS II, Hunter Iduronate sulfatase Dermatan sulfate Heparan sulfate X-linked Mental retardation, less in mild form + + + ++++ Retinal degene- ration, no corneal clouding Granula- ted lympho- cytes Coarse facies; cardiovas- cular involve- ment; joint stiffness; distinctive pebbly skin lesions MPS III, Sanfi- lippo A =Heparan -N-sulfa- tase. B=N-Acetyl -alpha-glu- cosamini- dase. C=Acetyl- CoA: Alpha -glucosa- minide N-acetyl- transferase. D=N-Acetyl glucosa- mine-6- sulfate sulfatase. Heparan sulfate AR Severe mental retarda- tion + + None Granula- ted lym- phocytes Mild coarse facies MPS IV A, Morquio N-Acetyl- galactose mine-6- sulfate sulfatase Keratan sulfate Chondroi- tin-6 sulfate AR None + ++++ Corneal clouding Granu- lated neutro- phils Distinctive skeletal deformity; odontoid hypopla- sia; aortic valve disease MPS IV B, Morquio Beta- Galacto- sidase AR None +- + + + + MPS VI, Marote- aux-Lamy Arylsulfa- tase B Dermatan sulfate AR None + + + + + + Corneal clouding Granula- ted neutron phils and lym- phocytes Coarse facies; valvular heart disease MPS VII Beta-Glu- curoni- dase Dermatan sulfate Heparan sulfate AR Mental retardation, absent in some adults + + + + + + Corneal clouding | 6,845 | medmcqa_train |
Following accidental intra-aerial injection of thiopentone, which should not be done? | Thiopental slows the activity of your brain and nervous system. Thiopental is used to help you relax before you receive general anesthesia with an inhaled medication.Thiopental may be used for other purposes not listed in this medication guide. | 6,846 | medmcqa_train |
Bih weight triples at: Odisha 11 | Ans. 1 year of age | 6,847 | medmcqa_train |
A 7 year old girl is brought with complaints of generalized swelling of the body. Urinary examination reveals Grade 3 proteinuria and the presence of hyaline and fatty casts. She has no history of Hematuria. Which of the following statements about her condition is TRUE? | A young girl presenting with generalized edema, significant proteinuria, absence of hematuria and hyaline and fatty casts is most likely to be suffering from Minimal change disease (Lipoid nephrosis), the most common type of Nephrotic Syndrome. In patients with Minimal change disease, C3 levels are normal and renal biopsy does not show any significant abnormalities except obliteration of epithelial foot processes. Therefore, No IgG Deposits or C3 deposition on renal biopsy is the best answer. Ref: Essential Pediatrics By O P Ghai, 6th Edition, Pages 446, 450 | 6,848 | medmcqa_train |
What is the cardiothoracic ratio in children is - | “The cardiac silhouette occupies 50-55% of the chest width.
Cardiomegaly is present when the cardiothoracic (CT) ratio is more than 55%” he CTR is measured on a PA chest x-ray and is the ratio of maximal horizontal cardiac diameter to maximal horizontal thoracic diameter (inner edge of ribs / edge of pleura).
