dataset
string | id
string | question
string | choices
sequence | rationale
string | answer
string |
|---|---|---|---|---|---|
medmcqa | medmcqa_200 | In cytochrome P450, P stands for | [
"Structural proteins",
"Substrate protein",
"Pigment",
"Polymer"
] | Molecular oxygen is incorporated into a variety of substrates by enzymes designated as oxygenases; many drugs, pollutants, and chemical carcinogens (xenobiotics) are metabolized by enzymes of this class, known as the cytochrome P450 systemCytochromes P450 Are Monooxygenases Impoant in Steroid Metabolism & for the Detoxification of Many DrugsReaction and also works together with cytochromes P450 in drug detoxificationRef: Harper&;s biochemistry text, 30th edition, biological oxidation | C |
medmcqa | medmcqa_201 | Primary granules in neutrophlis contain all except __. | [
"Myeloperoxidase",
"Defensin",
"Acid hydrolases",
"Lactoferrin"
] | Neutrophils have two main types of granules
The smaller specific (or secondary) granules contain lysozyme, collagenase, gelatinase, lactoferrin, plasminogen activator, histaminase, and alkaline phosphatase.
The larger azurophil (or primary) granules contain myeloperoxidase, bactericidal factors (such as defensins), acid hydrolases, and a variety of neutral proteases (elastase, cathepsin G, non-specific collagenases, proteinase).
Reference-Robbins BASIC PATHOLOGY 10th edition pg-68 | D |
medmcqa | medmcqa_202 | Dreaming is charactersitic of- | [
"REM sleep",
"Stage II NREM sleep",
"Stage IV NREM sleep",
"Stage I NREM sleep"
] | Ans. is 'a' i.e., REM sleep o Features of REM sleep are: -i) EEG - Beta-wave, Reappearance of alpha wave, Saw-tooth wave (low voltage fast activity), Ponto-genital- occipital spikes.ii) Dreamingiii) Other features :- Generalized muscular atony, Penile erection, autonomic hyperactivity (Increased pulse rate & BP) and intermittent movement of small muscle groups. | A |
medmcqa | medmcqa_203 | Which of the following is not an alkylating agent:- | [
"Melphalan",
"Cyclophosphamide",
"Busulfan",
"5-Fluorouracil"
] | Melphalan Cyclophosphamide Busulfan These are alkylating agents. | D |
medmcqa | medmcqa_204 | Acute diffuse proliferative glomerulonephritis will have all of the following features, except: | [
"Microscopic haematuria",
"Raised blood urea level",
"Raised serum creatinine level",
"Hypoalbuminaemia"
] | . Hypoalbuminaemia | D |
medmcqa | medmcqa_205 | Virulence of a disease is indicated by: | [
"Proportional mortality rate",
"Specific mortality rate",
"Case fatality rate",
"Amount of GDP spent on control of disease"
] | Ans. (c) Case fatality rateCASE FATALITY RATE (CFR):* CFR represents 'killing power of a disease'- It is 'closely related to virulence of organism'CFR=Totalno.ofcasesduetoadiseaseTotalno.ofdeathsduetoadisease x100* CFR is a Proportion: Always expressed in percentage* CFR is the 'complement of Survival Rate', thus CFR =1 - Survival Rate* Limitations of CFR:- Time interval is not specified- Usefulness is limited for chronic diseases - CFR for the same disease may vary in different epidemics | C |
medmcqa | medmcqa_206 | A 28 year old male admitted in the hospital with a history of vague pains. His examination revealed many scars of previous surgeries. He was very curious about knowing his diagnosis and was persistently asking for various diagnostic procedures and biopsy. He gave the past history of gall stone & appendicitis pain diagnosed by previous doctors, but the history regarding this was inappropriate and semed to be manipulative. There were no previous records suggesting this diagnosis. The probable diagnosis is: | [
"Hypochondriasis",
"Somatization disorder",
"Conversion disorder",
"Factitious disorder"
] | D i.e. Factitious disorder | D |
medmcqa | medmcqa_207 | Symptom of sudden onset bilateral vocal cord palsy - | [
"Dyspnea & Stridor",
"Hoarseness of voice",
"Asymptomatic",
"Bovine cough"
] | Sudden onset of bilateral vocal cord paralysis produces respiratory obstruction with dysnea and stridor. | A |
medmcqa | medmcqa_208 | Positive urinary anion gap is found in- | [
"Alcholic ketoacidosis",
"Diabetic ketoacidosis",
"Renal tubular acidosis",
"Diarrhea"
] | Urinary anion gap : used to differentiate GIT causes from Renal causes. UAG= Urine anions - urine cations =( HCO3-) - (NH4+) NORMAL = 0 In GIT cause : NEGATIVE In Renal cause : POSITIVE Ref: Harrison&;s 19thE | C |
medmcqa | medmcqa_209 | Hemiballismus is due to lesion in | [
"Ipisilateral caudate nucleus",
"Contralateral sub-thalamic lesion",
"Contralateral putamen",
"Ipsilateral sub-thalamic lesion"
] | Answer- B. Contralateral sub-thalamic lesionSub-thalamic nucleus- Contralateral hemiballismus | B |
medmcqa | medmcqa_210 | Cytomegalovirus causes what cancer in AIDS patients - | [
"Lymphoma",
"Kaposi sarcoma",
"Leukemia",
"Glioma"
] | In AIDS patients the already weakened immune response is fuher damaged by the nonspecific CMI inhibiting effect of CMV REF:ANANTHANARYANAN TEXTBOOK OF MICROBIOLOGY 9EDITION PGNO.474 | A |
medmcqa | medmcqa_211 | Sub periosteal hemorrhage is seen in: (Repeat) | [
"Vit C deficiency",
"Vit A deficiency",
"Vit E deficiency",
"Vit B2 deficiency"
] | Ans: A (Vitamin C deficiency) Ref: Nelson's Textbook of Pediatrics. 19th Edition, Page 198Explanation:Radiographic Changes in ScurvyThe typical radiographic changes occur at the distal ends of the long bones and are particularly common at the knees.The shafts of the long bones have a ground- glass appearance due to trabecular atrophy.The cortex is thin and dense, giving the appearance of pencil outlining of the diaphysis and epiphysis (Pencil thin cortex).The white line of Frankel. an irregular hut thickened white line at the metaphysis, represents the zone of well-calcified cartilage.The epiphyseal centers of ossification also have a ground-glass appearance and are surrounded by a sclerotic ring.The more specific but late radiologic feature of scurvy is a zone of rarefaction under the white line at the metaphysis. This zone of rarefaction (Trumerfeld zone), a linear break in the bone that is proximal and parallel to the white line, represents area of debris of broken-down bone trabeculae and connective tissue.A Pelkan spur is a lateral prolongation of the white line and may be present at cortical ends. Epiphyseal separation can occur along the line of destruction, with either linear displacement or compression of the epiphysis against the shaft.Subperiosteal hemorrhages are not visible using plain radiographs during the active phase of scurvy. However, during healing the elevated periosteum becomes calcified and radiopaque, giving a dumbbell or club shape to the affected bone. | A |
medmcqa | medmcqa_212 | Which of the following features is not shared between `T cells' and B cells' - | [
"Positive Selection During Development",
"Class I MHC Expression",
"Antigen Specific Receptors",
"All of the above"
] | null | A |
medmcqa | medmcqa_213 | Intracranial calcification with cystic lesion in plain X? Ray skull is seen in | [
"Meningioma",
"Glioma",
"Craniopharyngioma",
"Meduloblastoma"
] | C i.e. Craniopharyngioma | C |
medmcqa | medmcqa_214 | Gonioscopy is used to study: | [
"Anterior chamber",
"Posterior chamber",
"Angel of anterior chamber",
"Retina"
] | Ans: C (Angel of anterior chamber) Ref: Kanski. Cliniccd Ophthalmology 6th edition: PS- 11Explanation:GONIOSCOPY - To study the angle of the anterior chamber:Structures: From anterior to posteriorS - Schwalbe lineT - trabecular mesh workS - sclera spurC - ciliary bodyUses:Diagnostic - Abnormal angle structure , estimation of the width of the chamber angle.Surgical gonioscopy - While doing goniotomy, laser trabeculoplasty.Types of Lenses:Direct - Gonioprism - Direct view of the angle - KOEPPE LENS.Indirect - Goniomirror - Image of the opposite angle - GGLDMANN, ZEISS, POSNER and SUSSMAN. | C |
medmcqa | medmcqa_215 | Methotrexate resistance is due to : | [
"Depletion of folate",
"Overproduction of DHFRase",
"Overproduction of thymidylate kinase",
"Decreased DHFRase"
] | Mechanisms of pharmacokinetic and cellular resistance to methotrexate. Metabolism of methotrexate in the liver to paly inactive 7-hydroxymethotrexate reduces plasma concentrations of methotrexate and creates competition for cellular uptake RFC, which also internalizes reduced folates and folic acid, although with low affinity for the latter. Folate receptors mediate low affinity endocytosis of methotrexate. Quantitative or qualitative alterations in RFCs or folate-receptor expression confer transpo-related resistance to methotrexate, as do high levels of exogenous folates competing for cell entry. Intracellularly, methotrexate is metabolized to polyglutamated forms by FPGS, and these are broken down by FPGH. The monoglutamated forms and, to some extent, polyglutamated forms are expelled transpoers ABCC1-ABCC5 and ABCG2. ABCB1 does not transpo anionic drugs such as methotrexate. Polyglutamated forms of methotrexate can inhibit several key enzymes in folate metabolism, such as DHFR and TS, preventing de novo purine biosynthesis by APFase and AICAFase. Enzyme inhibition, folate depletion, and direct or indirect effects on cytokine release signaling pathways (such as those mediated by NFkB and IKK) all create routes which methotrexate could suppress RA. REFERENCE: www.medscape.com | A |
