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Treponema is most difficult to isolate from?
|
[
"Gumma",
"Chancre",
"Mucosal lesions",
"Macular rash"
] |
Explanation:
Gumma REF: Jawetz, Melnick, & Adelberg's Medical Microbiology, 24T" edition Chapter 25 "Gumma is a lesion of teiary syphilis, and treponemes are rare in teiary lesions" In about 30% of cases, early syphilitic infection progresses spontaneously to complete cure without treatment. In another 30%, the untreated infection remains latent (principally evident by positive serologic tests). In the remainder, the disease progresses to the "teiary stage," characterized by the development of granulomatous lesions (Gumma) in skin, bones, and liver; degenerative changes in the central nervous system (meningovascular syphilis, paresis, tabes); or cardiovascular lesions (aoitis, aoic aneurysm, aoic valve insufficiency). In all teiary lesions, treponemes are very rare, and the exaggerated tissue response must be attributed to hypersensitivity to the organisms. However, treponemes can occasionally be found in the eye or central nervous system in late syphilis.
|
a
| 0 |
medmcqa
|
Type I Cryoglobulinemia is associated with all of the following, except:
|
[
"Hyperviscosity",
"Monoclonal 1gM paraprotein",
"Normal complement levels",
"Strongly Positive Rheumatoid factor"
] |
Explanation:
Answer is D (Strongly Positive Rheumatoid factor): Type I Cryoglobulinemia (simple cryoglobulinemia) is typically associated with Monoclonal IgM paraprotenemia producing a Hyperviscosity type syndrome. Type I Cryoglobulins rarely have Rheumatoid Factor Activity and do not activate complement in vitro (hence complement levels are usually normal). `Monoclonal Cryoglobulins (Type I) rarely exhibit Rheumatoid Factor activity and do not interfere with complement mediated function in vitro' -- 'Cryoglobulins and Cryoglobulinemia' from Clinical Reviews in Allergy and Immunology: Vol 16, Number 3 (1998) page 249-264 `Type I Cryoglobulins do not activate the complement cascade and are therefore associated with normal complement levels' Mixed Cryoglobulinemias (Type II/Type III) are associated with Strongly Positive Rheumatoid Factors and Reduced Complement levels. Hypocomplementemia occurs in 90% of patients with mixed cryoglobulinemias. Rheumatoid factor is positive in 80-100% ofpatients with mixed cryoglobulinemia Cryoglobulinemia Cryoglobulins are immunoglobulins that precipitate as serum is cooled below core body temperature (below 37deg C) and re-dissolve on re-warming. Cryoglobulinemia is characterized by the presence of cryoglobulins in the serum. Cryoglobulinemia is most commonly classified into three types in accordance with the Brouet Classification based on the components of the cryoprecipitate. Type I (Simple Cryoglobulinemia) and Type II, Type III (Mixed cryoglobulinemia) Feature Type I Type II Type III (Simple Cryoglobulinemia) (Mixed Cryoglobulinemia) (Mixed Cryoglobulinemia) Cryoglobulin Single Monoclonal Mixed Monoclonal' Mixed Polyclonal Molecular composition Monoclonal IgM or Monoclonal IgG Monoclonal IgM* (>IgG*) Polyclonal IgG Polyclonal IgM and Polyclonal IgG Composed entirely of Monoclonal Immunoglobulins, usually IgM or IgG Composed of Monoclonal Immunoglobulins usually IgM along with Polyclonal Composed of polyclonal immunoglobulin of more than once isotype such as polyclonal IgM and polyclonal IgG Immunoglobulin usually IgG Rheumatoid Factor Activity Rheumatoid factor activity is absent (rarely present) - Rheumatoid Factor activity is strongly positive Rheumatoid factor activity is positive Monoclonal IgM in Type I Syndrome does not have Rheumatoid Factor Activity Monoclonal IgM in Type II Syndrome has Rheumatoid Factor activity against IgG ' Polyclonal IgM has Rheumatoid factor activity Complement Activation in Vitro Do not activate the complement cascade Activate the complement cascade Activate the complement cascade Complement levels normal Complement levels reduced Complement levels reduced. Predominant clinical manifestation Primarily related to Hyperviscosity and consequent thrombosis Primarily related to vasculitis due to immune complex formation and activation of complement * Acrocyanosis * Retinal Hemorrhages * Raynaud's phenomenon with digital ulceration * Livido reticularis * Aerial reticularis * Aerial Thrombosis * Cutaneous vasculitis * Renal Glomerulonephritis * Neuropathy (Vasculitis) * Abdominal pain (mesenteric vasculitis) * Ahralgia & myalgia Mitzer's Triad: Purpura + Ahralgia + Weakness Associations Lymphoproliferative Diseases * Chronic hepatitis C * Autoimmune disease * Sjogren's syndrome * CLL * NHL Autoimmune Diseases * Multiple Myeloma * `Waldenstroms Macroglobulinemia' * Monoclonal Gammopathy * Systemic Lupus Erythematous * Rheumatoid Ahritis * Inflammatory Bowel Disease * Biliary Cirrhosis Chronic Infections * Viral (EBV, CMV, HIV, Hepatitis E) * Bacterial (Leprosy, Spirochetal, SBE) * Fungal * Parasitic
|
d
| 3 |
medmcqa
|
A 60 years old man presented with itchy tense blisters on normal looking skin and urticarial rash, investigation done for the diagnosis:
|
[
"Direct immunofluorescence",
"Indirect immunofluorescence",
"Histopathology",
"Cytopathology"
] |
Explanation:
Ans. a. Direct immunofluorescence (Ref: Harrison 19/e p372, 18th/426-428)A 60 years old man presented with itchy tense blisters on normal looking skin and urticarial rash. This patient is suffering from pemphigoid. Investigation done for the diagnosis direct immunofluorescence.The most likely diagnosis in this patient with tens blisters on normal looking skin associated urticarial plaques as seen in the figure are bullous pemphigoid.Immunologically Mediated Blistering DiseaseDiseasePemphigus vulgarisBullous PemphigoidLinear IgA DiseaseDermatitis HerpetiformisAuto antigenDesmoglein 3QBP230 > BP180BPAG 2Epidermal and tissue transglutaminaseHistologyEpidermalAcantholytic blister in suprabasal spinous cell layerSubepidermal blister with eosinophil rich infiltrateQ in perivascular and vesicular sites.Subepidermal blister with neutrophils in dermal papillaeQSubepidermal blister with neutrophils in Dermal papillaeQDirect ImmunofluorescenceMicroscopyCells surface deposits of IgG on keratinocytes in fishnet patternLinear band of IgG and/ or C3 in epidermalBMZLinear band of IgA, inepidermalBMZGranular deposits of IgA in dermal papillaeQAssociationsHLA-DR4 and DRW6QHLA-DQb1 * 0301- HLA-B8 (+)-TNF2 alleleSubclinical gluten sensitive enteropathy (100%)HLA-B8 (60%) / DRW3 (95%)and HLA-DQW2 haplotype (95-100%)Clinical featuresFlaccid blisters, denuded skin, oro- mucosal lesionsQLarge tense blisters on flexor surfaces and trunkQPruritic small papules on extensor surfaces occasionally larger, acneiform blisters in adultsExtremely pruritic small vesicles on elbows, knees, buttocks and posterior neckQPemphigoidLarge, tense blisters on flexor surface located over lower part of bodyQ (limbs >trunk)Non-itchy and painlessQMainly seen in patients over 60 yearsQMucosa is not involvedQPathology:Subepidermal blisters without acantholysisQSubepidermal collection of IgG, C3-complement. eosinophils, polymorphsQDiagnosis:Direct immunofluorescence: Linear band of IgG and/or C3 in epidermal basement membrane zoneQTreatment:Systemic steroids, immunosuppressants
|
a
| 0 |
medmcqa
|
Not true about red degeneration of myomas is :
|
[
"It occurs commonly during pregnancy",
"Immediate surgical intervention is needed",
"Due to interference with blood supply",
"Treated with analgesics"
] |
Explanation:
Ans. is b i.e. Immediate Surgical intervention is required Lets see each option one by one. Red Degeneration of fibroid commonly occurs during pregnancy. (Option "a" is thus correct) The pathogenesis of fibroid is obscure but the initial change appears to be one of sub acute necrosis which is presembly due to an interference with its blood supply. Some say that aerial or venous thrombosis is the basis of this and the lesion is the result of infarction. (Option "c" is thus correct). Red degeneration should be managed conservatively with bed rest and analgesics to relieve the pain. (option "d" is thus correct) There is no need for surgical intervention. For more details on Red Degeneration, refer answer 6
|
b
| 1 |
medmcqa
|
Most common leukemia in down syndrome?
|
[
"AMC",
"ALL",
"CLL",
"CML"
] |
Explanation:
Acute lymphoblastic leukemia is the most common leukemia in patients with down syndrome.
