question
stringlengths 1
1.57k
| exp
stringlengths 1
22.5k
⌀ | cop
int64 1
4
| opa
stringlengths 1
287
| opb
stringlengths 1
287
| opc
stringlengths 1
286
| opd
stringlengths 1
301
| subject_name
stringclasses 21
values | topic_name
stringlengths 3
135
⌀ | id
stringlengths 36
36
| choice_type
stringclasses 2
values |
|---|---|---|---|---|---|---|---|---|---|---|
Which is the most common cause of male infertility | Varicocele is the most common cause of male infertility. | 2 | Smoking | Varicocele | Epididymitis | Idiopathic | Surgery | null | 6553360a-576c-46a0-9ed3-118c9cc0c85e | single |
Sterile vegetations are seen in all except | Infective endocarditis is a serious infection mandating prompt diagnosis and intervention. Microbial invasion of hea valves or mural endocardium--often with destruction of the underlying cardiac tissues--characteristically results in bulky, friable vegetations composed of necrotic debris, thrombus, and organisms.destruction of the underlying cardiac tissues--characteristically results in bulky, friable vegetations composed of necrotic debris, thrombus, and organisms. (Robbins Basic Pathology,9th edition,pg no.393) | 2 | SLE | Infective endocarditis | Rheumatic fever | Marantic endocarditis | Pathology | Cardiovascular system | b2cba28d-1f02-4b5d-86c8-a2016827a54a | multi |
BASDAI criteria is indicated in | BASDAI(Bath Ankylosing Spondylitis disease activity index) Used to know effectiveness of drug therapy On a scale of 1-10 it is measured by various factors like discomfo, pain, morning stiffness etc If the value is >4 there is suboptimal control of disease | 1 | Ankylosing spondylitis | Rheumatic Ahritis | Kawasaki Disease | Any autoimmune disease | Surgery | Trauma | ecdacc04-6369-4fb1-a791-73f9a796fb2a | single |
A patient has Rinne test +ve for left ear and weber test is lateralized to right ear, what type of deafness may be seen in this case? | Tuning fork tests and their interpretation Test Normal Conductive deafness SN deafness Rinne AC>BC (Rinne +ve) BC>AC (Rinne -ve) AC>BC Weber Not lateralized Lateralized to poorer ear Lateralized to better ear. | 3 | Left conductive HL | Right conductive HL | Left sensorineural HL | Right sensorineural HL | ENT | DNB 2018 | 27645fbc-0642-4689-8465-62e9f48af013 | single |
The blood pressure regulatory system that is labeled as a buffer system is | Baroreceptor system opposes either increases or decreases in aerial pressure, it is called a pressure buffer system, and the nerves from the baroreceptors are called buffer nerves.Ref: Guyton and Hall textbook of medical physiology 13th edition. Page: 221 | 1 | Baroreceptor | Chemoreceptor | Kidney | CNS ischemic response | Physiology | Cardiovascular system | 03116128-cd45-484a-aafc-b11f4f50b82a | single |
A patient requires mild cholinomimetic stimulation following surgery. Physostigmine and bethanechol in small doses have significantly different effects on which of the following ? | null | 2 | Gastric secretion | Neuromuscular junction | Sweat glands | Ureteral tone | Pharmacology | null | 375bc644-1968-4f4c-91e5-fee8e160a3b2 | multi |
Least common valve involved in rheumatic fever? | Ans. is 'd' i.e., Pulmonary valve Endocarditis in rneumatic fever Mitral valve involved almost all the cases of Acute Rheumatic Fever. Almost 25% of MR is asociated with aoic regargitation. Tricuspid regurgitation is seen in 10-30% cases. Pulmonary valve involvement is never seen. | 4 | Aoic valve | Tricuspid valve | Mitral valve | Pulmonary valve | Pediatrics | null | a6e85470-310a-47ff-ac79-e6a9802d1d7e | single |
t(2,8) is associated with: | t(2,8) causing translocation vetween immunoglobulins k chain on chromosome 2 and the myc gene present on chromosome 8 and is seen in Burkitts lymphoma .The translocation results in the increased expression of c-myc resulting in development of neoplasia. (ref Robbins 8th/608) | 2 | T cell ALL | B cell ALL | CML | CLL | Anatomy | Haematology | 2574b5c2-7fdc-47a5-9317-de536dd69da6 | multi |
Cause of persistance of a sinus or fistulae includes? | Ans. is `d' i.e., All of the above | 4 | Foreign body | Non dependentt drainage | Unrelieved Obstruction | All of the above | Surgery | null | 859f17f6-fb76-4ed6-b791-7fa63b1c87d4 | multi |
Multiple submucosal neuromas is most likely associated with - | Mucosal neuromas are made up of nerve cells, often with thickened perineurium, intewined with one another in a plexiform pattern. Multiple endocrine neoplasia type 2B is a genetic disease that causes multiple tumors on the mouth, eyes, and endocrine glands. It is the most severe type of multiple endocrine neoplasia,differentiated by the presence of benign oral and submucosal tumors in addition to endocrine malignancies. Ref Harrison 20th edition pg 530 | 1 | Multiple endocrine neoplasia type 2B | Ovarian carcinoma | Testicular teratoma | Pancreatic beta cell carcinoma | Medicine | Oncology | 0298a527-253e-4da8-b617-00530b799454 | single |
Baby born to DM have following except: | null | 1 | Hypercalcemia | Hypokalemia | Hypoglycemia | Obesity | Gynaecology & Obstetrics | null | 0edf59d8-0f01-48d7-9d9e-b659aa4df6ba | multi |
Daily vitamin A intake | null | 4 | 1000 I.U | 2000 I.U | 3000 I.U | 4000 I.U | Biochemistry | null | 70a6f70a-d6a6-4579-b2a4-54bce21a29b1 | single |
Not an indication for cholecystectomy for asymptomatic gallstones | Indications of prophylactic Cholecystectomy Cardiac transplant recepients Lung transplant recipients Chronic TPN requirements Recepients of biliopancreatic diversion (bariatric patient) Children with hemoglobinopathy (sickle cell, thalassemia and spherocytosis) Asymptomatic gallstone >=3cm Stone associated with the polyp Family history of GB cancer and asymptomatic stones Cholelithiasis encountered during elective abdominal procedures Non functioning GB Typhoid carrier with positive bile culture Trauma to GB Procelain GB Ref: Sabiston 20th edition Pgno :1494 | 1 | Diabetes | Sickle cell anaemia | Procelain GB | In high prevalence areas CA GB | Anatomy | G.I.T | 78cbda4a-43bf-4fac-937f-ffaf87db3770 | multi |
Trident hand is seen in – | Trident hand is seen in achondroplasia. | 1 | Achondroplasia | Mucopolysaccharidosis | Diphyseal achlasia | Cleidocranial dystosis | Radiology | null | 7b6588dd-a205-4193-b1b0-ff4e388e19ea | single |
A Hand radiograph of a child given suggests the diagnosis of? | The Wrist radiograph shows a immature skeleton and the lower ends of radius and ulna showing cupping,splaying and fraying suggestive of Rickets | 2 | Scurvy | Rickets | Hyperparathyroidism | Osteogenesis imperfecta | Radiology | Musculoskeletal Radiology | 1f44c028-cadc-44ce-a4d2-a0bbedf914fa | single |
Earliest feature of vitamin deficiency is: | Conjunctival xerosis | 1 | Conjunctival xerosis | Nyctalopia | Retinopa thy | Pain | Ophthalmology | null | 81823eff-fcee-4c7f-b6ad-e6f4250deeb9 | single |
Release of histamine and leukotrienes from mast cells is prevented by: | nedocromil and sod.cromoglycate- mast cell stabilizers Sodium cromoglycate (Cromolyn sod.) is a synthetic chromone derivative which inhibits degranulation of mast cells (as well as other inflammatory cells) by trigger stimuli. Release of mediators of asthma-like histamine, LTs, PAF, interleukins, etc. are restricted. Nedocromil sodium has propeies similar to those of cromolyn Sodium Pharmacology and pharmacotherapeutics Satoskar 24th page no. 586 ESSENTIALS OF MEDICAL PHARMACOLOGY 7th EDITION KD TRIPATHI PG NO.229 | 2 | Zileuton | Nedocromil sodium | Zafirlukast | Fexofenadine | Pharmacology | Respiratory system | 43f49022-83b5-40f5-967e-bd4a4d4a348c | single |
Which layer involved in blister formation in a superficial partial thickness burn: | Ans. (c) Papillary dermisRef: Surgery Sixer 2nd edition, Page 892* First degree: Involves only epidermis* Second degree: Involves epidermis and some part of dermis. (Also known as partial thickness burns)Further divided into:* Superficial second degree or superficial partial thickness involves upper part of dermis* Deep second degree or deep partial thickness extends up to reticular layer of dermis.* Third degree or full thickness burns -- involves full thickness of dermis* Fourth degree burns -- involves subcutaneous fat and deep structures. | 3 | Epidermis | Dermis | Papillary dermis | Reticular dermis | Surgery | Plastic & Reconstructive Surgery | eb09f8db-d795-45c2-a852-875d694abac9 | single |
A laboratory technician was accidentally exposed to a HIV serum positive sample, which of the following shall be the role of zidovudine in treatment of this patient ? | null | 1 | Protects against acquiring the HIV infection | Makes the patient seronegative | Delays the progression of disease | None | Pharmacology | null | a2390673-39df-408a-a011-d8264a421a47 | multi |