medmcqa | medmcqa_216 | A 74 yr old male patient was brought to the OPD by his daughter complaining of urinary incontinence and ataxia, also he has difficulty in calculating simple arithemetics and memory loss. What is the probable diagnosis | [
"Normal pressure hydrocephalus",
"Vascular dementia",
"VIT B12 dofficiency",
"Tabes dorsalis"
] | CLINICAL FEATURES IN NORMAL PRESSURE HYDROCEPHALUS Difficulty walking. This problem can be mild or severe. ... Dementia. This often involves confusion, sho-term memory loss/forgetfulness, trouble paying attention, changes in mood, and a lack of interest in daily activities. Problems with bladder control. REF : HARRISONS 21ST ED | A |
medmcqa | medmcqa_217 | Which of the following is the best tuning fork to do Rinne's and Weber s tests | [
"128 Hz",
"256 Hz",
"512 Hz",
"1024 Hz"
] | Ans. (c) 512 HzRef: Dhingra's ENT 6th ed./22, 5th ed. / 26 | C |
medmcqa | medmcqa_218 | Which of the following is not true about testicular tumor? | [
"About 95% are embryonal tumors",
"10% are bilateral",
"Pulmonary metastases suggest that the tumor is teratoma",
"Lymphatic spread is to retroperitoneal and intrathoracic lymph nodes"
] | About 95% of testicular tumours are Germ cell tumours. Embryonal carcinoma is a type of non seminomatous germ cell tumour. Pure embryonal carcinoma constitutes 30% of germ cell tumours but areas of embryonal carcinoma are present in about 40% of germ cell tumours. Teratomas spreads mainly through blood ( to lungs, liver, brain etc) , less commonly through lymphatics.Lymphatic spread occurs to retroperitoneal, para-aoic, mediastinal and left supraclavicular nodes.Reference : page 1083 SRB's manual of surgery 5th edition and page 708 textbook of pathology Harshmohan 6th edition | A |
medmcqa | medmcqa_219 | In humans, the brain is considered to be "responsive" because? | [
"It has control centers for all motor actions and sensory inputs",
"Every cell of brain has got specific function",
"It is a closed system and so not influenced by changes occurring outside",
"Its functions are profoundly affected by changes in external environment"
] | Ans. d. Its functions are profoundly affected by changes in external environmentIn humans, the brain is considered to be "responsive" as its functions are profoundly affected by changes in external environment | D |
medmcqa | medmcqa_220 | Which of the following is not a GnRH agonist? | [
"Leuprolide",
"Nafarelin",
"Ganirelix",
"Busurelin"
] | GnRH Agonist Drugs Leuprolide Nafarelin Goserelin Buserelin -They are all injectables. -They all have flare up reaction as adverse effect when given in continuous form GnRH Antagonist Drugs Cetrorelix Ganirelix Abarelix Degarelix -Given as injectables -They do not increase the sex hormone | C |
medmcqa | medmcqa_221 | Headaches typically affecting young to middle aged men, unilateral, oculo temporal, excruciating and associated with lacrimation, rhinorrhoea is called | [
"Migraine",
"Trigeminal neuralgia",
"Cluster headache",
"Tension headache"
] | Cluster headache Unilateral, periorbital, frontal or temporal headache with ipsilateral epiphora, rhinorrhoea, sweating,nasal stuffiness and ptosis. Lasts minutes to hours, recurs once or twice daily for several weeks followed by symptom-free intervals of months to years. Affects men (90%) and may be precipitated by alcohol or nitroglycerink room. Migraine- Migraine is characterized by recurrent headaches widely variable in intensity, duration and frequency. Migrainous headache is commonly unilateral, associated with nausea and vomiting and may be preceded by, or associated with, neurological and mood disturbances. Trigeminal neuralgia - Trigeminal neuralgia is characterized by brief attacks of severe pain that sta in the distribution of one of the divisions of the trigeminal nerve. The pain is paroxysmal and sharp, usually occurring in multiple bursts in rapid succession lasting a few seconds. Attacks can be triggered either by cutaneous stimulation such as shaving or by motor activity such as chewing. Tension headache Affects females more than males. Generalized nondescript band-like discomfo present continuously A major difference from cluster headache, SUNCT syndrome and paroxysmal hemicrania is that autonomic features are sparse or absent. | C |
medmcqa | medmcqa_222 | Severe malaria is indicated on peripheral smear by: | [
">2% parasitized RBCs in low endemic",
">5% in hyperendemic areas",
">5% parasitized RBCs in low endemic",
">15% in hyperendemic areas 18 months"
] | Severe malaria is indicated by Hyperparasitaemia (>5% parasitized RBCs in low endemic and >10% in hyperendemic areas) Ref: | C |
medmcqa | medmcqa_223 | A patient with a long-standing intrauterine contraceptive device (IUCD) develops chronic pelvic pain. The device is removed, and a biopsy of the endometrium is performed. The biopsy specimen shows a prominent infiltrate composed of lymphocytes, plasma cells, and histiocytes. Which of the following is the most likely diagnosis? | [
"Acute endometritis",
"Adenomyosis",
"Chronic endometritis",
"Endometriosis"
] | This is chronic endometritis, evidenced by the chronic inflammatory infiltrate of lymphocytes, plasma cells, and histiocytes. This disorder may be idiopathic but is more often associated with an obvious predisposing factor, such as chronic pelvic inflammatory disease, tuberculosis, retained gestational tissue, or as in this case, an intrauterine contraceptive device. Chronic endometritis can cause abnormal bleeding, pain, and infeility. Acute endometritis is characterized by a prominent neutrophilic infiltrate and usually occurs after delivery or miscarriage. Adenomyosis refers to endometrium abnormally located in myometrium. Endometriosis refers to abnormally located patches of endometrium (except in the myometrium, where it would be called adenomyosis). | C |
medmcqa | medmcqa_224 | Which is a fructosan | [
"Pectin",
"Chitin",
"Inulin",
"Glycogen"
] | The polysaccharide of glucose (glucosan or glucan):- starch, glycogen, cellulose, dextrin, dextran, chitin
The polysaccharide of fructose (fructosan) :- Inulin | C |
medmcqa | medmcqa_225 | Hyperkeratosis of palm and sole is seen in: | [
"Carcinoma colon",
"Hepatoma",
"Adenocarcinoma lung",
"Ca oesophagus"
] | Answer is D (Ca Esophagus) Congenital hyperkeratosis and pitting of palms and soles (Le tylosis palmaris et plantaris) is a known etiological factor for squamous Ca of Esophagus' - Harrison | D |
medmcqa | medmcqa_226 | Psoriasis has the following features except | [
"Munro abscesses in the parakeratotic layer",
"Prominent granular cell layer",
"Acanthosis with thickened lower portion",
"Suprapapillary thinning of epidermis"
] | Granular cell layer is thinned or almost absent. | B |
medmcqa | medmcqa_227 | Horner's syndrome is seen in all except - | [
"Carotid artery aneurysm",
"Medial medullary syndrome",
"Can occur following surgery for raynaud's syndrome",
"Multiple sclerosis"
] | Ans. is 'b' i.e., Medial medullary syndrome Horner*s syndrome is a classic neurologic syndrome whose signs include : -Miosis,Ptosis, andAnhidrosisAlso called ocul sympathetic paresis, a Horner's syndrome can be produced by a lesion anywhere along the sympathetic pathway that supplies the head, eye, and neck.NeuroanatomyHorner's syndrome can result from a lesion anywhere along a three-neuron sympathetic (adrenergic) pathway that originates in the hypothalamusThe first-order neuronDescends caudally from the hypothalamus to the first synapse, which is located in the cervical spinal cord (levels C8-T2, also called ciliospinal center of Budge).The second-order neuronTravels from the sympathetic trunk, through the brachial plexus, over the lung apex. It then ascends to the superior cervical ganglion, located near the angle of the mandible and the bifurcation of the common carotid artery.The third-order neuronThen ascends within the adventitia of the internal carotid artery, through the cavernous sinus, where it is in close relation to the sixth cranial nerve.The ocul sympathetic pathway then joins the ophthalmic (VI) division of the fifth cranial nerve (trigeminal nerve).In the orbit and the eye, the ocul sympathetic fibers innervate the iris dilator muscle as well as Muller's muscle, a small smooth muscle in the eyelids responsible for a minor portion of the upper lid elevation and lower lid retraction.EtiologyThe etiology of Horner's syndrome in adults relates to the lesion location.First-order syndrome (central)* Lesions of the sympathetic tracts in the brainstem or cervicothoracic spinal cord can produce a first-order Horner's syndromeLateral medullary syndromeQ (M.C.)Brainstem disease (stroke, tumour, demyelinating disorder)SyringomyeliaCervical cord trauma (including surgery)Spinal cord tumourDiabetic autonomic neuropathyMultiple sclerosisSecond-order syndromeTrauma or surgery involving spinal cord, thoracic outlet lung apex.Pancoast tumourCarotid and Aortic aneurysm and dissectionLumbar epidural anaesthesia.Third-order syndrome (Postganglionic)Lesions of internal carotid artery such asDissection, thrombosisOtitis mediaCavernous sinus mass Surgery for Raynaud's syndrome (cervical sympathectomy) may cause trauma to cervical spinal cord. | B |