|
b
| 1 |
medmcqa
|
The interior of right atrium is partially divided into two parts by -
|
[
"Crista terminalis",
"Musculi pectinati",
"Fossa ovalis",
"Sinus venarum cavarum"
] |
Explanation:
Right atrium is divided into rough anterior and smooth posterior parts by crista terminalis.
|
a
| 0 |
medmcqa
|
Thymoma commonly presents with
|
[
"Myasthenia gravis",
"Renal failure",
"Hepatic failure",
"Testicular fiminization"
] |
Explanation:
Thymus is abnormal in 75% patients with MG; 65%is hyperplastic and 10 % have thymic rumours or thymomas These patients may present with cough, chest pain, superior vena cava (SVC) syndrome, dysphagia, and hoarseness if the recurrent laryngeal nerve is involved. One third of cases are found incidentally on radiographic examinations during a workup for myasthenia gravis (MG). Ref Harrison20th edition pg 2789
|
a
| 0 |
medmcqa
|
Primary Pulmonary T.B, true about -a) Cavitary lesionb) Pleural effusionc) Fibrocaseous lesiond) Phlyctenular keratitis
|
[
"abc",
"acd",
"bcd",
"bd"
] |
c
| 2 |
medmcqa
|
|
Magaldrate is conveed by gastric acid to ?
|
[
"Magnesium hydroxide",
"Magnesium hydroxide and calcium carbonate",
"Magnesium hydroxide and Aluminium hydroxide",
"Calcium carbonate and aluminium hydroxide"
] |
Explanation:
Ans. is `c' i.e., Magnesium hydroxide and Aluminium hydroxide Magaldrate: Magaldrateis a common antaciddrug that is used for the treatment of duodenal and gastric ulcers, esophagitis from gastroesophageal reflux. Magaldrate is a hydroxymagnesium aluminate complex that is conveed rapidly in gastric acid to Mg(OH), and Al(OH)3, which are absorbed poorly and thus provide a sustained antacid effect.
|
c
| 2 |
medmcqa
|
Cow's milk contains what % proteins -
|
[
"1.1",
"3.2",
"3.5",
"4.1"
] |
Explanation:
Cow milk contain 3.2%of proteinREF. PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICAL 21ST EDITION. PAGE NO - 582
|
b
| 1 |
medmcqa
|
What is the most common oppounistic infection in aids?
|
[
"Tuberculosis",
"Cryptococcosis",
"Pneumocystitis cannii",
"Histoplasmosis"
] |
Explanation:
Globally ,tuberculosis is the most common cause of moality & morbidity in HIV-infected patients . When CD4 count is less than 500cells/cubic millimeter ,tuberculosis may occur in an HIV patient .It is the most common cause of admission in patients with mild immune suppression . Reference: Harrison20th edition pg 877
|
a
| 0 |
medmcqa
|
which of the following is not a complication of acute osteomyelitis
|
[
"Malignancy",
"Factors of the affected bone",
"Sepsis",
"Chronicity"
] |
Explanation:
Chronic osteomyelitis is the most common complication. Other complications are : septicemia and pyemia septic ahritis metastatic infection to other body pas pathological fractures altered growth from damage to epiphyseal growth plate recurrence. malignancy can be seen in chronic osteomyelitis. image of acute osteomylitis ref : maheswari9th ed
|
a
| 0 |
medmcqa
|
Artery not supplying Kisselbacks plexus is-
|
[
"Anterior ethmoidal artery",
"Greater Palatine artery",
"Sphenopalatine artery",
"Ascending pharyngeal artery"
] |
Explanation:
Ans. is 'd' i.e., Ascending pharyngeal artery * Kiesselbach's plexus, which lies in KiesselbaclTs area or Little's area, is a region in the anteroinferior part of the nasal septum where four arteries anastomose to form a vascular plexus. The arteries arei) Anterior ethmoidal artery (branch of the ophthalmic artery)ii) Sphenopalatine artery (terminal branch of the maxillary artery)iii) Greater palatine artery (from the maxillary artery)iv) Septal branch of the superior labial artery (from the facial artery)
|
d
| 3 |
medmcqa
|
Dietary triglycerides are transpoed by
|
[
"Chylomicrons",
"VLDL",
"LDL",
"HDL"
] |
Explanation:
A i.e. Chylomicrons
|
a
| 0 |
medmcqa
|
All are true about gestational trophoblastic disease except :
|
[
"Complete mole genome is triploidy",
"Choriocarcinoma rarely follows full term pregnancy",
"Suction and curettage remove most of hydatidiform mole",
"Snowstorm appearance on USG"
] |
Explanation:
Complete mole genome is triploidy
|
a
| 0 |
medmcqa
|
Cholera vaccination is indicated -
|
[
"To control epidemics",
"For travellers",
"In endemic areas",
"In Neonates"
] |
Explanation:
Ans. is 'c' i.e., in endemic areas o Cholera vaccination should be considered in areas where cholera is endemic.o However, it should always be done in conjunction with implementation of safe water, sanitation and hygiene promotion programme.o In resource poor areas, vaccination should be targeted at children aged > 2 years.o Cholera vaccine has not been recommended in outbreak/epidemic settings or complex humanitarian emergencies because of the logistical challanges of administering 2-dose vaccine, and concern that long-scale vaccination would divert limited resources from higher priority measures,o As it does not prevent epidemic cholera transmission, it is not recommended for general population,o Cholera transmission is not recommended for travelers, as counseling about risk avoidance is more cost effective than vaccination.
|
c
| 2 |
medmcqa
|
TPN may be complicated by ?
|
[
"Obstructive jaundice",
"Hyperosteosis",
"Hypercalcemia",
"Pancreatitis"
] |
Explanation:
Ans. is 'c' i.e., Hypercalcemia
|
c
| 2 |
medmcqa
|
Alkalinization of urine is done in which of the following drug poisoning? ()
|
[
"Amphetamine",
"Morphine",
"Phenobarbitone",
"Digoxin"
] |
Explanation:
Most drugs taken in overdose are extensively detoxified by the liver to produce inactive metabolites which are voided in the urine. Sometimes hepatic degradation produces active metabolites, but the secondary compounds are then conveed to non-toxic derivatives. Under these circumstances, forced diuresis is inappropriate. The procedure should be undeaken only if the following conditions are satisfied: # A substantial propoion of the drug is excreted unchanged. # The drug is distributed mainly in the extracellular fluid. # The drug is minimally protein-bound. # Principle-- Most drugs are weak electrolytes and exist paly as undissociated molecules at physiological pH. The extent of ionisation is a function of the ionisation constant of the drug (Ka for both acids and bases), and the pH of the medium in which it is dissolved. Ionisation constants are usually expressed in the form of their negative logarithm, pKa. Hence the pKa scale is analogous to the pH notation : the stronger an acid the lower its pKa, and the stronger a base the higher its pKa. Thus when pKa = pH, the concentrations of ionised and non-ionised drugs are equal. Cell membranes are most permeable to substances that are lipid soluble and in the non-ionised, rather than the ionised form. Thus the rate of diffusion from the renal tubular lumen back into the circulation is decreased when a drug is maximally ionised. Because ionisation of acidic drugs is increased in an alkaline environment, and that of basic drugs is increased in an acid solution, manipulation of the urinary pH enhances renal excretion. # Forced alkaline diuresis : This is most useful in the case of phenobarbitone, lithium, and salicylates. Administer 1500 ml of fluid IV, in the first hour as follows : - 500 ml of 5% dextrose - 500 ml of 1.2 or 1.4% sodium bicarbonate - 500 ml of 5% dextrose. # Forced acid diuresis : Forced acid diuresis is no longer recommended for any drug or poison, including amphetamines, strychnine, quinine or phencyclidine. REF:THE SYNOPSIS OF FORENSIC MEDICINE AND TOXICOLOGY:K S NARAYANA REDDY;PAGE NO 289
|
c
| 2 |
medmcqa
|
Platelet adhesion to collagen occurs :
|
[
"Factor VIII",
"Factor IX",
"von Willebrand factor",
"Fibronectin"
] |
Explanation:
Platelet adhesion to collagen occurs von-Willebrand factor)Endothelial injury allows platelets to contact the underlying extracellular matrix; subsequent adhesion occurs through interactions with von Willebrand factor (vWF), which is a product of normal endothelial cells and an essential cofactor for platelet binding to matrix elements.