RBC cast is seen in? | Ans. (d) Rapidly progressive Glomerulo-nephritisRef: Robbiris pathology 9th ed. /912-915* RBC casts are a feature of glomerular damage. Normally < 3 RBC/HPF are going to leak. But in case of glomerular damage the number of RBC in urine will exceed the limit mentioned above and these RBC get impinged on tamm- horsfall protein. The resultant RBC casts can be seen under microscopic examination of urine.* Bladder schistomiasis will cause hematuria and eosinophiluria.* Renal vein thrombosis is a complication of severe dehydration and causes a painful enlarged kidney with hematuria.* Minimal change disease is the most common cause of nephritic syndrome and causes proteinuria.Also knowDifferent Renal Casts and conditions where they are seen:* Hyaline cast: MC type; seen in normal individuals in dehydration or vigorous exercise * Muddy brown cast: seen in acute tubular necrosis* Waxy casts: nephritic syndrome* Fatty casts: pathognomonic for high urinary protein nephrotic syndrome.* White blood cell casts: pyelonephritis | 4 | Minimal change disease | Renal vein thrombosis | Bladder schistomiasis | Rapidly progressive Glomerulo-nephritis | Pathology | Glomerular Diseases | 6e5be42e-f370-4272-95a6-5680d0ccb542 | single |
A 15-year-old girl incurs a cut to the sole of her foot after stepping on a piece of broken glass. On examination, a superficial 0.5-cm laceration ceases to bleed within 5 minutes after application of local pressure. Which of the following substances is released by endothelium and is most likely to counteract platelet aggregation near this site of injury? | Endothelial injury releases glycoprotein tissue factor (factor III) that drives the coagulation process and activates platelets. Adjacent intact endothelium generates prostacyclin (PGI2 ) via arachidonic acid metabolism to inhibit clot propagation beyond where it is needed. PGI2 and nitric oxide are powerful vasodilators and inhibitors of platelet aggregation. This limits thrombus formation just to the area of injury. Glycoprotein IIb/IIIa, which induces shape change; phospholipid, which binds fibrinogen and calcium; and platelet-activating factor are procoagulants that drive thrombosis and platelet activation. Tissue-type plasminogen activator promotes fibrinolytic activity after a thrombus has formed. Thrombomodulin binds to thrombin to form an anticoagulant that activates protein C, which then cleaves activated factor V and factor VIII. Thromboxane is generated via arachidonic acid metabolism in platelets to promote platelet activation and vasoconstriction. | 3 | Glycoprotein IIb/IIIa | Platelet-activating factor | Prostacyclin | Tissue-type plasminogen activator | Pathology | Hemodynamics | 1890b3f1-1b57-437c-9d31-f2daeb309d84 | multi |
Large Intracytoplasmic glycogen storage is seen in which of the following malignancy - | null | 3 | Osteosarcoma | Mesenchymal chondrosarcoma | Ewing's sarcoma | Leiomyosarcoma | Pathology | null | 82163ba0-ca52-4f03-85a0-3cf21d777bbf | single |
3. Drug used in the Pseudomonas treatment | Psedomonas is inherently resistant to most of the antibiotics. Cephalosporins such as ceftazidime ,cefoperazone, ceftolozane and cefepime are used to treat it | 2 | Cefixime | Ceftazidime | Ampicillin | Cotrimoxazole | Anatomy | Bacteriology | f89fdba6-62bb-46fd-bda5-af610b529256 | single |
Host receptor for streptococcus pyogenes is? | Ans. (d) CD46(Ref: Wintrobes I2th/pg 2523)CD46 (Complement Membrane Cofactor Protein): It is a receptor to a number of pathogens, such as herpes virus 6, M protein of group A streptococci, Neisseria gonorrhoeae, and Escherichia coli. | 4 | CD4 | CD21 | CD44 | CD46 | Pathology | Misc. (W.B.C) | 507087b4-4908-4633-a10e-5943cd2eee8a | single |
Aniseikonia means - | Ans. (d) Difference in the size of image formed by the two eyesRef: Parsons 22/e, p. 283, 613Aniseikonia is defined as a condition where the images projected on the visual cortex from the two retinae are abnormally unequal in size or shape. | 4 | Difference in the axial length of the eyeballs | Difference in the size of cornea in both eyes | Difference in the size of pupil in both eyes | Difference in the size of image formed by the two eyes | Ophthalmology | Elementary Optics | abb157dc-18ba-49d5-ba6e-f1abd0610d45 | multi |
Which of the following is associated with suicide risk? | Ans. B SerotoninLow concentrations of 5-hydroxyindoleacetic acid (5-HIAA- metabolite of serotonin) in CSF associated with higher suicide risk | 2 | Noradrenaline | Serotonin | GABA | Dopamine | Psychiatry | Mood Disorders | 79eb80d0-7a00-4be6-98f6-0d115fa4997d | single |
Most common coagulopathy noted in surgical patients is - | Ans. is 'a' i.e., Thrombocytopenia | 1 | Thrombocytopenia | Afibrinogenemia | Fibrinolysis | Factor VIII defeciency | Surgery | null | a5942743-3cc4-4a4b-904f-295334408bc0 | single |
Which of the following drug is a reverse transcriptase inhibitor ? | null | 4 | Indinavir | Ritonavir | Nelfinavir | Abacavir | Pharmacology | null | dd3e0f40-d128-4467-8d95-bf76ee0ed2be | single |
An anterolaternal corodotomy relieving pain in right leg is effective because it interrupts the | C i.e. Left lateral spinothalmic tract The anterior/ ventral - spinothalmic tract carries crude touch and pressueQ from opposite half of body; whereas lateralspinothalmic tract carries pain and temperature from the opposite half of body. Therefore any lesion in lateral spinothalmic tract will result in loss of pain and temperature sensation contralaterally below the level of lesion; and lesion of anterior spinothalmic tract will 1/ t loss of crude touch & pressure sensation contralaterally. | 3 | Left dorsal column | Left ventral spinothalmic tract | Left lateral spinothalmic tract | Right lateral spinothalmic tract | Anatomy | null | 048b366b-609e-4fe1-841e-7fbacdaf286a | single |
Features of Alzheimer include all except | Dementia is a chronic organic mental disorder, characterized by the following main clinical features: 1. Impairment of intellectual functions, 2. Impairment of memory (predominantly of recent memory, especially in early stages), 3. Deterioration of personality with lack of personal care. Reference: A sho textbook of Psychiatry by Niraj Ahuja, page no.22. | 4 | More common in females | Recent memory loss | MMSE useful in diagnosis | Medications offer near 100% cure | Psychiatry | Organic mental disorders | db65f0d5-ec29-40b0-8622-695c4e98cb1e | multi |
A Neonate is brought with history of not having passed meconium on examination there is no anal opening but a dimple. Investigation of choice is - | • Anorectal malformations are associated with VACTERL abnormalities. | 4 | X-ray erect posture | X-ray supine posture | Gastrograffin study | Invertogram | Surgery | null | 491a7cd5-2279-4d87-979d-023a778b78db | single |
M.C. organism in acute osteomyelitis - | Ans. is 'a' i.e., Staphylococcus aureus o Acute osteomyelitis may be : -Primary (hematogenous) : - Organisms reach the bone through blood stream.Secondary: - Organism gain emery directly through wound such as in compound fractures or surgical operation,o Hematogenous osteomyelitis is the commonest form of osteomyelitis and most common source of bone and joint infection is hematogenous.o It is caused most commonly by staphylococcus aureus.o Other causative organisms are streptococcus, pneumococcus, and gram negative bacilli.o Infection by pseudomonas becomes proportionally much more common in !YT drug abuser. But, the most common organism is staphylococcus aureus. | 1 | Staphylococcus aureus | Salmonella | Pseudomonas aeruginosa | Streptococcus pneumonia | Orthopaedics | Infection of Bones & Joints | 02200fb4-27cc-4305-8fb4-7fe4808c06e1 | single |
Surgical ciliated cyst is often associated with surgeries of the | null | 3 | Maxillary impaction | Mandibular set back | Caldwell Luc procedure | mucocele | Surgery | null | e2cb5ab2-7ce9-4284-9e03-aa5271277b61 | single |
Meningococci differs from gonococci in that they | Meningococci are capsulated, unlike gonococci. Based on their capsular polysaccharide antigens, they are classified into at least 13 serogroups, of which A, B, C, X, Y and W-135 are most impoant. Reference: Textbook of Microbiology; Anathanarayan and panicker's; 10th edition; Page no: 230 | 2 | Are intracellular | Possess a capsule | Cause fermentation of glucose | Are oxidase positive | Microbiology | Bacteriology | c524b80b-8102-4219-b13a-63fd276b9417 | single |
Which of the following structures passes behind the inguinal ligament? 1. Femoral branch of genitofemoral nerve 2. Superficial epigastric aery 3. Psoas major 4. Femoral vein 5. Saphenous vein | Three small cutaneous aeries (superficial external pudendal, superficial epigastric and superficial circumflex iliac aeries) arising from the femoral aery can be seen a little below the inguinal ligaments.Femoral branch of the genitofemoral nerve pierces the femoral sheath and overlying deep fascia 2 cm below the mid inguinal point.The great saphenous vein pierces the saphenous opening in the deep fascia (fascia lata) of the thigh and joins the femoral vein 4 cm below and lateral to the pubic tubercle.So from the above discussion it is clear that femoral branch of the genitofemoral nerve, superficial epigastric aery and saphenous vein passes below (not behind) the inguinal ligament. Psoas major inseion: The muscle passes behind the inguinal ligament and in front of the hip joint to enter the thigh. Femoral vein leaves the thigh by passing behind the inguinal ligament. Ref: Snell's 8/e, Page 650-52; BDC 4/e, Vol II, Page 47, 48, 318. | 2 | 1,2 & 3 | 3 & 4 | 1,3,4 & 5 | All | Anatomy | null | fbc058c1-41e7-447c-b399-ae85cf9edc26 | multi |
