question
string | options
list | rationale
string | label
string | label_idx
int64 | dataset
string |
|---|---|---|---|---|---|
One year old male child with sparse blond hair, developmental delay and tremors, diagnosis
|
[
"Albinism",
"Phenylketonuria",
"Cerebral palsy",
"Infantile tremor syndrome"
] |
Explanation:
Phenylketonuria is due to deficiency of enzyme phenylalanine hydroxylase or of its cofactor tetrahydrobiopterin ;leads to accumulation of phenylalanine in body fluids and brain. It is mainly characterized by profound mental retardation ,lighter complexion and neurologic symptoms like tremors,hyperreflexia and spasticity. Reference: Nelson TB of pediatrics 19th edition, pg 418
|
b
| 1 |
medmcqa
|
Referred pain in external hemorrhoids is due to
|
[
"Common pudendal nerve",
"Inferior rectal nerve",
"Splanchnic nerve",
"Sympathetic nerve"
] |
Explanation:
Internal hemorrhoids are located on the inside lining of the rectum and cannot be felt unless they prolapse and push through the anus opening causing pain and itching. A thrombosed external hemorrhoid occurs when blood within the blood vessel clots, and may cause significant pain and swelling.
|
b
| 1 |
medmcqa
|
A 11-month old child presents with complaints of respiratory distress. On examination there is bilateral crepitation and wheezing. Which of the following is the most likely cause?
|
[
"Pneumonia",
"Adenovirus",
"Respiratory syncytial virus",
"Rhinovirus"
] |
Explanation:
Respiratory syncytial virus (RSV) is the most impoant cause of pneumonia and bronchiolitis in infants. The classic disease is bronchiolitis, characterized by diffuse wheezing, variable fever, cough, tachypnea, difficulty feeding, and, in severe cases, cyanosis. In severe cases, children must be hospitalized and given humidified oxygen. Ref: Levinson W. (2012). Chapter 39. RNA-Enveloped Viruses. In W. Levinson (Ed), Review of Medical Microbiology & Immunology, 12e.
|
c
| 2 |
medmcqa
|
Which of the following is specifically associated with infection with Schistosoma haematobium?
|
[
"Adenocarcinoma of the bladder",
"Adenocarcinoma of the renal pelvis",
"Squamous cell carcinoma of the bladder",
"Transitional cell carcinoma of the bladder"
] |
Explanation:
Carcinomas of the bladder and renal pelvis are usually transitional cell carcinomas. However, Schistosoma haematobium infection (where Schistosomes lay eggs in the veins near the bladder, thereby inducing a marked inflammatory response) is associated with squamous metaplasia and squamous cell carcinoma of the bladder. Some authors have suggested that medications used to kill the worms may contribute to the etiology. Adenocarcinomas of the renal pelvis and bladder are rare. Ref: Brooks G.F. (2013). Chapter 46. Medical Parasitology. In G.F. Brooks (Ed),Jawetz, Melnick, & Adelberg's Medical Microbiology, 26e.
|
c
| 2 |
medmcqa
|
Increased dopamine levels are associated ?
|
[
"Depression",
"Mania",
"Delirium",
"Schizophrenia"
] |
Explanation:
Ans. D. SchizophreniaDopamine hypothesis is the most accepted hypothesis for schizophrenia.There is hyperactivity of dopaminergic system.Other neurotransmitters involved are : - Increased serotonin, Decreased GABA, variable change (Increased or decreased) glutamate, and increased norepinephrine.
|
d
| 3 |
medmcqa
|
According to WHO, blindness is defined as a visual acuity of the better eye, less than
|
[
"6/60.",
"5/60.",
"4/60.",
"3/60."
] |
Explanation:
Blindness
WHO has proposed a uniform criterion and defined blindness as "Visual acuity of less than 3/60 or its equivalent".
In the absence of appropriate vision charts, the WHO has now added the "inability to count fingers in daylight at a distance of 3 meters" to indicates less than 3/60 or its equivalent.
|
d
| 3 |
medmcqa
|
Not a specific tumor marker is?
|
[
"CD 99",
"HMB45",
"b- globulin",
"CEA"
] |
Explanation:
Ans is 'd' i.e., CEA o Carcinoembryonic antigen (CEA) is used as tumor marker for colorectal cancer (major use), lung cancer, breast cancer and ovarian cancer. It is alsoincreased in non-neoplastic conditions like alcoholic cirrhosis, hepatitis, IBD (CD, UC), smoking and pancreatitis.o CEA lacks sensitivity as well as specificity, hence cannot be used to confirm the diagnosis.About other optionso CD 99 - specific marker for Ewing's sarcomao HMB 45 - specific marker for malignant melanomao b- globulin - specific marker for multiple myeloma
|
d
| 3 |
medmcqa
|
Which of the following statements about Langerhans cells is true?
|
[
"They are commonly found in the dermis.",
"They function as sensory mechanoreceptors.",
"They function as receptors for cold.",
"They play an immunological role in the skin."
] |
Explanation:
Langerhans cells in the epidermis function as antigen-presenting cells by trapping antigens that penetrate the Epidermis and transpoing them to regional lymph nodes, where they are presented to T lymphocytes.
|
d
| 3 |
medmcqa
|
What enzyme is inhibited by etoposide -
|
[
"Topoisomerase I",
"Topoismerase II",
"Dihydrofolate reductase",
"Dihydro orotate oxidase"
] |
Explanation:
Ans. is 'b' i.e., Topoismerase II Etoposide* It is a semisynthetic derivative of podophyllotoxin, a plant glycoside.* It is not a mitotic inhibitor, but arrests cells in the G2 phase and causes DNA breaks by affecting DNA topoisomerase-2 function.* While the cleaving of double stranded DNA is not interfered, the subsequent resealing of the strand is prevented.* Etoposide is used in testicular tumours, lung cancer, Hodgkin's and other lymphomas, carcinoma bladder and stomach. Alopecia, leucopenia and g.i.t. disturbances are the main toxicity. Oral bioavailability is 50%; oral dose is double than i.v. dose.
|
b
| 1 |
medmcqa
|
Max duration of time spent is in NREM stage ?
|
[
"I",
"II",
"III",
"IV"
] |
Explanation:
Ans. B. II
|
b
| 1 |
medmcqa
|
Golf-hole ureter is seen in
|
[
"Ureteric calculus",
"Ureteral polyp",
"Tuberculosis of ureter",
"Retroperitoneal fibrosis"
] |
c
| 2 |
medmcqa
|
|
A 25 year male presented with high grade fever, headache, neck stiffness, on examination found to have neck rigidity, kernig's sign positive, csf analysis showed neutrophilic predominance, low glucose and limulus amebocyte lysate assay was positive. Which of the following is the likely pathogen?
|
[
"Staphylococcus aureus",
"Streptococcus pneumonia",
"Neisseria meningitides",
"Listeria monocytogenes"
] |
Explanation:
The Limulus amebocyte lysate assay is a rapid diagnostic test for the detection of gram-negative endotoxin in CSF and thus for making a diagnosis of gram-negative bacterial meningitis. The test has a specificity of 85-100% and a sensitivity approaching 100%. Thus, a positive Limulus amebocyte lysate assay occurs in viually all patients with gram-negative bacterial meningitis, but false positives may occur. Ref Harrison 20th edition page 1001
|
c
| 2 |
medmcqa
|
Which type thyroid carcinoma is classically associated with calcitonin induced amyloid deposition?