medmcqa | medmcqa_228 | Which of the following disease is notifiable internationally? | [
"Cholera",
"Relapsing fever",
"Influenza",
"Louse borne typhus"
] | Ans: a (Cholera) Ref: Park, 19th ed, p. 103At International level, the diseases which are notifiable to WHO in Geneva under the International health regulations are:1. Cholera2. Plague3. Yellow feverDiseases which are subject to international surveillance:1 Louse borne typhus2. Relapsing fever3. Polio4. Influenza5. Malaria6. Rabies7. Salmonellosis | A |
medmcqa | medmcqa_229 | Which of the following does not contribute to glucose by gluconeogenesis? | [
"Lactate",
"Acetyl CoA",
"Pyruvate",
"Oxaloacetate"
] | Ans. B. Acetyl-CoA(Ref: Harper 31/e page 172, 173)Lactate from muscle and RBC are converted to glucose in the liver (Coris Cycle)Lactate and Alanine is converted to Pyruvate which can enter into Gluconeogenesis.Oxaloacetate is converted to Phospho enol Pyruvate by PEPCK and enter in to Gluconeogenesis. | B |
medmcqa | medmcqa_230 | True about Jvenile Myoclonic Epilepsy | [
"DOC is sodium valproate",
"Mental retardation",
"Seizure can develop",
"Neurological examination abnormal"
] | Drug of choice of juvenile myoclonic epilepsy is Sodium valproate. Ref : Ghai - 8th edition , pg no : 559 , 560 ( table 18.5) | A |
medmcqa | medmcqa_231 | A 52 year old female patient complains of pain in her abdomen. General examination reveals BMI 30 Kg/m2. X-ray examination reveals osteoporotic changes. Doctor suspects impaired absorption of calcium in this patient. All of the following could be the reason for this except: | [
"Inositol hexaphosphate in cereals",
"High intake of oxalate",
"High concentrations of fatty acids in the intestinal lumen",
"Decreased iron intake"
] | Phytic acid (inositol hexaphosphate) in cereals binds calcium in the intestinal lumen, preventing its absorption. Other minerals, including zinc are also chelated by phytate.
This is mainly a problem among people who consume large amounts of unleavened whole-wheat products; yeast contains an enzyme, phytase, that dephosphorylates phytate, so rendering it inactive.
High concentrations of fatty acids in the intestinal lumen, as a result of impaired fat absorption, can also reduce calcium absorption by forming insoluble calcium salts; a high intake of oxalate can sometimes cause deficiency since calcium oxalate is insoluble.
Reference: HARPERS ILLUSTRATED BIOCHEMISTRY30th, Page No: 541 | D |
medmcqa | medmcqa_232 | Na+: Ca++ binding ratio on the sodium-calcium exchanger (NCX) in the myocardial fibers is:- | [
"1:01",
"1:03",
"3:01",
"4:01"
] | Sodium-calcium Exchanger (NCX) is an example of counter-transpo /antipo (a type of secondary active transpo) It carries 3 sodium Ions into the cell & one calcium Ion out of the cell It is critically dependent on primary active transpo (Na+-K+ pump). Two mechanisms can be explained on basis of this exchanger:(i) Action of digitalis: Digitalis binds with Na+-K+ pump & inhibits it; thus Na+ cannot be pumped out, its concentration gradient cannot be created therefore NCX will not work. Ca+ accumulates inside the cell which increases myocardial contractility. (ii) Reperfusion Injury: After MI there is failure of Na+-K+ pump results in NCX failure, Thus Intracellular Ca+2 |. Now perfusion is established (nutrients are available) because of |ICF Ca+2 cardiac fibers contract very strongly. Already muscle fibers are fragile due to M.I, now this contraction results in fuher damage. This is reperfusion Injury. | C |
medmcqa | medmcqa_233 | The immunoglobulin involved in type 1 hypersensitivity reactions is | [
"IgE",
"IgM",
"IgA",
"IgG"
] | Ref Robbins 9/e p202 Immediate hypersensitivity is a tissue reaction that occurs rapidly (typically within minutes) after the interaction of antigen with IgE antibody that is bound to the surface of mast cells in a sensitized host. The reaction is initiated by entry of an antigen, which is called an allergen because it triggers allergy. Many allergens are environmental substances that are harmless for most persons on exposure. Some people apparently inherit genes that make them susceptible to allergies. This susceptibility is manifested by the propen- sity of such persons to mount strong TH2 responses and, subsequently, to produce IgE antibody against the aller- gens. The IgE is central to the activation of the mast cells and release of mediators that are responsible for the clinical and pathologic manifestations of the reaction. Immediate hypersensitivity may occur as a local reaction that is merely annoying (e.g., seasonal rhinitis, or hay fever), severely debilitating (asthma), or even fatal (anaphylaxis). | A |
medmcqa | medmcqa_234 | Persistent multinodular goiter may cause - | [
"Follicular Carcinoma",
"Pappilary Carcinoma",
"Medullary Carcinoma",
"Colloid Carcinoma"
] | Ans. is 'a' i.e., Follicular Carcinoma "An increased incidence of cancer (usually follicular) has been reported from endemic areas. Dominant or rapidly growing nodules in longstanding goiters should always be subjected to aspiration cytology." - Bailey & Love | A |
medmcqa | medmcqa_235 | Which of the following drug reduces blood pressure by directly decreasing the hea rate: | [
"Propanolol",
"Prazosin",
"Alpha methyl dopa",
"Nitroprusside sodium"
] | Propranolol is a non-selective beta blocker. It has a negative chronotropic effect (decreases hea rate) It decreases hea rate by blocking the beta1 receptors located on the hea. It also decreases renin production from JG cells of kidney decreasing BP (Ref- Essentials of medical pharmacology K D TRIPATHI 8th Edition) | A |
medmcqa | medmcqa_236 | Which of the following does not need treatment | [
"Neuroblastoma",
"Burkitt's lymphoma",
"T cell lymphoblastic leukemia",
"AML"
] | Ans. a. Neuroblastoma Though all of the four malignancies in the given options should be treated, but spontaneous regression might be seen in neuroblastoma. So, the Ans. of exclusion is neuroblastoma Tumors with Spontaneous Regression (NCR MR) NeuroblastomaQ Malignant melanomaQ ChoriocarcinomaQ RetinoblastomaQ Renal cell carcinomaQ Leukemia Treatment AML Cytarabine + Anthracycline +/- Etoposideoside CML Imatinib mesylate (DOC), Hydroxyurea, Interferon-y ALL Induction: Vincristine, prednisone, Daunorubicin, asparaginase, intrathecal Methotrexate Consolidation: Cyclophosphamide, aspraginase Maintenance: 6-mercaptopurine, Methotrexate CLL Fludarabine and Chlorambucil Burkitt's Lymphoma Treatment of Burkitt's Lymphoma in both children and adults should begin within 48 hours of diagnosis andinvolves the use of intensive combination chemotherapy regimens incorporating high doses of cyclophosphamide. Prophylactic therapy to the CNS is mandatory. Today, cure can be expected in 70-80% of both children and young adults when effective therapy is | A |
medmcqa | medmcqa_237 | Factors which decrease insensible water losses are all, except - | [
"Humidified air",
"Sedation",
"Hypothermia",
"Prematurity"
] | Ans. is 'd' i.e., Prematurity o Prematurity increases insensible water loss. | D |
medmcqa | medmcqa_238 | Kocher Langenbeck approach for emergency acetabular fixation is done in all Except | [
"Open fracture",
"Progressive sciatic nerve injury",
"Recurrent dislocation inspite of closed reduction and traction",
"None of the above"
] | Progressive sciatic nerve injury "Sciatic nerve palsies as a result of the initial injury occur in approximately 10% to 15% of patients with acetabular fractures. Sciatic nerve injury as a result of surgery occurs in 2% to 6% of patients and is more often associated with posterior fracture patterns treated through the Kocher-Langenbeck and extensile exposures." - Campbell's operative ohopaedics 11/e Chapter 53 -Fractures of Acetabulum and Pelvis Despite searching extensively I could not get any relevant text explaining the rest of options. Here's some material on Kocher-Langenbeck approach, which might be useful. Ref: http://www.maitrise- ohop.com/ corpusmaitri/ohopaedichno74Jractures_cotyle/index_us.shtml The posterior Kocher-Langenbeck approach is probably the best-known and the easiest incision for the management of acetabular fractures. Indications of the Kocher-Langenbeck Approach The following fractures are always accessed through a Kocher-Langenbeck approach: - Posterior wall fractures; - Posterior column fractures; - Posterior column plus posterior wall fractures; - Juxtatectal or infratectal transverse fractures. The following fractures may be accessed through a Kocher-Langenbeck approach: - Transverse fractures through the acetabular roof. However, a lateral approach will often be preferred. - T-shaped fractures, especially if the anterior column is not excessively displaced. Where difficulties are encountered, a large lateral approach is often preferred . - Low both-column fractures that do not involve the iliac wing . The following fractures are never accessed through a Kocher-Langenbeck approach: - Both-column fractures; - Anterior column fractures; - Anterior column plus posterior hemitransverse fractures. | B |
medmcqa | medmcqa_239 | The law stating that "the relative frequency of each gene allele tend to remain constant from generation to generation" is known as - | [