A normal measurement should be <0.5(50%). | 6,849 | medmcqa_train |
Which ophthalmological investigation is being performed on the patient? | Ans. (c) Direct ophthalmoscopyThe only confusion (if any) should be with Retinoscopy, as both the instruments look the same, but retinoscopy is usually performed from a distance of 1 meter. | 6,850 | medmcqa_train |
Phase 1 biotransformation includes ? | Ans. is 'a' i.e., Reduction Types of biotransformation reactions Biotransformation reactions (metabolism) of drugs can be classified : A. Non-synthetic (phase I) reactions Metabolism brings about a change in the drug molecule by : Oxidation Hydrolysis Decyclization Reduction Cyclization The new metabolite may retain biological activity or it may be an inactive metabolite. Oxidation is the most impoant metabolizing reaction. The most impoant enzyme for oxidation reaction is cytochrome P450. B. Synthetic (phase H or conjugation) reaction Metabolism involves union of the drug with one of several polar (water-soluble) endogenous molecules that are products of intermediary metabolism, to form a water-soluble conjugate which is readily eliminated by kidney or, if the molecular weight exceeds 300, in the bile. Phase II metabolism almost invariably terminates biological activity, i.e. metabolites are usually inactive. o Reactions are Acetylation Glutathione conjugation Neucleotide synthesis Glucuronide conjugation Sulfate conjugation Glycine conjugation Methylation | 6,851 | medmcqa_train |
True about central nystagmus is | Nystagmus is central when the lesion is in the central neural pathways. It cannot be suppressed by optic fixation. The direction of nystagmus is changing and is non-fatiguable. (Ref: Diseases of EAR, NOSE AND THROAT by PL DHINGRA - 6th Edition) | 6,852 | medmcqa_train |
Most common site of primary carcinoma in a case of Krukenberg tumor is: | Krukenberg tumor is secondaries to the ovary, it is most commonly from the CA Stomach (usually adenocarcinoma of gastric pylorus). Other primary sites are breast cancer, appendix, colon, small intestine, rectum gall bladder, biliary tract. Firm to solid waxy consistency and it is bilateral in 90% cases Signet ring cells are seen Most often present in bilateral ovaries, consistent with metastatic nature | 6,853 | medmcqa_train |
Abnormal a-fetoprotein is seen in : | All of the above | 6,854 | medmcqa_train |
ASA grading is to assess? | Ans is 'c' i.e. risk factors * ASA is the simplest and most widely used system for describing patient's physical status to assess the risk factors before anaesthesia.* Brain dead patient is ASA grade-2.American society of anaesthesiologist (asa) classification* ASA classification is for the Preoperative assessment to quantify the risk for patients who require anaesthesia for surgery. This is the simplest and most widely used system for describing patient's physical status (Rajasthan 01). Based on physical status, the patients are classified into six categories. The morbidity and mortality ishighest in grade V patients and minimum is grade I patients.ASA GradePatient conditionASA 1Normal healthy patient (no physical or mental illness)ASA 2Mild systemic disease not limiting functional activity(mild heart disease, DM Mild hypertension, Anemia, Old age, obesity, mild chronic bronchitis)ASA 3Severe systemic disease that limits activity but not incapaciating (Angina,Severe DM, cardiac failure)ASA 4Severe systemic disease that is life-threatening(Marked cardiac insufficiency; presistent angina; severe renal, respiratory or hepatic insufficiency)ASA 5Moribund patient who is not expected to survive whthout operationASA 6Brain dead patient (for organ donation) | 6,855 | medmcqa_train |
Dapoxetine is specifically developed for? | Ans. is 'c' i.e., Premature ejaculation Dapoxetine Dapoxetine is the first compound developed specially for the treatment of premature ejaculation (PE) in men 18-64 years old. Dapoxetine works by inhibiting the serotonin transpoer, increasing serotonin's action at the post synaptic cleft, and as a consequence promoting ejaculatory delay. As a member of selective serotonin reuptake inhibitor (SSRI) family, dapoxetine was initially created as an antidepressant. However, unlike other SSRIs, dapoxetine is absorbed and eliminated rapidly in the body. Its fast-acting propey makes it suitable for the treatment of PE but not as an antidepressant. | 6,856 | medmcqa_train |