|
[
"Papillary",
"Follicular",
"Anaplastic",
"Medullary"
] |
Explanation:
Ans. D. Medullary. (Ref. Robbin's pathology 8,h/pg. 771; harrison's medicine 17th/pg. Table 77-5 )Robbin's pathology 8th/pg. 771......."Sporadic cases of medullary carcinoma present most often as a mass in the neck, sometimes associated with compression effects such as dysphagia or hoarseness. In some instances the initial manifestations are caused by the secretion of a peptide hormone (e.g., diarrhea caused by the secretion of VIP). Notably, hypocalcemia is not a feature, despite the presence of raised calcitonin levels. Screening of relatives for elevated calcitonin levels or RET mutations permits early detection of tumors in familial cases. All MEN-2 kindred carrying RET mutations are offered prophylactic thyroidectomies to preempt the development of medullary carcinomas;. Recent studies have shown that specific RET mutations correlate with an aggressive behavior in medullary carcinomas".Harrison's medicine l7th/pg. 2246.........."Elevated serum calcitonin provides a marker of residual or recurrent MCT".Medullary carcinomas of the thyroid# Introduction: Neuroendocrine neoplasms derived from the parafollicular cells, or C cells, of the thyroid.# Genetics: Both familial and sporadic medullary forms demonstrate activating RET mutations. Sporadic medullary carcinomas, as well as FMTC, occur in adults.# Distinct features:- Like normal C cells, medullary carcinomas secrete calcitonin, the measurement of which plays an important role in the diagnosis and postoperative follow-up of patients.- In some cases, the tumor cells elaborate other polypeptide hormones such as somatostatin, serotonin, and vasoactive intestinal peptide (VIP).- Medullary carcinomas arise sporadically in about 80% of cases. The remaining 20% are familial cases occurring in the setting of MEN syndromes 2A or 2B, or familial medullary thyroid carcinoma (FMTC) without an associatedMEN syndrome.- Multicentricity is particularly common in familial cases.- Acellular amyloid deposits, derived from altered calcitonin molecules, are present in the adjacent stroma (distinctive feature).- Electron microscopy reveals variable numbers of intracytoplasmic membrane-bound electron-dense granules. One of the peculiar features of familial is the presence of multicentric C-cell hyperplasia in the surrounding thyroid parenchyma, a feature usually absent in sporadic lesions.# Management: primarily surgical. Unlike tumors derived from thyroid follicular cells, these tumors do not take up radioiodine. External radiation and chemotherapy may provide palliation in advanced disease.Thyroid Neoplasms# Most thyroid neoplasms present as solitary thyroid nodules;# Only 1% of all thyroid nodules are neoplastic.# Follicular adenomas are the most common benign neoplasms.0# Papillary carcinoma is the most common malignancy.0# Multiple genetic pathways are involved in thyroid carcinogenesis. Some of the genetic abnormalities that are fairly unique to thyroid cancers include:- PAX8-PPAR71 fusion = follicular carcinoma.- Chromosomal rearrangements involving the RET oncogene = papillary cancers &- Mutations of RET = medullary carcinomas.0# Follicular adenomas and carcinomas are both composed of well-differentiated follicular epithelial cells, and are distinguished by evidence of capsular and/or vascular invasion in the latter.0# Papillary carcinomas are recognized based on nuclear features (ground-glass nuclei, pseudo-inclusions) even in the absence of papillae. Psammoma bodies are a characteristic feature of papillary cancers; these neoplasms typically metastasize via lymphatics but their prognosis is excellent.# Medullary cancers are nonepithelial neoplasms arising from the parafollicular C cells and can occur in either sporadic (80%) or familial (20%) settings. Multicentricity and C-cell hyperplasia are features of familial cases. Amyloid deposits are a characteristic histologic finding.# Anaplastic carcinomas are thought to arise by dedifferentiation of more differentiated neoplasms. They are highly aggressive, uniformly lethal cancers.Multiple endocrine neoplasiaMEN1IVIEN2Mixed Syndromes1. Parathyroid hyperplasia or adenoma2. Pancreatic Islet cell hyperplasia, adenoma, or carcinoma3. Pituitary hyperplasia or adenoma4. Other less common manifestations: foregut carcinoid, pheochromocytoma, subcutaneous or visceral lipomasA. MEN2A1. MTC2. Pheochromocytoma3. Parathyroid hyperplasia or adenomaB. MEN2A with cutaneous lichen amyloidosisC. MEN2A with Hirschsprung diseaseD. Familial MTCE. MEN2B1. MTC2. Pheochromocytoma3. Mucosal and GI neuromas4. Marfanoid featuresA. Von Hippel-Lindau syndrome1. Pheochromocytoma2. Islet cell tumor3. Renal cell carcinoma (B/L)4. Hemangioblastoma of CNS5. Retinal angiomasB. Neurofibromatosis with features of MEN1 or 2C. Carney complex1. Myxomas of heart, skin, and breast2. Spotty cutaneous pigmentation3. Testicular, adrenal, and GH- producing pituitary tumors4. Peripheral nerve schwannomas
|
d
| 3 |
medmcqa
|
USG FAST does not involve scanning of which region from the following?
|
[
"Pericardial",
"Pleural",
"Pelvic",
"Hepatic"
] |
Explanation:
Ans is 'b' i.e., Pleural Focused abdominal sonar for trauma (FAST)* FAST is a technique whereby ultrasound imaging is used to assess the torso for the presence of blood, either in the abdominal cavity or in the pericardium. The purpose of the ultrasound evaluation of the injured casualty is to determine the presence of free intra-abdominal or pericardial fluid. The technique therefore focuses only on four areas : a) Pericardial, b) Splenic, c) Hepatic and d) Pelvic
|
b
| 1 |
medmcqa
|
Which is the following structure passes through the lateral pa of superior orbital fissure
|
[
"Superior ophthalmic vein",
"Inferior ophthalmic vein",
"Abducent nerve",
"Nasociliary nerve"
] |
Explanation:
Superior ophthalmic vein is a tributary of cavernous sinus Passes through lateral pa of SOF which is outside the ring of Zinn through which cranial nerves passes Nasociliary nerve passes within the ring of Zinn. Inferior ophthalmic vein passes more medially to superior ophthalmic vein.
|
a
| 0 |
medmcqa
|
A 40 year old patient has undergone an Open cholecystectomy. The procedure was repoed as uneventful by the operating surgeon. She has 100ml of bile output from the drain kept in gallbladder bed on the first postop day. On. Examination she is afebrile and anicteric. The abdomen is soft and bowel sounds are normally heard. As an attending physician, what should be your best possible advice
|
[
"Order an urgent endoscopic Retrograde cholangiography and biliary stenting",
"Urgent laparotomy",
"Order an urgent hepatic imino diacetuc acid scintigraphy (HIDA)",
"Clinical observation"
] |
Explanation:
A small amount of biliary drainage following cholecystectomy should cause no alarm because it usuly disappears within 1 or 2 days. However, excessive biliary drainage through the wound or drain site, jaundice, sepsis or a combination of these events early in the postoperative periods should suggest a bile duct injury, as should copious biliary drainage for more than few post op days Ref : Sabiston 20th edition Pgno :1503
|
d
| 3 |
medmcqa
|
Diagnosis based on given radiograph:
|
[
"Abfraction",
"Irreversible pulpitis",
"Vertical root fracture",
"Infraction"
] |
Explanation:
VERTICAL ROOT FRACTURE
Etiology
Root anatomy, amount of remaining sound tooth structure, loss of moisture in dentin, amount of bony support, pre-existing cracks and biochemical properties of root dentin are predisposing etiological factors.
Traumatic occlusion.
Excessive load on an endodontically treated tooth.
Bruxism.
Clinical Features
Dull spontaneous pain, mastication pain, tooth mobility, periodontal-type abscesses and bony radiolucencies.
Deep osseous defects: The typical bone loss pattern in teeth with vertical root fracture is the loss of alveolar bone, specifically in relation to the fracture area.
Sinus tract located near the cervical area.
Radiographic Features
Separation of root segments associated with a radiolucency surrounding the bone between the roots.
Hairline fracture – like radiolucency.
Halo appearance – a combined periapical and periradicular radiolucency on one or both sides of the involved root.
Clinical Notes
Vertical root fracture (VRF) are seen most commonly in endodontically treated teeth.
The condition presents with a challenging diagnosis; however, exploratory surgery aids in a defective diagnosis.
Additional imaging techniques such as CBCT (cone beam computed tomography) to detect and visualize VRFs have been introduced.
|
c
| 2 |
medmcqa
|
Bezold-Jarisch reflex is produced by the receptors located in the
|
[
"Lungs",
"Hea",
"Pluera",
"Brain"
] |
Explanation:
Bezold-Jarisch reflexApnea followed by rapid breathing, hypotension, and bradycardia (the coronary chemoreflex or Bezold-Jarisch reflex).The response is produced by receptors in the hea.The receptors are probably C fiber endings, and the afferents are vagal.Its physiologic role is unceain, but in patients with myocardial infarcts, substances released from the infarcted tissue may stimulate ventricular receptors, contributing to the hypotension that is not infrequently a stubborn complication of this disease.
|
b
| 1 |
medmcqa
|
A 40 year old man presents to ohopedics emergency with the following deformity. He is daily wage laborer by profession and this problem occurred following lifting heavy load. Usg reveals following finding: Which of the following structure is affected?
|
[
"B",
"A",
"D",
"C"
] |
Explanation:
Marked structure: A- Biceps brachii (sho head) B- Pectoralis major C- Biceps brachii (long head) D- Triceps brachii (long head) The symptoms of Popeye deformity depend on the extent of the tear. hearing or feeling a pop a sudden, sharp pain (in arm) bruising, soreness, or tenderness weakness cramping difficulty turning arm fatigue when doing repetitive motions muscle spasms in shoulder or arm Possible causes of Popeye deformity include: overuse of biceps muscle repetitive motion spos injury injury from a fall Risk of a Popeye deformity include: smoking coicosteroid use anabolic steroid use tendinopathy rheumatoid ahritis fluoroquinoione antibiotics statin therapy Treatment for Popeye deformity is usually conservative since the tendon heals on its own over time. Conservative treatment involves the following: Ice NSAIDs ibuprofen aspirin naproxen Rest Modify activities to avoid strenuous activity with the affected arm. Physical therapy strengthening and stretching exercises range-of-motion and flexibility exercises occupational therapy
|
d
| 3 |
medmcqa
|
All are presentation of retinoblastoma except:
|
[
"Leucocoria",
"Squint",
"Cataract",
"Glaucoma"
] |
Explanation:
C i.e. Cataract
|
c
| 2 |
medmcqa
|
Which of the following is seen in Angelman Syndrome
|
[
"Uniparental disomy of maternal Chromosome",
"Obesity",
"Defective genomic imprinting of maternal chromosome",
"All of the above"
] |
Explanation:
Angelman Syndrome
Uniparental disomy of Paternal Chromosome
Defective imprinting of maternal Chromosome
Clinical features
Mental retardation
Happy puppets.
