antoine-444/MNLP_M2_mcqa_dataset · Datasets at Hugging Face

dataset string	id string	question string	choices sequence	rationale string	answer string
medmcqa	medmcqa_0	Failure to initiate and maintain spontaneous respiration following bih is clinically k/a -	[ "Bih asphyxia", "RDS-Respiratory distress syndrome", "Respiratory failure", "Pulmonary oedema" ]	Ans. is 'b' i.e., RDS-Respiratory distress syndrome	B
medmcqa	medmcqa_1	Coho study reveals all except:	[ "Incidence", "Attributable risk", "Relative risk", "Odds ratio" ]	Odds ratio	D
medmcqa	medmcqa_2	Cause of death in diabetic ketoacidosis in children?	[ "Cerebral edema", "Hypokalemia", "Infection", "Acidosis" ]	Ans. is 'a' i.e., Cerebral edema o High blood sugar will cross the blood brain barrier and simultaneously will draw water inside leading to cerebral edema. Cerebral edema accounts for 60-90% of all DKA related deaths in children,o Infection is a precipitator for development of DKA.o Other precipitating factor can be tissue ischemia, inadequate insulin administration, drugs (cocaine) and pregnancy.	A
medmcqa	medmcqa_3	Which is not a high pitched hea sound	[ "Mid systolic click", "Pericardial shudder", "Opening snap", "Tumor plop sound" ]	Ans. is 'd' i.e., Tumor plop sound Low pitch hea sounds are : S3 S4 Tumor plop sound Mid systolic clicks are Heard in mitral valve prolapse during systole and are high pitch sounds. The pericardial knock (PK) is Also high-pitched and occurs slightly later than the opening snap, corresponding in timing to the abrupt cessation of ventricular expansion after tricuspid valve opening and to an exaggerated y descent seen in the jugular venous waveform in patients with constrictive pericarditis. A tumor plop is A lower-pitched sound that can be heard in patients with atrial myxoma. It may be appreciated only in ceain positions and arises from the diastolic prolapse of the tumor across the mitral valve	D
medmcqa	medmcqa_4	Patau syndrome feature include A/E –	[ "Cleft lip", "Hypotelorism", "Holoprosencephaly", "Rocker bottom foot" ]	Patau Syndrome Trisomy of 13th chromosome Cleft lip often midline Polydactyl with flexed fingers Ocular hypotelorism Bulbous nose Low set ear Holoprosencephaly Microphthalmia Cardiac malformation Scalp defect Hypoplastic or absent ribs Rocker bottom foot is seen in Edwards Syndrome (Trisomy 18)	D
medmcqa	medmcqa_5	Which of the following procedures can be replaced by the use of occlusal sealants	[ "Topical fluoride application", "Prophylactic odontotomy", "Amalgam fillings", "All the above" ]	null	B
medmcqa	medmcqa_6	The antianginal effect of propranolol may be attributed to which of the following ?	[ "Block of exercise induced tachycardia", "Dilation of constricted coronary vessels", "Increased cardiac force", "Increased resting heart rate" ]	null	A
medmcqa	medmcqa_7	Which of the following Intrauterine device has a minimum failure rate	[ "Progestase", "Cu T-380 A", "Levonorgestrel IUD", "T Cu -200" ]	Mirena (Levonorgestrel IUD) has least failure rate among IUD's Contraceptive implants (Implanon) have the least failure rates among all contraceptive methods. Ref : Park 23rd edition Pgno : 496	C
medmcqa	medmcqa_8	Highest concentration of potassium is seen in:	[ "Jejunum", "Ileum", "Duodenal", "Sigmoid colon" ]	Ans. (d) Sigmoid colonRef: Schwartz 10/e p69* Highest concentration of potassium seen in Colon (30mEq/L).* Highest absorption of potassium occurs in colon	D
medmcqa	medmcqa_9	Most sensitive index of recent transmission of malaria in community:	[ "Spleen rate", "Infant parasite rate", "Annual parasite rate", "Slide positivity rate" ]	Ans. is 'b'Annual parasite index measures incidence, spleen rate measures endemicity, ABER-Annual blood examination rate (index of operational efficiency) and SPR (slide positivity rate) - forecasting malaria and defining any area to be high risk or low risk.	B
medmcqa	medmcqa_10	Treatment of choice for angiofibroma:	[ "Surgery", "Radiotherapy", "Both", "Chemotherapy" ]	(a) Surgery (best option)(Ref. Cummings, 6th ed., 1422)Radiotherapy is indicated in angiofibroma only when the tumour has intracranial extension.	A
medmcqa	medmcqa_11	Platelet aggregation is caused by -	[ "Nitrous oxide", "Thromboxone A2", "Aspirin", "PGI2" ]	Robbins basic pathology 9th edition page no 46, Answer is option 2, thromboxaneA2 Thromboxane A2 is a potent platelet aggregating agent and a vasoconstrictor, is the major prostaglandin produced in these cells. Itvis an intrmediate produced in the cyclooxygenase pathway by the enzyme thromboxane synthase.	B
medmcqa	medmcqa_12	Investigation of choice for diagnosis of CA colon	[ "Colonoscopy", "Double contrast barium enema", "Triple phase CT", "Viual colonoscopy" ]	Colonoscopy is the "gold standard" for establishing the diagnosis of colon cancer. It permits biopsy of a tumour to verify the diagnosis while allowing inspection of the entire colon to exclude metachronous polyps or cancers; the incidence of a synchronous cancer is approximately 3%. Colonoscopy is generally performed even after a cancer is detected by barium enema to obtain a biopsy specimen and to detect (and remove) small polyps that may be missed by the contrast studyRef: Sabiston, 20e, page: 1398	A
medmcqa	medmcqa_13	A forceps delivered premature baby develops fever, abnormal behavior, bulging fontanelle 5 days after bih. What is the likely causative organism?	[ "Neisseria meningitidis", "Listeria monocytogenes", "Staph aureus", "Pneumococcus" ]	Given scenario suggests diagnosis of Meningitis Neonatal Listeriosis 2 clinical presentations are recognized: EARLY ONSET (<5 DAYS ) LATE ONSET (>=5 DAYS) Positive result of maternal Listeria culture Obstetric complications Premature delivery Low bihweight Neonatal sepsis Negative result of maternal Listeria Culture Uncomplicated pregnancy Term delivery Normal bihweight Neonatal meningitis	B
medmcqa	medmcqa_14	The vitelline vein forms the	[ "Hepatic vein", "Azygos vein", "Inferior mesenteric vein", "Splenic vein" ]	A i.e. Hepatic vein	A
medmcqa	medmcqa_15	Most common complicationassociated with ‘Total Parenteral Nutrition’ is :	[ "Catheter related infection", "Hyperglycemia", "Pneumothorax", "Hyperkalemia" ]	Most common complication associated with TPN is Catheter related infection Total Parenteral Nutrition : For providing nutritional support All nutritional requirements given only through IV route TPN is given through central vein and not through a peripheral vein Can also use Peripherally Inserted Central Catheter (PICC) Preferred site for central vein infusion is the Superior vena cava Preferred access sites are Subclavian > Jugular > Femoral vein Total volume of PN should be 2000-300 ml/day	A
medmcqa	medmcqa_16	All of the following are risk factors for deep vein thrombosis (DVT) except:	[ "Obesity", "Age less than 40 years", "Duration of surgery more than thiy minutes", "Use of the oestrogen-progesterone contraceptive pills" ]	Patients over the age of 40 years is a risk factor for DVT. High dose estrogen therapy is also associated with DVT. Ref: Bailey and Love's Sho Practice of Surgery, 24th Edition, Page 970.	B
medmcqa	medmcqa_17	Multiple brain abscesses are characteristic of	[ "Cyanotic heart disease", "Otitis media", "Hematogenous", "Hemorrhage" ]	(C) Hematogenous # Metastatic abscesses are commonly located in the parietal, frontal, or temporal lobes, and multiple brain abscesses are usually the result of metastatic spread from remote primary foci, accounting for 6% to 22% of cases.> Most common cause of brain abscesses was haematogenous spread, accounting for 26% of the episodes.	C
medmcqa	medmcqa_18	True about Henoch-schonlein pupura -	[ "Palpable pupura", "Thrombocytopenia", "C-ANCA positive", "All" ]	Ans. is 'a' i.e., Palpable pupura	A
medmcqa	medmcqa_19	The connective tissue cells of pulp are derived from	[ "The pool of undifferentiated mesenchymal cells", "The pool of fibroblasts", "The pool of undifferentiated ectodermal cells", "The pool of osteoblasts" ]	null	A
medmcqa	medmcqa_20	Which of the following has a normal level of alpha-fetoprotein value in serum?	[ "Ovarian dysgerminoma", "Hepatoblastoma", "Embroynal carcinoma", "Yolk sac tumours" ]	null	A
medmcqa	medmcqa_21	Most specific test to detect blood stains is	[ "Benzidine test", "Teichmann's test", "Ohotoluidine test", "Spectroscopic test" ]	Spectroscopic test is the most specific for blood stains. Tests for blood stains Spectroscopy tests can give information about what chemical compounds and elements are present in a sample, whether ceain types of degradation have occurred in a sample, the amount and type of crystallinity present in the sample, to name a few uses. Ref ganong's review of medical physiology 25e	D
medmcqa	medmcqa_22	Granular casts in urine are?	[ "Regarded as normal", "Hyaline casts embedded with RBC", "Made up of mucoprotein substances", "Formed in the DCT" ]	On microscopic examination of urine, presence of granular cast ,RBC ,bacteria glucose, albumin, ketone bodies is abnormal granular cast are the hyaline casts embedded with RBC or WBC or these are degenerate glomerular cells or tubular epithelial cells in large number Their presence indicates renal destruction of glomerular tubular cells. Ref: page no 575 Textbook of physiology Volume 1 AK Jain 7th edition	B
medmcqa	medmcqa_23	Maryland bridge was first developed by:	[ "Thompson", "Dunn", "Tanaka", "Rochette" ]	Based on the work of Tanaka et al. on pitting corrosion for retaining acrylic resin facings and the metal etching studies of Dunn and Reisbick, Thompson and Livaditis at the University of Maryland developed a technique for the electrolytic etching of Ni-Cr and Cr-Co alloys.	A
medmcqa	medmcqa_24	Clinical GOAl recommended by WHO for Prevention of CAD is	[ "Cholesterol / LDL ratio", "Cholesterol / HDL ratio", "Triglycerides / LDL ratio", "Triglycerides / HDL ratio" ]	null	B
medmcqa	medmcqa_25	An infant is diagnosed with MEN-2B trait. Which the following will be best line of management?	[ "Prophylactic surgery", "Clinical observation and follow up", "Regular FNAC", "All of the above" ]	Prophylactic Thyroidectomy in RET Mutation Carriers MEN-2A Before 5 years MEN-2B Before 1 year	A
medmcqa	medmcqa_26	Megaloblastic anemia is caused by:	[ "Diphyllobothriumlatum", "H-NaNa", "Taeniasaginata", "Echinococcusgranulosis" ]	Habitat: Adult worm lives in small intestine (ileum orjejunum) of man D. Latum is the longest tapeworm found in man. Life cycle: The worm passes its life cycle in one definitive host and Two intermediate host. Definitive host: Man is the main definitive host Intermediate host: First intermediate host: Small copepods mainly of genraDiaptomus and Cyclops Second intermediate host: Freshwater Fishes. Humans become infected when they eat undercooked raw or lightly salted meat or roe from infected freshwater fishes. Pathogenicity: Most human infections arc caused by only one tape worm and cause no or very vague ill effects. Patient may develop fatigue, weakness, diarrhea and numbness of extremities. Some Patient develops mechanical obstruction. In few cases pernicious anemia may develop due to B12 deficiency. D. Latum has been shown to absorb as much as 80-100% of a single oral dose of vit- B12 thereby competing with the host for this important vitamin. Treatment of choice: Niclosamide and praziquantel Important: Vit B12 Absorb in the ILEUM. Iron is absorbed in the Duodenum.	A
medmcqa	medmcqa_27	A child had hematuria and nephrotic syndrome (minimal change disease) was diagnosed. True about it is -	[ "A type of focal segmental GN", "IgA deposition on basement membrane", "Foot process of glomerular membrane normal", "Glomerular function is lost due to loss of poly charge on both sites of glomerular foot process." ]	null	D
medmcqa	medmcqa_28	A cancer patient who is on cisplatin therapy develops severe vomiting on the 1st day of treatment, drug indicated to treat this is:	[ "Aprepitant.", "Ondansetron", "Fosaprepitant.", "All of the above." ]	Cisplatin induced vomiting has two phases. EarlyPhase: It occurs within first 24 hours. 5 HT3 antagonists like ondansetron are the agents of choice for this condition. Delayed Phase: Vomiting occurring after 24 hours is less responsive to ondansetron and other drugs. It is best controlled by substance P antagonist like aprepitant	B
medmcqa	medmcqa_29	Nephrocalcinosis is seen in -	[ "Hypoparathyroidism", "Medullary sponge kidney", "DM", "All" ]	Ans. is 'b' i.e., Medullary sponge kidneyo Deposition of calcium stones on renal papillae is called nephrocalcinosis.o Nephrocalcinosis seen in -Renal tubular acidosis type I (A). Bater's syndrome Excess calcium intake Medullary sponge kidney Multiple myeloma Sarcoidosis Severe hypercalciuria Vitamin-D intoxication TB kidney (Love & Bailey) Hyperparathyroidism Metastatic bone disease	B
medmcqa	medmcqa_30	A 46-year-old patient comes to doctor's OPD with complains of chest pain and headache. His computed tomography (CT) scan reveals a tumor located just superior to the root of the right lung. Blood flow in which of the following veins is most likely blocked by this tumor?	[ "Hemiazygos vein", "Arch of the azygos vein", "Right subclan vein", "Right brachiocephalic vein" ]	The azygos vein arches over the root of the right lung and empties into the SVC. Other veins do not pass over the root of the right lung.	B
medmcqa	medmcqa_31	High environmental temperature, best step for malaria control?	[ "Remove breeding place", "Full sleeve cloth", "Indoor insecticide", "Early treatment" ]	Ans. is 'a' i.e., Remove breeding place "The most impoant step in reducing number of mosquitoes is to eliminate their breeding places" Park	A