|
c
| 2 |
medmcqa
|
Finger in glove sign is seen in
|
[
"Chronic bronchitis",
"Bronchocele",
"Bronchogenic carcinoma",
"Pleuritis"
] |
Explanation:
The finger in glove sign can be seen on either chest radiograph or CT chest and refers to the characteristic sign of a bronchocoele. The same appearance has also been referred to as:rabbit ear appearancemickey mouse appearancetoothpaste shaped opacitiesY-shaped opacitiesV-shaped opacitiesThe finger-in-glove sign is the chest CT/radiographic finding of tubular and branching tubular opacities that appear to emanate from the hila, said to resemble gloved fingers.The tubular opacities represent dilated bronchi impacted with mucus. The CT finger-in-glove sign is branching endobronchial opacities that course alongside neighboring pulmonary aeries. The finding is classically associated with allergic bronchopulmonary aspergillosis (ABPA), seen in persons with asthma and patients with cystic fibrosis, but may also occur as an imaging manifestation of the endobronchial tumor, bronchial atresia, cystic fibrosis, and postinflammatory bronchiectasis.Bronchoscopy may be necessary to exclude endobronchial tumor as the cause of the finger-in-glove sign. The tubular opacities that occur in ABPA result from hyphal masses and mucoid impaction and typically affect the upper lobes( Ref: AJR:202, March 2014, Walker et al.Imaging Pulmonary Infection: Classic Signs and Patterns)
|
b
| 1 |
medmcqa
|
Second attack rate is minimum in
|
[
"Diphtheria",
"TB",
"Measles",
"Whooping cough"
] |
b
| 1 |
medmcqa
|
|
The following drug is not used for the treatment of type II lepra reaction
|
[
"Chloroquin",
"Thalidomide",
"Cyclosporine",
"Coicosteroids"
] |
Explanation:
C i.e. Cyclosporine
|
c
| 2 |
medmcqa
|
Incidence of gall stone is high in -
|
[
"Paial hepatectomy",
"Ileal resection",
"Jejunal resection",
"Subtotal gastrectomy"
] |
Explanation:
Ileal resection or ileal disease decreases enterohepatic circulation of bile salts (or acids). This decreases the biliary secretion of bile salts, thus increasing the cholesterol bile acid ratio (lithogenic bile). Ref - Baileg and love 27e Topic -Gallbladder and Bileducts p1188
|
b
| 1 |
medmcqa
|
In sickle cell anemia all are true except:
|
[
"Sickle cells",
"Target cells",
"Howell jolly bodies",
"Ringed sideroblast"
] |
Explanation:
Ans. (d) Ringed sideroblast(Ref: Robbins 9th/pg 635-636)Ring sideroblasts are not seen in sickle cell anemia, but in Sideroblastic AnemiaPeripheral smear finding in sickle cell anemia:Ansiopoikilocytosis, polychromasia, Increased Retie %Irreversibly sickle RBCs and target cells (increased after autosplenectomy).Howell-Jolly bodies due to asplenia. Q
|
d
| 3 |
medmcqa
|
All are true for Point source epidemic except:
|
[
"Person-to-person transmission",
"Clustering of cases within a short period of time",
"Epidemic curve rises and falls sharply",
"All cases usually develop within one incubation period"
] |
Explanation:
EPIDEMIC:
Definitions of epidemic:
– Occurrence of no. of cases of a disease ‘clearly in excess of normal expectancy (NE)’
Normal expectancy is derived by looking at average of no. of cases of the disease in previous 3 – 5 years in that geographical area
If NE = zero, ‘even one case is considered epidemic’
– Statistically speaking, epidemic is when no. of cases ‘exceed twice the standard deviation’
No. of cases > Mean + 2SD ( >μ + 2σ)
– Occurrence of a new disease in a population (as NE = Zero)
– Reoccurrence of an eliminated/ eradicated disease in a population (as NE = Zero)
|
a
| 0 |
medmcqa
|
Commonest degenerative joint disease in-
|
[
"Gout",
"Osteoporosis",
"Rheumatoid arthritis",
"Osteo arthritis"
] |
d
| 3 |
medmcqa
|
|
A patient of acute myocardial infarction being treated in intensive care unit developed left ventricular failure with raised central venous pressure. It was decided to use nitroglycerine. Which route of administration would be most suitable?
|
[
"Sublingual",
"Oral",
"Intravenous bolus injection",
"Slow intravenous infusion"
] |
Explanation:
(Ref: KDT 6/e p527) Nitrates can be used in acute LVF by slow i.v. infusion.
|
d
| 3 |
medmcqa
|
In scurvy all of the following radiological signs are seen except:
|
[
"Pelican spur",
"Soap bubble appearance",
"Zone of demarcation near epiphysis",
"Frenkel's line"
] |
Explanation:
Ans. Soap bubble appearance
|
b
| 1 |
medmcqa
|
A patient on amiodarone is diagnosed to have cornea verticillata. What should be management –
|
[
"Stop the drug",
"Penetrating keratoplasty",
"Lamellar keratoplasty",
"Observation"
] |
Explanation:
Cornea Verticillata
This is a whorl-like opacity in the corneal epithelium seen in patients on long-term treatment with medication such as amiodarone, chloroquine, phenothiazines and indomethacin.
It is also seen in patients with Fabry disease and its carrier state. The condition is generally asymptomatic, harmless and reversible on stopping the drug.
The whorl-like pattern shows the direction of migration of corneal epithelial cells. Occasionally the condition had been known to cause glare and surface discomfort which response to topical lubricants.
|
a
| 0 |
medmcqa
|
The EEG cabins should be completely shielded by a continuous sheet of wire mesh of copper to avoid the picking up of noise from external electromagnetic disturbances. Such a shielding is called as:
|
[
"Maxwell cage",
"Faraday cage",
"Edison's cage",
"Ohms cage"
] |
Explanation:
Ans. Faraday cage
|
b
| 1 |
medmcqa
|
Imipenem. True statement about it is:
|
[
"Narrow spectrum of action",
"Easily broken by beta lactamase",
"Used with cilastatin",
"Used with sulbactam"
] |
Explanation:
Used with cilastatin
|
c
| 2 |
medmcqa
|
Which pa of the hea is infarcted in case of occlusion of the anterior descending branch of Left Anterior Descending aery?
|
[
"Anterior wall of the left ventricle",
"Lateral pa of the left ventricle",
"Inferior surface of right ventricle",
"Posterior pa of the interventricular septum"
] |
Explanation:
Occlusion of left anterior descending aery results in infarction of anteroapical region of left ventricle. It runs downward in the anterior interventricular groove to the apex of the hea. The anterior interventricular branch supplies the right and left ventricles with numerous branches that also supply the anterior pa of the ventricular septum. Ref: Clinical Anatomy for Medical Students By Richard S Snell, 6th Edition, Pages 103-4
|
a
| 0 |
medmcqa
|
A 68-year-old diabetic male presents with persistent ear discharge with fever and headache. He complained of pain out of propoion. On examination, granulations and tenderness are observed on the floor of the external auditory canal along with facial nerve palsy. He is not responding to antibiotics. What is the most probable diagnosis?
|
[
"Malignant otitis externa",
"Malignant disease of middle ear",
"Malignant disease of nasopharynx",
"Chronic otitis externa"
] |
Explanation:
Ans. a. Malignant otitis externa Presence of a painful lesion in the external ear with the evidence of granulation tissue and associated cranial nerve palsies (VII nerve) in a diabetic (or immunocompromised) patient suggest a diagnosis of malignant otitis externa.
|
a
| 0 |
medmcqa
|
Post paum hemorrhage is blood loss of 500 cc or more within :
|
[
"6 hours of the beginning of 3rd stage of labour",
"12 hours of the beginning of 3'd stage of labour",
"18 hours of the beginning of 3rd stage of labour",
"24 hours of the beginning of 3'd stage of labour"
] |
Explanation:
24 hours of the beginning of 3'd stage of labour
|
d
| 3 |
medmcqa
|
The aminoacid excreted in Hartnup's disease is -
|
[
"Arginine",
"Hydroxyproline",
"Tryptophan",
"Proline"
] |
Explanation:
Ans. is 'c' i.e., Tryptophan* Hartnup's disease is caused by a defect of a neutral aminoacid transporter which is specific for tryptophan absorption along intestine and tryptophan reabsorption along renal tubules.* Tryptophan malabsorption leads to tryptophan deficiency* As tryptophan is necessary for formation of niacin, Hartnup's disease presents with niacin deficiency manifestations or pellagra.# Photosensitive Dermatitis# Diarrhoea# Psychiatric manifestations - anxiety, mood changes, delusions, hallucinations* As niacin is necessary for insertion of neutral aminoacid transporters into the renal tubules, Hartnup's disease presents with aminoaciduria . There is increased excretion of neutral aminoacids like :# Tryptophan# Isoleucine# Phenyalanine# Histidine# Leucine# Lysine* Characteristically in aminoaciduria due to hartnup s disease, levels of proline, hydroxyproline and arginine levels are normal. This differentiates Hartup's disease aminoaciduria from fanconi's syndrome* Onset of presentation is variable. Infants with Hartnup's disease present with failure to thrive, ataxia, nystagmus.* As when tryptophan gets oxidised, the indole ring is released, Obermeyer's test or test for urinary Indican is positive.