|
d
| 3 |
medmcqa
|
Strongest oxygen radical amongst the following is
|
[
"O2-",
"OH-",
"H2O2",
"HCIO"
] |
Explanation:
Reactive Oxygen Species (ROS) radicals like the hydroxyl radical . It is the most reactive of them all; note how it differs from the hydroxyl ion . the superoxide anion which is both ion and radical
|
b
| 1 |
medmcqa
|
Mean aerial pressure depends upon
|
[
"Cardiac output",
"Cardiac output & peripheral resistance",
"Aerial complaince",
"Peripheral resistance"
] |
Explanation:
Cardiac output and peripheral resistance. As blood is pumped out of the left ventricle into the aoa and distributing aeries, pressure is generated. The mean aerial pressure (MAP) is determined by the cardiac output (CO), systemic vascular resistance (SVR), and central venous pressure (CVP).
|
b
| 1 |
medmcqa
|
A patient is suspected of having neuroangiofibroma. Investigation of choice for neuroangiofibroma is?
|
[
"USG",
"MRI",
"Contrast enhanced CT scan",
"Plain CT scan"
] |
Explanation:
The juvenile neuroangiofibroma or nasopharyngeal angiofibroma is a lesion of young adolescent males. The presenting symptoms are epistaxis and nasal obstruction foremost, with rarer complaints of proptosis, and involvement of cranial nerves. CT scan of the head with contrast enhancement is now the investigation of choice. It shows the extent of tumor, bony destruction or displacements. Anterior bowing of the posterior wall of maxillary sinus (often called the antral sign or Holman-Miller sign) is pathognomonic of angiofibroma. Ref: Principles of neuro-oncology by David Schiff, 2005, Page 452; Diseases of EAR, NOSE & THROAT By PL Dhingra, 5th edition, 2010, Page 262; Thoracic imaging: a practical approach by Pol J Radiol, 2005, Page 197.
|
c
| 2 |
medmcqa
|
Muscular voice in females is treated by
|
[
"Thyroplasty type 1",
"Thyroplasty type 2",
"Thyroplasty type 3",
"Thyroplasty type 4"
] |
Explanation:
THYROPLASTY Isshiki divided thyroplasty procedures into four categories to produce functional alteration of vocal cords. (a) Type I:- It is medial displacement of vocal cord as is achieved in teflon paste injection. (b) Type II:- It is lateral displacement of vocal cord and is used to improve the airway (c) Type III:- It is used to shoen (relax) the vocal cord. Relaxation of vocal cord lowers the pitch. This procedure is done in mutational falsetto or in those who have undergone gender transformation from female to male. (d) Type IV:- This procedure is used to lengthen (tighten) the vocal cord and elevate the pitch. It conves male character of voice to female and has been used in gender transformation. It is also used when vocal cord is lax and bowing due to aging process or trauma. Ref:- Dhingra; pg num:-301,302
|
d
| 3 |
medmcqa
|
A 30-year-old female, RBC count 4.5 million, MCV- 55 fl, TLC- 7000, no history of blood transfusion, Mentzer index - 12. Diagnosis is?
|
[
"Iron deficiency anemia",
"Thalassemia major",
"Thalassemia minor",
"Megaloblastic anemia"
] |
Explanation:
* Since MCV is reduced this indicates microcytic anemia, which rules out choice D. * No history of blood transfusion rules out thalassemia major. * Mentzer index = MCV/RBC count If mentzer index < 13 - Thalassemia minor > 13 - Iron deficiency The Mentzer index in the given question is - 12 thus it is most likely a case of thalassemia minor.
|
c
| 2 |
medmcqa
|
Which of the following is associated with least common Suicidal tendencies
|
[
"Alone",
"Depression",
"Male",
"Married person"
] |
Explanation:
Risk factors for suicide are: Age>40years, male, staying single, previous suicidal attempts, depression, suicidal preoccupation, alcohol or drug dependence, social isolation, recent serious loss or major stressful life events. (Ref: a sho textbook of psychiatry, Niraj Ahuja, 7th edition, pg no.223)
|
d
| 3 |
medmcqa
|
The drug of choice in treatment of typhoid fever in pregnancy is -
|
[
"Ampicillin",
"Chloramphenicol",
"Ciprofloxacin",
"Ceftriaxone"
] |
Explanation:
Fluoroquinolones and third-generation cephalosporins are the preferred treatment for typhoid and in pregnancy the latter is given. Typhoid vaccines appear to exe no harmful effects when administered to pregnant women and should be given in an epidemic or before travel to endemic areas.
|
d
| 3 |
medmcqa
|
Kilnefelter no of chromosomes
|
[
"47",
"46",
"45",
"44"
] |
Explanation:
Klinefelter syndrome is best defined as male hypogonadism that develops when there are at least two X chromosomes and one or more Y chromosomes. Most affected patients have a 47,XXY karyotype. This karyotype results from nondisjunction of sex chromosomes during meiosis. The extra X chromosome may be of either maternal or paternal origin. (Robbins Basic Pathology, 9 th edition. page : 239)
|
a
| 0 |
medmcqa
|
In all of the following conditions Troponin-T is preferable to CPK-MB in the diagnosis of acute myocardial infarction (MI) except in diagnosing:
|
[
"Small infarcts",
"Bedside diagnosis of MI",
"Postoperative infarct (after CABG)",
"Reinfarction after 4 days"
] |
Explanation:
Troponin-T levels remain elevated for 10 days following myocardial infarction so it cannot be used to assess reinfarction 4 days after an acute MI. The amino acid sequence of cardiac-specific troponin I and T are different from skeletal muscle forms of these proteins. It is the preferred biochemical marker for myocardial infarction. It is useful in diagnosing small infarcts and to distinguish unstable angina from NSTEMI. Levels of cTnI and cTnT remain elevated for 7-10 days following STEMI. Ref: Harrison's Internal Medicine, 18th Edition, Chapter 245
|
d
| 3 |
medmcqa
|
Pemphigus vulgaris is caused by:
|
[
"Bacteris",
"Virus",
"Autoimmune",
"Fungal"
] |
Explanation:
Ans: (c) AutoimmuneHarrison 19th ed. / 370# PEMPHIGUS* Pemphigus is an autoimmune blistering disorder* It results from the loss of integrity of normal intercellular attachments with the epidermis.* Commonly affects indiciduals of age between 40-60.* Equal prevalence among males and females.* There are five variants of pephigus:# Pemphigus Vulgaris: most common type# Pemphigus Foliaceous: superficial pemphigus# Pemphigus Vegetans: least common type# Pemphigus Erythematous# Fogo Selvagem: an endemic form of pemphigus foliacious.* Refer to above table
|
c
| 2 |
medmcqa
|
Which of the following is the mechanism of action of local anaesthetic?
|
[
"Block Na+ channel",
"Block K+ channel",
"Open Na+ channel",
"Block Ca++ channel"
] |
Explanation:
preventing channel activation and inhibiting the Na influx associated with membrane depolarization. Local anesthetic binding to Na channels does not alter the resting membrane potential. With increasing local anesthetic concentrations, an increasing fraction of the Na channels in the membrane bind a local anesthetic molecule and cannot conduct Na ions. As a consequence, impulse conduction slows, the rate of rise and the magnitude of the action potential decrease, and the threshold for excitation and impulse conduction increases progressively. At high enough local anesthetic concentrations and with a sufficient fraction of local anesthetic-bound Na channels, an action potential can no longer be generated and impulse propagation is abolished. Ref: Butterwoh IV J.F., Butterwoh IV J.F., Mackey D.C., Wasnick J.D., Mackey D.C., Wasnick J.D. (2013). Chapter 16. Local Anesthetics. In J.F. Butterwoh IV, J.F. Butterwoh IV, D.C. Mackey, J.D. Wasnick, D.C. Mackey, J.D. Wasnick (Eds), Morgan & Mikhail's Clinical Anesthesiology, 5e.
|
a
| 0 |
medmcqa
|
Non seminal germ cell tumors of testis secrete -
|
[
"CEA",
"Acid phosphatase",
"Alfa feto protein",
"Cytokeratin"
] |
Explanation:
Answer- C. Alfa feto proteinNon-seminoma germ cell tumors (NSGCT) are spermatocytic seminoma, embryonal carcinoma, Yolk sac tumor (also called endodermal sinus tumor or infantile embryonal carcinoma), teratoma, and choriocarcinoma.
|
c
| 2 |
medmcqa
|
Best test to determine etiology of SAH
|
[
"Enhanced CT",
"Unenhanced CT",
"Intra aerial digital Substraction Angiography",
"MRI"
] |
Explanation:
C i.e. Intra aerial digital Substraction Once dx is done by CT Scan; digital substraction angiography (DSA) is done to determine etiology. DSA is most sensitive & best inv. for determining etiologyQ. Now DSA is being replaced by noninvasive methods as MRA (MRI - angiography) & CTA (CT - Angiography).
