Datasets:
NicoHelemon
/
MNLP_M2_mcqa_dataset

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Which of the following is the vascular arrangement inside the young red bone marrow?
[ "Nutrient aery-central longitudinal aerioles-radial capillaries-sinuses-central longitudinal veins-nutrients vein", "Nutrient Aery-central longitudinal aerioles-radial capillaries-sinuses- nutrient nutrient vein", "Radial Capillaries-sinuses-nutrients in", "Nutrient aery-radial aeries-sinusoids-nutrient vein" ]
Explanation: Nutrient aery-central longitudinal aerioles-radial capillaries- sinuses-nutrient vein, is the correct vascular arrangement inside the young red bone marrow. A nutrient aery enters the cavity through a large nutrient foramen in the shaft of the bone. Other aeries typically enter the cavity near the ends of the bone. These are designated as metaphysical aeries. At least one large nutrient vein leaves the marrow cavity through the nutrient foramen with the nutrient aery. Blood vessels also pass from the narrow cavity into the compact bone of the shaft. The vessels leaving the compact bone of the shaft exit as periosteal vessels. Ref: Kaushansky K. (2010). Chapter 16. Hematopoietic Stem Cells, Progenitors, and Cytokines. In J.T. Prchal, K. Kaushansky, M.A. Lichtman, T.J. Kipps, U. Seligsohn (Eds), Williams Hematology, 8e.
b
1
medmcqa
Which needle is used for pleural biopsy
[ "Vin Silvermann's", "Abram's", "Abraham's", "Osgood's" ]
Explanation: Abram's needle is used for pleural biopsy.Techniques of biopsy include CT guided needle biopsy,VATS biopsy open surgical biopsy. Abraham's needle is used for pleural tap.Osgood's needle is used for bone marrow aspiration.Vin silvermann's needle is used for liver biopsy Reference:Bailey & Love's sho practise of surgery,25th edition,page no:881
b
1
medmcqa
Which of the following is not seen with hepatitis C infection
[ "PAN", "Cryoglobulinemia", "Porphyria cutanea tarda", "Lichen planus" ]
Explanation: Hepatitis C virus causes both acute and chronic infection. New HCV infections are usually asymptomatic. Some persons get acute hepatitis which does not lead to a life-threatening disease. Around 30% (15-45%) of infected persons spontaneously clear the virus within 6 months of infection without any treatment. The remaining 70% (55-85%) of persons will develop chronic HCV infection. Of those with chronic HCV infection, the risk of cirrhosis ranges between 15% and 30% within 20 years. Transmission The hepatitis C virus is a bloodborne virus. It is most commonly transmitted through: injecting drug use through the sharing of injection equipment; the reuse or inadequate sterilization of medical equipment, especially syringes and needles in healthcare settings; the transfusion of unscreened blood and blood products; sexual practices that lead to exposure to blood (for example, among men who have sex with men, paicularly those with HIV infection or those taking pre-exposure prophylaxis against HIV infection). HCV can also be transmitted sexually and can be passed from an infected mother to her baby; however, these modes of transmission are less common. Hepatitis C is not spread through breast milk, food, water or casual contact such as hugging, kissing and sharing food or drinks with an infected person. WHO estimates that in 2015, there were 1.75 million new HCV infections in the world (23.7 new HCV infections per 100 000 people). Symptoms The incubation period for hepatitis C ranges from 2 weeks to 6 months. Following initial infection, approximately 80% of people do not exhibit any symptoms. Those who are acutely symptomatic may exhibit fever, fatigue, decreased appetite, nausea, vomiting, abdominal pain, dark urine, grey-coloured faeces, joint pain and jaundice (yellowing of skin and the whites of the eyes). Testing and diagnosis Because new HCV infections are usually asymptomatic, few people are diagnosed when the infection is recent. In those people who go on to develop chronic HCV infection, the infection is also often undiagnosed because it remains asymptomatic until decades after infection when symptoms develop secondary to serious liver damage. HCV infection is diagnosed in 2 steps: Testing for anti-HCV antibodies with a serological test identifies people who have been infected with the virus. If the test is positive for anti-HCV antibodies, a nucleic acid test for HCV ribonucleic acid (RNA) is needed to confirm chronic infection because about 30% of people infected with HCV spontaneously clear the infection by a strong immune response without the need for treatment. Although no longer infected, they will still test positive for anti-HCV antibodies. After a person has been diagnosed with chronic HCV infection, they should have an assessment of the degree of liver damage (fibrosis and cirrhosis). This can be done by liver biopsy or through a variety of non-invasive tests. The degree of liver damage is used to guide treatment decisions and management of the disease Ref Harrison20th edition pg 997
a
0
medmcqa
Post exposure measles vaccine must be given within ----- days of exposure
[ "1", "3", "7", "10" ]
Explanation: Post-exposure Measles Vaccine must be given within : 3 days of exposure IP for naturally accuired Measles : 10 days IP for Vaccine induced Measles : 7 days Measles outbreak control Measures Isolation for 7 days after outbreak of rash Immunization of contacts within 2 days of exposure. Immunoglobulin administration within 3-4 days of exposure (if vaccine is contraindicated) Prompt immunization at begining of Epidemic Ref: Park 25th edition Pgno : 161
b
1
medmcqa
The length of the female urethra is :
[ "20 mm", "40 mm", "45 mm", "60 mm" ]
Explanation: 40 mm
b
1
medmcqa
Pulmonary aery pressure is
[ "120/80 mm Hg", "25/0 mm Hg", "25/8 mm Hg", "120/0 mm Hg" ]
Explanation: The pressure gradient in the pulmonary system is about 7 mmHg, compared with a gradient of about 90 mmHg in the systemic circulation. Pulmonary capillary pressure is about 10 mmHg, whereas the oncotic pressure is 25 mmHg so that an inwardly directed pressure gradient of about 15 mmHg keeps the alveoli free of all but a thin film of fluid. When the pulmonary capillary pressure is more than 25 mm Hg--as it may be, for example, in "backward failure" of the left ventricle--pulmonary congestion and edema result.Ref: Ganong review of medical physiology 23rd edition Page no: 602
c
2
medmcqa
Helicobacter pylori infection is associated with all of the following conditions , except
[ "Peptic ulcer", "Gastric adenocarcinoma", "B cell lymphoma", "Burkitt's lymphoma" ]
Explanation: Ref Robbins 7/e p814 , Robbins 8/e p315-316,9/e p329 H. pylori gastritis typically affects the antrum and is associ- ated with increased gastric acid production. The induced mucosa-associated lymphoid tissue (MALT) can transform into lymphoma. Peptic ulcer disease can be caused by H. pylori chronic gastritis and the resultant hyperchlorhydria or NSAID use. Ulcers can develop in the stomach or duodenum and usually heal after suppression of gastric acid production and, if present, eradication of the H. pylori. H. pylori: Chronic gastritis, most commonly due to H. pylori infection, promotes the development and progres- sion of cancers that may be induced by diverse genetic alterations (Chapter 5). As is the case with many forms of chronic inflammation, H. pylori-induced chronic gastritis is associated with increased production of proinflamma- tory proteins, such as interleukin-1b (IL-1b) and tumor necrosis factor (TNF). It is therefore not surprising that polymorphisms associated with enhanced production of these cytokines confer increased risk of chronic gastritis- associated intestinal-type gastric cancer in those with co- existing H. pylori infection.
d
3
medmcqa
Laryngofissure is -
[ "Opening the larynx in mid line", "Making window in thyroid cartilage", "Removal of arytenoids", "Removal of epiglottis" ]
a
0
medmcqa
Perinatal mortality rate includes
[ "Deaths within first week of life", "Abortions, Stillbirths, deaths within first week of life", "Deaths within one month of life", "Deaths from 28 weeks to with first week of life" ]
d
3
medmcqa
"Sub mucosal" glands are present in which one of the following organs?