medmcqa	medmcqa_32	Leisch nyhan syndrome due to?	[ "HGP ase deficieny (complete)", "HGP ase deficiency (paial)", "Hexosaminidase deficiency (complete)", "Hexosaminidase deficiency (paial)" ]	Ans. is 'a' i.e., HGPase deficiency (complete)	A
medmcqa	medmcqa_33	Brugada syndrome is characterized by	[ "ST elevation", "Prolonged PR interval", "Prolonged QT interval", "Tall T waves" ]	Brugada syndrome is a rare syndrome characterized by >0.2 mV of ST-segment elevation with a coved ST segment and negative T wave in more than one anterior precordial lead (V1-V3) and episodes of syncope or cardiac arrest due to polymorphic VT in the absence of structural hea disease.Harrison 19e pg: 1497	A
medmcqa	medmcqa_34	HEV and HDV false is -	[ "Both can infect simultaneously", "HDV causes more serious infecton d/t superinfection", "HDV cannot infect in absence of HBV", "DNA viruses" ]	null	D
medmcqa	medmcqa_35	Green stick fracture is seen in?	[ "Children", "Older persons", "Immunocompromised persons", "Females" ]	(A) Children # Partial or Greenstick fracture. Bones in young people are very flexible. They bend and then may buckle or partially break, instead of breaking cleanly when overloaded (as bones in adults do). One characteristic of a greenstick fracture is that there may be a discontinuity in one cortex of the bone, but not in the other.	A
medmcqa	medmcqa_36	Risk factor for preeclampsia includes all except :	[ "Antiphospholipid syndrome", "Obesity", "Previous h/o preeclampsia", "Multigravida" ]	Risk factors for pre-eclampsia : Primigravida (young and elderly) Family history Placental abnormalities Obesity Thrombophilias Ref: Dutta Obs 9e pg 208.	D
medmcqa	medmcqa_37	Which of the following organelle is associated with production and destruction of H2O2 ?	[ "Peroxisomes", "Lysosomes", "Ribosomes", "Golgi bodies" ]	Oxidases use O2 to oxidize organic substances and produce hydrogen peroxide (H2O2). Breakdown of hydrogen peroxide (H2O2), a potentially dangerous product of fatty-acid oxidation. It is catalyzed by the enzyme catalase. Both enzymes are present in peroxisomes. Though Lysosomes produce H2O2 it can't degrade it.	A
medmcqa	medmcqa_38	12-year-old girl with sexual abuse presented with bleeding from genitals and fracture pelvis. Appropriate sequence of management is: AIIMS 14	[ "Internal iliac aery ligation, blood transfusion, inform police, medico-legal repo", "Blood transfusion, internal iliac aery ligation, inform police, medico-legal repo", "Blood transfusion, medico-legal repo, internal iliac aery ligation, inform police", "Inform police, medico-legal repo, blood transfusion, internal iliac aery ligation" ]	Ans. Blood transfusion, medico-legal repo, internal iliac aery ligation, inform police	C
medmcqa	medmcqa_39	All the following are true in a Randomized control trial (RCT) except:	[ "Baseline characteristics of intervention are similar in both arms", "Investigator's bias is minimized by double blinding", "The sample size required depends on the hypothesis", "The dropouts from the trial should be excluded from the analysis" ]	Intention to treat trial (ITT): Implies that the results of a RCT are unaffected by attrition (loss to follow up) or droupouts or changeover of study subjects from one group to another. The dropouts from the trial are not excluded from the analysis It provides information about the potential effects of treatment policy rather than on the potential effects of specific treatment	D
medmcqa	medmcqa_40	Turcot's syndrome is associated with -a) Duodenal polypsb) Familial adenomatous polyposisc) Brain tumorsd) Villous adenomae) Hyperplastic polyps	[ "a", "c", "bc", "ad" ]	Turcot's syndrome is a variant of Familial adenomatous polyposis characterized by - Colorectal polyposis - Brain tumors (Medulloblastoma, Glioblastoma multiforme) The colonic polyps in Turcot's syndrome are fewer and larger than in classic FAP.	C
medmcqa	medmcqa_41	Oncocytes are seen in all of the following except-	[ "Pitutary", "Thyroid", "Pancreas", "Thymus" ]	Ans. is 'd' i.e., ThymusOncocytes are cells with marked cytoplasmic eosinophilia and granularity.There is a great increase in the number of mitochondria which is typical of oncocytes morphology.Oncocytes are present in the acini and ducts of normal salivary gland.o They are also present in some benign tumors of salivary glands, thyroid, parathyroid, kidney, lung and pituitary - Ackerman. o It is also seen in oncocytic carcinoma. - Ackerman	D
medmcqa	medmcqa_42	Lysosomal Storage disorders are associated with	[ "Non-disease-specific physical findings", "Loss of function", "Enzyme assays not useful", "Genetic testing is helpless" ]	(B) Loss of function # Lysosomal storage disorders (LSDs) are inherited diseases characterized by lysosomal storage and dysfunction.> Loss of lysosomal function is associated with severe neurodegeneration, which is the prominent pathological hallmark of LSDs.> Physical findings are disease-specific, and enzyme assays or genetic testing can be used to make a definitive diagnosis.	B
medmcqa	medmcqa_43	The tensile strength of the wound stas and increases after ?	[ "Immediately after suturing", "3 to 4 weeks", "10-12weeks", "after 6 months" ]	Wounds do not begin to gain tensile strength from collagen immediately after the suturing . Wound stas achieving tensile strength around 20 % by 3 weeks, and increases by around 80 % by 12 weeks. The maximum scar strength is 80% of that of unwounded skin. Scar tissue continues to remodel for at least 6 - 12 months after an injury. Ref: Surgery of Bailey and love,26th edition.	B
medmcqa	medmcqa_44	Which is the only nerve which exits the brainstem on dorsal side ?	[ "Facial", "Trigeminal", "Trochlear", "Abducent" ]	Unique features of trochlear nerve are :?i) Most selender cranial nerve.ii) Only cranial nerve to emerge on the dorsal aspect of brain.iii) Only cranial nerve to undergo complete internal decussation before emerging i.e. right trochlear nerve arises from left trochlear nucleus and vice versa.iv) Has'longest intracranial course (Vagus nerve has overall longest course).v) Thinnest cranial nerve (smallest nerve in terms of the number of axons it contains).	C
medmcqa	medmcqa_45	All of the following statements are true about Benedikt's syndrome except	[ "Contralateral tremor", "3rd nerve palsy", "Involvement of the penetrating branch of the basila aery", "Lesion at the level of the pons" ]	. *Benedikt's syndrome involve injury to red nucleus results in ipsilateral oculomotor palsy and contralateral tremor,chorea and athetosis. Benedikt's Syndrome describes an ipsilateral III nerve palsy accompanied by contralateral 'cerebellar' tremor - a slow rhythmic tremor of the contralateral hand and foot, increased by excitement and voluntary movement, absent in sleep Ref Harrison20th edition pg 2456	D
medmcqa	medmcqa_46	Following are the features of cretinism, except	[ "Pot — belly", "Idiotic look", "Normal intelligence", "Stunted growth" ]	null	C
medmcqa	medmcqa_47	Typhus, spotted fever, and scrub typhus share which of the following manifestations of disease?	[ "Short incubation period (<48 h)", "Fever, rash, and rickettsemia", "Common vector", "Similar geographic distribution" ]	Typhus, spotted fever, and scrub typhus are all caused by rickettsiae (R. prowazekii, R. rickettsii, and R. tsutsugamushi, respectively). Clinically, the diseases have several similarities. Each has an incubation period of 1 to 2 weeks followed by a febrile period, which usually includes a rash. During the febrile period, rickettsiae can be found in the patient's blood and there is disseminated focal vasculitis of small blood vessels. The geographic area associated with these diseases is usually different. Scrub typhus is usually found in Japan, Southeast Asia, and the Pacific, while spotted fever is usually found in the Western hemisphere. Typhus has a worldwide incidence.	B
medmcqa	medmcqa_48	Obstructive azoospermia is characterized by?	[ "FSH & LH levels normal", "Increased FSH and Low LH", "Increased LH and Low FSH", "Both, FSH and LH low" ]	Ans. A. FSH and LH levels are normalA normal testicular biopsy in an azoospermic man with a normal FSH level suggests obstruction of the vas.Obstruction (Obstructive Azoospermia)Approximately 6% of men have blockages in the genital tract that prevent the passage of sperm between the testes to the penis and result in absence of sperm in the semen.There are three major groups of causes of male genital tract blockages:a. Disorders of development of the epididymis, vas and seminal vesicles,b. Scarring from inflammation (especially Gonorrhoea) andc. Vasectomy.The function of the testes is dependent upon hormones from the pituitary gland, follicle stimulating hormone (FSH) and luteinizing hormone (LH). The blood levels of these hormones rise during the early stages of puberty and stimulate testicular development. LH controls production of the male sex hormone testosterone which in turn is responsible for the growth that occurs at puberty: development of the genitals, beard and body hair, prostate and seminal vesicles, and also development of bone and muscle and other aspects of masculine physique. If LH and FSH are deficient, the tests do not develop or function properly. In contrast, if the testes are damaged directly, the levels of these hormones in the blood rise.	A
medmcqa	medmcqa_49	Features of carotid-cavernous fistula include	[ "Dilated superior ophthalmic vein on CT scan", "Blood in the Schlemm's canal", "Proptosis of contralateral eye suggests bilateral carotid-cavernous fistula", "Traumatic fistula rarely close spontaneously" ]	* With anterior drainage through orbit carotid cavernous fistula produce proptosis, diplopia, glaucoma and corkscrew, aerialized conjunctival vessels carotid-cavernous fistula results from an abnormal communication between the aerial and venous systems within the cavernous sinus in the skull. It is a type of aeriovenous fistula Ref Harrison20th edition pg 2567	C
medmcqa	medmcqa_50	False regarding the foreign body of oropharynx is ?	[ "Impacted foreign bodies most often lodge in the soft tissue at the base of tongue", "Food paicles are the most common oropharyngeal foreign bodies in children", "Clinical hypopharyngeal foreign bodies are amenable to clinical examination", "Endoscopy and MDCT are used in the diagnosis" ]	Ans. is 'b' i.e., Food paicles are the most common oropharyngeal foreign bodies in children Oropharyngeal foreign bodies Most ingested foreign bodies do not impact in the oropharynx Sharp foreign bodies like fish and chicken bones most commonly impact in the soft tissues at the base of the tongue. Hypopharyngeal foreign bodies can be detected by good physical examination. Endoscopy and MDCT are used in the diagnosis of foreign bodies of cervical esophagus. Coins are the most common impacted oropharyngeal foreign bodies encountered in children followed by food paicles.	B
medmcqa	medmcqa_51	A 50 year old man known to have diabetes since many years presents with poor urinary stream, hesitancy, difficulty in micturition and failure to void completely. What is he most likely suffering from?	[ "BPH", "UTI", "Atonic bladder", "Autonomic neuropathy" ]	The above mentioned clinical features of poor urinary stream, hesitancy, difficulty in micturition and failure to void completely are consistent with both BPH and autonomic neuropathy. Since the the patient is diabetic, he would most likely be suffering from diabetic autonomic neuropathy. Ref: Harrison's Principles Of Internal Medicine, 16th Edition, Page 2165,2166; R Alagappan, Manual Of Practical Medicine, 3rd Edition, Page, 372, 373.	D
medmcqa	medmcqa_52	True about iron absorption are all, except ?	[ "Major site of absorption is duodenum", "Stored as Ferritin", "Absorbed in ferrous form", "Pancreatic secretions improves the absorption" ]	Ans. is 'd' i.e., Pancreatic secretions improves the absorption Iron absorption Iron is absorbed from upper small intestine mainly duodenum. In diet iron occurs in two forms, haeme iron and inorganic (non-haeme) iron. Haem iron is better absorbed than inorganic iron, but the major fraction of diet is inorganic iron. Inorganic iron is mostly in ferric form; needs to be reduced to ferrous form because iron is absorbed in ferrous form. After absorption ferrous form is once again oxidized to ferric form inside enterocytes. A fraction of absorbed iron is rapidly delivered to plasma transferrin. However, most of the iron is deposited in the enterocytes as ferritin, some to be transferred more slowly to plasma transferrin, and some to be lost when senescent mucosal cells (enterocytes) are sloughed into the intestine. Iron absorption is regulated according to the demand, e.g., when there is iron deficiency, absorption increases. This regulation is mediated by "iron metabolism regulatory hormone", i.e., hepcidin that inhibit iron absorption. When there is iron deficiency, concentration of hepacidin falls and there is increase iron absorption. Hepacidin also decreases release of iron from storage sites. Transpo and storage of iron Iron is transpoed is blood in combination with a glycoprotein transferrin. Iron is transpoed into cells through attachment of transferrin to specific membrane bound receptors. Iron is stored as ferritin (major storage form) or haemosiderin. Ferritin is a complex of iron and apoferritin (iron + apoferritin ferritin). Iron is mainly stored in reticulo-endothelial cells monocytes/macrophages of liver, spleen, bonemarrow. It is also stored in hepatocytes (parenchymal cells of liver) and myocytes of skeletal muscles. Note : Iron is stored in ferritin in ferric form.	D