Which of the following best responds to sympathectomy? | Hyperhydrosis responds best to sympathectomy . Indications of Sympathectomy (BARA CHEF) Buerger's disease Atherosclerosis producing ischemia of limbs Raynaud's disease Acrocyanosis Erythrocyanosis Frost bite Hyperhydrosis Peripheral vascular insufficiency Causalgia | 2 | Buerger's disease | Hyperhydrosis | Raynaud's disease | Acrocyanosis | Surgery | Aerial disorders | bd0e5286-b52a-49c6-a014-5b245dcd17f9 | single |
Which is the immunoglobulin which activates complement by alternate pathway? | The central process in the complement is the activation of C3 which is the major component of complement. In classical pathway, activation of C3 is achieved by C42 (C3 convease). The activation of C3 without the prior paicipation of C142 is known as alternate pathway. The first example of alternate pathway was that of properdin system as a group of serum proteins contributing to antimicrobial defence without requiring specific antibodies. The activator in this system was zymogen, a polysaccharide from the yeast cell wall, but many other substances can also be used to activate the pathway. Theses include bacterial endotoxins, IgA & D, cobra venom factor & nephritic factor. Ref: Ananthanarayanan & Paniker's microbiology 8th Ed Page 120. | 2 | Ig E | Ig A | Ig M | Ig G | Microbiology | null | 73beb125-23e1-4ec0-b63a-b191cb6c60cf | single |
Propaganda is defined as – | Health education : Facilitate learning
Propaganda or publicity : Knowledge instilled in the mind of people. | 1 | Forcing of knowledge into mind | Active aquiring of knowledge | Requiring knowledge after thinking | Training of people to use judgment before acting | Social & Preventive Medicine | null | 78c57e83-d210-4ded-96ca-ba1deba007a4 | single |
K nail work on the pricliple of - | Ans. is 'c' i.e., Three point fixation * K-nail is used for transverse or short oblique fracture of femur, especially in isthemic area.* K-nail (Kuntscher cloverleaf intramedullary nail) provides three points fixation due to elastic deformation.* These three points of fixation are both ends of bone (2 points) and isthmus (3rd point). | 3 | One point fixation | Two point fixation | Three point fixation | Four point fixation | Orthopaedics | Management In Orthopedics | 693cf8db-f1ae-4939-9130-da5a5fb23250 | single |
Anemia in chronic renal failure is due to | Ref Harrison 19 th ed pg 630 The anemia is primarily due to a failure of EPO production by the diseased kidney and a reduction in red cell survival. In ceain forms of acute renal failure, the correlation between the anemia and renal function is weaker. Patients with the hemolytic-uremic syndrome increase eryth- ropoiesis in response to the hemolysis, despite renal failure requiring dialysis. | 1 | Decreased erythropoietin production | Iron deficiency | Hypoplastic bone marrow | Decreased folate levels | Anatomy | Haematology | 326dff05-eb4e-403b-8449-136265f44e71 | single |
Primordial prevention is done in a population | Primordial prevention aims at preventing the emergence of risk factors. This is the primary prevention in its purest sense, that is, prevention of emergence or development of risk factors in countries or population groups in which they have not yet appeared. Ref: Park's Textbook of Preventive and Social Medicine; 24th edition - Page no. 45 | 2 | With risk factors | Without risk factors | With low prevalence of disease | With disease | Social & Preventive Medicine | Concept of health and disease | 1a15e330-8e55-4c23-bb37-4568776f5f57 | single |
If you are suspecting a child to have Congenital Hypertrophic Pyloric Stenosis clinically. Next, the best investigation is? | ANSWER: (B) USGREF: Schwartz's 9th ed chapter 39, Sabiston Surgery, 18th edition, Page 2058,2059See details of Congenital hypertrophic pyloric stenosis in Surgery 2007See PLATER-38 KEY PLATER-38 KEYHYPERTROPHIC PYLORIC STENOSISContrast study:Elongation + narrowing of the pyloric canal (2-4 cm in length)Double/triple track sign" = crowding of mucosal folds in pyloric channel"String sign" = passing of small barium streak through a pyloric channelTwining recess = "diamond sign" = transient triangular tentlike deft/niche in the midportion of the pyloric canal with the apex pointing inferiorly secondary to mucosal bulging between two separated hypertrophied muscle bundles on the greater curvature side within pyloric channel"Antral beaking" = mass Impression upon antrum with a streak of barium pointing toward the pyloric channelKirklin sign = "mushroom sign" = indentation of base of bulb (in 50%)Gastric distension with fluid"Caterpillar sign" = gastric hyperperistaltic wavesUSG:Palpation of the pyloric tumor (also called the olive) in the epigastrium or right upper quadrant by a skilled examiner is pathognomonic for the diagnosis of HPS. If the olive is palpated, no additional diagnostic testing is necessary1.When the olive cannot be palpated, the diagnosis of HPS can be made with an ultrasound exam or fluoroscopic UGI series.USG has now replaced barium meal as the first-line investigation in an infant with nonbilious vomiting to whomHPS is suspected (Sutton 7th ed vol 1 page 854)"Target sign" = hypoechoic ring of hypertrophied pyloric muscle around echogenic mucosa centrally on the cross-sectionElongated pylorus with thickened muscle: Elongated pyloric canal >16 mm in length, Pyloric muscle wall thickness > 3.5 mm (some books says > 4 mm)Pyloric volume >1.4 cm3"Cervix sign" = indentation of muscle mass on fluid-filled antrum on the longitudinal section"Antral nipple sign" = redundant pyloric channel mucosa protruding into gastric antrumExaggerated peristaltic wavesDelayed gastric emptying of fluid into the duodenum | 2 | Barium meal | USG | CT | MRI | Unknown | null | 3297104e-f989-43d3-ba78-3e45f525fe8c | multi |
Which of the following is not true regarding "thumb sucking" | Ans. is None | 4 | Feels insecurity | Pleasurable sensation | Leads to dental problems | None | Pediatrics | null | 59061af5-4aad-4d6e-93d9-d172c6c66549 | multi |
DNA fingerprinting is based on possessing in DNA of - | Variable number of tandem (one after another) repeats (VNTR), is unique for any individual & therefore serves as molecular DNA fingerprint. VNTR may be short tandem (microsatellite) or large tandem (minisatellite) repeats. | 2 | Constant Tandem Repeat | Variable Number Tandem Repeats (VNTR) | Non-repeatative sequence | Exon | Biochemistry | null | e4b8bafb-bc5c-4757-83ad-037c00fa11a2 | single |
Olympian f"-ow and I hi:odes | Ans. c. Congenital syphilis Clinical Presentation of Syphilis Early Congenital Syphilis: Snuffles (rhinitis)Q is earliest feature. Lesions are vesicobullousQ, and snail track ulcers on mucosa Clinical Presentation of Syphilis Late Congenital Syphilis: Characterized by Hutchinson's triad (interstitial keratitis + 8th nerve deafness + Hutchinson's teeth i.e. pegged central upper incisors)Q Saddle nose, sabre tibia, mulberry molarsQ Bull dog's jaw (protrusion of jaw) Rhagadesdeg (linear fissure at mouth, nares) Frontal bossing, hot cross bun deformity of skull Clutton's jointdeg (painless swelling of joints, most commonly both knee) Palatal perforationdeg Higaumenakis sign (periostitis leads to unilateral enlargement of sterna end of clavicle) Primary Syphilis: Painless, indurated, nonbleeding, usually single punched out ulcer (hard chancre)Q Painless, rubbery shotty lymphadenopathy Secondary Syphilis: Bilateral symmetrical asymptomatic localized or diffuse mucocutaneous lesiondeg (macule, papule, paulosquamous and rarely pustule) Non-tender generalized lymphadenopathyQ Highly infectious condylomata late, in warm moist interiginous areas Moth eaten alopecia, ahritis, proteinuriaQ Teiary Syphilis: Gumma, neurosyphilis/tabes dorsalisQ Ostitis, periostitis Aoitis, aoic insufficiency, coronary stenosis and nocturnal anginaQ | 3 | CMV inclusion disease | Ectodermal dysplasia | Congenital syphilis | Hyper IgE syndrome | ENT | null | 92101996-5056-435e-9091-35abdad25fc9 | single |
Which of the following is the LEAST likely physiological change in pregnancy? | Blood volume expansion begins early in the first trimester, increases rapidly in the second trimester, and plateaus at about the 30th week. Cardiac output increases approximately 40% during pregnancy, with maximum values achieved at 20-24 weeks' gestation. Stroke volume increases 25-30% during pregnancy, reaching peak values at 12-24 weeks' gestation. Vascular resistance decreases in the first trimester, reaching a nadir of approximately 34% below nonpregnancy levels by 14 to 0 weeks of gestation with a slight increase toward term. Ref: Flick A.A., Kahn D.A. (2013). Chapter 8. Maternal Physiology during Pregnancy & Fetal & Early Neonatal Physiology. In DeCherney A.H., Nathan L, Laufer N, Roman A.S. (Eds), CURRENT Diagnosis & Treatment: Obstetrics & Gynecology, 11e. | 4 | Increase in intravascular volume | Increase in cardiac output | Increase in stroke volume | Increase in peripheral vascular resistance | Gynaecology & Obstetrics | null | b79492e4-22b2-4d06-a163-a67f99da0ed5 | single |