In chronic alcoholics which the following enzymes are inhibited- | Ans. is 'a' i.e., Glycogen phosphorylase kinase Alcohol effects on Carbohyrate metabolism* Ethanol adversely affects the carbohydrate metabolism in skeletal muscle.* Chronic alcohol intake is associated with an increase in glycogen concentration in skeletal muscles because of incapacity to degrade glycogen due to partial inhibition of glycogen phosphorylase kinase at glycogenolysis and by decrease in pyruvate kinase activity at glycolysis.* Activities of the glycolytic enzymes phosphofructokinase and lactate dehydrogenase are not affected. | 6,857 | medmcqa_train |
Post traumatic stress syndrome is due to - | REACTION TO STRESS AND ADJUSTMENT DISORDERS This category in ICD-10 consists of disorders which are temporally related to an exceptionally stressful life event ( acute stress reaction and post-traumatic stress disorder) or a significant life change (adjustment disorders) immediately before the onset of illness. Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no.111 | 6,858 | medmcqa_train |
Body dysmorphic disorder can be associated with all except | BDD (Body dysmorphic disorder) is a body-image disorder characterized by persistent and intrusive preoccupations with an imagined or slight defect in one's appearance. People with BDD can dislike any pa of their body, although they often find fault with their hair, skin, nose, chest, or abdomen. People with BDD commonly also suffer from anxiety disorders such as social anxiety disorder, as well as other disorders such as depression, eating disorders, or obsessive-compulsive disorder (OCD). | 6,859 | medmcqa_train |
All are associated with EBV except ? | Ans. is 'd' i.e., Epidermodysplasia Epstein - Barr Virus (EBV) . Belongs to Herpes viruses family. . Infection is most common in early childhood, with a second peak during late adolescence. . Infectious mononucleosis (IM) is usually a disease of young adults. . EBV is transmitted by saliva (oral secretions) of infected person. . Intimate oral contact, as in kissing is the predominant mode of transmission causes kissing disease. . The virus enter the pharyngeal epithelial cells and B cells through (CR 2 / or CD21) receptors. . Memory B Cells are the reservoir of EBV: Clinical Manifestations :Most primary infections are asymptomatic . Causes an acute self limited illness ---> Infectious mononucleosis (Glandular fever) . Incubation period 4-8 weeks . Age groups young adults . Most common symptom of IMN is sore throat . Most common sign is lymphadenopathy . Most common complication --> meningitis/encephalitis | 6,860 | medmcqa_train |
The following is true about prevalence and incidence: | Incidence rate is defined as 'the number of NEW cases occurring in a defined population during a specific period of time.' Disease prevalence refers specifically to all current cases(old and new) existing at a given point in time or over a period of time in a given population. Although referred to as a rate, prevalence rate is really a ratio. Ref: 25th edition, Park's Textbook of Preventive and Social Medicine, Page no. 68, 69 | 6,861 | medmcqa_train |
A child presents with Hepatosplenomegaly, Abdominal distension, Jaundice, Anemia and Adrenal calcification. Which of the following is the Diagnosis ? | Wolman disease is a congenital disease characterized by an impaired metabolism of the fats (lipids). It is the most severe type of lysosomal acid lipase deficiency. The lysomal acid lipase deficiency causes a buildup of lipids (fats) in body organs and calcium deposits in the adrenal glands. Reference: GHAI Essential pediatrics, 8th edition | 6,862 | medmcqa_train |
Perifasicular atrophy of muscle fibres is seen in? | A distinctive feature of dermatomyositis is atrophy and degeneration of myofibres at the periphery of fasicles (perifasicular) which occurs even in the absence of inflammation. | 6,863 | medmcqa_train |