medmcqa	medmcqa_53	If the 3rd supralabial scales are large and touching the eye and nasal shield, the snake may be	[ "Krait", "Pit viper", "Saw scaled viper", "Cobra" ]	If the head scales are large, it may be poisonous or non poisonous. Look for the 3rd supra labial and if it is touching the eye and the nasal shield, it is poisonous (cobra or coral snake) Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 511	D
medmcqa	medmcqa_54	Concurrent list includes	[ "Census collection", "International health relations", "Vital statistics", "Immigration" ]	Ans. is 'c' i.e., Vital statistics	C
medmcqa	medmcqa_55	Ten readings of BP taken before and after treatment is studied by-	[ "Paired 't' test", "'Z' test", "Students 't' test", "Correlation test" ]	Ref:Parks 23rd edition pg 852 Here a Quantitative measurement is taken. But there is only a single group( before and after intervention.) so., paired T test is used . Tests of significance: Qualitative: Chi- square : 2 or more than 2 groups Mc Nemar test : 1 group. ( before and after intervention) Quantitative: Paired T test: 1 group Student T test/ unpaired T test: 2 groups Anova: more than 2 groups.	A
medmcqa	medmcqa_56	Number of ATPs formed per cycle of TCA -	[ "10", "24", "8", "30" ]	Ans. is 'a' i.e., 10o Every turn of TCA cycle produces -i) 10 A TPs - If starting meterial is considered acetyl CoAii) 12 5 ATPs - It starting material is considered pyruvate.Energetics of TCA cycleso One turn of the TCA cycle, starting with acetyl CoA produces 10 ATPs. When the starting molecule is pyruvate, the oxidative decarboxylation of pyruvate, the oxidative decarboxylation of pyruvate yields 2.5 ATPs and therefore, 12.5 ATPs are produced when starting compound is pyruvate. Since, two molecules of pyruvate enter the TCA cycle when glucose is metabolized (glycolysis produces 2 molecules of pyruvate), the number of ATPs is doubled. Therefore, 25 ATP molecules, per glucose molecule, are produced when pyruvate enters the TCA cycleo Note: Previously calculations were made assuming that NADH produces 3 ATPs and FADH generates 2 ATPs. This will amount a net generation of 30 ATP molecules in TCA per molecule glucose and total 38 molecules from starting. Recent experiments show that these values are overestimates and NADH produces 2.5 ATPs and FADH produces 1.5 ATPs. Therefore, net generation during TCA is 25 ATPs and complete oxidation of glucose through glycolysis plus citric acid cycle yield a net 32 ATPs.o Energy yield (number of ATP generated) per molecule of glucose when it is completely oxidized through glycolysis plus citric acid cycle, under aerobic conditions, is as followsPathwayStep EnzymeSourceMethod of ATP formationNo of ATPs gained perglucose (new calculation)No of ATPs As per old calculationGlycolysis1 Hexokinase_ Minus 1Minus1Do3 Phosphofructokinase- Minus 1Minus1Do5 Glyceraldehyde-3-p DHNADHRespiratory chain2.5x2 =53x2=6Do6 1,3-BPG kinaseATPSubstrate level1x2 =21x2=2Do9 Pyruvate kinaseATPSubstrate level1 x 2 =21x2=2Pyruvate to Acetyl CoAPyruvateDehydrogenaseNADHRespiratory chain2.5 x 2 =53x2=6TCA cycle3 Isocitrate DHNADHRespiratory chain2.5 x 2 =53x2=6Do4 Alpha keto glutarate DHNADHRespiratory chain2.5 x 2 =53x2=6Do5 Succinate thiokinaseGTPSubstrate level1x2 =21x2=2Do6 Succicinate DHFADH2Respiratory chain1.5 x 2 =32x2= 4Do8 Malate DHNADHRespiratory chain2.5 x 2 =53x2= 6Net generation in glycolytic pathway9 minus 2=7 10 minus 2 = 8Generation in pyruvate dehydrogenase reaction=5= 6Generation in citric acid cycle=20= 24Net generation of ATP from one glucose mole=32= 38	A
medmcqa	medmcqa_57	Orthodontic treatment in management of cleft lip and palate is usually carried out in:	[ "Deciduous dentition and mixed dentition", "Mixed dentition", "Mixed and permanent dentition", "Permanent dentition" ]	Many children with cleft lip and palate require orthodontic treatment. Orthodontic treatment is commonly carried out in two phases: Mixed dentition (8 - 10 years) – to expand the maxillary arches as a prelude to alveolar bone graft. Permanent dentition (14 -18 years) – to align the dentition and provide a normal functioning occlusion. This phase of treatment may also include surgical correction of a malpositioned/ retrusive maxilla by maxillary osteotomy.	C
medmcqa	medmcqa_58	Choristoma is -	[ "Normal tissue in abnormal site", "Normal tissue in excess at normal site", "Abnormal tissue at any site", "None of the above" ]	null	A
medmcqa	medmcqa_59	Perjury is :	[ "Willful utterance of falsehood", "An act comitted within cou premises", "Failure to sign summons", "Failure to appear as a witness" ]	A i.e. Willful utterance of falsehood	A
medmcqa	medmcqa_60	All are chest x-ray signs of pulmonary embolism except	[ "Westermark's sign", "Felson's sign", "Palla's sign", "Monod sign" ]	Monod sign - Aspergilloma.	D
medmcqa	medmcqa_61	Indium labelled WBC scan is used to locate:	[ "Occult malignancy", "Occult bleeding", "Abscess", "Aneurysm" ]	Inflammatory process and abscess which are difficult to locate with routine scanning can be diagnosed by Radionuclied scanning. They are, 1. Technitium 99 scan 2. Gallium 67 citrate scan 3. Indium 111 scan Ref: Harrison, Edition-18, Page-163.	C
medmcqa	medmcqa_62	Most common cause of anorectal abscess is -	[ "Inflammation of anal gland", "Folliculitis", "Inflammation of rectal mucosa", "Rectum" ]	null	A
medmcqa	medmcqa_63	Which of the following drug is commonly used for narco analysis	[ "Atropine sulfate", "Scopolamine hydrochloride", "Phenobarbitone", "Morphine" ]	Refer psychiatry and law 447 Controlled administration of intravenous hypnotics to obtain information from subject who are unable or unwilling to provide it otherwise, known as narcoanalysis or narcosynthesis Drugs used for narcoanalysis are: Ethanol Scopolamine Temazepam Barbiturates like thiopentone and amobarbitol These drugs are also known as truth drug or truth serum Phenobarbitine is not used ,rather amobarbitol is used for narcoanalysis	B
medmcqa	medmcqa_64	About skull of newborn, all of the following statements are TRUE, EXCEPT:	[ "Paranasal sinuses are absent", "Absent diploic spaces", "Middle ear ossicles are of same size as in adults", "Mastoid process is not completely formed" ]	All paranasal sinuses are present to varying degrees in newborn. Ethmoid sinuses are first to fully develop followed in order by maxillary, sphenoid and frontal sinuses. The auditory ossicles malleus, incus and stapes reach the adult size as early as sixth month of fetal life. The oval window and round window are the same size in the newborn infant as in the adult. The tympanic membrane completes its full growth by bih. Mastoid process is not completely formed by bih, so the facial nerve coming out of the stylomastoid foramen is not protected by the mastoid process. Hence it can be pressed by forceps in case of forceps delivery leading to temporary facial paralysis.	A
medmcqa	medmcqa_65	Which of the following conditions is associated with hypocalcemia?	[ "a) Medullary Ca thyroid", "b) Squamous Ca lung", "c) Tumor lysis syndrome", "Both 'a' and 'c'" ]	Medullary carcinoma of the thyroid (MTC) originates in the parafollicular C cells of the thyroid gland. These C cells produce calcitonin. It acts to reduce blood calcium (Ca2+), opposing the effects of parathyroid hormone (PTH). Tumor lysis syndrome refers to the constellation of metabolic disturbances that may be seen after initiation of cancer treatment. Tumor lysis syndrome is typically associated with acute leukemias and high-grade non-Hodgkin lymphomas, such as Burkitt lymphoma. Clinically, the syndrome is characterized by rapid development of hyperuricemia, hyperkalemia, hyperphosphatemia, hypocalcemia, and acute renal failure.	D
medmcqa	medmcqa_66	Which of the following agent of meningitis can grow on chocolate agar but not on blood agar?	[ "Neisseria meningitides", "Haemophilus influenzae", "Moraxella catarrhalis", "Escherichia coli" ]	H influenzae growns in the presence of factor X and V avaliable in blood. Factor V is intracellular hence not available easily. Also sheep blood contain NAdase thatdestroys factor V. In chocolate agar, blood is poured in molten agar which inactivates NADase and lyses RBCs releasing factor V.	B
medmcqa	medmcqa_67	Ponderal index for a malnourished child is ____________	[ "< 1", "< 2", "< 4", "< 6" ]	PI is calculated from measurements of body mass (M) and height (H). PI = the cube root of body weight divided by height, where body mass is in kilograms and height in meters. Be aware that there are variations of this formula which are also sometimes called the Ponderal Index. Ref.nelson 20th edition page 339 nutrition chapter	B
medmcqa	medmcqa_68	Object permanence milestone develop at?	[ "6 months", "9 months", "12 months", "15 months" ]	Ans. is 'b' i.e., 9 month	B
medmcqa	medmcqa_69	Drug for long term treatment of paial seizure is?	[ "Valproate", "Carbamazepine", "Eptoin", "Phenobarbitone" ]	Ans. is 'b' i.e., Carbamazepine Carbamazepine is effective drug for long term treatment of GTcs & paial seizure advantage being furious side effect. Does of CBZ is 10-30 mg/kg/day in 2-3 divided doses. Phenobarbitone : Used in GTCS type below 1 year of age Because of development of hyperkinesia & learing disabilities after 1st year of life should be avoided prolonge period. Eption : Maintain prolongs seizure effect Very cheap Used in GTCS & paial seizure. Valproate : Useful in GTCS, absence, myoclonic, paial and akinetic seizure.	B
medmcqa	medmcqa_70	Which of the following is a nonhereditary phakomatoses?	[ "Neurofibromatosis", "Sturge Weber syndrome", "Tuberous sclerosis", "Ataxia telangiectasia" ]	Ans BStruge Weber syndrome is the only acquired phakomatosis. Rest all major phakomatosis are inherited and most of them like NF1, NF2,Tuberous sclerosis are autosomal dominant while ataxia telengectasia is autosomal recessive.	B
medmcqa	medmcqa_71	A rickshaw tyre passed on a 8 year old child. Tyre marks were found on the body. This is an exmaple of :	[ "Percolated bruise", "Imprint abrasion", "Contusion", "Patterned bruise" ]	Imprint abrasion Real confusion in this question is between imprint abrasion and patterned bruising. In both imprint abrasion and patterned brusing there is mark or pattern of the object causing injury. Abrasion is caused by friction and/or pressure between the skin and some rough object or surface. For abrasions to occur some movement along with pressure is essential between the object or instrument or weapon and the skin. In abrasions superficial layers of skin are crushed and damaged. Bruises or contusions are caused by blunt trauma resulting in rupture of small blood vessels which lead to effusion of blood in subcutaneous or subepithelial tissues. However skin is intact in most cases until associated with abrasions. In an accident in which victim is overrun by vehicle, there will be movement and friction between the tyre and skin along with pressure by the tyre leading to imprint or patterned abrasion. There can be intradermal bruises also which are usually associated with patterned objects. So the tyre mark will be primarily an imprint or patterned abrasion (tyre has a pattern because of ridges and grooves) associated with bruises too. Also know? Abrasions are of following types Scratches - a linear injury produced by a sharp object, such as a pin, thorn, nail or tip of any sharp weapon. Graze - An injury which is produced when a broad surface of skin slides or scraps against a rough surface. These are the most common type. Commonly seen in road accidents. Violent lateral (tangential) rubbing against a rough surface can produce abrasion known as 'brush burn' or 'gravel rash'. 'Friction burn' can occur due to tangential contact with a smooth surface. 3. Patterned abrasions: In it pattern of the object causing injury is produced over the skin when the force is applied at right angle to the surface of the skin. Patterned abrasions are produced either by pressure of the object or by impact with a rough object. The .former is called pressure (crushing or friction) abrasion and the latter is known as impact (contact or imprint) abrasion. There can be associated bruising in the surrounding area. Examples are ligature mark, nail and Muir& mark, teeth bite marks, whip marks, radiator, grill or tyre marks in vehicular accidents and muzzle marks in gunshot injuries.	B
medmcqa	medmcqa_72	Which of the following parameters adds predictive information regarding cardiovascular risk stratification and the measurement of serum cholesterol?	[ "Anti-chlamydia pneumoniae antibodies", "C-reactive protein", "Homocysteine", "Plasminogen activator inhibitor 1" ]	Recent studies have demonstrated that markers of inflammation correlate with coronary risk and that inflammation plays a role in atheromatous plaque instability. Elevations of C-reactive protein, (CRP) identify patients at increased risk of myocardial infarction (MI) and poor outcome of acute coronary syndromes. Measurement of CRP adds information regarding risk stratification to standard risk factor such as hypeension, diabetes, smoking, and lipids. Elevations in homocysteine, lipoprotein A, and plasminogen activator factor I have all been associated with an increased risk at cardiovascular events; however, at the time none have been shown to be useful in populations to improve risk stratification.	B
medmcqa	medmcqa_73	All of the following are true about Broca's aphasia except:	[ "Lesion lies in frontal lobe", "Fluency is impaired", "Neologisms are absent", "Repetition is preserved" ]	Answer is D (Repetition is preserved): Repetition is impaired in both Broca's and Wernicke's aphasias. Aphasias are disorders of understanding, thought and word finding. Anomie aphasia : Remember : Most common language disturbance seen in - Head trauma = Anomie ApahsiaQ Most common language disturbance seen in - Metabolic encephalopathy = Anomie Apahsiae Most common language disturbance seen in - Alzheimer's disease = Anomie Apahsiae	D