[ "Duodenum", "Colon", "Anal canal", "Stomach" ]
Explanation: Duodenum
a
0
medmcqa
Most common cause of abdominal aortic aneurysm is:
[ "Trauma", "Vsculitis", "Syphilis", "Atherosclerosis" ]
Explanation: • “90% all abdominal aortic aneurysms are related to atherosclerotic disease and most of these aneurysms are below the level of renal arteries.” • Aneurysm: permanent and irreversible localized dilatation of blood vessel with at least 50% increase in diameter • Ectasia: dilatation <50% of normal diameter • AAA (abdominal aortic aneurysm) is diagnosed if diameter >3 cm in males or >2.6 cm in females • MC location: Aorta >Iliac >Popliteal >Femoral (AIPF) • MC site of extra-cranial arterial aneurysm is infrarenal aorta • MC site of peripheral aneurysm: Popliteal aneurysm • Degenerative aneurysms (caused by atherosclerosis) are MC AAA (90%) • Width of aneurysm is most important predicting factor of rupture. • Juan Parodi introduced endovascular aortic aneurysm repair (EVAR). Classification • True (all three layers of vessel are involved), false (do not have all three layers of vessel) • Infected (mycotic) aneurysm are false aneurysm • Dissecting aneurysm (dissection with aneurysmal dilatation of false lumen) • Fusiform (symmetrical enlargement involving whole circumference of artery) • Saccular (affect only part of the arterial circumference) have higher risk of rupture
d
3
medmcqa
Drug of choice for maintenance in PSVT is
[ "Amiodarone", "Lignocaine", "Verapamil", "Adenosine" ]
Explanation: Adesosine (3-12mg rapidly IV in incremental doses until tachycardia stops) or verapamil(5mg IV over 1min) will restore sinus rhythm in most cases. Reference : Harrison 20th edition pg 1432
d
3
medmcqa
Abnormal Fetal tachycardia is defined as:
[ "Fetal hea rate >= 160 bpm", "Fetal hea rate >= 180 bpm", "Fetal hea rate >= 200 bpm", "None of the above" ]
Explanation: Fetal hea rate above 180bpm is considered as abnormal tachycardia. Refer page no 519 of Text book of obstetrics,sheila balakrishnan,2 nd edition.
b
1
medmcqa
Lipid in tissue detected by aEUR'
[ "Oil Red 0", "Muciramine", "PAS", "Myeloperoxidase" ]
Explanation: Oil red 0 Congo red is not used in lipid staining. It is used in the staining of amyloid protein. STANING FOR LIPIDS Non polar lipids Example Stain used * Unconjugated lipids Fatty acids III & IV Oil red 0, Sudan black Sudan Cholesterol Filipin * Esters Cholesteryl esters Schultz Monodi and Tri-glycerides Calcium lipase * Polar lipids Phospholipids Glycerol bases Phosphatidylcholine Nile blue sulfate Phosphatidylserine Nile blue sulfate Phosphatidylethanol amine Plasmal reaction Sphingosine-base Sphingomyelins Fenic hematoxylin Glycolipids Cerebrosides PAS Sulfatides Acetone/Toluidine blue Ganglisides PAS
a
0
medmcqa
Broca's area is situated in
[ "Inferior frontal gyrus", "Superior temporal gyrus", "Inferior temporal gyrus", "Parietal gyrus" ]
Explanation: (A) Inferior frontal gyrus[?]BROCA'S AREA (Motor Speech Area) is a section of the human brain that is involved in language processing, speech or sign production & comprehensionBroca's area is located in the opercular and triangular sections of the Inferior Frontal Gyrus of the Frontal lobe of the Cortex.Broca's & Wernicke's areas are found unilaterally in the brain (left hemisphere) dominant hemisphere.Broca's area comprises Brodmann area 44 and (according to some authorities) Brodmann area 45.Broca's Area is connected to Wernicke's area by a neural pathway called the arcuate fasciculus.Inability to speak after injury to the posterior-inferior frontal gyrus of the brain.Pierre Paul Brocahe identified this region, known as Broca's area.Difficulty in language production as Broca's aphasia, also called expressive aphasia.Broca's area is now typically defined in terms of the pars opercularis & pars triangularis of the inferior frontal gyrus.Present in left hemisphere in 90% of right handed & 70% of left handed people.Present in right hemisphere only in any of left handed peopleCEREBRAL CORTEX & CORTICAL AREAS AT A GLANCEAREALOCATIONFUNCTION* Motor area (Area 4)Precentral gyrus & anterior part of para-central lobuleVoluntary movements* Premotor area (Area 6)Posterior parts of frontal gyriVoluntary movements* Frontal eye field (8) Includes Areas 6 & 9Anterior to premotor area in posterior part of middle frontal gyrusConjugate deviation of eyes to opposite side.* Broca's speech area (Areas 44,45)Posterior part of inferior frontal gyms of dominant hemisphereControls motor element of speech.* Prefrontal cortexAnterior part of frontal gyri, orbital gyri, most of medial frontal gyms, & anterior part of cingulate gyms.Intellectual activity* Sensory Cortex (Areas 3,1,2)Post central gyms & adjoining parts of post central gyms & posterior part of para-central lobuleAppreciation of somatic sensations* Areas 39,40Inferior parietal lobule, supra marginal & angular gyri.Recognition of somatic sensory stimuli & their integration steriognosis* Primary visual area (17) Visual cortex or striate cortex (Visual-Sensory Cortex)Surrounds post calcarine sulcus.Primary visual function* Visual association cortex (18,19) (peristriate & parastriate areas) (Visual-Psychic)Occipital lobe adjacent to striate areaRecognition & integration of visual stimuli* Primary acoustic area (41) or 1st acoustic area (Al)Anterior transverse temporal gyms extending to superior temporal gymsPrimary auditory function* Auditory association area (Area 42)Posterior transverse temporal gymsIntegration of auditory stimuli with other sensory modalities.* Area 24Anterior part of cingulate gymsPulse, Respiration & B.P. control* Limbic systemHippocampus, alveus, fimbria, fornix & its termination into mamillary bodies are grouped under this systemMaintenance of normal homeostasis of body along with hypothalamus.* Second speech area of WernickeOccupies parietal area extending into temporal lobe round the posterior extremity of lateral sulcus.Second motor speech area.
a
0
medmcqa
Aldosterone is known to cause sodium retention. Its Na+ retaining action is exeed on which pa of the nephron?
[ "Proximal convoluted tubule", "Ascending limb of loop of Henle", "Collecting ducts", "Early distal convoluted tubule" ]
Explanation: * Aldosterone is the principal mineralocoicoid. It stimulates the reabsorption of Na+ and excretion of K+ and H+ by its action on late distal tubules and collecting ducts.
c
2
medmcqa
Adverse effects of INH are all EXCEPT
[ "Peripheral neuritis", "Hepatitis", "Hypothermia", "Acne" ]
Explanation: (C) Hypothermia # Adverse effects INH is well tolerated by most patients.> Peripheral neuritis and a variety of neurological manifestations (paresthesias, numbness, mental disturbances, rarely convulsions) are the most important dose dependent toxic effects.> These are due to interference with utilization of pyridoxine and its increased excretion in urine.> Pyridoxine given prophylactically (10 mg/day) prevents neurotoxicity even with higher doses, but routine use is not mandatory.> INH neurotoxicity is treated by pyridoxine 100 mg/day.> Hepatitis, a major adverse effect of INH, is rare in children but more common in older people and in alcoholics> It is due to dose related damage to liver cells and is reversible on stopping the drug.> Other side effects are rashes, fever, acne and arthralgia.
c
2
medmcqa
Rarest variety of pemphigus among the following is
[ "P. vulgaris", "P. foliaceus", "P. vegetans", "P. erythematosis" ]
Explanation: "Pemphigus vulgaris is most common among all pemphigus patients followed by pemphigus foliaceus, pemphigus erythrematosis and then pemphigus vegetans"(Ref: IADVL textbook volume 1 pg 937)
c
2
medmcqa
Soluble Transferrin receptor in iron deficiency anemia is
[ "Increased", "Decreased", "Normal", "None" ]
Explanation: (A) Increased # The diagnosis of iron deficiency anemia ultimately rests on laboratory studies.> Both hemoglobin and hematocrit are depressed, usually to moderate levels, and are associated with hypochromia, microcytosis, and some poikilocytosis.> The serum iron and serum ferritin are low, and the total plasma iron-binding capacity (reflecting transferrin concentration) is high.> Low serum iron with increased iron-binding capacity results in a reduction of transferrin saturation levels to below 15%.> Transferrin receptor, expressed on the surface of many cells, is required for the transport of iron into cells.> The level of transferrin receptors is inversely related to available serum iron.> With iron deficiency, the level of cell-bound transferrin receptors and their soluble forms that circulate in the blood is elevated.
a
0
medmcqa
Adrenal cortex of fetus mainly releases which hormone during early part of pregnancy?