|
c
| 2 |
medmcqa
|
Gutter fracture is due to
|
[
"Sharp edged weapon",
"Fire arm injury",
"Blunt weapon",
"Serrated edge"
] |
Explanation:
Bullet striking on the skull but not entering it: Bullet may tangentially touch the skull and doesn't enter the skull cavity . In such a case , there may be a gutter that is produced on the skull- Gutter fracture ref: FORENSIC MEDICINE AND TOXICOLOGY DR PC IGNATIUS THIRD EDITION PAGE 154
|
b
| 1 |
medmcqa
|
15 mm/cm hyperpigmented lesion on shoulder enlarging and hair over it ?
|
[
"Melanocytic nevus",
"Becker nevus",
"Sebaceous nevus",
"Comedo nevus"
] |
Explanation:
Ans. is 'b' i.e., Becker nevus Becker Nevus Usually stas in adolescence as an irregular smooth hyperpigmented macule. Usually involves shoulder, anterior chest and scapular region, although any pa of the may be involved. Slowly grows in size of a palm wile acquiring thick dark hair. Often lesion resembling acne vulgaris in different stages may appear on surface. No treatment is required.
|
b
| 1 |
medmcqa
|
Hematuria with dysmorphic RBC are seen in
|
[
"Acute glomerulonephritis",
"Renal TB",
"Renal calculi",
"Chronic renal failure"
] |
Explanation:
Acute pyelonephritis, a common suppurative inflammation of the kidney and the renal pelvis, is caused by bacterial infection. It is an impoant manifestation of urinary tract infection (UTI), which can involve the lower (cystitis, prostatitis, urethritis) or upper (pyelonephritis) urinary tract, or both. As we shall see, the great majority of cases of pyelonephritis are associated with infection of the lower urinary tract. Such infection, however, may remain localized without extending to involve the kidney. UTIs constitute an extremely common clinical problem. Refer robbins 9/e p911
|
a
| 0 |
medmcqa
|
Cocospinal tract lesion leads to:
|
[
"Spaticity",
"Extensor plantar response",
"Exaggerated tendon reflexes",
"All"
] |
Explanation:
A, B, C i.e. Spaticity, Extensor plantar response, Exaggerated tendon reflexes
|
d
| 3 |
medmcqa
|
In transcription anticodon is seen in ?
|
[
"t-RNA",
"m-RNA",
"r-RNA",
"None"
] |
Explanation:
A i.e. t - RNA
|
a
| 0 |
medmcqa
|
Insulin secretion is decreased by ?
|
[
"Glucogen",
"Gastrin",
"Secretin",
"Somatostatin"
] |
Explanation:
Ans. is 'd' i.e., Somatostatin
|
d
| 3 |
medmcqa
|
Frie test is done in –
|
[
"Donovanosis",
"LGV",
"Syphillis",
"Leprosy"
] |
Explanation:
Frie's test is an obsolete intradermal test for LGV.
|
b
| 1 |
medmcqa
|
T cell functions are assessed by -
|
[
"phagocyte index",
"T cell count",
"Migration inhibition test",
"Immunoglobin index"
] |
Explanation:
Migration inhibitory factor test an in vitro test for the production of migration inhibitory factor (MIF) by lymphocytes in response to specific antigens; used for evaluation of cell-mediated immunity. MIF production is absent in ceain immunodeficiency disorders, such as wiskott-aldrich syndrome and hodgkin's disease. Called also MIF test. Reff: www.mayoclinic.com
|
c
| 2 |
medmcqa
|
Which of the following is not a common manifestation of Congenital Rubella –
|
[
"Deafness",
"PDA",
"Aortic stenosis",
"Mental retardation"
] |
Explanation:
Nerve deafness is the single most common clinical finding among infant with congenital Rubella syndrome.
FDA is the most common CHD in congenital rubella syndrome.
Classical triad of congenital rubella consists of → Cataract, Deafness, CHD
Mental retardation is also common.
|
c
| 2 |
medmcqa
|
Most common strain of E.coli giving rise to traveller's diarrhea is
|
[
"Entero-invasive E.coli (EICE)",
"Entero-pathogenic E.coli (EPEC)",
"Entero-toxigenic E.coli (ETEC)",
"Entero-aggregative E.coli (EAEC)"
] |
Explanation:
Ans. is 'c' i.e., Entero-toxigenic E.coli
|
c
| 2 |
medmcqa
|
Which of the following is least narcotic: AIIMS 09
|
[
"Morphine",
"Codeine",
"Thebane",
"Papaverine"
] |
Explanation:
Ans. Papaverine
|
d
| 3 |
medmcqa
|
One of the following is a sure sign of rape :
|
[
"Ruptured hymen in a girl aged 20 years",
"Presence of semen in the posterior fornix in a girl age 20 years",
"Presence of semen in the posterior fornix in a girl age 14 Years",
"Presence of semen in the posterior fornix in a married girl age 16 years"
] |
Explanation:
C i.e. Semen in fornix in a girl < 14 years
|
c
| 2 |
medmcqa
|
Commonest endocrine tumor of pancreas
|
[
"A cells",
"B cells",
"Delta cells",
"VIPoma"
] |
Explanation:
Insulinomas- arising from B cells of pancreas- are the commonest endocrine pancreatic tumour(60%). Gastrinomas - arising from non-beta cells (G cells) of the pancreas- are the 2nd most common endocrine pancreatic tumour. Then comes Glucagonomas (arising from A cells) and VIPomas (arising from D2 cells of pancreas). Reference : page 709-10 SRB's manual of surgery 5th edition
|
b
| 1 |
medmcqa
|
Lignocaine is used as anesthetic and class IB antiarrhythmic. Which of the following are the preparations available for lignocaine?
|
[
"0.5%jelly, 1 % injection",
"1% jelly, 2% injection",
"2% jelly, 4% injection",
"4% jelly, 5% injection"
] |
Explanation:
Preparations of lignocaine: Inj local: 0.5, 1, 1.5, 2, 4, 10, 20%. Inj IV: 1% (10 mg/mL), 2% (20 mg/mL); admixture 4, 10, 20%. IV inf: 0.2%, 0.4%; cream 2%; gel 2, 2.5%; oint 2.5, 5%; liq 2.5%; soln 2, 4%; viscous 2% Ref: Gomella L.G., Haist S.A. (2007). Chapter 22. Commonly Used Medications. In L.G. Gomella, S.A. Haist (Eds), Clinician's Pocket Reference: The Scut Monkey, 11e.
|
c
| 2 |
medmcqa
|
A = ACE inhibitor, B = beta blocker, C = calcium channel blocker, D= diuretics. For elderly with hypeension antihypeensive drug of choice is ?
|
[
"A or D",
"A or B",
"A or C",
"C or D"
] |
Explanation:
Ans. is 'd' i.e., C or D Pharmacological treatment of hypeension Indications of drug therapy (the British hypeension society guidelines). When sustained BP exceeds 160/100 mmHg or. When BP is in the range of 140-159 / 90-99 mmHg and there is target organ damage or cardiovascular disease. For diabetics when BP exceeds 140/90 mmHg. The optimal target is to lower BP to or below 140/85 mmHg in nondiabetics and 140/80 mmHg in diabetics (WHO target is 130/85 mmHg). Drug therapy A simple stepped AB/CD regimen is used.
|
d
| 3 |
medmcqa
|
Chronic lymphoedema of the limb is predisposed to all of the following except
|
[
"Thickenening of the skin",
"Recurrent soft tissue infections",
"Marjolin's ulcer",
"Sarcoma"
] |
Explanation:
Marjolin's ulcer: - Refers to the development of malignant ulcers over chronic scars most commonly those from burns. Malignancy is usually a squamous cell carcinoma and has not been mentioned as a complication of lymphoedema. Features of chronic lymphoedema of limb Initially, the lymphoedema is soft and pits on the pressure but with time the skin becomes thickened & non-pitting due to fibrosis, dermal thickening and hyperkeratosis. Frequent episodes of lymphangitis and cellulitis may occur. this is believed to be due to loss of local immune defence mechanism. Chronic eczema, a fungal infection of the skin (dermatophytosis) and nails (onychomycosis), fissuring, verrucae and papillae (was) are frequently seen in advanced disease. Rarely malignancy (lymphangiosarcoma or angiosarcoma) may occur in chronic lymphoedema. This neoplastic transformation of blood vessels and lymphatics is called Stewa - Treves syndrome.