A patient is a known case of polyarteritis nodosa. On examination of biopsy, accumulation of amorphous, basic, proteinaceous material in the vessel wall was seen. This finding is suggestive of: | Ans. (a) Fibrinoid necrosisFibrinoid necrosis is a form of necrosis, or tissue death, in which there is accumulation of amorphous, basic, proteinaceous material in the tissue matrix with a staining pattern reminiscent of fibrin.How to differentiate from hyaline arteriosclerosis?- please remember in fibrinoid necrosis, pink material has fibrin like quality as opposed to glassy homogenous hyaline in hyaline arteriosclerosis, (refer to image 2) | 1 | Fibrinoid necrosis | Leucocytoclastic vasculitis | Hyaline arteriosclerosis | Caseous necrosis | Pathology | C.V.S | 30d2513b-c3b8-487a-9d58-ff1a57ea039e | multi |
Post exposure immunization is given in -a) Rabiesb) Pertussisc) Measlesd) Yellow fever | null | 2 | b | ac | ab | bd | Social & Preventive Medicine | null | 6e060086-aa82-46a3-9ca8-002ac9a941b8 | single |
Inhibition of glycolysis by increased supply of 02 is called ? | Ans. is 'b' i.e., Pasteur effect Pasteur effect It has been observed that under anaerobic condition a tissue or microorganism utilizes more glucose than it does under aerobic conditions. It reflects inhibition of glycolysis by oxygen and is called pasteure effect. The Pasteur effect is due to inhibition of the enzyme phosphofructokinase because of inhibitory effect caused by citrate and ATP, the compounds produced in presence of oxygen due to operation of TCA cycle. Crabtree effect This is opposite of Pasteur effect, which represents decreased respiration of cellular systems caused by high concentration of glucose. When oxygen supply is kept constant and glucose concentration is increased, the oxygen consumption by cells falls, i.e., relative anaerobiosis is produced when glucose concentration is increased in constant supply of oxygen. It is seen in cells that have a high rate of aerobic glycolysis. In such cells the glycolytic sequence consumes much of the available Pi and NAD+, which limits their availability for oxidative phosphorylation. As a result, rate of oxidative phosphorylation decreases, and oxygen consumption also shows a corresponding fall. | 2 | Crabtree effect | Pasteur effect | Lewis effect | None | Biochemistry | null | 73905f18-3a06-4f45-b8d5-5df553438642 | multi |
The technique of laparoscopic cholecystectomy was first described by | History of Laparoscopic Cholecystectomy Dr. Ku Semm, the father of 'Pelviscopy', performed the first laparoscopic appendectomy in 1980 Eric Muhe performed the first laparoscopic cholecystectomy in 1982. He used a modified operating laparoscope placed at the umbilicus after establishing pneumoperitoneun In 1987, Phillip Mouret performed the first video laparoscopic cholecystectomy by using a camera attached to the laparoscope Ref: Blumga 5th edition Pgno :512 | 1 | Eric Muhe | Philip Moure | Ku semm | Eddie Reddick | Anatomy | G.I.T | 7ae763ce-fb83-4025-8834-2535363cfbce | single |
Which of the following is the most common form of persistent trophoblastic disease that follows a non molar pregnancy? | Gestational trophoblastic neoplasia (GTN) Invasive mole: Develops after molar pregnancy only. Very rarely follows other gestations PSTT (Placental Site Trophoblastic Tumor): may follow any type of gestation Choriocarcinoma: 2/3rd cases after normal delivery, 1/3rd cases after molar pregnancy Epitheloid Trophoblastic tumor: remote antecedant pregnancy NOTE: After a nonmolar pregnancy, persistent GTN always has the histologic pattern of choriocarcinoma. Histologic characterization of choriocarcinoma depends on sheets of anaplastic syncytiotrophoblast and cytotrophoblast without chorionic villi. The choriocarcinoma is classically a soft, fleshy, yellow-white tumour with a marked tendency to form large pale areas of ischemic necrosis, foci of cystic softening, and extensive haemorrhage. | 1 | Choriocarcinoma | Invasive mole | Placental site trophoblastic tumor | Paial mole | Gynaecology & Obstetrics | Twin Pregnancy, Molar Pregnancy, Gestational Trophoblastic disease and contraception in special situations (Sour Grapes!) | 7595f69c-d234-485c-a53c-f6f32558e294 | single |
All of the following can cause megakaryocytic thrombocytopenia, except: | Disseminated Intravascular Coagulation (DIC) DIC is an acute, subacute, or chronic thrombohemorrhagic disorder characterized by the excessive activation of coagulation and the formation of thrombi in themicrovasculature of the body. It occurs as a secondary complication of many different disorders.Patients with DIC can present with prolonged coagulation times, thrombocytopenia, high levels of fibrin degradation products (FDPs), elevated D-dimer levels. Microangiopathic pathology (schistocytes) on peripheral smears are suggestive findings for DIC. Aplastic anemia - Reduction in the number of Hematopoietic stem cells bone marrow is hypoactive amegakaryocytic | 3 | Idiopathic thrombocytopenia purpura | Systemic lupus erythematosus | Aplastic anemia | Disseminated intravascular coagulation (DIC) | Pathology | Bleeding disorder | 46f077c2-55be-4506-accd-9d88bbb504d4 | multi |
A person had an accident and came to casualty with contusion on left precordium. There was decrease in breath sounds on left side, trachea deviated to right side and normal heart sounds. Which of the following is the first line of management? | Ans. (a) Needle Thoracocentesis* History is clearly indicative of Tension Pneumothorax- hence urgent need is Thoracocentesis at 2nd ICS. MCL. | 1 | Needle thoracocentesis | Chest tube thoracocentesis | Pericardiocentesis | Open surgery | Surgery | Trauma | 4eca9834-7ec0-4163-bc74-80a90a842f21 | single |
Spastic paraplegia is caused by all of the following, except: | Cord compression due to Cervical spondylosis, sub acute combined degeneration of cord due to vitamin B12 deficiency, and motor neuron disease involving the upper motor neuron's are all established cause for spastic paraplegia. Causes of spastic paraplegia includes: Thrombosis of anterior spinal aery Inflammation of cord: acute transverse myelitis Trauma of the spinal cord: fracture of veebrae, gunshot injury Nutritional: sub acute combined degeneration of the cord, lathyriasis Spinal cord compression: tumor in meninges or cord, caries of spine, syphilitic patchy meningitis Degeneration of the cord: multiple sclerosis, cervical spondylosis, amyotropic lateral sclerosis and syringomyelia Ref: Principles and Practice of Medicine a TB for Students and Practitioners By Prasad, Page 670 | 1 | Lead poisoning | Cervical spondylosis | Vitamin B12 deficiency | Motor neuron disease | Medicine | null | e8f64a7d-2bd3-4772-8989-2a4bb0e06096 | multi |
Arrange the following tooth in the order of age of eruption of temporary teeth Upper lateral incisor Lower lateral incisor Lower medial incisor Upper medial incisor | Eruption sequence of Temporary Dentition Lower medial incisor 6 to 8 months Upper medial incisor 7 to 9 months Upper lateral incisor 7 to 9 months Lower lateral incisor 10 to 12 months First molar 12 to 14 months Canine 17 to 18 months Second molar 20 to 30 months | 3 | 1-2-4-3 | 3-2-1-4 | 3-4-1-2 | 2-3-4-1 | Forensic Medicine | Human identification | 3064cd1f-d9a3-4830-a969-e6b1324abef7 | single |
The earliest manifestations of increased intracranial pressure following head injury is : | Answer is C (Altered mental status) : `Early signs of elevated ICP include drowsiness and a diminished level of consciousness (altered mental status). Coma and unilateral papillary changes are late signs and require immediate intervention.' -Harrisons | 3 | Ipsilateral papillary dilatation | Contralateral papillary dilatation | Altered mental status | Hemiparesis | Medicine | null | d322f687-c57a-4362-9756-e2e0db75919c | single |
All are the pharmacologic therapeutic options for achalasia, EXCEPT: | Pharmacologicals therapies are usually ineffective. They can be used as a temporary measures. The agents used are: 1. Nitrates 2. Calcium channel blockers 3. Botulinum toxin 4. Sildenafil- phosphodiesterase inhibitors, effectively decrease LES pressure. Botulinum toxin, injected into the LES under endoscopic guidance, inhibits acetylcholine release from nerve endings and improves dysphagia in about 66% of cases for at least 6 months Ref: Harrison, Edition-18, Page-2432 | 2 | Nitrates | Beta blockers | Botulinum toxin | Sildenafil | Medicine | null | 36fca4ec-e72f-4b12-bc05-73fdafdccf71 | multi |
A 25-year-old male presented with painless testicular swelling and with history of fever and weight loss. All the following investigations are indicated in this patient, except: | Ans. (d) Trans-scrotal biopsyRef: Bailey and love, 26th Edition, Pages 1385-1388* Painless testicular swelling in a 25 male with history of fever and weight loss amounts to a diagnosis of malignant testicular swelling, i.e. testicular cancer.* To confirm the histopathological evidence of testicular cancer, orchidectomy in form of high inguinal orchidectomy to be done after a manuever known as Chevasu Manuever* Trans scrotal biopsy is contraindicated, as Tunica albuginea will be breached during biopsy. Since Tunica albuginea is a natural barrier to testicular cancer, following biopsy, this will be breached and extend into the scrotum. | 4 | USG scrotum | CT abdomen and pelvis | Chest x-ray | Trans-scrotal biopsy | Surgery | Urethra & Penis | f950fd08-7047-4b36-8ec4-4070291c14ea | multi |