[ "Cortisol", "Corticosterone", "Progesterone", "DHEAS" ]
Explanation: a. Cortisol(Ref: Nelson's 20/e p 2700)Shortly after the fetal adrenal gland forms (wk 8-10), it efficiently secretes cortisol, which is able to negatively feedback on fetal pituitary and hypothalamus to suppress ACTH secretion.After wk 12, 3b hydroxy steroid dehydrogenase activity in the fetal adrenal gland decreases and steroid sulfokinase activity increases. Thus, the major steroid products of the midgestation fetal adrenal gland are DHEA and DHEA sulfate (DHEAS).Cortisol activity is low during the 2nd trimester, which might serve to prevent premature secretion of surfactant by the developing fetal lungs; surfactant levels can affect the timing of parturition.
a
0
medmcqa
Unilateral water discharge from the eye of a newborn with no edema or chemosis is due to
[ "Chlamydia", "Gonococcus", "Sticky eye", "Chemical conjuctivitis" ]
Explanation: Chemical conjuctivitis occurs due to silver nitrate eye drops given in children to prevent gonorrhea infection REF:Refer Khurana 6th edition page number 65
d
3
medmcqa
Which one of the following is most suggestive of neonatal small bowel obstruction -
[ "Generalized abdominal distension", "Failure to pass meconeum in the first 24 hours", "Bilious vomiting", "Refusal of feeds" ]
Explanation: Ans. is 'c' i.e., Bilious vomiting "Bilious vomiting is the most common symptom". -- Internet Intestinal obstruction in newborn Presentation depends on the site of obstruction. 1. Proximal obstruction o A history ofpolyhydramnios is common. o The higher the obstruction in the intestine the earlier the infant will develop vomiting which may be bile stained. o Abdominal distension will be less prominent. o Obstipation is less common. 2. Distal obstruction o Abdominal distension and obstipation are more common. o Vomiting is less common. Note ? In neonates proximal intestinal obstruction are much more common than distal. So, bilious vomiting is the most common presentation of neonatal intestinal obstruction.
c
2
medmcqa
Wastes not to be incinerated are those -
[ "With a low heating volume", "Whose content of combustible matter is above 60%", "Whose content of Non-combustible", "With a moisture content above 30%" ]
Explanation: - the characteristic of waste suitable for incineration are ; a low heating volume a moisture content below 30% content of Non-combustible content of combustible matter is above 60 Reference : Park's textbook of preventive and social medicine, 23rd edition, pg no:791 <\p>
d
3
medmcqa
Active search for disease in an apparently healthy individual is k/a
[ "Monitoring", "Case finding", "Screening", "Sentinel surveillance" ]
Explanation: Ans. is 'c' i.e. screening Screening is defined as 'the search for unrecognized disease or defect by means of rapidly applied tests, examination or other procedures in apparently healthy individuals."Other termsCase finding : is the use of clinical and/or laboratory tests to detect disease in individuals seeking health care for other reasons for example ELISA for HIV in pregnant women.Monitoring : is performing and analysing routine measurements to detect changes in the health status of population or changes in the environment for eg. monitoring of air pollution, water quality, growth and nutritional status etc.Sentinel surveillance : As no routine notification system can detect all cases of infection or disease, sentinel surveillance is a method to identify the missing cases.
c
2
medmcqa
Features of T wave in ECG of hypokalemia patients are all except: September 2009
[ "Elevated T wave", "Inveed T wave", "Flat T wave", "Bigeminal T wave" ]
Explanation: Ans. A: Elevated T wave ECG changes of few impoant conditions: Hypocalcemia- Prolonged ST and QT intervals Hypercalcemia- shoened ST segment - widened T wave Hypokalemia- ST depression - flat or inveed T wave- Prominent U wave Hyperkalemia- Tall, peaked T waves Flat P waves widened QRS complex - Prolonged PR interval Hypomagnesemia- Tall T waves - Depressed ST segment Hypermagnesemia- Prolonged PR interval - widened QRS complexes
a
0
medmcqa
Fetal placenta derived from which layer:
[ "Zonabasalis", "Zona capsularis", "Zona parietalis", "d. Inner cell mass" ]
Explanation: Ans-A Zona basalisRef: D.C. Dutta 8th ed. / 32SAILENT FEATURE OF PLACENTA* Wt-500gm* Wt of placenta: wt of fetus= 1: 6* Human placenta is discoidal(disc shape) and deciduate(shed off during delivery), hemochoroidal (in contact with maternal blood)* Formed at decidua basalis* Formed by trophoblast.* Placental circulation established at 21-22ndday(same time heart is formed, hence fetal circulation is established.)
a
0
medmcqa
Moality for AIDS -
[ "50%", "90%", "90%", "100%" ]
Explanation: Once infected with HIV ,it is infected for life.strictly speaking,the term AIDS refers only to the last stage of the HIV infection.so the moality is 100%(Ref.PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE 21st Edition page no.316)
d
3
medmcqa
Kala azar is transmitted by
[ "Phlebotomous papatasii", "Phlebotomous sergenti", "Phlebotomous argentipes", "Phlebotomous punjabensis" ]
c
2
medmcqa
Diagnosis in a ten-year-old boy with recurrent epistaxis and a unilateral nasal mass is-
[ "Antrochoanal polyp", "Hemangioma", "Angiofibroma", "Rhinolith" ]
c
2
medmcqa
Intraepidermal blisters are seen in all of the following conditions except –
[ "Pemphigus foliaceous", "Pemphigus vulgaris", "Paraneoplastic pemphigus", "Pemphigoid" ]
d
3
medmcqa
A patient was hospitalized after an automobile accident. The wounds became infected and the patient was treated with tobramycin, carbenicillin, and clindamycin. Five days after antibiotic therapy was initiated, the patient developed severe diarrhea and pseudomembranous enterocolitis. Antibioticassociated diarrhea and the more serious pseudomembranous enterocolitis can be caused by
[ "Clostridium sordellii", "Clostridium perfringens", "Clostridium difficile", "S. aureus" ]
Explanation: Patients treated with antibiotics develop diarrhea that, in most cases, is self-limiting. However, in some instances, paicularly in those patients treated with ampicillin or clindamycin, a severe, life-threatening pseudomembranous enterocolitis develops. This disease has characteristic histopathology, and membranous plaques can be seen in the colon by endoscopy. Pseudomembranous enterocolitis and antibiotic-associated diarrhea are caused by an anaerobic Gram-positive rod, Clostridium difficile. It has been recently shown that C. difficile produces a protein toxin with a molecular weight of about 250,000. The "toxin" is, in fact, two toxins, toxin A and toxin B. Both toxins are always present in fecal samples, but there is approximately one thousand times more toxin B than toxin A. Toxin A has enterotoxic activity--that is, it elicits a positive fluid response in ligated rabbit ileal loops-- whereas toxin B appears to be primarily a cytotoxin. Reference: Ananthanarayan and Paniker&;s Textbook of Microbiology Tenth edition
c
2
medmcqa
Pen test is done for which nerve injury ?
[ "Median", "Ulnar", "Radial", "Axillary" ]
Explanation: Ans. is 'a' i.e., Median Tests/Features of Median Nerve Injury Pointing index or oschner's clasp test :- When patient is asked to clasp his hand, index finger fails to flex. Benediction test : - Patient is unable to flex the index and middle finger on lifting the hand due to paralysis of long flexors of these two fingers. Pen test : - Patient is unable to touch the pen, held above the thumb (due to APB paralysis). Ape thumb (Simian thumb) deformity :- The thumb is adducted and laterally rotated so that the thumb lies in the same plane as the other fingers. It is due to over action of adductor pollicis (supplied by ulnar nerve). Loss of opposition due to paralysis of opponens pollicis. Atrophy of thenar eminence.
a
0
medmcqa
17-a hydroxylase is not involved in the pathway for synthesis of ?
[ "Coisol", "Aldosterone", "Androsteredione", "Testosterone" ]
Explanation: Ans. is 'b' i.e., Aldosterone
b
1
medmcqa
Monro's abscesses, with not elongated rete ridges:
[ "Benign migratory glossitis.", "Reiter's syndrome.", "Psoriasis.", "Pemphigus." ]
b
1
medmcqa
Which of the following is the most recognised symptom of alcohol withdrawal?