|
c
| 2 |
medmcqa
|
Einthovens law -
|
[
"I+ III= II",
"I -III=II",
"I+II+III= 0",
"I+III=avL"
] |
Explanation:
Ans is 'a' i.e., I + III = II o Einthoven's triangle is an equilateral triangle formed by two shoulder and the pubis with the heart is in the center as moving dipole.o For convenience Eithoven's triangle consider right arm (RA), left arm (LA), and Left leg (LL)Q to which electrodes are connected.o An electrode connected to all the three comers of Eithoven's triangle will always be at zero potentials regardless of the direction of the cardiac vector.o Such an electrode is called the indifferent electrode (or the central terminal of wiison)Q.o The indifferent electrode is connected to RA, LA and LL through high (5000 Ohm) resistance.ECG Leadso An ECG is recorded by picking up potentials from two parts of the body. The two sites selected for this purpose constitue the ECG leads. Usually ECG is recoreded by 12 leads (12 lead ECG): - Three bipolar (standard) limb leads, three Unipolar limb leads and six unipolar chest leads.Bipolar (standard) limb leads or Einthoven's leado Bipolar recording involves recording of potential difference between two different sites on the body using two electrodes, one serving as the reference and the other called the exploring or active electrode. These leads are:-Lead I: - Between right arm (negative/reference electrode) and left arm (positive or active or exploring electrode).LeadII: - Between right arm (negative or reference electrode) and left leg (positive electrode).Lead III: - Between left arm (negative electrode) and left leg (positive electrode).o The direction in wrhich positive electrode points is called the axis of lead. If the direction of the lead axis is similar to the direction of the flow of current in the heart, the recorded deflection is positive (upward). Hence electrodes are arranged in such a way that most of the deflections in the ECG are positive,o Einthoven's law Q: - This law states that if the electrical potential of any of the three bipolar limb leads are known at any given instant, the third one can be determined mathematically by simply summing the first two (but note that the positive and negative signs of different leads must be observed when making this summation). Thus the sum of the voltages in leads I and III equals the voltage in lead IIQ.Unipolar limb leadso Unipolar recording involves recording the potential difference between an active electrode and an indifference electrode. Thus, unipolar limb leads and chest leads employ an active electrode and an indifference electrode. The indifferent electrode is connected to left arm, right arm and left leg through a very high resistance (has been explained). Because of the high resistance, the indifferent electrode stays at an almost constant (zero) potential. Since the leads measure the potential difference between two electrodes, one of which is at constant voltage (indifferent), it essentially measures the potential at the other (active) electrode. There are three unipolar limb leads:-o VR : Between right arm and an indifferent electrode,o VL : Between left arm and an indifferent electrode,o VF: Between left leg and an indifferent electrode.o These unipolar limb leads are not much used in practice because augmented limb leads which provide a magnified version of the same information; therefore, unipolar augmented limb leads are used. Augmented limb leads are recordings between one limb and two other limbs12, i.e., the positive (active) electrode is connected to one limb and the negative electrode to the other two through high resistances. This results in an increase in the voltages recorded in the ECG That is why these leads are called augmented limb leads. There are three augmented limb leads: -aVR : - Between right arm (positive electrode) and left arm + left leg (negative or refrence electrode).aVL : - Between left arm (positive electrode) and right arm + Left leg (negative electrode).aVF : - Between left leg (positive electrode) and right arm + left arm (negative electrode).Unipolar chest leadsQo These leads emply an exploring (active or positive) electrode on the chest and an indifferent (reference or negative) electrode. The indifferent electrode is connected to the right arm, left arm and left leg through high resistances. The position of chest electrode (positive electrode) is as follows (VI - V6Q): -V1: In the right 4th intercostal space at the right border of the sternum.V2: In the left 4th intercostal space at the left border of sternum.V3: At midpoint between V2 and V4.V4: In the left 5th intercostal space in the midclavicuiar line.V5: In the left 5th intercostal space at the anterior axillary line.V6: In the left 5th intercostal space at the mid-axillary line.
|
a
| 0 |
medmcqa
|
Not true about rodent ulcer -
|
[
"Radiosensitive",
"Lymphnode not involved",
"Facial lesion",
"Blood spread is rare"
] |
Explanation:
Answer- A. RadiosensitiveBasal cell carcinoma is moderately radiosensitive.Basal cell ca usually spreads by local invasionLymphatic spread is not seenbasal cell carcinomas are seen in the face.
|
a
| 0 |
medmcqa
|
Lymphatics from the spongy urethra drain into the following lymph nodes
|
[
"Superior inguinal nodes",
"Internal inguinal nodes",
"Deep inguinal nodes",
"Sacral nodes"
] |
Explanation:
It drains into deep injuinal lymph node . Ref - bdc 6e vol2 pg376-379
|
c
| 2 |
medmcqa
|
In congenital dislocation of hip, clinical sign which shows that the affected thigh is at a lower level when the knees and hips are flexed to 90 degrees is known as:
|
[
"Oolani's sign",
"Barlow's sign",
"Von Rosen's sign",
"Galeazzi's sign"
] |
Explanation:
Galeazzi sign or Allis sign is done for Development Dysplasia of Hip in which on hip flexion and knee flexion the knee on affected side is at lower levels.
|
d
| 3 |
medmcqa
|
Cystic neoplasm of the pancreas with dismal prognosis is:
|
[
"Serous cystadenoma",
"Mucinous cystic neoplasm",
"Solid pseudopapillary neoplasm",
"Ductal adenocarcinoma with cystic degeneration"
] |
Explanation:
TYPE of CYSTIC NEOPLASM SEX PREDILECTION MALIGNANT POTENTIAL AND NATURAL HISTORY Serous cystadenoma Female Resection is curative serous cystadenocarcinoma is extremely rare Mucinous cystic neoplasm Female Resection is curative, regardless of degree of epithelial dysplasia; poor prognosis when invasive adenocarcinoma is present Intraductal papillary mucinous neoplasm Equal distribution Excellent prognosis for lesions showing only adenomatous and borderline cytologic atypia; poor prognosis when invasive adenocarcinoma is present Solid pseudopapillary neoplasm Female Indolent neoplasm with rare nodal and extranodal metastases; excellent prognosis when completely resected Cystic endocrine neoplasm Equal distribution Similar to that of solid neuroendocrine neoplasm Ductal adenocarcinoma with cystic degeneration Male predominance Dismal prognosis, similar to that of solid adenocarcinoma Acinar-cell cystadenocarcinoma Male Similar to that of solid type; aggressive neoplasm with slightly better prognosis than ductal adenocarcinoma Ref: Sleisenger and Fordtran's, E-9, P-1027
|
d
| 3 |
medmcqa
|
Superior oblique muscle performs action of -a) Intortionb) Extortion c) Elevationd) Medial rotation
|
[
"b",
"ad",
"ac",
"ab"
] |
Explanation:
The primary action of superior oblique muscle is intorsion.The subsidiary actions are depression and abduction.
Dont get confuse by option d. Intorsion is also called medial rotation or internal rotation and extorsion is also called lateral rotation or external rotation.
Note:-
Khurana has mentioned medial rotation as adduction and lateral rotation as abduction. This is incorrect. I have checked it from various standard textbook of ophthalmology and also from internet. If you dont believe, read following statments:-
"Superior rectus causes elevation (upward movement), adduction and intorsion (medial rotation) of the eye".— Clinical ophthalmology
"Contraction of superior oblique muscle causes depression, medial rotation and abduction". — Oswald steward
"The rolling movement of eye towards the nose is called intorsion or medial rotation while rolling movement away from nose is called extorsion or lateral rotation". — Textbook of practical physiology
|
b
| 1 |
medmcqa
|
A patient presents with lower gastrointestinal bleed. Sigmoidoscopy shows ulcers in the sigmoid. Biopsy from this area shows flask-shaped ulcers. Which of the following is the most appropriate treatment ?
|
[
"Intravenous ceftriaxone",
"Intravenous metronidazole",
"Intravenous steroids and sulphasalazine",
"Hydrocoisone enemas"
] |
Explanation:
Ans. is `b' i.e., Intravenous metronidazole Lower gastrointestinal bleeding along with the presence of flask shaped ulcers on sigmoidoscopy confirms the diagnosis of intestinal amoebiasis (Amoebic colitis). Drug therapy for Amoebiasis Asymptomatic carrier (Luminal agents) * lodoquinol * Paromomycin 650 mg t.i.d. for 20 days 500 , '0 day.s. Acute colitis * Metronidazole * plus Luminal agents as above 750 mg PO or IV tid for 5-10 days Amoebic liver abscess * Metronidazole or * Tinidazole or * Ornidazole * plus Luminal agent as above 750 mg PO or IV tid for 5-10 days 2gPO 2 g PO once
|
b
| 1 |
medmcqa
|
False about the phenomenon illustrated below is:
|
[
"The gap between the CEJ and the alveolar bone crest contains dentin only, leading to less material available in cervical region to absorb X-rays",
"The rounded cross-section of most roots accentuates this phenomenon peripherally",
"The mesial and distal surfaces of teeth show bands of burnout, which end abruptly at the alveolar bone margin",
"None of the above"
] |
Explanation:
Diffuse radiolucent areas with ill-defined borders may be apparent radiographically on the mesial or distal aspects of teeth in the cervical regions between the edge of the enamel cap and the crest of the alveolar ridge (The gap between the CEJ and the alveolar bone crest contains dentin only). This phenomenon, called cervical burnout, is caused by the normal configuration of the affected teeth, which results in decreased X-ray absorption in the areas in question. Close inspection reveals intact edges of the proximal surfaces. The perception of these radiolucent areas results from the contrast with the adjacent, relatively opaque enamel and alveolar bone. Such radiolucencies should be anticipated in almost all teeth and should not be confused with root surface caries, which frequently have a similar appearance.