Fat content is highest in _____- | Fat content is highest in beef. REF. PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICAL 21ST EDITION.PAGE NO - 582 | 1 | Beef | Mutton | Chicken | Fish | Social & Preventive Medicine | Nutrition and health | b107dcff-c435-420a-972f-f91628165c77 | single |
In Scaphoid fracture, impoant views are all except: | D i.e. Cone | 4 | AP | Lateral | Oblique | Cone | Surgery | null | c5c69e5a-0a01-4248-99cd-7ce2972baaa6 | multi |
Miyagawa body is characteristically seen in | (D) LGV # MIYAGAWA BODIES:> Chlamydia trachomatis (Miyagawa Nella lymphogranulomatosis), the elementary bodies that develop in the intracytoplasmic mi- crocolonies of Lymphogranuloma Venereum.> Lab diagnosis of LGV (Lymphogranuloma Venereum):> The primary lesion usually goes unnoticed and the disease is seen commonly first in the stage of inguinal adenitis (bubo).> Smears of material aspirated from the buboes may show the elementary bodies (Miyazawa's granular corpuscles).> The sensitivity of microscopic diagnosis is very low.> Isolation of the chlamydia by intracerebral inoculation into mice and into yolk sac of eggs has been replaced by cell cultures.> LGV patients develop high titres of circulating antibodies, with titres of 1:64 or more in CF test and 1:512 or more in micr - IF.> Serological diagnosis is therefore feasible. An intradermal test originally described by Frei in 1825 was commonly used formerly. | 4 | Kala azar | Syphilis | Granuloma inguinale | LGV | Skin | Miscellaneous | aba545c4-8c29-473c-9686-f547959d5eca | multi |
Tom smith's arthritis is due to - | Ans. is 'a' i.e., Pyogenic infection in infancy Tom smith arthritis (septic arthritis of infancy)o Tom smith arthritis is the septic arthritis of hip joint, occurs in infancy. At this stage head of the femur is cartilaginous and is rapidly and completely destroyed by the pyogenic process. Onset is acute with abscess formation, which heals rapidly after spontaneous bursting outside or after incision and drainage. Quite often it is a delayed presentation and the child is brought for consultation when he begins to walk with a limp. On examination:-i) Limb is shortii) Hip movements are increased in all directions.iii) There is instability with positive telescoping. | 1 | Pyogenic infection in infancy | TB | RA | OA | Orthopaedics | Infective Arthritis | 359068eb-8bf2-4571-9092-40b6fdc100ed | single |
8 days after cesarean section a new mother presented with fever of 101.4degF. On examination her uterus is soft and extremely tender. Puerperal infection is confirmed. She mostly have: | Most women with fever in the postpaum period have endometritis. Urinary tract infection is the next most common infection. caesarean section is easily the most common identifiable risk factor for development of puerperal infection. Fever and a soft, tender uterus are the most prominent signs of endometritis. Risk factors are, Prolonged rupture of the membranes (>24 hours) Chorioamnionitis An excessive number of digital vaginal examinations Prolonged labor (>12 hours) Toxemia Intrauterine pressure catheters (>8 hours) Fetal scalp electrode monitoring Preexisting vaginitis or cervicitis Operative vaginal deliveries Caesarean section Intrapaum and postpaum anemia Poor nutrition Obesity Low socioeconomic status Coitus near term Ref: Poggi S.B. (2013). Chapter 21. Postpaum Hemorrhage & the Abnormal Puerperium. In A.H. DeCherney, L. Nathan, N. Laufer, A.S. Roman (Eds),CURRENT Diagnosis & Treatment: Obstetrics & Gynecology, 11e. | 2 | Vaginitis | Endometritis | Parametritis | Salpingitis | Gynaecology & Obstetrics | null | 3f885a29-7ba3-4a15-ae4f-386df0545d5e | single |
Montgomery tube used in ENT procedure is a: | Montgomery tracheal tube is designed to give the surgeon a complete program for creating a secondary airway-from initial incision through long-term tracheostomy care. It is a tracheal cannula system used in place of tracheostomy tubes. The system provides long-term access to the tracheal airway in situations that require an aificial airway or where access is needed for pulmonary hygiene. It is so designed that the thin inner flange of the cannula is shaped to fit snugly against the contour of the inner anterior tracheal wall. No tube projects into the tracheal lumen. All tracheal cannulas are made of flexible implant grade silicone to assure patient comfo and safety while reducing complications. | 4 | Double barrel tub | Lobster tail tube | Airway tube | Silicone tube | ENT | null | 98a251f1-f206-4b59-aac2-f1669a108ece | single |
Following are the propeies of Biguanides, EXCEPT: | Biguanides are contraindicated in patients with renal failure, congestive hea failure, alcoholism and hepatic diseases. Ref: Richard Finkel, Michelle Alexia Clark, Pamela C. Champe, Luigi X. Cubeddu (2009), Pharmacology, 4th Edition, Lippincott Williams and Wilkins Publications, United States Page 292 | 2 | Decrease hepatic gluconeogenesis | Not contraindicated in renal dysfunction | Can be used along with sulfonylureas | Don't stimulate insulin Release | Pharmacology | null | 7010d5ab-cbed-49ae-a461-c31a44f8c5ae | multi |
Difference between active & resting cell depend on which phase of cell cycle: | Ans; A (G0) "The cell cycle consists of G, (presynthetic), S (DMA synthesis), G, (premitotic), and SI (mitotic) phases.Quiescent cells are in a physiologic state called Ga. Tissues may be composed primarily of quiescent ceils in Gv but most mature tissues contain some combination of continuously dividing cells, terminally differentiated cells, stem ceils, and quiescent ceils that occasionally enter into the cell cycle"- Abeloff's Clinical Oncology/ 4^/428;Phases of Cell CycleThe cell cycle consists of four distinct phases: G, phase. S phase (synthesis91, G\ phase (collectively known as interphase) and M phase (mitosis)Q,M phase is itself composed oftwo tightly coupled processes: mitosis, in which the cell's chromosomes are divided between the two daughter cells, and cytokinesis, in which the cell's cytoplasm divides in half forming distinct cells.Activation of each phase is dependent on the proper progression and completion of the previous one. Ceils that have temporarily or reversibly stopped dividing are said to have entered a state of quiescence called G phaseS Phase# Th e ensuing S phase starts when DNA synthesis commenceswhen it is complete, all of the chromosomes have been replicated, i.e., each chromosome has two (sister) chromatids.# During this phase, the amount of DNA in the cell has effectively doubled, though the ploidv of the cell remains the same.StatePhaseAbbreviationDescriptionQuiescent/ senescentGap 0G0A resting phase where the cell has left the cyde and has stopped' dividing. Gap 1G1Cells increase in size in Gap 1. The checkpoint control mechanism ensures that everything is ready' for DNA synthesis.SynthesisSDNA replication occurs during this phase.Interphase Gap 2G2During the gap between DNA synthesis and mitosis, the cell will continue to grow. The G, checkpoint control mechanism ensures that everything is ready to enter the M (mitosis) phase and divide.Cell growth stops at this stage and cellular energy' is focused on the orderly' division into two daughter cells. A checkpoint in the middle of mitosis (Metaphase Checkpoint) ensures that the cell is ready to complete cell division.Cell divisionMitosisM Fig: Sequence of events during the cell cycle | 1 | G0 | G1 | G2 | M | Pathology | Cellular Pathology | fc7760f3-17a1-4a21-a65f-baa50d529373 | single |
Vascular complications of acute pancreatitis include the following except - | Acute pancreatitis is rarely associated with arterial vascular complications.
MC vessel affected: Splenic artery.
Other vessels: Superior mesenteric, cystic, and gastroduodenal arteries.
Vascular Thrombosis
Pancreatic inflammation can produce vascular thrombosis.
MC affected vessel: Splenic vein.
In severe cases, it can extend into the portal venous system.
Imaging demonstrates splenomegaly, gastric varices, and splenic vein occlusion.
Thrombolytics have been described in the acute early phase.
Most patients can be managed with conservative treatment.
Recurrent episodes of upper gastrointestinal bleeding caused by venous hypertension should be treated with splenectomy.
Pathogenesis
It has been proposed that pancreatic elastase damages the vessels, leading to pseudoaneurysm formation.
Clinical Features
Spontaneous rupture results in massive bleeding.
Clinical manifestations include sudden onset of abdominal pain, tachycardia, and hypotension.
Treatment
If possible, arterial embolization should be attempted to control the bleeding.
Refractory cases require ligation of the affected vessel.
The mortality ranges from 28-56%.
MC affected vessel in acute pancreatitis: Splenic artery (pseudoaneusysm formation).