[ "Bodyache", "Tremor", "Diarrhoea", "Rhinorrhea" ]
Explanation: Alcoholic tremulousness is perhaps the most common form of withdrawal, and also the most easily recognized. Ref: Kaplan & Sadock's Synopsis of Psychiatry 9th Edition, Page 403-405; A Sho Textbook of Psychiatry by Neeraj Ahuja 5 Edition, Page 40 ; Current Diagnosis & Treatment in Psychiatry, Page 240-259; Avoiding Common Errors in the Emergency Depament By Amal Mattu, Arjun S. Chanmugam, Carrie D. Tibbles, 2010, Page 724.
b
1
medmcqa
All of the following are in the anterior triangle of neck EXCEPT:
[ "Diagastric", "Subclan", "Muscular", "Submental" ]
Explanation: Posterior triangle of neck has 2 pas: Occipital & subclanSubclan triangle is also c/d as supraclavicular or omoclavicular triangle.Anterior triangles of neck are-Submental, Digastric, Carotid, Muscular.
b
1
medmcqa
A patient presented with B/L hilar lymphadenopathy with negative Mantoux test. Diagnosis is: (PGI Dec 2007)
[ "Erythema nodosum", "Sarcoidosis", "Hepatitis", "TB" ]
Explanation: Ans.: B (Sarcoidosis) Bilateral hilar fymphadenopathy with negative montaux test is the characteristic of sarcoidosis-Erythema nodosum, Hepatitis; uveitits may be the part of sarcoidosis]A positive gallium scan can support the diagnosis if increased activity is noted in the parotids and lacrimal glands (Panda sign) or in the right par a tracheal and left hilar area (lam bda sign)The Kviem-Siltzbach procedure is a specific diagnostic test for sarcoidosisTable : Frequency of Common Organ Involvement and Lifetime Risk Presentation %Follow-up, %cLungQ9594Skin2443Eye1229Extrathoracic lymph node1516Liver1214Spleen78Neurologic516Cardiac23
b
1
medmcqa
All the following are adverse outcomes associated with threatened aboion except
[ "Placenta pre", "Preterm bih", "Manual removal of placenta", "Fetal macrosomia" ]
Explanation: Adverse Outcomes That are Increased in Women with Threatened AboionMaternalPerinatalPlacenta prePlacental abruptionManual removal of placentaCesarean deliveryPROMPreterm bihLow-bihweightFetal growth restrictionFetal and neonatal deathReference: William's Obstetrics; 25th edition; Chapter 18; Aboion
d
3
medmcqa
True regarding breast carcinoma is: March 2008
[ "Occurs most commonly in upper inner quadrant", "Late menarche and early menopause predisposes for breast malignancy", "Commoner in nulliparous women", "Unrelated with the family history of breast cancer" ]
Explanation: Ans. C: Commoner in nulliparous women Breast carcinoma are found more commonly in upper-outer quadrant
c
2
medmcqa
In a typical blood gas analyser
[ "Oxygen tension will be overstimulated in hypothermia", "pH is a derived measurement", "Standard bicarbonate can be used to indicate the respiratory component", "The oxygen tension can be measured using Clarke electrode." ]
Explanation: Oxygen tension falls with hypothermia. The pH electrode directly measure pH. The standard bicarbonate measured in sample titrated to pCO2 of 5.3 kPa, which eliminates respiratory component.
d
3
medmcqa
Which one of the following methods is used for the estimation of chlorine demand of water?
[ "Horrock’s apparatus", "Chlorometer", "Berkefeld filter", "Double pot method" ]
Explanation: Chlorine demand of water : Is the amount of chlorine that is needed to destroy bacteria, and to oxidize all the organic matter amd ammoniacal substances present in water. Is the amount of chlorine added to water minus amount of residual chlorine remaining at the end of a specific period of contact (1 hr). Estimation of chlorine demand of water (or dose of bleaching powder required for disinfection of water) is done by ‘Horrock’s apparatus.
a
0
medmcqa
True about juvenile respiratory papillomatosis:
[ "Affects children commonly", "Lower respiratroy tract can be involved", "May resolve spontaneously", "All" ]
Explanation: Juvenile respiratory papillomatosis: Affects children commonly, Lower respiratory tract can be involved - though larynx is the M/C site affected - Mouth, pharynx, tracheobronchial tree and oesophagus can all be affected May resolve spontaneously Micro laryngoscopic surgery is the Treatment of choice CO, laser surgery, which is a form of microlaryngoscopic surgery is the Treatment of choice
d
3
medmcqa
Intrauterine exposure of diethylstilboestrol is associated with -
[ "Squamous cell carcinoma of cervix", "Adenocarcinoma of endometrium", "Clear cell adenocarcinoma of vagina", "Sarcoma of uterus" ]
c
2
medmcqa
Adductor canal contains all except
[ "Femoral aery", "Femoral vein", "Femoral nerve", "Saphenous nerve" ]
Explanation: ADDUCTOR CANAL:- Also known as Hunter's or subsaorial canal.It is an intermuscular space situated on the medial side of the middle one-third of the thigh. Extend:-from apex of femoral triangle above to the tendinous opening in adductor magnus below.Shape:- Triangular on cross section. Boundaries:--Anterolateral wall : vastus medialis.-Posteriomedial wall/Floor:Adductor longus above and adductor magnus below.-Medial wall/Roof: strong fibrous membrane joining Anterolateral and posteromedial walls.Roof overlapped by saorius. Subsaorial plexus of nerves lies on the fibrous roof of the canal under saorius. Plexus is formed by branches from the medial cutaneous nerve of thigh,the saphenous nerve and the anterior division of the obturator nerve. It supplies skin over fascia lata and neighbouring skin. Contents:-1.Femoral aery:enters the canal at the apex of the femoral triangle. Within the canal it gives off muscular branches and descending genicular branch. It leaves the canal through opening in adductor magnus to continue as popliteal aery.2. Femoral vein: lies posterior to femoral aery( upperclassmen pa) and lateral to the aery ( lower pa).3. Saphenous nerve:cross the femoral aery anteriorly from lateral to medial side.4. Nerve to vastus medialis5. Branches of two divisions of obturator nerve: Anterior division emerges at the lower border of adductor longus, gives branches to subsaorial plexus and ends by supplying femoral aery. Posterior division of the obturator nerve runs on anterior surface of adductor magus and ends by supplying knee joint. {Reference:BDC 6Epg no.56}
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A chronic alcoholic presents with abdominal pain radiating to the back that responds to analgesics. At evaluation the pancreatic duct was found to be dilated and stones were noted in the tail of pancreas. The most appropriate management is:
[ "Pancreatic Tail Resection", "Pancreatico Jejunostomy", "Percutaneous removal of stone", "Medical Management" ]
Explanation: Dilated pancreatic duct and stones in the tail of pancreas suggest diagnosis of chronic pancreatitis. Surgical intervention in the treatment of chronic pancreatitis is considered when the pain is severe enough to limit the patient's lifestyle or reduce productivity. the pain persists despite complete abstinence from alcohol and administration of non-narcotic analgesics. Here the patient's pain is not intractable and can be controlled by analgesics. Thus he does not need any surgical intervention and can be well managed by medicines and abstinence from alcohol. Abstinence from alcohol has been shown to provide relief from pain and recurrent attacks of pancreatitis in more than half of cases.
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Young male Kallu is brought to the hospital with Severe asthama. PharmacoKinetics of theophylline include the following parameters:Vd=35L ;CL=48ml/min;half life is 8hrs.if an intravenous infusion of theophylline is staed at a rate of 0.48mg/min,how long will it take to reach 93.75% of the final steady stare
[ "Approximately 48min", "Approximately 5.8hrs", "Approximately 8hrs", "Approximately 32hrs" ]
Explanation: Ref-Katzung 10/e p52 For a drug following first order kinetics,rise in plasma concentration as well as fall in plasma concentraton is similar.when the steady state is attained and the drug administration is stopped.it will be eliminated from the body.50% will be eliminated in one half life 75% in second half life and 87.5%(50+25+12.5%) in third half life and 93.75% (50+25+12.6+6.5%) in four half lives. When constant i.v. is administered, plasma concentration increases in the same manner.in one half life,it is 50% of the steady state and to reach 93.75% of steady state ,4half loves will be required As the half life of this drug is 8hrs, approximately 32hrs will be taken
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3
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In which of the following conditions would the (patient most likely be normotensive?