In rural area, cattle sheds should be ..... away from the houses ? | Ans. is 'd' i.e., 25 feet Rural housing In rural areas, the 'approved' standards may be lower than in towns. The following minimum standards have been suggested : There should be at least two living rooms. Ample verandah space may be provided. The built-up area should not exceed one-third of the total area. There should be a separate kitchen with a paved sink or platform for washing utensils. The house should be provided with a sanitary latrine. The window area should be at least 10 percent of the floor area. There should be a sanitary well or a tube well within a quaer of a mile from the house. It is insanitary to keep cattle and livestock in dwelling houses. Cattle sheds should be at least 25 feet away from dwelling houses. A cattle shed should be open on all sides; an area 8 fit 4 fit is sufficient for each head of cattle. There should be adequate arrangement for the disposal of waste water, refuse and garbage. | 6,864 | medmcqa_train |
Vibrio parahemolyticus is seen in which of the following if undercooked? | Vibrio parahaemolyticus infections are associated with the consumption of raw shellfish, cross-contaminated food, and the exposure of wounds to seawater containing V. parahaemolyticus. It is the cause of numerous outbreaks of foodborne illness where raw or uncooked seafoods are commonly consumed. | 6,865 | medmcqa_train |
Ankle sprain due to forced inversion of a plantar flexed foot is due to injury to | Ans. a. Anterior talofibular ligament | 6,866 | medmcqa_train |
Zones of operation theatre includes all except: | Ans: a-septic zone...Protective Zone: Areas included in this zone are:ReceptionWaiting areaTrolley bayChanging roomClean Zone: Areas included in this zone are:Pre-op roomRecovery roomPlaster roomStaff roomStoreSterile Zone: Areas included in this zone are:Operating SuiteScrub RoomAnesthesia Induction RoomSet up RoomDisposal Zone: Areas included in this zone are:Diy UtilityDisposal corridor | 6,867 | medmcqa_train |
A 20 year old man complains of difficulty in reading the newspaper with his right eye, three weeks after sustaining a gun shot injury to his left eye. The most likely diagnosis is: | B i.e. Sympathetic opthalmitis | 6,868 | medmcqa_train |
A 56 year old man is brought to the emergency depament with rapid onset of severe abdominal pain. But physical examination seemed to be out of propoion to his symptom. Acute mesenteric ischemia was diagnosed. What is the MOST common cause of acute mesenteric ischemia? | Acute mesenteric ischemia occurs when prolonged reduction in the splanchnic blood flow occurs. The most common cause is aerial embolism, which accounts for 50% of cases. The emboli most commonly originate from a cardiac source. Most emboli lodge in the superior mesenteric aery (SMA) because of the angle from which it takes off from the aoa. Risk factors for developing the mural thrombi that embolize to the mesenteric aeries include, Myocardial ischemia/infarction Atrial arrhythmias (specifically atrial fibrillation and atrial flutter) Valvular disorders Cardiomyopathies Endocarditis Ventricular aneurysms Ref: Travis A.C., Saltzman J.R. (2012). Chapter 161. Small Bowel Disorders. In G.V. Lawry, S.C. McKean, J. Matloff, J.J. Ross, D.D. Dressler, D.J. Brotman, J.S. Ginsberg (Eds), Principles and Practice of Hospital Medicine. | 6,869 | medmcqa_train |
Untrue about acute cholecystitis | (A) Jaundice is the earliest symptom # ACUTE CHOLECYSTITIS often begins as an attack of biliary pain that progressively worsens.> Approximately 60 to 70% of patients report having experienced prior attacks that resolved spontaneously.> As the episode progresses, however, the pain of acute cholecystitis becomes more generalized in the right upper abdomen.> As with biliary colic, the pain of cholecystitis may radiate to the interscapular area, right scapula, or shoulder.> Peritoneal signs of inflammation such as increased pain with jarring or on deep respiration may be apparent.> The patient is anorectic and often nauseated.> Vomiting is relatively common and may produce symptoms and signs of vascular and extracellular volume depletion.> Jaundice is unusual early in the course of acute cholecystitis but may occur when edematous inflammatory changes involve the bile ducts and surrounding lymph nodes.> The serum bilirubin is mildly elevated in fewer than half of patients, while about one-fourth have modest elevations in serum aminotransferases (usually less than a fivefold elevation)> The radionuclide (e.g., HIDA) biliary scan may be confirmatory if bile duct imaging is seen without visualization of the gallbladder.> Ultrasound will demonstrate calculi in 90 to 95% of cases | 6,870 | medmcqa_train |