MC affected vessel leading to vascular thrombosis caused by acute pancreatitis: Splenic vein. | 4 | Splenic vein thrombosis | Splenic artery aneurysm | Gastroduodenal artery aneurysm | Middle colic artery thrombosis | Surgery | null | 6f2aaa53-af9e-4e71-b91f-22bcce256ffb | multi |
The drug that is never advised in pregnancy is: | Methotrexate is a analogue of folic acid and it prevents the synthesis of DNA by inhibiting the enzyme dihydrofolate reductase. It has been extensively used in medical termination of pregnancy, ectopic pregnancy, gestational trophoblastic disease and placenta accreta. It has been included in the "Category X" of the FDA risk categories classification. The commonly repoed side effects are leukopenia, thrombocytopenia, bone marrow aplasia, ulcerative stomatitis, hemorrhagic enteritis, elevated liver enzymes, alopecia, pneumonitis and diarrhea. It produces cranio-facial abnormalities in the fetus though it is not teratogenic. It is better to be avoided in women who are pregnant or in those who are planning for a pregnancy in the near future. Cyclosporine is a immunosuppressant that can be safely used in pregnancy. It is used in conditions like SLE, Multiple Sclerosis and renal transplant (associated with pregnancy). The other immunosuppressants that can be used in pregnancy are cyclophosphamide, prednisone and azathioprine. As malaria is a life threatening infection in pregnancy, the benefits obtained outweighs the risks that evolve from the use of anti-malarials. Chloroquine is used both in the treatment and in the prevention of malaria in pregnancy. Pyrazinamide is used in the treatment of active tuberculosis in pregnant mothers. It is given along with isoniazid, rifampicin and ethambutol for a period of nine months. Ref: Berek and Novak's Gynecology, Issue 935, Volume 2007 By Emil Novak, Page 622 ; Textbook of Obstetrics by D.C. Dutta, 6th Edition, Pages 510-13, 282-83, 295-96 | 1 | Methotrexate | Cyclosporine | Chloroquine | Pyrazinamid | Gynaecology & Obstetrics | null | 42ca0f7b-4904-48b9-9d1c-f4f85ef871c0 | single |
Graft versus host disease is due to ? | Ans. is 'a' i.e., Immunocompetent T cells in graft tissue Graft versus host disease Graft versus host disease occurs in any situation in which immunologically competent cells or their precursors are transplanted into immunologically crippled patients and the transferred cells recognize alloantigens in the host. Graft versus host disease occurs most commonly in the setting of allogenic bone marrow transplantation but may also follow transplantation of solid organs rich in lymphoid cells (e.g. the liver) or transfusion of unirradiated blood. Recipients of bone marrow transplants are immunodeficient because of either their primary disease or prior treatment of the disease with drugs or irradiation. When such recipients receive normal bone marrow cells from allogenic donors, the immunocompetent, T cells present in the donor marrow recognizes the recipient's HLA antigen as foreign antigen and react against them. Both CD4+ and CD8+T cells recognize and attack host tissues. In clinical practice GVH can be so severe that bone marrow transplants are done only between ILIA matched donor and recipient. Acute GVH disease occurs within days to weeks after allogenic bone marrow transplantation. Although any organ may be affected, the major clinical manifestation results from involvement of the immune system and epithelia of the skin, liver and intestines. Involvement of the skin in GVH disease is manifested by a generalized rash leading to desquamation in severe cases. Destruction of small bile ducts gives rise to jaundice and mucosal ulceration of the gut results in bloody diarrhoea. Immunodeficiency is a frequent accompaniment of GVH disease. The immunodeficiency may be a result of prior treatment, myeloablative preparation for the graft, a delay in repopulation of the recipient's immune system and attack on host's immune cells by grafted lymphocytes. Affected individuals are profoundly immunosuppressed and are easy prey to infections. Although many different types of organisms may infect patients, infection with cytomegalovirus is paicularly impoant. | 1 | Immunocompetent T cells in graft tissue | Immunocompetent T cells in host | Immunocompetent B cells in graft tissue | Immunocompetent B cells in host | Microbiology | null | 57e9823a-e879-4af7-867f-aa027221e26a | single |
All the following Vasculitis causes necrotizing inflammation | Kawasaki disease - Only one Vasculitis non-necrotising. | 3 | Polyarteritis nodosa | Wegener's granulomatosis | Kawasaki disease | Microscopic polyangitis | Medicine | null | 1a05577c-55fb-4ebd-84f2-aee707b27f16 | multi |
The congenital Anomaly of Gallbladder shown here is | Ans. (d) Phrygian cap* Phrygian Cap anomaly is the MC congenital anomaly of GB in which the Fundus of Gallbladder folded upon itself. | 4 | Septum | Diverticulum | Normal | Phrygian cap | Surgery | Gall Bladder & Bile Ducts | 394cabfa-8810-4180-b576-e84554639ad1 | multi |
Painless burn in hand is seen in: | Syringomyelia is associated with Arnold Chiari malformation type 1 IOC: - MRI spine | 2 | SLE | Syringomyelia | Mononeuritis multiplex | Diabetes mellitus | Medicine | FMGE 2017 | bd6bccc8-1257-4eae-867f-63195f73879e | multi |
A sewerage worker presents to OPD with acute febrile illness alongwith jaundice and conjunctivitis. His blood sample was taken and sent to lab . Lab findings are suggestive of kidney failure and elevated hepatic enzymes. Which of following is likely diagnosis ? | Given scenario suggests diagnosis of Weil's disease/ Ictero-haemorrhagic disease/ Leptospirosis Leptospirosis - Caused by Leptospira interrogans Leptospira is an actively motile spirochete Mode of transmission: Zoonotic , by contact with water or moist soil contaminated with rat's urine or dead rats. 3 R associated with leptospirosis - Rat urine , Rice (Paddy field worker) and Rainy water Incubation period - 5-14 days. Disseminated Leptospirosis AKA Weil's disease is characterized by : High-grade fever (febrile illness) and conjuctivitis, jaundice and hemorrhages (Ictero-hemmorhagic disease) and impairment of kidney functions Lab diagnosis: a) Serological tests: - MAT - 1) Microscopic agglutination test (Preferred) 2) Macroscopic agglutination test b) PCR for Leptospira species Culture media: 1) EMJH medium 2) Koaokoff medium 3) Fletcher's medium Treatment: Leptospirosis is treated with antibiotics, such as doxycycline or penicillin, which should be given early in the course of the disease. Intravenous antibiotics ( penicillin/ ceftriaxone/cefotaxime ) may be required for persons with more severe symptoms. | 2 | Malaria | Leptospirosis | Peussis | Typhoid | Microbiology | Systemic Bacteriology (Haemophilus, Yersinia, Spirochaetes, Ricketssia, Chlamydia, Mycoplasma and Miscellaneous Bacteria) | d9ae47c5-3868-4669-9089-b0bf89e14a54 | single |
The most common congenital esophageal anomaly is which of the following? | The most common congenital esophageal anomaly is esophageal atresia, occurring in about 1 in 5,000 live bihs. Reference: Harrisons Principles of Internal Medicine, 18th Edition | 1 | Esophageal atresia | Esophageal psuedodiveiculum | Congenetal web | Schatzki ring | Medicine | null | cb229460-76f8-4706-aabd-49bfcf2ac14b | single |
The best site to obtain a swab in acute symptomatic gonorrhea is: | The best site to obtain a swab in acute symptomatic gonorrhea is Endocervix Diagnosis of Gonococcal infection: Acute Gonorrhea: Chronic Gonorrhea: a) Endocervical Culture - 80-90% sensitivity b) Urethral Discharge - 50% Sensitivity c) Rectal swab a) Morning drop secretion b) Exudate after prostatic massage c) Centrifuged deposit of urine when no urethral discharge - For DGI (Disseminated gonococcal infection): Blood culture and synol fluid culture - Transpo media: Charcoal impregnated swabs/medium (Stua/Amies media) For longer holding period: CO2 generating system - Gram staining of Cervical swab: N. gonorrhoeae - Kidney shaped, Non-capsulated. | 1 | Endocervix | Exudate after prostatic massage | Lateral vaginal wall | Posterior fornix | Microbiology | Systemic Bacteriology Pa 1 (Gram Positive Cocci, Gram Negative Cocci) | 56b0eab5-b49b-4a2d-86f5-2b272fdbdc11 | multi |
All are true about chaperones except | chaperones are proteins that assist the covalent folding or unfolding and the assembly or disassembly of other macromolecular structures. Chaperones are present when the macromolecules perform their normal biological functions and have correctly completed the processes of folding and/or assembly. The chaperones are concerned primarily with protein folding. The first protein to be called a chaperone assists the assembly of nucleosomes from folded histones and DNA and such assembly chaperones, especially in the nucleus, are concerned with the assembly of folded subunits into oligomeric structures Ref-Sathyanarayana 4/e p387 | 2 | Cause folding of proteins | Are lipid in nature | May have ATPase activity | Include heat shock proteins | Biochemistry | Metabolism of nucleic acids | a3030f62-fce5-4ba5-ab7f-beff8dd6b542 | multi |