"MendeTs law",
"Hardy-Weinberg law",
"David-Morgan's law",
"Lamarck's law"
] | Ans. is 'b' i.e., Hardy-Weinberg law Hardly-Weinberg lawo The hardly-weinberg law states that "The relative frequencies of each gene allele tends to remain constant from generation to generation ".o Thus, the study of gene frequencies, and the influences which operate to alter the "gene pool'' and their long term consequences is the central theme in population genetics. | B |
medmcqa | medmcqa_240 | Intra uterine hydronephrosis of 32-34 weeks-management? | [
"Intrauterine drainage",
"Wait until 3 weeks",
"Immediate delivery",
"Require serial USG and other associated anomalies"
] | Ans. is `d' i.e., Require serial USG and other associated anomalies Antenatal hydronephrosis (ANH) is transient and resolves by the third trimester in almost one-half cases. The presence of oligohydramnios and additional renal or extrarenal anomalies suggests significant pathology. o All patients with ANH should undergo postnatal ultrasonography The intensity of subsequent evaluation depends on anteroposterior diameter (APD) of the renal pelvis and/or Society for Fetal Urology (SFU) grading. Patients with postnatal APD exceeding 10 mm and/or SFU grade 3-4 should be screened for upper or lower urinary tract obstruction and vesicoureteric reflux. Surgery is considered in patients with increasing renal pelvic APD and/or an obstructed renogram with differential renal function <35-40% or its subsequent decline. | D |
medmcqa | medmcqa_241 | Common drugs responsible for Lichenoid reaction is/are: | [
"Antihypertensive.",
"NSAIDS.",
"Pencillamine.",
"All of the above."
] | Lichenoid reactions are drug induced and exhibit histopathological features similar to lichen planus. The common drugs implicated in oral lichenoid reactions are - antihypertensives, NSAIDS, pencillamine followed by dapsone, ketocanazole, streptomycin, sulfamethoxazole, tetracycline, chloroquine, and oral hypoglycemic agents, etc. | D |
medmcqa | medmcqa_242 | A 16-yrs-old girl presents with bowel obstruction. Laparotomy reveals markedly enlarged para-aoic lymph nodes. Biopsy of lymph nodes exhibit a diffuse neoplastic infiltrate of small, round lymphocytes with a "starry sky" appearance on low power. The cytoplasm of some of the lymphocytes is vacuolated and fat stains are positive. You would expect the neoplastic cells to demonstrate a | [
"Positive non-specific esterase stain of the cells",
"Positive specific esterase stain of the cells",
"Low leukocyte alkaline phosphatase score",
"t(8;14) translocation"
] | The patient has Burkitt lymphoma (Lukes-Collins; small non-cleaved), which is the most common malignant lymphoma in children. Approximately one-third of all childhood lymphomas in the United States are of the Burkitt type. There is an American and a Noh American variant. The relationship of Burkitt to the Epstein-Barr virus is more secure with the Mrican than the Noh American variant. The American variant has a predilection for the jaw, while the Noh American variant is more often an abdominal mass, located in the ileocecal region, ovary, or retroperitoneum. The lymph nodes are diffusely involved with monotonous, round, non-cleaved cells with numerous mitoses (very aggressive cancer) punctuated by clear spaces with macrophages containing debris ("tingible" macrophages) giving the impression of a "starry sky appearance," the stars representing the macrophages and the black of night the lymphocytes. The neoplastic B cells have a characteristic t(8;14) translocation where the c-myc oncogene is translocated from chromosome 8 to chromosome 14. Burkitt cells contain vacuoles that contain lipid, which stains positively with oil red O. It is a high-grade lymphoma with a predilection for metastasis to the bone marrow and other organs. | D |
medmcqa | medmcqa_243 | True about lupus anticoagulant include the following except - | [
"Bleeding episodes can be life threatening",
"↑aPTT",
"May occur without clinical signs",
"May be associated with recurrent mid trimester abortions"
] | null | A |
medmcqa | medmcqa_244 | Best method to find out cases of TB in a community is - | [
"Chest X-ray",
"Mantoux test",
"Sputum smear examination",
"Sputum culture sensitivity"
] | Sputum smear examination by direct microscopy is now considered as the method of choice for case finding. The reliability, cheapness and ease of direct microscopic examination has made it number one case-finding method all over the world . It enables us to discover the epidemiologically most impoant cases of pulmonary tuberculosis , ie; those excreting tubercle bacilli in their sputum . Ref: PARK&;S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE 23rd edition , Page :182 | C |
medmcqa | medmcqa_245 | Best marker to assess prognosis after Surgery for colon carcinoma: March 2005 | [
"CA 19-9",
"CA-125",
"Alpha fetoprotein",
"CEA"
] | Ans. D: CEA CEA is a family of related glycoproteins initially found in embryonic tissue and colon malignancies. The half-life of CEA is approximately 2 weeks. Plasma levels of CEA can be determined readily by radioimmunoassay. However, its usefulness in colon carcinogenesis screening is limited because of its high level in the plasma of a patient's malignancies originating from other sites such as breast, pancreas, stomach and lung. Fuhermore, CEA plasma levels may also be increased in smokers or patients with chronic diseases, such as inflammatory bowel disease, bronchitis and alcoholic liver disease. The clinical usefulness of CEA for screening purposes is fuher limited by the fact that its increase in level typically occurs only when the tumor penetrates through the serosa. Thus, early lesions may not be detected by serum CEA level changes. CEA is typically elevated with metastatic liver disease, but rarely with peritoneal involvement. Thus, while the specificity for CEA to identify occult CRCs is high, the sensitivity is low in most studies for screening. Accordingly, CEA is not a useful test for the screening of CRC. Regardless of the clinicopathologic stage, a preoperative elevation of the plasma CEA level predicts eventual tumour recurrence. High level of CA 19-9 is seen in the plasma of a patient's malignancies originating from colon, breast and pancreas | D |
medmcqa | medmcqa_246 | Treatment of uniocular retinoblastoma in 1st and 2nd stages is: March 2004 | [
"Enucleation",
"Radiotherapy",
"Chemotherapy",
"None"
] | Ans. A i.e. Enucleation | A |
medmcqa | medmcqa_247 | Avascular necrosis is not uncommon. select the type of fracture or dislocation with which it is most likely to be associated (SELECT 1 INJURY) | [
"Navicular (scaphoid) fracture",
"Monteggia's deformity",
"Greenstick fracture",
"Spiral fracture"
] | Fractures of the navicular bone of the wrist should be suspected in anyone, particularly a young person, who falls on an outstretched hand. Although x-rays are mandatory, it is important to realize that the fracture may not be seen on the initial x-ray and that a presumptive diagnosis can and should be made on clinical grounds alone. Typically, there will be tenderness to palpation over the navicular tuberosity and limitation of wrist flexion and extension. Immobilization of the wrist for about 16 week and sometimes up to 6 month is required. Nonunion or avascular necrosis is not uncommon and may require bone grafting for correction.Dislocation of the radial head with a fracture of the proximal third of the ulna is known as Monteggia's deformity. Usually, the radial head is dislocated anteriorly. The injury is usually caused by forced pronation. The injury can be treated by reduction and stabilization of the ulna followed by reduction of the radial head via supination and direct pressure.Anterior shoulder dislocations occur more frequently than posterior dislocations. However, posterior dislocations are seen in special situations, such as during an epileptiform convulsion and during electroshock therapy. Closed reduction followed by immobilization is usually sufficient therapyA spiral fracture, frequently seen in the tibia in skiers, results from the application of torque to a long bone. Greenstick fractures are common in children. The bones of young children are able to bend to a greater degree than those of adults; the fracture may occur only at the site of maximal cortical stress but not at the opposite cortex, the site of maximal longitudinal compression. | A |
medmcqa | medmcqa_248 | Bronchial asthma is characterized by -a) Inflammatory disease of airwayb) Allergic disease of air wayc) Hyporesponsiveness of airwayd) Hyperresponsiveness of airwaye) Treatment is mostly inhaled steroid | [
"abcd",
"bcde",
"acde",
"abde"
] | Asthma -
"Asthma is a chronic inflammatory disorder of the airway that causes recurrent episodes of wheezing, breathlessness, chest tightness and cough particularly at night or in the early morning. These symptoms are usually associated with wide spread but variable bronchoconstriction and airflow limitation that is at least partly reversible, either spontaneously or with treatment. It is thought that inflammation causes an increase in airway responsiveness (bronchospasm) to a variety of stimuli".