medmcqa	medmcqa_74	Most common visually debilitating cataract in children:	[ "Blue dot cataract", "Zonular cataract", "Anterior polar cataract", "Posterior polar cataract" ]	Zonular cataract is most debilitating cataract in children. Types of congenital cataract Punctate: Blue Dot Cataract (Asymptomatic). Sutural cataract : Y suture opaque, nuclear cataract. Zonular cataract/Lamellar Most Common visually significant cataract (riders). Fusiform Nuclear Coronary Anterior polar Lamellar Cataract With Rider Blue dot cataract Anterior polar cataract Posterior polar cataract	B
medmcqa	medmcqa_75	Peripheral aerial disease can be treated by all, EXCEPT:	[ "Pentoxifylline", "Cilostazol", "Sildenafil", "Percutaneous angioplasty" ]	Pentoxifylline, a xanthine derivative, is thought to act by reducing the viscosity of blood, allowing it to flow more easily through paially obstructed areas. Cilostazol, a phosphodiesterase type 3 (PDE3) inhibitor, is poorly understood, but may have selective antiplatelet and vasodilating effects. Both drugs have been shown to increase exercise tolerance in patients with severe claudication. Percutaneous angioplasty with stenting is often effective in patients with medically intractable signs and symptoms of ischemia. Ref: Katzung, 11th edition, Chapter 12.	C
medmcqa	medmcqa_76	Alveoli are kept dry because of	[ "Surfactants", "Glycorprotiens", "Buffers Bohr's", "Effect" ]	Pulmonary surfactant is a mixture of lipids and proteins which is secreted into the alveolar space by epithelial type II cells. The main function of surfactant is to lower the surface tension at the air/liquid interface within the alveoli of the lung. Ref: guyton and hall textbook of medical physiology 12 edition page number: 317,318,319	A
medmcqa	medmcqa_77	Honeycomb histological appearance is seen in:	[ "Adenoid cystic carcinoma", "Primordial cyst", "Burkitt’s lymphoma", "Pernicious anemia" ]	Adenoid cystic carcinoma is composed of myoepithelial cells and ductal cells which have a varied arrangement. Morphologically, three growth patterns have been described: cribriform (classic), tubular, and solid (basaloid). The tumors are categorized according to the predominant pattern. The cribriform pattern shows basaloid epithelial cell nests that form multiple cylindrical cyst like patterns resembling a Swiss cheese or honeycomb pattern, which is the most classic and best recognized pattern. The lumina of these spaces contain periodic acid-Schiff (PAS) positive mucopolysaccharide secretion. The tubular pattern reveals tubular structures that are lined by stratified cuboidal epithelium. The solid pattern shows solid groups of cuboidal cells with little tendency towards duct or cyst formation. The cribriform pattern is the most common, whereas the solid pattern is the least common. Ref: Shafer's textbook of oral pathology 7th edition page 239	A
medmcqa	medmcqa_78	What is the type of Galactosemia cataract?	[ "Snowflake", "Oil drop", "Blue dot", "Polychromaticlustre" ]	Ans. is 'b' i.e., Oil drop DiseaseCataractMyotonic DystophyChristmas tree cataractWilson's disease, chalcosisSunflower cataractDM, Down's SyndromeSnowflake cataractAtopic dermatitisBlue dot cortical cataract, posterior subcapsular cataractCongenital rubellaNuclear cataractGalactosemiaOil drop cataractComplicated cataract (Iridocyclitis, High myopia)Posterior cortical breads's crumb appearance Polychromatic lusture / Rainbow cataractBlunt traumaVossius ring on anterior surface of lens Rosette shaped cataract	B
medmcqa	medmcqa_79	YAG laser is used in	[ "Retinal detachment", "diabetes", "Refractive errors", "After cataract" ]	Posterior capsular opacity/after cataract treated by ND-YAG capsulotomy A Yag capsulotomy is a special laser treatment used to improve your vision after cataract surgery. It is a simple, commonly performed procedure which is very safe. During your cataract operation, the natural lens inside your eye that had become cloudy was removed. Yag laser capsulotomy is the only way to treat this. Reference: khurana 6th edition pg 233	D
medmcqa	medmcqa_80	The thickness of thin rubber dam is:	[ "0.002 inch", "0.004 inch", "0.006 inch", "0.2 inch" ]	null	C
medmcqa	medmcqa_81	Gene therapy is used for	[ "All of the below", "Sickle cell anemia", "Thalassemia", "Cystic fibrosis" ]	Gene transfer is a novel area of therapeutics in which the active agent is a nucleic acid sequence rather than a protein or small molecule. Most gene transfers are carried out using a vector or gene delivery vehicle because delivery of naked DNA or RNA to a cell is an inefficient process. More clear-cut success has been achieved in a gene therapy trial for another form of SCID, adenosine deaminase (ADA) deficiency. Other diseases likely to be amenable to transduction of hemaopietic stem cells (HSCs) include • Wiskott-Aldrich syndrome • Chronic granulomatous disease • Sickle cell disease • Thalassemia. Clinical trials using recombinant adeno-associated vectors are now ongoing for muscular dystrophies, alpha-1 antitrypsin deficiency, lipoprotein lipase deficiency, hemophilia B, and a form of congenital blindness called Leber’s congenital amaurosis.	A
medmcqa	medmcqa_82	A 18-year-old female presented with severe headache of sudden onset. On CT scan, a diagnosis of subarachnoid hemorrhage is made. Most common cause is: Al 06; UP 10, 12	[ "Hypeension", "Berry aneurysm rupture", "Basilar aery rupture", "Subdural venous sinuses rupture" ]	Ans. Berry aneurysm rupture	B
medmcqa	medmcqa_83	Under normal circumstances, left ventricular shoening fraction (LVSF) is:	[ "20%", "40%", "60%", "75%" ]	Left ventricular shoening fraction (LVSF) is the percentage of shoening of LV fibers from their end-diastolic length (EDL). EDL and ESL are end-diastolic length and end-systolic length, respectively. Normal LVSF = 35%-40%. The value of LVSF decreases in LV failure.	B
medmcqa	medmcqa_84	Best predictor for coronary aery disease -	[ "HDL", "LDL", "VLDL", "Chylomicron" ]	LDL is the best indicater of the risk for CAD.high level of LDL is the indicater	B
medmcqa	medmcqa_85	A female, Lalita, aged 26 yrs accidentally takes 100 tablets of paracetamol. What is the treatment of choice -	[ "Lavage with charcoal", "Dialysis", "Alkaline diuresis", "Acetylcysteine" ]	Ans. is 'd' i.e Acetylcysteine "In cases of moderate to severe poisoning N acetylcysteine (Mucomyst) should be given orally. It is most effective when given within 16-24 hours of overdosage. It prevents hepatic damage". - Parikh	D
medmcqa	medmcqa_86	You are performing a breast examination in the surgery clinic. In addition to the breast tissue examination, what other region is critical to complete the palpation of mammary tissue?	[ "Supraclavicular region", "Subclavicular region", "Axillary region", "Interscapular region" ]	This is not an examination of lymph node. The tail of Spence is located in the axillary area and contains mammary tissue.The axillary tail of Spence extends laterally across the anterior axillary fold. The upper outer quadrant of the breast contains a greater volume of tissue than do the other quadrants. The breast has a protuberant conical form. The base of the cone is roughly circular, measuring 10 to 12 cm in diameter. Ref: Hunt K.K., Newman L.A., Copeland E.M., Bland K.I. (2010). Chapter 17. The Breast. In F.C. Brunicardi, D.K. Andersen, T.R. Billiar, D.L. Dunn, J.G. Hunter, J.B. Matthews, R.E. Pollock (Eds), Schwaz's Principles of Surgery, 9e.	C
medmcqa	medmcqa_87	Monthly repo to be submitted in RCH program to monitor efficiency include all except -	[ "Minimum 3 ANC visits", "Minimum 2 PNC vistas", "Number of LBW babies recorded", "Number of women taking treatment of anemia" ]	Ans. is 'b" i.e., Minimum 2 PNC visits	B
medmcqa	medmcqa_88	Causative agent of syphilis-	[ "Treponema pertunae", "Treponema endemicum", "Treponema corateum", "Treponema pallidum" ]	Ans. is 'd' i.e., Treponema pallidum SpirocheteSpeciesDiseaseTreponemaPallidumEndemic umPertunaeCarateumSyphilisBejelYawsPintaBorretiaBurgdorferiRecurrentisVincentiLyme diseaseRelapsing feverVincent anginaLeptospiraInterrogansWeil's disease	D
medmcqa	medmcqa_89	Post delivery uterus becomes pelvic organ by	[ "48hours", "1week", "2weeks", "6weeks" ]	Following delivery, the fundus lies about 13.5 cm (5 1/2") above the symphysis pubis. During the first 24 hours, the level remains constant; thereafter, there is a steady decrease in height by 1.25 cm (1/2") in 24 hours, so that by the end of the second week the uterus becomes a pelvic organ. The rate of involution thereafter slows down until by 6 weeks, the uterus becomes almost normal in sizeReference: DC Dutta&;s Textbook of Obstetrics; Chapter 13; Normal Puerperium	C
medmcqa	medmcqa_90	Hypokalemia is not present in :	[ "Vomiting", "Diarrhoea", "Patient on diuretics", "Chronic renal failure" ]	null	D
medmcqa	medmcqa_91	Apnoea in infants is –	[ ">10 sec", ">20 sec", ">30 sec", ">40 sec" ]	null	B
medmcqa	medmcqa_92	Mechanism of action of an oral contraceptive containing a combination of oestrogen-progestin is the following except-a) Inhibition of ovulationb) A change in the cervical mucusc) Inhibition of motility of the uterine tubesd) Inhibition of motility of spermse) Changes in the uterine endometrium	[ "ab", "cd", "bd", "ac" ]	null	B
medmcqa	medmcqa_93	Which of the following is most common among all psychiatric disorders?	[ "Depression", "Anxiety disorder", "OCD", "Delusional disorder" ]	Anxiety disorder are the most common among all psychiatric disorders and among the group of anxiety disorders, Phobias are the most common.	B
medmcqa	medmcqa_94	Moderate excercise tachypnea is due to stimulation of which receptor	[ "Proprioception", "J receptor", "Lung receptor", "Baro receptor" ]	Inspiratory neurons are stimulated by proprioception from joints and muscles.	A
medmcqa	medmcqa_95	Cerelas are deficient in?	[ "Alanine", "Lysine", "Methionine", "Cysteine" ]	Cereal proteins are poor in nutritive value being deficient in the essential amino acid,lysine.REF.PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE.Editon-21.Page no.-578	B
medmcqa	medmcqa_96	True about neoplastic colorectal polyps ?	[ "Sessile polyps > 1 cm is malignant", "MC site is colon and rectum", "Adenomatous polyp is premalignant", "All" ]	Ans. 'a' i.e. Sessile Polyp> 1 cm is malignant; 'b' i.e. MC site is colon and rectum; 'c' i.e. Adenomatous polyp is premalignant Polyps are much more common in the large intestine than in the small intestine and more common in the rectosigmoid colon than the proximal colon.	D
medmcqa	medmcqa_97	In aortic dissection, blood enters in -	[ "Intima", "Media", "Adventitia", "Any of the above layer" ]	Aortic dissection Aortic dissection is a catastrophic illness characterized by dissection of blood between and along the laminar planes of aortic media. Blood enters inside the arterial wall (in the media layer) and leads to the formation of blood-filled channels within the aortic wall, which often ruptures outward causing massive haemorrhage. The most frequent pre-existing histologically detectable lesion is cystic medial degeneration. In aortic dissection, there is an intimial tear through which the blood enters into the media. Usually, the tear is within 10 cms of the aortic valve. The dissecting hematoma spreads characteristically along the laminar planes of the aorta, usually between the middle and outer third. Some times, blood ruptures into the lumen distally, i.e. there is the second tear distally. So that a complete new vascular channel is formed inside the media of aortic wall. Blood enters from proximal tear into the media and comes out into the lumen from the distal tear. This is called double - barrel aorta with a false-channel in the media. Later on, this false channel becomes endothelized → chronic dissection. Classification of Aortic dissection The risk and nature of serious complications of dissection depend strongly on the level of aorta affected, with the most serious complications occurring from the aortic valve to the arch. Thus aortic dissections are generally classified into two types - 1. Proximal lesion (Type A) More common and more dangerous. Involve either the ascending portion only or both ascending and the descending portion of aorta. 2. Distal lesion (Type B) Involve only descending part distal to the subclavian artery.	B
medmcqa	medmcqa_98	1711. All are true regarding Anaemia of Chronic Diseases, except -	[ "Decreased serum Fe", "Decreased Ferritin", "Decreased Total Fe Binding Capacity", "Increased Bone Marrow Fe" ]	<p>Serum ferritin levels are increased in anemia of chronic disorder & is the most distinguishing feature between true iron deficiency anemia & iron deficient erythropoiesis in anemia of disease.</p><p>A defect in transfer of iron from macrophages to the developing erythroid cells in the marrow leads to reduced availability of iron for haem synthesis despite adequate iron stores, elevating serum ferritin levels.</p><p>Reference : Hardh mohan textbook of pathology sixth edition pg no 302.</p>	B
medmcqa	medmcqa_99	Prunning of pulmonary aeries is seen in -	[ "Pulmonary hypeension", "Chronic bronchitis", "Pulmonary infections", "Pulmonary transplant" ]	Pulmonary Aerial Hypeension is characterised by enlargement of main pulmonary trunk and Right and Left main pulmonary aeries with dispropoinately small peripheral blood vessels. This is referred to as prunning of pulmonary aeries.. * elevated cardiac apex due to right ventricular hyperophy * enlarged right atrium * prominent pulmonary outflow tract * enlarged pulmonary aeries * pruning of peripheral pulmonary vessels	A