|
d
| 3 |
medmcqa
|
The most potent drugs to reduce plasma cholesterol level are:
|
[
"Plant sterols",
"Fibrates",
"Anion exchange resins",
"Statins"
] |
d
| 3 |
medmcqa
|
|
Barrier method
|
[
"Hormonal contraceptive",
"IUD",
"Condom",
"Sterilization"
] |
Explanation:
Barrier methods includes Physical, Chemical and Combined methods Physical methods include Condom, Diaphragm and Vaginal sponge Chemical methods include Foams, Creams, Suppositories and Soluble films Reference : Park&;s textbook of preventive and social medicine, 23rd edition, Page no: 494, 495
|
c
| 2 |
medmcqa
|
Most common site of gastrointestinal carcinoid is -
|
[
"Duodenum",
"Appendix",
"Ileo-Jejunum",
"Stomach"
] |
Explanation:
Answer- C. Ileo-JejunumCarcinoid tumors arise from the neuroendocrine cells (Argentaffin cells or Kulchitsky cells).The majority are found in GI tract, and more than,l0% in small intestine (jejunum & ileum).The tracheobronchial tree and lungs are the next common sites involved.
|
c
| 2 |
medmcqa
|
Elevated AFP levels are seen in all of the following conditions, EXCEPT:
|
[
"Hepatoblastoma",
"Seminoma",
"Teratoma",
"None of the above"
] |
Explanation:
AFP concentration is increased only in patients with nonseminoma. The presence of an increased AFP level in a patient whose tumor shows only seminoma indicates that an occult nonseminomatous component exists, and the patient should be treated for nonseminomatous GCT. AFP is normally produced by the fetal yolk sac and also exists in multiple isoforms. It is elevated in GCT cells derived from the embryological yolk sac, including endodermal sinus tumor and embryonal carcinoma. It has also been found to be elevated in other neoplasms such as hepatocellular carcinoma, pancreatic, gastric, and lung cancer. Ref: Motzer R.J., Bosl G.J. (2012). Chapter 96. Testicular Cancer. 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.
|
a
| 0 |
medmcqa
|
Class IV lupus nephritis is:
|
[
"Mesangial lupus nephritis",
"Proliferative lupus nephritis",
"Membranous lupus nephritis",
"Diffuse lupus nephritis"
] |
Explanation:
Classification of Lupus Nephritis Class I Minimal Mesangial Lupus Nephritis Class II Mesangial Proliferative Lupus Nephritis Class III Focal Proliferative Lupus Nephritis Class IV Diffuse Proliferative Lupus Nephritis Class V Membranous Lupus Nephritis Class VI Advanced Sclerotic Lupus Nephritis
|
d
| 3 |
medmcqa
|
Mulberry mucosa is seen in -
|
[
"Irritative rhinitis",
"Chronic atrophic rhinitis",
"Hypertrophic rhinitis",
"All of the above"
] |
c
| 2 |
medmcqa
|
|
Cholesterol is a predominant lipid in
|
[
"LDL and HDL",
"HDL and VLDL",
"Chylomicron and VLDL",
"IDL and HDL"
] |
Explanation:
LDL and HDL lipoproteins are the major carrier of cholesterol . Reference: Harpers illustrated biochemistry 31st edition page 248
|
a
| 0 |
medmcqa
|
Vagina develops from -
|
[
"Mesonephric duct",
"Paramesonephric duct",
"Wolffian duct",
"Ectoderm"
] |
Explanation:
Ans. is 'b' i.e., Paramesonephric duct o Vagina is derived from two sources:-i) Upper 2/3rd: It is derived from Utero-Vaginal Canal, i.e. the fused part of paramesonephric duct. Therefore, this part is mesodermal in origin.ii) Lower l/3rd: It is derived from sinovaginal bulb which intum is derived from urogenital sinus. Thus, this part is endodermal in origin.
|
b
| 1 |
medmcqa
|
Acellular peusis vaccine contains-(
|
[
"Peactin, flagillary hemagglutinin, cytotoxin, endotoxin",
"Peactin, flagillary hemagglutinin, fimbriae, endotoxin",
"Peactin, cytotoxin, fimbriae, peusis toxin",
"Flagillary hemagglutinin, peusis toxin, fimbriae"
] |
Explanation:
Ans. is 'd' i.e., Flagillary hemagglutinin, peussis toxin, fimbrial . Acellular peussis vaccines currently available from different manufactures should be considered as different and unique products because of the presence of one or more different components which are: - Chemically or genetically detoxified peussis toxin (PT toxoid). - Filamentous hemagglutinin - 69k Da outer membrane protein ( also known as peactin). - Fimbrial-2 and fimbrial-3 antigens.
|
d
| 3 |
medmcqa
|
The type of receptors present on T cells is-
|
[
"IgG",
"IgD",
"CD4",
"Prostaglandins"
] |
Explanation:
T cell receptor for antigen: The TCR is the recognition molecule for T cells. The TCR is a transmembrane heterodimeric protein containing two disulfide-linked chains. It is composed of two different classes of TCR called: alpha-beta (a and b) and gamma-delta (g and d). The majority of the T cells contain the ab TCR phenotype. However, a smaller percentage of T cells express the g d TCR. The ab T cells are subdivided by their surface markers: CD4 or CD8. They recognize peptide antigens presented by MHC molecules on the surfaces of APC's (antigen-presenting cells) The g d T cells are primarily located in the epithelial linings of the reproductive and GI tracts.(aiims nov. 2020). Theyrecognize different type of antigenswithout the requirement of MHC Prostglandins( eicosanoids) are the lipid compounds acting as mediators of pain and inflamation .they have diverse action such as bronchodilation ,vasodilataion etc.. IgG AND IgD are immunoglobolins involved in defence mechanism
|
c
| 2 |
medmcqa
|
A 70 kg young athlete was planned for surgery. During anesthesia,vecuronium was not available so repeated doses of succinylcholine was given intermittently up to 640mg. During recovery ,patient was not able to spontaneously respire and more limbs. What is the cause
|
[
"Pseudocholinestrease deficiency",
"Phase 2 blockade",
"Muscle weakness due to repeated fasiculations",
"Undiagnosed muscular dystrophy"
] |
Explanation:
Refer Wiley 7/584 Succinylcholine produces a characteristic depolarising block that is associated with absence of fade in response to train-of -four and titanic stimulation, the absence of post tetanic facilitation and increased block in the presence of anticholinesterase drugs. The type of block may change into a non depolarising type following prolonged admistration of drug
|
b
| 1 |
medmcqa
|
Clergyman's knee is due to involvement of: (Repeat)
|
[
"Infrapatellar bursa",
"Suprapatellar bursa",
"Prepatellar bursa",
"Semimembranous bursa"
] |
Explanation:
Ans: A (Infrapatellar bursa) Ref: Apley's Orthopedics, 9th ed.Explanation:Infrapatellar bursitis (clergyman's knee)It is the inflammation of the infrapatellar bursa, which is located just below the patella.It is often called "clergyman's knee" due to its historical frequency amongst clergyman, who injured the bursa by kneeling on hard surfaces during prayer.Prepatellar bursitisAlso known as heat knee, carpet layer's knee, coal miner's knee, housemaid's knee, rug cutter's knee, or nun's kneeIt is an inflammation of the prepatellar bursa at the anterior to patella.It is marked by swelling at the knee, which can be tender to the touch but which does not restrict the knee's range of motion.It is most commonly caused by trauma to the knee by chronic trauma over a period of time.As such, prepatellar bursitis commonly occurs among individuals whose professions require frequent kneeling.
|
a
| 0 |
medmcqa
|
The recommended oral dose of vitamin A in pregnant females is:
|
[
"50,000 U",
"1,00,000 U",
"2,00,000 U",
"3,00,000 U"
] |
Explanation:
Ans. c. 2,00,000 U style="font-size: 1.04761904761905em; font-family: Times New Roman, Times, serif; margin: 0 0 0 8px; text-indent: 0">'There was a previous recommendation by WHO on giving 2 lacs IU of Vitamin A to pregnant women immediately after delivery, which was withdrawn in 2011.'