|
c
| 2 |
medmcqa
|
Defective function of which of the following causes hyperacusis
|
[
"8th nerve",
"7th nerve",
"Stapedius muscle",
"Any of the above"
] |
Explanation:
Paralysis of stapedius muscle which is supplied by 7th cranial nerve causes hyperacusis or phonophobia Ref: Dhingra 7e pg 510.
|
d
| 3 |
medmcqa
|
Intranasal calcitonin used for:
|
[
"Post menopausal Osteoporosis",
"Paget's disease",
"Secondary hypoparathyroidism",
"Hypercalcemia"
] |
Explanation:
Ref: Goodman eft Gillman, The pharmacological basis of therapeutics. 12th edition, Pp-1294.1298, 1300Explanation:In Paget's disease. Calcitonin is administered by subcutaneous route and intranasal spray is not preferred because of the limited bioavailabilitv.It reduces serum calcium and phosphate levels in paget's disease by retarding the osteoclastic activity.In post menopausal osteoporosis, once daily Calcitonin nasal spray is recommended.Bisphosphonates like second and third generation drugs are used for both prevention and treatment of osteoporosis.Alendronate. Risedronate and ibemdronate.Dinosumab, a monoclonal antibody which binds with the RANK ligand blocks the osteoclast activity, administered subcutaneously once in 6 months.Teriparatide can also be used in treatment of osteoporosis, acts by increasing the new bone formation.
|
a
| 0 |
medmcqa
|
What is the histological appearance of brain in CJD?
|
[
"Neuronophagia",
"Micro abscess",
"Demyelination",
"Spongiform changes"
] |
Explanation:
CID(Creutfeldt Jakeb Disease) is a prion disease characterised by spongiform changes in the brain.
|
d
| 3 |
medmcqa
|
Pulmonary changes in lateral position in the anaesthetized patient?
|
[
"Dependent lung is relatively over ventilated and over-perfused",
"Dependent lung is relatively over ventilated and under-perfused",
"Dependent lung is relatively under ventilated and over-perfused",
"Dependent lung is relatively under ventilated and under-perfused"
] |
Explanation:
In the anaesthetized patient : Dependent lung is relatively under-ventilated and over-perfused Non-dependent lung is over-ventilated and under-perfused. This leads to a generally well tolerated increase in ventilation-perfusion inequality but can cause hypoxaemia in compromised patients.
|
c
| 2 |
medmcqa
|
Who discovered stainless steel?
|
[
"Adams C.P.",
"Schwarz A.M.",
"Brearley",
"Backofen W.A and Gales G.F"
] |
c
| 2 |
medmcqa
|
|
A retained stone impacted in distal common bile duct is seen on T- tube cholangiogram. What is the best management of stone -
|
[
"Dissolution therapy",
"Operative removal",
"Endoscopic sphincterotomy and stone extraction",
"No active treatment is required"
] |
c
| 2 |
medmcqa
|
|
Mosquito net hole diameter is-
|
[
"0.02 inch",
"0.0475 inch",
"0.5 inch",
"0.1 inch"
] |
Explanation:
Ans. is 'b' i.e., 0.0475 inch o The best pattern of mosquito net is the rectangular net.o There should not be a single rent in the net.o The Size of openings in the net is of utmost importance, the size should not exceed 0.0475 inch in any diameter.o The number of holes in one square inch in usually 150.
|
b
| 1 |
medmcqa
|
Modified Young's operation is done for:
|
[
"Atrophic rhinitis",
"Allergic rhinitis",
"Acute sinusitis",
"Chronic sinusitis"
] |
Explanation:
Ans: A (Atrophic rhinitis) Ref: Diseases of the Ear Nose and Throat by PL Dhingra. 5th edn. 2010 page 170Explantation:Young's OperationIt is done as a treatment of atrophic rhinitisIt involves closure of the nasal cavity affected with atrophic rhinitis by creating mucocutaneous flaps.These flaps are sutured together in two layers: first the mucosal layer, then the skin layer.The nasal cavity is kept closed for a period of 9 months.Re-examination is done after 9 months - if the crusts have disappeared, a revision surgery is performed and the nasal cavity is reopened.The theory behind this procedure is that the closed nasal cavity has time to heal.
|
a
| 0 |
medmcqa
|
True about spinal cord
|
[
"In adults spinal cord ends at lower border of L1 veebra",
"In newborn may extend up to L3",
"Cauda equina extends from lumbar veebra to coccyx",
"All of the above"
] |
Explanation:
*Upto 3rd month of intrauterine life, spinal cord extends throughout the entire length of veebral canal.*Thereafter, the veebral column grows faster than the Spinal cord and the terminal end of Spinal cord gradually shifts to a higher level.*At bih, it ends at level of L3 veebra and in adults, it ends at level of lower border of L1.(Ref: Vishram Singh textbook of clinical neuroanatomy second edition pg 51)
|
d
| 3 |
medmcqa
|
Carrier stage is seen in -
|
[
"Polio",
"Cholera",
"Peusis",
"Plague"
] |
Explanation:
Man is the only known reservoir of polio infection. It is the mild and subclinical infection that plays a major role in the spread of infection. They constitute the submerged poion of the iceberg of disease. Ref: 25th edition, Park's Textbook of Preventive and Social Medicine, Page no. 224
|
a
| 0 |
medmcqa
|
Which of the following drugs hyperpolarizes AV nodal tissue, is used in PSVT and has short lasting adverse effects ?
|
[
"Verapamil",
"Digoxin",
"Adenosine",
"Propranolol"
] |
c
| 2 |
medmcqa
|
|
The only fat-soluble vitamin that has coenzyme function
|
[
"A",
"D",
"E",
"K"
] |
Explanation:
Vitamin k acts as a Coenzyme in the formation of g-carboxyglutamate in enzymes of blood clotting and bone matrix.All water-soluble vitamins act as coenzymes.Harper 30th edition pg: 550
|
d
| 3 |
medmcqa
|
On stopping Alcohol, all the following changes are reversible EXCEPT:
|
[
"Hepatitis",
"Cirrhosis",
"Micro vesicular fatty change",
"Macro vesicular fatty change"
] |
Explanation:
"Alcoholic cirrhosis is the final and irreversible form of alcoholic liver disease usually evolves slowly and insidiously”
|
b
| 1 |
medmcqa
|
Infant moality rate includes all of the following except
|
[
"Early neonatal deaths",
"Late neonatal deaths",
"Post neonatal deaths",
"Stillbihs"
] |
Explanation:
Ans. d. Stillbihs
|
d
| 3 |
medmcqa
|
Which of the following anesthetic agents does not trigger malignant hypehermia
|
[
"Halothane",
"Isoflurane",
"Suxamethonium",
"Thiopentone"
] |
Explanation:
Malignant hypehermia (MH) is a rare (1:15,000 in pediatric patients and 1:40,000 in adult patients) genetic hypermetabolic muscle disease, the characteristic phenotypical signs and symptoms of which most commonly appear with exposure to inhaled general anesthetics or succinylcholine (triggering agents). MH may occasionally present more than an hour after emergence from an anesthetic, and rarely may occur without exposure to known triggering agents. Most cases have been repoed in young males; almost none have been repoed in infants, and few have been repoed in the elderly. Neveheless, all ages and both sexes may be affected. The incidence of MH varies significantly from country to country and even among different geographic localities within the same country, reflecting varying gene pools. The upper Midwest appears to have the greatest incidence of MH in the United States. Anesthetic drugs that trigger MH include ether, halothane, enflurane, isoflurane, desflurane, sevoflurane, and depolarizing muscle relaxants, succinylcholine being the only anesthetic drug currently used. Desflurane and sevoflurane appear to be less potent triggers than halothane and produce a more gradual onset of MH. The onset may be explosive if succinylcholine is used. Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e
|
d
| 3 |
medmcqa
|
The macrophage to epitheliod conversion in Mycobacterium tuberculosis infection is mediated by:
|
[
"TNF alpha",
"IFN-g",
"IL-4",
"TGF-Beia"
] |
Explanation:
Ref: Robbins Pathologic Basis of Disease, 8th edition, Pg: 183Explanation:T Cell-Mediated (Type IV) HypersensitivityThe cell-mediated type of hypersensitivity is initiated by antigen-activated (sensitized T lymphocytes, including CD4+ and CD8+ Tcells.Tubercle bacilli colonizing the lungs are persistent or nondegradable antigensThe perivascular infiltrate is dominated by macrophages over a period of 2 or 3 weeks.The activated macrophages often undergo a morphologic transformation into epithelium-like cells and are then referred to as epithelioid cells.A microscopic aggregation of epithelioid cells, usually surrounded by a collar of lymphocytes, is referred to as a granuloma.This pattern of inflammation, called granulomatous inflammation is typically associated with strong T-cell activation with cytokine production.M. tuberculosis enters macrophages by endocytosis mediated by several macrophage receptors: mannose receptors bind lipoarabino- mannan. a glvcolipid in the bacterial cell wall, and complement receptors bind opsonized mycobacteria.M. tuberculosis organisms replicate within the phagosome by blocking fusion of the phagosome and lysosomeAbout 3 weeks after infection, a T-helper 1 (TH1) response is mounted that activates macrophages to become bactericidal.Differentiation of TH1 cells depends on IL-12, which is produced by antigen-presenting cells that have encountered the mycobacteria.Mature TH1 cells, both in lymph nodes and in the lung, produce IFN-g.INF-g is the critical mediator that enables macrophages to contain the M. tuberculosis infection.IFN-g stimulates formation of the phagolysosome in infected macrophages, exposing the bacteria to an inhospitable acidic environment.Macrophages activated by IFN-y differentiate into the "epithelioid histiocytes" that characterize the granulomatous response, and may fuse to form giant cells.Activated macrophages also secrete TNF. which promotes recruitment of more monocytes.