- Inhaled steroid has an important role in the t/t of Asthma. | D |
medmcqa | medmcqa_249 | Most commonly this tumour is due to carcinoma of | [
"Stomach",
"Breast",
"Colon",
"Uterus"
] | Transperitoneal implantation of the carcinoma of the stomach may occur in which the carcinoma cells pass from, stomach into the peritoneal cavity; they "gravitate" into the pelvis where the secondaries palpable on rectal examination I may develop. In females, occasionally, they "alight" upon the ovaries giving rise to Krukenberg tumors which are I liable to produce diagnostic confusion. The term Krukenberg tumor is classically reserved" for metastatic involvement of the ovary by a gastrointestinal tumor. The microscopic appearance of Krukenberg tumors shows characteristic mucin-containing signet-ring cells. This term is often used loosely to describe the metastatic involvement of the ovaries in general. These metastatic lesions often present clinically as primary ovarian lesions and may have a similar radiographic appearance to primary carcinoma of the ovary. | A |
medmcqa | medmcqa_250 | Not true about blue sclera | [
"Seen in osteogenesis impeca",
"Does not seen in Ehlers-danlos syndrome",
"Blue colour is produced by underlying uveal pigment",
"Seen in marfan's syndrome"
] | Answer- B. Does not seen in Ehlers-danlos syndromeBlue Sclera is characterized by marked, generalized blue discolouration of sclera due to thinning, The uveal pigment shines through the thin sclera and produces the blue colour.Causes of blue Sclera:Pseudoxanthoma elasticumOsteogenesis imperfectaEhlers-Danlos syndromeMarfan's syndromeAlkaptonuriaHypophosphatasiaJuvenile paget's diseaseNormal in newbornsVan der Hoeve's syndrome | B |
medmcqa | medmcqa_251 | Cataract is NOT seen with | [
"Steroids",
"Vitamin B12 deficiency",
"Diabetes mellitus",
"Homocystinuria"
] | (B) Vitamin B12 deficiency # CAUSES OF CATARACT> Age: Age is the most common cause> Trauma: Blunt trauma, Electrical injuries> Radiation: Ultraviolet light: glassblowers, Lasers> Genetics Chromosome abnormalities associated with cataracts -- 1 q21.1 deletion syndrome, cri-du-chat syndrome, Down synd ome, Patau's syndrome, trisomy 18 (Edward's syndrome), and Turner's syndrome, and Neurofibromatosis type 2. Examples of single-gene disorder -- Alport's syndrome, Conradi's syndrome, myotonic dystrophy, and oculocerebrorenal syndrome or Lowe syndrome.> Skin diseases: Atopic dermatitis & Eczema: Ichthyosis (cuneiform cataracts); Basal-cell nevus & Pemphigus> Smoking and alcohol> Medications: Corticosteroids, Antipsychotics, Miotics> Post-operative: Vitrectomy, Cataract Surgery> Metabolic and nutritional diseases: Aminoaciduria or Lowe's syndrome, Diabetes mellitus, Fabry's disease, Galactosemia /galactosemic cataract, Homocystinuria, Hyperparathyroidism, Hypoparathyroidism, Hypervitaminosis D, Hypothyroidism, Hypocalcaemia, Mucopolysaccharidoses, Wilson's disease> Congenital: Congenital syphilis, Cytomegalic inclusion disease, Rubella, Cockayne syndrome\> Genetic syndromes: Down syndrome, Patau syndrome, Edwards syndrome> Infections: Cysticercosis, Leprosy, Onchocerciasis, Toxoplasmosis, Varicella> Secondary to other eye diseases: Retinopathy of prematurity, Aniridia, Uveitis, Retinal detachment, Retinitis pigmentosa | B |
medmcqa | medmcqa_252 | CD marker specific for myeloid series is: | [
"CD34",
"CD45",
"CD99",
"CD117"
] | . CD117 | D |
medmcqa | medmcqa_253 | What is true about Factories Act: | [
"Cannot be employed under 14",
"Cannot be employed under 14 for dangerous jobs",
"Maximum 72 hours per week for adolescents",
"It was can be employed"
] | Ans. a. Cannot be employed under 14THE FACTORIES ACTScope: The Act defines factory as an establishment employing 10 or more persons where power is used and 20 or more person where power is not used.Work related rules:Employment of young persons.Employment prohibited foe age less than 14 years.15-18 years old adolescents to be declared fit by "Certifying surgeon"; will work only between 6 AM and 7 PM.Employment prohibited in certain dangerous occupationsHours of work:A maximum of 4 Vi hours of work per day for adolescents.48 hours per week (9 hours per day).Maximum 60 hours per week (Including overtime).Leave with age:1 day per 15 days of work for adolescentsLeaves can be accumulated up to 40 days.Health, Safety and Welfare recommendations:A minimum of 500 cubic feet square space per workers.1 safety officer for per 100 workers1 canteen for greater than 250 workers.1 Creche for greater than 30 women workersUnder factories act, there are 29 disease which are modifiable. | A |
medmcqa | medmcqa_254 | Blow out fracture of the orbit, most commonly leads to fracture of: | [
"Posteromedial floor of orbit",
"Medial wall of orbit",
"Lateral wall of orbit",
"Roof of orbit"
] | "The most common site for a blowout fracture to occur is the posteromedial aspect of the orbital floor, medial to the infraorbital neurovascular bundle where the maxillary bone is very thin." - The Internet Journal of Otorhinolaryngology Blow out fracture: The usual mechanism is a blow to the eye, with the forces being transmitted by the soft tissues of the orbit downward to the thin floor of the orbit. The floor is usually the path of least resistance, and fractures downward into the maxillary sinus. Clinical features: Enophthalmos Recession of the eyeball within the orbit Diplopia: Double vision Especially on upward gaze Due to inferior rectus entrapment Forced Duction test is positive confirming the presence of muscle restriction Hypesthesia: Reduced sense of touch or sensation Due to injury of infraorbital nerve Usually have numbness of the gingiva and of the skin of the midface Investigation: Radiograph (Waters view) may see a soft tissue mass on the superior margin of the maxillary sinus, representing the herniated periorbital tissues into the sinus. Hanging drop or tear drop sign: hanging opacity of superior maxillary antrum. Computed tomography is the gold standard. Coronals provide best view. Extraocular muscle rounding and herniation of fat into maxillary sinus can be clearly viewed. Management: Medical management for asymptomatic patients-IV antibiotics and sho course of oral steriods. Surgical management for symptomatic patients. Ref: Parson's Disease of the eye, 20th Edition, Page 468; Comprehensive opthalmology, By A.K Khurana, 4th Edition, Page 397 | A |
medmcqa | medmcqa_255 | Laryngeal papillomas is caused by which HPV ? | [
"6, 11",
"16, 18",
"33, 45",
"4, 27"
] | Ans. is 'a' i.e.,6, 11Laryngeal papillomatosis is wa with commmonly site of invovement is larynx and respiratory tract,involving HPV type 6 and 11. | A |
medmcqa | medmcqa_256 | The following laxative lowers blood ammonia level in hepatic encephalopathy | [
"Bisacodyl",
"Lactulose",
"Magnesium sulfate",
"Liquid paraffin"
] | Lactulose:- It is a semisynthetic disaccharide of fructose and lactose which is neither digested nor absorbed in the small intestine--retains water. Fuher, it is broken down in the colon by bacteria to osmotically more active products. In a dose of 10 g BD taken with plenty of water, it produces soft formed stools in 1-3 days. Flatulence and flatus is common, cramps occur in few. In patients with hepatic encephalopathy, lactulose causes reduction of blood NH3 concentration by 25-50%. The breakdown products of lactulose are acidic--lower the pH of stools. Ammonia produced by bacteria in colon is conveed to ionized NH4 + salts that are not absorbed. Ref:- kd tripathi; pg num:-676 | B |
medmcqa | medmcqa_257 | A 21-year-old man presents with symptoms of headache, fever, chills, and discomfort in both sides of his jaw. He has also noticed discomfort in his testes, but no dysuria or urethral discharge. Physical examination reveals bilateral enlargement of the parotid glands, as well as bilateral testicular enlargement and tenderness on palpation. His temperature is 38.5degC pulse rate of 92/min, and the remaining examination is normal. Laboratory data show hemoglobin 15 g/dL; hematocrit 40%; WBC 12000/mL, with 30% segmented neutrophils, 8% monocytes, and 62% lymphocytes. Which of the following statements concerning this disease is true? | [
"the disease is caused by a herpesvirus",
"the incubation period is 3-5 days",
"the most common complication of this disease in post-pubertal boys and men is orchitis",
"recurrent infections may occur"
] | Orchitis occurs in about 20% of males, but is usually unilateral, thus sterility is rare. The disease is caused by a paramyxovirus and one infection confers lifelong immunity. The incubation period is 14-18 days. Serum amylase is elevated in most cases of mumps because of parotitis, not pancreatitis. Other complications include thyroiditis, myocarditis, and polyarthritis. | C |
medmcqa | medmcqa_258 | Tubercular laryngitis affects primarily - | [
"Anterior commissure",
"Posterior commissure of larynx",
"Anywhere within the larynx",
"Superior surface of larynx"
] | Tuberculosis affects posterior part of larynx more than anterior part.