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medmcqa_0

Failure to initiate and maintain spontaneous respiration following bih is clinically k/a -

[ "Bih asphyxia", "RDS-Respiratory distress syndrome", "Respiratory failure", "Pulmonary oedema" ]

Ans. is 'b' i.e., RDS-Respiratory distress syndrome

B

medmcqa

medmcqa_1

Coho study reveals all except:

[ "Incidence", "Attributable risk", "Relative risk", "Odds ratio" ]

Odds ratio

D

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medmcqa_2

Cause of death in diabetic ketoacidosis in children?

[ "Cerebral edema", "Hypokalemia", "Infection", "Acidosis" ]

Ans. is 'a' i.e., Cerebral edema o High blood sugar will cross the blood brain barrier and simultaneously will draw water inside leading to cerebral edema. Cerebral edema accounts for 60-90% of all DKA related deaths in children,o Infection is a precipitator for development of DKA.o Other precipitating factor can be tissue ischemia, inadequate insulin administration, drugs (cocaine) and pregnancy.

A

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medmcqa_3

Which is not a high pitched hea sound

[ "Mid systolic click", "Pericardial shudder", "Opening snap", "Tumor plop sound" ]

Ans. is 'd' i.e., Tumor plop sound Low pitch hea sounds are : S3 S4 Tumor plop sound Mid systolic clicks are Heard in mitral valve prolapse during systole and are high pitch sounds. The pericardial knock (PK) is Also high-pitched and occurs slightly later than the opening snap, corresponding in timing to the abrupt cessation of ventricular expansion after tricuspid valve opening and to an exaggerated y descent seen in the jugular venous waveform in patients with constrictive pericarditis. A tumor plop is A lower-pitched sound that can be heard in patients with atrial myxoma. It may be appreciated only in ceain positions and arises from the diastolic prolapse of the tumor across the mitral valve

D

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medmcqa_4

Patau syndrome feature include A/E –

[ "Cleft lip", "Hypotelorism", "Holoprosencephaly", "Rocker bottom foot" ]

Patau Syndrome Trisomy of 13th chromosome Cleft lip often midline Polydactyl with flexed fingers Ocular hypotelorism Bulbous nose Low set ear Holoprosencephaly Microphthalmia Cardiac malformation Scalp defect Hypoplastic or absent ribs Rocker bottom foot is seen in Edwards Syndrome (Trisomy 18)

D

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medmcqa_5

Which of the following procedures can be replaced by the use of occlusal sealants

[ "Topical fluoride application", "Prophylactic odontotomy", "Amalgam fillings", "All the above" ]

null

B

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medmcqa_6

The antianginal effect of propranolol may be attributed to which of the following ?

[ "Block of exercise induced tachycardia", "Dilation of constricted coronary vessels", "Increased cardiac force", "Increased resting heart rate" ]

null

A

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medmcqa_7

Which of the following Intrauterine device has a minimum failure rate

[ "Progestase", "Cu T-380 A", "Levonorgestrel IUD", "T Cu -200" ]

Mirena (Levonorgestrel IUD) has least failure rate among IUD's Contraceptive implants (Implanon) have the least failure rates among all contraceptive methods. Ref : Park 23rd edition Pgno : 496

C

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medmcqa_8

Highest concentration of potassium is seen in:

[ "Jejunum", "Ileum", "Duodenal", "Sigmoid colon" ]

Ans. (d) Sigmoid colonRef: Schwartz 10/e p69* Highest concentration of potassium seen in Colon (30mEq/L).* Highest absorption of potassium occurs in colon

D

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medmcqa_9

Most sensitive index of recent transmission of malaria in community:

[ "Spleen rate", "Infant parasite rate", "Annual parasite rate", "Slide positivity rate" ]

Ans. is 'b'Annual parasite index measures incidence, spleen rate measures endemicity, ABER-Annual blood examination rate (index of operational efficiency) and SPR (slide positivity rate) - forecasting malaria and defining any area to be high risk or low risk.

B

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medmcqa_10

Treatment of choice for angiofibroma:

[ "Surgery", "Radiotherapy", "Both", "Chemotherapy" ]

(a) Surgery (best option)(Ref. Cummings, 6th ed., 1422)Radiotherapy is indicated in angiofibroma only when the tumour has intracranial extension.

A

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medmcqa_11

Platelet aggregation is caused by -

[ "Nitrous oxide", "Thromboxone A2", "Aspirin", "PGI2" ]

Robbins basic pathology 9th edition page no 46, Answer is option 2, thromboxaneA2 Thromboxane A2 is a potent platelet aggregating agent and a vasoconstrictor, is the major prostaglandin produced in these cells. Itvis an intrmediate produced in the cyclooxygenase pathway by the enzyme thromboxane synthase.

B

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medmcqa_12

Investigation of choice for diagnosis of CA colon

[ "Colonoscopy", "Double contrast barium enema", "Triple phase CT", "Viual colonoscopy" ]

Colonoscopy is the "gold standard" for establishing the diagnosis of colon cancer. It permits biopsy of a tumour to verify the diagnosis while allowing inspection of the entire colon to exclude metachronous polyps or cancers; the incidence of a synchronous cancer is approximately 3%. Colonoscopy is generally performed even after a cancer is detected by barium enema to obtain a biopsy specimen and to detect (and remove) small polyps that may be missed by the contrast studyRef: Sabiston, 20e, page: 1398

A

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medmcqa_13

A forceps delivered premature baby develops fever, abnormal behavior, bulging fontanelle 5 days after bih. What is the likely causative organism?

[ "Neisseria meningitidis", "Listeria monocytogenes", "Staph aureus", "Pneumococcus" ]

Given scenario suggests diagnosis of Meningitis Neonatal Listeriosis 2 clinical presentations are recognized: EARLY ONSET (<5 DAYS ) LATE ONSET (>=5 DAYS) Positive result of maternal Listeria culture Obstetric complications Premature delivery Low bihweight Neonatal sepsis Negative result of maternal Listeria Culture Uncomplicated pregnancy Term delivery Normal bihweight Neonatal meningitis

B

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medmcqa_14

The vitelline vein forms the

[ "Hepatic vein", "Azygos vein", "Inferior mesenteric vein", "Splenic vein" ]

A i.e. Hepatic vein

A

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medmcqa_15

Most common complicationassociated with ‘Total Parenteral Nutrition’ is :

[ "Catheter related infection", "Hyperglycemia", "Pneumothorax", "Hyperkalemia" ]

Most common complication associated with TPN is Catheter related infection Total Parenteral Nutrition : For providing nutritional support All nutritional requirements given only through IV route TPN is given through central vein and not through a peripheral vein Can also use Peripherally Inserted Central Catheter (PICC) Preferred site for central vein infusion is the Superior vena cava Preferred access sites are Subclavian > Jugular > Femoral vein Total volume of PN should be 2000-300 ml/day

A

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medmcqa_16

All of the following are risk factors for deep vein thrombosis (DVT) except:

[ "Obesity", "Age less than 40 years", "Duration of surgery more than thiy minutes", "Use of the oestrogen-progesterone contraceptive pills" ]

Patients over the age of 40 years is a risk factor for DVT. High dose estrogen therapy is also associated with DVT. Ref: Bailey and Love's Sho Practice of Surgery, 24th Edition, Page 970.

B

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medmcqa_17

Multiple brain abscesses are characteristic of

[ "Cyanotic heart disease", "Otitis media", "Hematogenous", "Hemorrhage" ]

(C) Hematogenous # Metastatic abscesses are commonly located in the parietal, frontal, or temporal lobes, and multiple brain abscesses are usually the result of metastatic spread from remote primary foci, accounting for 6% to 22% of cases.> Most common cause of brain abscesses was haematogenous spread, accounting for 26% of the episodes.

C

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medmcqa_18

True about Henoch-schonlein pupura -

[ "Palpable pupura", "Thrombocytopenia", "C-ANCA positive", "All" ]

Ans. is 'a' i.e., Palpable pupura

A

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medmcqa_19

The connective tissue cells of pulp are derived from

[ "The pool of undifferentiated mesenchymal cells", "The pool of fibroblasts", "The pool of undifferentiated ectodermal cells", "The pool of osteoblasts" ]

null

A

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medmcqa_20

Which of the following has a normal level of alpha-fetoprotein value in serum?

[ "Ovarian dysgerminoma", "Hepatoblastoma", "Embroynal carcinoma", "Yolk sac tumours" ]

null

A

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medmcqa_21

Most specific test to detect blood stains is

[ "Benzidine test", "Teichmann's test", "Ohotoluidine test", "Spectroscopic test" ]

Spectroscopic test is the most specific for blood stains. Tests for blood stains Spectroscopy tests can give information about what chemical compounds and elements are present in a sample, whether ceain types of degradation have occurred in a sample, the amount and type of crystallinity present in the sample, to name a few uses. Ref ganong's review of medical physiology 25e

D

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medmcqa_22

Granular casts in urine are?

[ "Regarded as normal", "Hyaline casts embedded with RBC", "Made up of mucoprotein substances", "Formed in the DCT" ]

On microscopic examination of urine, presence of granular cast ,RBC ,bacteria glucose, albumin, ketone bodies is abnormal granular cast are the hyaline casts embedded with RBC or WBC or these are degenerate glomerular cells or tubular epithelial cells in large number Their presence indicates renal destruction of glomerular tubular cells. Ref: page no 575 Textbook of physiology Volume 1 AK Jain 7th edition

B

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medmcqa_23

Maryland bridge was first developed by:

[ "Thompson", "Dunn", "Tanaka", "Rochette" ]

Based on the work of Tanaka et al. on pitting corrosion for retaining acrylic resin facings and the metal etching studies of Dunn and Reisbick, Thompson and Livaditis at the University of Maryland developed a technique for the electrolytic etching of Ni-Cr and Cr-Co alloys.

A

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medmcqa_24

Clinical GOAl recommended by WHO for Prevention of CAD is

[ "Cholesterol / LDL ratio", "Cholesterol / HDL ratio", "Triglycerides / LDL ratio", "Triglycerides / HDL ratio" ]

null

B

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medmcqa_25

An infant is diagnosed with MEN-2B trait. Which the following will be best line of management?

[ "Prophylactic surgery", "Clinical observation and follow up", "Regular FNAC", "All of the above" ]

Prophylactic Thyroidectomy in RET Mutation Carriers MEN-2A Before 5 years MEN-2B Before 1 year

A

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medmcqa_26

Megaloblastic anemia is caused by:

[ "Diphyllobothriumlatum", "H-NaNa", "Taeniasaginata", "Echinococcusgranulosis" ]

Habitat: Adult worm lives in small intestine (ileum orjejunum) of man D. Latum is the longest tapeworm found in man. Life cycle: The worm passes its life cycle in one definitive host and Two intermediate host. Definitive host: Man is the main definitive host Intermediate host: First intermediate host: Small copepods mainly of genraDiaptomus and Cyclops Second intermediate host: Freshwater Fishes. Humans become infected when they eat undercooked raw or lightly salted meat or roe from infected freshwater fishes. Pathogenicity: Most human infections arc caused by only one tape worm and cause no or very vague ill effects. Patient may develop fatigue, weakness, diarrhea and numbness of extremities. Some Patient develops mechanical obstruction. In few cases pernicious anemia may develop due to B12 deficiency. D. Latum has been shown to absorb as much as 80-100% of a single oral dose of vit- B12 thereby competing with the host for this important vitamin. Treatment of choice: Niclosamide and praziquantel Important: Vit B12 Absorb in the ILEUM. Iron is absorbed in the Duodenum.

A

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medmcqa_27

A child had hematuria and nephrotic syndrome (minimal change disease) was diagnosed. True about it is -

[ "A type of focal segmental GN", "IgA deposition on basement membrane", "Foot process of glomerular membrane normal", "Glomerular function is lost due to loss of poly charge on both sites of glomerular foot process." ]

null

D

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medmcqa_28

A cancer patient who is on cisplatin therapy develops severe vomiting on the 1st day of treatment, drug indicated to treat this is:

[ "Aprepitant.", "Ondansetron", "Fosaprepitant.", "All of the above." ]

Cisplatin induced vomiting has two phases. EarlyPhase: It occurs within first 24 hours. 5 HT3 antagonists like ondansetron are the agents of choice for this condition. Delayed Phase: Vomiting occurring after 24 hours is less responsive to ondansetron and other drugs. It is best controlled by substance P antagonist like aprepitant

B

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medmcqa_29

Nephrocalcinosis is seen in -

[ "Hypoparathyroidism", "Medullary sponge kidney", "DM", "All" ]

Ans. is 'b' i.e., Medullary sponge kidneyo Deposition of calcium stones on renal papillae is called nephrocalcinosis.o Nephrocalcinosis seen in -Renal tubular acidosis type I (A). Bater's syndrome Excess calcium intake Medullary sponge kidney Multiple myeloma Sarcoidosis Severe hypercalciuria Vitamin-D intoxication TB kidney (Love & Bailey) Hyperparathyroidism Metastatic bone disease

B

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medmcqa_30

A 46-year-old patient comes to doctor's OPD with complains of chest pain and headache. His computed tomography (CT) scan reveals a tumor located just superior to the root of the right lung. Blood flow in which of the following veins is most likely blocked by this tumor?