|
b
| 1 |
medmcqa
|
Femoral hernia all EXCEPT: March 2013 (h)
|
[
"MC in female",
"MC to strangulate",
"MC than inguinal hernia",
"Mostly aymptomatic"
] |
Explanation:
Ans. C i.e. MC than inguinal hernia Hernia Spigelian hernia: Interparietal hernia (sub-umbilical/ level of arcuate line) Littres hernia: Hernia of Meckel's diveiculum Morgagni's hernia: Hernia between costal & sternal pas of diaphragm Hernia en glissade/ sliding hernia: - Content on left side are sigmoid colon & mesentry; - Right side content is caecum Femoral hernia: - MC in Female, - MC on Right side, - MC strangulates
|
c
| 2 |
medmcqa
|
10 yr old male patient came to OPD with itching and cobblestone papillae on examination. The symptoms aggravate in the summer. What is probable diagnosis
|
[
"Phlyctenular conjunctivitis",
"Trachoma",
"Atopic conjunctivitis",
"Vernal Keratoconjunctivitis"
] |
Explanation:
Vernal keratoconjunctivitis Young boys in 1st decade of life severe itching present cobble stone papillae seen: hallmark. It is a papillary hyperophy not follicular. VKC is type 1 hypersensitivity. Phlyctenular type 4. Signs: Shield ulcer Maxwell lyon sign Horner trantas spots Pseudogerontoxon A/w keratoconus is seen Rx Steroids-Fluorometholone & loteprednol topical. Antibiotics does not have any prominent role. DOC- Olopatadine, Sodium Cromoglycate, Ketotifen and Epinastine. Refractony -Cyclosporine,Tacrolimus & acetyl cysteine 0.5%. Horner Tranta spots Cobblestone pappila Others options: TRACHOMA: commonest infective cause of blindness. hallmark : sago grain follicles. herbet pits seen.
|
d
| 3 |
medmcqa
|
A rickshaw tyre passed on a 8-year old child. Marking of tyre was found on body. It is an example of -
|
[
"Percolated bruise",
"Contusion",
"Pattern bruises",
"Imprint abrasion"
] |
Explanation:
Rickshaw tyre mark is an example of patterned bruise (‘or patterned abrasion) depending on amount 0f energy/ force producing it as it mirrors the shape and size of tyre causing it.
|
c
| 2 |
medmcqa
|
Use of combined pill is contraindicated in women with any of the following conditions except?
|
[
"Lactation",
"Diabetes",
"Thromboembolism",
"Tuberculosis"
] |
Explanation:
Ans. is 'd' i.e., Tuberculosis
|
d
| 3 |
medmcqa
|
Feta] erythropoietin production is inhibited by?
|
[
"Testosterone",
"Estrogen",
"Cortisol",
"Hypoxia"
] |
Explanation:
ANSWER: (B) EstrogenREF: William's 23rd ed chapter 4, Guyton physiology 12th ed page 932ERYTHROPOIESISThis process is controlled primarily by fetal erythropoietin because maternal erythropoietin does not cross the placenta. Fetal erythropoietin production is influenced by testosterone, estrogen, prostaglandins, thyroid hormone, and lipoproteins. After birth, erythropoietin normally may not be detectable for up to 3 months.Factors influencing erythropoietin productionIncreaseDecreaseTestosteroneThyroid hormonesCorticotropinProlactinProstaglandins A2, El, and E2 enhance erythropoiesis by augmenting the renal cortical release of erythropoietinEstrogenProstaglandins F2aLipoproteinTumor necrosis factorInterleukin 1
|
b
| 1 |
medmcqa
|
The administration of succinylocholine to a paraplegic patient led to the appearance of dysarrhythmias, conduction abnormalities and finally cardiac arrest. The most likely cause is
|
[
"Hypercalcemia",
"Hyperkalemia",
"Anaphylaxis",
"Hypermagnesemia"
] |
Explanation:
B i.e. Hyperkalemia
|
b
| 1 |
medmcqa
|
Calcium channel blocking agents of use in the treatment of hypertension include:
|
[
"Prazosin",
"Lidoflazine",
"Captopril",
"Nifedipine"
] |
Explanation:
Ans. (D) Nifedipine(Ref: Katzung 10/e p175; KDT 8th/e p605)Nifedipine, amlodipine like calcium channel blockers can be used for hypertension.
|
d
| 3 |
medmcqa
|
Kleihaeur Bethke test is done for:
|
[
"Cephalopelvic disproportion",
"Fetomaternal hemorrhage",
"Determining karyotype of normal fetus",
"Diagnosing fetal infections"
] |
Explanation:
b. Fetomaternal hemorrhage(Ref: Nelson's 20/e p 2335, Ghai 8/e p 340)A common approach to evaluating Fetomaternal Hemorrhage (FMH) is the rosette test to screen for the presence of fetal cells followed by the Kleihauer-Betke acid elution method to quantify the magnitude of feto-maternal bleed.
|
b
| 1 |
medmcqa
|
Herpetic keratitis is treated by
|
[
"Analgesics",
"Atropine",
"Steroids",
"Idoxuridine"
] |
Explanation:
D i.e. Idoxuridine Drug of choice for herpetic keratitis is Acyclovir Q (topical) Other antiviral drugs used are - Idoxuridine - Trifluorothyrnidine - Vidarabine
|
d
| 3 |
medmcqa
|
Which Is NOT true about iron deficiency anemia?
|
[
"Hyper-segmented neutrophils",
"Microcytosis precedes hypochromia",
"MCHC<50%",
"Commonest cause of anemia in India"
] |
Explanation:
Hypersegmented neutrophils (more than 5 lobes of neutrophils) is seen in vitamin B12 deficiency. Iron deficiency anemia is the most common cause of anemia in India. It is characterized by microcytic hypochromic peripheral smear.
|
a
| 0 |
medmcqa
|
IgA nephropathy is characterised by all of the following except
|
[
"Hypeension",
"Hematuria",
"Nephrite syndrome",
"Re Al biopsy having thin basement membrane"
] |
Explanation:
Refer Robbins page no Pg925 Beingn familial hematuria is common hereditary entity manifested clinically by familial asymptomatic hematuria usually uncovered on. Routine urine analysis and morphologically by diffuse thinning of glomerular basement membrane to width between 150 and 225 nm
|
d
| 3 |
medmcqa
|
Drug having very narrow therapeutic range is-
|
[
"Lithium",
"Seraline",
"Roboxetine",
"Dothiepin"
] |
Explanation:
Lithium may also be used to treat alcoholism, schizoaffective disorders, and cluster headaches . Thus, lithium is an indispensable pharmaceutical component of modern psychiatric therapy. Unfounately, lithium also has a narrow therapeutic index, with therapeutic levels between 0.6 and 1.5 mEq/L Ref Davidson 23rd edition pg 1200
|
a
| 0 |
medmcqa
|
In the cou of law, professional secrecy can be divulged under: MAHE 11
|
[
"Doctrine of Common Knowledge",
"Privileged communications",
"Res ipsa loquitor",
"Therapeutic privilege"
] |
Explanation:
Ans. Privileged communications
|
b
| 1 |
medmcqa
|
Which is the earliest marker of hepatocellular failure ?
|
[
"Abnormal PTT",
"Decrease Albumin: Globulin ratio",
"Increased PT",
"Increased ammonia"
] |
Explanation:
The PT and/or the international normalized ratio (INR) are used to determine the presence or severity of coagulopathy. They are earliest and sensitive markers of hepatic synthetic failure. The serum ammonia level may be elevated dramatically in patients with fulminant hepatic failure. The aerial serum ammonia level is most accurate, but venous ammonia levels are generally acceptable. An elevated serum ammonia level does not exclude the possibility of another cause for mental status changes. Albumin:globulin ratio commonly decreases in hepatic failure.