[ "Primary hyperparathyroidism", "Hypothyroidism", "Cushing syndrome", "Barter syndrome" ]
Explanation: Bartter syndrome is a mineralocorticoid excess state caused by a defect in chloride reabsorption in the kidneys. The defect in chloride reabsorption in the ascending tubule also affects the reabsorption of so­dium; therefore, there is an augmented distal delivery of sodium with increased exchange of sodium for po­tassium and hydrogen ions in the distal tubule, produc­ing a hypokalemic metabolic alkalosis. Hypokalemia is a stimulus of renin release from the juxtaglomerular (JG) apparatus, which results in JG apparatus hyper­plasia. Activation of the renin-angiotensin-aldoste­rone system increases the production of angiotensin II and aldosterone. Hypokalemia also increases the synthesis of prostaglandin E2 and 12 in the kidneys. Both of these chemical mediators are potent vasodila­tors. Angiotensin II and aldosterone stimulate the syn­thesis of renal kallikrein, which is then converted into bradykinin, a potent vasodilator. Because of this se­quence of events, patients with Bartter syndrome do not develop hypertension, even in the presence of the excess aldosterone and angiotensin II, because their hypertensive effects are offset by the vasodilatation induced by the prostaglandins and bradykinin. In ad­dition, for unexplained reasons, these patients are resis­tant to the effects of infused angiotensin II.
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3
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Drug of choice for treating schistosoma haematobium is -
[ "Metronidazole", "Praziquantel", "Pyrantel pamoate", "None of the above" ]
b
1
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Drug causing agranulocytosis ?
[ "Pimozide", "Clozapine", "Risperidone", "Olanzapine" ]
Explanation: Ans. is 'b' i.e., Clozapine Agranulocytosis is a known side effect of clozapine "Because of the risk of agranulocytosis, patients, recieving clozapine must have weekly blood counts for the first 6 months and every 3 weeks thereafter" Side effects of clozapine Agranulocytosis Unstable BP & Tachycardia Worsening of diabetes Seisures Urinary incontinence Hypersalivation (sialorrhoea) Weight gain Sedation
b
1
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The setting expansion of gypsum products can be reduced by:
[ "Increased spatulation", "Adding potassium sulfate", "Less water powder ratio", "Allowing setting under water" ]
b
1
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Drug contraindicated in hyperiglyceridemia
[ "Fibrates", "Simvastatin", "Niacin", "Cholestyramine" ]
Explanation: Bile acid binding resins like cholestyramine causes increase in triglycerides and are thus contraindicated in patients with hyperiglyceridemia due to risk of development of pancreatitis. Statins - decrease LDL and increase HDL Niacin - decrease LDL and triglyceride, maximum increase in HDL Fibrates - decrease triglyceride, decrease LDL.
d
3
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All are true about management of uterine inversion, EXCEPT?
[ "Repositioning of uterus should be attempted immediately if diagnosed at the time of inversion", "May require laparotomy", "In case of delayed presentation repositioning to be attempted only after securing IV lines and adequate anesthesia", "Surgical management is hysterectomy" ]
Explanation: MANAGEMENT OF UTERINE INVERSION Immediate management: manual repositioning, (iv access, fluid and blood for resuscitation) Delayed management: attempt manual repositioning under anesthesia (iv access, fluid and blood for resuscitation, hydrostatic method (O Sullivans) Surgical management: laparotomy f/b pulling uterus with clamps (huntington method), release of constriction ring (haultain method)
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3
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Temporal association of a disease is best established by
[ "Case-Control study", "Cross-section study", "Coho study", "Descriptive study" ]
Explanation: Temporal relationship: Exposure must precede disease"A well-designed coho study is considered the most reliable means of showing an association between a suspected risk factor and subsequent disease"Park 23e pg:76
c
2
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Trendlenberg's sign is positive in injury to:
[ "Gluteus maximus", "Gluteus medius", "Quadriceps lemons", "Quadratuslumborum" ]
Explanation: Ans: B (Gluteus medius) Ref: Press wood L, Cronin J. Keogh J. Whatman C (2008). Ghtietis Medius: Applied Anatomy, Dysfunction, Assessment, and Progressive Strengthening. Strength and Conditioning Journal, 30 (5), 41-53Explanation:Trendelenburg's sign is found in people with w-eak or paralyzed abductor muscles of the hip, namely gluteus medius and minimus.It is named after the German surgeon Friedrich Trendelenburg.The Gluteus mediusis far more valuable as a pelvis and lower extremity dynamic stabilizer than it is a pure hip abductor.This is apparent when looking at the mechanism of a Trendelenburg GaitThe role of the gluteus medius during activities such as walking and running is to dynamically stabilize the pelvis in a neutral position during single leg stance.Weakness of the right gluteus medius will cause the left hip to drop when standing on the right limb.
b
1
medmcqa
Mili is suspected to have an infection on her second pre-natal visit. Her pet cat could act as a reservoir for which of the following conditions?
[ "Toxoplasma gondii", "Rabies", "Streptocerca infection", "Plague" ]
Explanation: Toxoplasmosis is usually a self-limiting infection due to a parasite called Toxoplasma gondii. The toxoplasmosis parasitic disease is capable of infecting almost all species of warm-blooded animals, including humans, but the primary host is the various members of the cat family. They are the only hosts in which the oocyst-producing sexual stage of Toxoplasma can develop. A wide host range, comprising all the hot-blooded animals including birds and rodents, can serve as a reservoir of rabies. Monkeys are reservoirs for Streptocerca. Wild rodents such as field mice, gerbils, and skunks are the natural reservoir of plague. In India, Tatera indica (wild rat) is considered the main reservoir and not Ratus ratus (domestic rat).
a
0
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American Heart Association standard pediatric dose of amoxicillin for antibiotic prophylaxis, in cases of endocarditis is
[ "20mg/kg", "50mg/kg", "100mg/kg", "125mg/kg" ]
b
1
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Following drugs are immunosuppresants except
[ "Cephalosporin", "Cyclosporine", "Azathioprine", "Steroids" ]
Explanation: Ans. is 'a' i.e., Cephalosporin Immunosuppressants These are drugs which inhibit cellular or humoral response or both These are mainly used in organ transplantation and autoimmune disease.
a
0
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Which is not true about indication of exchange transfusion ? (Not a criteria for exchange transfusion)
[ "Cord bilirubin is 5 mg% or more", "Cord Hb is 10 mg% or less", "Rate of bilirubin increase is > 0.5 mg%", "Total bilirubin 10 mg/dl" ]
Explanation: Double volume exchange tranfusion (DVET) should be performed if the total serum bilirubin(TSB) levels reach to age specific cut off for exchange transfusion or th infant shows signs of bilirubin encephalopathy irrespective of TSB levels .For < 28 wk gestation, TSB cut off is 11-14 mg/dl. For 28 to 29 wks, 30 to 31 wks and 32 to 33gestation, cut off is 12-14, 13 - 16 and 15-18 mg/dl respectively . For 34 wks of gestation, cut off is 17-19 mg /dl. Reference : page 172 Ghai Essential Pediatrics 9 th edition
d
3
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Fifth disease is caused by
[ "Parvo virus 70", "HPV", "Hepatitis Virus", "HPV" ]
Explanation: (A) Parvo virus 70 # ERYTHEMA INFECTIOSUM (FIFTH DISEASE): The disease is caused by Human Parvovirus.> Erythema infectiosum is the most common clinical manifestation of human parvovirus infection.NAMENUMBERVIRUS(Rubeola) measles"First disease"Measles virusRubella, ("German Measles") identified in 1881."Third disease"Rubella virusErythema infectiosum, identified as a distinct condition in 1896."Fifth disease"Parvovirus B19Roseola infantum"Sixth disease"HHV-6 and HHV-7
a
0
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Core body temperature is closest to
[ "Rectal", "Surface", "Oral", "Axillary" ]
Explanation: (A) Rectal [Ganong22-251; 19th*-239/# Rectal temperature is representative of the temperature at the core of the body and varies least with changes in environmental temperature. Oral temperature is normally 0.5 degC lower than the rectal temperature, but it is affected by many factors, including ingestion of hot or cold fluids, gum-chewing, smoking, and mouth breathing.
a
0
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Incidental adrenal masses:
[ "May be seen in as many as 10% of abdominal CT studies.", "Most commonly represent pheochromocytoma; adrenocoical adenoma, adrenocoical carcinoma, and metastases from other primary cancers occur less frequently.", "May represent adrenocoical carcinoma if greater than 6 cm. in diameter.", "Should be routinely evaluated by measurement of 24-hour urine levels of catecholamines and their metabolites, coisol, and aldosterone plus fine-needle aspiration." ]
Explanation: The incidental adrenal mass is seen in as many as 1.3% of abdominal CT scans performed for other reasons. Adrenocoical adenomas are most common, followed by adrenocoical carcinoma, metastases from other primary cancers, and pheochromocytoma. Biochemical evaluation must weigh the prevalence of adrenal neoplasms against the consequences of a missed life-threatening diagnosis, as in pheochromocytoma. All adrenal masses should be evaluated for pheochromocytoma with measurement of 24-hour urine catecholamines and their metabolites. Aldosterone and coisol measurement are indicated if clinical features suggest aldosteronism or Cushing's syndrome. Fine-needle aspiration of adrenal masses is indicated for clearly cystic lesions or if metastasis is suspected based on the presence of another known primary. Fine-needle aspiration is not routinely indicated in the evaluation of adrenal lesions and is contraindicated until pheochromocytoma is definitively excluded. Adrenal lesions should be resected if they are functional, are larger than 6 cm., or have enlarged during follow-up.