Parts affected are: Inter arytenoid fold > Ventricular bands > Vocal cords > Epiglottis | B |
medmcqa | medmcqa_259 | The commonest malignant tumor of the orbit in the 19A decade (children) is | [
"Retinoblastoma",
"Neuroblastoma",
"Rhabdomyosarcoma",
"Chloroma (AML) and ALL"
] | C i.e. Rhabdomyosarcoma | C |
medmcqa | medmcqa_260 | All the following changes are caused in the retina by benign hypertension except – | [
"Narrowing of arterioles",
"Exudates",
"Cotton wool spots",
"Retinal hemorrhage"
] | The major objection to Keith-Wagener classification is that, it does not clearly distinguish between the retinal changes of benign and malignant hypertension. So, by looking keith - wagener classification, you can not differentiate the retinal lesions of benign and malignant hypertension. For example, soft exudates (cotton wool spots are characteristic of malignant hypertension and hard exudates are usually seen in elderly patients with benign hypertension; however, both are included in keith-wagner's grade III. Therefore, Fishberg and oppenheimer proposed a classification which draws a distinction between retinal lesions of benign hypertension (i.e., retinal arteriosclerosis with arteriosclerotic retinopathy) and retinal lesions of malignant hypertension ( hypertensive neuroretinopathy).
Retinal arteriosclerosis with arteriosclerotic retinopathy (Benign hypertension)
Arteriolar narrowing (diffuse)
Focal arteriolar narrowing
Arteriovenous crossing changes
Broadening of light reflex (copper wire or silver wiring)
Perivasculitis
Solitary round hemorrhage
Hard exudates
Central or branch venous occlusion
Hypertensive uenroretinopathy (Malignant hypertension)
Generalized arteriolar narrowing
Striate (flame-shaped) hemorrhage
Cotton - wool spots (soft exudates)
Bilateral papilledema
Macular star | C |
medmcqa | medmcqa_261 | Treatment of alcohol dependence includes? | [
"Morphine",
"Chlordiazepoxide",
"Sertarline",
"Methadone"
] | Ans. is 'b' i.e., Chlordiazepoxide Treatment of alcohol dependence* Detoxification (treatment of withdrawal) BZDs are the drugs of choice, e.g. chlordiazepoxide (1st choice), Diazepam (2nd choice).* Maintenance after detoxification (to prevent relapse and maintenance of abstinence)i) Aversive agents (deferent agents):- Disulfiram, CCC, metronidazole, Natrafezole.ii) Anticraving agent:- Naltrexoney Acamprosate, fluoxetine, Topiramate, Nalmefene* Naltrexone is the preferred agent for maintenance of abstinence | B |
medmcqa | medmcqa_262 | Which is not a NNRTI - | [
"Ritonavir",
"Nevirapine",
"Efavirenz",
"Delavirdine"
] | Ans. is 'a' i.e., Ritonavir Antiretroviral drugsa) Nucleoside reverse transcriptase inhibitors (NRTIs) - Zidovudin, Didanosine, Zalcitabine, Stavudine, Lamivudine, Abacavir.b) Nucleotide reverse transcriptase inhibitor - Tenofovirc) Nonucleoside reverse transcriptase inhibitors (NNRTIS) - Nevirapine, Efavirenz, Delavirdine, Etravirine Rilpivirine.d) Protease inhibitors - Ritonavir, Indinavir, Nelfinavir, Saquinavir, amprenavir, Lopinavir, Fosamprenavir, Atazanavir, Darunavir, Tipranavir.e) Fusion inhibitor - Enfuvirtide, Maraviroc.f) Integrase inhibitors - Roltegravir, Elvitegravir. | A |
medmcqa | medmcqa_263 | Danazol is used in the treatment of: | [
"Cyclical mastalgia",
"Breast cyst",
"Non-cyclical mastalgia",
"Epithelial changes in breast"
] | Danazol is a synthetic testosterone which binds to progesterone and androgen receptors Danazol is used for benign breast diseases and is good for fibrocystic disease. Cyclical mastalgia due to increase engorgement (estrogenic ) will also be relieved with danazol. Almost 70% patients with cyclical mastalgia will repo relief. | A |
medmcqa | medmcqa_264 | Ine foreign body in the eye - | [
"Nickel",
"Copper",
"Iron",
"Silver"
] | Ine substances- glass, plastic, porcelain and metals like gold, silver, platinum and titanium ( no reaction) Suppurative reaction is excited by pure copper, zinc, nickel and mercury paicles. Specific reactions are prodeuced by iron (siderosis bulbi) and copper alloys (chalcosis). Ref : Parsons' 22 nd edition, page no.395 | D |
medmcqa | medmcqa_265 | Wandering acetabulum is seen in | [
"Septic arthritis of Hip",
"TB Hip",
"Transient synovitis of Hip",
"Psoas abscers"
] | null | B |
medmcqa | medmcqa_266 | Which of the follow ing hepatitis viruses is a DNA virus - | [
"Hepatitis C virus",
"Hepatitis B virus",
"Delta agent",
"Hepatitis E virus"
] | Ans. is 'b' i.e., Hepatitis B virus o Hepatitis B is the only hepatitis virus w hich has DNA. All others are RN A viruses.o Among the hepatitis viruses, HBV (hepadanavirus) and HCV (flavivirus) can cause hepatocellular carcinoma.VirusHAV, 27 nm RNA Picomavirus (Hepatovirus)HBV, 47 nm DNA (Hepadnavirus)HCV, 30-60 nm RNA, Flavivirus (Hepacivirus)HD V, 35-37 nm Defective RNA DeltavirusHEV, 32-34 nm RNA HerpesvirusModes of infectionFecal-oralPercutaneous, Vertical, SexualPercutaneousPercutaneousFecal-oralAge affectedChildrenAny ageAdultsAny ageYoung adultsIncubation period (days)154530-18015-16030-18015-60OnsetAcuteInsidiousInsidiousInsidiousAcuteIllnessMildOccasionally severeModerateOccasionally severeMild, except in pregnancyCarrier stateNilCommonPresentNil (only with HBVNilOncogenicityNilPresent specially after neonatal infectionPresentNilNilPrevalenceWorldwideWorldwideProbably worldwideEndemic areas (Mediterranean, N Europe, Central and N America)Only developing countries (India Asia. Africa Central, America)Specific prophylaxisIg and Vaccineig and vaccineNilHBV vaccineNil | B |
medmcqa | medmcqa_267 | All are seen in Thalassemia major EXCEPT: | [
"Transfusion dependency",
"Splenoheptatomegaly",
"Ineffective erythropoiesis",
"Macrocytic anemia"
] | Ans. (d) Macrocytic anaemiaRef. Robbins pathology 9th ed. /638* Thalassemia major presents before 1 yr of age with severe anemia which necessitates packed RBC transfusions every 2-3 months. The child is said to be transfusion dependent as survival is decided by RBC being transfused.* The ineffective erythropoiesis in bone marrow results in shift of hematopoiesis to liver and the bone marrow. Hence the liver and spleen enlarge in size. But the net result is defective microcytes being produced. The type of anaemia is microcytic hypochromic anaemia.* Remember: causes of MACROCYTIC ANAEMIA: "ABCDEF":# Alcohol + liver disease# B12 deficiency# Compensatory reticulocytosis (blood loss and hemolysis)# Drug (cytotoxic and AZT)/ Dysplasia (marrow problems)# Endocrine (hypothyroidism)# Folate deficieny/Fetus (pregnancy) | D |
medmcqa | medmcqa_268 | In which of the following vegetations are friable and easily detachable from the cardiac valves | [
"Rheumatic hea",
"Rheumatoid disease",
"SLE",
"Infective endocarditis"
] | . | D |
medmcqa | medmcqa_269 | Early cord clamping is done is all except : | [
"Rh isoimrnunization",
"Fetal asphyxia",
"Postmaturity",
"Prematurity"
] | Postmaturity | C |
medmcqa | medmcqa_270 | Mononuclear phagocytes are produced by ? | [
"Thymus",
"Spleen",
"Bone marrow",
"Liver"
] | Ans. is 'c' i.e., Bone marrow Mononuclear macrophage cells originate in the bone marrow from precursor cells and become monocytes in about 6 days. | C |
medmcqa | medmcqa_271 | Which one of the following bonds links two nucleotides in a nucleic acid? | [
"3'-3' phosphodiester bond",
"3'-5' phosphodiester bond",
"5'-5' phosphodiester bond",
"5'-5' phosphotriester bond"
] | Nucleic acids are directional molecules: 5' end is the end with free (unesterified) phosphate group. 3' end is the end with free OH group. Nucleic acid sequences are written in 5'-3' direction. During the synthesis of nucleic acids, 3' OH group of existing nucleotide is esterified to the 5' phosphoryl group of the incoming nucleotide 3'-5' phosphodiester bond. | B |
medmcqa | medmcqa_272 | Which drug directly stimulates contraction of cardiac muscle | [
"Digitalis",
"ACE inhibitors",
"Nesiritide",
"Losaan"
] | Ans. is'a'i.e., DigitalisCardiac glycosides (digitalis) act directly on the hea to increase the force of contraction. | A |