|
c
| 2 |
medmcqa
|
A seven year old asymptomatic girl is found to have persistant hypeension. There is no significant history and urine examination is the following is the most likely cause:
|
[
"Essential Hypeension",
"Renal Parenchymal Disease",
"Renal Parenchymal Disease",
"Coarctation of Aoa"
] |
Explanation:
Answer is B (Renal Parenchymal Disease): Renal Parenchymal Disease is the most contmon cause of hypeension in children and should be considered in the evaluation of all asymptomatic children with hypeension Coarctation of Aoa may present with hypeension in children but this is an uncommon cause and usually presents with a charachteristic finging of blood pressure differential of > 10 mm Hg between upper and lower extremities, systolic hypeension in upper extremity along with decreased or absent femoral pulses Polycystic kidney Disease does not usually present with hypeension in children. Hypeension usually becomes clinically apparent in middle age and hence the condition is also called 'Adult' polycystic kidney disease.
|
b
| 1 |
medmcqa
|
The following acute respiratory response to ascent to high altitude, there is normalization of blood pH. The mechanism is
|
[
"Increased erythropoesis leads to increased buffering by hemoglobin",
"Increased excretion of HCO3 - by the kidneys",
"Increased levels of 2, 3--DPG",
"Retention of bicarbonate by the kidneys"
] |
Explanation:
The lung response to acute altitude exposure is mainly hyperventilation which, together with elevated hea rate, aims at achieving an adequate supply of oxygen to the tissues. At rest, ventilation increases by firstly increasing the tidal volume, at least up to 3500 m. Ref: guyton and hall textbook of medical physiology 12 edition page number:365,376,377
|
d
| 3 |
medmcqa
|
Which of the following is NOT true about prostatic urethra?
|
[
"It passes through the prostate from the apex to the base",
"It contains opening of prostatic ducts",
"Presence of verumontanum",
"Contains urethral crest"
] |
Explanation:
The prostatic urethra is about 1.25 in. (3 cm) long and begins at the neck of the bladder. It passes through the prostate from the base to the apex where it becomes continuous with the membranous pa of the urethra. It is the widest and most dilatable poion of the entire urethra. On the posterior wall is a longitudinal ridge called the urethral crest. In the middle of the crest is a small swelling, the seminal colliculus (verumontanum), on which opens the prostatic utricle (utriculus masculinus). On each side of this ridge is a groove called the prostatic sinus; the prostatic glands open into these grooves. Alongside it, on the urethral crest, the ejaculatory ducts open. Ref: Clinical Anatomy By Regions By Richard S. Snell, 2011, Page 278.
|
a
| 0 |
medmcqa
|
Autopsy of a 23-year-old male victim of a motor vehicle accident reveals a small cluster of caseating granulomas in the right lung just above the interlobar fissure and similar granulomas in the hilar lymph nodes. Acid-fast staining demonstrates acid-fast bacilli within these lesions. No other lesions were found in the remaining organs and systems. Which of the following is the MOST accurate interpretation of these findings?
|
[
"Cavitary tuberculosis",
"Ghon complex",
"Histoplasma infection",
"Miliary tuberculosis"
] |
Explanation:
The Ghon complex is the most frequent pathologic form of primary pulmonary tuberculosis. Mycobacterium tuberculosis first localizes in the lung parenchyma and then in the hilar lymph nodes. In both these locations, a granulomatous reaction takes place. These lesions usually heal by fibrosis, leaving only small scars at the sites of remote tuberculous infection. In some cases, owing to immunosuppression (e.g., AIDS, immunosuppressant treatment, and lymphomas), reactivation of dormant bacilli in old lesions or additional re-exposure leads to secondary tuberculosis, with progression of lesions. Sometimes, active lesions of the Ghon complex are discovered by chance at autopsy. More frequently, scars due to remote healed tuberculosis are found postmoem and listed in autopsy repos as incidental findings. Also know: Cavitary tuberculosis and miliary tuberculosis are expressions of secondary infection, following reactivation of old, usually clinically silent, lesions. The cavitary form is characterized by development of large areas of liquefactive necrosis that empty into the air spaces, leading to cavities within the lung parenchyma. The miliary form is due to lymphohematogenous dissemination and subsequent seeding of tubercle bacilli throughout the body, with myriad small granulomas forming in the lungs, spleen, liver, bone marrow, retina, and adrenals, for example. Acid-fast bacilli suggest tuberculosis, rather than an infection with a fungus such as Histoplasma. Ref:Raviglione M.C., O'Brien R.J. (2012). Chapter 165. Tuberculosis. 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
|
b
| 1 |
medmcqa
|
In hyponatremia following renal failure sodium level should be maintained at -
|
[
"I20meq/ml",
"125 meq/ml",
"130 meq/ml",
"135 meq/ml"
] |
Explanation:
Hyponatremia in CKD population is associated with increased moality, but the effect on renal outcome was unknown. ... Hyponatremia (serum sodium <135 mEq/L) was associated with excessive volume and volume depletion, measured as total body water by bioimpedance analysis, in diuretic users, but not in diuretic non-users. Ref Harrison20th edition pg 234
|
d
| 3 |
medmcqa
|
Radiological signs of crohn's disease:
|
[
"String sign of cantor",
"Pipestem appearance",
"Pseudo polyp",
"Backwash ileitis"
] |
Explanation:
Ans, A. (String sign of cantor) Characteristic Radiological features of Crohn's disease or Regional Enteritis:Terminal ileum is the MC siteGranularity' & asymmetrical involvement with skip lesionUlcer: Apthous ulcer & fissure ulcerCobblestone pattern (serpiginous longitudinal + transverse ulcer separated by areas of edema)Rigidity' of mesenteric boarder and pseudosacculation of antimesenteric boarder (Omega sign)Wide gapping of bowel loops due to thickening of bowel wallStricture : long segment (string .sign if cantorDoule Halo configuration is seen on CT scan (Radiology review manual by wolfgang Dahnert 5th/809) Characteristic features of ulcerative colitisCollar button ulcerDouble Trackingflongitudinal submucosal ulceration over several centimeter)Symmetrical involvement of colonRectum involved in 95% of casesThumbprinting due to mucosal oedemBlunting of haustral fold (Pipestem appearance)Inflammatory palypBackwash ileitis: In ulcerative colitis when whole colon involved, the inflammation extends 1-2 cm into terminal ileum in 10-20% cases called Backwash ilitis .
|
a
| 0 |
medmcqa
|
A diabetic patient developed cellulites due to S. aureus, which was found to be methicillin resistant on antibiotic sensitivity testing. All of the following antibiotics would be appropriate except :
|
[
"Linezolid",
"Vancomycin",
"Teicoplanin",
"Imipenem"
] |
d
| 3 |
medmcqa
|
|
Action of inferior oblique ?
|
[
"Adduction",
"Depression",
"Extorsion",
"Intorsion"
] |
Explanation:
Ans. is 'c' i.e., Extorsion MusclePrimary ActionSecondary ActionSuperior rectusElevationAdduction and intorsionInferior rectusDepressionAdduction and extorsionMedial rectusAdduction Lateral rectusAbduction Superior oblique Intorsion Abduction and depression Inferior obliqueExtorsion Abduction and elevation
|
c
| 2 |
medmcqa
|
On per vaginal examination, anterior fontanelle and supra-orbital ridge is felt in the second stage of labor. The presentation is:
|
[
"Brow",
"Shoulder",
"Veex",
"Face"
] |
Explanation:
BROW PRESENTATION The diameter of engagement is MentoVeical which is 14 cms Occurs in a deflexed head Supraorbital ridges and anterior fontanelle is palpable Occiput is higher than sinciput No mechanism of labour as a mentoveical diameter. Delivery is by cesarean section
|
a
| 0 |
medmcqa
|
What is the contribution of this scientist to molecular genetics?
|
[
"Chemical synthesis of ribonucleotide",
"Sequencing of amino acid",
"Base pairing rule",
"Structure of DNA"
] |
Explanation:
Ans. A. Chemical synthesis of ribonucleotide* The scientist given in picture is Har Gobind Khorana* Developed chemical method to synthesize polyribonucleotide.* This lead to the cracking of genetic code.
|
a
| 0 |
medmcqa
|
2-month-old girl present with verrucous plaque on the trunk. What is your most probable diagnosis?
|
[
"Incontinentia pigmentosa",
"Daer disease",
"Congenital naevus",
"Icthyosis"
] |
Explanation:
A i.e. Incontinentia pigmenti
|
a
| 0 |
medmcqa
|
True about obsession - compulsive disorder are A/E -
|
[
"Ego-alien",
"Patient tries to resist against",
"Ego syntonic",
"Insight is present"
] |
Explanation:
OCD is ego-dystonic (not egosyntonic).
Characteristic features of obsession & compulsion
They are egoalien, i.e. experienced as foreign to person's experience of himself.
They are egodystonic, i.e. (unwanted behavior).