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2
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Osteomalacia is associated with -
[ "Decreases in osteoid volume", "Decrease in osteoid surface", "Increase in osteoid maturation time", "Increase in mineral apposition rate" ]
Explanation: First, see the structural composition of the bone. Bone is made up of : - Organic matrix (Protein matrix also called osteoid): - This is mainly made up of collagen and non-collagen protein. Inorganic matrix (mineral) : - Hydroxyapatite . Bone cells. As osteoid (organic matrix) does not contain mineral (hydroxyapatite), it is also called unmineralized bone. Mineralization of osteoid forms the complete mineralized bone. In rickets/osteomalacia mineralization of osteoid is defective, i.e., the osteoid formation is normal, but mineralization of osteoid is defective. On the other hand, In scurvy, Collagen synthesis is defective. Collagen is the major constituent of osteoid. Thus, In scurvy osteoid formation is defective. In osteoporosis, resorption is increased from the fully formed bone. Therefore, both the organic matrix (osteoid) as well as non-organic minerals are decreased.
c
2
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In sweat glands, the sympathetic neurotransmitter-
[ "Norepinephrine", "Epinephrine", "Dopamine", "Acetylcholine" ]
Explanation: Ans. is 'd' i.e., Acetylcholine o Neurotransmitter in all preganglionic autonomic nerves (both sympathetic and parasympathetic) is acetylcholine (ACH)o Neurotransmitter in all ganglia (both sympathetic and parasympathetic) is acetylcholine.o Neurotransmitter in postganglionic parasympathetic fibres is acetylcholine.o In posganglionic sympathetic fibres, the major neurotransmitter is noradrenaline (NA) except in renal and mesentric vasculature where it is dopamine, in sweat glands, some blood vessels where it is acetylcholine and in adrenal medulla where it is adrenaline.o Most of the visceral organs are supplied by both sympathetic and parasympathetic system except;1. Blood vessels, spleen, sweat glands and hair follicles receive only sympathetic innervation.2 Ciliary muscle gastric and pancreatic glands receive only parasympathetic innervation,o In general sympathetic and parasympathetic systems are antagonistic except;# Refractory period of atrial fibres is decreased by both.o At almost all organs except heart, cholinergic system has excitatory activity and adrenergic system has relaxing properties - Sympathetic system stimulates (Tachycardia, Positive inotropic) and parasympathetic system depresses (Bradycardia, Negative inotropic) the heart.
d
3
medmcqa
Which of the following is not an inhalational steroids?
[ "Beclomethasone", "Betamethasone", "Budesonide", "Fluticasone acetonide" ]
Explanation: Ans. is 'b' i.e., Betamethasone * Corticosteroid may be used as inhaled or systemic drugs is asthma :A) Inhaled steroids# These are glucocorticoids with high topical and low systemic activity. Commonly used drugs are beclomethasome, budesonide, fluticasone and ciclesonide. Inhaled steroids are the most effective antiinflammatory agents used in asthma.# Inhaled steroids are not considered necessary for patients with mild and episodic asthma. They are indicated when inhaled b2-agonists are required almost daily or the disease is only episodic.Ihey have no role during acute attack or in status astmaticus.# Ciclesonide is known as soft steroid, i.e. steroid with high topical and negligible systemic effect. It is metabolized by enzymes in lung and therefore has least risk of systemic toxicity when given by inhalational route.# Inhaled steroids are safe during pregnancy. Common side effect of inhaled steroid is oropharyngeal condidiasis.B) Systemic steroids# Are used in severe chronic asthma and status asthmaticus (acute asthma exacerbation).
b
1
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Active component of a white oleander -
[ "Nerine", "Nicotine", "Abrine", "Pilocarpine" ]
Explanation: NERIUM ODORUM / WHITE OLEANDER contains-oleadrin and nerin resembles digitalis like action REF;THE SYNOPSIS OF FORENSIC MEDICINE:KS NARAYANA REDDY;28th EDITION;PAGE NO355
a
0
medmcqa
What is the genotype of Klinefilter's syndrome?
[ "45X0", "47 XXX", "47XXY", "Trisomy 13" ]
Explanation: Ans. is 'c' i.e., 47 XXY o Klinefelter syndrome is the most common chromosomal disorder associated with male hypogonadism and infertility.o It is defined classically by a 47, XXY karyotype with variants demonstrating additional X and Y chromosomes. (Other variants can have 48 XXXY, rarely 49 XXXXY or mosaics can be there with some cells containing normal 46, XY and others 47, XXY). Classically, it results from meiotic non-dysjunction of sex chromosomes (40% during spermatogenesis and 60% during oogenesis). Mostly, non-dysjunction occur during 1st meiotic divisiono The patient has male phenotype with feminizing features due to extra X-chromosome (note : presence of one Y chromosome is sufficient for male phenotype. Thus XY, XXY, XXXY all are males). Extra inactive chromosome appears as Barr body.o Important clinical features include microorchidism with nonnal external genitalia, mental retardation, gynecomastia, lack of secondary sexual characteristics with eunuchoid(PGI 01) body habits, disproportionately long arms and legs, hypogonadism, increased incidence of tumors (breast carcinoma, germ cell tumors), increased incidence of autoimmune disorders (e.g. SLE), and cardiac problems (most common is mitral valve prolapse). Testosterone levels are decreased, whereas levels of gonadotropins (FSH/LH) are elevated.
c
2
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Ileal obstruction due to round worm obstruction treatment is
[ "Resection with end to end anstomosis", "Resection with side to side anastomosis", "Enterotomy, removal of worms and primary closure", "Diversion" ]
Explanation: If the bowel wall is healthy, enterotomy and removal of the worms may be performed Ref: Bailey & Love&;s Sho Practice of Surgery,E25,Page-53
c
2
medmcqa
IVC pierces the diaphgram at what vertebral level-
[ "T6", "T8", "T10", "T12" ]
Explanation: Ans. is 'b' i.e., T8 OpeningVertebral levelIn which part of diaphragmPassing structureVena CavalT8Central tendon# Inferior vena cava# Right phrenic nerveOseophagealT10Muscular portion derived from right crus# Oesophagus# Oesophageal br. of left gastric artery# Gastric or vagus nerveAorticT12Osseoaponeurotic between right and lateral crus# Aorta# Thoracic duct# Azygous vein
b
1
medmcqa
IPC 320 deals with -
[ "Hurt", "Abetment of suicide", "Punishment for murder", "Grievous hurt" ]
Explanation: Ans. is 'd' i.e.. Grievous hurto 3191 PC : Defines hurt,o 320IPC : Defines grievous hurt,o 321 IPC : Voluntarily causing hurt,o 322 IPC : Voluntarily causing grievous hurt.o 323 IPC : Punishment for voluntarily causing hurt {no provocation, no dangerous weapon) (1 years imprisonment),o 324 IPC : Punishment for voluntarily causing hurt by dangerous weapon (3 years imprisonment +- fine),o 325 IPC : Punishment for voluntarily causing grievous hurt (no provocation, no dangerous weapon) (7 years imprisonment +- fine).
d
3
medmcqa
The given TVS shows
[ "Proliferative endometrium", "Secretory endometrium", "Menstrual phase endomertrium", "Post menopausal endometrium" ]
Explanation: In menopause, endometrium atrophies with cessation of Estrogen and cyclic sloughing cease. Post menopausal endometrium appears thin and uniform.
d
3
medmcqa
Muehrcke lines in nails are seen in
[ "Nephrotic syndrome", "Barer syndrome", "Nail patella syndrome", "Acute tubular necrosis" ]
Explanation: Ans. is 'a' i.e., Nephrotic syndrome
a
0
medmcqa
Which is provided by linear accelerator
[ "Electron", "Neuron", "Proton", "Infrared rays" ]
Explanation: A i.e. Electron
a
0
medmcqa
Which of the following is not seen in scoline apnea ?