|
c
| 2 |
medmcqa
|
A 24-year-old female presents with nonspecific symptoms including fever and malaise. A chest x-ray reveals enlarged hilar lymph nodes , while her serum calcium level is found to be elevated. Biopsies of the enlarged hilar lymph nodes would most likely reveal
|
[
"Caseating granulomas",
"Dense, granular, PAS-positive, eosinophilic material",
"Markedly enlarged epithelial cells with intranuclear inclusions",
"Noncaseating granulomas"
] |
Explanation:
Sarcoidosis is a systemic disease characterized by noncaseating granulomas in multiple organs. The diagnosis of sarcoidosis depends upon finding these noncaseating granulomas in commonly affected sites. In 90% of cases, bilateral hilar lymphadenopathy ("potato nodes") or lung involvement is present and can be revealed by chest x-ray or transbronchial biopsy. The eye and skin are the next most commonly affected organs, so that both conjunctival and skin biopsies are clinical possibilities. Noncaseating granulomas may be found in multiple infectious diseases, such as fungal infections, but sarcoidosis is not caused by any known organism. Therefore, before the diagnosis of sarcoidosis can be made, cultures must be taken from affected tissues, and there must be no growth of any organism that may produce granulomas. In patients with sarcoidosis, blood levels of angiotensin-conveing enzyme are increased, and this may also be used as a clinical test. In the past, the Kveim skin test was used to assist in the diagnosis of sarcoidosis, but since it involves injecting into patients extracts of material from humans, it is no longer used Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition.
|
d
| 3 |
medmcqa
|
Posterior one-third of the tongue develops from:
|
[
"Lingual swellings",
"Tuberculum impar",
"Hypobranchial eminence",
"Tongue bud"
] |
Explanation:
Posterior one-third of the tongue develops from the cranial part of hypobranchial eminence (copula of His).
|
c
| 2 |
medmcqa
|
Abnormal mousy/mushy odour of urine is associated with
|
[
"Phenylketonuria",
"Tyrosinemia",
"Maple syrup urine disease",
"Hawkinsuria"
] |
Explanation:
Ans. a (Phenylketonuria) (Ref. Harrison's Internal Medicine 17th/Ch. 358)Inborn errors of amino acid metabolism associated with abnormal odourInborn error of metabolismUrine odorGlutaric acidemia (type II)Sweaty feet, acridHawkinsinuriaSwimming poolIsovaleric acidemiaSweaty feet, acridMaple syrup urine diseaseMaple syrup/Burnt sugarHypermethioninemiaBoiled cabbageMultiple carboxylase deficiencyTomcat urineOasthouse urine diseaseHops-likePhenylketonuriaMousy or mustyTrimethylaminuriaRotting fishTyrosinemiaBoiled cabbage, rancid butterTHE HYPERPHENYLALANINEMIAS# result from impaired conversion of phenylalanine to tyrosine.# The most common and clinically important is phenylketonuria (frequency 1:10,000), which is an autosomal recessive disorder characterized by an | concentration of phenylalanine and its by-products in body fluids and by severe mental retardation if untreated in infancy.# It results from | activity of phenylalanine hydroxylase (phenylketonuria type I).# The accumulation of phenylalanine inhibits the transport of other amino acids required for protein or neurotransmitter synthesis, reduces synthesis and increases degradation of myelin, and leads to inadequate formation of norepinephrine and serotonin.# Phenylalanine is a competitive inhibitor of tyrosinase, a key enzyme in the pathway of melanin synthesis, and ac- counts for the hypopigmentation of hair and skin.# Untreated children with classic phenylketonuria are normal at birth but fail to attain early developmental milestones, develop microcephaly, and demonstrate progressive impairment of cerebral function.# Hyperactivity, seizures, and severe mental retardation are major clinical problems later in life.# EEG abnormalities; "mousy" odor of skin, hair, and urine (due to phenylacetate accumulation); and a tendency to hypopigmentation and eczema are devastating clinical picture.# In contrast, affected children who are detected and treated at birth show none of these abnormalities.Treatment# To prevent mental retardation, diagnosis and initiation of dietary treatment of classic phenylketonuria must occur before the child is 3 weeks of age.# Dietary phenylalanine restriction is usually instituted if blood phenylalanine levels are >250 pmol/L (4 mg/dL).# Treatment consists of a special diet low in phenylalanine and supplemented with tyrosine, since tyrosine becomes an essential amino acid in phenylalanine hydroxylase deficiency.# With therapy, plasma phenylalanine cone should be maintained between 120 and 360 pmol/L (2 and 6 mg/dL).# Dietary restriction should be continued and monitored indefinitely..# Pregnancy risks can be minimized by continuing lifelong phenylalanine-restricted diets and assuring strict phenylalanine restriction 2 months prior to conception and throughout gestation.ConditionEnzyme DefectClinical FindingsInheritance1. Phenylketonuria type IPhenylalanine hydroxylaseMental retardation, microcephaly, hypopig- mented skin and hairs, eczema, "mousy" odorAR2. Phenylketonuria type IIDihydropteridine reductaseMental retardation, hypotonia, spasticity, myoclonusAR3. Phenylketonuria type III6-Pyruvoyl- tetrahydropterin synthaseDystonia, neurologic deterioration, seizures, mental retardationAR4. GTP cyclohydrolase I deficiencyGTP cyclohydrolase IMental retardation, seizures, dystonia, temperature instabilityAR5. Carbinolamine dehydratase deficiencyPterin-4-carbinolamine dehydrataseTransient hyperphenylalaninemia (benign)AR
|
a
| 0 |
medmcqa
|
Armoured endotracheal tube is used in?
|
[
"Cardiovascular surgery",
"Neurosurgery",
"Thoracic surgery",
"Pediatric surgery"
] |
Explanation:
Neurosurgery REF: Miller 6th ed 1628, Current Diagnosis & Treatment in Otolaryngology--Head & Neck Surgery 2e "In neurosurgical operations armoured endotracheal tube is used" Three of the more commonly used endotracheal tubes are RAE endotracheal tubes, armoured endotracheal tubes, and laser-resistant endotracheal tubes. These tubes are commonly used for head and neck surgery.RAE endotracheal tubes, named after the inventors of the tube (Ring, Adair, and Elwyn), have a preformed shape to fit the mouth or nose. The "armoured" endotracheal tubes are cuffed, wire-reinforced, silicone rubber tubes which are quite flexible but yet difficult to compress or kink. This can make them useful for situations in which the trachea is anticipated to remain intubated for a prolonged duration, or if the neck is to remain flexed during surgery. Armoured endotracheal tubes are frequently used during anaesthesia when bending or compression of the tube is likely to occur as in neurosurgery or head and neck and oral surgery. REF: A & A March 1980 vol. 59no. 3 215-216
|
b
| 1 |
medmcqa
|
Most common salivary gland tumor a -
|
[
"Mucoepidermoid carcinoma",
"Pleomorphic adenoma",
"Wahims tumor",
"Oncocytoma"
] |
Explanation:
Pleomorphic Adenoma (Mixed Salivary Tumour)This is the most common tumour of major (60-75%) andminor (50%) salivary glands. Pleomorphic adenoma is thecommonest tumour in the parotid gland and occurs less oftenin other major and minor salivary glands. The tumour iscommoner in women and is seen more frequently in 3rd to5th decades of life. The tumour is solitary, smooth-surfacedbut sometimes nodular, painless and slow-growing. It is oftenlocated below and in front of the ear TEXTBOOK OF PATHOLOGY 6th edition pg no 534
|
b
| 1 |
medmcqa
|
Which antibody protects from intestinal infection?
|
[
"IgA",
"IgM",
"IgG",
"IgE"
] |
Explanation:
Ans. (a) IgA(Ref: Kuby immunology pg 419)IgA antibodies are found in circulation, they are the major isotype found in secretions, including mucus in the gut, milk from mammary glands, tears, and saliva. In these secretions, IgA can neutralize both toxins and pathogens, continually interacting with the resident (commensal) bacteria that colonize our mucosal surfaces and preventing them from entering the bloodstream
|
a
| 0 |
medmcqa
|
In circulatory biomechanics which of the following is true-
|
[
"Blood viscosity is increased in anemia",
"Blood viscosity is decreased in polycythemia",
"Cardiac output is increased in anemia",
"Cardiac output is decreased in Beri-Beri"
] |
Explanation:
Ans. is 'c' i.e., Cardiac output is increased in anemia o Cardiac output is increased in conditions which cause decrease in peripheral vascular resistanceExerciseAV fistula or shuntSevere anemiaThyrotoxicosisWet beri-beriAbout other optionso Blood viscosity is lowr in anemia and high in polycythemia.