[ "Hemiazygos vein", "Arch of the azygos vein", "Right subclan vein", "Right brachiocephalic vein" ]

The azygos vein arches over the root of the right lung and empties into the SVC. Other veins do not pass over the root of the right lung.

B

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medmcqa_31

High environmental temperature, best step for malaria control?

[ "Remove breeding place", "Full sleeve cloth", "Indoor insecticide", "Early treatment" ]

Ans. is 'a' i.e., Remove breeding place "The most impoant step in reducing number of mosquitoes is to eliminate their breeding places" Park

A

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medmcqa_32

Leisch nyhan syndrome due to?

[ "HGP ase deficieny (complete)", "HGP ase deficiency (paial)", "Hexosaminidase deficiency (complete)", "Hexosaminidase deficiency (paial)" ]

Ans. is 'a' i.e., HGPase deficiency (complete)

A

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medmcqa_33

Brugada syndrome is characterized by

[ "ST elevation", "Prolonged PR interval", "Prolonged QT interval", "Tall T waves" ]

Brugada syndrome is a rare syndrome characterized by >0.2 mV of ST-segment elevation with a coved ST segment and negative T wave in more than one anterior precordial lead (V1-V3) and episodes of syncope or cardiac arrest due to polymorphic VT in the absence of structural hea disease.Harrison 19e pg: 1497

A

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medmcqa_34

HEV and HDV false is -

[ "Both can infect simultaneously", "HDV causes more serious infecton d/t superinfection", "HDV cannot infect in absence of HBV", "DNA viruses" ]

null

D

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medmcqa_35

Green stick fracture is seen in?

[ "Children", "Older persons", "Immunocompromised persons", "Females" ]

(A) Children # Partial or Greenstick fracture. Bones in young people are very flexible. They bend and then may buckle or partially break, instead of breaking cleanly when overloaded (as bones in adults do). One characteristic of a greenstick fracture is that there may be a discontinuity in one cortex of the bone, but not in the other.

A

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medmcqa_36

Risk factor for preeclampsia includes all except :

[ "Antiphospholipid syndrome", "Obesity", "Previous h/o preeclampsia", "Multigravida" ]

Risk factors for pre-eclampsia : Primigravida (young and elderly) Family history Placental abnormalities Obesity Thrombophilias Ref: Dutta Obs 9e pg 208.

D

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medmcqa_37

Which of the following organelle is associated with production and destruction of H2O2 ?

[ "Peroxisomes", "Lysosomes", "Ribosomes", "Golgi bodies" ]

Oxidases use O2 to oxidize organic substances and produce hydrogen peroxide (H2O2). Breakdown of hydrogen peroxide (H2O2), a potentially dangerous product of fatty-acid oxidation. It is catalyzed by the enzyme catalase. Both enzymes are present in peroxisomes. Though Lysosomes produce H2O2 it can't degrade it.

A

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medmcqa_38

12-year-old girl with sexual abuse presented with bleeding from genitals and fracture pelvis. Appropriate sequence of management is: AIIMS 14

[ "Internal iliac aery ligation, blood transfusion, inform police, medico-legal repo", "Blood transfusion, internal iliac aery ligation, inform police, medico-legal repo", "Blood transfusion, medico-legal repo, internal iliac aery ligation, inform police", "Inform police, medico-legal repo, blood transfusion, internal iliac aery ligation" ]

Ans. Blood transfusion, medico-legal repo, internal iliac aery ligation, inform police

C

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medmcqa_39

All the following are true in a Randomized control trial (RCT) except:

[ "Baseline characteristics of intervention are similar in both arms", "Investigator's bias is minimized by double blinding", "The sample size required depends on the hypothesis", "The dropouts from the trial should be excluded from the analysis" ]

Intention to treat trial (ITT): Implies that the results of a RCT are unaffected by attrition (loss to follow up) or droupouts or changeover of study subjects from one group to another. The dropouts from the trial are not excluded from the analysis It provides information about the potential effects of treatment policy rather than on the potential effects of specific treatment

D

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medmcqa_40

Turcot's syndrome is associated with -a) Duodenal polypsb) Familial adenomatous polyposisc) Brain tumorsd) Villous adenomae) Hyperplastic polyps

[ "a", "c", "bc", "ad" ]

Turcot's syndrome is a variant of Familial adenomatous polyposis characterized by - Colorectal polyposis - Brain tumors (Medulloblastoma, Glioblastoma multiforme) The colonic polyps in Turcot's syndrome are fewer and larger than in classic FAP.

C

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medmcqa_41

Oncocytes are seen in all of the following except-

[ "Pitutary", "Thyroid", "Pancreas", "Thymus" ]

Ans. is 'd' i.e., ThymusOncocytes are cells with marked cytoplasmic eosinophilia and granularity.There is a great increase in the number of mitochondria which is typical of oncocytes morphology.Oncocytes are present in the acini and ducts of normal salivary gland.o They are also present in some benign tumors of salivary glands, thyroid, parathyroid, kidney, lung and pituitary - Ackerman. o It is also seen in oncocytic carcinoma. - Ackerman

D

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medmcqa_42

Lysosomal Storage disorders are associated with

[ "Non-disease-specific physical findings", "Loss of function", "Enzyme assays not useful", "Genetic testing is helpless" ]

(B) Loss of function # Lysosomal storage disorders (LSDs) are inherited diseases characterized by lysosomal storage and dysfunction.> Loss of lysosomal function is associated with severe neurodegeneration, which is the prominent pathological hallmark of LSDs.> Physical findings are disease-specific, and enzyme assays or genetic testing can be used to make a definitive diagnosis.

B

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medmcqa_43

The tensile strength of the wound stas and increases after ?

[ "Immediately after suturing", "3 to 4 weeks", "10-12weeks", "after 6 months" ]

Wounds do not begin to gain tensile strength from collagen immediately after the suturing . Wound stas achieving tensile strength around 20 % by 3 weeks, and increases by around 80 % by 12 weeks. The maximum scar strength is 80% of that of unwounded skin. Scar tissue continues to remodel for at least 6 - 12 months after an injury. Ref: Surgery of Bailey and love,26th edition.

B

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medmcqa_44

Which is the only nerve which exits the brainstem on dorsal side ?

[ "Facial", "Trigeminal", "Trochlear", "Abducent" ]

Unique features of trochlear nerve are :?i) Most selender cranial nerve.ii) Only cranial nerve to emerge on the dorsal aspect of brain.iii) Only cranial nerve to undergo complete internal decussation before emerging i.e. right trochlear nerve arises from left trochlear nucleus and vice versa.iv) Has'longest intracranial course (Vagus nerve has overall longest course).v) Thinnest cranial nerve (smallest nerve in terms of the number of axons it contains).

C

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medmcqa_45

All of the following statements are true about Benedikt's syndrome except

[ "Contralateral tremor", "3rd nerve palsy", "Involvement of the penetrating branch of the basila aery", "Lesion at the level of the pons" ]

. *Benedikt's syndrome involve injury to red nucleus results in ipsilateral oculomotor palsy and contralateral tremor,chorea and athetosis. Benedikt's Syndrome describes an ipsilateral III nerve palsy accompanied by contralateral 'cerebellar' tremor - a slow rhythmic tremor of the contralateral hand and foot, increased by excitement and voluntary movement, absent in sleep Ref Harrison20th edition pg 2456

D

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medmcqa_46

Following are the features of cretinism, except

[ "Pot — belly", "Idiotic look", "Normal intelligence", "Stunted growth" ]

null

C

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medmcqa_47

Typhus, spotted fever, and scrub typhus share which of the following manifestations of disease?

[ "Short incubation period (<48 h)", "Fever, rash, and rickettsemia", "Common vector", "Similar geographic distribution" ]

Typhus, spotted fever, and scrub typhus are all caused by rickettsiae (R. prowazekii, R. rickettsii, and R. tsutsugamushi, respectively). Clinically, the diseases have several similarities. Each has an incubation period of 1 to 2 weeks followed by a febrile period, which usually includes a rash. During the febrile period, rickettsiae can be found in the patient's blood and there is disseminated focal vasculitis of small blood vessels. The geographic area associated with these diseases is usually different. Scrub typhus is usually found in Japan, Southeast Asia, and the Pacific, while spotted fever is usually found in the Western hemisphere. Typhus has a worldwide incidence.

B

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medmcqa_48

Obstructive azoospermia is characterized by?

[ "FSH & LH levels normal", "Increased FSH and Low LH", "Increased LH and Low FSH", "Both, FSH and LH low" ]

Ans. A. FSH and LH levels are normalA normal testicular biopsy in an azoospermic man with a normal FSH level suggests obstruction of the vas.Obstruction (Obstructive Azoospermia)Approximately 6% of men have blockages in the genital tract that prevent the passage of sperm between the testes to the penis and result in absence of sperm in the semen.There are three major groups of causes of male genital tract blockages:a. Disorders of development of the epididymis, vas and seminal vesicles,b. Scarring from inflammation (especially Gonorrhoea) andc. Vasectomy.The function of the testes is dependent upon hormones from the pituitary gland, follicle stimulating hormone (FSH) and luteinizing hormone (LH). The blood levels of these hormones rise during the early stages of puberty and stimulate testicular development. LH controls production of the male sex hormone testosterone which in turn is responsible for the growth that occurs at puberty: development of the genitals, beard and body hair, prostate and seminal vesicles, and also development of bone and muscle and other aspects of masculine physique. If LH and FSH are deficient, the tests do not develop or function properly. In contrast, if the testes are damaged directly, the levels of these hormones in the blood rise.

A

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medmcqa_49

Features of carotid-cavernous fistula include

[ "Dilated superior ophthalmic vein on CT scan", "Blood in the Schlemm's canal", "Proptosis of contralateral eye suggests bilateral carotid-cavernous fistula", "Traumatic fistula rarely close spontaneously" ]

* With anterior drainage through orbit carotid cavernous fistula produce proptosis, diplopia, glaucoma and corkscrew, aerialized conjunctival vessels carotid-cavernous fistula results from an abnormal communication between the aerial and venous systems within the cavernous sinus in the skull. It is a type of aeriovenous fistula Ref Harrison20th edition pg 2567

C

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medmcqa_50

False regarding the foreign body of oropharynx is ?

[ "Impacted foreign bodies most often lodge in the soft tissue at the base of tongue", "Food paicles are the most common oropharyngeal foreign bodies in children", "Clinical hypopharyngeal foreign bodies are amenable to clinical examination", "Endoscopy and MDCT are used in the diagnosis" ]

Ans. is 'b' i.e., Food paicles are the most common oropharyngeal foreign bodies in children Oropharyngeal foreign bodies Most ingested foreign bodies do not impact in the oropharynx Sharp foreign bodies like fish and chicken bones most commonly impact in the soft tissues at the base of the tongue. Hypopharyngeal foreign bodies can be detected by good physical examination. Endoscopy and MDCT are used in the diagnosis of foreign bodies of cervical esophagus. Coins are the most common impacted oropharyngeal foreign bodies encountered in children followed by food paicles.

B

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medmcqa_51

A 50 year old man known to have diabetes since many years presents with poor urinary stream, hesitancy, difficulty in micturition and failure to void completely. What is he most likely suffering from?

[ "BPH", "UTI", "Atonic bladder", "Autonomic neuropathy" ]

The above mentioned clinical features of poor urinary stream, hesitancy, difficulty in micturition and failure to void completely are consistent with both BPH and autonomic neuropathy. Since the the patient is diabetic, he would most likely be suffering from diabetic autonomic neuropathy. Ref: Harrison's Principles Of Internal Medicine, 16th Edition, Page 2165,2166; R Alagappan, Manual Of Practical Medicine, 3rd Edition, Page, 372, 373.

D

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medmcqa_52

True about iron absorption are all, except ?

[ "Major site of absorption is duodenum", "Stored as Ferritin", "Absorbed in ferrous form", "Pancreatic secretions improves the absorption" ]

Ans. is 'd' i.e., Pancreatic secretions improves the absorption Iron absorption Iron is absorbed from upper small intestine mainly duodenum. In diet iron occurs in two forms, haeme iron and inorganic (non-haeme) iron. Haem iron is better absorbed than inorganic iron, but the major fraction of diet is inorganic iron. Inorganic iron is mostly in ferric form; needs to be reduced to ferrous form because iron is absorbed in ferrous form. After absorption ferrous form is once again oxidized to ferric form inside enterocytes. A fraction of absorbed iron is rapidly delivered to plasma transferrin. However, most of the iron is deposited in the enterocytes as ferritin, some to be transferred more slowly to plasma transferrin, and some to be lost when senescent mucosal cells (enterocytes) are sloughed into the intestine. Iron absorption is regulated according to the demand, e.g., when there is iron deficiency, absorption increases. This regulation is mediated by "iron metabolism regulatory hormone", i.e., hepcidin that inhibit iron absorption. When there is iron deficiency, concentration of hepacidin falls and there is increase iron absorption. Hepacidin also decreases release of iron from storage sites. Transpo and storage of iron Iron is transpoed is blood in combination with a glycoprotein transferrin. Iron is transpoed into cells through attachment of transferrin to specific membrane bound receptors. Iron is stored as ferritin (major storage form) or haemosiderin. Ferritin is a complex of iron and apoferritin (iron + apoferritin ferritin). Iron is mainly stored in reticulo-endothelial cells monocytes/macrophages of liver, spleen, bonemarrow. It is also stored in hepatocytes (parenchymal cells of liver) and myocytes of skeletal muscles. Note : Iron is stored in ferritin in ferric form.