[ "It is due to succinylcholine", "It can be inherited", "Patients usually do not die of scoline apnea if they are properly managed", "It occurs due to deficiency of cholinesterase" ]
Explanation: Succinylcholine apnoea occurs due to deficiency of "pseudocholinesterase or plasma cholinesterase".
d
3
medmcqa
Nosocomial infection occurs in hospital in
[ "<12 hours", "12-14 hours", "24-48 hours", ">48 hours" ]
Explanation: The term hospital infection, hospital-acquired infection or nosocomial infection are applied to infections developing in hospitalized patients, not present or in incubation at the time of their admission. Such infections may become evident during their stay in hospital or, sometimes, only after their discharge. Infections are considered nosocomial if they first appear 48 hours or more after hospital admission or within 30 days after discharge.
d
3
medmcqa
Not a feature of fat embolism
[ "Tachycardia", "Hypotension", "Petechial Rashes", "Tachypnoea" ]
b
1
medmcqa
False about nerve entrapment syndromes
[ "Guyon's canal syndrome - ulnar nerve", "Cubital tunnel syndrome - ulnar nerve", "Cheiralgia paresthetica - femoral nerve", "Tarsal tunnel syndrome - posterior tibial nerve" ]
Explanation: Nerve entrapment syndromes  Carpal tunnel syndrome - Median nerve  Cubital tunnel syndrome - Ulnar nerve Guyon's canal syndrome - Ulnar nerve  Pyriformis syndrome - Sciatic nerve  Meralgia Paresthetica - Lateral cutaneous nerve of thigh  Cheiralgia Paresthetic - Superficial Radial nerve Tarsal tunnel syndrome - Posterior tibial nerve
c
2
medmcqa
All are derivatives of mullarian duct except ?
[ "Fallopian tube", "Uterus", "Upper 2/3rd of vagina", "Lower2/3rd of vagina" ]
Explanation: Ans. is 'd' i.e., Lower 2/3rd of vagina PARAMESONEPHRIC DUCT (MULLERIAN DUCT) : Main genital duct in females Females Males Fallopian tubes Appendix of testis (Hydatid of morgagni) Uterus Prostatic utricle Upper 2/3 of vagina
d
3
medmcqa
All of the following statements is/are true about post streptococcal glomerulonephritis except -a) Early treatment of streptococcal pharyngitis prevents glomerulonephritisb) All cases of streptococcal infection lead to glomerulonephritisc) Hump sign may be presentd) Immune complex deposits are seene) Commonly presents with crescent formation
[ "abc", "bcd", "abe", "acd" ]
Explanation: There is no evidence to date that the early treatment of streptococcal disease, either pharyngitic or cellulitic, will alter the risk of PSGN. Not all cases of streptococcal infection lead to glomerulonephritis. PSGN usually develops 1-3 weeks following acute infection with specific nephritogenic strains of group A beta-hemolytic streptococcus. The incidence of GN is approximately 5-10% in persons with pharyngitis and 25% in those with skin infection. The characteristic ultrastructural feature of PSGN is subepithelial like dense deposits. By immunofluorescence microscopy, there are granular deposits of IgG, IgM and C3 in the mesangium and along GBM. Focal and sparse immune complex deposits are almost universally present. PSGN does not commonly present with crescent formation. Only in its severe form PSGN may show rapid deterioration of renal function with formation of crescent in the glomeruli It is referred to as rapidly progressive glomerulonephritis.
c
2
medmcqa
ORS WHO glucose in mmol/L
[ "75", "120", "9", "111" ]
Explanation: (A) 75 CONCENTRATIONS OF INGREDIENTS IN REDUCED OSMOLARITY ORSIngredientg/LMolecule/ionmmol/L* Sodium chloride (NaCI)2.6Sodium75* Glucose, anhydrous (C6H12O6)13.5Glucose75* Potassium chloride (KCI)1.5Potassium20* Chloride65 * Trisodium citrate, dehydrate Na3C6H5O7-2H2O2.9Citrate10
a
0
medmcqa
Which of the following statement about carcinogenesis is false
[ "Asbestos exposure increase the incidence of lung cancer", "Papilloma viruses produce tumors in animal but not in human", "Exposure to aniline dyes predisposes to cancer of the urinary bladder", "Hepatitis B virus has been implicated in hepatocellular carcinoma" ]
Explanation: Ref Harrison 17/e p487 HPV, the causative agent of cervical neoplasia, has a tropism for the immature squamous cells of the transformation zone. Most HPV infections are transient and are eliminated within months by an acute and chronic inflammatory response. A subset of infections persists, however, and some of these progress to cervical intraepithelial neoplasia (CIN), precursor lesion from which most invasive cervical carcino- mas develop. HPV is detectable by molecular methods in nearly all cases of CIN and cervical carcinoma. Impoant risk factors for the development of CIN and invasive carcinoma thus are directly related to HPV exposure and include * Early age at first intercourse * Multiple sexual paners * Male paner with multiple previous sexual paners * Persistent infection by high-risk strains of papillomavirus Although HPV infection occurs in the most immature squamous cells of the basal layer, replication of HPV DNA takes place in more differentiated overlying squamous cells. Squamous cells at this stage of maturation do not normally replicate DNA, but HPV-infected squamous cells do, as a consequence of expression of two potent oncoproteins encoded in the HPV genome called E6 and E7. The E6 and E7 proteins bind and inactivate two critical tumor suppressors, p53 and Rb, respectively (Chapter 5), and in doing so promote growth and increased susceptibility to additional mutations that may eventually lead to carcinogenesis
b
1
medmcqa
Fast breathing in less than 2 month child the respiratory rate is
[ "60 breaths per minute", "50 breaths per minute", "40 breaths per minute", "30 breaths per minute" ]
Explanation: A. i.e. (60 breaths per minute) (144- Park 19th) (154- Park 20th)* FAST BREATHING is present when the respiratory rate is- 60 breaths per minute or more in a child less than 2 months of age- 50 breaths per minute or more in a child aged 2 months upto 12 months- 40 breaths per minute or more in a child aged 12 months upto 5 years.
a
0
medmcqa
Vasoconstriction in blood vessels is seen with:
[ "Cocaine", "Lignocaine", "Prilocaine", "Bupivacaine" ]
Explanation: Cocaine
a
0
medmcqa
According to WHO clinical staging of HIV in children oral hairy leukoplakia belongs to which clinical stages?
[ "Clinical stage 1", "Clinical stage 2", "Clinical stage 3", "Clinical stage 4" ]
Explanation: Oral hairy leukoplakia belongs to Clinical stage 3.
c
2
medmcqa
C wave in JVP is due to -
[ "Atrial contraction", "Tricuspid valve bulging into right atrium", "Right atrial filling", "Rapid ventricular filling" ]
Explanation: Atrial pressure rises during atrial systole and continues to rise during isovolumetric ventricular contraction when the AV valves bulge into the atria. When the AV valves are pulled down by the contracting ventricular muscle, pressure falls rapidly and then rises as blood flows into the atria until the AV valves open early in diastole. The return of the AV valves to their relaxed position also contributes to this pressure rise by reducing atrial capacity. The atrial pressure changes are transmitted to the great veins, producing three characteristic waves in the record of jugular pressure . The a wave is due to atrial systole. As noted above, some blood regurgitates into the great veins when the atria contract. In addition, venous inflow stops, and the resultant rise in venous pressure contributes to the a wave. The c wave is the transmitted manifestation of the rise in atrial pressure produced by the bulging of the tricuspid valve into the atria during isovolumetric ventricular contraction. The v wave mirrors the rise in atrial pressure before the tricuspid valve opens during diastole. The jugular pulse waves are superimposed on the respiratory fluctuations in venous pressure. Venous pressure falls during inspiration as a result of the increased negative intrathoracic pressure and rises again during expiration. Ref Harrison 20th edition pg 1436
b
1
medmcqa
Cholera toxin binds to which receptors in intestine-
[ "Sphingosine through A subunit", "Sphingosine through B subumit", "GM1 gangliosides through A subunit", "GM1 gangliosides through B subunit" ]
Explanation: Ans. is 'd' i.e., GM1 gangliosides through B subunito V. cholerae produces cholera toxin, the model for enterotoxins, whose action on the mucosal epithelium is responsible for the characteristic diarrhoea of the cholera. Cholera toxin resembles heat labile toxin of E. coli.o Cholera toxin is a protein complex made up of six subunits --> a single copy of'A' subunit (Port A) and five copies of 'ET subunit (Part B). 'A' subunit has two fragments; Ai and A2. Cholera toxin |||A subunit (active part)B subunit|||| |Al fragmentA2 fragmentBinds to GM1 Ganglioside|| A DP ribosylation of G-proteinLinks the A, fragment to B subunit|Stimulation of adenyl cyclase and increased production of cAMPo cAMP inhibits the absorptive sodium transport system (decreases sodium & chloride reabsorption) and activates the secretory chloride transport system (increases chloride and bicarbonate secretion)o This leads to accumulation of sodium choride in the intestinal lumen.o Accumulated sodium chloride draws water into the lumen due to increased osmolality leading to watery diarrhoea.o Cholera toxin production is determined by a filamentous phage integrated with bacterial chromosome.o Endotoxin has no role in pathogenesis.
d
3
medmcqa
The longest transit time in GIT is seen in
[ "Stomach", "Jejunum", "Colon", "Ileum" ]
Explanation: The longest transit time is seen in the colon. Average Transmit Time Segment Transit time Esophagus 2-3 seconds Stomach 2-5 hours Small intestine 3-6 hours Caecum 4 hours First third of colon 6 hours Second third of colon 9 hours Sigmoid colon 12 hours Ref: Ganong&;s Review of medical physiology 26th edition pgno: 493-494
c
2
medmcqa
All of the following statements about Lupus Anticoagulant are true, Except.