Fallen fragment sign is a feature of ? | Ans. is 'a' i.e., Simple bone Simple bone cyst (Solitery/Unicameral bone cyst) Simple bone cyst occurs before the age of 20 years The most common site is proximal humerus (50%)followed by Proximal femur (25-30%). Radiological features are : - Concentric Metaphyseal Expansile lucent (lytic) Well defined border with sclerotic margin Fallen Fragment sign : - Coical fragment of pathological fracture settles in the most dependent poion. Hinged fragment sign : - Sometimes fractured fragment does not separate from adjacent coex. | 6,871 | medmcqa_train |
The sensation of posterior aspect of tongue is by | The glossopharyngeal nerve is the nerve for both general sensation and taste for the posterior one third of the tongue including the circumvallate papillae.The posterior most pa of the tongue is supplied by the vagus nerve through the internal laryngeal branch.The sensory supply of anterior two thirds is lingual nerve where as the taste sensation from the anterior two thirds is carried out by chorda tympani except vallate papillae(pre-trematic branch of first arch). REF.BDC VOL 3,Fifth edition. | 6,872 | medmcqa_train |
A 56-year-old woman with diabetes, hypertension, and hyperlipidemia is found to have an A1C of 11 despite her best attempts at diet and faithfully taking her metformin and glyburide. The patient mentions that she has been unable to exercise much, partially due to severe fatigue and sleepiness in the daytime. On examination she is obese, has a full appearing posterior pharynx, clear lungs, a normal heart examination, and trace bilateral edema. Reflexes and skin are normal. Her TSH is 2.0 m/L (normal). The patient asks if there is anything else that can be done before adding another oral agent or switching to insulin. What is the best next step? | Obstructive sleep apnea (OSA) that has gone untreated contributes to increased insulin resistance. This appears to have an additional effect even beyond the common cooccurrence of obesity as in this patient. Treatment of OSA can lead to improvement in glucose control. This patient is obese, has a crowded oropharynx on examination, and has daytime somnolence. Although overnight oxygen saturation monitor may be performed at home as screening, this patient is at high risk of complications of OSA should proceed directly to formal overnight polysomnography. Sleep hygiene is important for patients with sleep disturbance but is not likely to help in this patient with probable severe OSA. Similarly, sedative hypnotic agents such as zolpidem are widely prescribed for sleep but could exacerbate the OSA. Depression should always be explored but there are no clues beyond fatigue to suggest this diagnosis. Low vitamin D levels are generally asymptomatic unless the condition is severe and prolonged and would not affect sleep apnea or glucose control specifically. | 6,873 | medmcqa_train |
What is the size of particle is rapid sand filter ? | Rapid sand filter → 0.4 - 0.7 mm
Slow sand filter → 0.2 - 0.3 | 6,874 | medmcqa_train |
Which of the following diseases is not transmitted by fleas? | Diseases transmitted by fleas include: Plague Endemic typhus Chiggerosis Hymenolepis diminuta. Ref: Park 21st edition page: 719. | 6,875 | medmcqa_train |
Fetal blood loss occurs in : | Vasa pre | 6,876 | medmcqa_train |
What will be reversible damage? | In this question primarily we talking about asthma= We give salbutamol FEV1 becomes Normal Change of FEV1 before & after giving salbutamol (SABA) should be at least 12% to call it Bronchial Asthma. | 6,877 | medmcqa_train |
4 drugs in AKT used because - | <p> 4 drugs used in AKT because of decrease in resistance by mutation. Park&;s textbook of preventive and social medicine,K.Park,22nd edition,page no:173. <\p> | 6,878 | medmcqa_train |