Thought is recognized as irrational and absurd (insight is present)
Patient tries to resist against it however patient is unable to do so (thought is irresistible) → Inability to resist causes marked distress or anxiety.
|
c
| 2 |
medmcqa
|
The long term complications of Tracheostomy include all EXCEPT
|
[
"Tracheal stenosis",
"Tracheocutaneous fistula",
"Tracheooesophageal fistula",
"Apnoea due to decreased PaCO2"
] |
Explanation:
(D) Apnoea due to decreased paCO2 # LATE COMPLICATIONS OF TRACHEOSTOMY (with prolonged use of tube for weeks and months):1. Haemorrhage, due to erosion of major vessel.2. Laryngeal stenosis, due to perichondritis of cricoid cartilage.3. Tracheal stenosis, due to tracheal ulceration and infection.4. Tracheo-oesophageal fistula, due to prolonged use of cuffed tube or erosion of trachea by the tip of tracheostomy tube.5. Problems of decannulation. Seen commonly in infants and children.6. Persistent tracheocutaneous fistula7. Problems of tracheostomy scar. Keloidor unsightly scar.8. Corrosion of tracheostomy tube and aspiration of its fragments into the tracheobronchial tree.
|
d
| 3 |
medmcqa
|
The normal value of Fetal scalp pH is?
|
[
"7.3",
"6.9",
"7",
"7.1"
] |
a
| 0 |
medmcqa
|
|
In pyridoxine deficiency, tryptophan is converted to -
|
[
"Nicotine",
"Acetoacetate",
"Xantheurenic acid",
"Acetyl CoA"
] |
Explanation:
Ans. is 'c' i.e., Xantheurenic acid o In vitamin B6 deficiency the metabolism is shuted to xanthurenic acid. Therefore, xantheurenic acid excretion is increased in urine.
|
c
| 2 |
medmcqa
|
Vaginal defence is lost in:
|
[
"Within 10 days of birth",
"After 10 days of birth",
"During pregnancy",
"At puberty"
] |
Explanation:
Vaginal defence is lost at 10 days after birth. The maternal estrogen circulating the newborn maintains the vaginal defence for 10 days.
Thereafter it is lost up to pre-puberty and after menopause. High level of circulating estrogen increase the vaginal defence during puberty, pregnancy and in premenstrual phase.
|
b
| 1 |
medmcqa
|
Continuous murmur is found in which aerial disease: September 2005
|
[
"Atherosclerosis",
"Dissecting aoic aneurysm",
"Aeriovenous Fistula",
"Thromboangitis obliterans"
] |
Explanation:
Ans. C: Aeriovenous Fistula Continuous murmurs begin in systole, peak near the second hea sound, and continue into all or pa of diastole. Their presence throughout the cardiac cycle implies a pressure gradient between two chambers or vessels during both systole and diastole. The continuous murmur associated with a patent ductus aeriosus is best heard at the upper left sternal border. Large, uncorrected shunts may lead to pulmonary hypeension, attenuation or obliteration of the diastolic component of the murmur, reversal of shunt flow, and differential cyanosis of the lower extremities. A ruptured sinus of Valsalva aneurysm creates a continuous murmur of abrupt onset at the upper right sternal border. Rupture typically occurs into a right hea chamber, and the murmur is indicative of a continuous pressure difference between the aoa and either the right ventricle or right atrium. A continuous murmur may also be audible along the left sternal border with a coronary aeriovenous fistula and at the site of an aeriovenous fistula used for hemodialysis access. Enhanced flow through enlarged intercostal collateral aeries in patients with aoic coarctation may produce a continuous murmur along the course
|
c
| 2 |
medmcqa
|
All statements are true about gas cylinders except
|
[
"Pressure of N2O is 745 psig at 20 degrees centigrade",
"Higher pressure indicates impurity in N2O",
"N2O is in liquid form",
"Emergency oxygen 'E' cylinder has more gas than 'H' cylinder"
] |
Explanation:
.N20 is stored in blue steel cylinders as a colorless liquid under 745 psi pressure and is in equilibrium with the gas phase (approximately 50 atmospheres at room temperature). The tank maintains that pressure until it is empty.
|
d
| 3 |
medmcqa
|
In what period, following delivery, does the cardiac output return to the pre-pregnancy state?
|
[
"4 hours",
"4 weeks",
"6 weeks",
"8 weeks"
] |
Explanation:
Cardiac output returns to pre labour values by one hour following delivery and pre pregnancy level by 4 weeks. Cardiac output: It stas to increase from 5th week of pregnancy reaches a peak 40-50% at about 30-34 weeks. It increases fuher during labour (50%) and immediately following delivery (70%) over pre labour values. Increase in cardiac output is due to: Increased blood volume To meet the additional oxygen required due to increased metabolic activity during pregnancy. Ref: Textbook of Obstetrics By D.C Dutta, 6th edn, page 53
|
b
| 1 |
medmcqa
|
Knudson's hypothesis is applied for:
|
[
"Glaucoma",
"Retinoblastoma",
"Cataract",
"Melanoma"
] |
Explanation:
Ans. Retinoblastoma
|
b
| 1 |
medmcqa
|
In a case of chest pain with pericarditis and pericardial effusion, pain is referred by?
|
[
"Superficial cardiac plexus",
"Phrenic nerve",
"Deep cardiac plexus",
"Vagus nerve"
] |
Explanation:
The phrenic nerve arises from the ventral rami of cervical spinal nerves C3-5 and courses down in the preveebral fascia, in front of the anterior scalene muscle, into the thorax between the subclan aery and vein. It provides motor innervation to the diaphragm. The fibrous and parietal pericardial are supplied by the phrenic nerve (C3-C5). They are sensitive to pain. The visceral pericardium or epicardium is supplied by autonomic nerves, not sensitive to pain.
|
b
| 1 |
medmcqa
|
In Ohotolidine Arsenite test errors caused by the presence of interfering substances are overcome for all except:
|
[
"Iron",
"Nitrites",
"Magnesium",
"Manganese"
] |
Explanation:
OHOTOLIDINE-ARSENITE (OTA) Modification of the OT test to determine the free and combined chlorine residuals separately. Errors caused by the presence of interfering substances such as nitrites, iron andmanganese will produce a yellow colour with Ohotolidine, are overcome by the OTA test. The test is carried out by adding 0.1 ml of the reagent to 1 ml of water. The yellow colour produced is matched against suitable standards or colour discs. It is essential to take the reading within 10 seconds after the addition of the reagent to estimate free chlorine in water. The colour that is produced after a lapse, say 15-20 minutes, is due to the action of both free and combined chlorine.
|
c
| 2 |
medmcqa
|
Treatment of H. pylori is required in all of the following expect ?
|
[
"Gastro esophageal reflex disease",
"Gastric ulcers",
"Duodenal ulcers",
"Gastric lymphoma"
] |
a
| 0 |
medmcqa
|
|
The cause of pseudoclass III malocclusion is:
|
[
"Developmental deficiency",
"Increased mandibular growth",
"Functional abnormality",
"Hormonal disturbance"
] |
Explanation:
Functional class III or Pseudo class III
This condition requires special mention because treatment of this class of malocclusion is entirely different from the true class III situation. The differentiating feature of this condition is that the dental occlusion is class III in maximum intercuspation or habitual occlusion, while it is actually class I in centric occlusion. Here the disturbance is a functional one, where as a result of dental interference, the mandible is deviated anteriorly to achieve a ‘bite of convenience’. Thus, a static evaluation will give a class III reading, but functional examination at postural rest and at first dental contact shows that the mandible is closing in a normal class I way.
Ref:Orthodontics: Diagnosis and Management of Malocclusion and Dentofacial Deformities
THIRD EDITION Om P. Kharbanda Pg- e328
|
c
| 2 |
medmcqa
|
Chordoma can occur over all the following sites, except -
|
[
"Rib",
"Clivus",
"Sacrum",
"Vertebral body"
] |
Explanation:
Chordoma occurs only in vertebrae and clivus
Chordoma
Chordoma is a rare malignant tumour originating from the remnants of the primitive notochord.
As the vertebrae develop, notochord disappears and in adults, the normal remnant of notochord is nucleus pulpous of the intervertebral disc. In chordoma, this embryonic notochordal foci remains inside the vertebral body and forms tumours.
It occurs in adult males after 50 years.
It commonly occurs in the sacrococcygeal or in the sphere-occipital regions. The sacrum is the most common site: - Sacrum 50% clivus (35%), cervical thoracic/lumbar (15%).