[ "May present with an isolated prolongation of APTT", "May present with Recurrent Aboions", "May occur with minimal clinical manifestations", "Thrombotic spells can be followed by severe life threatening haemmorrhage" ]
Explanation: Answer is D (Thrombotic spells can be followed by severe life threatening haemmorrhage): Bleeding episodes after Thrombotic spells may occur as a result of consumptive Thrombocytopenia. However such bleeding episodes are rare even with severe thrombocytopenia and do not lead to life threatening haemorrhage. Catastrophic Life threatening Antiphospholipid Syndrome results from rapid onset thrombosis and ischemia in multiple organ systems and not from severe bleeding. Bleeding is rarely associated with Lupus Anticoagulant Lupus Anticoagulant may cause thrombocytopenia, but bleeding complications secondary to thrombocytopenia are rare & severe life threatening bleeding due to Lupus anticoagulant has not been repoed in any standard text book. `Although Thrombocytopenia is a common finding in patients with APS, bleeding complications are rare, even with severe thrombocytopenia Bleeding in an APS patient should trigger evaluation for the presence of antiprothrombin antibodies and other disorders that may affect hemostasis, such as DIC & Uremia' - William's Hematology `Bleeding is unsual in APS despite the prolongation of in vitro clotting time. When bleeding is present it suggests the presence of antiprothrombin antibody with hypoprothrombinemia but it may rarely be caused by thrombocytopenia'. - Samter's Immunologic diseases
d
3
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An infant with intolerance to breast feed, vomiting and diarrhoea develops cataract. Which of the following is the most likely diagnosis?
[ "Lowe syndrome", "Galactosemia", "Fabry disease", "Congenital hypoglycemia" ]
Explanation: Ans. (b) GalactosemiaRef: Kanski 7/e, p. 301Galactosemia - becomes manifest during infancy with features of failure to thrive, lethargy, vomiting and diarrhea. Reducing substance is found in urine after drinking milk.Cataract develops (oil droplet central opacity) within first few days to weeks of life. The exclusion of galactose (milk and milk products) from the diet will prevent the progression of cataract and may reverse early lens changes.
b
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Supraomohyoid neck dissection includes removal of:
[ "Level I - IV Lymph nodes", "Level II - V Lymph nodes", "Level I - III Lymph nodes", "Level II - IV Lymph nodes" ]
c
2
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The time between entry of the organism and to produce maximum infection is known as
[ "Lead time", "Generation time", "Serial interval lead", "Incubation period" ]
Explanation: Generation Time- The interval of time between receipt of infection by a host and maximal infectivity of that host. The incubation period is used for infections that manifest disease whereas generation time refers to the transmission of infection whether clinical or subclinical. Ref : Park 23rd edition Pgno : 100
b
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A patient presents to the emergency room with vomiting, diarrhea, high fever, and delirium. Upon physical examination, you notice large buboes, which are painful on palpation, and purpura and ecchymoses suggestive of disseminated intravascular coagulation. Gram stain on aspirate of a bubo reveals gram-negative rods with bipolar staining. Which of the following antibiotics is the drug of choice for empiric therapy?
[ "Ceftazidime", "Chloramphenicol", "Penicillin", "Streptomycin" ]
Explanation: The patient is infected with Yersiniapestis and has bubonic plague. The drug of choice for plague is streptomycin (d). Gentamicin or another aminoglycoside can be substituted. Ceftazidime, chloramphenicol, penicillin, and vancomycin are not used to treat plague.
d
3
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Selective medium for Naegleria fowleri is -
[ "Nutrient aga rich with E. Coli", "NNN media", "Non-nutrient agar with E. Coli", "Diamond media" ]
Explanation: Non nutrient agar spread with a lawn of washed E. coli or enter enterobacter aerogens is used for culture.CSF specimen is inoculated on this medium and incubated at 37 degree Celsius for overnight (refer pgno:26 baveja 3 rd edition)
c
2
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Monoclonal antibody used for Rheumatoid arthritis:
[ "Anakinra", "Leflunomide", "Adalimumab", "Sulfasalazine" ]
Explanation: Ans. A. AnakinraAnakinra is IL-1 antagonist, leflunomide inhibit the growth of B cells. Adalimumab is monoclonal antibody which inhibit the TNF alpha. Sulfasalazine is DMARD.
a
0
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Hypersensitivity pneumonitis is classically a/an
[ "Allergic reaction", "Type II hypersensitivity", "Immune complex mediated hypersensitivity", "Cell mediated hypersensitivity" ]
Explanation: Hypersensitivity pneumonitis Allergic alveolitis TYPE III +TYPE IV HS Complement & Ig in the vessel walls - Type III Non-caseating granulomas in 2/3rd patients - Type IV
c
2
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Which one of the following is not a transport or binding protein?
[ "Erythropoietin", "Ceruloplasmin", "Lactoferrin", "Transferrin" ]
Explanation: Ans. is 'a' ie Erythropoietin (Ref: Harper, 26/e, p609, p620, p583, Ganong 22/e, p488)Erythropoietin is a plasma protein that acts as a hormone. It's the major regulator of human erythropoiesis.Other Options.Ceruloplasmin - transports copper.Transferrin - transports iron.Lactoferrin - binds iron.
a
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Which one of the following is an established clinical use of morphine?
[ "Management of generalized anxiety disorders", "Relief of pain associated with biliary colic", "Pulmonary congestion", "Treatment of cough associated with use of ACE inhibitors" ]
Explanation: Morphine continues to be used in pulmonary congestion, in part because of its sedative (calming) and analgesic effects and also because of its vasodilating actions, which result in favorable hemodynamics in terms of cardiac and pulmonary function. Similarly, morphine is of value in an acute MI, especially its ability to relieve pain. However, morphine is not suitable for pain of biliary origin because it causes contraction of the sphincters of Oddi, leading to spasms. None of the other proposed indications are appropriate.
c
2
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Which joint is spared in Rheumatoid arthritis
[ "MP joints of hand.", "DIP joints of finger", "PIP joints of finger", "Atlanto-axial joint" ]
Explanation: Ans. is 'b' i.e. DIP joints of finger. DIP joint is characteristically spared in RA.Joint most commonly involved in RA Metacarpophalangeal joints especially of index finger.
b
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The tumour marker for Granulosa cell tumour is:
[ "Inhibin", "CA 19-9", "CA 15-3", "CA 125" ]
Explanation: . Inhibin
a
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Popcorn calcification in mammography is seen in the following condition of breast:
[ "Fibroadenoma", "Fat necrosis", "Cystosarcoma phyllodes", "Ca Breast" ]
Explanation: Fibroadenomas are very common and are frequently the cause of benign breast biopsy. They occur in very young women (teenagers and women under 30 years of age). They may also become palpable or mammographically visible in older women. Fibroadenoma and carcinoma have overlapping mammographic features and both are common lesions in middle-aged women. With age, fibroadenomas become involuted and heavily calcified. Large lobulated ("popcorn") calcifications have a characteristic mammographic appearance. Ref: Robbins and Cotran pathologic basis of disease edited by Vinay Kumar, Abul K. Abbas, Nelson Fausto, Volume 1, Page 1149.
a
0
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Infective endocarditis is commonly seen in all except-
[ "Small VSD", "Tetralogy of fallot", "PDA", "ASD" ]
d
3
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