The child , Makes tower of 9 cubes at age of ____________ | Emerging patterns of Adaptive milestones from 1-5years of age 15months Makes a tower of 3 cubes Makes a line with a crayon Inses raisin in a bottle 18months Makes a tower of 4 cubes Imitates scribbling Imitates veical stroke Dumps raisin from a bottle 24months Makes a tower of 7 cubes (6 at 21 mo) Scribbles in a circular pattern Imitates horizontal stroke Folds paper once imitatively 30months Makes a tower of 9 cubes Makes veical and horizontal strokes, but generally will not join them to make cross Imitates circular stroke, forming a closed figure 36months Makes a tower of 10 cubes Imitates construction of "bridge" of 3 cubes Copies circle Imitates cross 48months Copies bridge from model Imitates construction of "gate" of 5 cubes Copies cross and square Draws man with 2-4 pas besides the head Identifies longer of 2 lines 60months Draws a triangle from copy Names heavier of 2 weights Ref: Nelson paediatrics; Table 11-1 | 6,879 | medmcqa_train |
Actinomycosis most commonly affects | Facio - cervical Actinomycosis is most common type. | 6,880 | medmcqa_train |
Pseudosulcus in larynx is | Laryngeal pseudosulcus refers to edema of the ventral surface of the true vocal fold that extends from the anterior commissure to the posterior larynx. Patients with pseudosulcus are nearly 2.5 times more likely to have pH-documented Larynopharyngela reflux. | 6,881 | medmcqa_train |
Thinnest pa of retina | Foveola High Yield Facts Posterior Pole: Macula + Optic nerve head. Optic disc: 1.5 mm Macula: 5.5 mm (Temporal to optic disc) Fovea - Centralis : Central depressed pa of Macula, 1.5 mm Foveola - 0.35 mm. Thinnest pa of retina after ora serrata. Contains no ganglion cells, only cones. | 6,882 | medmcqa_train |
Absolute contraindications of oral contraceptive pill are all EXCEPT : | Smoking | 6,883 | medmcqa_train |
A 22 year old man presents with a solitary 2 cm space occupying lesion of mixed echogenicity in the right lobe of the liver on ultrasound examination. The rest of the liver is normal. Which of the following tests should be done next – | Lesion in right hepatic lobe with mixed echogenicity on USG suggests the diagnosis of hemangioma.
MRI is the most accurate method of diagnosing liver hemangioma and is indicated when liver hemangioma is suspected on USG and the diameter of the lesion is smaller than 2.5 cm. However, MRI is not provided in the options.
A second most accurate method of diagnosing liver hemangioma is SPECT RBC scintigraphy (hepatic scintigraphy). It is indicated to confirm the diagnosis when hemangioma is suspected on USG and the diameter of the lesion is greater than 2.5 cm.
Suspected hemangioma on USG:-
Lesion smaller than 2.5 cm in diameter → MRI
Lesion greater than 2.5 cm in diameter → hepatic scintigraphy | 6,884 | medmcqa_train |
True about Lucio's phenomenon is- | Ans. is 'c' i.e. Ischemic necrosis * Lucio's phenomenon is seen in untreated cases of lepromatous leprosy.Lucio's phenomenon* Lucio's phenomenon is seen in lepromatous leprosy (LL). It occurs in patients who are untreated. Patients develop recurrent crops of large sharply marginated, ulcerative lesions, particularly on lower extrimities. It is due to heavy parasitism of endothelial cell, endothelial proliferation and thrombus formation which lead to ischemic necrosis. | 6,885 | medmcqa_train |
Anakinrais- | Ans. is 'b' i.e., IL 1 antagonist BIOLOGIC RESPONSE MODIFIER (BRMs)* Several recombinant proteins/monoclonal antibodies that bind and inhibit cytokines, especially TNFa or IL-1 have been used succesfully in autoimmune diseases like RA, IBD, psoriosis or scleroderma.A. TNF-a inhibitorsa. Etanercept# It is a recombinant fusion protein of TNF - receptor and Fc portion of human IgG1'# It is administered by S.C. injection.b. Infliximab# It is a chimeral monoclonol antibody which binds and neutralizes TNF-a.# It is given by i.v. route.# It is indicated in RA, psoriotic arthritis, Crohn's disease, Wegener's granulomatosis and sarcoidosis.c. Adalimumab# This recombinant monoclonal anti-TNF antibody.