D

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medmcqa_53

If the 3rd supralabial scales are large and touching the eye and nasal shield, the snake may be

[ "Krait", "Pit viper", "Saw scaled viper", "Cobra" ]

If the head scales are large, it may be poisonous or non poisonous. Look for the 3rd supra labial and if it is touching the eye and the nasal shield, it is poisonous (cobra or coral snake) Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 511

D

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medmcqa_54

Concurrent list includes

[ "Census collection", "International health relations", "Vital statistics", "Immigration" ]

Ans. is 'c' i.e., Vital statistics

C

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medmcqa_55

Ten readings of BP taken before and after treatment is studied by-

[ "Paired 't' test", "'Z' test", "Students 't' test", "Correlation test" ]

Ref:Parks 23rd edition pg 852 Here a Quantitative measurement is taken. But there is only a single group( before and after intervention.) so., paired T test is used . Tests of significance: Qualitative: Chi- square : 2 or more than 2 groups Mc Nemar test : 1 group. ( before and after intervention) Quantitative: Paired T test: 1 group Student T test/ unpaired T test: 2 groups Anova: more than 2 groups.

A

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medmcqa_56

Number of ATPs formed per cycle of TCA -

[ "10", "24", "8", "30" ]

Ans. is 'a' i.e., 10o Every turn of TCA cycle produces -i) 10 A TPs - If starting meterial is considered acetyl CoAii) 12 5 ATPs - It starting material is considered pyruvate.Energetics of TCA cycleso One turn of the TCA cycle, starting with acetyl CoA produces 10 ATPs. When the starting molecule is pyruvate, the oxidative decarboxylation of pyruvate, the oxidative decarboxylation of pyruvate yields 2.5 ATPs and therefore, 12.5 ATPs are produced when starting compound is pyruvate. Since, two molecules of pyruvate enter the TCA cycle when glucose is metabolized (glycolysis produces 2 molecules of pyruvate), the number of ATPs is doubled. Therefore, 25 ATP molecules, per glucose molecule, are produced when pyruvate enters the TCA cycleo Note: Previously calculations were made assuming that NADH produces 3 ATPs and FADH generates 2 ATPs. This will amount a net generation of 30 ATP molecules in TCA per molecule glucose and total 38 molecules from starting. Recent experiments show that these values are overestimates and NADH produces 2.5 ATPs and FADH produces 1.5 ATPs. Therefore, net generation during TCA is 25 ATPs and complete oxidation of glucose through glycolysis plus citric acid cycle yield a net 32 ATPs.o Energy yield (number of ATP generated) per molecule of glucose when it is completely oxidized through glycolysis plus citric acid cycle, under aerobic conditions, is as followsPathwayStep EnzymeSourceMethod of ATP formationNo of ATPs gained perglucose (new calculation)No of ATPs As per old calculationGlycolysis1 Hexokinase_ Minus 1Minus1Do3 Phosphofructokinase- Minus 1Minus1Do5 Glyceraldehyde-3-p DHNADHRespiratory chain2.5x2 =53x2=6Do6 1,3-BPG kinaseATPSubstrate level1x2 =21x2=2Do9 Pyruvate kinaseATPSubstrate level1 x 2 =21x2=2Pyruvate to Acetyl CoAPyruvateDehydrogenaseNADHRespiratory chain2.5 x 2 =53x2=6TCA cycle3 Isocitrate DHNADHRespiratory chain2.5 x 2 =53x2=6Do4 Alpha keto glutarate DHNADHRespiratory chain2.5 x 2 =53x2=6Do5 Succinate thiokinaseGTPSubstrate level1x2 =21x2=2Do6 Succicinate DHFADH2Respiratory chain1.5 x 2 =32x2= 4Do8 Malate DHNADHRespiratory chain2.5 x 2 =53x2= 6Net generation in glycolytic pathway9 minus 2=7 10 minus 2 = 8Generation in pyruvate dehydrogenase reaction=5= 6Generation in citric acid cycle=20= 24Net generation of ATP from one glucose mole=32= 38

A

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medmcqa_57

Orthodontic treatment in management of cleft lip and palate is usually carried out in:

[ "Deciduous dentition and mixed dentition", "Mixed dentition", "Mixed and permanent dentition", "Permanent dentition" ]

Many children with cleft lip and palate require orthodontic treatment. Orthodontic treatment is commonly carried out in two phases: Mixed dentition (8 - 10 years) – to expand the maxillary arches as a prelude to alveolar bone graft. Permanent dentition (14 -18 years) – to align the dentition and provide a normal functioning occlusion. This phase of treatment may also include surgical correction of a malpositioned/ retrusive maxilla by maxillary osteotomy.

C

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medmcqa_58

Choristoma is -

[ "Normal tissue in abnormal site", "Normal tissue in excess at normal site", "Abnormal tissue at any site", "None of the above" ]

null

A

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medmcqa_59

Perjury is :

[ "Willful utterance of falsehood", "An act comitted within cou premises", "Failure to sign summons", "Failure to appear as a witness" ]

A i.e. Willful utterance of falsehood

A

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medmcqa_60

All are chest x-ray signs of pulmonary embolism except

[ "Westermark's sign", "Felson's sign", "Palla's sign", "Monod sign" ]

Monod sign - Aspergilloma.

D

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medmcqa_61

Indium labelled WBC scan is used to locate:

[ "Occult malignancy", "Occult bleeding", "Abscess", "Aneurysm" ]

Inflammatory process and abscess which are difficult to locate with routine scanning can be diagnosed by Radionuclied scanning. They are, 1. Technitium 99 scan 2. Gallium 67 citrate scan 3. Indium 111 scan Ref: Harrison, Edition-18, Page-163.

C

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medmcqa_62

Most common cause of anorectal abscess is -

[ "Inflammation of anal gland", "Folliculitis", "Inflammation of rectal mucosa", "Rectum" ]

null

A

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medmcqa_63

Which of the following drug is commonly used for narco analysis

[ "Atropine sulfate", "Scopolamine hydrochloride", "Phenobarbitone", "Morphine" ]

Refer psychiatry and law 447 Controlled administration of intravenous hypnotics to obtain information from subject who are unable or unwilling to provide it otherwise, known as narcoanalysis or narcosynthesis Drugs used for narcoanalysis are: Ethanol Scopolamine Temazepam Barbiturates like thiopentone and amobarbitol These drugs are also known as truth drug or truth serum Phenobarbitine is not used ,rather amobarbitol is used for narcoanalysis

B

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medmcqa_64

About skull of newborn, all of the following statements are TRUE, EXCEPT:

[ "Paranasal sinuses are absent", "Absent diploic spaces", "Middle ear ossicles are of same size as in adults", "Mastoid process is not completely formed" ]

All paranasal sinuses are present to varying degrees in newborn. Ethmoid sinuses are first to fully develop followed in order by maxillary, sphenoid and frontal sinuses. The auditory ossicles malleus, incus and stapes reach the adult size as early as sixth month of fetal life. The oval window and round window are the same size in the newborn infant as in the adult. The tympanic membrane completes its full growth by bih. Mastoid process is not completely formed by bih, so the facial nerve coming out of the stylomastoid foramen is not protected by the mastoid process. Hence it can be pressed by forceps in case of forceps delivery leading to temporary facial paralysis.

A

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medmcqa_65

Which of the following conditions is associated with hypocalcemia?

[ "a) Medullary Ca thyroid", "b) Squamous Ca lung", "c) Tumor lysis syndrome", "Both 'a' and 'c'" ]

Medullary carcinoma of the thyroid (MTC) originates in the parafollicular C cells of the thyroid gland. These C cells produce calcitonin. It acts to reduce blood calcium (Ca2+), opposing the effects of parathyroid hormone (PTH). Tumor lysis syndrome refers to the constellation of metabolic disturbances that may be seen after initiation of cancer treatment. Tumor lysis syndrome is typically associated with acute leukemias and high-grade non-Hodgkin lymphomas, such as Burkitt lymphoma. Clinically, the syndrome is characterized by rapid development of hyperuricemia, hyperkalemia, hyperphosphatemia, hypocalcemia, and acute renal failure.

D

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medmcqa_66

Which of the following agent of meningitis can grow on chocolate agar but not on blood agar?

[ "Neisseria meningitides", "Haemophilus influenzae", "Moraxella catarrhalis", "Escherichia coli" ]

H influenzae growns in the presence of factor X and V avaliable in blood. Factor V is intracellular hence not available easily. Also sheep blood contain NAdase thatdestroys factor V. In chocolate agar, blood is poured in molten agar which inactivates NADase and lyses RBCs releasing factor V.

B

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medmcqa_67

Ponderal index for a malnourished child is ____________

[ "< 1", "< 2", "< 4", "< 6" ]

PI is calculated from measurements of body mass (M) and height (H). PI = the cube root of body weight divided by height, where body mass is in kilograms and height in meters. Be aware that there are variations of this formula which are also sometimes called the Ponderal Index. Ref.nelson 20th edition page 339 nutrition chapter

B

medmcqa

medmcqa_68

Object permanence milestone develop at?

[ "6 months", "9 months", "12 months", "15 months" ]

Ans. is 'b' i.e., 9 month

B

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medmcqa_69

Drug for long term treatment of paial seizure is?

[ "Valproate", "Carbamazepine", "Eptoin", "Phenobarbitone" ]

Ans. is 'b' i.e., Carbamazepine Carbamazepine is effective drug for long term treatment of GTcs & paial seizure advantage being furious side effect. Does of CBZ is 10-30 mg/kg/day in 2-3 divided doses. Phenobarbitone : Used in GTCS type below 1 year of age Because of development of hyperkinesia & learing disabilities after 1st year of life should be avoided prolonge period. Eption : Maintain prolongs seizure effect Very cheap Used in GTCS & paial seizure. Valproate : Useful in GTCS, absence, myoclonic, paial and akinetic seizure.

B

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medmcqa_70

Which of the following is a nonhereditary phakomatoses?

[ "Neurofibromatosis", "Sturge Weber syndrome", "Tuberous sclerosis", "Ataxia telangiectasia" ]

Ans BStruge Weber syndrome is the only acquired phakomatosis. Rest all major phakomatosis are inherited and most of them like NF1, NF2,Tuberous sclerosis are autosomal dominant while ataxia telengectasia is autosomal recessive.

B

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medmcqa_71

A rickshaw tyre passed on a 8 year old child. Tyre marks were found on the body. This is an exmaple of :

[ "Percolated bruise", "Imprint abrasion", "Contusion", "Patterned bruise" ]

Imprint abrasion Real confusion in this question is between imprint abrasion and patterned bruising. In both imprint abrasion and patterned brusing there is mark or pattern of the object causing injury. Abrasion is caused by friction and/or pressure between the skin and some rough object or surface. For abrasions to occur some movement along with pressure is essential between the object or instrument or weapon and the skin. In abrasions superficial layers of skin are crushed and damaged. Bruises or contusions are caused by blunt trauma resulting in rupture of small blood vessels which lead to effusion of blood in subcutaneous or subepithelial tissues. However skin is intact in most cases until associated with abrasions. In an accident in which victim is overrun by vehicle, there will be movement and friction between the tyre and skin along with pressure by the tyre leading to imprint or patterned abrasion. There can be intradermal bruises also which are usually associated with patterned objects. So the tyre mark will be primarily an imprint or patterned abrasion (tyre has a pattern because of ridges and grooves) associated with bruises too. Also know? Abrasions are of following types Scratches - a linear injury produced by a sharp object, such as a pin, thorn, nail or tip of any sharp weapon. Graze - An injury which is produced when a broad surface of skin slides or scraps against a rough surface. These are the most common type. Commonly seen in road accidents. Violent lateral (tangential) rubbing against a rough surface can produce abrasion known as 'brush burn' or 'gravel rash'. 'Friction burn' can occur due to tangential contact with a smooth surface. 3. Patterned abrasions: In it pattern of the object causing injury is produced over the skin when the force is applied at right angle to the surface of the skin. Patterned abrasions are produced either by pressure of the object or by impact with a rough object. The .former is called pressure (crushing or friction) abrasion and the latter is known as impact (contact or imprint) abrasion. There can be associated bruising in the surrounding area. Examples are ligature mark, nail and Muir& mark, teeth bite marks, whip marks, radiator, grill or tyre marks in vehicular accidents and muzzle marks in gunshot injuries.

B

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medmcqa_72

Which of the following parameters adds predictive information regarding cardiovascular risk stratification and the measurement of serum cholesterol?

[ "Anti-chlamydia pneumoniae antibodies", "C-reactive protein", "Homocysteine", "Plasminogen activator inhibitor 1" ]

Recent studies have demonstrated that markers of inflammation correlate with coronary risk and that inflammation plays a role in atheromatous plaque instability. Elevations of C-reactive protein, (CRP) identify patients at increased risk of myocardial infarction (MI) and poor outcome of acute coronary syndromes. Measurement of CRP adds information regarding risk stratification to standard risk factor such as hypeension, diabetes, smoking, and lipids. Elevations in homocysteine, lipoprotein A, and plasminogen activator factor I have all been associated with an increased risk at cardiovascular events; however, at the time none have been shown to be useful in populations to improve risk stratification.