medmcqa | medmcqa_273 | The following are recognised signs any symptoms of raised intracranial tension in a 9 month old infant, except – | [
"Bulging fontanel",
"Diplopia",
"Papilloedema",
"Increase in head size"
] | null | C |
medmcqa | medmcqa_274 | Commonest causative organism for ASOM in 2 years child is: | [
"Pneumococcus",
"H. influenzae",
"Staphylococcus",
"Streptococcus"
] | Most common cause of acute otitis media:Streptococcus pneumonia / pneumococcus (35-40% cases)H. influenza (25-30%)M. catarrhalis (10-20%) | A |
medmcqa | medmcqa_275 | Reversible cause of dementia | [
"Hypothyroidism",
"Alzheimer's disease",
"None",
"Vitamin A deficieny"
] | A i.e (Hypothyroidism) | A |
medmcqa | medmcqa_276 | Function of mitochondrial DNA - | [
"Encodes proteins of cell membrane",
"Encodes proteins of respiratory chain",
"Helps in cell replication",
"Formation of rRNA"
] | Ans. is 'b' i.e., Encodes proteins of respiratory chain o Human mitochondria contain two to ten copies of a small circular double-stranded DNA molecule that makes up approximately 1% of total cellular DNA. The majority of the peptides in mitochondria (about 54 out of 67) are coded by nuclear genes. The rest are coded by genes found in mitochondrial (mt) DNA.This mtDNA codes for mt ribosomal and transfer RNAs and for 13 proteins that play key roles in the respiratory chain.Some Major Features of the Structure and Function of Human Mitochonrial DNAo Is circular, double-stranded, and composed of heavy (H) and light (L) chains or strands,o Contains 16,569 bp.o Encodes 13 protein subunits of the respiratory chain (of a total of about 67) -y Seven subunits of NADH dehydrogenase (complex I)y Cytochrome b of complex IIIy Three subunits of cytochrome oxidase (complex IV)y Two subunits of ATP synthaseo Encodes large (16S) and small (12S) mt ribosomal RNAso Encodes 22 mt tRNA moleculeso Genetic code differs slightly from the standard code -y VGA (standard stop codon) is read as Trp.y AGP and AGG (standard codons for Arg) are read as stop codons,o Contains very few untranslated sequences,o High mutation rate (5 to 10 times that of nuclear DNA).o Comparisons of mtDNA sequences provide evidence about evolutionary origins of primates and other species. | B |
medmcqa | medmcqa_277 | Locard’s principle is concerned: | [
"Theory of relativity",
"Theory of decomposition",
"Theory of trauma",
"Theory of exchagnge"
] | Ref. Textbook of forensic medicine. Krishnan Vij. Page. 302
Locard Principle:
When any two objects come into contact, there is always a transfer of material from each object on the other.
Some examples are fingerprints, footprints,hair, tool marks etc. | D |
medmcqa | medmcqa_278 | Which of the following is a prodrug - | [
"Enalapril",
"Clonidine",
"Salmeterol",
"Acetazolamide"
] | Ans. is 'a' i.e., Enalapril Prodrugo Few drugs are inactive as such and need conversion in the body to one or more active metabolites,o Such a drug is called a prodrug.o All the drugs in following table are very important, sorry, I can not shorten the listProdrugLevodopaEnalaprila - MethyldopaChloralhydrateDipiveffineOxcarbazepinePrednisoneBacampicillinSulfasalazineCyc lophospham ideMercaptopurineFluorouracilSulindacAzathioprineCortisoneBenorilateProguanilZidovudinTerfenadineProntosilo Advantages of prodrugs over active formMore stableBetter bioavailabilityLess side effects and toxicity. | A |
medmcqa | medmcqa_279 | The endotoxin of the following gram negative bacteria does not play any pa in the pathogenesis of the natural disease. | [
"E. coli",
"E. coli",
"Vibrio cholerae",
"Pseudomonas"
] | Ans. is 'c' i.e., Vibrio cholerae . Cholera vibrios possess the lipopolysaccharide 0 antigen (LPS endotoxin), but it has no role in pathogenesis. About other options . Somatic lipopolysaccharide surface 0 antigen of E.coli has endotoxic activity and also protect the bacilli from phagocytosis . Long chain lipopolysaccharide (endotoxin) of klebsiella protects it from the action of serum complement . Endotoxin of pseudomonas causes fever, leukocytosis or leukopenia, shock, DIC, hypotension, ARDS, SIRS. | C |
medmcqa | medmcqa_280 | According to the WHO, what is the minimum bacteriological standard for drinking water - | [
"All the samples should not contain coliform organisms",
"3 consecutive samples of water should not contain any coil forms",
"3 coliforms in a 100 ml water",
"I coliform in a 100 ml water"
] | Ans. is 'a' i.e., All the samples should not contain coliform organisms | A |
medmcqa | medmcqa_281 | All are infraclavicular branches of brachial plexus except? | [
"Ulnar nerve",
"Long thoracic nerve",
"Axillary nerve",
"Thoracodorsal nerve"
] | The long thoracic nerve arises from the root stage of the brachial plexus. They are present behind the scalenus anterior and scalenus medius in the neck. The ulnar nerve is a branch of the medial cord. The thoracodorsal and axillary nerve are branches of the posterior cord. The cords of the brachial plexus are formed in the cervicoaxillary canal and hence are infraclavicular in position Reference: Clinical Anatomy for students, a problem-solving approach, Neeta v Kulkarni, 2nd edition, page no.98, 99 | B |
medmcqa | medmcqa_282 | All are waterborne diseases except - | [
"Typhoid",
"Fish tape worm",
"HAV",
"Cholera"
] | Fish tapeworm(Diphyllobothrium latum) Infection is acquired when the person eats undercooked fish containing the parasite and not by drinking water! Park's Textbook of Preventive and Social Medicine, 25th Edition Ref: 25th Ed K.Park's Textbook Of Preventive and Social Medicine | B |
medmcqa | medmcqa_283 | First substrate of Kreb's cycle is | [
"Pyruvate",
"Glycine",
"HC1",
"Lipoprotein"
] | Ans. is 'a' i.e. Pyruvate The Kreb's cycle or citric acid cycle or tricarboxylic acid cycle is the final common pathway for the aerobic oxidation of carbohydrate, lipid and protein because glucose, fatty acids and most amino acids are metabolised to acetyl-CoA or intermediates of the cycle.The first reaction of the citric acid cycle is the condensation of acetyl-CoA with oxaloacetate to form citrate, catalyzed by citrate synthase. Oxalo-acetate is the first substrate of citrate synthase, it binds to the enzyme and induces a large conformational change in the flexible domain, creating a binding site for the second substrate, acetyl CoA.Thus the answer should be oxalo-acetate. Since it was not amongst the option, the best option is Pyruvate. Pyruvate formed at the end of glycolysis is taken up into mitochondria where it is converted to acetyl-CoA. | A |
medmcqa | medmcqa_284 | Terminal spined eggs are seen in: | [
"Schistosoma haematobium",
"Sch. mansoni",
"Sch. Japonicum",
"Chlonorchis sinensis"
] | Ans. is 'a' i.e., Schistosoma haematobium (Ref: Chatterjee, 12th/e, p. 138)Schistosoma haematobium - has terminal spine QSchistosoma mansoni - Egg has lateral spine QSchistosoma japonicum - Egg has lateral knob Qs | A |
medmcqa | medmcqa_285 | Hematuria with dysmorphic RBCs is a feature of which one of the following ? | [
"Acute cystitis",
"Prostatitis",
"Hereditary nephritis",
"Cyclophosphamide toxicity"
] | Hereditary nephritis is a genetically heterogeneous disorder characterized by nephritic syndrome (ie, hematuria, proteinuria, hypeension, eventual renal insufficiency) often with sensorineural deafness and, less commonly, ophthalmologic symptoms. Cause is a gene mutation affecting type IV collagen Ref Harrison20th edition pg 278 | C |
medmcqa | medmcqa_286 | Which of the following bacteria manifests its clinical features by increasing cAMP? | [
"Vibrio cholerae",
"Staphylococcus aureus",
"E. coli heat stable toxin",
"Salmonella"
] | Vibrio cholerae secretes an enterotoxin called choleragen (cholera toxin). Choleragen consists of an A (active) subunit and a B (binding) subunit. The B subunit binds to a ganglioside receptor on the surface of the enterocyte. The A subunit is inseed into the cytosol, where it catalyzes the addition of ADP-ribose to the Gs protein. This locks the Gs protein in the "on" position, which causes the persistent stimulation of adenylate cyclase. The resulting overproduction of cyclic AMP activates cyclic AMP-dependent protein kinase, an enzyme that phosphorylates ion transpoers in the cell membrane, resulting in the loss of water and ions from the cell. The watery efflux enters the lumen of the gut, resulting in a massive watery diarrhea that contains neither neutrophils nor red blood cells. Ref: Levinson W. (2012). Chapter 18. Gram-Negative Rods Related to the Enteric Tract. In W. Levinson (Ed), Review of Medical Microbiology & Immunology, 12e. | A |