# It is administered by S.C. route.B. IL-1 antagonistAnakinra# It is a recombinant human IL-1 receptor antagonist.# It is less effective than TNF inhibitors.# It is administered by S.C. route.C. T-cell costimulatory blockersAbatacept# It is a fusion protein that combines the extracellular domain of the molecule CTLA4 (CD 154) with the Fc portion of a human immunoglobulin.# It interfere with the interactions between antigen presenting cells and T lymphocytes. Therefore, it affects early stages in the pathogenic cascade of event in RA.D. B-cell depletersRituximab# B-cells are inflammatory cells with multiple functions in the immune response. The depletion of B cells has been shown to be effective in reducing signs and symptoms of RA and in slowing radiographic progression.# Rituximab is a chimeric monoclonal antibody that binds to the CD20 molecule on the B cell surface leading to the removal of B cells from the circulation. | 6,886 | medmcqa_train |
Excessive sexual desire in females is known as? | Ans. is 'a' i.e. Nymphomania Sexual dysfunction* Sexual dysfunction are characterized by repeated inability to participate in sexual relationship or its unsatisfying nature. Important sexual dysfunctions are: -1. Disorder of sexual desire:- i) Excessive sexual desire - Satyriasis in males and nymphomania in women, ii) Hypoactive sexual desire - Frigidity2. Disorder of sexual arousal (Impotence or erectile dysfunction)# This disorder is characterized by an inability to have or sustain penile erection till the completion of satisfactory sexual activity. One of the important method to distinguish psychogenic impotence from organic impotence is nocturnal penile tumescence & early morning erection which are preserved in psychogenic impotence but not in organic cause of impotence.# Phosphodiesterase-5-inhibitors (Sildenafil, Todafil, vardenafil) are the drug of choice for erectile dysfunction. Other treatment includes PIPE therapy (Papaverine/Phentolamine induced penile erection), Alprastadil (Prostaglandin El), Androgens, and penile prosthesis/vaccume constrictor device. Sensate focus technique is the method in which the aim is to discover on body (excluding genitals) sensate focus, where manipulation leads to sexual arousal.3. Orgasmic dysfunction : - Premature ejaculation : -# Premature ejaculation is defined as ejaculation before the completion of satisfactory sexual activity for both partners.# Squeeze technique (Seman's technique) is used for premature ejaculation. When the male partner experiences 'ejaculatory inevitability' the female partner 'squeezes' the penis on the coronal ridge thus delaying ejaculation.# Dapoxetine (A new SSRI) can be used in treatment | 6,887 | medmcqa_train |
Sertoli cells in male secrete - | Ans. is 'c1 i.e., MIHo Sertoli cells are stimulated by FSH and secreteAndrogen binding protein (ABP)InhibinMullerian inhibiting substance (MIS) or Mullerian inhibiting hormone (MIH)o Leydig cells are stimulated by LH and secrete androgens (testesterone), dihydrotestosterone, androstendione, dehydroepiandrosterone. | 6,888 | medmcqa_train |
Which statement regarding transmission of viral illness through homologous blood transfusion is true? | CMV is harbored in blood leukocytes. While acute CMV infection may cause transient fever, jaundice, and hepatosplenomegaly in cases of large blood donor exposures, post transfusion l.CMV infection (seroconversion) is not a significant clinical problem in immunocompetent recipients, and therefore blood is not routinely tested for the presence of CMV Post transfusion non-A, non-S hepatitis, however, not only represents the most frequent infectious complication of transfusion but also is associated with an incidence of chronic active hepatitis up to 16% and an 8 to 10% incidence of cirrhosis or hepatoma or both. The etiologic agent in over 90% of cases of post transfusion hepatitis has' been identified as hepatitis C. | 6,889 | medmcqa_train |
Deformity with decreased carrying angle is | Refer Apleys 9th e p 372 Cubitus varus develops which is reduced carrying angle and Cubitus valgus is increased carrying angle | 6,890 | medmcqa_train |