Millennium Development goals are to be achieved by: March 2012 | Ans: C i.e. 2015 Governments have set a date of 2015 by which they would meet the Millennium Development Goals/ MDGs, i.e. eradicate extreme povey and hunger; achieve universal primary education; promote gender equality; improve maternal health; combat HIV/ AIDS, malaria and other communicable diseases; ensure environmental sustainability; and develop a global panership for development. | 3 | 2005 | 2010 | 2015 | 2020 | Social & Preventive Medicine | null | 5fea06ae-c794-427c-aa17-5fc64d69718e | single |
Most dicient larval control method ent transmission of urban malaria: | Ans. b. Cleaning of drains | 2 | Covering overhead tanks | Cleaning of drains | Filling of ditches and cesspools | Uprooting of plants | Social & Preventive Medicine | null | 9c6d744e-6f6b-4c65-b3ed-d52475d10d4b | single |
Mood congruent delusion seen in Depression | Nihilistic delusion is seen severe depression where patient denies the existence of himself & world. Also called as "Cotard syndrome". | 2 | Delusion of grandeur | Delusion of nihilisim | Delusional parasitosis | Delusion of reference | Psychiatry | null | 636d6e7c-212d-4411-88e8-453f5685ca9d | single |
A 46-year-old man sustains a spider bite on his upper eyelid, and an infection develops. The physician is very concerned about spread of the infection to the dural venous sinuses of the brain emissary veins. With which of the following dural venous sinuses does the superior ophthalmic vein directly communicate? | The anterior continuation of the cavernous sinus, the superior ophthalmic vein, passes through the superior orbital fissure to enter the orbit. Veins of the face communicate with the superior ophthalmic vein. Because of the absence of valves in emissary veins, venous flow may occur in either direction. Cutaneous infections may be carried into the cavernous sinus and result in a cavernous sinus infection which may lead to an infected cavernous sinus thrombosis. The cavernous sinus is located lateral to the pituitary gland and contains poions of cranial nerves III, IV, V1, V2 and VI, and the internal carotid aery. | 1 | Cavernous sinus | Occipital sinus | Sigmoid sinus | Superior petrosal sinus | Anatomy | null | 95bc9027-5a53-442b-b6d3-c479cc4a59bc | single |
Distichiasis is | Answer- B. Growth of eyelashes from Meibomian OrificesDistichiasis is a rare disorder defined as the abnormal grorvth of lashes from the orifces of the meibomian glands on the posterior lamella of the tarsal plate. | 2 | Increased number of lashes in the lower eyelid | Growth of eyelashes from Meibomian Orifices | Hyperpigmentation of eyelashes | Increased thickness of eyelashes | Ophthalmology | null | eb5981c0-5a4c-4a9a-9d70-6a2aed54cda8 | single |
Change in length of upper anterior teeth in complete denture teeth setting, which sounds are affected: | null | 1 | f, v | d, t | Dentoalveolar sounds | b, p, m | Dental | null | 76eef1b4-1973-4ce9-ad85-1fe55a55e0f1 | single |
A very ill 3-year-old child is brought into the emergency room with a fever. On physical examination, the child has large cervical lymph nodes and a desquamating skin rash that involves the palms, soles, and mouth. This child should be monitored for the development of which of the following conditions? | The child has Kawasaki's syndrome (mucocutaneous lymph node syndrome). In this disorder, small, medium, and large aeries are affected, with transmural inflammation and variable necrosis. About 20% of affected children have damage to the coronary vessels; some develop coronary aery aneurysms. In 1-2% of cases, sudden death may occur from aneurysm rupture or thrombosis producing infarction.Good to know:Abdominal aoic aneurysms are associated with atherosclerosis.Aneurysms of aoic root are usually associated with syphilis.Berry aneurysms are caused by congenital defects in the vessel wall, and are associated with polycystic kidney disease. Ref: Waller B.F. (2011). Chapter 55. Nonatherosclerotic Coronary Hea Disease. In V. Fuster, R.A. Walsh, R.A. Harrington (Eds), Hurst's The Hea, 13e. | 4 | Abdominal aoic aneurysm | Aneurysm of the aoic root | Berry aneurysm | Coronary aery aneurysm | Pathology | null | 99285b60-26e9-4e92-b212-91febc803b29 | single |
All of the follow ing are risk factors for carcinoma gall bladder, except - | Ans. is 'd' i.e., Oral contraceptives No risk of Ca G.B. has been noted with the use of oral contraceptiveso Risk factors for Ca Gall bladder are :i) Gall stonesApproximately 90% of patients with Ca GB have gall stonesSize of the stone has a direct relationship with development of carcinoma, the risk is ten times more for larger stones (3 cm in diameter) than for stones less than 1 cm in diameterThe risk is higher with symptomatic than asymptomatic stones.ii) Adenomatous gall bladder polyps (particularly polyps larger than 10 mm)Calcified (porcelain) gall bladderCholeduochal cystEstrogensAnomalous pancreaticobiliary duct junctionExposure to carcinogens (azotoulene, nitrosamine)Typhoid carriersSclerosing cholangitisCholecystoenteric fistula Ulcerative colitis o ASI Surgery mentions two other risk factorsChemicals used in rubber industryUse of adulerated mustard cooking oil in India | 4 | Typhoid carriers | Adenomatous gall bladder polyps | Choledochal cysts | Oral contraceptives | Pathology | Disorders of Gallbladder and Extrahepatic Biliary Tract | 38ab88c6-9a02-48b6-bf3f-22dead1b52c1 | multi |
Peripheral pulmonic stenosis is associated with | Answer is C and E (William syndrome and Rubella) Peripheral pulmonic stenosis is often associated with various congenital and acquired conditions including Rubella and williams syndrome. | 3 | Subaoic stenosis | Takayasu's aeritis | William syndrome | Coarctation of syndrome | Medicine | null | ec11ccad-6faa-4e2a-82bb-1569a9836dcf | single |
Helmet Cells are characteristic of | Schistocytes are typically irregularly shaped, jagged, and have two pointed ends. A true schistocyte does not have central pallor.
Helmet cells are also known as schistocytes / triangle cells / burr cells are a Feature of microangiopathic diseases including disseminated intravascular coagulation (DIC), thrombotic microomgiopathies (TTP), mechanical artificial heart valves and hemolytic Uremic syndrome (HUS). | 1 | Hemolytic uremic syndrome | Polysplenia | Spherocytosis | Acanthocytosis | Pathology | null | 3941f530-4ec6-4be6-af7d-a132197c625e | single |
Blisters are seen in | Superficial second degree burns Involve upper layer of dermis (papillary dermis) Erythematous Blisters are seen Blanch to touch Painful Heals without scarring in 7-14 days Ref: Sabiston 20th edition Pgno :506-507 | 2 | 1st degree burn | Superficial 2nd degree burn | Deep 2nd degree burn | 3rd degree burn | Surgery | General surgery | fdfdc54c-df08-4f84-b066-7a2f244abe8a | single |
Fetal and maternal blood can be differentiated by | Apt testKleihauer-Betke testSource of SampleMaternal or NeonatalMaternalPrincipleAdding 1% NaOH destroys adult HbA but not fetal HbFAdding acid destroys adult HbA but not fetalHbFAssessment TypeQualitativeQuantitativeResultPositive means blood is of fetal originRepoed in estimated milliliters of fetal bloodNote:When fetal blood needs to be differentiated from maternal bloodApt Test is used (Qualitative estimation)When the amount of fetal blood needs to be estimatedKleihauer-Betke test is used(Quantitative estimation)Approximate volume of fetal blood entering into the maternal circulation is to be estimated by Kleihauer-Betke test using acid elution technique to note the number of fetal red cells per 50 low power fields.If there are 80 fetal erythrocytes in 50 low power fields in maternal peripheral blood films, it represents a transplacental hemorrhage to the extent of 4ml of fetal blood.(Refer: Mudaliar and Menon&;s Clinical Obstetrics, 11th edition, pg no:227) | 2 | Kleihaurbetke test | Apt test | Bubbling test | Osmotic fragility test | Pathology | All India exam | 6bd16a82-bf65-4771-867e-24cbafdc6522 | single |
A child with pyoderma becomes toxic and presents with respiratory distress. His chest radiograph shows patchy areas of consolidation and multiple bilateral thin-walled air containing cysts. The most likely etiological agent in this case is – | Pneumonia with pneumatoceles (multiple thin-walled breaths of air containing cysts) is s/o staphylococcal pneumonia.
Clinical features of staphylococcal pneumonia
The illness usually follows upper respiratory tract infection, pyoderma or another associated purulent disease.
Besides the usual features of pneumonia child has fever and anorexia and is listless and irritable.
The abdomen is usually distended due to septicemia and ileus.
Cyanosis may be present
Progression of the symptoms and signs is rapid.
Diagnosis-
The diagnosis of staphylococcal pneumonia is suspected in a newborn or an infant with respiratory infection who has evidence of staphylococcal infection elsewhere in the body (here it is pyoderma).
Complications such as pyopneumothorax and pericarditis are highly suggestive of diagnosis (Empyeina in a child below 2 yrs of age is nearly always staphylococcal in etiology)
Presence of Pneumatoceles is considered pathognomic for staphylococcal pneumonia (It can also be seen in pneumonia due to Klebsiella)
Note: Pyoderma or impetigo is a superficial infection of the skin caused primarily by group A streptococci and occasionally by other streptococci and staphylococci.