B

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medmcqa_73

All of the following are true about Broca's aphasia except:

[ "Lesion lies in frontal lobe", "Fluency is impaired", "Neologisms are absent", "Repetition is preserved" ]

Answer is D (Repetition is preserved): Repetition is impaired in both Broca's and Wernicke's aphasias. Aphasias are disorders of understanding, thought and word finding. Anomie aphasia : Remember : Most common language disturbance seen in - Head trauma = Anomie ApahsiaQ Most common language disturbance seen in - Metabolic encephalopathy = Anomie Apahsiae Most common language disturbance seen in - Alzheimer's disease = Anomie Apahsiae

D

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medmcqa_74

Most common visually debilitating cataract in children:

[ "Blue dot cataract", "Zonular cataract", "Anterior polar cataract", "Posterior polar cataract" ]

Zonular cataract is most debilitating cataract in children. Types of congenital cataract Punctate: Blue Dot Cataract (Asymptomatic). Sutural cataract : Y suture opaque, nuclear cataract. Zonular cataract/Lamellar Most Common visually significant cataract (riders). Fusiform Nuclear Coronary Anterior polar Lamellar Cataract With Rider Blue dot cataract Anterior polar cataract Posterior polar cataract

B

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medmcqa_75

Peripheral aerial disease can be treated by all, EXCEPT:

[ "Pentoxifylline", "Cilostazol", "Sildenafil", "Percutaneous angioplasty" ]

Pentoxifylline, a xanthine derivative, is thought to act by reducing the viscosity of blood, allowing it to flow more easily through paially obstructed areas. Cilostazol, a phosphodiesterase type 3 (PDE3) inhibitor, is poorly understood, but may have selective antiplatelet and vasodilating effects. Both drugs have been shown to increase exercise tolerance in patients with severe claudication. Percutaneous angioplasty with stenting is often effective in patients with medically intractable signs and symptoms of ischemia. Ref: Katzung, 11th edition, Chapter 12.

C

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medmcqa_76

Alveoli are kept dry because of

[ "Surfactants", "Glycorprotiens", "Buffers Bohr's", "Effect" ]

Pulmonary surfactant is a mixture of lipids and proteins which is secreted into the alveolar space by epithelial type II cells. The main function of surfactant is to lower the surface tension at the air/liquid interface within the alveoli of the lung. Ref: guyton and hall textbook of medical physiology 12 edition page number: 317,318,319

A

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medmcqa_77

Honeycomb histological appearance is seen in:

[ "Adenoid cystic carcinoma", "Primordial cyst", "Burkitt’s lymphoma", "Pernicious anemia" ]

Adenoid cystic carcinoma is composed of myoepithelial cells and ductal cells which have a varied arrangement. Morphologically, three growth patterns have been described: cribriform (classic), tubular, and solid (basaloid). The tumors are categorized according to the predominant pattern. The cribriform pattern shows basaloid epithelial cell nests that form multiple cylindrical cyst like patterns resembling a Swiss cheese or honeycomb pattern, which is the most classic and best recognized pattern. The lumina of these spaces contain periodic acid-Schiff (PAS) positive mucopolysaccharide secretion. The tubular pattern reveals tubular structures that are lined by stratified cuboidal epithelium. The solid pattern shows solid groups of cuboidal cells with little tendency towards duct or cyst formation. The cribriform pattern is the most common, whereas the solid pattern is the least common. Ref: Shafer's textbook of oral pathology 7th edition page 239

A

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medmcqa_78

What is the type of Galactosemia cataract?

[ "Snowflake", "Oil drop", "Blue dot", "Polychromaticlustre" ]

Ans. is 'b' i.e., Oil drop DiseaseCataractMyotonic DystophyChristmas tree cataractWilson's disease, chalcosisSunflower cataractDM, Down's SyndromeSnowflake cataractAtopic dermatitisBlue dot cortical cataract, posterior subcapsular cataractCongenital rubellaNuclear cataractGalactosemiaOil drop cataractComplicated cataract (Iridocyclitis, High myopia)Posterior cortical breads's crumb appearance Polychromatic lusture / Rainbow cataractBlunt traumaVossius ring on anterior surface of lens Rosette shaped cataract

B

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medmcqa_79

YAG laser is used in

[ "Retinal detachment", "diabetes", "Refractive errors", "After cataract" ]

Posterior capsular opacity/after cataract treated by ND-YAG capsulotomy A Yag capsulotomy is a special laser treatment used to improve your vision after cataract surgery. It is a simple, commonly performed procedure which is very safe. During your cataract operation, the natural lens inside your eye that had become cloudy was removed. Yag laser capsulotomy is the only way to treat this. Reference: khurana 6th edition pg 233

D

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medmcqa_80

The thickness of thin rubber dam is:

[ "0.002 inch", "0.004 inch", "0.006 inch", "0.2 inch" ]

null

C

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medmcqa_81

Gene therapy is used for

[ "All of the below", "Sickle cell anemia", "Thalassemia", "Cystic fibrosis" ]

Gene transfer is a novel area of therapeutics in which the active agent is a nucleic acid sequence rather than a protein or small molecule. Most gene transfers are carried out using a vector or gene delivery vehicle because delivery of naked DNA or RNA to a cell is an inefficient process. More clear-cut success has been achieved in a gene therapy trial for another form of SCID, adenosine deaminase (ADA) deficiency. Other diseases likely to be amenable to transduction of hemaopietic stem cells (HSCs) include • Wiskott-Aldrich syndrome • Chronic granulomatous disease • Sickle cell disease • Thalassemia. Clinical trials using recombinant adeno-associated vectors are now ongoing for muscular dystrophies, alpha-1 antitrypsin deficiency, lipoprotein lipase deficiency, hemophilia B, and a form of congenital blindness called Leber’s congenital amaurosis.

A

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medmcqa_82

A 18-year-old female presented with severe headache of sudden onset. On CT scan, a diagnosis of subarachnoid hemorrhage is made. Most common cause is: Al 06; UP 10, 12

[ "Hypeension", "Berry aneurysm rupture", "Basilar aery rupture", "Subdural venous sinuses rupture" ]

Ans. Berry aneurysm rupture

B

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medmcqa_83

Under normal circumstances, left ventricular shoening fraction (LVSF) is:

[ "20%", "40%", "60%", "75%" ]

Left ventricular shoening fraction (LVSF) is the percentage of shoening of LV fibers from their end-diastolic length (EDL). EDL and ESL are end-diastolic length and end-systolic length, respectively. Normal LVSF = 35%-40%. The value of LVSF decreases in LV failure.

B

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medmcqa_84

Best predictor for coronary aery disease -

[ "HDL", "LDL", "VLDL", "Chylomicron" ]

LDL is the best indicater of the risk for CAD.high level of LDL is the indicater

B

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medmcqa_85

A female, Lalita, aged 26 yrs accidentally takes 100 tablets of paracetamol. What is the treatment of choice -

[ "Lavage with charcoal", "Dialysis", "Alkaline diuresis", "Acetylcysteine" ]

Ans. is 'd' i.e Acetylcysteine "In cases of moderate to severe poisoning N acetylcysteine (Mucomyst) should be given orally. It is most effective when given within 16-24 hours of overdosage. It prevents hepatic damage". - Parikh

D

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medmcqa_86

You are performing a breast examination in the surgery clinic. In addition to the breast tissue examination, what other region is critical to complete the palpation of mammary tissue?

[ "Supraclavicular region", "Subclavicular region", "Axillary region", "Interscapular region" ]

This is not an examination of lymph node. The tail of Spence is located in the axillary area and contains mammary tissue.The axillary tail of Spence extends laterally across the anterior axillary fold. The upper outer quadrant of the breast contains a greater volume of tissue than do the other quadrants. The breast has a protuberant conical form. The base of the cone is roughly circular, measuring 10 to 12 cm in diameter. Ref: Hunt K.K., Newman L.A., Copeland E.M., Bland K.I. (2010). Chapter 17. The Breast. In F.C. Brunicardi, D.K. Andersen, T.R. Billiar, D.L. Dunn, J.G. Hunter, J.B. Matthews, R.E. Pollock (Eds), Schwaz's Principles of Surgery, 9e.

C

medmcqa

medmcqa_87

Monthly repo to be submitted in RCH program to monitor efficiency include all except -

[ "Minimum 3 ANC visits", "Minimum 2 PNC vistas", "Number of LBW babies recorded", "Number of women taking treatment of anemia" ]

Ans. is 'b" i.e., Minimum 2 PNC visits

B

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medmcqa_88

Causative agent of syphilis-

[ "Treponema pertunae", "Treponema endemicum", "Treponema corateum", "Treponema pallidum" ]

Ans. is 'd' i.e., Treponema pallidum SpirocheteSpeciesDiseaseTreponemaPallidumEndemic umPertunaeCarateumSyphilisBejelYawsPintaBorretiaBurgdorferiRecurrentisVincentiLyme diseaseRelapsing feverVincent anginaLeptospiraInterrogansWeil's disease

D

medmcqa

medmcqa_89

Post delivery uterus becomes pelvic organ by

[ "48hours", "1week", "2weeks", "6weeks" ]

Following delivery, the fundus lies about 13.5 cm (5 1/2") above the symphysis pubis. During the first 24 hours, the level remains constant; thereafter, there is a steady decrease in height by 1.25 cm (1/2") in 24 hours, so that by the end of the second week the uterus becomes a pelvic organ. The rate of involution thereafter slows down until by 6 weeks, the uterus becomes almost normal in sizeReference: DC Dutta&;s Textbook of Obstetrics; Chapter 13; Normal Puerperium

C

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medmcqa_90

Hypokalemia is not present in :

[ "Vomiting", "Diarrhoea", "Patient on diuretics", "Chronic renal failure" ]

null

D

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medmcqa_91

Apnoea in infants is –

[ ">10 sec", ">20 sec", ">30 sec", ">40 sec" ]

null

B

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medmcqa_92

Mechanism of action of an oral contraceptive containing a combination of oestrogen-progestin is the following except-a) Inhibition of ovulationb) A change in the cervical mucusc) Inhibition of motility of the uterine tubesd) Inhibition of motility of spermse) Changes in the uterine endometrium

[ "ab", "cd", "bd", "ac" ]

null

B

medmcqa

medmcqa_93

Which of the following is most common among all psychiatric disorders?

[ "Depression", "Anxiety disorder", "OCD", "Delusional disorder" ]

Anxiety disorder are the most common among all psychiatric disorders and among the group of anxiety disorders, Phobias are the most common.

B

medmcqa

medmcqa_94

Moderate excercise tachypnea is due to stimulation of which receptor

[ "Proprioception", "J receptor", "Lung receptor", "Baro receptor" ]

Inspiratory neurons are stimulated by proprioception from joints and muscles.

A

medmcqa

medmcqa_95

Cerelas are deficient in?

[ "Alanine", "Lysine", "Methionine", "Cysteine" ]

Cereal proteins are poor in nutritive value being deficient in the essential amino acid,lysine.REF.PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE.Editon-21.Page no.-578

B

medmcqa

medmcqa_96

True about neoplastic colorectal polyps ?

[ "Sessile polyps > 1 cm is malignant", "MC site is colon and rectum", "Adenomatous polyp is premalignant", "All" ]

Ans. 'a' i.e. Sessile Polyp> 1 cm is malignant; 'b' i.e. MC site is colon and rectum; 'c' i.e. Adenomatous polyp is premalignant Polyps are much more common in the large intestine than in the small intestine and more common in the rectosigmoid colon than the proximal colon.

D

medmcqa

medmcqa_97

In aortic dissection, blood enters in -

[ "Intima", "Media", "Adventitia", "Any of the above layer" ]

Aortic dissection Aortic dissection is a catastrophic illness characterized by dissection of blood between and along the laminar planes of aortic media. Blood enters inside the arterial wall (in the media layer) and leads to the formation of blood-filled channels within the aortic wall, which often ruptures outward causing massive haemorrhage. The most frequent pre-existing histologically detectable lesion is cystic medial degeneration. In aortic dissection, there is an intimial tear through which the blood enters into the media. Usually, the tear is within 10 cms of the aortic valve. The dissecting hematoma spreads characteristically along the laminar planes of the aorta, usually between the middle and outer third. Some times, blood ruptures into the lumen distally, i.e. there is the second tear distally. So that a complete new vascular channel is formed inside the media of aortic wall. Blood enters from proximal tear into the media and comes out into the lumen from the distal tear. This is called double - barrel aorta with a false-channel in the media. Later on, this false channel becomes endothelized → chronic dissection. Classification of Aortic dissection The risk and nature of serious complications of dissection depend strongly on the level of aorta affected, with the most serious complications occurring from the aortic valve to the arch. Thus aortic dissections are generally classified into two types - 1. Proximal lesion (Type A) More common and more dangerous. Involve either the ascending portion only or both ascending and the descending portion of aorta. 2. Distal lesion (Type B) Involve only descending part distal to the subclavian artery.

B

medmcqa

medmcqa_98

1711. All are true regarding Anaemia of Chronic Diseases, except -

[ "Decreased serum Fe", "Decreased Ferritin", "Decreased Total Fe Binding Capacity", "Increased Bone Marrow Fe" ]

Serum ferritin levels are increased in anemia of chronic disorder & is the most distinguishing feature between true iron deficiency anemia & iron deficient erythropoiesis in anemia of disease.A defect in transfer of iron from macrophages to the developing erythroid cells in the marrow leads to reduced availability of iron for haem synthesis despite adequate iron stores, elevating serum ferritin levels.Reference : Hardh mohan textbook of pathology sixth edition pg no 302.

B

medmcqa

medmcqa_99

Prunning of pulmonary aeries is seen in -

[ "Pulmonary hypeension", "Chronic bronchitis", "Pulmonary infections", "Pulmonary transplant" ]

Pulmonary Aerial Hypeension is characterised by enlargement of main pulmonary trunk and Right and Left main pulmonary aeries with dispropoinately small peripheral blood vessels. This is referred to as prunning of pulmonary aeries.. * elevated cardiac apex due to right ventricular hyperophy * enlarged right atrium * prominent pulmonary outflow tract * enlarged pulmonary aeries * pruning of peripheral pulmonary vessels

A