|
c
| 2 |
medmcqa
|
Most common site of admantinomaof the long bones is
|
[
"Femur",
"Ulna",
"Tibia",
"Fibula"
] |
Explanation:
Ameloblastoma---most common site jaw Ameloblastoma---most of long bones---called adamantinoma and is most common in tibial diaphysis Refer Ohopedic pathology 6th/e 449
|
c
| 2 |
medmcqa
|
The most common sourse of embolism -
|
[
"DVT",
"Trauma",
"Infection",
"Surgery"
] |
Explanation:
In greater than 95% of cases, venous emboli originate from thrombi within deep leg veins proximal to the popliteal fossa; embolization from lower leg thrombi is uncommon. Depending on size, a PE can occlude the main pulmonary aery, lodge at the bifurcation of the right and left pulmonary aeries (saddle embolus), or pass into the smaller, branching aerioles . Rarely, an embolus passes through an atrial or ventricular defect and enters the systemic circulation (paradoxical embolism) ( Robbins Basic Pathology, 9 th edition, page 90 )
|
a
| 0 |
medmcqa
|
Teiary hyperparathyroidism is-
|
[
"High PO4 level with metastasis",
"Secondary hyperparathyroidism with CRF",
"Primary hyperparathyroidism with low Ca\" levels",
"Secondary hyperparathyroidism with chief cell adenoma"
] |
Explanation:
Ans. is 'd' i.e., Secondary hyperparathyroidism with chief cell adenoma o Davidson states "In very small propoion of cases of secondary hyperparathyroidism continuous stimulation of the parathyroid may result in adenoma formation and autonomous PTH secretion. This is known as teiary hyperparathyroidism".
|
d
| 3 |
medmcqa
|
Which of the following blotting technique does not exist:
|
[
"Western",
"Southern",
"Eastern",
"Northern"
] |
Explanation:
Ans: c (Eastern) Ref: Lippincott, p. 464Few points about gene analysis:TechniqueSample analysedPurposeASO (Allele specific oligonucleotide)DNADetects DNA mutationsMicro assayRNA or C-DNAMeasures many mRNA levels at onceProteonomicsProteinMeasures abundance, distribution, post translational modification, functions and interactions of cellular proteinsDNA chipsDNAOligonucleotides embedded on the chip can detect various DNA mutations and diseasesNumerical chromosomal abnormalities:Euploid cells: Multiples of 23 chromosomes.E.g.: Haploid (23). dipoid (46), triploidetc.Aneuploidy: Deviation from euploid number.E.g.: Trisomy - Three copies of a specific chromosome.Monosomy - One copy of a specific chromosome.Nullysomy - No copy of a specific chromosome.
|
c
| 2 |
medmcqa
|
Rivastigmine and donepezil are drugs used predominantly in the management of:
|
[
"Depression",
"Dissociation",
"Delusion",
"Dementia"
] |
Explanation:
Acetylcholinesterase inhibitors (donepezil, galantamine, rivastigmine) increase the concentration of and duration of action of acetylcholine in the central nervous system. There is evidence that in moderately severe Alzheimer's disease, these drugs improve cognitive function and behavior for up to a year.
|
d
| 3 |
medmcqa
|
Ulcus serpens is caused by-
|
[
"Pseudomonas pyocynaeceous",
"Pneumoeoccus",
"Corynebacteria",
"Gonorrhoea niesseria"
] |
Explanation:
The characteristic hypopyon corneal ulcer caused by Pneumococcus is called 'ulcus serpens'. Reference:Comprehensive Ophthalmology,AK Khurana,6th edition,pg no.102
|
b
| 1 |
medmcqa
|
Local anesthetic is not effective in an inflammed tissue because:
|
[
"All impulses generated cannot be blocked",
"Myelin sheath is inflammed so it does not absorb the solution",
"pH is more acidic, so LA is ineffective",
"All of the above"
] |
c
| 2 |
medmcqa
|
|
Pneumococcus producing mucoid colonies most often is type
|
[
"I",
"II",
"III",
"IV"
] |
Explanation:
Pneumococci on blood agar, after incubation for 18 hours, the colonies are small, dome-shaped with an area of greenish discoloration ( alpha hemolysis). some strains streptococcus pneumoniae type III and VII form large mucoid colonies due to the abundance of capsular material. Reference: Textbook of Microbiology; Anathanarayan and panicker's; 10th edition; Page no: 224
|
c
| 2 |
medmcqa
|
2 months old child having bih weight 2kg, with poor feeding, very sleepy and wheezing. The diagnosis is?
|
[
"No pneumonia",
"Severe pneumonia",
"Very severe disease",
"None"
] |
Explanation:
Ans. is 'c' i.e., Very severe disease
|
c
| 2 |
medmcqa
|
Highest priority is given to which color code in Triage-
|
[
"Red color",
"Yellow color",
"Green color",
"Black color"
] |
Explanation:
Ans. is 'a' i.e., Red colour * The most common triage classification system used international is four colour code system.1. Red - High priority treatment or transfer2. Yellow - Medium priority3. Green - Ambulatory patients4. Black - Dead or moribund patients
|
a
| 0 |
medmcqa
|
Most common cause of placenta pre:
|
[
"Myomectomy",
"Primigravida",
"Multigravida",
"Previous cesarean section"
] |
Explanation:
A history of prior cesarean section and uterine curettage are significantly associated in patients with placenta pre. Placenta pre is most commonly found in Multiparous but most common cause is Previous cesarean section.
|
d
| 3 |
medmcqa
|
Which of the following is used in forgeries as an ink remover solution :
|
[
"Sulphuric acid",
"Nitric acid",
"Carbolic acid",
"Oxalic acid"
] |
Explanation:
D i.e. Oxalic acid
|
d
| 3 |
medmcqa
|
Mechanism responsible for high rates of spontaneous abortion in septate uterus is
|
[
"Distorted uterine cavity",
"Associated cervical abnormality",
"Implantation on avascular septum",
"Unfavourable endometrial lining"
] |
Explanation:
The primary mechanism responsible for spontaneous abortion in septate uterus is partial or complete implantation on avascular septum.
|
c
| 2 |
medmcqa
|
What is net reproduction rate?
|
[
"No. of female children a newborn girl has in her life time taking into account mortality",
"No. of female children a newborn girl has in her life time",
"No. of male children a newborn girl has in her life time",
"No. of children a newborn girl has in her left time"
] |
a
| 0 |
medmcqa
|
|
Sexual asphyxia is associated with which of the following perversions
|
[
"Voyeurism",
"Masochism",
"Sadism",
"Fetishism"
] |
Explanation:
.
|
b
| 1 |
medmcqa
|
The acceptable noise level is -
|
[
"95 dB",
"100 dB",
"90 dB",
"85 dB"
] |
Explanation:
Sound in dB Effect 20 Whispering 40 Quiet library 60 Normal conversation 70 heavy street traffic 80 printing press 85 Recommended maximum 110 Train passing through station 120 Motor car horn 140 Threshold of pain 150-160 Mechanical damage Park's Textbook of Preventive and Social Medicine, 25th edition, Page No. 802
|
d
| 3 |
medmcqa
|
1st extensor compartment of wrist contains -
|
[
"EPL",
"EPB",
"ECRL",
"ECRB"
] |
Explanation:
Ans. is 'b' i.e., EPB CompartentContentsIAbductor pollicis longus, extensor pollicis brevisIIExtensor carpi radialis longus and brevisIIIExtensor pollicis longusIVExtensor digitorum, extensor indicis, posterior interosseus nerve, anterior interosseus arteryVExtensor digiti minimiVIExtensor carpi ulnaris
|
b
| 1 |
medmcqa
|
Vector for T.cruzi is -
|
[
"Reduvid bug",
"Tsetse fly",
"Sand fly",
"Hard tick"
] |
Explanation:
T.cruzi passes its life cycle I two host Definitive host- humans Intermediate host-triatomine bugs Humans become infectious when reduviid bug bites and the infected faecal matter is discharged near bite wound (refer pgno:49 baveja 3 rd edition)
|
a
| 0 |
medmcqa
|
Which of the following is an ultrashort acting muscle relaxant ?
|
[
"Rocuronium",
"Atracurium",
"Succinyl choline",
"Doxacurium"
] |
Explanation:
Ans- C Fastest acting MR Scoline Fastest acting NDMR Rocuronium Shortest acting MR Gantacurium or scoline Shortest acting NDMR Gantacurium or mivacurium Longest acting MR Doxacurium
|
c
| 2 |
medmcqa
|
Endoscopic stapling procedure would be ideal in
|
[
"Pharyngeal pouch",
"Gastric ulcer",
"Esophageal varices",
"Perforation"
] |
Explanation:
Stappling of diveicula is done as a treatment procedure for pharyngeal pouch(Zenker's diveiculum). Other method is Dohlman's procedure. In this Pouch is excised using double lipped endoscopy. Cautery or laser is used. It is quicker procedure with sho duration of anaesthesia, with fast recovery. Other treatment option is Diveiculectomy with cricopharyngeal myotomy. Reference: SRB's Manual of Surgery, 6th Edition, page no= 422.
|
a
| 0 |
medmcqa
|
Which of the following conditions could arise as a sequelae of periodontal infection?
|
[
"Ischemic heart disease",
"Thrombogenesis",
"Atherosclerosis",
"All of the above"
] |
d
| 3 |
medmcqa
|
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