Tachypnea is the most consistent clinical manifestation of pneumonia. - Nelson 18th /e 1797 | 2 | Mycobacterium tuberculosis | Staphylococcus aureus | Mycobacterium avium intracellulare | Pneumocystis carinii | Pediatrics | null | 4a5d2acf-e102-4a0c-a422-86c45db0509a | multi |
Counter transference is - | Ans is 'b' i.e. Doctor's feelings towards the patient TransferenceTransference is the phenomenon whereby unconsciously transfer feelings and attitudes from a person or situation in the past on to a person or situation in the present. The process is at least partly inappropriate to the present.Characteristic features of TransferenceTransference is unconsciousIt is at least partly inappropriate to the presentIt is the transferring of a relationship, not a personOnly an aspect of a relationship, not the entire relationship, is transferredPoints to noteThe process of transference is not conscious, and the patient unwittingly projects a needed aspect of a previously experienced or wished-for relationship on to doctor.Because it is a relationship that is "transferred", the patient and doctor are expected to take complementary roles.So a patient who is afraid that he or she is seriously ill may adopt a helpless child-like role and project an omnipotent parent-like quality on to the doctor, who is then expected to provide a solution.Projection and transferenceTransference involves the projection of a mental representation of previous experience on to the present.Other people are treated as though they are playing the complementary role needed for the projected relationship.There are subtle (unconscious) behavioural "nudges" to take on these feelings and behavioursExamples to explain transferenceSuppose a patient is in a session with a therapist and the therapist says something that sets him of and he get way angry at him.He lash back with anger and says things that really have nothing to do with him at all.He has said something that triggers another relationship from the past and that anger from the old relationship gets transferred onto him.Another example is love transference and this is very common in therapyA lady patient go to see therapist and starts having strong feelings about him. He reminds her of someone from the past - her father and now seems to be transferring feelings that she had towards her father on to the therapist and she wants him to meet the needs that she had towards daddy.CountertransferenceDefinitionCountertransference is the response that is elicited in the recipient (therapist) by the other9s (patient9s) unconscious transference communications.Countertransference response includes both feelings and associated thoughts.When transference feeling are not an important part of the therapeutic relationship, there can obviously be no countertransference.CountertransferenceIncludes the feelings evoked in the doctor by the patient's transference projections.These can be a useful guide to the patient's expectations of relationships.They are easier to identify if they are not congruent with the doctor's personality and expectation of his or her role.Awareness of the transference-countertransference relationship allows reflection and thoughtful response rather than unthinking reaction from the doctor.The degree to which the projected role is congruent with some aspect of the personality of the recipient will affect the likelihood of his or her adoptions it.An understanding of transference and countertransference is essential to good practice in psychiatry. Being aware of the hidden agenda in the clinical relationship will help the doctor recognize some of the patients wishes and fears which are not full conscious and which can contribute to conflict or intense dependency. The doctor is then more likely to stand back a little from patients emotional demand and avoid getting caught up in agenda.Mr D was a young man with a long history of unstable relationships, depressive episodes and alcohol misuse attending a day hospital. He was often hostile to his keyworker whom he accused of not caring whether he lived or died. The keyworker was an experienced community psychiatric nurse and was confident that she was neither negligent nor uncaring about her patient. She was aware that Mr D projected a scenario in which he was neglected and at risk, while she was experienced as a callous uncaring parent. Her recognition of this transference allowed her to remain calm and supportive and not to retaliate.<< A role may be congruent with an aspect of the therapist's personality and he or she may unconsciously accept and collude with the projection.Ms E had a long history of repeated treatment episodes for eating disorder, depression and relationship problems. Following a move to university, the university general practitioner referred her to the local psychiatric service for treatment. She confided in the young SHO that he was the first doctor to whom she had been able to talk freely, and that she had told him things she had never told previous doctors. The doctor enjoyed this idealisation and accepted that he had a special relationship with the patient. | 2 | Patient's feelings towards therapist | Doctor's feelings towards the patient | Psycic connection between patient and diseas | Type of Defence mechanism | Psychiatry | Psychoanalysis and Psychotherapy | 32bab35a-c62d-4485-88a5-39c98c199412 | single |
Phase 4 clinical trials is carried out: | A new drug/ vaccine is launched in the market after phase III (RCT). Phase IV is 'Post marketing surveillance phase' Is the longest phase in a clinical trial. Should be carried out life long (minimum 10-25 years). Is done for finding 'long term side effects and rare side effects' of the drug. | 2 | Before the marketing approval of a drug | After a drug is marketed | For drugs used in rare disease | For drugs used in pediatric patients | Social & Preventive Medicine | RCT, Trials | c16dcef6-d6c0-4d0a-a28d-0f8b46d3732f | single |
RET proto oncogene is located on which chromosome: | b. 10(Ref: Nelson's 20/e p 595)Important genes and their chromosomal location:Gene (Associated diseases)Chromosomal locationRb (Retinoblastoma)13q14.3p53 (Li-Fraumeni syndrome, sarcomas)17q13.1APC (Carcinoma Colon)5q21NF1 (Neurofibromatosis 1)17q11NF2 (Neurofibromatosis 2)22p12WT1 (Wilm's tumor)11p13RET (MEN2 syndrome)10q | 2 | 9 | 10 | 11 | 12 | Pediatrics | Genetics And Genetic Disorders | 1468c629-941d-4e6e-babd-0254b0f7a2db | single |
With reference to neoplasia, the term 'tumor progression means | Multi step.theory of carcinogenesis Phy.attributes are .self sufficient in growth signal .local invasion ,metastasis .karyotic pattern .hormonal response .response to Anti malignant drugs Evading apoptosis All these acquired in a step wise fashion This phenomenon is tumour progression | 4 | Spread of cancer to distant sites | Rate of growth of tumors | Abi1ity of cancer cells to resemble their normal counterpa | Sequential appearnace of features of increasing malignancy | Pathology | Cardiovascular system | 6c6a45c8-5e43-45f5-87bb-f0756a61e4f5 | single |
Which of the following statements about Xanthogranulomatous is not true - | Xanthogranulomatous pyelonephritis is relatively rare form of chronic pyelonephritis charecterized by accumulation of foamy macrophages intermingled with plasma cells ,lymphocytes,polymorphonuclear leukocytes, and occational giant cells.Often associated with Proteus infections and obstruction,the lesions sometimes produce large , yellow orange nodules that may be grossly confused with renal cell carcinoma. From Pathologic basis of disease Robbins,volum 2 pg no:934 | 2 | Foam cells are seen | Associated with tuberculosis | Yellow nodules are seen | Giant cells may be seen | Pathology | Urinary tract | 0ea6d3bd-97f5-4556-9977-b73ada18c177 | multi |
All of the following are clinical features of myxoma, EXCEPT: | Myxomas are benign cardiac tumors. Most commonly it arise from the endocardial surface of the left atrium, and with a stalk it is attached to the interatrial septum close to the fossa ovalis. Myxomas present with obstructive symptoms and signs, and may be sudden in onset or positional in nature, owing to the effects of gravity on tumor position. Patients presents with peripheral or pulmonary emboli, fever, weight loss, cachexia, malaise, ahralgias, rash, digital clubbing, raynaud's phenomenon, hypergammaglobulinemia, anemia, polycythemia, leukocytosis, elevated ESR, thrombocytopenia and thrombocytosis. Ref: Harrisons Internal Medicine, 18th Edition, Page 1979 ; CURRENT Diagnosis and Treatment: Cardiology By Michael H. Crawford, 3rd Edition, Chapter 30 | 3 | Fever | Clubbing | Hypeension | Embolic phenomenon | Medicine | null | f21547d8-ecc7-41ed-b388-25822cd33e33 | multi |
Mesentric tumours are | Mesenteric cysts and cystic mesenteric tumors are very rare abdominal growths. They may be localized all over the mesentery, from duodenum to rectum, however, they are mostly found in the ileum and right colon mesentery. There are several classifications of these formations, among which the one based on histopathologic features including 6 groups has been most commonly used: 1) cysts of lymphatic origin--lymphatic (hilar cysts) and lymphangiomas; 2) cysts of mesothelial origin--benign or malignant mesothelial cysts; 3) enteric cysts; 4) cysts of urogenital origin; 5) dermoid cysts; 6) pseudocysts--infectious or traumatic REFERANCE.nih.gov | 2 | Usually solid | Usually cystic | Highly malignant | Highly vascular | Pathology | G.I.T | 6ca3ad9e-ae6c-4264-94c6-05134f985c93 | multi |
A 60 yr old smoker came with the history of painless gross hematuria for one day. The investigation of choice would be : | null | 4 | Urine routine and microscopy | Plain x-ray KUB | USB KUB | Urine for malignant cytology | Surgery | null | e0366bbf-9174-467b-9b21-aedd32d8d832 | single |
A patient with autoimmune thyroditis present with hypothyroidism. Which of the following is true | The major cause of hypothyroidism in adults is Hashimoto thyroiditis, autoimmune-mediated destruction of thyrocytes. The disorder predominates in women Presence of TSH-blocking antibodies, such as thyroid peroxidase antibodies, can be detected The onset, thyroid status and the type of goitre vary profoundly from case to case. The onset may be insidious and asymptomatic, or so sudden and painful that it resembles the acute form of granulomatous thyroiditis. Papillary carcinoma and malignant lymphoma are occasionally associated with autoimmune thyroiditis Source Sabiston 20 th edition Pg : 891 Bailey and Love Pg : 770 | 1 | Thyroid peroxidase antibodies | Painless enlargement of thyroid | Common in men | No malignant risk | Surgery | Endocrinology and breast | 6e12ed27-2d52-4839-8e73-72334e834d44 | multi |
One of the following disease will show urinary bladder calcification radiologically which resembles fetal head in pelvis: | A plain film of the abdomen may show areas of grayness in the flank (enlarged hydronephrotic kidney) or in the bladder area (large tumor). Opacifications (stones) may be noted in the kidney, ureter, or bladder. Linear calcification may be seen in the ureteral and bladder walls. Punctate calcification of the ureter (ureteritis calcinosa) and a honeycombed calcification of the seminal vesicle may be obvious. The classic presentation of a calcified bladder, which looks like a fetal head in the pelvis, is pathognomonic of chronic urinary schistosomiasis. Ref: Tanagho E.A., Kane C.J. (2008). Chapter 14. Specific Infections of the Genitourinary Tract. In E.A. Tanagho, J.W. McAninch (Eds), Smith's General Urology, 17e. | 2 | Tuberculosis | Schistosomiasis | Chronic cystitis | Malignancy | Surgery | null | 793e77d8-2a03-4f1f-8218-758ae58f9fb2 | multi |
A 20-year-old woman complains of weakness that is worse in the afternoon, worse during prolonged activity, and improved by rest. When fatigued, the patient is unable to hold her head up or chew her food. She often notes diplopia when driving home from work. On physical examination, she has no loss of reflexes, sensation, or coordination. Which of the following is the likely pathogenesis of this disease? | The disease process described is myasthenia gravis (MG), a neuromuscular disease marked by muscle weakness and fatigability. Myasthenia gravis results from a reduction in the number of junctional acetylcholine receptors as a result of autoantibodies. Antibodies cross-link these receptors, causing increased endocytosis and degradation in lysosomes. A decreased number of available acetylcholine receptors results in decreased efficiency of neuromuscular transmission. MG patients also have autoantibodies against muscle-specific tyrosine kinase (MuSK) receptors. MG presents with weakness and fatigability, particularly of cranial muscles, causing diplopia, ptosis, nasal speech, and dysarthria. Proximal limb weakness also occurs. Diseases of the central nervous system (poliomyelitis, Friedreich ataxia, or multiple sclerosis, as in the option b, c, and d) cause changes in reflexes, sensation, or coordination. ALS, a pure motor disorder, causes fasciculations and muscle atrophy as a result of lower motor neuron involvement. McArdle disease, a glycogen storage disease, causes muscle cramping and occasionally rhabdomyolysis with heavy exertion but only very rarely with usual daily activities.Ten percent of myasthenia patients have thymic tumors. Surgical removal of a thymoma is necessary because of local tumor spread. Even in the absence of tumor, 85% of patients clinically improve after thymectomy. It is common practice to perform thymectomy in most patients with generalized MG who are between puberty and age 55. | 1 | Autoantibodies directed against the postsynaptic acetylcholine receptor causing neuromuscular transmission failure | Destruction of anterior horn cells by virus | Progressive muscular atrophy caused by spinal degeneration | Demyelinating disease | Medicine | C.N.S. | 42704339-3d53-479b-be41-bb9bd4425157 | single |
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.