Most of them occur in vertebral bodies.
|
a
| 0 |
medmcqa
|
In acute inflammation due to the contraction of endothelial cell cytoskeleton, which of the following results -
|
[
"Delayed transient increase in permeability",
"Early transient increase in permeability",
"Delayed permanent increase in permeability",
"Early permanent increase in permeability"
] |
Explanation:
Ans. is 'b' i.e., Early transient increase in permeability Increased vascular permeability o The hallmark of acute inflammation is increased vascular permeability The following mechanisms have ben proposed for increased permeability. i) Formation of endothelial gaps in venules (immediate transient response) This is the most common mechanism of vascular leakage and is caused due to the mediators such as histamine, bradykinin, leukotrienes, neuropeptide sustance Classically this type of leakage affects venules, leaving capillaries and aerioles unaffected. The precise reason for this restriction to venules is unceain, it may be because there is greater density of receptors for mediators in venular endothelium. Binding of mediators such as histamine to their receptors on endothelial cells activate intracellular signaling pathways that lead to phosphorylation of contractile and cytoskeletal proteins such as myosin. These proteins contract leading to contraction of endothelial cells and separation of intercellularjunction. Thus the gaps in the vascular endothelium are largely intercellular or close to the intercellular junctions. This type of leakage occurs rapidly after exposure to the mediator and is usually reversible and sho lived (15-30 minutes), it is thus known as immediate transient response. Cytokines such as interleukin-1 (IL-1), tumour necrosis factor (TNF) and interferon y also increase vascular permeability by inducing a structural reorganization of the cytoskeleton such that the endothelial cells retract from one another. In contrast to the histamine effect, the cytokine induced response is somewhat delayed (4-6 hrs) and long lived (24 hrs or more). Direct endothelial injury resulting in endothelial cell necrosis and detachment (immediate sustained response) This effect is usually encountered in necrotizing injuries and is due to direct damage to the endothelium by injurious stimulus e.g severe burns or lytic infections. The reaction is known as immediate sustained response because the leakage stas immediately after the injury and is sustained at high levels for several hours until the damaged vessels are thrombosed or repaired. o All levels of microcirculation are affected including venules, capillaries and aerioles. iii) Delayed prolonged leakage This is curious but relatively common type of increased permeability that begins after a delay of 2-12 hours, lasts for several hours or even days and involves venules as well as capillaries. This type of leakage is caused by mild to moderate thermal injury, X-ray radiation or ultraviolet radiation and ceain bacterial toxins. It is caused either by direct effect of injurious agent or by cytokine mediated endothelial retraction. iv) Leucocyte mediated endothelial injury Leucocytes adhere to endothelium relatively early in inflammation. These leucocytes may be activated releasing toxic oxygen species and proteolytic enzymes which then cause endothelial injury or detachment. This type of leakage affects venules (mostly); pulmonary & glomerular capillaries. v) Increased transcytosis across the endothelial cytoplasm Transcytosis occurs across channels consisting of clusters of interconnected uncoated vesicles and vacuoles called the vesiculovacuolar organelle, many of which are located close to intercellular junctions. It usually occurs in venules. vi) Leakage from new blood vessels During repair formation of new vessels occur (angiogenesis) New vessel sprouts, remain leaky until the endothelial cells mature.
|
b
| 1 |
medmcqa
|
What is the most likely cause of this finding in a man from Mexico who had a biopsy showing gram-negative bacilli?
|
[
"Klebsiella rhinoscleromatis",
"Mycobacterium leprae",
"Acinetobacter baumannii",
"Treponema pallidum"
] |
Explanation:
Answer A. Klebsiella rhinoscleromatisRhinoscleroma is a chronic bacterial infection that is typically caused by the gram-negative bacillus K. rhinoscleromatis.
|
a
| 0 |
medmcqa
|
First cell in RBC development is
|
[
"Proerythroblast",
"Intermediate normoblast",
"Reticulocyte",
"Basophilic erythroblast"
] |
Explanation:
.
|
a
| 0 |
medmcqa
|
Treatment of choice in basal cell carcinoma at inner canthus of eye is
|
[
"Radium implant",
"Radiotherapy",
"Chemotherapy",
"Wide excision and reconstruction"
] |
Explanation:
D i.e. Wide excision and reconstruction Basal cell carcinoma is the most common malignant eyelid tumor Q accounting for 90% of all cases. Radiotherapy & cryotherapy are contraindicated in medial canthus BCC Q. Basal Cell CA (BCC) Basal cell CA is the most common tumor of eyelid Q In most frequently arise from lower eyelid > medial canthus > upper eyelid > lateral canthus. Xeroderma pigmentosa (AR disorder characterized by skin damage on exposure to natural sunlight, progressive cutaneous pigmentation, skin malignancy & bird like facies) & Gorlin-Goltz syndrome are predisposing conditions.
|
d
| 3 |
medmcqa
|
A patient has complaint of seeing coloured holoes in the evening and blurring of vision for last few days with normal 10P ?
|
[
"Prodromal phase of acute angle closure glaucoma",
"Acute angle closure glaucoma",
"Chronic glaucoma",
"Epidemic dropsy"
] |
Explanation:
Ans. is 'a' i.e., Prodromal phase of acute angle closure glaucoma Features of latent PACG (Prodromal stage) are :? Shallow anterior chamber Occasionally complain of halos around light Sometimes slight-haziness or blurring of vision Normal 10P It is the only phase of glaucoma, where IOP pressure is normal at all the time. Whereas in incipient stage, there is recurrent elevation of IOP by predisposing factors like dim light.
|
a
| 0 |
medmcqa
|
Which is usually a presentation of the condition shown in the immunofluorescence study of the kidney?
|
[
"Development of renal vein thrombosis",
"Steroid responsive selective proteinuria",
"Nephelometer assay showing increased serum free light chain",
"Fibrillary immunotactoid glomerulopathy"
] |
Explanation:
The above shown immunofluorescence study is of MGN(Membranous Glomerulonephritis) It is associated with Renal vein thrombosis, CT disorder, Malignancy, Hep B & C infection Steroid responsive selective Proteinuria is a feature of Minimal change disease Nephelometer showing | Serum free light chain is feature of Multiple Myeloma. Fibrillary immunotactoid glomerulopathy is seen in non-amyloid fibril deposition is Associated with CLL.
|
a
| 0 |
medmcqa
|
A 6-year-old girl presents with precocious pubey, some bony lesions & hyperpigmented skin lesions as shown below. What is the most probable diagnosis?
|
[
"Prader Willi syndrome",
"Laurence Moon syndrome",
"Cushing syndrome",
"McCune-Albright syndrome"
] |
Explanation:
The history & image given in question suggests the diagnosis of MC CUNE ALBRIGHT SYNDROME: MC CUNE ALBRIGHT SYNDROME: - Characterized by Triad of Precocious pubey Cafe au lait spots Polyostotic fibrous dysplasia - Occurs due to somatic activating mutation of stimulatory G- protein - Associated endocrine abnormalities are * Hypehyroidism Rickets GH excess Precocious pubey
|
d
| 3 |
medmcqa
|
Which of the following does not involve nerve damage?
|
[
"Guillain barre syndrome",
"Erb's paralysis",
"Volkmann's paralysis",
"Neurotmesis"
] |
Explanation:
Guillain barre syndrome, erb's paralysis, and neurotmesis primarily involves nerves, whereas volkmann's paralysis is primarily ischemic paralysis of muscles due to raised intracompamental pressure (vascular phenomenon). It may secondarily lead to nerve ischemia and damage. Ref: Tachdjian's Pediatric Ohopedics 3/e, Page 2139-77, 2060; Rockwood and Green's Fracture in Children 6/e, Page 543-86; Apley's 8/e, Page 596-99, 563-64; Watson Jones : Fracture and Joint injuries 6/e, Page 591-609.
|
c
| 2 |
medmcqa
|
The most impoant source of Infection for meningococci is
|
[
"Case",
"Subclinical case",
"Carriers",
"Latent case"
] |
Explanation:
The human nasopharynx is the only reservoir of the Meningococcus. Natural infection is limited to the nasopharynx. Asymptomatic nasopharyngeal carriers rarely contract the illness but serve right infect their contacts. During the inter-epidemic period, the carrier rate is 5-10 percent. An increase in carriers rate heralds the onset of an epidemic. During epidemics, the carrier rates of closed communities may go up to 90 percent. Reference: Textbook of Microbiology; Anathanarayan and panicker's; 10th edition; Page no: 232
|
c
| 2 |
medmcqa
|
Age for regular mammography is
|
[
"20",
"30",
"40",
"50"
] |
Explanation:
Screening mammography: For screening purpose it is done after 40 years. Early screening is indicated when there is family history of carcinoma breast or histological risk factor. Mammography before 35 years of age is usually not done unless there is a suspicious lump or a strong family history. Screening is done in asymptomatic female where even cancer is suspected. Ref; (page no; 515) 5th edition of SRB&;S manual of Surgery.
|
c
| 2 |
medmcqa
|
All of the following are contents of the posterior triangle of the neck except:
|
[
"Spinal pa of accesory nerve",
"Trunks of brachial plexus",
"Internal jugular vein",
"Transverse cervical aery"
] |
Explanation:
The posterior triangle is bounded posteriorly by the trapezius muscle, anteriorly by the sternocleidomastoid muscle, and inferiorly by the clavicle.The posterior cervical triangle is subdivided into the following triangles by the inferior belly of the omohyoid muscle:Occipital triangle, whose contents are:Nerve to rhombideusCutaneous branches of cervical plexus of nervesSpinal accessory nerveUpper pa of brachial plexusTransverse cervical aery and veinCervical lymph nodesOccipital aerySupraclavicular nodesSubclan triangle (also known as omoclavicular), whose contents are:Third pa of subclan aeryPa of subclan veinSuprascapular aery and veinSupraclavicular lymph nodesThree trunks of brachial plexusNerve to serratus anteriorNerve to subclaviusSuprascapular nerveLower pa of external jugular veinTransverse cervical aery and vein
|
c
| 2 |
medmcqa
|
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