Aery forming anastomosis around surgical neck humerus - | Ans. is'c'i.e., 3rd pa of axillary aeryAnastomosis around surgical neck of humerus is formed by -Anterior circumflex humeral aery.Posterior circumflex humeral aeryBoth are branches of 3rd pa of axillary aery. | 6,891 | medmcqa_train |
In which of the following state, a person is mute and akinetic, but can be awakened and even be ale? | Ans.A. StuporStupor refers to a higher degree of arousability in which the patient can be transiently awakened only by vigorous stimuli, accompanied by motor behaviour that leads to avoidance of uncomfoable or aggravating stimuli. | 6,892 | medmcqa_train |
The deltoid ligament is a strong ligament. It is attached to all of the following structures, EXCEPT? | Medial collateral ligament (deltoid ligament) attaches to the medial malleolus of the tibia and the navicular, talus, and calcaneus bones. This ligament prevents medial distraction (eversion) and excessive range of motion. It is subdivided into four pas:Tibionavicular pa attaches the margin of the plantar calcaneonavicular ligament (spring ligament).Tibiocalcaneal pa attaches to the sustentaculum tali of the calcaneus bone.Posterior tibiotalar pa attaches to the medial side and medial tubercle of the talus.Anterior tibiotalar pa attaches to the medial surface of the talus. | 6,893 | medmcqa_train |
The major purpose of Randomization in clinical trials is to - | Ans. is 'd' i.e., Reduce selection bias in allocation of treatment | 6,894 | medmcqa_train |
Which of the following is an indor air-pollutonts- | Ans. is 'a' i.e., Carbon dioxide Important indoor air pollutantsPOLLUTANTSSOURCESRespirable particlesTobacco smoke, Stove, Aerosol sprays.Carbon monoxideCombustion equipment, Stove, Gas heaters.Nitrogen dioxideGas cookersCigarettesSulphur dioxideCoal combustionCarbon dioxideCombustion, respirationFormaldehydeParticle board, Carpet adhesives, Insulation.Other organic vapours(benzene, toluene, etc)Solvents, adhesives, resin products, aerosol sprays.OzoneElectric arcing, UV light sourceRadon and "daughters"Building materialAsbestosInsulation, Fire proofingMineral fibersAppliances | 6,895 | medmcqa_train |
Which of the following is a feature of Vit B12 deficiency anemia? | Clinical manifestations of Vitamin B12 deficiency: Haematological: Macro-ovalocytes, Hypersegmentation of neutrophils. Neurological: Demyelination in peripheral nerves and spinal cord B12 deficiency leads to megaloblastic anemia due to folate trap The peripheral smear given below shows hypersegmented neutrophil and macro-ovalocytes | 6,896 | medmcqa_train |
Rate of involution of uterus is: March 2011 | Ans. C: 1.25 cm per day During the first 24 hours after delivery, the level of the uterus remains constant; thereafter there is a steady decrease in height by 1.25 cm (half inch) in 24 hours, so that by the end of 2^d week, the uterus becomes a pelvic organ Remember: Puerperium period: 6 weeks after delivery Involution of uterus is complete by: 6 weeks Uterus becomes a pelvic organ: 2 weeks after the delivery MC cause of puerperal infection: Streptococcus MC route of puerperal infection: Direct spread | 6,897 | medmcqa_train |
The CSF findings in TB meningitis include – | CSF in T meningitis
Low sugar o Predominant cells --> Lymphocytes o Opening pressure is elevated
High protein o Very low chloride | 6,898 | medmcqa_train |
All are true about Dermatitis herpetiformis EXCEPT: | Lesions have epidermal bullae REF: Fitzpatrik dermatology 6th ed p. 558-73 Dermatitis herpetiformis (DH) is an intensely pruritic, papulovesicular skin disease characterized by lesions symmetrically distributed over extensor surfaces (i.e., elbows, knees, buttocks, back, scalp, and posterior neck). Almost all DH patients have an associated, usually subclinical, gluten-sensitive enteropathy , and >90% express the HLA-B8/DRw3 and HLA-DQw2 haplotypes. DH may present at any age, including childhood; onset in the second to fouh decades is most common. The disease is typically chronic. Biopsy: Small intestine shows paial villus atrophy Skin lesions show sub-epidermal bullae and papillary tip abscess , IgA in papillary tips (on DIF) Treatment: Dapsone and gluten free diet | 6,899 | medmcqa_train |
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