medmcqa | medmcqa_287 | A deficiency of pancreatic exocrine secretion can result in which one of the following? | [
"An increased pH in the intestinal lumen",
"An increased absorption of fat-soluble vitamins",
"A decreased formation of bile salt micelles",
"Increased levels of blood chylomicrons"
] | The pancreas produces bicarbonate (which neutralizes stomach acid) and digestive enzymes (including pancreatic lipase and colipase, enzymes that degrade dietary lipids). The decreased production of bicarbonate will lead to a decrease in intestinal pH. Lower levels of pancreatic lipase will result in the decreased digestion of dietary triacylglycerols, which will lead to the formation of fewer bile salt micelles. The reduced pH will also interfere with the ability of the bile salts to effectively form micelles. Intestinal cells will have less substrate for chylomicron formation, and less fat-soluble vitamins will be absorbed. More dietary fat will be excreted in the feces. | C |
medmcqa | medmcqa_288 | Which intravenous anaesthetic agent has cocaine line effect on cardiovascular system | [
"Thiopentone",
"Propofol",
"Ketamine",
"Etomidate"
] | Ketamine like cocaine inhibits adrenaline and noradrenaline uptake and act as sympathomimetic. KETAMINE * It is structurally related to phencyclidine * Water soluble, transparent available in 1%, 2% and 5% solution * Routes of administration - IV, IM, oral, Rectal intranasal. * Produces so - called dissociative anesthetics Characterized by profound analgesia and amnesia even though patients may be conscious and maintain protective reflexes. The proposed mechanism for this cataleptic state includes electro physiologic inhibition of thalmocoical pathways and stimulation of limbic system. * Metabolism - Extensively metabolized by hepatic microsomal cytochrome P450 enzymes and its primary metabolite, norketamine is one-third to one-fifth as potent as the parent compound. * CNS - Increase CMRO2, CBF and ICP Neuroprotective Can induce myoclonic and seizure like activity but paradoxically has anticonvulsant propeies also. * CVS - Cardiovascular - Stimulating effects secondary to direct stimulation of the sympathetic nervous system. New - Ketamine is available as Racemic mixture. S(+) Ketamine separated is three times more potent in anesthetics and analgesic propeies | C |
medmcqa | medmcqa_289 | UV light damage to the DNA leads to: | [
"Formation of pyrimidine dimers",
"No damage to DNA",
"DNA hydrolysis",
"Double stranded breaks"
] | Ans. A. Formation of pyrimidine dimers(Ref: Harper 31/e page 374)DNA lesions formed by UV light damage are Bulky adducts and Pyrimidine Dimers | A |
medmcqa | medmcqa_290 | Allen's test is used to diagnose: | [
"Thoracic outlet syndrome",
"Palmar arch insufficiency",
"Superior vena cava syndrome",
"Coarctation of aorta"
] | Ref: Bailey and One's Short Practice of Surgery 25th EditionExplanation:Allen's testIt is a test for the patency of the radial artery after insertion of an indwelling monitoring catheter. The patient's hand is formed into a fist *nd the ulnar artery is compressedcompression continues while the fist is opened.If blood perfusion through the radial artery is adequate, the hand should Hush and resume its normal pinkish coloration.Adsonks testIt is the loss of the radial pulse in the arm by- rotating head to the ipsi lateral side with extended neck following deep inspiration.It is seen in thoracic outlet syndrome (TOS) | B |
medmcqa | medmcqa_291 | An 18-year-old boy is admitted with psychotic behavior. On examination, he is having dystonia and in-coordination. Liver enzymes are elevated. Which of the following is a possible diagnosis? | [
"Rheumatic Chorea",
"Westphal variant of Huntington disease",
"Wilson disease",
"Hallervorden Spatz disease"
] | Disease Differentiating Features Rheumatic chorea -Emotional lability and poor handwriting -Hung up reflexes, -Pronator sign -Daing tongue LFT is normal. Westphal variant of Huntington disease Akinetic-rigid Parkinsonism like LFT isnormal. Hallervorden Spatz disease -Parkinsonism like features -Cognitive decline -Retinal pigmentary changes Wilson disease. -Basal ganglia damage -Deranged liver function | C |
medmcqa | medmcqa_292 | Mutton for keratic precipitate and Busacca's nodules is seen in: | [
"Granulomatous uveitis",
"Non-granulomatous uveitis",
"Posterior uveitis",
"Choroiditis"
] | Ans. Granulomatous uveitis | A |
medmcqa | medmcqa_293 | The use of desmopressin is best indicated for therapy in which of the following bleeding disorders? | [
"Severe hemophilia A",
"Severe hemophilia B",
"Von Willebrand disease (VWD)",
"Glanzmann thrombasthenia"
] | Patients with Von Willebrand disease facing hemostatic challenges (dental work, surgery, etc.) can be treated with desmopressin, which stimulates vWF release, or with infusions of plasma concentrates containing factor VIII and vWF. Hemophilias A and B (severe phenotype) are treated by deficient factor replacement therapy, fresh frozen plasma, etc. Desmopressin can be used in the treatment of mild hemophilia A. Platelet transfusion is the standard treatment for severe bleeding and perioperative hemostasis in patients with Glanzmann thrombasthenia. | C |
medmcqa | medmcqa_294 | During neonatal resuscitation, the chest compression to ventilation ratio is ___________ | [
"3:01",
"5:01",
"10:01",
"15:01"
] | * Chest compressions consists of rhythmic compressions of sternum that compress the hea against the spine , increase the intra thoracic pressure and circulate the blood to vital organs of the body . *It is impoant to ventilate in between chest compressions. A positive breath should follow every third chest compression(chest compression to ventilation ratio is 3:1). In one minute, 90 chest compressions and 30 breaths are administered(120 events). To obtain this, the chest should be compressed 3 times in 1.5 seconds leaving out approx. 0.5 second for ventilation. Reference: page 131 Ghai Essential Pediatrics 9 th edition | A |
medmcqa | medmcqa_295 | Ricketssia Reckettsii is responsible for which disease - | [
"Endemic typhus",
"Epidemic typhus",
"Scrub typhus",
"Rocky mountain spotted fever"
] | Ans. is 'd' i.e., Rocky mountain spotted fever VectorDiseases and organisms1) MiteScrub typhus (R. tsutsugamushi), Rickettsial pox (R. akari)2) LouseEpidemic typhus (R. prowaekii), Trench fever (R. quintana)3) FleaEndemic or murine typhus (R. typhi)4) TickIndian tick typhus (R. conorii), RMSF (R. Rickettsii) | D |
medmcqa | medmcqa_296 | A 2 day old newborn baby presented with microcephaly, macroglossia, visceromegaly and a blood glucose level of 20 mg/d1. What is the most likely diagnosis | [
"Prader-Willi syndrome",
"Beckwith Wiedman syndrome",
"Werner syndrome",
"Cockayne syndrome"
] | Ans. is 'b' i.e., Beckwith-Wiedman syndrome o Beckwith-Wiedman syndrome has been explained -3 See wilms tumor. | B |
medmcqa | medmcqa_297 | Which substance is/are not deposited in hepatocyte? | [
"Lipofuschin",
"Melanin like pigment",
"Bile pigment",
"Melanin"
] | Bile pigment deposition at sweat pores of patients with liver disease REFERANCE. jaad .org | C |
medmcqa | medmcqa_298 | The rash in measles occurs first in occurs first in the .....region : | [
"Forehead",
"Post auricular",
"Chest",
"Neck"
] | B i.e. Post auricular | B |
medmcqa | medmcqa_299 | Which one of the following is the best irrigation solution during TURP is | [
"Normal Saline",
"Isotonic glycine",
"RLL",
"5% Dextrose"
] | Best soulution is Isotonic glycine
NS can be used while using bipolar cautery. | B |
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